Myelodysplastic syndrome (MDS) is a group of clonal blood cell disorders characterized by abnormal-looking cells (cytologic dysplasia) and low cell count (refractory cytopenias) as a result of ineffective blood production (hematopoiesis). About 30-40 percent of MDS cases progress to acute myeloid leukemia (AML), a type of blood cancer, with poor prognosis and short survival time. We have discovered that a novel embryonic stem cell factor also a leukemic stem cell factor SALL4 is involved in the development of MDS and AML. We propose to study the SALL4 pathway in MDS and AML using murine models and test small molecule drugs that can block SALL4 function in MDS/AML. This study will provide new and critical insights and novel pathways in mediating MDS and its progression to AML which will enable us to develop innovative drugs in treating these patients in the near future.
The precision oncology approach to the treatment of cancer bases treatment decisions on the biology of an individual’s cancer, most often using genetic alterations or mutations to inform therapy. This approach has been successful in a few cancer types, including lung cancer, melanoma, and chronic myelogenous leukemia where oral targeted therapies have led to both improved patient outcomes and fewer side effects compared to standard chemotherapy. However, this approach has not yet realized its full potential in these or other cancer types. In this proposal we plan to study new cancer-causing gene mutations involving the NTRK1, NTRK2 and NTRK3 genes, which are found in numerous types of cancer. We have already demonstrated that tumor cells treated with targeted therapies against this gene family can kill cancer cells in the laboratory. We have also observed early and dramatic tumor shrinkage in patients with different tumor types that share mutations in these NTRK genes. This proposal will focus on determining additional mutations of NTRK genes that may respond to therapy. The proposal will also study how cancer cells become resistant to targeted therapies and develop new laboratory models of NTRK+ cancer to develop new therapies for these cancers.
One of the most exciting frontiers in cancer treatment is the field of immunotherapy where beneficial effects have been observed in a broad range of cancers. The major goal of our project is to identify the determinants of immunotherapy success in patients with head and neck cancers. We are performing a novel clinical trial with an immunotherapy-targeted agent that allows the patient’s own immune system to control their cancer. Using samples from this trial, our goal is to understand why some patients do or do not respond to immunotherapy. We have assembled a multi-disciplinary team that will use genetic and immunologic tests on patient samples to clarify which patients may actually benefit from this powerful approach. These data will allow us to define a precision approach to immunotherapy and in addition will provide an improved biologic understanding of the mechanism of immunotherapeutic modalities.
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