North Carolina (NC) has the largest American Indian population east of the Mississippi River. Yet, we do not know much about the health and health care of NC American Indians. Because cancer is the number one cause of death in NC American Indians, we need to better understand cancer and cancer-related needs in this unique population in order to reduce the cancer burden. Three NC cancer centers joined together in 2021 to partner and learn more about how to help American Indians with cancer. We also want to find and develop community resources for American Indians with cancer in North Carolina.
In this study, we will explore how cancer affects American Indians in North Carolina. First, we will measure the number of cancer diagnoses and deaths from 2003-2019. We will also learn more about how and where American Indians receive cancer care. These data will come from the North Carolina Cancer Registry and health insurance files. Second, we will ask tribal leaders to help us explore the needs and barriers to healthcare in American Indian communities. Finally, we will work with American Indian youth leaders to understand tribal community strengths and local resources that can help with cancer care.
This information will help American Indians by showing where the greatest needs lie and pointing to opportunities for better care, with a long-term goal of improving cancer outcomes in all American Indians.
Lineberger Comprehensive Cancer Center (LCCC) is committed to making cancer care accessible to the people of North Carolina. This includes opportunities to participate in clinical trials, which are important to improving cancer treatments. Few patients participate in clinical trials, and fewer still are patients who identify as Black, Indigenous, or a person of color (BIPOC). Many BIPOC patients are hesitant to participate in clinical trials. Enhancing diversity in our workforce will help BIPOC patients feel more comfortable enrolling in trials. This grant will provide opportunities for local BIPOC college students to learn about cancer care and research. The goal is to create interest in pursuing a career in this field at LCCC, and ultimately, ease hesitations that prevent BIPOC patients from participating in clinical trials. We will partner with NC Central University in creating a summer internship for 5 students. Students will be matched with mentors with experience in cancer research, clinical trials, and patient care. Students will also receive overall professional development such as resume and presentation development. To measure project success, we will encourage students to provide feedback during and after the program. A follow up survey will allow students to provide additional insights such as barriers to participation and measure their interest in a cancer related field. We will follow the students over time to understand the number that become employees at LCCC; we will also measure the number of BIPOC patients who enroll on clinical trials at LCCC.
Black patients are more likely to die from breast, prostate, lung, and colorectal cancers than White patients. There are many reasons for these differences, including barriers to accessing treatment. In recent years, scientists have created new and better treatments that match a cancer’s unique biology, changing the way that we treat the disease. The first step to getting these therapies is genomic testing, which looks closely at the cancer to understand what might be causing it. Black patients are less likely to get genomic testing and these new therapies than White patients. If we don’t improve access to genomic testing, Black patients will continue to experience barriers to life-saving treatments, causing even bigger differences in survival between Black and White patients. In this study, we will look at the factors that cause differences in genomic testing between Black and White patients. We will also interview Black patients and cancer doctors about their experiences and preferences related to genomic testing. We will use our results to create strategies to improve access to genomic testing for Black patients. In the future, we hope to use our strategies at Duke Cancer Institute and in community hospitals in the Duke Cancer Network to reach cancer patients who are mostly Black, rural, and low-income, a group with large barriers to genomic testing.
African Americans develop a form of blood cancer called multiple myeloma more often than Caucasians. On average, African Americans live less long with it. That may be in part because African Americans take part in clinical trials less often. Clinical trials are studies designed to develop new treatment drugs. Those trials can sometimes help people to live longer with this illness. We are trying to improve how many take part in clinical trials at UNC. We are creating an easier, more comfortable doctors’ office to get care at and take part in trials at UNC. We are making it easier for African American researchers at UNC to work on this important issue. We will make a video that shows what clinical research is. It will show why it can be helpful to take part in research. The video will be shown to African Americans and other patients treated at UNC. The UNC team will compare how many African Americans join multiple myeloma trials before and during this grant. If more African Americans enroll in multiple myeloma trials after the grant begins, it would show that these efforts have helped solve this problem. That may help African Americans with multiple myeloma to live longer. IT will also help make important progress in this research.
Cancer is caused by changes that happen in the genes of cancer cells. Special tests can find genes that start or promote cancer growth. New drugs can target cancer causing genes and kill cancer cells. The Duke project team wants to increase awareness and use of both the special tests and the new drugs.The project will bring a group of experts together to talk about patient cases and help find the best medicine for patients. If medicines are not available, the project team can find clinical trial options for patients. The team will also provide training to doctors and nurses on new tests for cancer genes and medicines. We will create information to help patients learn about the special gene tests and how the results can help the doctors choose the right medicine to treat their cancer. When the project is finished,the team hopes to provide the information and tools created to other local doctor’s offices and patients.
African Americans have the highest percentage of new cancer cases in the United States and the worst outcomes. Other diverse populations have difficulty getting to a cancer treatment center or need help figuring out the system one they arrive. Some people die from cancers that can be prevented or treated, simply because they are not aware of all of the treatment options. Cancer care can be very difficult because many times a patient has more than one doctor who is part of their care team. This can be scary and may make some people choose not to get cancer treatment, even if they can be cured. WFBCCC wants to make sure that everyone has access to the best cancer care possible. This may include patients participating in research that may improve outcomes for them but also may help provide information that can help tailor treatments for the next generation of cancer patients. It is important to make sure all populations are represented in studies that look at new treatments or supports for cancer patients. To meet that goal, we created a population health navigator program- people who are from the community who can help people learn about cancer, how to prevent it, what screening is required and what treatments are available. If someone is diagnosed with cancer, the navigator will assist that person by helping to remove barriers to care and will talk with patients about clinical research as part of their care.
Co-funded by the Dick Vitale Gala, and WWE in honor of Connor’s Cure
Years of cancer research have shown that combining therapies virtually always works better than when therapies are used alone. Recently, medications have been discovered that change the way genes are turned on and off. At the same time, treatments have been developed that use the body’s own cells to find and attack cancer cells. Each of these treatments have been shown to work alone on specific cancers. Each has known limits. However, the combination has not been studied. Our project explores whether combining these treatments will improveour treatments for childhood cancer. We are especially interested in if combining these therapies will increase the success of cellular therapies. Our proposal initially studies one specific medication that is already approved for use in children. We will also evaluate a large group of possible medications. We expect that our results will quickly result in a clinical trial for children. In addition, it may lead to a new treatment approaches for many cancers.
Funded by the Constellation Gold Network Distributors
Non-Hodgkin Lymphomas are common cancers which can be cured in some patients by combinations of multiple chemotherapy drugs. Currently, these treatments consist of giving many drugs at the same time, waiting some weeks to recover from side effects, and repeating the cycle several times. We have discovered that in the most common combination therapy for Non-Hodgkin Lymphomas, while the use of many chemotherapies kills more cancer cells, the drugs do not enhance one another’s activity. Instead, certain drug pairs interfere with one another’s effects. This suggests that treatment might be more effective at killing cancer cells, and cure more patients, if this interference were avoided. This could be accomplished by giving certain chemotherapies at different times from each other. We will study a few lymphomas and measure how chemotherapies interact to determine which should or should not be given at the same time. A computer model will simulate how tumors respond to combinations of drugs given at various times. This simulation will use measured drug interactions to predict which treatment designs will be most effective at killing cancer cells. We will test these treatments on human lymphoma cells, and compare them to the current ‘all-drugs-at-once’ strategy. If this research finds a more effective approach to treatment, it can next be tested in animals, and eventually in human clinical trials. Ultimately we hope to identify a simple change in the use of already approved medicines that has the potential to cure more cases oflymphoma.
All cancer patients should have the opportunity to get very good care through research studies. Research studies are important to make cancer treatments and survival from cancer better but very few people of color are treated on cancer research studies called clinical trials. One way to solve this problem is to use specially trained staff to help cancer patients better understand clinical trials. These staff are called patient navigators. In this project, we will use patient navigators to teach and support patients asked to be in a cancer research study. These navigators will work as a team to make sure that all African Americans who receive care at the Cancer Center are considered for a clinical trial. In order for the patient navigator to know which patients may be fit to participate in research, we will use information from the medical record to create a list of patients that could be asked about their interest to get treatment with a clinical trial. The patient navigator will use this list to contact patients and will teach patients about clinical trials and connect patients to finance counselors, social workers and other helpful community services as needed. To understand if the project is a success, we will compare the total number of patients, by race, treated on a cancer research study before and after the project.
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