State: Texasdfdhd

Funded in Collaboration with Stand Up To Cancer (SU2C)

Clinical oncology has entered an era of personalized molecular diagnosis and targeted therapy. This means treatments are tailored to each patient based her tumor’s histopathological and genetic characteristics. Such personalized treatment often involves a combination of multiple active agents to treat one tumor. In estrogen receptor positive (ER+) breast cancers, the three most promising classes of treatments are hormonal therapy, PI3K pathway inhibitors and cell cycle inhibitors.

Although patients derive benefit from such treatment, for most of the advanced ER+ breast cancers, the tumors respond initially but then stop responding, which is called “resistance” to therapy. Unfortunately, this resistance results in death in most cases of advanced breast cancer. Treating these cases requires developing novel therapeutic strategies to overcome the resistance based on an understanding of the mechanisms of resistance.

In this project, we leverage the leading edge technology of high-throughput whole-genome screening to discover mechanisms of resistance to each of three classes of drugs and all of their combinations. We also characterize the identified genes and their function in a variety of breast cancer cell types and mouse models. The knowledge of resistance to treatment obtained through this project will guide our effort to design more effective combinational therapeutics to overcome resistance. Ultimately, this work will be translated to benefit most of the patients with ER+ breast cancers.

Funded by Papa John’s International

Funded by Papa John’s International

Funded by Hooters of America, LLC

Fewer than 5% of adult cancer patients in the United States are enrolled in clinical trials. In addition, minorities constitute a small proportion of individuals participating in cancer studies. These strikingly low figures delay scientific advances, limit generalizability of trial results, and limit patient access to cutting-edge therapies. Proposed reasons for low accrual include lack of study availability, stringent eligibility criteria, physicians’ biases and lack of awareness, logistical issues, and patient mistrust.

Parkland Health and Hospital System (PHHS) serves as the safety-net hospital for Dallas County. Parkland, in partnership with the University of Texas Southwestern, provides medical care to a large population that disproportionately includes underserved minorities. Cancer patients presenting to Parkland are typically diagnosed at a more advanced stage and are more likely to have had delays in their care.

Based on our previous observations, we believe that the greatest potential impact lies in addressing specific and modifiable aspects of patient care. We therefore propose a Breast Cancer Clinical Research Navigator with a role distinct from research coordinators that will focus on early identification of trial candidates, expediting initial patient evaluation, and improving provider awareness of trial options.

We believe that engaging a Breast Cancer Clinical Research Navigator in the ways outlined above, will result in early and integrated consideration and presentation of trial options and will impact both patient and clinician interest in clinical trials, thereby augmenting accrual.