Designated grants are inspired by particular areas of scientific interest and/or geographic reach. They are selected on the basis of scientific merit, as determined by our scientific advisors.
Diffuse large B-cell lymphoma (DLBCL) is a common and aggressive type of malignant B-cell tumor. Despite progress in lymphoma treatment, up to 40% of patients will ultimately succumb to their disease. Chimeric antigen receptor (CAR) T-cells (CAR-T) are immune cells from patients where a patient’s own white blood cells are isolated and engineered to target and kill tumor cells. CAR-T cell therapies demonstrated an entirely new paradigm for cancer therapy and produced unprecedented initial responses in patients of relapsed or refractory DLBCL. However, our group and others recently observed that over half of patients on CAR-T therapy eventually had disease relapse and fatal progression due to development of resistance. Thus, there is an urgent need to improve the efficacy of response and delay or prevent CAR-T therapy resistance. To tackle this major obstacle, my group has developed sophisticated models and expertise to develop a novel strategy to target the tumor in a more precise, personalized manner to overcome chemo-, targeted- and CAR-T therapy resistance. Ultimately, we will rationally design and test the improved and safe combinations of CART with the newly discovered inhibitor for DLBCL therapy. The outcomes of this study have broad applicability 1) improve the current standard of care by overcoming refractory and relapsed DLBCL current therapy resistance, 2) enhance the CAR-T therapy efficacy, and 3), we anticipate, can be readily translated to improve quality of life and/or length of life and has immediate impact on DLBCL patient care.
North Carolina (NC) has the largest American Indian (AI) population east of the Mississippi River. Yet, we do not know much about the health and health care of AIs in NC. We do know cancer is their number one cause of death. We need to better understand cancer and cancer-related needs in this group to reduce the burden of cancer. Three NC cancer centers joined together in 2021 to learn more about how to help AIs with cancer. We will study how cancer of the liver and stomach affects American Indians in NC. And we want to find and create resources for our AI community. First, we will use the NC Cancer Registry and health insurance files to learn more about how and where AIs in NC get cancer care and any potential disparities. We will then have a community event to test for and treat the top cause of stomach cancer. Lastly, we will educate about liver and stomach cancer to help prevent them. This work will help AIs in NC by showing what the greatest needs are and the opportunities for better care. The long-term goal is to improve cancer outcomes in all AIs.
Head and neck cancer is deadly because there are no effective drugs. Cisplatin is a commonly used drug for cancer treatment. However, patients with head and neck cancer usually develop resistance to this drug, which eventually leads to death. Although cisplatin can effectively kill most cancer cells, it is less effective in killing a specific type of cancer cells called cancer stem cells, which are responsible for the regrowth of the cancer after cancer therapy. Accordingly, inventing a new drug that can effectively kill cancer stem cells will improve patient survival. However, no drugs are available for killing cancer stem cells. Identifying key players maintaining cancer stem cell growth will help develop more effective drugs. Recently, we found a protein named FOSL1 is required to maintain cancer stem cell growth in head and neck cancer. However, the reason why FOSL1 keeps cancer stem cells growing is not fully understood. We also found a drug that can block FOSL1 function to prevent cancer stem cell growth. However, the efficiency is low. To increase the treatment effect, we developed a more potent compound based on this drug that can more effectively kill cancer stem cells 100 times in head and neck cancer. Our goals are: 1) using this compound to explore why FOSL1 can maintain cancer stem cell growth; 2) determine whether this compound can overwhelm cisplatin resistance using animal models. The knowledge obtained in this study will lead to developing more effective drugs to improve head and neck cancer patient survival.
Cancer is a leading cause of sickness and death around the world, with limited treatment options available for people whose disease has progressed or spread. While new treatments have improved how long people can live with cancer, lifespan for those whose disease has spread has seen far less improvement. One reason for this is the cancer’s ability to become resistant, or “immune,” to treatment. A new method of treating cancer, called precision oncology, uses molecular testing to not only understand how and why a tumor grows, but also how it can begin to become resistant to treatments that may have once worked.
One challenge, however, is that access to this molecular testing is not always available to all groups of people. This unequal access, based on race and other factors, can have a measurable impact on cancer patients’ lives — in a recent study, black patients were 38% less likely to receive this type of testing compared to white patients. Through our research, we hope to change this to create a more equal approach to cancer treatment regardless of race or other factors. To do this, we will create a high quality molecular testing program in the DC region, with particular attention to communities in need of more equal access to these treatment approaches. By including all racial groups more equally in this research, we will also be able to better answer future research questions in a way that does not exclude any groups of people.
In patients with hormone positive breast cancer that has spread to other parts of the body eventually the cancer can stop responding to hormone blocking pills and their cancer starts to grow again. In this project we will develop vaccines that eliminate breast cancer cells that no longer respond to hormone blocking pills. This will cause the remaining breast cancer cells start responding again to hormone blockers. The result of these vaccines would be that those patients with hormone positive breast cancer will have a much longer time where that the hormone blocking medication would work. The immune response would also help to kill more of the breast cancer cells. This should mean that patients will live much longer with hormone positive breast cancer that has spread. This research will be tested first in mice and then in patients with hormone positive breast cancer that has spread to other parts of the body.
We are testing a drug, tucatinib with a form of focused radiation called stereotactic radiosurgery for a type of breast cancer (HER2-positive) that affects 20-25% of breast cancer cases when it spreads to the brain.
This study will help find out if the combination of tucatinib and radiation is safe and if patients can tolerate it well without too many side effects.
About 40 patients with this type of breast cancer that has spread to the brain will be part of the study. First, they will receive the drug tucatinib along with the focused radiation treatment. After that, they will continue taking tucatinib along with two other medicines called capecitabine and trastuzumab. These three medicines are already used as the standard treatment and have been effective for patients like these. Patients will receive this combination until their tumor grows back or if there are serious side effects.
This study will also help find out the correct dose of tucatinib to use. Additionally, the study will answer how well the treatment works and how it affects brain function.
Funded in partnership with WWE in honor of Connor’s Cure
Diffuse midline glioma (DMG) is a devastating and aggressive type of brain tumor that primarily affects children and young adults. Despite advancements in medical research, DMG remains a medical challenge with limited treatment options and a poor outcomes. Considering these difficulties, there is an urgent unmet need to develop new and innovative therapies for DMG. One promising avenue for discovery is the exploration of targeted agents that disrupt key signaling pathways involved in tumor progression without affecting the healthy normal cells in the brain. Our previous work has identified a potential new therapeutic target that could be leveraged in this way to specifically combat this tumor. New drugs that selectively inhibit this aberrant signaling pathway show great potential for slowing down the growth of DMG cells, thus creating a new opportunity for intervention. In these proposed studies, we will explore precisely how this intracellular signaling pathway controls cancer progression. Further, we will test in the lab whether treatment with new drugs designed to inhibit this pathway can halt DMG tumor growth. We hope that our studies inform the use of new targeted drugs to treat this devastating childhood cancer and thereby drive advancement of patient care and redefine the treatment of DMG.
Washington, D.C., has some of the highest cancer death rates in the United States, especially among the the Black and Latinx communities in Wards 7 and 8. This is caused by differences in living conditions that make it hard for Ward 7 and 8 residents to get trusted information on ways to avoid cancer, as well as cancer screening that can find the disease early when it is more treatable. This means many women in Wards 7 and 8 find out they have breast cancer when it is farther along, harder to treat, and may not be curable. This work, through the Johns Hopkins Kimmel Cancer Center in the National Capital Region and Sibley Memorial Hospital, can help to address these differences.
To help fix these disparities, the first step is to share information with communities on ways to lower the chances of getting cancer and the tests that can find it early. We will begin with a focus on preventing and detecting breast cancer. Working with the community, we hope to help more women stay healthy and never need to be treated for breast cancer. Our educators will give coaching on ways to live a healthy life – like through diet, exercise, and how to quit smoking – as well as how and when cancer screening should be done so it can be found early. It is our hope that these efforts will mean that fewer women will be diagnosed with breast cancer, and those who are will have a better chance of surviving the disease.
Lung cancer is the leading cause of death from cancer in the United States. When lung cancer is found before it spreads to other parts of the body, it can be treated and people can live longer.
There is a screening test for people who are at high risk for lung cancer. People who are over 50 and have smoked may be able to get screened. However, less than 6% of Americans in this group have been screened for lung cancer. People may not be screened because they do not know about lung screening or are worried about being screened. This project will create educational materials to help people understand if they are eligible for lung cancer screening, explain the benefits and risks and help them talk to their doctor. Education will be made available by video, in print and by website. We will test the materials using a survey. The survey will help us learn how people like the materials and if they learned about lung cancer screening.
Funded in partnership with Miami Dolphins Foundation
Lymphoma is one of the most common cancers in the United States. People who are diagnosed with lymphoma often receive chemotherapy treatment, which can cause a lot of physical and emotional side effects. Although lymphoma is common, not that much is known about how nutrition or physical activity could help lymphoma patients.
Because so little is known, this research study plans to first explore if nutrition and exercise is something that lymphoma patients are interested in and able to do during chemotherapy. Secondly, this research study will look into whether the nutrition and exercise plan helped patients with the side effects of chemotherapy on their body, mind, and quality of life.
Mailing List
