The Duke Cancer Institute and the College of Veterinary Medicine at N.C. State University formed a Comparative Oncology Consortium (COC), taking advantage of their expertise and national leadership in their respective disciplines and their geographic proximity. The goals are to collaborate in pre-clinical and clinical cancer research activities in order to advance our understanding of both cancer causation (a high incidence of specific cancers in specific dog breeds provides opportunities to identify new cancer susceptibility genes and environmental factors in cancer causation) and of behaviors and genetics of specific tumor types, as well as to coordinate clinical trials in humans and canines so that novel therapies can be tested in both settings, with information gained in one setting informing the other. In addition to response outcomes of these cancer therapies, the ability to use biomarkers and pharmacology in the canine models can be a novel addition to the characterization of these new cancer therapies and these insights could result in significant enhancements of clinical trial designs (including dosing, scheduling, and combination therapies) when these treatments are tested in human clinical trials. Cost savings and improved clinical trials design would help encourage pharmaceutical companies to use the canine models as part of the assessment process and would benefit the canine patients by giving them access to these novel therapies.
Project 1: My research interest is cancer genetics with an emphasis on clinically relevant questions that will improve our understanding of the cancer genetics of clinical phenotype and simultaneously improve patient care in oncology. I have extensive bench research experience in the fields of genome sequencing technology development, human genetic analysis through human genome sequencing and molecular assay development. My research benefits from the various innovations in genomic and genetic technologies that my group has developed.
Project 2: Based on a series of recent discoveries using cutting edge tools in genomics, we have (1) identified a new targeted way of treating metastatic gastric cancer and (2) pioneered a new way of determining how gastric cancer cells control normal cells in the surrounding stomach tissue.
Our overall goal for this project is to use single cell genomic sequencing to identify new drug targets by analyzing primary gastric cancers from metastatic patients.
Project 3: Based on a series of recent discoveries using cutting edge tools in genomics, we have (1) identified a new targeted way of treating metastatic gastric cancer and (2) pioneered a new way of determining how gastric cancer cells control normal cells in the surrounding stomach tissue.
Our overall goal for this project is to determine if our new discovery of a drug combination will improve the treatment of metastatic gastric cancers with the FGFR2 defect.
Funded by the V Foundation’s Virginia Vine event, in honor of WWE Connor’s Cure
Our grant aims to develop drugs for altered forms of the protein MLL which arise in pediatric leukemia. Patients with leukemia harboring altered forms of MLL have very poor survival, highlighting the need for new approaches to treat these patients. The altered MLL proteins are highly dependent on the ability of one part of the protein to bind to DNA. We are developing drugs to block this binding. Our initial results support that this approach could be highly effective for treating this type of leukemia. Since this is a new way to treat the leukemia, it has the potential to be more effective than currently used drugs as well as less toxic. In addition, since this is a very different approach from existing drugs, it is likely that combinations of this new drug with existing drugs will provide unique benefits.
Funded in partnership with the Goldberg Family Foundation and in collaboration with the Gray Foundation
Individuals with BRCA1 or BRCA2 mutations have an increased risk of developing breast, ovarian, pancreas, prostate and other types of cancer. Tumors arising in these individuals are often sensitive to PARP inhibitors (PARPi) and this class of drugs has shown remarkable success in the treatment of BRCA1 and BRCA2-mutant tumors. Despite these successes, tumors frequently become resistant to therapy. Using functional genomic approaches, we will investigate mechanisms of resistance and identify novel genetic vulnerabilities that can be exploited by PARPi treatment. We will also investigate the immune response to BRCA-mutant tumors and explore ways to improve the ability of immune cells to recognize and kill these tumors. The ultimate goal of these studies is to improve outcomes for patients with BRCA-mutant tumors and to identify new groups of patients that can benefit from PARPi.
African Americans have the highest percentage of new cancer cases in the United States and the worst outcomes. 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. Wake Forest Baptist Comprehensive Cancer Center (WFBCCC) wants to make sure that everyone has access to the best cancer care possible. To meet that goal, we will engage an African American Patient navigator (AAPN) – someone who is 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 diagnosed with cancer comes to WFBCCC for treatment and needs assistance, the AAPN will meet with them and work to help remove any barriers to care. The AAPN will also talk about clinical research that may be recommended as part of a treatment plan. Cancer research may improve outcomes for them or it may provide information that can help improve treatments for the next generation of cancer patients. Since African Americans get cancer more often, it is important to make sure they are represented in studies that look at new treatments and supports for cancer patients.
Clinical trials are important to improve cancer treatments and survival. Very few people are treated on cancer clinical trials and an even small number of those treated on a trial are African American. 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, one who is African American, to teach and support patients asked to be in cancer clinical trials. These navigators will work as a team to make sure that all African Americans who receive care at the Cancer Center are considered for cancer clinical trials. They will teach patients about clinical trials. They will also help them better understand the hospital system and give advice to patients who live far away and don’t have a car or place to stay when they come to their appointments. They can connect patients to finance counselors, social workers and other helpful community
services. To understand if the project is a success, we will compare the total number of patients, by race, treated on cancer clinical trials before and after the project. We will also study why patients chose not to be on clinical trials even when they are eligible. This information will help us design new projects in the future.
There is a low number of people involved in clinical studies. This is a national problem. This problem plays a part in poor health for people with cancer. It is even more of a problem for people of color who do not take part in clinical studies at the same rate as whites for several reasons. Some of these reasons include fear and not knowing about clinical studies. Also, some current and past research studies did not tell people of color the truth about the study and caused high rates of sickness and death in some cases. These reasons play a role in some people deciding not to take part in a study. Some people of color are not involved with clinical studies because they were not asked. Research teams may not ask people of color due to bias that they may not be aware of or concerns about trust. Studies show that most people who take part in a study do so because they were asked. The main reason people do not enroll in clinical studies is because they were not asked and did not know anything about it.
Studies suggest there is a need to teach research teams how to build skills in working with people of color. There is a need to build trust between patients and clinical staff as well as learn ways to increase the number of people of color enrolled in studies. The Just Ask: Diversity in Clinical Research Training Program works with patients, the community, and research teams to build skills and increase the number of people of color in clinical studies.
The healthcare landscape has dramatically changed in South Florida, and we welcome you to be a partner in this transformation. Miami Cancer Institute at Baptist Health South Florida opened its doors in 2016 and is now seeing nearly 1,000 patients per day. The Institute, supported by a clinical and research alliance with Memorial Sloan Kettering, one of the leading academic cancer centers in the world, grants our patients access to the most advanced clinical trials for breast cancer. Patient accrual remains a huge challenge in clinical research, and the grant will go towards supporting recruitment for the important studies which in many cases, may give patients access to new therapies that are not yet readily available. The Institute will be proactive with the creation of recruitment materials as part of a well-coordinated campaign to address all aspects of enrollment as well as presenting information in an easy to understand and honest way. It is our goal to track enrollment efforts and adjust accordingly to what works best for our patient base and the community we serve. The mission of the breast clinical trial enrollment program is to provide innovative, patient centered cancer care through access to cutting edge treatment.
Minority patients are often underrepresented in clinical trials, data from which we derive our standard of care. Due to the underrepresentation of these patients, the clinical outcomes of treatments may be inappropriately extrapolated for these patients. Barriers to participation for minority patients include unconscious bias by medical practitioners, patient distrust of the medical enterprise, as well as language and medical literacy deficits. Ideally, clinical trials should aim for enrollment of ethnic composition that mirrors the proportion of patients affected by a particular cancer stage.
To address these deficits to equitable trial enrollment, we propose a supplementation of the traditional consent process to be tailored for the purposes of increasing minority enrollment. To this end, we propose to use video-based education tools using virtual-reality technology and to enhance our patient navigator program to increase minority recruitment an ongoing breast clinical trial. The use of virtual-reality videos will allow patients to see the environment in which they would receive treatment to reduce anxiety with an otherwise unfamiliar treatment such as radiation therapy.
We propose to employ the above recruitment strategies in an ongoing Phase I/II clinical trial aimed at investigating the safety and efficacy of concurrent cyclin-dependent kinase (CDK) 4/6 inhibitors with radiosurgery in women with advanced hormone receptor positive breast cancers with brain metastases. The goals of this study are to (1) improve minority clinical trial participation and to (2) improve the optimal communication strategies specific to this population that can be employed to help increase minority clinical trial enrollment.
Funded in partnership with the Kansas City Chiefs Football Club
Like smoking for lung cancer, infection by Helicobacter pylori (Hp) is the major risk factor for gastric cancer (GC). However, only <3% of those infected by Hp develop GC. We hypothesized that the interactions among Hp strains and/or between Hp and non-Hp microbes may affect their interaction with humans, therefore modify host clinical outcomes. We aim to find GC-associated microbial features that define the steps leading to GC. The results of this study will provide critical insights into the causes of GC. This study will also provide potential novel biomarkers to identify subjects at high risk or with early stage of GC, enabling interventions to reduce GC incidence and mortality.
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