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.
New treatments for cancer patients are developed through studies called clinical trials. All cancer patients should understand what treatment options are available to them, including clinical trials. However, few patients are treated on clinical trials. Minority groups are even less likely to be treated on clinical trials. One way to encourage more diverse participation is to offer education. We will create a short video that shows the basics of clinical trials. The video will include diverse patients and doctors from UNC that have experience with clinical trials. The video will teach cancer patients about the basics of clinical trials and encourage them to ask their doctor if a trial could be right for them. We will also place printed materials in waiting areas for patients to take home and discuss clinical trials with their family and caregivers.
Funded in partnership with Miami Dolphins Foundation
Our goal is to make sure all women with cancer get medical care that is consistent with what is important to them, no matter their race and ethnicity. To do this, we will work together with community health workers, who are trusted professionals that help connect people from their communities to medical care through education, support, and advocacy. Our past research shows that community health workers want to help cancer patients get the right care. They can do this by having conversations about advance care planning, which is a way for patients to think about the kind of medical care they would want if they became too sick to speak for themselves. However, community health workers need more training to have these conversations with patients. We will create a program to teach community health workers how to help patients with advance care planning. Next, we will improve the program by getting feedback from community health workers and making changes based on their suggestions. Finally, we will test this program by having community health workers have advance care planning conversations with cancer patients based on what they learned. We will then get feedback from both the patients they talk to and the community health workers to find out whether these conversations were useful. In the future, community health workers could work together with doctors to make sure that cancer patients get the right medical care so that they live as well as possible during their cancer journey.
Funded in partnership with Miami Dolphins Foundation
Sarcomas are cancers of the bone and muscles, often seen in children and young adults, which are very hard to treat with very few patients surviving. Our aim is to improve treatment options for these patients. A vaccine trial using patient’s dendritic cells which are a type of immune cells, modified to identify and attack the individualized cancer was conducted at Sylvester comprehensive cancer center in 2019. Surprisingly, we noted good response in a few patients, who remain cancer free over 2 years from receiving the vaccine treatment. Therefore, the aim of this research proposal is to study the immune/non-immune cells of the surgically removed tumors and blood of patients treated on this trial. Using special high-resolution imaging methods in which key immune markers are tagged in the tissue, we will describe the immune cells in each patient’s cancer environment and correlate these to whether the patient did or did not respond to the cancer vaccine. We will also measure key immune cells in the blood of these patients collected after vaccine treatment and compare this with response to the vaccine. These detailed immune studies on patient tissue and blood samples will then guide future anti-sarcoma cancer vaccines and potential immune cell therapy to cure these aggressive cancers.
Breast cancer is the most common cancer in women in the United States and second leading cause of cancer death. When a woman is diagnosed with metastatic breast cancer (MBC) (cancer that has spread to other parts of the body) she has a less than 30% chance of surviving 5 years. These statistics remain despite decades of research and many new treatments for MBC. This suggests that we need better ways to administer drugs for MBC.
Hormone receptor positive (HR+) breast cancer is fed or fueled by estrogen and progesterone, the natural hormones of the body. HR+ MBC is initially treated with drugs that block the estrogen and progesterone production in the body. However, eventually cancer cells can become “resistant” to these hormone blocker drugs, most commonly by developing a “mutation” in the receptor of estrogen called ESR1. Once this mutation develops, the treatment is more challenging and usually involves use of chemotherapy which can lead to patients feeling sick and having multiple side effects from treatment.
In this proposal we plan to enroll HR+ MBC patients who have already developed an ESR1 mutation and offer a novel way of targeting this mutation. This will help extend time on treatment with minor side effects and possibly increase survival. We will do so by creating vaccines out of their own immune system that will allow them to wake up and engage in the fight against their cancer. This treatment will be combined with standard of care hormone blocking therapy.
North Carolina (NC) has the largest American Indian population east of the Mississippi River. Many American Indians in NC smoke cigarettes, which can lead to lung cancer. Yet, we do not know much about the needs of NC American Indians related to tobacco use and lung cancer. Three NC cancer centers joined together in 2021 to learn more about how to help American Indians improve cancer outcomes. In this study, we will first explore how often American Indians use treatment to help them quit tobacco. We will also explore whether they have been screened for lung cancer and what cancer treatments they receive. Second, we will ask American Indian community members about quitting tobacco, lung cancer screening, and their healthcare. Finally, we will work with American Indian community members to modify a quit smoking program to make it more relevant to them. We will also work with them to modify materials that tell people about lung cancer screening. This information will help American Indians by helping them quit tobacco and detect lung cancer sooner, which will help improve the health of American Indians in NC.
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 difficulty receiving life-saving treatment. New treatments that match the type of cancer a patient has to specific drugs have been developed and has changed the way we treat the disease. The first step to getting these new treatments is for patient’s tumors to be tested for specific changes. However, Black patients are less likely to receive these tests and to receive the relevant treatment. If progress is not made in improving access to testing, Black patients will continue to have lower access to these lifesaving treatments, causing even bigger differences in survival. In this study, we will develop a program to understand the needs of Black cancer patients and provide support to ensure that they receive appropriate tests and treatment. To help design the program, we will interview Black patients and healthcare providers on what the needs are and provide navigation support to patients. We will measure how effective the program is in increasing testing and treatment among Black patients. In the future, we hope to use this data to develop broader strategies that will improve Black patients’ access to tests, clinical trials, and treatment.
Funded by Kay Yow Cancer Fund 2023 Final Four Research Award
One of the greatest challenges in cancer treatment is that response to standard treatment is frequently incomplete and causes many side effects. Current treatments are often ineffective because they function as a “one-size-fits-all” approach to a very personal disease. This lack of success is magnified in triple negative breast cancer (TNBC), which differs greatly between each individual. We have recently discovered a protein that is not expressed anywhere in females, except in TNBC tumors, where it is required for tumor growth. This protein is normally only found in male testes. Thus, this protein is a perfect target to inhibit tumor growth without impacting normal tissues. Here we will study the function of ZNF165 and determine how it promotes growth of tumors. Ultimately, this work could lead to a tailored approach for treating TNBC without harming the patient.
Funded in partnership with Miami Dolphins Foundation
Women who live in disadvantaged neighborhoods experience shorter breast cancer survival rates. One cause may be stress from social adversity. Social adversity includes exposure to violent crime, poverty, housing instability, and more. Studies have shown that this stress can lead to gene responses that increase inflammation and depress immune response. This can result in higher rates of metastasis (the spread of cancer cells to another part of the body) and shorter breast cancer survival. Previous research from our team has found that women in disadvantaged neighborhoods show these gene responses associated with worse outcomes. This study builds on this past research with a population that is both larger and more diverse. It will validate our previous findings and help us begin to identify how neighborhood disadvantage, stress, and more aggressive genes are related. It will set the stage for future interventions that can address this negative impact and reduce disparities in breast cancer survival rates.
Funded in partnership with Miami Dolphins Foundation
Liver cancer is deadly. Hepatocellular Carcinoma, or HCC, is the most common type of liver cancer. There are significant racial differences (disparities) in how long people with HCC survive. Black people with liver cancer do not live as long as White people. Also, Black patients are less likely to receive treatment. Previous studies have been unable to explain why these differences exist. We started a research study to learn about various factors that might contribute to these disparities. When we approach patients to participate, many say that they are too overwhelmed. Some patients do not understand what is happening when they are first diagnosed. In this study, we will ask patients and caregivers what needs we might be able to help with. We will also ask healthcare staff and patient advocates to identify what needs patients have. Together with patients, caregivers, advocates and medical staff, we will create a program that helps high-risk patients to navigate the health care system and provides extra support to the patients who need it most. This study is unique because we will train lay people to work as navigators, rather than nurses. By building a relationship between the patient and navigator, we will be better able to meet our patients’ needs. We expect this program to increase the number of patients that come to their appointments and get cancer treatment. This program may increase patients’ willingness to participate in research studies, which could dramatically improve our ability to understand and eliminate disparities in survival.
Funded in partnership with Miami Dolphins Foundation
Like computers, the cells that make up our bodies also have specialized ‘software’ that runs their specific functions. When cells in the blood become cancerous -known as leukemia-, they hijack this biological software. By doing this, the leukemia cells can grow very fast and quickly multiply. Despite the many different types of leukemia that exist, they all share certain defects in their biological software. We call these shared defects a ‘biological common denominator’ across all of them. As part of this biological common denominator of leukemia we have identified the abnormal loss of PDZD2. Although PDZD2 is a gene capable of stopping the growth of other types of cancers it has never been studied in leukemia. Normally, PDZD2 is present in healthy blood cells. However, when blood cells become malignant, they lose PDZD2. We will explore how loss of PDZD2 helps turn healthy blood cells into leukemia. Importantly, we will determine if treatment of cells with a synthetic version of PDZD2 can help stop the growth of leukemia cells. Our long-term goal is to develop a novel way to treat patients with leukemia. We expect that this synthetic PDZD2 will kill the leukemia cells while having no effect on healthy blood cells.
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