V Scholar Plus Award – extended funding for exceptional V Scholars
Pancreatic cancer is a very aggressive disease. It is the 3rd leading cause of cancer deaths in the USA. Only 8% of patients who can undergo surgery will survive past five years. Late diagnosis and lack of good treatment options are some of the reasons for this outcome. Recent progress in cancer immune therapy showed effect in cancers such as relapsed leukemia and metastatic melanoma. Unfortunately, immune therapy was not effective in patients with pancreatic cancer. One explanation for this result is that pancreatic cancer blocks immune responses against cancer. Thus, understanding how cancer promotes immune suppression is vital to our ability to treat this deadly disease. Our initial work has revealed that B cells promote growth of pancreatic cancer and resistance to immunotherapy. However, it is not clear how B cells promote cancer growth, and how targeting these cells can benefit patients. We propose to understand how B cells function in pancreatic cancer. The goal of this research project is to find new targets that can block immune suppression in pancreatic cancer. Using both mouse models of pancreatic cancer and patient samples, we hope to identify B cell based targets in pancreatic cancer. We ultimately hope to translate our findings into effective therapies that may also work with existing immune therapy treatments.
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.
V Scholar Plus Award – extended funding for exceptional V Scholars
Cure rates for childhood leukemia have considerably improved in the last few years. Despite this, there are certain sub-sets of leukemia that do not respond well to current therapies.Currently used treatments are often extremely aggressive and non-specific, leading to significant debilitating effects in these patients. The overall objective of this application is to validate exciting new therapeutic targets that we have identified in high-risk subsets of AML using genetic and chemical approaches.
V Scholar Plus Award – extended funding for exceptional V Scholars
More than 40,000 American women die of breast cancer each year. One out of every eight women in the U.S. will develop invasive breast cancer during their lifetime. In 70% of these women, estrogen and estrogen receptor α (ERα) are key players in breast cancer diseases. Keeping this endocrine signaling function low by endocrine therapy is the best treatment right now. Yet, after 5 years, hormonal treatment stops working in more than 30% of these patients and the disease returns. Because hormone resistance is still a challenge, there are few effective therapies for these patients. We plan to study estrogen and ERα related to hormone resistance.
ERα binds DNA elements that regulate gene expression. These elements are very important in cancer development and progression. When these elements lose control, breast cancer becomes resistant to hormones. Thus, if we can find ways to understand and correct these elements in hormone resistant cells, we can find cures for ERα-positive breast cancers. The goal of this project is to understand how ERα controls DNA elements. We will identify markers to measure the presence and progression of breast cancer. Our research results may lead to new therapies that target this disease. Discoveries from this project may help with treating other cancers and may be useful for other research fields.
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.
Funded in partnership with the Lung Cancer Initiative of North Carolina, utilizing Stuart Scott Memorial Cancer Fund matching funds
Lung cancer causes more deaths than the next three cancers combined, and small cell lung cancer (SCLC) is the most aggressive type. Lung cancer disproportionally affects African Americans. Existing therapies prolong life, but only by months, and at the cost of substantial side effects. Within the immune system, T cells are particularly important for fighting cancer, but in patients with SCLC, neither the native immune system alone, nor with augmentation with existing immunotherapy, controls cancer durably. CAR-T is an exciting new technology that modifies a patient’s own T cells to recognize and attack cancer cells that bare a particular marker. This technology has revolutionized the care of some lymphomas and leukemias, including cures.
We have made a CAR-T for the treatment of Glioblastoma Multiforme because it bears a particular marker, GD2. 60% of SCLC also has GD2 and so we hypothesize that for these patients, GD2-directed CAR-T could provide dramatic tumor regression. Our cancer center has committed funding to a clinical trial if we can provide the necessary data to support it. More specifically, we would like to treat animal models of human SCLC with the proposed therapy to see if it is safe and effective. We would study where the CAR-T cells go and how well they kill cancer cells. The CAR-T contains a safety switch in case of side effects; we would test to make sure that it works. During the resulting human trial, we also seek funding to assess where the T cells go.
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