Black Americans often do not take part in research. They also have more aggressive breast cancer and a higher death rate from breast cancer. Overall, clinical trials have led to better outcomes for patients with breast cancer. However, the lack of Black Americans in clinical trials may be one explanation for higher death rates because new treatments are not tested in their aggressive cancers. Our goal is to help the community learn more about the role of research in breast cancer, and the value of taking part in that research. We will work with trusted members of the Black American community through our partners and lay Community Ambassador (CA) program to plan three forums. At these forums, community members will be able to talk with our doctors, clinical research coordinators, and CAs to learn about breast cancer, clinical trials, and what it means to take part in research. The forums will focus on breast cancer research. They will include questions from a host as well as questions from the audience. This will allow for an open discussion about breast cancer research. The goal of the forums will be to raise participants’ knowledge about research, and increase their odds of taking part in research.
Only a small percentage of patients with cancer in the US enroll on to clinical trials. This is creating a bottleneck for the development of new treatments. Efforts to improve how patients are identified for clinical trials are important to overcome this problem. One such effort which is showing promise is to use an individual known as a “pre-screener” to aid the clinical team in identifying eligible patients. The pre-screener functions as an extra set of eyes to review information generated from our electronic medical record as their records come in from referring physicians. They will be trained to look for patients meeting certain eligibility criteria and then notify the clinical team about the matches ahead of their visit. This will allow the team to better prepare and notify the coordinator for the study to be available at that time. The pre-screener will also serve as a resource for patients using our clinical trial education center in the clinic waiting area to help them navigate through the available information to identify a potential trial option to discuss with their physician during their visit.
The reasons why cancer patients do or do not participate in cancer (clinical trials) research are complex. Often this is due to the lack of awareness of which studies are occurring by both the patient and their primary care clinicians. Another very important reason is that patients, especially patients that do not speak English, are not invited to participate because the research team does not have non-English speakers or study materials in the patient’s language. We at the UC San Diego Moores Cancer Center (MCC) have the opportunity to better understand and address low clinical trials participation among our largest under-represented racial/ethnic group, Hispanics. Working with a multidisciplinary team of physicians and non-physician scientists, we propose to 1.) Educate community providers about breast cancer trials at MCC, and 2.) Assess specific interests and needs among the MCC breast cancer team, and combine this with existing evidence, including interview findings (knowledge and Hispanic from a recent (2016) V Foundation grant), to develop and implement minority clinical trial accrual training for the MCC breast cancer team. By focusing on minority breast cancer patients, V Foundation funds complement and expand our emerging efforts to increase minority clinical trials enrollment (accrual) and related outreach and inform how to intervene with MCC patients, providers, and leadership. We are particularly interested in targeting Hispanic breast cancer patients because they are the largest minority group in San Diego County, the region served by the MCC.
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.
Funded in partnership with WWE in honor of Connor’s Cure
Medulloblastoma is the most common malignant brain tumor in children. There are four distinct forms of this tumor based on its gene profiles, and a form known as Group 3 medulloblastoma is the most aggressive and deadly, which accounts for 25%-30% of all medulloblastoma. Each medulloblastoma group has distinct abnormal gene expression that determines how it creates, grows, and spreads tumors. Changes in gene behavior, like overexpression or underexpression, are controlled by what is called epigenetics. Fortunately, we know how to manipulate epigenetics with drugs. Dr. Hu and his colleagues found two epigenetic components that play important roles in controlling gene expression in tumor. Interestingly, these two epigenetic components seem to work together: when one component is suppressed, the other increases, and vice versa. A gene called MYC is very active in many cancers including Group 3 medulloblastoma. In this project, Dr. Hu’s team will characterize these two epigenetic components to understand more precisely how they work, particular in controlling MYC expression, even further, they will test in the lab whether “drugging” these epigenetic factors can halt the growth and spread of medulloblastoma tumors. If this hypothesis is proven, it may be possible to use these drugs in combination to treat this devastating childhood cancer.
The goal of “Campaign to Improve Access to Clinical Trials” at The University of Arizona Cancer Center (UACC) is to increase the clinical trial access to a diverse population in Arizona. Dr. Pavani Chalasani, Breast Cancer Disease Oriented Team Leader, will oversee the campaign to improves access by involving the breast multidisciplinary team, patient navigators and physician liaisons to develop educational materials and outreach programs. Patients and community physicians will be targeted through proposed outreach programs by developing targeted educational materials. Materials and training will be provided to introduce and educate about clinical trials to patients early by various members of their cancer team. The goal of this campaign is to become a model for other disease teams and cancer centers to implement to improve clinical trial enrollment.
Multiple myeloma is a cancer of the blood and is the second most frequently diagnosed blood cancer in the US. Every year, about 30,000 patients are newly diagnosed, and about 12,000 die from this cancer. The main symptoms include anemia, bone pain, kidney failure, and infections. The most recent treatments have improved patient survival from about 3.5 to 5 years. Unlike some other blood cancers, myeloma still cannot be cured. Thus, the development of new drugs and treatments is essential. The purpose of our study is to understand how an understudied class of genes, called long noncoding RNA genes (lncRNAs), participates in the development of multiple myeloma and may be used to develop entirely new treatments. Specifically, we propose innovative approaches to investigate a specific lncRNA gene, MALAT1 (metastasis-associated lung adenocarcinoma transcript 1) and how it functions in the repair of damaged DNA to promote the initiation and progression of multiple myeloma. We recently discovered that the MALAT1 gene is involved in an alternative DNA repair network that has seldom been studied in multiple myeloma. We believe that MALAT1 modulates the transition to advanced myeloma and myleoma that occurs outside the bone marrow. Our fundamental goal is to establish how MALAT1 regulates the repair of DNA damage and therefore its functional significance in multiple myeloma initiation and progression. This entirely novel knowledge will open new avenues for patient therapy and ultimately improve patient outcomes.
Funded by the Constellation Gold Network Distributors
Only a limited number of proteins are found in nature, and many of them have multiple different functions that clash with one another, which makes them poor drugs. There is a growing interest in engineering existing proteins or designing brand new proteins that are better than the ones in nature. Most current methods for protein design use a random approach. However, as our understanding of protein structure improves, we have an exciting chance to use structure to guide design. My lab applies new tools from biology and engineering to figure out the mechanisms that control protein behavior. We then use this information to discover and develop better drugs.
One of the biggest cancer breakthroughs is immunotherapy, which activates the patient’s own immune system to fight disease. My lab aims to bias the activity of immune proteins in order to achieve a targeted response against cancer. For more than twenty years, immune proteins such as cytokines and antibodies have served as powerful weapons in cancer treatment, but they are limited by issues such as drug resistance and harmful side effects. As a result, there is an unmet need to create new proteins that overcome these challenges. Building on our lab’s insights and platforms we have designed, we will make a new protein drugs that act through unique pathways to induce potent anti-cancer immune responses.
Funded by the Dick Vitale Gala in memory of Chad Carr
Cancer is the leading cause of disease-related death of children past infancy in North America. All cancers contain mutations in their DNA, but the causes of these mutations are usually not known. This gap in our knowledge negatively impacts patient care: It is difficult to predict how a tumor will change – how it will respond and whether it will come back – if one does not understand why or how it developed in the first place. Recently, our lab and others have shown that some childhood cancers contain a fingerprint which can be used to pinpoint what caused its mutations and when they developed. The identification of these fingerprints, or mutational signatures, is a rapidly evolving area of research that has benefited from new technologies, such as whole genome sequencing. This project will identify mutational signatures in aggressive childhood cancers. We will seek to understand whether cancer- causing mutations have common fingerprints, and if these can be used to select patients that would benefit from ongoing clinical trials.
Volunteer Grant funded by the 2018 V Foundation Wine Celebration in honor of John and Biserka Noval
Cancer is a leading global health concern. Until recently, cancer patients are normally treated with surgery, pharmaceutical reagents that can kill tumor cells (chemotherapy), and radiation (radiotherapy). In recent years, scientists and doctors have been trying to improve patients’ own immune function to combat cancer, known as immunotherapy. Cancer cells can fool the immune system by expressing some markers that can inhibit immune function. These markers are called “immune checkpoints”, including CTLA-4 and PD-1. Subsequently, blocking “immune checkpoints” with reagents (anti-CTLA-4 and anti-PD-1) could enhance immune function and result in impressive curative effects in some patients with cancer. Yet, a lot of patients do not respond to anti-CTLA-4 and anti-PD-1. In order to broaden the patient populations that can benefit from these novel reagents, we plan to change the metabolic features of the microenvironment that tumor cells live in. We hope doing this will improve the function of immune cells, which then causes non-responsive tumors to respond to anti-CTLA-4 and anti-PD-1 treatment. Our studies might also identify some markers that can help doctors in selecting the right patients for these therapies. Our long-term goal is to translate our findings from bench to bedside by designing clinical trials to test combination therapies, particularly in cancer patients that have been non-responsive to anti-CTLA-4 and anti-PD-1 therapies.
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