Clinical trials are used to test new cancer treatments that may improve patient survival. Black or African American (AA) patients are less likely to be treated in a clinical trial than White patients. One way to try to reduce this inequality is to use specially trained staff to help people with cancer better understand clinical trials. These staff are called patient navigators. In this project, we will use patient navigators to teach and support patients with cancer and help them overcome barriers to joining clinical trials and gaining access to new treatments. These navigators will focus on making sure all Black/AA patients with endometrial cancer or prostate cancer who receive care at the Cancer Center are considered for cancer clinical trials. In addition to teaching patients about clinical trials, the navigators will also help them better understand the hospital system and make and keep appointments. They will assist patients who live far from the cancer center with travel and with finding a place to stay when they come for 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.
Cancer care can be tough to navigate. Atrium Health Wake Forest Baptist Comprehensive Cancer Center (AHWFBCCC) wants to make sure all patients can access the best cancer care as easily as possible. Sometimes the best treatment outcomes are achieved by joining cancer research studies. To be sure treatments studied in cancer research are reliable and consistent for all patients, it is important that all groups are represented. African Americans have the highest percentage of new cancer cases in the U.S. and the worst outcomes, yet are less likely to be represented in research. Due to language and cultural barriers, Hispanic patients also have low research participation rates. Adolescents and Young Adults have the lowest research participation rate of any age group. It can also be harder for patients who live outside of the city to get cancer treatment because of where they live. To help ensure all groups are included in studies, AHWFBCCC created a population health navigator (PHN) program to help community members learn about cancer, how to prevent it, what screening is required, and what treatments are available. If someone is diagnosed with cancer, the PHN can help to remove barriers to care and help patients learn about the benefits of cancer research. With PHNs, AHWFBCCC hopes to increase research participation so that all can be represented.
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.
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 the Dick Vitale Pediatric Cancer Research Fund in partnership with Mat Ishbia and Justin Ishbia
Years of cancer research have shown that combining therapies that work differently virtually always works better than when therapies are used alone. New medications are being discovered that change the way that genes are turned on and off. At this same time, treatments are also being developed that use the body’s own immune cells to find and attack cancers. Both of these treatments have been shown to work alone on specific cancers. But each have known limits. We are asking whether combining these treatments will result in a new approach to fight two aggressive cancers: Ewing sarcoma and osteosarcoma. We predict that combining these treatments will result in an effective and well tolerated therapy.
My research focuses on a class of proteins called chemokine receptors. Many types of cancers will express these receptors, and this can contribute to cancer metastasis. While many drugs have been developed to block chemokine receptors, very few of these drugs have been effective in clinical trials. This is largely because these drugs must hold these proteins in an “off” position 100% of the time to be effective, which is a tall order. We propose to develop a new class of drugs that turn on pathways in cells that will degrade these chemokine receptors—making them “disappear” from cells entirely. We anticipate that this will be a more effective way to prevent these proteins from promoting metastasis than previous drugs that just try to keep chemokine receptors from being turned “on.” This proposal is early stage validation of a new strategy to drug chemokine receptors. However, in the long term, we hope that this work will ultimately improve cancer treatments in two ways. First, it could inspire both new classes of drugs that will block cancer metastasis. Second, it could provide new strategies to discover drugs with these unique properties.
The immune system provides critical protection against cancer. In fact, new patient therapies designed to boost immune defenses (immunotherapies) have greatly improved cancer treatment. T-cells are a key component of the immune system that can protect against tumor growth. Notably, T-cells can be harnessed for use in cancer therapies in the form of ‘adoptive cell therapy’ (ACT). ACT is an exciting approach in which T-cells are administered to a patient to help fight cancer. Encouragingly, ACTs have successfully cured certain cancer types.
However, ACT does not work well for most cancers. In our work supported by the V Foundation, we will test new strategies to improve ACTs against pancreatic cancer, one of the most lethal cancer types. Completion of this project will yield two important outcomes: 1) Increase our understanding of how the immune system fails to control cancer, and 2) Provide important insight into enhancing the effectiveness of ACT in patients with pancreatic cancer. Immune-based therapies offer hope and promise to cancer patients were traditional treatment approaches (such as chemotherapy or surgery) have failed. This project funded by the V Scholar Program explores new opportunities to enhance cancer immunotherapies.
North Carolina (NC) has the largest American Indian population east of the Mississippi River. Yet, we do not know much about the health and health care of NC American Indians. Because cancer is the number one cause of death in NC American Indians, we need to better understand cancer and cancer-related needs in this unique population in order to reduce the cancer burden. Three NC cancer centers joined together in 2021 to partner and learn more about how to help American Indians with cancer. We also want to find and develop community resources for American Indians with cancer in North Carolina.
In this study, we will explore how cancer affects American Indians in North Carolina. First, we will measure the number of cancer diagnoses and deaths from 2003-2019. We will also learn more about how and where American Indians receive cancer care. These data will come from the North Carolina Cancer Registry and health insurance files. Second, we will ask tribal leaders to help us explore the needs and barriers to healthcare in American Indian communities. Finally, we will work with American Indian youth leaders to understand tribal community strengths and local resources that can help with cancer care.
This information will help American Indians by showing where the greatest needs lie and pointing to opportunities for better care, with a long-term goal of improving cancer outcomes in all American Indians.
