The goals of “precision medicine” in cancer are (1) to identify the molecules that drive the cancer and (2) develop “smart drugs” that block these drivers. These “smart drugs” should stop the cancer but not be toxic. Many “smart drugs” have been developed, but the cancer cells adapt and find escape routes. We get many hopeful “responses” to therapy but disappointingly few “cures.” Our research identifies escape routes that cancer cells use to evade death, and then uses additional drugs to block the escape from treatment.
Our approach is already showing success in treating a blood cancer called Mantle Cell Lymphoma. One of our combinations is causing complete responses in over half the patients we treat. Unfortunately, many cases show resistance to our drugs, even though the patients had never previously seen them. We are researching the ways that cancer cells become resistant to these powerful drug combinations. Our goal is to achieve deeper responses to therapy and turn the frequent “responses” into genuine “cures.”
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.
Cancer involving the lining of the uterus is known as endometrial cancer. Endometrial cancer is a common female cancer with about 61,880 new cases per year. When this cancer has spread beyond the uterus, most women will die of their disease. Endometrial cancer deaths have been increasing each year since 2006. We need better and more treatments for this disease. There are tests to identify abnormal genes and proteins on the cancer cells. More research is needed to see if these abnormal genes and proteins can be used to make treatment decisions. We believe that survival for women with endometrial cancer that has spread outside of the uterus will be improved by using the abnormal tumor genes and proteins to find treatments that will work better. Our goal is to look more closely at these abnormal genes and proteins in cancer cells and determine if this new way to make treatment decisions and find better treatments will help women live longer. We also plan to find new drugs to treat this disease. We will bring together a group of medical centers, experts who treat women with this disease, patients, and patient advocates to help guide our study.
Precision cancer medicine refers to the tailoring and targeting of cancer treatment to the individual characteristics of each patient. Triple negative breast cancers (TNBC), specific types of breast cancer, are known to be very aggressive and tend to occur more frequently in Hispanic than non-Hispanic white patients. A team of researchers at the UC San Diego Moores Cancer Center was formed to investigate the development of treatments that will target TNBC. This research will include the setup of clinical trials–research studies that test how well certain treatments work in patients with cancer. It is well known that there are obstacles that prohibit racial/ethnic minorities from participating in clinical trials. These include a variety of factors related to the patient, his/her provider, and the health system where he/she receives medical care. The goal of this application is to leverage work in a precision medicine project to engage with community partners on the topic of clinical trial accrual. This will be accomplished by addressing the following specific aims, focusing on Hispanic communities in San Diego and Imperial counties: 1) Assess the unique community perspective and experience of Hispanic breast cancer patients related to clinical trials; and 2) Educate community partners in precision medicine, clinical trials, patient perspective and experience, and the importance of minority representation in research. The proposed work will be conducted under the UC San Diego Moores Cancer Center’s Community Outreach and Engagement, led by an expert team of investigators, physicians, and disparities researchers and staff.
While breast cancer in the United States is highest in white women, the mortality and incidence of more virulent forms of cancer are higher in black women. An under- representation of black women in clinical trials prevents a full understanding of how new drugs will potentially affect them and limits our effectiveness in treating future black women with breast cancer. The purpose of this research is to identify the specific reasons for low enrollment of black women in breast cancer trials in southeast Louisiana and develop means of addressing the barriers to participation.
Hormone therapy medicine helps lower the chance of breast cancer growing or coming back. African American breast cancer survivors say they lack information about hormone therapy. Women also say that side effects are a main reason for stopping hormone therapy. We are doing a study that will test a text message program for these women. Women who join the study will be randomly assigned to one of two groups. One group will get text messages and the other will not. The text messages have information to help women deal with side effects. We think the women getting texts will have fewer side effects and greater belief they can manage hormone therapy. We also think they will understand why hormone therapy is important. We think this will help women worry less about hormone therapy and continue taking it. With the V-Foundation funding, our main goal is to increase the number of women who join the study. We will use our current partnership with community members and social media to recruit more women. This is the first study to test a text message program for African American women on hormone therapy. It is also one of the first to use a community partnership and social media to recruit women.
This project aims to improve the enrollment of men with prostate cancer into studies that require specific changes in DNA in order to be eligible. The largest barrier to enrolling patients is obtaining information about their DNA. Current standards of practice do not have clear recommendations on when to test the DNA of men with prostate cancer. Insurance does not always cover the DNA testing needed to get this information. The University of Virginia has two research programs open that obtain DNA testing on men with prostate cancer. This grant will support the efforts of the Clinical Research Outreach Program at UVA to recruit men with prostate cancer into these research programs in order to obtain DNA testing on a greater number of men with prostate 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. 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.
Prostate cancer represents the second most common cancer in men and the fifth leading cause of death worldwide. African American men in the US are more likely to develop prostate cancer and more likely to develop aggressive types when compared to other races. Between 2012 and 2016, 179 out of 100,000 African American men compared to 104 out of 100,000 Caucasian men were diagnosed with prostate cancer African American men with prostate cancer have a 2.5-fold greater risk of death from the disease.
Racial disparities exist in many disease types, including cancer. The development of cancer and survival of the disease are likely to include many components, including later detection and treatment, genetic factors, differences in biology, and social factors. Participation in cancer clinical trials provides access to new therapies, including potentially life-saving experimental therapy in patients for whom options are limited and prognosis is poor. African American patients are underrepresented in clinical trials in general, and more specifically in prostate cancer trials. The aim of this project is to promote, facilitate, and foster participation of minorities (with special emphasis on the African American population) in ongoing and to-be-opened prostate cancer clinical trials at VCU Massey Cancer Center (MCC). This will be accomplished by identifying current barriers, by increasing awareness among patients and physicians about available opportunities offered by MCC, and by organizing a prostate cancer clinical trial team that will guide eligible patients through screening and clinical trial treatment.
Funded by the V Foundation’s Virginia Vine event, in honor of WWE Connor’s Cure
Drugs are needed to treat cancer. Clinical trials are done to make sure drugs are safe and effective. Individuals volunteer for clinical trials. In cancer clinical trials, the volunteers usually have cancer. Volunteers may also be young or old, male or female and rich or poor. The important thing is to get a mix of volunteers who are similar to the cancer patients who will take the drug. Not very many people participate in clinical trials. More white people participate than any other race. This means that we don’t always know whether drugs are safe and effective in all people. Also, we don’t know if people are getting equal opportunity to participate in clinical trials. This study will look whether patients at Inova Schar Cancer Institute know about clinical trials. This study will also develop a program to help make all people, no matter what race, aware of clinical trials.
