Cervical cancer can be prevented with regular exams that detect precancerous lesions. However, these lesions are common and their progression to cancer is uncertain, resulting in unnecessary invasive procedures such as biopsies and their associated consequences of pain, bleeding, and scarring. Black women are disproportionately affected by these lesions and respective consequences. Black women also have different vaginal microbiomes (VMB) than their white counterparts. The VMB, comprising microorganisms in the vagina, has been linked to these lesions and could be a target for improved screening.
Our preliminary data suggests that the VMB’s protective effect may be influenced by race. To understand whether racially distinct pathways contribute to precancerous lesions and what factors influence them, we will recruit 90 Black and 90 white women with abnormal cervical cancer screenings. We will analyze VMB profiles, HPV viral load, and stress levels at two timepoints. Our goals are to determine if racial differences exist in HPV and VMB dynamics and assess the role of stress in disparities of lesion regression. We will also explore how HPV and VMB changes mediate the stress-regression relationship differently based on race.
This research will improve our understanding of the impact of VMB, HPV, and stress on lesion regression and racial disparities. By uncovering these factors, we can develop targeted interventions to improve the health outcomes of all women.
Cancer arises from alterations, termed mutations, of a cell’s genetic material (DNA). Understanding how different types of mutations promote cancer cell growth requires precise modeling of these mutations in tumor cells in order to discern how they specifically impact cell function. We propose to do this for two proteins that are frequently mutated in ovarian cancer. These proteins, CTCF and BORIS, bind to the DNA and can change the DNA’s structure to turn genes on or off. However, how their mutations affect the DNA binding for these two proteins and impact ovarian cancer cells is unclear. We propose to generate cellular models of BORIS and CTCF mutations and measure their impact on DNA structure and gene expression. From these data, we will discern the molecular alterations and functional consequences of their mutation. The goal is to define the mechanism by which these frequent mutations impact ovarian cancer cells, with the ultimate hope that such mechanistic insights can lead to novel therapeutic approaches to ovarian cancer.
Funded in partnership with WWE in honor of Connor’s Cure
Diffuse midline glioma (DMG) is a devastating and aggressive type of brain tumor that primarily affects children and young adults. Despite advancements in medical research, DMG remains a medical challenge with limited treatment options and a poor outcomes. Considering these difficulties, there is an urgent unmet need to develop new and innovative therapies for DMG. One promising avenue for discovery is the exploration of targeted agents that disrupt key signaling pathways involved in tumor progression without affecting the healthy normal cells in the brain. Our previous work has identified a potential new therapeutic target that could be leveraged in this way to specifically combat this tumor. New drugs that selectively inhibit this aberrant signaling pathway show great potential for slowing down the growth of DMG cells, thus creating a new opportunity for intervention. In these proposed studies, we will explore precisely how this intracellular signaling pathway controls cancer progression. Further, we will test in the lab whether treatment with new drugs designed to inhibit this pathway can halt DMG tumor growth. We hope that our studies inform the use of new targeted drugs to treat this devastating childhood cancer and thereby drive advancement of patient care and redefine the treatment of DMG.
Most people who die from skin cancer died because their cancer has spread to the brain. Recent progress in treating patients whose cancer has spread to other organs has not kept pace for patients in whom skin cancer spread to the brain. At least part of the reason for this is likely because the environment in the brain is so different from other parts of the body. To address this urgent need for better treatments developed specifically for patients with skin cancer who then develop brain tumors, we looked for genes that might help cancer cells that spread from the skin to adapt so they can do well in the brain. We have identified a molecule that explain how it might help skin cancer cells to adapt to the brain. Already, we have encouraging evidence of how this molecule allows tumor cells to survive and grow inside the brain. Equally exciting is that there are already ways to block this gene function by taking a pill or injection, which will allow us to test if we can prevent or reverse the spread of skin cancer to the brain in our models, and eventually in patients. However, we first need to better understand exactly how important this process is in helping skin cancer cells to adapt to the brain microenvironment, and gather more information about how this gene seems to help skin cancer cells to invade the brain and adapt to a new environment.
Myeloid neoplasms (MN), including acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), are fatal diseases because they are highly resistant to therapy. Ultimately, efforts at preventing MN might be the most successful way to eradicate this disease. Clonal hematopoiesis (CH) is thought to be the origin of MN. CH is a process whereby a hematopoietic stem or progenitor cell (HSPC) acquires a mutation (alteration in the nucleic acid sequence) that leads to a growth advantage compared to normal HSPCs. CH can be detected many years prior to a person developing MN but as of yet, there are no established therapies to prevent progression of CH to MN. We hypothesize that CDK4/6 inhibition might be a potential treatment to prevent MN through halting the progression of CH. Here we seek to: 1) further characterize the potential of CDK4/6 inhibitors to prevent CH expansion through analysis of pre-existing clinical trial data; and 2) using mouse modeling evaluate the potential of CDK4/6 inhibitors to inhibit CH independent of chemotherapy. If successful, this work will justify the development of clinical trials using CDK4/6 inhibitors to prevent CH from progressing to MN in high-risk populations. In the long term, we hope to use targeted approaches to eradicate high risk CH mutations to prevent the development of MN.
Immune therapy has introduced a new way to treat cancer. One type of immune therapy is called PD1 immune checkpoint inhibition (ICI). PD1 ICI has enabled some people with melanoma and other cancers to live longer. These people have specific features on their tumors that are called biomarkers. People without these biomarkers do not respond as well to PD1 ICI therapy.
Our lab recently showed that a combination of two drugs can completely clear tumors in mice. One drug is a type of immune therapy called CTLA4 ICI; the other is an oral cancer drug called a PARP inhibitor. We developed two clinical trials to test this combination in people. In the first clinical trial, we showed that people who lived longer had a new biomarker called VSTM5. In the second clinical trial, we will confirm that this biomarker predicts who will live longer when given this drug combination.
In this project, we will study why the VSTM5 biomarker predicts a response to the CTLA4 ICI therapy. We will use these results to select people who are likely to respond to CTLA4 ICI therapy. Our goal is to help more people get immune therapies that help them. We also want to help develop new types of treatments for ovarian and other cancers.
Acute myeloid leukemia (AML) is one of the most common and aggressive types of blood cancers. Even though we have made exciting progress and have stronger treatments available, around 30% of AML patients who receive treatment will experience a relapse and have a very low chance of survival. Therefore, we need to figure out how these diseases develop and become resistant to treatment. It has been proposed in AML, there are certain cells that have stem cell-like qualities, which allow them to evade therapy and cause the cancer to come back even after treatment. In this project, we will use advanced techniques to investigate how these cells acquire such characteristics by having specific chemical changes on messenger RNAs. Our ultimate goal is to develop new treatments that can improve the lives of people suffering from these deadly diseases.
Pancreatic cancer kills just about every patient that has it. Patients are first seen with advanced disease and rarely respond to current treatments. More advanced therapies are needed to save lives. Recent studies suggest that pancreatic cancer cells are especially reliant on cellular recycling processes for growth. Mouse models of pancreatic cancer show that blocking these recycling processes can decrease the growth of tumors. These results have led to the launch of several clinical trials. However, initial results from these clinical trials show that pancreatic cancer cells stop responding. The tumors become resistant to blocking recycling pathways. We have made pancreatic cancer cells resistant to these therapies in the lab. We will use these cells to uncover better therapies to prevent resistance and increase patient survival.
Previously, research showed that these recycling processes promote tumor growth. But, in some contexts these same recycling processes can block pancreatic tumor growth. Researchers still don’t know how or when this switch happens. This dual role could contribute to the therapeutic resistance seen in patients. To study this phenomenon, I will use mini-pancreatic organs, called organoids, that can be grown in the lab. For the first time, we will be able to study the mechanisms that regulate the dual roles of cellular recycling in pancreatic cancer. Together these studies will allow us to target the tumor promoting functions of the recycling pathways while preserving the tumor blocking functions. This will prevent resistance and increase patient survival.
Acute Myeloid Leukemia (AML) is the most common and deadliest blood cancer in adults. In 2022, over 11,000 AML patients sadly lost their lives in the USA. The treatment options for AML have stayed the same for many years. But in 2018, a new oral medication called Venetoclax was introduced as a potential breakthrough for AML treatment.
Normally, when our cells become damaged, they have a way of self-destructing called apoptosis. It helps stop any defects from spreading in our bodies. Unfortunately, cancer cells, including those in AML, don’t follow this program and become “immortal,” spreading and causing trouble. Venetoclax is designed to make those cancer cells self-destruct, specifically targeting and killing them.
At first, AML patients showed promising responses to Venetoclax. However, it’s disheartening that about 3 out of 10 patients don’t respond to the medication and in many other patients, AML comes back after treatment. That’s where our research comes in. We want to understand why some patients don’t respond to Venetoclax and how leukemia cells manage to escape apoptosis triggered by the medication.
Through our studies focusing on the molecular aspects of resistance to Venetoclax, we aim to identify potential targets for new and improved therapies for AML. Our studies will also propose combination treatments that could enhance the effectiveness of Venetoclax. Ultimately, with the knowledge gained from this research, we aspire to lay the groundwork for future clinical trials and develop better and safer treatments that will help AML patients live longer and have better lives.
Funded by the V Foundation Wine Celebration in honor of Mike “Coach K” and Mickie Krzyzewski
Few words inspire more fear than “pancreatic cancer,” which is the third leading cause of cancer death in the United States. Treatments have changed little over recent years despite the fact that researchers have learned a great deal about the genetic mutations that give rise to pancreatic cancer. One challenge is that there are different “subtypes” of pancreatic cancer, thereby making a one-size fits all approach difficult. Tailored therapeutic approaches are desperately needed. While studying pancreatic cancer subtypes, our lab identified that drugs which block a protein called cyclin-dependent kinase 7 (CDK7) could selectively kill the most lethal subtype of pancreatic cancer at extremely low doses. This subtype, referred to simply as basal, makes up ~25% of pancreatic tumors and has the worst overall survival. Further, because the drug works at such low doses, we may be able to treat patients at doses that do not cause significant toxicity. Here, we propose to study a drug that inhibits CDK7, in patients with early-stage pancreatic cancer following chemotherapy and before surgery. Concurrently, we will test new pancreatic cancer treatment strategies and drug combinations in mouse models of pancreatic cancer. We will validate and search for new blood markers of treatment response and drug resistance. Finally, we will identify pathways that allow cancer cells to survive CDK7 inhibition and determine whether other drugs can be added to enhance this therapy. The ultimate goal of our research is to provide a new targeted treatment option and hope to pancreatic cancer patients.
