Funded by the V Foundation Wine Celebration in honor of Laura Cortez
Radiation therapy is used to treat cancer and is very effective, but radiation can cause side effects in some patients. Scientists have shown that if radiation is delivered to a tumor very, very quickly (termed Ultra-high dose rate or FLASH radiation therapy), the tumor will still die, but the patient will have fewer side effects. This phenomenon is called the “FLASH effect”. However, this new type of radiation is very challenging to deliver and to be certain it was delivered correctly, because it is given so fast (less than a second). We need to make special machines and tools before this treatment can be used optimally for patients. The main goals of this study are to develop these new tools and to conduct a clinical trial to test the safety and feasibility of this new type of radiation. The first trial we will run will test this treatment in patients with lymphomas that involve the skin. Finally, building on the experience using this new (UHDR) radiation for lymphoma treatment, we will prepare and design a clinical trial for testing this treatment in breast cancer, a very common cancer. The overall goal of this project is to reduce the treatment related side effects of radiation, while maintaining or improving cure rates.
Funded by the V Foundation Sonoma Epicurean in honor of Leslie Sbrocco
CAR-T cell therapy is a type of therapy where a cancer patient’s immune cells, called T cells, are removed from the patient, altered in the laboratory to make them recognize cancer cells, and then given back to the patient. These CAR-T cell therapies have been unbelievably successful for liquid cancers like leukemias and lymphomas, however they have not yet been very successful for patients with solid tumors. Recently, a clinical trial of a certain kind of CAR-T cells for patients with stomach and pancreas cancers showed that CAR-T cells can fight these cancer cells in the body, but the patients only had short responses and their tumors came back. CAR-T cells need to be good serial killers of cancer cells, however they can often get tired in battle and stop working well. We want to apply our knowledge of gene engineering to make new and better versions of these CAR-T cells that do not tire quickly and can therefore fight cancer for longer. We do this by making different kinds of alterations in the genes of the CAR-T cells that give them more endurance, changing them from sprinters to long-distance runners. We can also make entirely new CARs (the part of the CAR-T cell that recognizes the tumor cells) that can bind the tumor cells with slightly different strengths, which we know can also make the cells less exhausted in battle. If successful, we will push these CAR-T cells to new heights, achieving longer remissions for patients battling gastrointestinal cancers.
Washington, D.C., has some of the highest cancer death rates in the United States, especially among the the Black and Latinx communities in Wards 7 and 8. This is caused by differences in living conditions that make it hard for Ward 7 and 8 residents to get trusted information on ways to avoid cancer, as well as cancer screening that can find the disease early when it is more treatable. This means many women in Wards 7 and 8 find out they have breast cancer when it is farther along, harder to treat, and may not be curable. This work, through the Johns Hopkins Kimmel Cancer Center in the National Capital Region and Sibley Memorial Hospital, can help to address these differences.
To help fix these disparities, the first step is to share information with communities on ways to lower the chances of getting cancer and the tests that can find it early. We will begin with a focus on preventing and detecting breast cancer. Working with the community, we hope to help more women stay healthy and never need to be treated for breast cancer. Our educators will give coaching on ways to live a healthy life – like through diet, exercise, and how to quit smoking – as well as how and when cancer screening should be done so it can be found early. It is our hope that these efforts will mean that fewer women will be diagnosed with breast cancer, and those who are will have a better chance of surviving the disease.
Lung cancer is the leading cause of death from cancer in the United States. When lung cancer is found before it spreads to other parts of the body, it can be treated and people can live longer.
There is a screening test for people who are at high risk for lung cancer. People who are over 50 and have smoked may be able to get screened. However, less than 6% of Americans in this group have been screened for lung cancer. People may not be screened because they do not know about lung screening or are worried about being screened. This project will create educational materials to help people understand if they are eligible for lung cancer screening, explain the benefits and risks and help them talk to their doctor. Education will be made available by video, in print and by website. We will test the materials using a survey. The survey will help us learn how people like the materials and if they learned about lung cancer screening.
Funded in partnership with Miami Dolphins Foundation
Lymphoma is one of the most common cancers in the United States. People who are diagnosed with lymphoma often receive chemotherapy treatment, which can cause a lot of physical and emotional side effects. Although lymphoma is common, not that much is known about how nutrition or physical activity could help lymphoma patients.
Because so little is known, this research study plans to first explore if nutrition and exercise is something that lymphoma patients are interested in and able to do during chemotherapy. Secondly, this research study will look into whether the nutrition and exercise plan helped patients with the side effects of chemotherapy on their body, mind, and quality of life.
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.
Funded in partnership with Miami Dolphins Foundation
Our goal is to make sure all women with cancer get medical care that is consistent with what is important to them, no matter their race and ethnicity. To do this, we will work together with community health workers, who are trusted professionals that help connect people from their communities to medical care through education, support, and advocacy. Our past research shows that community health workers want to help cancer patients get the right care. They can do this by having conversations about advance care planning, which is a way for patients to think about the kind of medical care they would want if they became too sick to speak for themselves. However, community health workers need more training to have these conversations with patients. We will create a program to teach community health workers how to help patients with advance care planning. Next, we will improve the program by getting feedback from community health workers and making changes based on their suggestions. Finally, we will test this program by having community health workers have advance care planning conversations with cancer patients based on what they learned. We will then get feedback from both the patients they talk to and the community health workers to find out whether these conversations were useful. In the future, community health workers could work together with doctors to make sure that cancer patients get the right medical care so that they live as well as possible during their cancer journey.
Funded in partnership with Miami Dolphins Foundation
Sarcomas are cancers of the bone and muscles, often seen in children and young adults, which are very hard to treat with very few patients surviving. Our aim is to improve treatment options for these patients. A vaccine trial using patient’s dendritic cells which are a type of immune cells, modified to identify and attack the individualized cancer was conducted at Sylvester comprehensive cancer center in 2019. Surprisingly, we noted good response in a few patients, who remain cancer free over 2 years from receiving the vaccine treatment. Therefore, the aim of this research proposal is to study the immune/non-immune cells of the surgically removed tumors and blood of patients treated on this trial. Using special high-resolution imaging methods in which key immune markers are tagged in the tissue, we will describe the immune cells in each patient’s cancer environment and correlate these to whether the patient did or did not respond to the cancer vaccine. We will also measure key immune cells in the blood of these patients collected after vaccine treatment and compare this with response to the vaccine. These detailed immune studies on patient tissue and blood samples will then guide future anti-sarcoma cancer vaccines and potential immune cell therapy to cure these aggressive cancers.
Breast cancer is the most common cancer in women in the United States and second leading cause of cancer death. When a woman is diagnosed with metastatic breast cancer (MBC) (cancer that has spread to other parts of the body) she has a less than 30% chance of surviving 5 years. These statistics remain despite decades of research and many new treatments for MBC. This suggests that we need better ways to administer drugs for MBC.
Hormone receptor positive (HR+) breast cancer is fed or fueled by estrogen and progesterone, the natural hormones of the body. HR+ MBC is initially treated with drugs that block the estrogen and progesterone production in the body. However, eventually cancer cells can become “resistant” to these hormone blocker drugs, most commonly by developing a “mutation” in the receptor of estrogen called ESR1. Once this mutation develops, the treatment is more challenging and usually involves use of chemotherapy which can lead to patients feeling sick and having multiple side effects from treatment.
In this proposal we plan to enroll HR+ MBC patients who have already developed an ESR1 mutation and offer a novel way of targeting this mutation. This will help extend time on treatment with minor side effects and possibly increase survival. We will do so by creating vaccines out of their own immune system that will allow them to wake up and engage in the fight against their cancer. This treatment will be combined with standard of care hormone blocking therapy.
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.
