DALLAS – August 24, 2016 – Six new cancer research projects involving treatment, prevention, outreach, and genetics recently received a total of $9.6 million in support from the Cancer Prevention and Research Institute of Texas (CPRIT). The funding will allow UT Southwestern Medical Center researchers to:
- Understand how cancer cells fuel their growth
- Target lung cancer with highly precise carbon radiation treatments
- Screen disadvantaged populations and those at a higher genetic risk to help reduce rates of colorectal cancer
- Reach breast cancer survivors through an active living intervention.
CPRIT also announced $4 million in new recruitment grants to UT Southwestern, which will be coupled with $4 million for recruitment announced in May, to help attract new cancer researchers. UT Southwestern currently has 34 cancer researchers on campus who have been recruited to Texas and UT Southwestern with assistance from CPRIT funding.
"Funding by Texas taxpayers through CPRIT has been fundamental in advancing our initiatives to develop better therapies and expand prevention efforts, as well as attracting top scientists from around the country to bring their knowledge, expertise and accompanying resources to our state," said Dr. Daniel K. Podolsky, President of UT Southwestern, who holds the Philip O'Bryan Montgomery, Jr., M.D. Distinguished Presidential Chair in Academic Administration, and the Doris and Bryan Wildenthal Distinguished Chair in Medical Science. "The exciting research that these awards will support will continue that success and bring us further toward our goal of reducing and eventually eliminating the terrible burden of cancer."
UT Southwestern researchers have been awarded a cumulative total of more than $331 million from CPRIT, including the latest awards, which have helped attract additional awards in basic science research, translational research and outreach and prevention programs.
"Our cancer researchers are continually seeking and finding new solutions to better understand, diagnose, and treat cancer," said Dr. Melanie Cobb, Interim Director of the Harold C. Simmons Comprehensive Cancer Center, Professor of Pharmacology and holder of the Jane and Bill Browning, Jr. Chair in Medical Science. "This effort includes a wide range of projects, from basic scientific findings at the molecular and cellular level needed to understand how cancer develops and spreads, to prevention and outreach efforts."
To date, CPRIT has awarded 1,059 grants to Texas researchers, totaling more than $1.64 billion. The agency was launched in 2009 after Texas voters overwhelmingly approved a 2007 constitutional amendment committing $3 billion to the fight against cancer. Texas has seen steadily declining mortality rates from cancer, which have dropped 13 percent, translating to approximately 3,306 fewer deaths, according to data from the Texas Department of State Health Services. Grantees have delivered more than 1.3 million cancer education and 1.5 million clinical preventive services statewide, according to CPRIT.
Awards to UT Southwestern researchers were:
Multi-Investigator Research Award
Dr. Steve Jiang, Professor of Radiation Oncology, holder of the Barbara Crittenden Professorship in Cancer Research
* Towards Carbon Beam Stereotactic Body Radiation Therapy (C-SBRT) for Higher Risk Early Stage Lung Cancer – $4,103,894
High Risk/High Impact Research Award
Dr. Jenna Jewell, Assistant Professor of Molecular Biology
* Amino Acid Sensing: Directing Cell Growth Through mTORC1 – $198,983 awarded in May 2016
Evidence-Based Cancer Prevention Services
Dr. Amit Singal, Associate Professor of Internal Medicine, and the Dedman Family Scholar in Clinical Care
* Implementation of an Evidence-Based Colorectal Cancer Screening Outreach Program among Socioeconomically Disadvantaged Patients in a Safety Net Health System -$1,499,826
Dr. Madhukar Trivedi, Professor of Psychiatry, holder of the Betty Jo Hay Distinguished Chair in Mental Health and the Julie K. Hersh Chair for Depression Research and Clinical Care
* Promoting Activity in Cancer Survivors (PACES): An active living intervention for breast cancer survivors – $1,365,226
Evidence-Based Cancer Prevention Services-Colorectal Cancer Prevention Coalition
Dr. Theodora Ross, Professor of Internal Medicine and Cancer Biology, and Director of Cancer Genetics; holder of the Jeanne Ann Plitt Professorship in Breast Cancer Research, and the H. Ben and Isabelle T. Decherd Chair in Internal Medicine in Honor of Henry M. Winans, Sr., M.D.
* Detecting Unaffected Individuals for Lynch Syndrome (DUAL): Screening, Diagnosis and Navigation- $2,100,000
Cancer Prevention Promotion and Navigation to Clinical Services
Dr. Theodora Ross, Professor of Internal Medicine and Cancer Biology, and Director of Cancer Genetics; holder of the Jeanne Ann Plitt Professorship in Breast Cancer Research, and the H. Ben and Isabelle T. Decherd Chair in Internal Medicine, in Honor of Henry M. Winans, Sr., M.D.
* Use of Genetic Patient Navigators to Help Mutation Carriers Comply with the NCCN Guidelines and to Enable Healthy Behaviors – $399,954
Please see attachment for lay summaries of these UT Southwestern CPRIT awards.
The Harold C. Simmons Comprehensive Cancer Center is the only NCI-designated comprehensive cancer center in North Texas and one of just 47 NCI-designated comprehensive cancer centers in the nation. Simmons Cancer Center includes 13 major cancer care programs. In addition, the Center's education and training programs support and develop the next generation of cancer researchers and clinicians. Simmons Cancer Center is among only 30 U.S. cancer research centers to be designated by the NCI as a National Clinical Trials Network Lead Academic Participating Site.
About UT Southwestern Medical Center
UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution's faculty includes many distinguished members, including six who have been awarded Nobel Prizes since 1985. The faculty of almost 2,800 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in about 80 specialties to more than 100,000 hospitalized patients and oversee approximately 2.2 million outpatient visits a year.
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UTSW Project Summaries for CPRIT Awards
Multi-Investigator Research Award: Dr. Steve Jiang
Lung cancer is the second most common type of cancer and the number one cause of cancer death in the United States. Radiation therapy continues to be the primary treatment for 60 percent of patients. Stereotactic body radiotherapy (SBRT) is a radiotherapy method that delivers a high dose of radiation to the cancer target with a high degree of precision through a small number of fractions. Over the years, SBRT has been successfully employed to early stage lung cancer using megavoltage X-ray beams. Clinical trials have clearly demonstrated high local control and improved survival benefits over conventional therapy. However, current SBRT under X-ray beam therapy has limitations for higher risk lesions, e.g. those with larger and/or centrally located tumors, due to unacceptable toxicity to normal tissues.
Advanced carbon radiation therapy holds great potential due to the unique physics and radiobiology of carbon beams that deliver a greatly reduced dose to normal tissues without compromising the high dose to the tumor. UT Southwestern Medical Center is currently in the process of constructing a carbon ion therapy facility, which will likely be the first one in the United States. This effort has received support from the National Institutes of Health and from the state of Texas.
One of the clinical focuses of our carbon ion therapy center is to transform the lung cancer treatment by delivering carbon beam SBRT (C-SBRT) for higher risk early stage lung cancer. However, prior to conducting clinical trials, novel technologies need to be developed to ensure that the dose delivered is accurate, robust, and safe. The current research program will perform a large-scale, coordinated, and interdisciplinary investigation to develop novel and carbon therapy-specific technologies to realize lung cancer C-SBRT. Upon completion, it is expected that key technologies will have been developed and we will be ready for clinical trials of C-SBRT treatment for higher risk early stage lung cancer.
High Risk/High Impact Research Award: Dr. Jenna Jewell
Growth is an essential process whereby cells and organisms accumulate mass and increase in size. Cells grow by responding to environmental cues that trigger signaling pathways to regulate growth. The mTORC1 pathway is constitutively active in many human cancers. Therapeutics such as rapamycin analogs, which target and block the mTORC1 pathway, have been approved by the FDA for renal and breast cancer. Thus, investigating how the mTORC1 pathway is regulated is of great interest. Our laboratory is focused on understanding how the mTORC1 pathway senses nutrients, such as amino acids, to control cell growth. Utilizing a combination of cell biology, biochemistry and CRISPR/Cas9 genome editing, we recently discovered a new pathway where the amino acid glutamine can regulate mTORC1. This is important because most cancer cells require glutamine for cell growth and proliferation. The CPRIT High Impact/High Risk award is supporting our lab to identify novel components involved in glutamine signaling to mTORC1 that can be manipulated pharmacologically. We anticipate that the findings from this research will reveal new targets that we can modulate to treat cancer.
Evidence-Based Cancer Prevention Services: Dr. Amit Singal
Colorectal cancer (CRC) is a significant health problem, particularly among racial/ethnic minorities and patients of low socioeconomic status. In our CPRIT proposal, we propose to conduct a CRC screening outreach program among more than 18,000 screen-eligible patients, ages 50-64 years, who receive primary care at Parkland Health and Hospital System, the sole safety net health system of Dallas County. This is a racially diverse and socioeconomically disadvantaged patient population at the highest risk for CRC mortality, but lowest rates of CRC screening.
Our intervention will include: a) low-literacy educational letters, b) mailed screening outreach invitations delivered annually, c) a one-sample home FIT kit and return mailer with prepaid postage, d) telephone reminder calls including one-on-one education, and e) centralized patient navigation for follow-up of abnormal FIT results. Because our data show some people invited for FIT prefer to instead complete colonoscopy, we will also build in a pragmatic "Screening Choice Trial" that will randomly select 2000 patients to receive mailed invites that provide a choice of completing a home FIT kit or scheduling a colonoscopy to evaluate if having a choice of test further increases screening success.
Our project will not only deliver potentially life-saving screening invitations to more than 18,000 patients and create a robust, sustainable screening program poised to improve outcomes for uninsured persons in Dallas County, but also serve as a proven, replicable model for improving CRC screening processes and outcomes among underserved populations in health systems throughout Texas.
Evidence-Based Cancer Prevention Services: Dr. Madhukar Trivedi
Recurrence of cancer is a major concern for over 3 million breast cancer survivors in the U.S., including at least 135,000 Texans. Physical activity is an effective, safe, and evidence-based behavior that improves physical and psychosocial functioning, and potentially improves recurrence and survival among breast cancer survivors. It is recommended that cancer survivors engage in at least 75 minutes intense or 150 minutes moderate activity per week, but despite the significant benefits of physical activity, at least two-thirds of breast cancer survivors do not meet these recommendations.
With a grant from the Cancer Prevention and Research Institute of Texas, UT Southwestern's Center for Depression Research and Clinical Care will be starting a new research project to increase physical activity among breast cancer survivors and address behavioral and psychological barriers to exercise. The primary goal is to provide education and the optimal combination of interventions to increase physical activity among breast cancer survivors. This program is innovative in its reach and focus, working to identify the most effective components of a behavior modification approach to implement a physical activity plan for breast cancer survivors. This program can serve as a catalyst to ensure that Texas leads the nation in active lifestyles during cancer survivorship.
Evidence-Based Cancer Prevention Services – Colorectal Cancer Prevention Coalition: Dr. Theodora Ross
In the U.S., there are approximately 150,000 colorectal cases per year that result in 50,000 deaths. Lynch syndrome, the most common hereditary colon cancer syndrome, affects approximately 1 in 300 individuals. Remarkably, only 2 percent of individuals with Lynch syndrome in the U.S. are aware of their genetic condition. When a patient without cancer is known to have LS, a cancer prevention management plan can save his or her life. By querying for family history of cancer through tele-counseling we plan to screen more than 300,000 people to increase Lynch syndrome identification and management. In addition to sending information annually by mail to homes in 23 local counties, we will connect with patients at our partner safety net hospitals (Parkland Health and Hospital System and JPS Health Network) as well as at UT Southwestern during routine screenings (mammograms or colonoscopies) or other health care visits. Risk assessment of patients will allow us to educate both patients and their physicians regarding genetic testing and cancer screening intervals for those at high risk for cancer. We will specifically measure if our program leads to an increase in compliance with early colonoscopies for individuals at high risk for colon cancer. This program's goal is to not only increase cancer genetic literacy and cancer prevention activities, but also to serve as a model for others in the world to use to identify individuals at risk for Lynch syndrome and other cancer genetic conditions.
Cancer Prevention Promotion and Navigation to Clinical Services: Dr. Theodora Ross
Patients with Hereditary Breast and Ovarian Cancer syndrome (HBOC) and Lynch syndrome have elevated lifetime risk for cancer. Based on the frequency of mutated genes, 72,280 individuals in Texas have HBOC or Lynch syndrome. If cancer risk reduction strategies are maximized, these individuals have the opportunity to prevent their cancers. In this project we will use a genetic patient navigator (GPN) to promote patient adherence to cancer prevention strategies. Our program has identified over 2,400 mutation carriers to date. Many of these patients have not received systematic follow up and at-risk family members have not been tested. Typically, patients are sent back to their referring providers for ongoing medical management needs, but studies have shown that many non-genetic health care providers have low genetic health literacy. The GPN will contact most of our HBOC/Lynch syndrome mutation carriers. The GPN will: 1) obtain updated medical history and 2) ascertain the need for services and current compliance with prevention recommendations. The GPN will then follow up with patients annually after scheduled screenings or risk-reduction efforts and obtain information on relatives tested. The GPN will be available to navigate relatives to genetic counseling and testing. The GPN role has the potential to decrease cancer incidence in our target population. To our knowledge, there is not a current GPN position at any facility that focuses solely on following mutation carriers and identifying at-risk family members. If successful, this will serve as a model for others to use to help their patients and evaluate the outcomes of genetic patient navigation.
Lori Sudeen Soderbergh