2007 Research Awards
Date: April 20, 2010
FORMER KIMMEL CANCER CENTER DIRECTOR and CRF co-director Martin D. Abeloff said, “In the history of medicine, the greatest progress has been made in the application of biology to the behavior of humans through public health initiatives. Based on the biology of cancer, there is great potential to prevent the disease through lifestyle and medical interventions. The success of cancer research relies on a continuum, and prevention and control must be a part of it. Cancer research is not an either-or proposition. It is all interconnected.”
On September 14, 2007, Dr. Abeloff lost his life to the disease he had dedicated his life to fighting. Under his leadership, some of the most salient findings in cancer genetics and cancer cell biology were realized and have begun to be translated into patient care.
A STRATEGY FOR REDUCING BREAST CANCER DISPARITIES
Breast cancer is a leading cause of cancer death in Maryland and throughout the U.S.
These mortality rates are even more striking among African-American women, who are
often diagnosed with more advanced states of disease, and so often don’t do as well as
their Caucasian counterparts. “A shift to earlier diagnosis would then be a logical step
toward a reduction in cancer mortality and, potentially, a reduction in existing racial disparities in cancer mortality,” says JEAN FORD, M.D. , director of the CRF Public
Health Grant. He began a pilot study to explore whether removing barriers to cancer
detection and treatment will improve outcomes for minority women with breast cancer.
Research has indicated that African Americans receive less intensive therapies and experience shorter survival time. Ford says it is interesting to note that in Baltimore City,
Caucasian and African-American women have comparable breast cancer death rates.
This, Ford says, is probably because both these groups are likely to have low incomes
that limit their access to care, and it provides further anecdotal evidence that delayed
detection and treatment may be at the root of the poor outcomes for minority women.
Ford proposed a strategy using nurse-led community healthcare workers, called
patient navigators, to work with lowincome, uninsured women in Baltimore City who are 40 or older and at average or increased risk for breast cancer due to personal or family history. Navigators will provide culturally-tailored educational materials adapted with literacy and age-related factors, such as vision and hearing, in mind. Navigators will assist women with scheduling screening and treatment appointments,arranging transportation, and even accompanying women to appointments, if necessary. The initial study will involve 250 women to determine if the participation of navigators leads to increased
screening, access to prompt and appropriate therapies, and proper follow-up care with the ultimate long-term goal of improving survival rates for African- American women in Baltimore City.
PATIENT NAVIGATION ELECTRONIC LOG
Preliminary data from the prostate cancer screening program suggest that community
healthcare workers are helpful to patients in coordinating cancer screening and followup. However, few tools are available to assist them in delivering interventions tailored specifically to patient needs. In collaboration with investigators at the University of Maryland, JEAN FORD, M.D. , and team have developed a Patient Navigation Electronic Log (PaNEL), a computerized system designed to guide community healthcare workers. The new system provides them with strategies to determine patient needs and improve coordination of prostate cancer screening while reducing barriers to care.
IN LUNG CANCER, SMALL CELL EQUALS BIG PROBLEM
Lung cancer tops all other cancers in terms of the number of lives it claims. Small cell lung cancer represents 15 percent of all lung cancers and occurs almost exclusively in smokers. While up to 85 percent of patients’ cancers initially respond to anticancer drugs, almost all
patients die of recurrent disease within one year of diagnosis. This has been the
ase for nearly two decades underscoring the critical need for new therapies. HRISTINE HANN, PH.D. , studied a gene called Bcl-2 that inhibits cell death and is over-expressed in the majority of small cell lung cancer cases. Abnormal expression of this protein has been linked to therapy resistance, making it a promising target for new therapies. Hann
and collaborators studied a drug that directly inhibits Bcl-2, which has proven
effective in laboratory models. Clinical trials of this drug and other combined approaches of Bcl-2 inhibitors and anticancer agents are now underway at Johns Hopkins. Hann also is studying cancer stem cells, an extremely small but lethal population of cells within tumors. Such populations have already been identified in several solid tumors, including breast and prostate cancers, and are thought to play a role in therapy resistance and
tumor recurrence. Hann and team are using the Bcl-2 inhibitor in preclinical studies to try to uncover lung cancer stem cells. They hope that the inhibitors, which successfully kill the bulk of the tumor, will help them reveal and define the rare treatment-resistant cancer stem
cells hiding within lung cancers.
NEW CANCER THERAPIES
Clinical trials are the mechanism by which research institutions like Johns Hopkins move promising new therapies from the laboratory to the bedside and confirm their safety and effectiveness. Recent studies of NCI-sponsored trials indicate that more than half of children diagnosed with cancer participate in clinical trials, regardless of race, ethnicity, or
socioeconomic status. By contrast, only two to three percent of adults with cancer enter clinical trials, and minorities and low-income patients are often underrepresented.
Improving Participation in Oncology Research Trials (IMPORT) is a pilot study led by MOLLIE HOWERTON, PH.D. , aimed at pinpointing specific factors that keep patients from participating in clinical trials. The research team will interview 102 patients, half of them African-American and half Caucasian, to better understand how patients make
decisions about clinical trials. The research team will explore awareness of trials, geographic proximity to trial sites, income and insurance status, social and cultural dynamics, and other factors to better determine what patients know about clinical trials and barriers that hinder participation.
UNCOVERING “SICK” COMMUNITIES
Evidence has long supported that many cancers originate because of where we are, not who we are. It is true that cancer is a genetic disease, but investigators are now asking where those bad genes come from. While it is clear that many of them come from behaviors such as cigarette smoking and poor and unbalanced diets, others are likely related to things outside of our direct control. There is evidence that people who live in communities close to highways and other high-traffic areas are exposed to airborne toxins that contribute to cancer and respiratory diseases. Investigators led by NORMA
KANAREK, PH.D. , studied Maryland communities in an effort to reveal environmental
factors, such as air quality, that contribute to cancer development. They believe well-being may be synonymous with positive demographics that have been traditionally associated with better health, including higher education, income, white race, and home or car
ownership are some of these factors, and they can be associated with individuals
CANCER AND DIET
A CRF Research Matters collaborative grant between Maureen Black of the University
of Maryland and ANN KLASSEN, PH.D. , of Johns Hopkins was used to study the impact of obesity on cancer. Experts report that 20 percent to 50 percent of fatal cancers are attributable to poor diet. Black and Klassen established a lifespan approach to reducing cancerrelated dietary risk in low-income families. They used information, including 24-hour diet records and food frequencies, from 1,300 infants, children, adolescents, and adults to identify determinants of diet and behavior associated with cancer risk. The researchers looked for risk factors for being overweight and rapid weight gain and ways to reduce these risks. The data was used to obtain additional grants for intervention studies.
CRF INVESTIGATORS RECEIVING HONORS AND AWARDS
The American Society of Clinical Oncology (ASCO) announced Kimmel Cancer Center
Director MARTIN D. ABELOFF, M.D. as the 2007 recipient of its Distinguished
Service Award for Scientific Achievement. Abeloff was recognized for his work in translational breast cancer research over many decades and for his leadership as director of what past ASCO president Larry Norton, M.D., called “one of the strongest cancer centers anywhere in the world.”
VICTOR VELCULESCU, M.D. , P H . D. won the Judson Daland Prize of the
American Philosophical Society, awarded for outstanding work in patient-oriented