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Making Bone Marrow Transplants Available to All: Science Conquers One Disparity

About half of patients who need bone marrow transplants have matches, and African-American and other minority ethnicities suffer disproportionately, having the most difficult time finding matching donors. If they do not have a match within their families, they have less than a 10 percent chance of finding one through large, unrelated donor registries. Building upon decades of bone marrow transplant laboratory science and clinical experience our experts figured out that using the drug cyclophosphamide after bone marrow transplant calms the immune system, allowing family members who are just a 50 percent match to the patient to donate bone marrow. Our experts call this type of transplant haploidentical—or half-matched—and it makes it possible for healthy parents, siblings, children of patients and sometimes even aunts, uncles, nieces, nephews, grandparents, and grandchildren to be donors. Kimmel Cancer Center scientists say this groundbreaking work has made it possible for almost every patient who needs a transplant to receive one.

Prostate Cancer Hits African-American Men Younger and Harder

African-American men, particularly those with a family history of prostate cancer, are well known to have a higher risk for the disease themselves, develop it at an earlier age and have a more aggressive form of the disease. Recent Johns Hopkins-led research found that African-American men who have surgery have a higher likelihood of needing additional treatment after surgery. African-American men also have lower levels of the screening marker prostate-specific antigen (PSA), and often have more aggressive and advanced prostate cancers than the PSA test indicates. They also found that African-American men tend to develop anterior tumors at the top of the prostate, and area that's more difficult to sample with a standard biopsy. For that reason, all high-risk and African-American patients at Johns Hopkins get a biopsy guided by MRI.

Targeting Triple Negative Breast Cancers

African-American women suffer disproportionately from a type of breast cancer, known as triple-negative breast cancer. It is so named because they are negative for, or lack, estrogen and progesterone receptors and the HER2 protein — all of which are implicated in other types of breast cancer. Without hormonal or HER2 receptors to target, patients with aggressive triple-negative breast cancers are not likely to respond to drugs that target those molecules. Combinations of chemotherapy drugs are the current standard treatments, but about one-quarter of patients with triple-negative breast cancers will not respond to them. Kimmel Cancer Center scientists are exploring new treatments for these cancers, including immune therapy aimed at helping the body's immune system fight cancer and epigenetic treatments that help prime cancers to respond better to anticancer drugs.

The Diabetes and Obesity Link to Cancer

African-Americans have a higher prevalence of diabetes, and Kimmel Cancer Center researchers are exploring a link between diabetes management and racial differences in cancer survival rates. Researchers are scouring a large federal database and data collected at the Kimmel Cancer Center to quantify the long-term risk of pre-existing diabetes and racial disparities in colon, breast and uterine cancer survival. They are also looking at potential links to increases in treatment-related side effects, such as infection. Our experts also are studying whether the diabetes drug metformin, compared with self-directed or counselor-supported weight loss programs, can increase cancer survival in African-American cancer patients who also have diabetes. Another avenue of research focuses on how weight gain in breast cancer patients may increase the risk of disease recurrence.   
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