Americans of African descent are at a significantly higher risk for developing and dying from Gastrointestinal (GI) cancers, which include colorectal and pancreatic cancers, compared to individuals who are of Caucasian descent. Because of this health disparity, researchers from Stony Brook University, SUNY Downstate, and the National Cancer Institute (NCI)-designated Cold Spring Harbor Laboratory (CSHL), is teaming up to launch a program to assess GI cancer biology in patients.
The initiative, supported by a four-year NCI grant totaling nearly $1.2 million, and initial funding from a SUNY Health Network of Excellence grant, will evaluate the biological and genetic differences of GI cancers in race and ethnicity. The goal of the research is to link the biological findings to differences in GI cancer incidence and outcomes observed in racial and ethnic minorities.
According to the American Cancer Society, colorectal cancer remains the second most common cause of cancer death in the United States, and it strikes African Americans more than any other racial group. African Americans with colorectal cancer are also approximately 40 percent more likely to die from colorectal cancer compared to individuals from other racial groups who have the disease. Additionally, African Americans have the highest incidence of pancreatic cancer of all racial groups. According to the Pancreatic Cancer Action Network, that rate is 31 percent to 65 percent higher than other racial groups.
"Collaborative research efforts to discover why there are disparities in cancer incidence and outcomes in race and ethnicity are essential to improve targeted treatments against life-threatening diseases such as colorectal and pancreatic cancer," said Kenneth Kaushansky, MD, Senior Vice President, Health Sciences, and Dean of the School of Medicine. "We believe this partnership and approach to evaluating racial difference in cancer biology can potentially serve as a model to investigating a number of forms of cancer and other diseases."
"A major barrier to investigators studying cancer disparities is lack of access to clinical samples from health disparities populations," said Ellen Li, MD, PhD, Professor of Medicine, Chief of the Division of Gastroenterology and Hepatology, and Professor of Microbiology and Molecular Genetics at Stony Brook University School of Medicine, and the Lead Investigator of the study. "With our institutional partnership, we will break this barrier by attaining tissue samples from relevant patient populations from both Stony Brook and Downstate, as well as use the broad molecular and cancer biology testing capabilities at Stony Brook and genetic testing at Cold Spring Harbor Laboratory to advance the exciting research conducted by collaborative teams of investigators," explained Dr. Li.
A key step to increasing community participation in the study among racial and ethnic minorities will be to use the educational resources and expertise at the SUNY Downstate Brooklyn Health Disparities Center, led by Dr. Moro Salifu. This will help to generate the large tissue samples needed for the research.
To store and begin analysis of the GI cancer tissue samples, the research team will develop a SUNY Downstate GI BioBank, led by Dr. Laura Martello-Rooney, which will operate in parallel to the Stony Brook GI Biobank, led by Dr. Ellen Li. In addition, Dr. Joel Saltz, Professor and Chair of the Department of Bioinformatics, is developing an integrative biomedical informatics platform that will link the data generated from tissue specimens with longitudinal clinical information to develop a full set of GI cancer biology data.
The collection and analyses of the bio specimens will be driven by two pilot research projects.
One project will be an integrative comparison of gene regulation in African American and Caucasian American colon cancer tissue, led by Dr. Jennie Williams, Associate Professor in the Department of Family, Population and Preventive Medicine at Stony Brook, in collaboration with Dr. W. Richard McCombie at CSHL. They are investigating genetic markers to pinpoint which individuals will develop colon cancer and, if so, will these individuals respond to conventional and novel chemotherapeutic treatments.
"Our approach is being implemented to better understand and reduce the unequal burdens of cancer in our society," explained Dr. Williams, whose research has already led to identification of miRNAs that are disproportionately expressed among African, Caucasian and Hispanic Americans with colon cancer. She has also demonstrated a differential DNA methylation profile (gene regulation) between African and Caucasian Americans with colon cancer. These findings are key steps to discovering better individualized cancer treatments, thereby potentially reducing disproportionate rates in the incidence of and mortality from colon cancer in ethnic and racial groups.
The other project involves a Stony Brook / CSHL collaborative that creates pancreatic cancer organoids (tissue grown to be like organs) led by Dr. David Tuveson at CSHL, in collaboration with Dr. Gerardo MacKenzie, Assistant Professor in the Department of Family, Population and Preventive Medicine at Stony Brook. These organoids will be used to define changes in gene regulation in pancreatic cancers and serve as a models for testing new chemotherapeutic agents targeted against pancreatic cancer.
Dr. Li emphasized that in addition to the collaborative research effort, the NCI grant also supports the building of a partnership to promote recruitment of students and investigators from cancer health disparity populations to train them in translational research and emerging technologies. The partnership is led by Dr. Patricia Thompson-Carino, Professor of Pathology and Associate Director for Basic Research at Stony Brook University Cancer Center.
"We are committed to improving the participation of underrepresented minorities in biomedical research and in increasing awareness of health disparities among established cancer researchers," said Dr. Li.
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