Cancer Research at UNC: Lineberger CCC Update

LISA A. CAREY, MDJacobs Preyer Distinguished Professor for Breast Cancer ResearchAssociate Director, Clinical Sciences Lineberger Comprehensive Cancer Center

UNC Lineberger:NC’S PUBLIC COMPREHENSIVE CANCER CENTER.

AREAS OF FOCUS

Basic Research

Population Sciences Research

Clinical and Translational Research

Dissemination and outreach in NC

Economic Development

Clinical Excellence

NC Cancer Hospital

UNC Lineberger History

NCI Designation; Joe Pagano, PhD

First Director

Norman E Sharpless, MD Third Director

University Cancer Research Fund Starts

H. Shelton Earp III, MD Second Director

Marsico Hall

“Comprehensive” Designation

1974 2009 2014200819951990

LCCC: Who We Are And How We Do It

2010 2014

LCCC Members 295 300

LCCC space (square feet) 100K 153K

NCI Funding $64m $71m

All Cancer Funcing $220m $210m

Cancer Patients on Trials Testing Interventions 1,079 1,731

20062007

20082009

20102011

20122013

2014 $40

$45

$50

$55

$60

$65

UNC

Top 30 Average

Ann

ual N

CI fu

ndin

g (in

$M

)Growth in NCI Funding

2014 NCI FUNDING:Stanford $55MMichigan $54MWash U $42MDuke $34M

UNC $58M(6th among matrix cancer centers)

http://report.nih.gov/award/index

NC Cancer Hospital UNC Lineberger

Marsico Hall

Gillings School of Global Public Health

Eshelman School of Pharmacy

Dental School

School of Nursing

One of the Reasons UNC is Great

RESEARCH PROGRAMS

Cancer in North Carolina

Cancer Deaths/100K Key AA-White Mortality DisparitiesLung (53.2) Prostate (2.8-fold)Prostate (23.4) Endometrial (2.3-fold)Breast (22.4) Myeloma (2.2-fold)Colon (14.8) Head &Neck (2.0-fold)Pancreas (10.5) Cervix (1.9-fold)

Colon (1.5-fold)Breast (1.4-fold)

Population: 9.9M Annual Cancer Cases: 52,550Annual Cancer Deaths: 19,300 22% African American, 9% Hispanic

UNC LCCC Disparities Research

Prostate – North Carolina-Louisiana Prostate Cancer Project

Endometrial – minority obesity interventions/metformin trial

Multiple Myeloma –North Carolina Multiple Myeloma Network

Head and Neck – Carolina Head and Neck Cancer Study

Cervical – HPV vaccine and screening interventions

Colorectal – Colonoscopy interventions in African-American and Hispanic populations

Breast – Carolina Breast Cancer Study

Lung – Intervention to increase early detection and lung cancer surgery in African American populations

Bladder – Investigating sub-types in African American populations

Understanding Cancer in NC: ICISSCombines Tumor Registry: 100% - 320,000 cases (2005-2013)

With Health Care Claims: Medicare, Medicaid, private payers, State Employees• = 80% of NC cancers (~255,000 cases)• Involves 4 UNC schools, 16 departments, 4 programs

STEPHANIE WHEELER

(SPH)

ETHAN BASCH

(Heme/Onc)

RON CHEN

(Radiation Onc)

ANNE-MARIE MEYER(SPH)

Powerful tool: Understanding how patients are being treated

in NC & how well they do

•Large population-based study of breast cancer•Combined classical and molecular epidemiology.•CBCS1 (1993-1996); CBCS2 (1996-2001). •CBCS1/2: >100 Publications•CBCS3 2008-2013, followup x 10y

ANDY OLSHAN(Chair, UNC Epi)

Carolina Breast Cancer Study (CBCS)

741756752

753

Black (age 20-49)Black (age 50-74)Non-Black (age 20-49)Non-Black (age 50-74)

Enrollment by Race

Identified Black/White disparities in:• Type of breast cancer• Access and adherence to drugs• Survival

NEIL HAYES

28 tumor types10,000 samples

>100 trillion bases

LCCC 1108 –UNCseqOver 1,700 patients consented

CHUCK PEROU,

KATIE HOADLEY

https://www.youtube.com/watch?v=Y9HumO20GKc

Cancer Genetics: National Leadership

--Hoadley, Cell, 2014

LCCC Sequencing Trials

DNA RNA

Pros

pecti

veRe

tros

pecti

ve

TCGA (10,000 tumors)

UNCseq (1,700 patients to date, tumor and germline)

Integrated Translational Science Center (tumor)

UNCseq

NCGenes (germline)

National Cooperative Group trialsInvestigator-initiated studies

Investigator-initiated studies

“Window” drug trials in melanoma, breast cancer, lymphoma

CBCS3 (3,000 tumors)

CBCS3 (3,000 germlines)

Integrated Translational Science Center

Integrated Translational Science Center (tumor)

Integrated Translational Science Center

Novel Tech: Carbon Nanotube X-rays

DEPT. OF PHYSICS AND ASTRONOMY WORKINGWITH CLINICAL RADIOLOGY

SMALLER, COOLER X-RAY SOURCES

CLINICAL APPLICATIONS• Chest, breast, dental radiography• Hi-energy sources for radiation oncology

OTTO ZHOU RAY LEE

Novel Tech: Kinome Profiling

Identifying ways that cancer cells RESIST targeted therapy

LISA CAREYMD

GARY JOHNSONPhD

STERGIOS MOSCHOSMD

Trials ongoing in melanoma, lung, pancreas, lymphoma and breast cancer

COLLABORATIVE CROSS

Mouse Avatars: Studying Cancer and DrugsMOUSE PHASE I UNIT• 50+ partners in academia and industry • 40+ publications (e.g. Cell, Nature, Cancer Cell, Cancer Disco.) • 32 funded grant proposals: $25M• 5,000 cages for serial housing• Small animal imaging (PET/CT, Optical, MRI, U/S) • Pharmacokinetics and Pharmacodynamic Monitoring

• Genetically engineered mice• 80+ publications since 2011 Sharpless et al., Cell 2013

NEW NCI FUNDING: U54, NCI supplement (7), R21 (2)

BLOSSOM DAMANIA DIRK DITTMER

MALAWI / ZAMBIA PARTNERSHIPTATA MEMORIAL, MUMBAI

SAO PAULO CANCER CENTER

Global Oncology

YURI FEDORIW GROESBECK PARHAM

SATISH GOPAL JENNIFER SMITH

MALAWI CANCER PROGRAM

Patient-Reported Outcomes

Methodological leadership of major initiatives at NCI, FDA, PCORI, industry (including development of NCI’s PRO-CTCAE)

NEW DEVELOPMENTAL PRO SHARED FACILITY (“PRO-CORE”)Hired software developer Two psychometricians

INVOLVES MULTIPLE INVESTIGATORS ACROSS CLINICAL AND PREVENTION PROGRAMS AT LCCC

BRYCE REEVE ETHAN BASCH

Communication on Tobacco Product Risk and FDA Authority

Kurt M. Ribisl, PhD

Communicating risk to different communities and with different

products. Inform FDA regulation.

Tobacco Centers of Regulatory Science Awards

Impact of Tobacco Exposure on Lung’s Innate Defense System

Robert Tarran, PhD

All forms of tobacco exposure

CENTER FOR INTEGRATIVE CHEMICAL BIOLOGY AND DRUG DISCOVERY (CICBDD)

Cancer drugs in development

Scientific focus for future drugs

Expansion in 2016

STEPHEN FRYE CICBDD DIRECTOR

Discovering Cancer Drugs

New Immunotherapy Program>$20M Investment

Manufacturing Facility:• Opening 2016• 6 T-cell expansion rooms and viral

production

New Faculty:• Barbara Savoldo and Gianpietro Dotti,

national leaders, recruited from Baylor.• New facility director from St Jude

FIRST TRIAL TO START AT UNC IN 2016!

Entrepreneurship

SUMMARY• Cancer research at UNC is huge and successful

• Centered at LCCC, one of the nation’s oldest and largest cancer centers

• Excellence in public health research, clinical translation, genetics, drug discovery, “big data” analytics and mouse models.

• Emerging programs in immunotherapy and novel imaging.

Questions?