Translational Science in Cancer Health Disparities Research Peter Ujhazy, M.D., Ph.D. Program...
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Transcript of Translational Science in Cancer Health Disparities Research Peter Ujhazy, M.D., Ph.D. Program...
Translational Science in Cancer Health Disparities Research
Peter Ujhazy, M.D., Ph.D. Program Director
Translational Research ProgramDivision of Cancer Treatment and Diagnosis
National Cancer InstituteE-mail:[email protected] http://trp.cancer.gov/
2014 Professional Development Workshop June 23-24, 2014
Natcher Conference CenterNIH Bethesda, MD
Continuum of Biomedical Research
Translational research means different things to different people, but it seems important to almost everyone.
The Meaning of Translational Research and Why It MattersSteven H. Woolf, MD, MPH JAMA. 2008;299(2):211-213.
Continuum of Biomedical Research
Translational research means different things to different people, but it seems important to almost everyone.
The Meaning of Translational Research and Why It MattersSteven H. Woolf, MD, MPH JAMA. 2008;299(2):211-213.
Institute of Medicine’s Clinical Research Roundtable; Woolf, 2008; Kon, 2008
T1 = The transfer of new understandings of disease mechanisms gained in the laboratory into the development of new methods for diagnosis, therapy, and prevention and their first testing in humansT2 = The translation of results from clinical studies into everyday clinical practice and health decision makingT3 = The task of discovering ways to move these findings into the daily care of patient(s) T4 = The challenge of moving scientific knowledge into the public sector and thereby changing people’s everyday lives
Institute of Medicine’s Clinical Research Roundtable; Woolf, 2008; Kon, 2008
Definitions
T1 = The transfer of new understandings of disease mechanisms gained in the laboratory into the development of new methods for diagnosis, therapy, and prevention and their first testing in humansT2 = The translation of results from clinical studies into everyday clinical practice and health decision makingT3 = The task of discovering ways to move these findings into the daily care of patient(s) T4 = The challenge of moving scientific knowledge into the public sector and thereby changing people’s everyday lives
Institute of Medicine’s Clinical Research Roundtable; Woolf, 2008; Kon, 2008
Definitions
NCI Director’s Update
Translational Research Program (TRP)Division of Cancer Treatment and Diagnosis (DCTD)
National Cancer Institute (NCI)National Institutes of Health (NIH)
9609 Medical Center Drive, Room 3W110, MSC 9726 Rockville, MD 20850-9726
Tel: 240-276-5730; Fax: 240-276-7881
Specialized Programs of Research Excellence (SPORE)
SPORE Web-site: http://trp.cancer.gov
Translational Research in the SPORE Program
Translational research uses knowledge of human biology to develop and test
the feasibility of cancer-relevant interventions* in humans AND/OR determines the biological basis for
observations made in individuals with cancer or in populations at risk for
cancer
* The term “interventions” is used in its broadest sense to include molecular assays, imaging techniques, drugs, biological agents, and/or
other methodologies applicable to the prevention, early detection, diagnosis, prognosis, and/or treatment of cancer.
SPORE RequirementsP50 Specialized Center Grant
Minimum of four research projects including the “required project”
All projects must be translational
Administrative Core
Scientific Collaboration (SC)
Shared Resources Cores: Biospecimen/pathology: required
Stats, clinical, animal, etc.: optional
Developmental Research Program (DRP)
Career Development Program (CDP)
External Advisory Board Members
Commitment to attend and participate in NCI sponsored meetings/workshops
Minimum Time Commitment: SPORE director(s): > 2.4 calendar
months
Project co-leader: > 0.6 calendar months
Core director: > 0.6 calendar months
DRP/CDP director: > 0.3 calendar months
Special Report Temporal Trends in Demographics and Overall Survival of Non–Small-Cell Lung Cancer Patients at Moffitt Cancer Center From 1986 to 2008
Matthew B. Schabath, PhD, Zachary J.Thom pson, PhD , and Jhanelle E . Gray, M D
January 2014, Vol. 21, No. 1
EPIDEMIOLOGY AND P R E V E N T IO N
Epidemiology of H ead and Neck Squam ous Cell C ancer Among H IV-In fected Patients
Gypsyamber D ’S o u z a , PhD,* Thomas E. Carey, PhD,† W ill ia m N. William, Jr., M D ,‡
Minh Ly Nguyen, MD,§ Eric C. Ko, MD, PhD,k James Riddell, IV, MD,¶ Sara I. Pai, MD, P h D ,# Vishal Gupta, MD,k Heather M. Walline, MS,** J. Jack Lee, PhD,†† Gregory T. W o lf , M D ,†
Dong M. Shin, MD,§§ Jennifer R. Grandis, MD,kk and Robert L. Ferris, MD, PhDkk on behalf of th e HNC SPORE HIV supplement co n s o rtiu m
J Acquir Immune Defic Syndr
Volume 65, Number 5, April 15, 2014
Special Report Temporal Trends in Demographics and Overall Survival of Non–Small-Cell Lung Cancer Patients at Moffitt Cancer Center From 1986 to 2008
Matthew B. Schabath, PhD, Zachary J.Thom pson, PhD , and Jhanelle E . Gray, M D
January 2014, Vol. 21, No. 1
Overall survival of non–small-cell lung cancer patients by time period (Moffitt)
Su
rviv
al P
rob
abili
ty
0.0
0.2
0.4
0.6
0.8
1.0
Log Rank P value < .001
1986 to 1988 (N = 207) 1991 to 1993 (N = 379) 1996 to 1998 (N = 791) 2001 to 2003 (N = 1,66 8) 2006 to 2008 (N = 1,80 6)
0 1 2 3 4 5
Years Schabath et al, 2014
Overall survival of NSCLC patients by time period and stage (Moffitt)
Su
rviv
al P
rob
abili
ty
Su
rviv
al P
rob
abili
ty
Su
rviv
al P
rob
abili
ty
0.0
0
.2
0.4
0
.6
0.8
1
.0
0.0
0
.2
0.4
0
.6
0.8
1
.0
0.0
0
.2
0.4
0
.6
0.8
1
.0
Log Rank P value < .001
1986 to 1988 (N = 56) 1991 to 1993 (N = 119) 1996 to 1998 (N = 279) 2001 to 2003 (N = 580) 2006 to 2008 (N = 667)
0 1 2 3 4 5
A Years
Log Rank P value < .001
1986 to 1988 (N = 77) 1991 to 1993 (N = 136) 1996 to 1998 (N = 268) 2001 to 2003 (N = 449) 2006 to 2008 (N = 446)
0 1 2 3 4 5
B Years
Log Rank P value < .001
1986 to 1988 (N = 61) 1991 to 1993 (N = 100) 1996 to 1998 (N = 210) 2001 to 2003 (N = 495) 2006 to 2008 (N = 521)
0 1 2 3 4 5
C Years
Stage I-II
Stage III
Stage IV
Schabath et al, 2014
Multivariable Cox Proportional Hazard Models for 5 Time Periods
1986 to 1988 1991 to 1993 1996 to 1998 2001 to 2003 2006 to 2008mHR (95% CI) mHR (95% CI) mHR (95% CI) mHR (95% CI) mHR (95% CI)
SexFemale 1.00 (referent) 1.00 (referent) 1.00 (referent) 1.00 (referent) 1.00 (referent)Male 1.21 (0.84–1.73) 1.58 (1.23– 2.03) 1.42 (1.19–1.68) 1.39 (1.23–1.58) 1.24 (1.09–1.41)RaceWhite 1.00 (referent) 1.00 (referent) 1.00 (referent) 1.00 (referent) 1.00 (referent)Black 2.92 (0.85–9.97) 2.41 (1.20–4.88) 0.60 (0.29–1.24) 1.21 (0.83–1.76) 1.52 (1.14–2.02)Other or unknown N/A 2.87 (0.67–12.31) 1.51 (0.69–3.28) 1.87 (0.99–3.53) 0.76 (0.48–1.19)EthnicityNon-Spanish 1.00 (referent) 1.00 (referent) 1.00 (referent) 1.00 (referent) 1.00 (referent)Spanish 0.33 (.07–1.56) 1.58 (0.48–5.17) 0.84 (0.45–1.59) 0.90 (0.64–1.25) 1.19 (0.86–1.65)Unknown N/A N/A 0.88 (0.12–6.56) 1.41 (0.58–3.43) 2.14 (1.14–4.04
Schabath et al, 2014
EPIDEMIOLOGY AND P R E V E N T IO N
Epidemiology of H ead and Neck Squam ous Cell C ancer Among H IV -In fected Patients
Gypsyamber D ’S o u z a , PhD,* Thomas E. Carey, PhD,† W ill ia m N. William, Jr., M D ,‡
Minh Ly Nguyen, MD,§ Eric C. Ko, MD, PhD,k James Riddell, IV, MD,¶ Sara I. Pai, MD, P h D ,# Vishal Gupta, MD,k Heather M. Walline, MS,** J. Jack Lee, PhD,†† Gregory T. W o lf , M D ,†
Dong M. Shin, MD,§§ Jennifer R. Grandis, MD,kk and Robert L. Ferris, MD, PhDkk on behalf of th e HNC SPORE HIV supplement co n s o rtiu m
J Acquir Immune Defic Syndr
Volume 65, Number 5, April 15, 2014
Survival among the subset of 86 HIV-infected HNC cases with survival data, CD4 at diagnosis, HPV composite status, tumor site,
and cancer stage
D’Souza et al, 2014
Comparison of HIV-HNC with US-HNC general population
D’Souza et al, 2014
D’Souza et al, 2014
Patients HIV-HNC US-HNC
Male 91% 68%
Median Age 50 years 62 years
Nonwhite 49% 18%
Current smokers 61% 18%
Median survival 63 months 61 months
Comparison of HIV-HNC with US-HNC general population
EPIDEMIOLOGY AND P R E V E N T IO N
Epidemiology of H ead and Neck Squam ous Cell C ancer Among H IV -In fected Patients
Gypsyamber D ’S o u z a , PhD,* Thomas E. Carey, PhD,† W ill ia m N. William, Jr., M D ,‡
Minh Ly Nguyen, MD,§ Eric C. Ko, MD, PhD,k James Riddell, IV, MD,¶ Sara I. Pai, MD, P h D ,# Vishal Gupta, MD,k Heather M. Walline, MS,** J. Jack Lee, PhD,†† Gregory T. W o lf , M D ,†
Dong M. Shin, MD,§§ Jennifer R. Grandis, MD,kk and Robert L. Ferris, MD, PhDkk on behalf of th e HNC SPORE HIV supplement co n s o rtiu m
J Acquir Immune Defic Syndr
Volume 65, Number 5, April 15, 2014
Conclusion: Risk factors for the development of HNC in patients with HIV infection are similar to the general population, including both HPV-related and tobacco/alcohol-related HNC.