Pathways TO DISCOVERY
AT T H E FO R E F R O NT O F C A N CE R CARE AND DIS COVE RY
Cancer’s Impact on the Community A Two-Way Conversation with Our Neighbors
FEATURE STORIES 1 REACH AND ENGAGE: IMPACTING CANCER CARE IN OUR COMMUNITY 5 CLOSING THE GAP IN BREAST CANCER DEATHS AMONG AFRICAN-AMERICAN WOMEN 8 M OBILE UNITS MAKE IT EASIER FOR THE COMMUNITY TO PARTICIPATE IN RESEARCH 11 CANCER HEALTH EQUITY IN ACTION SUMMER 2019
Pathways TO DISCOVERY
AT THE FOREFRONT OF CANCER CARE AND DISCOVERY
Summer 2019 E X E C U T I V E E D I TO R
Jane Kollmer SENIOR SCIENCE WRITER
Kathleen Goss, PhD E D I TO R I A L A DV I S O R S
Michelle Le Beau, PhD Marcy List, PhD DESIGN
Pivot Design, Inc. PRINTING
G Thomas Partners LLC
Pathways to Discovery is a publication of the University of Chicago Medicine Comprehensive Cancer Center. T H E U N I V E R S I T Y O F C H I C AG O M E D I C I N E CO M P R E H E N S I V E C A N C E R C E N T E R 5 8 41 S . M A RY L A N D AV E . MC1140, H212 C H I C AG O , I L 6 0 6 3 7 P H O N E 1 -7 7 3 -70 2- 6 1 8 0 FA X 1 -7 7 3 -70 2- 9 3 1 1 F E E D B AC K@ B S D . U C H I C AG O . E D U
Š 2019 The University of Chicago Medicine Comprehensive Cancer Center. All rights reserved.
From the Director As a National Cancer Institute-designated Comprehensive Cancer Center, we have a unique opportunity to help reduce cancer’s impact in our very own community. In Chicago especially, a city comprising 2.7 million people from diverse racial and ethnic groups, the rates of cancer incidence and mortality are alarmingly higher than in many other parts of the country. At UChicago Medicine, we are doing our part to understand why cancer affects different groups of people disproportionately and apply that knowledge to develop and implement interventions. Maintaining a vibrant, two-way conversation with our South Side neighbors helps Comprehensive Cancer Center members better understand and meet patient needs. We collaborate closely with community, ethnic, and faith-based groups on programming that will increase access to care, reduce risk factors for cancer including behavior factors such as tobacco use, increase participation in cancer research, and improve the quality of life for cancer patients and survivors. This issue of Pathways is devoted to our community outreach and engagement efforts, including several large-scale efforts around cancer prevention and screening. In this issue, you will also find examples of our most recent research breakthroughs, new faculty, member honors, and other news and updates. As always, we thank you for your support!
Michelle M. Le Beau, PhD Director, The University of Chicago Medicine Comprehensive Cancer Center; Arthur and Marian Edelstein Professor of Medicine
R E AC H A N D E N G AG E :
IMPACTING CANCER CARE IN OUR
COMMUNITY BY JANE KOLLMER
Chicago is home to 2.7 million people from diverse racial and ethnic backgrounds. Some of these groups carry a heavier burden of cancer incidence and mortality than others. For example, rates of liver cancer are higher in people of Asian and Pacific Islander heritages, African Americans suffer from higher death rates from breast and prostate cancer, and Hispanic women have higher rates of cervical cancer. These inequities, known as disparities, are one of the biggest health problems faced by residents of the South Side of Chicago, where the University of Chicago Medicine Comprehensive Cancer Center is located.
Cancer disparities are caused by a combination of factors, including behavioral, biological, treatment, prevention, and economic issues. The Comprehensive Cancer Center recognizes the critical need to address cancer disparities in local neighborhoods and to reach out to these communities with information, research, and educational programs to promote health equity. “We want to send the message that cancer awareness, early detection, and prevention can lead to improved quality of life for all cancer patients, including in communities of color,” said Karen E. Kim, MD, professor of medicine, associate director for Community Outreach and Engagement, and director of the Comprehensive Cancer Center Office of Community Engagement and Cancer Health Equity (OCECHE). The OCECHE was initiated in 2010 to build partnerships with local organizations and bring advances in cancer research directly to the underserved neighborhoods that need them. Through this work, the OCECHE fulfills a vital role to enhance public awareness about: • Cancer prevention, early cancer detection and control; • The role of behavior, lifestyle and genetics in cancer; and • The importance of participation in cancer research and clinical trials.
12,000 WOMEN IN THE UNITED STATES ARE DIAGNOSED WITH CERVICAL CANCER EACH YEAR. “Finding new ways to detect cancer earlier and prevent it altogether is a large part of the Comprehensive Cancer Center’s mission to reduce cancer’s burden in Chicago’s highly socioeconomically diverse, urban community,” said Michelle M. Le Beau, PhD, Comprehensive Cancer Center director and Arthur and Marian Edelstein Professor of Medicine. “Our researchers and outreach team strive to promote cancer health equity among ethnic and social groups by implementing new cancer prevention and control research studies and improving screening rates.”
THE HPV EPIDEMIC’S LINK TO CANCER Certain strains of the human papillomavirus (HPV) are considered high-risk and linked to multiple cancer types, including cervical cancer, which affects 12,000 women in the United States annually. Over 4,000 women die from this preventable disease in a year. “Sadly, most women who develop cervical cancer are patients who have not had a Pap smear for many years, as they did not realize they were at
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risk or they lacked access to care,” said Nita Lee, MD, assistant professor of obstetrics/gynecology and faculty director of the OCECHE. “Appropriate follow-up after an abnormal Pap/HPV test is also critical to be able to find and treat early precancer and cancers quickly and easily.” The development of a HPV vaccine represents a monumental scientific accomplishment, yet the compliance rates with vaccination recommendations are still lower than the healthcare community would like. The Comprehensive Cancer Center joins all of the NCI Cancer Centers, the American Cancer Society, and many other organizations in making cancer prevention by HPV vaccination a national priority. The Comprehensive Cancer Center played an instrumental role in local and statewide conversations about HPV vaccine education and cancer prevention through the HPV Cancer-Free Illinois Roundtable Event in November 2018. The event brought together health professionals, patients, government officials, and advocates to discuss ways to eliminate HPV-related cancers and increase HPV vaccination rates. Researchers and clinicians at the Comprehensive Cancer Center are collaborating across disciplines of oncology, gynecology, surgery, and adult and pediatric primary care to both promote HPV vaccination and raise awareness about HPV-related cancers such as cervical cancer, oropharyngeal (throat) cancer, and anal cancers. With the rates of HPV-related cancers on the rise, Comprehensive Cancer Center researchers are also seeking out new ways to treat these diseases. For example, in HPV-associated head and neck cancers, Everett Vokes, MD, and colleagues are leading efforts to develop new approaches to reduce side effects while maintaining high cure rates. Widely regarded as international experts in developing new treatments for head and neck cancer, this team continues to set the standard of care.
LARGE, LONG-TERM POPULATION STUDY FOCUSES ON CANCER PREVENTION By preventing cancer, lowering risk, or diagnosing cancers early when they are more treatable, we can reduce cancer’s devastating impact on people’s
lives. However, pinpointing the causes of cancer is not an easy task. Population or cohort studies provide the unique opportunity for scientists to follow a large group of people over an extended period of time to see how the interaction of the environment, the health and behavior of specific populations, and the role of genetics, lead to some people getting diseases such as cancer. The National Cancer Institute (NCI) is launching a new precision medicine effort to study the causes of cancer, and the means of its prevention and early diagnosis. To achieve this ambitious goal, the NCI will gather data, including serial samples, biospecimens, and comprehensive medical record data, from one million patients. The University of Chicago has been awarded a contract from NCI for $24 million to enroll tens of thousands of individuals in the study over 10 years. “By including large numbers of University of Chicago Medicine patients, we hope that the effort will shed light on racial disparities and the causes of those cancers that are particularly burdensome for our
4K OVER 4,000 WOMEN DIE FROM CERVICAL CANCER IN A YEAR.
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“FINDING NEW WAYS TO DETECT CANCER EARLIER AND PREVENT IT ALTOGETHER IS A LARGE PART OF THE COMPREHENSIVE CANCER CENTER’S MISSION TO REDUCE CANCER’S BURDEN IN CHICAGO’S HIGHLY SOCIOECONOMICALLY DIVERSE, URBAN COMMUNITY.” Michelle M. Le Beau, PhD
communities,” says Brisa Aschebrook-Kilfoy, PhD, co-principal investigator and scientific director for the grant. This large research project integrates advances in data science, genomics, sensor and digital health technology, and other technological advances with the power of longitudinal epidemiologic designs to generate novel approaches to risk assessment, early diagnosis, and prevention of cancer. “We hope to contribute to national efforts that will inform cancer research in general but also assure that more precise approaches to cancer prevention and care will be available to the populations we serve,” says principal investigator Habibul Ahsan, MBBS, Louis Block Distinguished Service Professor of Public Health Sciences.
COLORECTAL CANCER PREVENTION Colorectal cancer screening detects disease early. It can also prevent many cancers by finding and removing precancerous polyps. The state of Illinois ranks in the lowest 25 percent of states for colorectal cancer screening in the United States and, consequently, has a high colorectal cancer incidence. Cook County, the most populous and diverse county in Illinois, has one of the highest colorectal cancer mortality rates in the state. It has significantly more African Americans, Hispanics and Asian Americans than any other county, and more people living close to the poverty level. University of Chicago cancer specialists will target underrepresented populations for preventive care through a program called Accelerating Colorectal
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Cancer Screening and Follow-up through Implementation Science (ACCSIS). ACCSIS will provide an evidence base for multilevel interventions that increase rates of colorectal cancer screening, follow-up, and referral-to-care. It will also establish best practices for how to scale up interventions to reduce colorectal cancer. Led by Karen Kim, MD, professor of medicine and director of the University of Chicago Medicine’s Center for Asian Health Equity (CAHE), and Blase Polite, MD, MPP, associate professor of medicine, the ACCSIS-Chicago team has been awarded nearly $6 million over five years to test novel ways to improve colorectal cancer screening and follow-up among groups that have not been screened. The grant is part of the NCI’s Beau Biden Cancer Moonshot Initiative to accelerate the pace of progress in the fight against cancer. “We are thrilled to have this opportunity to study the implementation of evidence-based interventions to increase colorectal cancer screening among vulnerable populations,” said Kim. “ACCSIS-Chicago has the potential to transform our understanding of the health system and community factors that enhance or impede colorectal cancer screening and follow-up.” CAHE will partner with four federally qualified health centers serving diverse and low-income populations. ACCSIS-Chicago has a unique opportunity to have a significant and sustainable impact on reducing disparities in colorectal cancer. It provides a mechanism for establishing the research infrastructure necessary to find the best ways to test and implement scientific approaches to cancer control.
Closing the Gap in Breast Cancer Deaths among AfricanAmerican Women BY JANE KOLLMER
Researchers at the University of Chicago Medicine Comprehensive Cancer Center are pursuing new ways to prevent, diagnose, and treat cancers among minority populations that carry the highest burden of cancer. A recently funded National Cancer Institute P20 planning grant will lay the groundwork for a disparities and health equity-focused Specialized Program of Research Excellence (SPORE) grant application in a few years.
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The planned UChicago Interdisciplinary Cancer Health Disparities SPORE will leverage the institution’s strengths in areas such as bioinformatics, genomics, and immunology, along with its location on the ethnically diverse South Side of Chicago, to make a major impact on cancer disparities. TAKING ON AGGRESSIVE BREAST CANCERS The P20 grant centers on new personalized interventions for African-American women who, of all racial and ethnic groups, are at the highest risk of dying from breast cancer. Although healthcare delivery patterns and access to care contribute to this disparity, research has revealed that differences in tumor biology and genomics account for a significant portion of the divide between breast cancer outcomes in white women of European ancestry and black women of African ancestry in the U.S. Therefore, innovative research focused on biological and genomic differences is needed.
“We are taking an integrated approach to translate recent scientific advances to the benefit of women who are at risk of dying from the most aggressive forms of breast cancer.” Olufunmilayo Olopade, MBBS
Under the leadership of breast cancer geneticist Olufunmilayo Olopade, MBBS, cancer epidemiologist Dezheng Huo, MD, PhD, and medical oncologist Rita Nanda, MD, the team will explore new ways to make chemotherapy more effective for patients with aggressive cancers and improve breast cancer screening for high-risk populations. To better understand how breast cancer progresses and responds to chemotherapy, researchers will study genetic features of tumors, how mutations in the tumor genome vary between women of European and African ancestries, and how these mutations influence breast cancer progression.
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The team will also collect stool samples from patients receiving chemotherapy before surgery to determine whether fecal microbial biomarkers can predict how patients will respond to treatment. The microbes in the gut are believed to influence the immune system’s response to invading pathogens, and recent scientific data suggest that these adjustments to the immune system may be related to response to immunotherapy and chemotherapy. IMPROVING BREAST CANCER SCREENING FOR PATIENTS AT HIGH RISK In a separate project, researchers will develop a risk score based on the genes known to be associated with breast cancer. The scoring system can help categorize women by genetic risk and enable caregivers to use that information in the clinic to personalize culturally tailored, risk-appropriate interventions, such as screening by magnetic resonance imaging (MRI) to detect cancers earlier, when treatment is more effective. The imaging group, led by Gregory Karczmar, PhD, professor of radiology, and Deepa Sheth, MD,
assistant professor of radiology, will test if newly developed MRI techniques—specifically, ultra-fast dynamic contrast-enhanced MRI combined with abbreviated MRI—can reduce scan times without compromising diagnostic accuracy. If proven successful, these enhancements may reduce costs and increase convenience, thereby eliminating some of the hurdles that underserved populations face. The researchers hope that implementation of inexpensive MRI methods will impact large numbers of women at risk of developing deadly forms of breast cancer at young ages in the U.S., and will also impact global cancer control efforts. “We are taking an integrated approach to translate recent scientific advances to the benefit of women who are at risk of dying from the most aggressive forms of breast cancer,” said Olopade, who is the Walter L. Palmer Distinguished Service Professor of Medicine and Human Genetics, associate dean for Global Health and director of the Center for Clinical Cancer Genetics. “Our results will change clinical practice by allowing us to individualize risk assessment, diagnosis, and treatment of breast cancer and improve overall outcomes for each patient.”
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Mobile Units
Make It Easier for the Community to Participate in Research
By Anastasia Beiriger
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You may have seen it rolling through your neighborhood: a large, colorful vehicle boldly proclaiming “The Future of Health Begins with You.” Inside, the vehicle looks remarkably similar to a doctor’s office, with a waiting area, exam rooms, and a small lab for processing samples.
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UChicago is taking a unique approach to engaging participants. Instead of recruiting solely from the hospital campus in Hyde Park, the IPPH is bringing All of Us directly to Chicago residents and UChicago patients in the neighborhoods where they live. Using funds from the consortium’s five-year, $51 million grant from NIH, the IPPH purchased a new mobile unit fully equipped for enrollment and data collection. In preparation for the launch of its first mobile unit, the IPPH initiated a year-long effort to develop relationships with community-based partners and ambassadors. These community ambassadors helped recruit participants to the study and bridge the digital divide for older residents who were less familiar with the iPad technology used in the All of Us consent and enrollment process. Brisa AschebrookKilfoy, PhD, a research associate professor in the Department of Public Health Sciences and co-investigator at IPPH, says that these community partners were crucial in helping the IPPH open a dialogue about population and precision health with the diverse neighborhoods in the area it serves. “Our hope is that together we can lay the groundwork for a new community-based research model that helps retain participants and ensures that communities historically underrepresented in biomedical research are represented in these newer programs,” she says. “We want what we learn, in everything from general health to cancer and cancer disparities, to be relevant to the population we serve.”
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This is the first of two mobile research units operated by the Institute for Population and Precision Health (IPPH) at UChicago. Their purpose is to enroll community participants in All of Us, a research program sponsored by the National Institutes of Health (NIH) that seeks to advance personalized healthcare. The goal of All of Us is to build a cohort of one million people who are willing to share information about their health, lifestyle, and genetics to drive future medical breakthroughs. Over time, the data generated by participants will allow researchers to gain insights into how diseases develop and what can be done to prevent them.
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The Institute for Population and Precision Health’s mobile units will be used to recruit and enroll participants in All of Us and COMPASS trials as well as others down the road. Gail Briggs (pictured) was the first participant enrolled on the mobile unit.
This is also true for COMPASS, or the ChicagO Multiethnic Prevention And Surveillance Study (COMPASS), which is being run concurrently by researchers at the University of Chicago Medicine Comprehensive Cancer Center. COMPASS is specifically designed to address disparities in disease incidence and mortality in Chicago, where there are higher rates of cancer and chronic diseases than in other parts of the United States. COMPASS has already identified important differences in the distribution of certain risk factors: the rate of cancer screenings, for example, varies widely at the community level in Chicago. Based on this finding, future research efforts at UChicago Medicine and the Comprehensive Cancer Center can be directed to better understand this specific problem and work toward interventions that increase screening rates and ultimately improve cancer prevention efforts. The IPPH mobile unit research program is recruiting for both All of Us and COMPASS, and eligible city residents are welcome to enroll in UCHICAGOMEDICINE.ORG/CANCER
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“We want what we learn, in everything from general health to cancer and cancer disparities, to be relevant to the population we serve.” Brisa Aschebrook-Kilfoy, PhD
ox ice Kn nd J an a ) t the t f u o le ( rd ab o Colar l w e e z h a ing t do r s H spread b as s a ole by r ity am y. t n it n u a n t m u C om omm impor lay an g the c p n ) o t h m (rig jects a ch pro PH resear IMAG
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programs. Anyone 18 or older can join All of Us, while COMPASS is recruiting participants over 35 years.
both studies simultaneously. Residents who sign up for either or both programs through the mobile units can expect their experience to be similar to a doctor’s visit. The vehicles are equipped with stations where participants use an iPad to complete surveys on their health history, plus two exam rooms where phlebotomists can draw blood and record participants’ height, weight, and blood pressure. Blood and urine samples are processed on the spot by research professionals in the onboard lab space. The All of Us consent process and health surveys typically take about an hour to complete but can be finished ahead of a visit to the mobile unit. The collection of biospecimens and biometric data onsite takes about 30 minutes, and participants are compensated for their time with $25–75, depending on whether they enroll in one or both of the research 10
PATHWAYS TO DISCOVERY SUMMER 2019
Although neither study provides medical treatment, participants will have access to some information about their health generated in the course of these research programs. However, Habibul Ahsan, MD, MMedSc, director and principal investigator at the IPPH, says that “eventually, we hope to offer medical care on the units as a service to the communities with which we partner.” Because both All of Us and COMPASS are designed as long-term studies, it will be many years before their full impact on precision healthcare is felt. In the meantime, Chicago residents can seek out the mobile units in their neighborhoods, knowing that they are helping build some of the most ambitious and diverse biomedical datasets to date. “By contributing to these datasets, participants are helping to improve the health of their own community and taking part in the advancement of scientific research,” says Ahsan. “We’re excited to bring these initiatives into the community, thereby making it easier and more convenient for Chicago residents to participate,” adds Aschebrook-Kilfoy. “Our hope is that the mobile units will help make sure that all the communities we serve have a seat at the table.”
CANCER HEALTH EQUITY IN ACTION BY JANE KOLLMER face a similar reality. Racial and ethnic minorities and low-income population groups experience higher death rates due to cancer. Reduced access to high-quality, culturally sensitive cancer care contributes to this increased mortality.
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he University of Chicago Medicine Comprehensive Cancer Center has a global presence, attracting cancer patients from around the world; however, our most important commitment is to the people of the Chicago metropolitan area and, particularly, the residents of surrounding neighborhoods.
Maintaining a continuous two-way conversation with our South Side neighbors helps Comprehensive Cancer Center members better understand and meet the community’s unique needs. When it comes to cancer, not all Chicagoans
In 2010, the Comprehensive Cancer Center formed the Office of Community Engagement and Cancer Health Equity (OCECHE) to address obstacles in cancer disparities through research, advocacy, education, and development of innovative programs. “We want to send the message that cancer awareness, early detection, and prevention can lead to improved quality of life for all cancer patients, including in communities of color,” said Karen E. Kim, MD, professor of medicine and associate director for Community Outreach and Engagement at the Comprehensive Cancer Center (see “Meet the Expert” on pg. 14). Under Kim’s leadership, the OCECHE provides cancer information and resources to predominantly
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STRONG PARTNERSHIPS ARE CRITICAL TO ENGAGING DIRECTLY WITH THE COMMUNITIES SO THAT ADVANCES IN CANCER CARE REACH THE UNDERSERVED NEIGHBORHOODS THAT NEED THEM. C
A Gina Curry, MPH, MBA, director of the Comprehensive Cancer Center Office of Community Engagement and Cancer Health Equity, helps a community member fill out a questionnaire. B A medical student works with a community member to better understand cancer risk and prevention among Asian Americans. C Members of the Latinx community learn about the importance of mammography for breast cancer screening. D OCECHE Education Outreach Specialist Alia Poulos, MA, Intern Vanessa Robateau, OCECHE Director Gina Curry, MPH, MBA, and Intern Mariam Usman. The interns are from Chicago State University and are learning about community health. ALL PHOTOS COURTESY OF OCECHE
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At a recent community health event for ChineseAmericans, OCECHE delivered a dual-language presentation on the importance of colorectal cancer screening and walked participants through the Fecal Immunochemical Test (FIT) kit process. These are but a few examples of community-based work. In addition, the OCECHE has formed strategic alliances with UChicago units and other healthcare organizations, as well as community, ethnic, and faith-based groups to create innovative programs that will increase access to care, reduce risk factors for cancer, reduce tobacco use, increase participation in cancer research, and improve the quality of life for cancer patients and survivors. “At the Comprehensive Cancer Center, we have the wonderful ability to disseminate scientific findings into the community to help tackle cancer disparities,” said Kim. “This is a great example of how science can make a big impact on health.” The impact of OCECHE on the community is expected to accelerate in the near-term, as the Comprehensive Cancer Center added two staff members. Gina Curry, MPH, MBA, the new director, will develop and oversee community-based education, outreach, and research programs, expand community partnerships, and serve as a liaison between Comprehensive Cancer Center investigators and community partners.
African-American, Asian-American, and Latinx communities, while at the same time learning about their cancer-related needs. Strong partnerships are critical to engaging directly with the communities so that advances in cancer care reach the underserved neighborhoods that need them. For example, tobacco use is higher among African Americans on Chicago’s South Side than in other areas of the country. The OCECHE recently partnered with a local youth program on an anti-smoking campaign to increase awareness about the negative impact tobacco has on health, specifically through its connection to cancer. Colorectal cancer, the second leading cause of cancer-related death among men and women, can be prevented or detected at an early stage through screening. Of all the population groups in Chicago, Asian Americans have the lowest screening rates.
Alia Poulos, MA, has joined the OCECHE as an education outreach specialist and will be responsible for developing and implementing community outreach programs. Additional team members include Faculty Director Nita K. Lee, MD, MPH, assistant professor of obstetrics and gynecology; and Helen Lam, PhD, RN, director of research and lead community health educator. Among ongoing initiatives, Curry and Poulos are developing plans to expand the OCECHE’s reach into Chicago’s Latinx community. Most recently, they started laying the foundation for a Latinx Community Task Force that will tackle issues raised by members of the Latinx community in South Chicago, including a lack of access to transportation and critical cancer resources. Visit www.uchicagomedicine.org/cancer to learn more. UCHICAGOMEDICINE.ORG/CANCER
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Research
Meet the Expert Karen E. Kim, MD PROFESSOR OF MEDICINE
Karen E. Kim, MD, professor of medicine, specializes in the prevention, screening, and early detection of colorectal cancer, hepatitis B, and women’s health issues—particularly functional bowel diseases. Kim’s research explores chemoprevention for colon cancer and screening methods for populations with average and high risk. Her research interests include underserved and minority populations, understanding health disparities, cultural competency, and cancer prevention. She is the Associate Director for Community Outreach and Engagement, director of the Center for Asian Health Equity, and the director of the Comprehensive Cancer Center Office of Community Engagement and Cancer Health Equity.
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Research
If you were not a physician or researcher, what would your profession be? Most of my current work lies at the interface of public health and medicine. If I had to choose another direction for my career, I would want to lead a department of public health. What is the most rewarding part of your job? The ability to create solutions to address health disparities. What do you hope to accomplish during your career? I would love to eliminate colorectal cancer disparities. If you had one piece of advice for someone considering your field, what would it be? Stay focused on the big picture and remember that there are multiple ways to meet the same goal. In what direction do you see cancer research in general, or your field specifically, going? I think we are definitely heading toward understanding the intersection of precision medicine and population health, and the natural interface is through implementation science and implementation research. How did you get interested in studying cancer and/ or treating cancer patients? When my mother was diagnosed and subsequently died from a preventable cancer, I knew that there had to be a better way to address the needs of vulnerable populations through advocacy, science, and policy. Who inspires you? All of the communities that do not have a voice. What is your favorite way to relax? Spending time with my kids. What was the last book you read? “Becoming” by Michelle Obama. What do you love about Chicago? What could you do without? The diversity. The weather. What is one thing on your bucket list? To see the Northern Lights.
Research Highlights New Treatment Options for Adolescents with Acute Lymphoblastic Leukemia Acute lymphoblastic leukemia (ALL) is a quickly-progressing cancer which affects white blood cell production in the bone marrow. While survival rates are high for pediatric patients of ALL, adult patients typically experience much poorer outcomes. However, recent retrospective studies focusing on survival outcomes in adolescent and young adult (AYA) patients found that they responded much better to pediatric treatment regimens than to adult treatment protocols. In response, Wendy Stock, MD, Anjuli Seth Nayak Professor in Leukemia, and Richard Larson, MD, professor of medicine, led a clinical trial with other cancer centers across the country to establish a new treatment standard for AYA patients. The team analyzed the response of 295 patients, ages 17–39, to a pediatric treatment regimen. This regimen was generally characterized by more intensive dosing of several chemotherapeutic agents. The approach was well tolerated by trial participants, with low treatment-related (3%) mortality. The median time without relapse was 78.1 months, more than double that of historical controls. Promisingly, overall survival was 73%, a substantial improvement from previously described 30–40% survival for adult ALL patients. Overall, this cooperative group trial establishes a new treatment standard for adolescent and young adult ALL patients. Stock et al., Blood 133:1548-9, 2019.
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Research
Research Highlights (continued) New RNA-Modifying Enzyme Impacts Tumor Progression
Study Reveals New Target of Metformin in Ovarian Cancer Though initially used as a diabetes drug, metformin has since been established as a promising anticancer drug, particularly for ovarian cancer patients. However, its mechanism of action has remained elusive to researchers. Ernst Lengyel, MD, PhD, Arthur L. and Lee G. Herbst Professor of Obstetrics and Gynecology, and Iris Romero, MD, associate professor of obstetrics and gynecology, led a team of researchers from UChicago, Duke University, and University of Wisconsin-Madison that identified a new target of metformin. Using patient samples, the team found that individuals undergoing ovarian cancer treatment with metformin had lower levels of serum sphingosine1-phosphate (S1P), a biologically active lipid known to promote cell growth, proliferation, and migration. The researchers examined the effects of metformin on various parts of the S1P synthesis pathway and found that metformin decreased SPHK1 expression in a dose-dependent manner in ovarian cancer cells. Meanwhile, SPHK1 overexpression in mouse models and in cells resulted in cancer-like phenotypes such as increased tumorigenesis, cell motility, and self-renewal. The researchers also found that ovarian cancer cells with high levels of SPHK1 were more highly sensitive to the cytotoxic effects of metformin. Taken together, their work identifies a mechanism of action for metformin in ovarian cancer and suggests that serum S1P may be a strong candidate biomarker for sensitivity to metformin. Hart et al., Mol Cancer Res 17:870-81, 2019.
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Chuan He, PhD, John T. Wilson Distinguished Service Professor of Chemistry, builds on his discovery of eukaryotic N6-methyladenosine (m6A) methylation in a new study describing ZCCHC4, a human methyltransferase. In collaboration with Tao Pan, PhD, professor of biochemistry and molecular biophysics, and an international, multicenter team, He’s group demonstrated that ZCCHC4 methylates 28S ribosomal RNA (rRNA), which is packaged together with protein to create the translation machinery of the cell. If the role of ZCCHC4 is similar to that of bacterial methyltransferases, the m6A addition may affect how different rRNAs fit together, much like modifying the edge of a puzzle piece. In turn, this could impact the stability and distribution of different ribosomal subunits. Importantly, ZCCHC4 is overexpressed in hepatocellular carcinoma, the most common kind of liver cancer. The authors found that knocking out ZCCHC4 in hepatocellular carcinoma cells reduced global translation and inhibited proliferation, and it also significantly reduced tumor size in xenograft mouse models. Further studies will be needed to understand whether m6A methylation impacts ribosomal selectivity for certain messenger RNAs and how this selectivity controls aspects of tumorigenesis. Ma et al., Nat Chem Biol 15:88-94, 2019
News
New Faculty For more information about our new faculty, visit https://www.uchicagomedicine.org/ find-a-physician.
21 ILLINOIS RAISES MINIMUM AGE TO BUY TOBACCO PRODUCTS
Simona Chivu, MD, clinical associate of medicine, is a hematologist/oncologist specializing in breast cancer, gastrointestinal malignancies, and lymphomas. Chivu sees patients at the University of Chicago Medicine Comprehensive Cancer Center at Silver Cross Hospital in New Lenox, Ill.
Xavier Keutgen, MD, assistant professor of surgery, is a surgical oncologist with particular expertise in treating neuroendocrine, thyroid, parathyroid, and adrenal tumors. Keutgen is the director of the University of Chicago Neuroendocrine Tumor (NET) Center and works closely with a multidisciplinary team that specializes in NETs.
Illinois’ Tobacco 21 law, which raises the minimum age to purchase tobacco products and e-cigarettes to 21, went into effect July 1, 2019. We are proud to have been a strong supporter and advocate for this life-saving legislation with our partners from the American Cancer Society Cancer Action Network, American Lung Association, American Heart Association, Respiratory Health Association, and other healthcare organizations.
ACS Patient Navigator Helps Connect Cancer Patients to Resources Erika Coronado is the new American Cancer Society Patient Navigator at the University of Chicago Medicine in the Center for Supportive Oncology, located on the sixth floor of the Duchossois Center for Advanced Medicine. She is available to assist cancer patients and their families in securing valuable resources, such as transportation, lodging, financial assistance, and community resources.
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News
UChicago Medicine Re-certified for High-Quality Cancer Care
FOOD PANTRY GIVES CANCER PATIENTS ACCESS TO HEALTHY FOODS
The University of Chicago Medicine has received re-certification by the QOPI® Certification Program LLC, a wholly owned subsidiary of the American Society of Clinical Oncology (ASCO). The QOPI® Certification Program (QCP) builds on ASCO’s Quality Oncology Practice Initiative (QOPI®), providing a three-year certification for outpatient hematology-oncology practices that meet nationally recognized standards for quality cancer care. Blase Polite, MD, MPP, associate professor of medicine, led the effort for re-certification.
Numerous studies demonstrate that food insecurity, or lack of access to healthy food options, can make recovering from health problems even more challenging. For some University of Chicago Medicine patients and families touched by cancer, this is a huge barrier. To help lessen this burden, patients in need—along with their families, guardians, and caregivers—can quietly help themselves to the products in the food pantry, located on the sixth floor of the Duchossois Center for Advanced Medicine. Since the establishment of the pantry, almost 3,631 individuals from 1,246 households have used the resource. That translates to 3.5 tons of groceries.
3.5T
Since the establishment of the pantry, almost 3,631 individuals from 1,246 households have used the resource. That translates to 3.5 tons of groceries.
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PATHWAYS TO DISCOVERY SUMMER 2019
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Faculty Awards and Honors
Chuan He, PhD, John T. Wilson Distinguished Service Professor of Chemistry, was the 2019 Recipient of the American Chemical Society Chemical Biology Lectureship Award.
Aytekin Oto, MD, MBA, professor of radiology and surgery, has been named Interim Chair of the Department of Radiology, effective February 1, 2019. Oto has been a Co-Leader of the Advanced Imaging Research Program since 2016.
S. Diane Yamada, MD, Joseph Bolivar DeLee Professor of Obstetrics and Gynecology, is the president-elect of the Society of Gynecologic Oncology.
Sonia S. Kupfer, MD, associate professor of medicine, has been awarded the Young Investigator Award in Clinical Science from the American Gastroenterological Association.
Michelle M. Le Beau, PhD, Arthur and Marian Edelstein Professor of Medicine and director of the University of Chicago Medicine Comprehensive Cancer Center, was elected to the American Cancer Society national board of directors.
RETHINK
Susan L. Cohn, MD, professor of pediatrics, received the American Association for Cancer Research (AACR)-Joseph H. Burchenal Memorial Award for Outstanding Achievement in Clinical Cancer Research.
READ NOW:
Rethink What’s Possible The 2018 Annual Report Visit www.uchicagomedicine.org/ CancerAR2018
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UCHICAGO FACULTY PRESENT CLINICAL RESEARCH AT ONCOLOGY’S BIGGEST GATHERING
Michelle M. Le Beau, PhD
ResearcHERS Supports Women in Cancer Research The pace of cancer discovery is more rapid than ever before, but government funding for cancer research is limited. Young women researchers are at a disadvantage because they are awarded smaller first-time National Institutes of Health research grants than men, $41,000 less annually. The American Cancer Society has created a new initiative, ResearcHERS, to fund women-led research and inspire the next generation of women in science. Michelle Le Beau, PhD, Arthur and Marian Edelstein Professor of Medicine and director of the Comprehensive Cancer Center, is the co-chair for the initiative. She said, “ResearcHERS is a unique opportunity to invest in promising young women investigators.”
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PATHWAYS TO DISCOVERY SUMMER 2019
Each year, the American Society of Clinical Oncology (ASCO), a professional organization representing healthcare providers of all oncology sub-specialties, holds its annual meeting in Chicago. More than 42,000 oncology professionals from around the globe attended the meeting to exchange of the latest findings from clinical research studies of novel treatments, cancer risk, survivorship, and the value of cancer care. ASCO took place from May 31–June 4 and focused on the theme, “Caring For Every Patient, Learning From Every Patient.” Popular topics that were addressed at this year’s conference included optimizing responsiveness to immunotherapy, applying cellular therapy to solid tumors, improving access to care, overcoming challenges in hard-to-treat cancers or undruggable molecular targets, and enhancing patient quality of life. Over 30 UChicago Medicine faculty, staff, and trainees presented their most recent research findings at the conference. In a plenary session, Hedy Kindler, MD, FASCO, professor of medicine, Medical Director of Gastrointestinal Oncology and Director of the Mesothelioma Program, described promising results from a POLO trial of olaparib in advanced pancreatic cancer patients with germline BRCA mutation. This work represents a new standard of care in pancreatic cancer. “In a disease where almost nothing works,” Kindler said, “it is truly remarkable to finally have a drug that makes such a difference, even for a small subset of patients.”
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Cancer survivors and caregivers came together to learn about what resources are available to them.
UChicago Medicine Holds 2nd Annual Survivors Event In May, UChicago Medicine held an event called “Survive. Thrive. Celebrate” to honor survivors and their caregivers. A cancer survivor is defined as anyone who is living with cancer or has overcome the disease, while caregivers are those who provide an important circle of support, such as family members.
The celebration of survivorship gave approximately 150 attendees the opportunity to network with fellow patients and advocacy groups. In addition, guests heard from UChicago Medicine faculty and staff on important topics such as nutrition and wellness, meeting the needs of patients and their caregivers, and medical advances brought about by clinical trials. “As physicians, we are interested in treating you, not just your cancer,” said Tara Henderson, MD, MPH, director of Cancer Survivorship at UChicago Medicine. “We recognize that patients and families are going to need support beyond the clinic, so that’s why these types of events are so important.”
NCI Designation: The Gold Standard of Excellence for Cancer Centers The highest federal rating a cancer center can achieve is a comprehensive designation from the National Cancer Institute. Learn how we earned this designation and are shaping the future of cancer care. https:// www.uchicagomedicine.org/nci
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Pathways Summer '16 FIN.indd 4
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