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:pu5s@nih.gov 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.