Working Together, FAU and MCI Aim to Make Cancer Research More Inclusive
By Wynne Parry
Rapid advancement in cancer therapy is making the prospect of longer, healthier lives a reality for more patients. But ensuring everyone a more hopeful future requires the field to face up to past oversights.
Historically, the studies that have fueled progress in cancer care have focused on white patients to the exclusion of others. A collaborative effort between the FAU and Memorial Healthcare System’s Memorial Cancer Institute (MCI), seeks to address this long-standing deficit.
“Cancer research, like the rest of medicine, faces a major challenge right now,” said Gregg Fields, Ph.D., executive director of the Institute for Human Health and Disease Intervention (I-Health). “We know certain diseases, including cancer, hit some racial or ethnic groups harder than others, and that some treatment strategies aren’t equally effective for everyone.”
The partnership between MCI and FAU, which the state has designated as a Florida Cancer Center of Excellence, leverages the two institutions’ combined research and medical expertise to move toward a solution. Together, they are gathering and storing samples and information from predominantly Black or Hispanic patients — contributions that will fuel studies to better understand and treat this devastating disease.
The researchers plan to establish a collection that covers a wide range of solid tumors, which they will house in FAU’s Clinical Research Unit on the Boca Raton campus. Teams are already collecting specimens from two types of solid tumors, breast and pancreatic cancer, while the partners, along with Tampa General Hospital and the University of South Florida, are seeking funding to broaden their effort.
BIOLOGY MATTERS
MCI’s patient population reflects the diversity of South Florida. Nineteen percent of patients are Black, and another 19% are Hispanic, so promoting health equity in cancer care is a priority for the institute, said Luis E. Raez, M.D., MCI’s medical director and chief
scientific officer.
“We know certain diseases, including cancer, hit some racial or ethnic groups harder than others, and that some treatment strategies aren’t equally effective for everyone.”
— Gregg Fields, Ph.D.
“For many years, we assumed if a treatment works for whites, it works for everybody,” Raez said. “We were wrong, because there are tremendous disparities in cancer clinical outcomes among whites, Asians, Blacks and Hispanics.”
For example, a small study at MCI found that minority lung cancer patients fared more poorly than white patients when using a new immunotherapy drug that helps the body’s immune system fight the disease.
Social and economic determinants, such as income level or access to health insurance, can’t fully explain disparities like this, he said. “There are biological and genetic factors that need to be addressed,” he said.
REACHING OUT
To begin to correct this long-standing bias, researchers must make a concerted effort to reach out to people who are traditionally underrepresented in medical research and clinical trials.
With a $220,000 grant from the Community Foundation of Broward focusing on breast cancer, a team from MCI has already begun seeking patients. Those who participate receive screening and treatment, and they have the option of contributing blood, and, if they have breast cancer, tumor tissue to the research effort.
Once samples are collected, researchers at FAU will step in. They plan to search for genetic differences, such as changes in a single letter of the DNA code, unique to Black and Hispanic women. By creating genetic profiles of patients and following how the
women fare, researchers hope to better understand how genetic factors can play into disparities.
Their findings could help explain a racial paradox within this field: While Black women develop breast cancer slightly less frequently than white women, the disease is more deadly for them. The reasons appear quite complex, but research has implicated biology, including ancestry and the control of gene expression.
REPLICATING TUMORS
Researchers are also recruiting patients with a second type of malignancy: pancreatic cancer, which is among the deadliest form of cancer for anyone. For this project, FAU and MCI have joined forces with Cold Spring Harbor Laboratory. At this New York lab, scientists are taking their studies of patients’ cancer cells a step further, by growing them into small, spherical replicas of tumors known as organoids.
They use these organoids to lay the scientific groundwork for a much-needed screening test for early-stage disease and a method for determining the most potentially effective treatment for a particular patient. Samples from South Florida patients will diversify the collection the New York researchers have on hand for this research.
There’s still a lot to be done, but Fields said he is optimistic about what patient contributions today could mean for the future. “What we’ve learned is that using samples from patients gives us much more accurate information, especially when it comes to treatment strategies,” he said.