Sylvester Receives its First Specialized Program of Research Excellence Award from NIH
Summary
- The award supports an interdisciplinary, collaborative research program on anal and cervical cancer prevention and treatment.
- The program, Personalized Outreach and Multifaceted Interventions for Screening Enhancement (PROMISE), is led by researchers at Sylvester, Emory University and the Morehouse School of Medicine.
- The program involves community members from the Miami and Atlanta regions to best serve those at highest risk in these catchment areas.
Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, has earned an award from the National Cancer Institute (NCI) to establish the center’s first Specialized Program of Research Excellence, or SPORE.
SPOREs, first established in 1992 by the NCI, focus on a specific organ site or related cancers and promote interdisciplinary, collaborative and translational research.
The Sylvester program, known as PeRsonalized Outreach and Multifaceted Interventions for Screening Enhancement (PROMISE), is spearheaded by researchers at Sylvester, Emory University and the Morehouse School of Medicine. It aims to transform treatment and prevention for anal and cervical cancer, two cancers linked to infection with human papillomavirus, or HPV. These cancers enact a disproportionately large burden in South Florida and in the Atlanta area, where Emory and Morehouse are located. They also affect populations differently: Incidences of both these cancers are higher in HIV-positive people, while cervical cancer has a disproportionately high incidence in the population that Sylvester serves.
“In many ways these are forgotten cancers. They affect the most vulnerable, globally and in the United States,” said Erin Kobetz, Ph.D., M.P.H., the vice president for health promotion and chief wellbeing officer and the John K. and Judy H. Schulte Senior Endowed Chair in Cancer Research at Sylvester. “In South Florida, the incidence of HPV-associated malignancies is higher than in the U.S. overall. We feel that we have an obligation to be responsive to this data and to develop high-impact science to address this disparity.”
Dr. Kobetz leads the PROMISE program, along with:
• Isabella Rosa-Cunha, M.D., associate professor in the Division of Infectious Diseases at the Miller School
• Lisa Flowers, M.D., M.P.H., professor of gynecology and obstetrics at Emory
• James Lillard, Ph.D., M.B.A., professor of microbiology, biochemistry and immunology at Morehouse
The program comprises three large research projects, three cores that support the program and an educational component to support and train faculty new to translational cancer research.
Anal Cancer Screening and Awareness
One of the three research projects, led by Dr. Rosa-Cunha, builds off innovative anal cancer screening research at Sylvester that fed into the first federal anal cancer screening guidelines. Like cervical cancer, anal cancer develops from precancerous lesions. If these lesions are found and treated early, the development of anal cancer can be prevented.
But, until recently, anal cancer screening was not routinely recommended. Dr. Rosa-Cunha was the site leader at Sylvester for a large, nationwide clinical trial led by the University of California, San Francisco, that demonstrated that treating anal pre-cancers in HIV-positive adults reduced the risk of developing anal cancer by 60%.
However, that screening method, known as high-resolution anoscopy, is not available in many clinics, even in urban areas. In the new project, Dr. Rosa-Cunha is exploring whether self-swabbing to screen for HPV in the anus is feasible and acceptable among adults at high risk for anal cancer. The project, dubbed USCREEN, will enroll 400 adults in the Atlanta and Miami areas to test the self-collection.
Just last year, the U.S. Food and Drug Administration approved an at-home, self-collected cervical swab for HPV strains related to cervical cancer. The researchers hope that a similar procedure might one day increase access to anal cancer screening and prevention for those at highest risk. There’s also a need for increased awareness about anal cancer screening, as many people at high risk don’t know that they should be screened and their providers may not bring it up.
“Our vision is to link science with our communities,” said Dr. Rosa-Cunha. “We’re also hoping that through outreach and engagement, we can bring awareness to the community beyond the people enrolled in the study.”
The screening project will collect and store blood and tissue samples through PROMISE’s biorepository core, which is led by Sylvester’s Nipun Merchant, M.D., professor in the DeWitt Daughtry Family Department of Surgery and chief of the Division of Surgical Oncology at the Miller School. The biorepository will also house cervical and anal cancer samples donated by patients in other PROMISE research projects.
Community Engagement
Dr. Kobetz is leading a PROMISE core centered around community outreach and engagement. This core builds off Dr. Kobetz’s previous community engagement work at Sylvester, including the Game Changer™ mobile cancer screening vehicles and SCAN 360, a community-focused website that helps individuals find more information about their cancer risks.
Community stakeholders also participate on review boards for pilot awards given through PROMISE. The team’s focus on cervical and anal cancers itself was informed in part by recommendations from Sylvester’s Community Advisory Committee, a requirement of Sylvester’s status as an NCI-designated cancer center.
“That’s a really beautiful aspect of NCI designation, because it ties science to purpose,” Dr. Kobetz said. “Our program similarly gives attention to community input and making sure our science aligns with their priorities, and that we disseminate our findings back to the community so that they can be actionable.”
A Promise for the Next Generation
PROMISE’s two other large research projects involve using AI to model and predict cervical and anal cancers to improve treatment and to study how the immune system and vaginal microbiome vary in women without cervical cancer, those with pre-cancerous lesions and those with cervical cancer. Sylvester’s Yan Guo, Ph.D., a professor of biostatistics at the Miller School, is leading a bioinformatics core to support statistical and computational needs in these and all of PROMISE’s research projects.
Sophia George, Ph.D., associate professor in the Miller School’s Department of Obstetrics, Gynecology and Reproductive Sciences and a member of Sylvester Comprehensive Cancer Center, is co-leading the immune, microbiome and single-cell genomics project and, with Mario Stevenson, Ph.D., professor in the Division of Infectious Diseases at the Miller School, leads PROMISE’s career enhancement and developmental research programs. These programs develop the next generation of faculty working in cervical and anal cancers by supporting their career development and providing financial support for pilot projects in these areas.
The team has just selected its first set of five one-year pilot awards given to early-career researchers at Sylvester and Emory.
“Through these programs, we’re developing the next generation of cancer researchers, to prevent, to treat and to cure these diseases,” Dr. George said.
Tags: Department of Obstetrics Gynecology and Reproductive Sciences, Division of Infectious Diseases, Division of Surgical Oncology, Dr. Erin Kobetz, Dr. Isabella Rosa-Cunha, Dr. Mario Stevenson, Dr. Nipun Merchant, Dr. Sophia George, Dr. Yan Guo, Game Changer, Infectious diseases, Newsroom, SCAN 360, surgical oncology