Genomics-Driven Statewide Endometrial Cancer Research Initiative Underway
A statewide clinical cancer research project called Ohio Prevention and Treatment of Endometrial Cancer (OPTEC), which is supported by $1.25 million in Pelotonia funds, aims to recruit up to 700 women with endometrial cancer from partner hospitals across the state and screen them for Lynch syndrome (LS) and other inherited genetic conditions linked to greater risk of endometrial, colorectal, stomach and ovarian cancers.
Their tumor samples will undergo molecular profiling to identify targeted treatments personalized to each patient’s tumor characteristics. Patients identified with LS and their at-risk family members will be educated about the importance of genetic testing and cancer-prevention strategies based on their increased risk for LS-associated cancers. Those whose tumors have defective DNA mismatch repair will be considered for immunotherapy clinical trials for endometrial cancer.
OPTEC is led by David Cohn, MD, and Paul Goodfellow, PhD, with multiple collaborators from the OSUCCC – James and Nationwide Children’s Hospital Research Institute. OPTEC will conduct its LS screening with a novel one-step genetic sequencing technique developed by Goodfellow and Elaine Mardis, PhD, a geneticist at Nationwide Children’s Hospital Research Institute. In addition, genomic profiling will help identify patients who are most likely to benefit from new medical therapies, including immunotherapy drugs that target certain proteins.
OPTEC also is supported by a five-year, multimillion grant that the National Cancer Institute (NCI) awarded in July 2018 to principal investigators Goodfellow, Mardis and Heather Hampel, MS, LGC, for a study titled “Combined NGS Tumor-Based Detection of Germline Lynch Syndrome Mutations and Prognostic Classification of Endometrial Cancers.” The NCI grant extends research supported by Pelotonia and supports the study of nearly 1,000 additional tumors from women with endometrial cancer.
The grant will help researchers develop low-cost and highly sensitive tumor-based DNA methods to identify women with inherited forms of endometrial cancer and, at the same time, test for genetic changes useful for treatment planning. Studying DNA specimens prepared in clinically approved laboratories will make it possible to rapidly translate research findings to tumor-based testing that can be applied to all endometrial cancer patients and thus improve cancer prevention and treatment.
Ohio Colorectal Cancer Prevention Initiative Draws to Successful Close
A five-year statewide initiative to screen newly diagnosed colorectal cancer patients and their biological relatives for Lynch syndrome has closed but will have far-reaching benefits by setting the stage for future LS screening in Ohio and around the nation.
Funded over five years (2013-18) by $4.3 million from Pelotonia, the Ohio Colorectal Cancer Prevention Initiative (OCCPI) established a 50-hospital network to accommodate screenings for Lynch syndrome (LS), an inherited genetic condition that predisposes to colorectal, endometrial, ovarian, stomach and other cancers. The LS screenings identify patients and family members who may be at risk of developing these cancers so they can take precautionary measures, including heightened surveillance (e.g., colonoscopies) for early detection.
OCCPI director Heather Hampel, MS, LGC, associate director of the Division of Human Genetics at Ohio State, says the OCCPI enrolled 3,346 newly diagnosed colorectal cancer (CRC) patients, of whom 143 tested positive for LS. She also reports that 204 of their relatives tested positive, and another 101 CRC patients were found to have a hereditary cancer syndrome other than LS.
The initiative has also resulted in six publications in prestigious medical journals, including Journal of the American Medical Association (JAMA) Oncology, Gynecologic Oncology, Gastroenterology (two articles), Family Cancer and Journal of Medical Genetics. The overall results of the study are being analyzed in preparation for publication.
Hampel and colleagues estimate the OCCPI will save about 1,000 years of life and provide some $32 million in community benefit because of the lives it has saved in Ohio through early diagnosis of LS and, consequently, through a reduced need for cancer treatment.
“Our study findings demonstrate the need and value of screening early-onset CRC patients for LS,” Hampel says, noting that her team is working to help launch this screening approach nationally. “We believe the OCCPI can serve as a roadmap for other states to implement LS screening as well.”
OSUCCC – James Leads Statewide Initiative Against Lung Cancer
Recruitment continues for a statewide clinical research initiative taking aim at lung cancer, the No. 1 cancer killer among men and women in the United States. Led by Peter Shields, MD, David Carbone, MD, PhD, Mary Ellen Wewers, RN, PhD, MPH, and Barbara Andersen, PhD, the initiative is called Beating Lung Cancer in Ohio (BLC-IO) and is supported by $3 million from Pelotonia.
The initiative will draw upon a network of 50 hospitals around Ohio that was established by an earlier Pelotonia-funded statewide project (the OCCPI, see above). BLC-IO has two aims: to assess the impact of advanced gene testing and expert advice on lung cancer treatment and patient survival; and to improve smoking-cessation rates among smokers with lung cancer and their family members (assess the impact of centralized telephone counseling and provider support on smoker cessation). A three-year patient recruitment period began in March 2017.
Project leaders anticipate that more than 2,000 newly diagnosed patients with stage IV non-small cell lung cancer will enroll in BLC-IO via the community hospital network. Enrollees will receive free testing for more than 300 genes in their cancer specimens, and the physicians who treat them will receive expert support for interpreting test results and determining treatments. BLC-IO also will provide smoking-cessation support for up to three years to all participating patients and family members.