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Published in CenterView on May 14, 2012
Dr. Lucio Miele with Dr. Mary Ann Van Duyn, program director at the National Cancer Institute’s Center to Reduce Cancer Health Disparities.
Dr. Lucio Miele with Dr. Mary Ann Van Duyn, program director at the National Cancer Institute’s Center to Reduce Cancer Health Disparities.

Conference explores environmental, clinical, biological aspects of malignant health disparities

By Jack Mazurak

A two-day cancer-fighting conference at the UMMC Cancer Institute brought together scientists and physicians from nine Southeastern centers to improve cancer research.
 The goals of the GMaP/BMaP Region 3 conference, which took place April 23-24 at the Jackson Medical Mall Thad Cochran Center, were to design population studies and drug clinical trials that include minorities and to build tissue banks that better represent the region’s diversity.

The conference attracted an expert consortium of about 50 physicians and scientists from Tulane University, the University of Alabama at Birmingham, the Moffitt Cancer Center, Emory University, Tuskegee University, Morehouse College, the Ponce School of Medicine and Health Sciences, Xavier University and UMMC.

“We are working together to study the environmental, cultural, clinical and biological aspects of health disparities in cancer,” said Dr. Lucio Miele, director of the UMMC Cancer Institute.

The group formed in 2009 to address health disparities in cancer through two main avenues: GMaP – or Geographic Management Program – and BMaP – or Biospecimen Management Program.

The GMaP’s portion looks to find ways the institutions can collaborate on population studies and clinical trials. By identifying regional and ethnicity-based differences in cancer outcomes, the consortium can design population research and clinical trials that include statistically significant numbers of minorities.

“There is no such thing as a single cancer,” Miele said. “Cancers happen in the same place – breast, lung, bones – but there are many different types. Environmental, behavioral, genetic and epi-genetic risk factors affect cancer incidence and outcome, and these are in part influenced by an individual’s ethnicity.

“A majority of cancer drugs have been developed and approved based on studies that did not include a significant number of minorities. So we don’t know if these drugs are optimal for minorities.”

At the meeting, the group worked on next year’s planned joint study of factors that hinder or help recruit diverse participation in cancer-related research studies.

“The South has a heavier burden of cancer than other U.S. regions, and minorities are disproportionately affected,” Miele said. “But ultimately, the cost of cancer health-care disparities affects everyone nationwide.

“The best way to reduce this burden is to find effective strategies to prevent cancer, to diagnose it earlier and to treat it more effectively. This cannot be accomplished without understanding cancer risk factors and biology in all Americans, irrespective of ethnicity and socioeconomic status.”

BMaP will create a regionally shared tissue bank system that will let researchers throughout the Mid-South study novel biomarkers of disease. Understanding differences in cancer subtypes may help explain why certain ethnic groups experience different incidence of cancer and different outcomes in treatment.

“Gene expression and molecular profiling data do not exist on many minorities’ cancers,” Miele said. “So we don’t know if we are dealing with different disease subtypes. It’s why we need biospecimen repositories.

“We want to ensure we build tissue banks that are as broad and diverse as the U.S. population.”
The biospecimen repository will first focus on breast cancers, then grow to include prostate, head and neck, colorectal, lung and ovarian
cancers.

The group also established member prices for use of each other’s high-tech core facilities – typically expensive machinery and processes – which will help widen the pool of resources. And members planned outreach and education efforts that will use culturally, linguistically and literacy-appropriate means to educate and raise community awareness about biobanks and biospecimen collection. They plan to work toward a federal grant submission to fund the outreach.

The regional consortium formed three years ago with funding from the National Cancer Institute’s Center to Reduce Cancer Health Disparities. The members meet quarterly and conduct monthly teleconferences.

The April gathering marked the consortium’s first meeting in Jackson and included a visit from Dr. Mary Ann Van Duyn, program director at the Center to Reduce Cancer Health Disparities.

“To my knowledge, there hasn’t been such a gathering of cancer centers in Jackson ever,” Miele said.

The Region 3 Consortium members represent five states – Louisiana, Mississippi, Alabama, Florida and Georgia – and Puerto Rico. Those areas share various demographic, cultural and socioeconomic features including large minority populations, urban and rural poverty, poor education track records and inadequate access to health care.

Miele said African-Americans and Latinos have been as willing as any other communities to donate tissue samples and to participate in population studies and clinical trials.

“But the infrastructure to do those things has not been strong enough,” he said. “All these things cost money – handling, banking and human costs of tissue storage, and the immense costs of conducting long-term population research.

“The idea is that, between these nine members, we can share each other’s strengths and compensate for each other’s weaknesses.”

For example, UMMC has resources in lipidomics and circulating tumor cells. Moffitt offers many resources, including proteomics, flow cytometry and analytic microscopy. UAB has resources in behavioral and population sciences. Emory brings RNA sequencing expertise. Xavier has proteomics, Tuskegee and Morehouse have tremendous expertise in medical ethics.

“We’re trying to provide the infrastructure so people who have not been able to participate in research, tissue specimen banking and clinical trials can participate,” Miele said. “We are creating cancer team science across the Southeast, focusing on the part of the U.S. where cancer incidence and mortality are highest.”