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NIH grant to fund research into how lifestyle affects colon cancer outcomes
The NIH awarded an $8.8 million grant to Huntsman Cancer Institute at University of Utah to expand research into how lifestyle and other factors affect colon cancer outcomes.
Neli Ulrich, PhD, senior director of population sciences at Huntsman Cancer Institute, will coordinate the international study. The collaborative effort also includes Fred Hutchinson Cancer Research Center, Moffitt Cancer Center, Cedars-Sinai, Washington University School of Medicine in St. Louis, The University of Tennessee and University of Heidelberg in Germany.
HemOnc Today spoke with Ulrich about the research she and her colleagues plan to conduct, as well as the impact she hopes their findings will have on colon cancer care and outcomes.
Question: How were the institutions for this collaboration chosen?
Answer: Several of the institutions — Huntsman Cancer Institute, Fred Hutchinson, Moffitt Cancer Center and University of Heidelberg — already have worked closely on research into colorectal cancer prognosis. With the new funding we received, we can include two new sites that focus on minority recruitment. One of these sites is Cedars-Sinai in Los Angeles, where Hispanic patients will be recruited. The other is Washington University School of Medicine in St. Louis, where the focus will be on black. We also included The University of Tennessee as another study site, and we will focus on recruiting black patients at that site, as well.
Q: What is your study designed to assess, and what makes it unique?
A: We received a grant to build on and expand a cohort of patients with colorectal cancer. We have a repeat collection of biospecimens and data, and we really are trying to understand prognosis from multiple different angles. Our long-term goals are to find out how to best treat colorectal cancer by tailoring therapy to patients with a unique biology. Additionally, we hope to find out what patients can do to improve their health. There will be a component that studies biomarkers, in which we will look at the proteome, the metabolome [and] the microbiome gene expression. There is a health behavior component, in which we will assess supplement use, diet and physical activity. All of these factors are important to better understand what determines prognosis, as well as to identify biomarkers that help us understand who will or will not experience colon cancer recurrence.
Q: How will the study be conducted?
A: The study design is unique in that we will recruit patients at the time of surgery. We will obtain tumor tissue, normal tissue and blood samples, and we also will obtain stool, urine and saliva samples. We also will ask an extensive set of questions on health behaviors. At 3 months, we will do a follow-up to evaluate symptoms. At 6 months, 12 months, and annually after that, we again will assess health behaviors through questionnaires and we will obtain samples. We may conduct physical activity assessments in the future. Additionally, we plan to obtain our patient’s CT scans to evaluate their body composition. We are trying to understand, from a lot of different measurements and angles, what determines prognosis.
Q: What are the potential implications of your findings?
A: One grant that we already have is [funding research designed] to discover new biomarkers that predict recurrence in patients with stage II and III colorectal cancer. This would be a blood-based test, and we are using a very stringent design of discovery and validation. We evaluate state-of-the-art methods such as proteomics and glycomics. In this case, the outcome would be a biomarker blood test that could predict who is more likely to develop a recurrence and should, therefore, be treated differently. We also want to provide our clinicians and patients information about health behaviors. Increasing evidence shows there are things patients can do to increase their survival. However, we do not know much about supplement use, such as its interaction with specific tumor characteristics. These are some of the questions that we hope to address.
Q: What additional research is planned after these studies are complete?
A: The grant we just received provides a base for building a large research program in colorectal cancer prognosis. This will provide a research base that is very powerful and can be used for several different studies. We are very interested in understanding obesity and the associated risk factors for colorectal cancer, with a specific focus on adipose tissue as a direct driver of colon carcinogenesis. Adipose tissue — particularly intraabdominal fat — is very biologically active, and it secretes cytokines and adipokines that can perhaps directly affect tumor growth.
Q: Is there anything else that you would like to mention?
A: This has been a wonderful effort working with great collaborators at a number of institutions who, for many years, did a lot of work for free. We are very excited that we received the funding to amplify our efforts. The NIH put trust in us to carry forward in a much larger scope and capacity. It is very important for me to say thank you to the participants and collaborators. – by Jennifer Southall
For more information:
Neli Ulrich, PhD, can be reached at Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT 84112; email: neli.ulrich@hci.utah.edu.
Disclosure: Ulrich reports no relevant financial disclosures.