Today, the National Cancer Institute announced that Virginia Commonwealth University Massey Cancer Center, 听and City of Hope Comprehensive Cancer Center secured a highly competitive Specialized Program of Research Excellence (SPORE) grant that aims to address lung cancer racial disparities through precision medicine, targeted smoking cessation programs and community outreach.

The grant will establish the Translational Research Center in Lung Cancer Disparities听鈥� TRACER for short听鈥� based at VCU Massey, in partnership with MUSC Hollings and City of Hope. TRACER will also engage a host of community groups, including local health departments, community health centers, marginalized populations, civic activists, educational institutions, faith-based groups and cancer survivors.

鈥淚t鈥檚 important that the community has a seat at the table,鈥� said TRACER principal investigator Robert Winn, M.D., director of the VCU Massey Cancer Center and the Lipman Chair in Oncology. 鈥淲e鈥檙e optimistic that this dream team of researchers and community stakeholders will translate our basic science into clinical impact in reducing lung cancer disparities.鈥�

Lung cancer is the leading cause of cancer death in the U.S., accounting for more deaths than breast, prostate and colon cancer combined.

"TRACER is where the heart and mind come together 鈥� you have the intellect but also the researchers鈥� authentic commitment to equity in cancer care and outcomes."
鈥� Dr. Gayenell Magwood

Although the racial gap in lung cancer cases appears to be closing, likely due to the success of antismoking campaigns, Black men still have a higher risk of developing lung cancer compared with white men, even though they tend to smoke less听鈥� an effect referred to as the 鈥淏lack smoking paradox.鈥� Black patients are also more likely than white patients to be diagnosed at later stages and to receive no treatment at all for their cancer.

To understand more fully the Black smoking paradox, TRACER will investigate how stress and smoking interact with gene expression to raise lung cancer risk for Black men. Preliminary data shows that Black men tend to express the PRMT6 gene听鈥� which drives lung tumor development听鈥� at higher levels than white men, and smoking further stimulates PRMT6 expression. This project will ask how stress plays a role and also create early detection tools suitable for use in the Black population.

Winn will co-lead this project with S. Patrick Nana-Sinkam, M.D., a member of Massey鈥檚 Cancer Prevention and Control research program.

鈥淚t鈥檚 no secret that the Black community faces higher levels of stress, compared with more socioeconomically advantaged groups,鈥� said Nana-Sinkam. 鈥淲e want to understand how environmental stress, smoking and biology intersect to increase lung cancer risk. And we want to translate that knowledge into better early detection and prevention tools, designed with the Black community in mind.鈥�

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The next project, led by Chanita Hughes-Halbert, Ph.D., will investigate how cortisol听鈥� the body鈥檚 main stress hormone听鈥� relates to racial differences in smoking behaviors and overall lung cancer risk. These findings could lead to more tailored approaches to smoking cessation as well as medications that reduce the lung cancer burden on the Black community by counteracting stress.

鈥淲e are excited to be a part of this collaboration that will lead to novel discoveries and advance the science for lung cancer equity through a multi-institutional collaboration,鈥� said Hughes-Halbert, who retains an adjunct appointment at MUSC but recently joined USC Norris Comprehensive Cancer Center and the Keck School of Medicine at the University of Southern California as vice chair for Research and associate director for Cancer Equity.

The study goals fit well with the goal of 听to reduce cancer health disparities by focusing on preventive measures and better treatment options for minority and underserved communities.

鈥淭his study is exciting because it advances and extends findings from previous observational studies that have looked at the relationship between self-reported levels of stress and smoking behavior,鈥� Hughes-Halbert said. 鈥淏y collecting and measuring cortisol levels as men are living, working and playing in their neighborhoods and communities, we鈥檒l be able to understand the ways in which their stress levels change and how that correlates with smoking behavior.鈥�

Both projects will use human tissue and fluid samples collected across Massey, Hollings and City of Hope to ensure genetic and geographic diversity of research participants.

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Hollings researcher , who also is a professor in MUSC鈥檚 College of Nursing, will serve as the MUSC site primary investigator. 鈥淭RACER is where the heart and mind come together听鈥� you have the intellect but also the researchers鈥� authentic commitment to equity in cancer care and outcomes. Our goal is to establish a center that can be used as a national model for promoting equity in multiple cancers and other diseases.鈥�

Victoria Seewaldt, M.D., the Ruth Ziegler Chair in Population Sciences at City of Hope, will lead TRACER鈥檚 Developmental Research Program, which will identify and fund new lung cancer disparities research projects beyond those explicitly outlined in this grant. For instance, projects may investigate how pollution contributes to lung cancer burden in Black communities.

鈥淲hile smoking rates are declining, the incidence of nonsmoking related lung cancer is on the rise. We need to better understand how disparities in exposure to air pollution contributes to lung cancer in African American men and women,鈥� Seewaldt said. 鈥淣ow is the time for change. Our goal is to generate the data to drive improvement in air quality, particularly for individuals living near highways and factories.鈥�

After the three-year funding period of this initial award, which is considered a P20 exploratory grant, the infrastructure will be in place to apply for a larger five-year P50 SPORE award that will establish a more permanent research program devoted to ending racial inequities in lung cancer.

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