Guillermo Tortolero-Luna - US grants

DESCRIPTION (provided by applicant): This is a resubmission for The University of Puerto Rico Comprehensive Cancer Center (UPRCCC) and The University of Texas M. D. Anderson Cancer Center (MDACC) Partnership for Excellence in Research Grant, which addresses comments and recommendations from the 1) summary statement, 2) NCI Site Visit, and 3) IAC and PSC Committees. Areas strengthened in this application include: leadership, communication, committee oversight, evaluation, career development and mentorship. Funds granted in this award will be used to: 1) support 3 full projects in cancer biology and prevention and 1 pilot project in epidemiology, 2) enhance existing collaborations and establish new collaborations, 3) increase faculty/trainee participation in the training program, 4) expand efforts in our Outreach Program to impact a larger audience, and 5) fortify and stabilize the infrastructure developing at the UPRCCC. Research grants included target 1) developing new cancer imaging techniques, 2) regulating RNA in eukaryotic cells, 3) reducing cancer risk through combined alcohol and tobacco treatment and 4) assessing the role of insulin resistance syndrome as a risk factor for endometrial cancer. The Outreach Program, which was added into the original grant mid-year 3, has been expanded to include cancer related to tobacco, as well as breast, cervical and HPV. The Training Program has also been expanded in scope to impact more faculty and trainees through a comprehensive career development and mentorship training program. The original grant (2002) was awarded to establish a comprehensive long-term mutually beneficial relationship to target and eradicate cancer health disparities. The two short term objectives of the original application were met: 1) develop independent cancer research investigators and 2) establish a strong working relationship based on mutual benefit, identified strengths and reciprocity. The 3rd long-term objective of the Partnership is to regain NCI-designation for the UPRCCC. Thus far, the Partnership has set the foundation for a dynamic collaboration dedicated to enhancing each partner's strengths and eliminating each partner's weaknesses. The Partnership has also served as the catalyst for two major laws passed in Puerto Rico, one of which resulted in the allocation of funding for establishing the infrastructure and recruiting top notch faculty to the UPRCCC. As of 2008, the Partnership is far from reaching its long-range goal of regaining NCI-designation for the UPRCCC. Funding for the U54 resubmission is critical to maintain the momentum of the Partnership's joint efforts in Cancer Research, Training and Outreach.

DESCRIPTION (provided by applicant): The Puerto Rico NCI Community Oncology Research Program (PRNCORP) will be the principal organization in the island that promotes cancer prevention, control and screening/post-treatment surveillance clinical trials. It will conduct cancer care delivery research and will provide access to treatment and imaging clinical trials conducted under the reorganization of the National Clinical Trials Network (NCTN). It will evaluate disparity issues and outcomes in cancer care delivery and treatments. The program will accelerate the transfer of new knowledge to treat, control and prevent cancer in the community. The PRNCORP will build and expand upon the scope and activities of the previously NCI-funded San Juan MBCCOP with a more comprehensive approach to adult and pediatric oncology. The island of Puerto Rico, USA, is 100 miles by 35 miles. It is located in the Caribbean Sea, 1,200 miles from the US mainland. The last census of 2010 revealed a population of 3.7 million. The island cancer registry reports about 12,500 new cancer cases per year. There is an excess incidence of cancer as compared with mainland USA for tobacco/alcohol related malignancy especially head and neck, esophageal and liver cancer. Also there is an increased mortality in cervical, uterine and gastric cancer. 40% of the population is medically uninsured but depends on a Medicaid type program called Mi Salud that reaches all areas of the island. The PRNCORP will interact and participate with NCORP-research bases including but not limited to: 1) ECOG-ACRIN, 2) NRG, 3) MD Anderson, 4) University South Florida, 5) Wake Forest University, 6) CTSU, and 7) COG. The program has expanded to include 4 hospitals, one University Cancer Center, 3 radiology groups, 2 radiation oncology facilities, 9 medical oncology groups and 1 primary care physician group. The program will have 85 investigators including 11 oncology fellows in-training. The PRNCORP will continue to expand its activities and increase the participation of more cancer healthcare professionals and institutions in the island. It will develop research affiliations with NCI-sponsored research bases that offer meaningful and other culturally sensitive cancer care delivery research.

Project Summary. Research being performed in Puerto Rico provides an opportunity to advance knowledge of cancer risk, and cancer prevention and control among Hispanic and non-Hispanic populations in the United States (US). The Cancer Prevention and Control (CAPAC) Research Training Program at the Division of Cancer Control and Population Sciences of the University of Puerto Rico Comprehensive Cancer Center aims to increase the pool of master?s degree graduates and other health professionals that pursue a doctoral degree and/or a career in cancer prevention and control research with a focus on Hispanic health and health disparities. The program will recruit participants from all racial/ethnic groups and cultural backgrounds to participate in a hands-on research experience in a Hispanic population and cultural environment. Participants will be matched to a mentor based on their research interest in basic, clinical, and population-based research. The CAPAC aims to: 1) Recruit 20 master level and health professional students (and recent graduates from these programs) per year to participate in hands-on research experience in cancer prevention and control; 2) Provide participants with a mentored hands-on research experience in cancer prevention and control research with a focus on Hispanic health and health disparities; 3) Provide program participants with the skills to pursue a doctoral degree and/or a career in cancer prevention and control research, and 4) Conduct process and outcome evaluation of short-, intermediate-, and long-term goals. The CAPAC Program will increase participants? understanding of the spectrum of cancer prevention and control research, strengthen their skills in cancer research, and increase their cultural sensitivity skills. Potential areas of cancer prevention and control research will include topics within the cancer control continuum: prevention, early detection, screening and survivorship, and topics that are relevant within the mission of the National Cancer Institute (cause, diagnosis, prevention, treatment of cancer, rehabilitation from cancer, and the continuing care of cancer patients and the families of cancer patients). The duration of the program is 10 weeks. Upon request and evaluation of the request, the program will support a maximum of 10 participants to extend their research experience to a maximum of 15 weeks. The hands-on cancer research experience will be overseen by a cancer researcher/mentor, to whom each student will be assigned. Areas of expertise of the proposed mentors include basic, clinical, population-based and translational research. Educational activities will include seminars and workshops that will strengthen the participant?s skills to pursue a doctoral degree and careers in cancer prevention and control research. Outcomes of interest to determine program success will include: (1) participant and mentor satisfaction with the program, (2) mentor?s satisfaction with the participants, (3) participants that become co-authors in scientific presentations and/or manuscripts, and (4) participants that continue doctoral studies and/or careers in cancer prevention and control research.

PROJECT SUMMARY/ABSTRACT The PR NCORP will be the only organization that conducts significant, meaningful NCI - directed Clinical Cancer Research on the island of Puerto Rico focused on minorities and underserved communities for cancer treatment and cancer care delivery. It will be the backbone for the development of the multidisciplinary cancer care for the newly built University of Puerto Rico Comprehensive Cancer Center (UPRCCC), which will officially open to patient care on August 20, 2018. All faculty members including translational researchers and clinical care providers are expected to participate in the PR NCORP for the purposes of broadening the catchment base for accrual to our clinical trials. Each department within the CCCUPR, such as Gynecologic Oncology for example with four active faculty surgeons, will participate directly in NRG studies and will use the PR NCORP as the platform for development of the department. All patients seen in the CCCUPR will be consented for enrollment in the PR NCORP broadly for purposes of demographical and clinical data gathering with specialized consent for tissue donation. The PRNCORP is also a source of knowledge to the broad oncology medical community. It will serve to improve cancer treatment and care for Adult and Pediatric patients throughout its participating institutions and beyond. Our PI's and Co-PI's are experienced professionals with over 30 years of experience in Clinical Research with very strong staff and support personnel. Our fellows and attendings are active participants of Medical Schools, tumor boards, cancer seminars and are involved in yearly updates to the Medical Community, such as ASCO and ASH Review Conference Series in the island. Our research environment will improve: (1) Pathology Departments, (2) Radiology Imaging Departments, (3) Radiotherapy Service, (4) Gastroenterology, (5) Surgery, (6) Hematology-Oncology Treatment Program and (7) Direct Patient Care.