UNC and Duke researchers receive CTSA Consortium Collaborative Pilot Award to develop a new way to study cancer
For doctors and patients, the fight against cancer can be a lot like an exceedingly tricky version of the classic arcade game of whack-a-mole. You might beat back a tumor or part of a tumor, only to have another one pop up. To make matters worse, the "mallet" or treatment that successfully whacks the first tumor cells doesn't always work on those arising later. You might need a new strategy or even an entirely different drug. It's a tough game to win.
The reason it is often unsuccessful to apply a singular approach to beating cancer is that cancer cells evolve and change over time as cells divide and tumors expand. That ever-changing, increasingly heterogeneous nature of cancer has been a particular problem in effectively treating glioblastoma multiforme, a common and aggressive form of brain cancer. Even when treated with cancer-fighting drugs, only one out of three patients with glioblastoma multiforme are alive two years after their diagnosis.
"There might be a drug that works against the founding mutation in a tumor, but now this branch diverged and might then show resistance," explained Albert Baldwin, Professor and Associate Director of Basic Research at University of North Carolina at Chapel Hill's Lineberger Comprehensive Cancer Center.
When University of North Carolina MD/PhD students Nick Brazeau and Anna Kahkoska volunteered at the Open Door Clinic, which provides free medical care to residents of Alamance County who do not have health insurance, they were surprised to see just how many patients with diabetes were unable to control their blood sugar levels. Brazeau was taken aback by the overwhelming challenges patients faced even though they desired to be healthy.
"Many of them are limited by time, resources, and even access to necessary medications and health care," said Brazeau, who is a doctoral student in the Department of Epidemiology in the UNC Gillings School of Public Health. "These barriers are immense and often seem insurmountable, which speaks to the tenacity and capacity of patients who strive to overcome them."
The students wanted to change the entire clinic structure by transitioning from individual appointments to shared medical appointments so they applied to the Schweitzer Fellowship to implement their vision. The process involved collaboration from the clinic directors, the visiting endocrinologists, and all of the students who work at the clinic, including undergraduate students, PA students, and pharmacy residents. After almost a year of running shared medical appointments, they are seeing great signs of improvement among patients in their clinic.
"Did you plan this pregnancy?" the academic mentor demanded of his post-doctoral researcher. "What about our project timeline?" His mentee blinked in surprise. She'd just announced exciting news, but the reaction she received was not what she'd expected.
How would you respond to a similar comment from a mentor? How would you respond to your own mentees in this scenario? These were the questions Theater Delta performers posed to a group of about sixty academics from local universities in late January. The postdoctoral researchers and faculty came together to participate in a mentoring workshop organized by the North Carolina Translational and Clinical Science (NC TraCS) Institute and Duke University Office of Research Mentoring. The two-day workshop brought together faculty from different disciplines and schools to improve their understanding of an important influence on many academic careers: mentorship.
Mentoring, even informally done among academics, can make or break a researcher's career. Female researchers and those from underrepresented minorities are particularly vulnerable to diminished career advancement when they have poor mentorship options. Good mentorship is valuable to everyone, not just to those in the early stages of a career. According to Mark Dewhirst, director of Duke Office of Research Mentoring, it's important to remember that you can be both mentor and mentee at every stage throughout your career. When done right, these relationships benefit everyone involved throughout their careers.
Researchers from Duke and UNC team up to find an answer, with funding from the two institutions' NIH Clinical and Translational Science Awards (CTSA).
For hundreds of millions of people around the world with chronic hepatitis B infection, anti-viral treatments do a good job of keeping the virus under wraps. Anti-viral treatments are essential in slowing damage to the liver, reducing the chance of liver cancer, and helping people live longer. But in the vast majority of cases, there is no end to the infection. If a patient stops medication for any reason, the hepatitis B virus (HBV) re-emerges. The cause of its resilience is circular bits of DNA, called covalently closed circular DNA, or cccDNA, that lurk in the liver cells of infected patients.
"Treatment blocks new viral replication," said Lishan Su, a professor of microbiology and immunology at the University of North Carolina, Chapel Hill. "It doesn't touch this cDNA." When treatment stops, new virus is produced from these cccDNA templates, he continued. As a result, "you need almost lifetime (or very long-term) treatment."