This is an application for a Fogarty International Center K01 International Research Scientist Development Award for Dr. Satish Gopal, an infectious disease physician and medical oncologist at the University of North Carolina at Chapel Hill. Dr. Gopal is establishing himself as a young investigator in the areas of HIV-associated lymphoma and lymphoma treatment in resource-limited settings. This K01 award will provide Dr. Gopal with the support necessary to accomplish the following goals: (1) to become an expert in clinical trial conduct in resource-limited settings;(2) to develop skills in multidisciplinary, long-distance collaboration;(3) to gain additional experience in advanced study design and biostatistical methods;and (4) to learn fundamentals of health-related quality of life research. To achieve these goals, Dr. Gopal has assembled a mentoring team comprised of a US primary mentor, Dr. Thomas Shea, Interim Chief of the Division of Hematology and Oncology, an international leader in collaborative clinical trials in hematologic malignancies, and a Malawi primary mentor, Dr. Mina Hosseinipour, Clinical Director of UNC Project-Malawi and an expert in clinical trials in sub-Saharan Africa, as well as three co-mentors;Drs. Blossom Damania and Dirk Dittmer, experts in pathogenic mechanisms of viral oncogenesis with particular interest in HIV malignancies;and Dr. William Miller, an expert in analytic methods and mentoring young investigators toward research independence. Lymphoma is one of the most common cancers in sub-Saharan Africa with rapidly increasing incidence. Dr. Gopal's research will focus on accurate histopathologic diagnosis among patients with suspected lymphoma in Malawi (Aim 1), systematic collection of clinical and laboratory data among patients with suspected lymphoma (Aim 2), and longitudinal follow-up among those with confirmed hematologic malignancies receiving treatment under local conditions (Aim 3).
In Aim 1, Dr. Gopal will perform core lymph node biopsies on at least 200 consecutively enrolled patients with suspected lymphoma.
In Aim 2, Dr. Gopal will collect relevant clinical and laboratory data among patients at the time of enrollment and lymph node biopsy, and correlate these data with final histopathologic diagnosis.
In Aim 3, Dr. Gopal will perform systematic, longitudinal assessments for 2 years among those with confirmed hematologic malignancies to evaluate response to therapy, treatment-related toxicities, costs of treatment, and health-related quality o life (HRQOL) measures. The studies outlined in this proposal will form the basis for a multicenter clinical trial of lymphoma treatment in sub-Saharan Africa to be proposed in an R01 application before the end of the career development award period.

Public Health Relevance

The burden of lymphoma is rapidly increasing in sub-Saharan Africa, and current diagnostic and treatment strategies are inadequate. Improved understanding of the clinical and histopathologic features of lymphoma is critical to developing effective treatments which are feasible under local conditions in resource- limited settings.

Agency
National Institute of Health (NIH)
Institute
Fogarty International Center (FIC)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
1K01TW009488-01
Application #
8436855
Study Section
International and Cooperative Projects - 1 Study Section (ICP1)
Program Officer
Jessup, Christine
Project Start
2012-09-20
Project End
2017-06-30
Budget Start
2012-09-20
Budget End
2013-06-30
Support Year
1
Fiscal Year
2012
Total Cost
$140,175
Indirect Cost
$10,383
Name
University of North Carolina Chapel Hill
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Westmoreland, Katherine D; Montgomery, Nathan D; Stanley, Christopher C et al. (2017) Plasma Epstein-Barr virus DNA for pediatric Burkitt lymphoma diagnosis, prognosis and response assessment in Malawi. Int J Cancer 140:2509-2516
Westmoreland, Katherine D; El-Mallawany, Nader K; Kazembe, Peter et al. (2017) Dissecting heterogeneous outcomes for paediatric Burkitt lymphoma in Malawi after anthracycline-based treatment. Br J Haematol :
Kaimila, Bongani; van der Gronde, Toon; Kasonkanji, Edwards et al. (2017) Short Communication: CD4 Count and HIV RNA Trends for HIV-Associated Lymphoproliferative Disorders in Malawi. AIDS Res Hum Retroviruses 33:1045-1047
Kaimila, Bongani; van der Gronde, Toon; Stanley, Christopher et al. (2017) Salvage chemotherapy for adults with relapsed or refractory lymphoma in Malawi. Infect Agent Cancer 12:45
Kohler, Racquel E; Gopal, Satish; Miller, Anna R et al. (2017) A framework for improving early detection of breast cancer in sub-Saharan Africa: A qualitative study of help-seeking behaviors among Malawian women. Patient Educ Couns 100:167-173
Chinula, Lameck; Moses, Agnes; Gopal, Satish (2017) HIV-associated malignancies in sub-Saharan Africa: progress, challenges, and opportunities. Curr Opin HIV AIDS 12:89-95
Stanley, Christopher C; Westmoreland, Kate D; Itimu, Salama et al. (2017) Quantifying bias in survival estimates resulting from loss to follow-up among children with lymphoma in Malawi. Pediatr Blood Cancer 64:
Kohler, Racquel E; Miller, Anna R; Gutnik, Lily et al. (2017) Experiences and perceptions regarding clinical breast exam screening by trained laywomen in Malawi. Cancer Causes Control 28:137-143
Murphy, G; McCormack, V; Abedi-Ardekani, B et al. (2017) International cancer seminars: a focus on esophageal squamous cell carcinoma. Ann Oncol 28:2086-2093
Westmoreland, Katherine D; Stanley, Christopher C; Montgomery, Nathan D et al. (2017) Hodgkin lymphoma, HIV, and Epstein-Barr virus in Malawi: Longitudinal results from the Kamuzu Central Hospital Lymphoma study. Pediatr Blood Cancer 64:

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