This program pursues a set of overarching scientific goals: (1) to identify environmental, biological, psychosocial, epigenetic, and genetic factors that influence cancer risk, occurrence, and progression through basic, genetic and epigenetic, and epidemiologic research;(2) to clarify the impact of cancer and cancer treatment through outcomes research;(3) to develop, implement, evaluate, and disseminate educational, behavioral, and psychosocial interventions aimed at preventing cancer, improving eariy detection, enhancing symptom management, improving health and quality of life for cancer survivors, caregivers, and families, and advancing the science to improve palliative and end-of-life care;and (4) to advance cancer prevention, detection, and control within the broader contexts of institution and society through quality, economic, and policy studies. Program activities target five prioritized themes: disparities, tobacco cessation, obesity and nutrition, geriatric oncology, and survivorship (including symptom control and palliative care). Structurally, research within three main program sections - Epidemiology and Genetics Research, Behavioral Sciences Research, Applied Research - address these cross-cutting themes. Leading-edge research is underway in each section;examples are studies of epigenetic markers of cancer risk (Epidemiology and Genetics Research), neural correlates of nicotine addiction (Behavioral Sciences Research), and impact of Medicare policy change on access to chemotherapy (Applied Research). The program is integrally involved in forerunning national and institutional initiatives. Among these directions are: personalized medicine;patientreported outcomes;survivorship care, including palliative and end-of-life care;increasing minority enrollment in clinical trials, incorporation of bioinformatics and complex data functions across the full research spectrum; development of quality assessment approaches;and creation of a learning healthcare environment. This program currently comprises 46 Duke Comprehensive Cancer Institute members across 21 departments, divisions, schools and institutes. Grant funding has increased since our last submission, from $13,177,478 direct funding in 2004 to $21,317,489 in 2008 (11% NCI funding, 40% NIH funding). During the recent fiveyear period, we have published over 1,100 peer-reviewed papers;152 papers (13%) demonstrate intraprogrammatic collaboration and 162 papers (14%) demonstrate inter-programmatic collaborations.

Public Health Relevance

Despite a proliferation of novel treatment approaches, cancer continues to pose a major public health threat. Improved prevention, through higher screening rates and new strategies enabling eariier detection, will help reduce cancer incidence. For cancer patients at all stages, better symptom management - employing pharmaceutical, cognitive-behavioral, communication, and psychosocial approaches - will minimize suffering and optimize quality of life. Applied research will support the translation of epidemiologic, genetic, and behavioral research findings to improve outcomes, and the quality and cost effectiveness of cancer care.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Center Core Grants (P30)
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Subcommittee G - Education (NCI)
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Duke University
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Adams, Rebecca N; Mosher, Catherine E; Blair, Cindy K et al. (2015) Cancer survivors' uptake and adherence in diet and exercise intervention trials: an integrative data analysis. Cancer 121:77-83
Pruszynski, Marek; Koumarianou, Eftychia; Vaidyanathan, Ganesan et al. (2014) Improved tumor targeting of anti-HER2 nanobody through N-succinimidyl 4-guanidinomethyl-3-iodobenzoate radiolabeling. J Nucl Med 55:650-6
Batinic-Haberle, Ines; Tovmasyan, Artak; Roberts, Emily R H et al. (2014) SOD therapeutics: latest insights into their structure-activity relationships and impact on the cellular redox-based signaling pathways. Antioxid Redox Signal 20:2372-415
Sachdeva, Mohit; Mito, Jeffrey K; Lee, Chang-Lung et al. (2014) MicroRNA-182 drives metastasis of primary sarcomas by targeting multiple genes. J Clin Invest 124:4305-19
Tovmasyan, Artak; Carballal, Sebastian; Ghazaryan, Robert et al. (2014) Rational design of superoxide dismutase (SOD) mimics: the evaluation of the therapeutic potential of new cationic Mn porphyrins with linear and cyclic substituents. Inorg Chem 53:11467-83
Azrad, Maria; Demark-Wahnefried, Wendy (2014) The association between adiposity and breast cancer recurrence and survival: A review of the recent literature. Curr Nutr Rep 3:9-15
Blair, Cindy K; Madan-Swain, Avi; Locher, Julie L et al. (2013) Harvest for health gardening intervention feasibility study in cancer survivors. Acta Oncol 52:1110-8
Mito, Jeffrey K; Min, Hooney D; Ma, Yan et al. (2013) Oncogene-dependent control of miRNA biogenesis and metastatic progression in a model of undifferentiated pleomorphic sarcoma. J Pathol 229:132-40
Pruszynski, Marek; Koumarianou, Eftychia; Vaidyanathan, Ganesan et al. (2013) Targeting breast carcinoma with radioiodinated anti-HER2 Nanobody. Nucl Med Biol 40:52-9
Hover, Bradley M; Loksztejn, Anna; Ribeiro, Anthony A et al. (2013) Identification of a cyclic nucleotide as a cryptic intermediate in molybdenum cofactor biosynthesis. J Am Chem Soc 135:7019-32

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