This application is to establish the UNC-Malawi Cancer Consortium (UNC-MCC), to develop capacity and conduct high-impact research focused on HIV-associated cancers. The consortium builds on longstanding collaborations between the University of North Carolina at Chapel Hill (UNC-CH), Lighthouse Trust, Malawi Ministry of Health, and University of Malawi College of Medicine. These partnerships have resulted in internationally recognized contributions for HIV care and prevention in sub-Saharan Africa. This infrastructure can now be leveraged for HIV-associated malignancies. UNC-MCC is focused on the herpesvirus-associated cancers, Kaposi sarcoma (KS), and lymphoma. Our consortium will be led by three principal investigators with highly complementary expertise (Satish Gopal MD, clinical research;Sam Phiri PhD, implementation science;Blossom Damania PhD, virology). The second of three research projects undertaken by UNC-MCC attempts to elucidate subsets of HIV-associated KS in Malawi to improve outcomes. The project is led by three co-PIs, Dr. Agnes Moses (UNC Project-Malawi), Joe Gumulira (Lighthouse Trust), and Dr. Dirk Dittmer (Lineberger Comprehensive Cancer Center). The project addresses a central problem that despite significant heterogeneity across a large KS population in Malawi, it is difficult to prospectively identify patients who are likely have relapsed or refractory disease. This is a population for whom better treatments are urgently needed. We will attempt to better understand KS heterogeneity through the following aims: (1) to develop a prognostic score using comprehensive clinical, laboratory, and biomarker data for recurrent or progressive disease;(2) to establish prevalence of KSHV-associated lymphoproliferative diseases in the KS population and effects on outcomes;(3) to identify KS-associated herpesvirus genomic features in tumor specimens which are associated with recurrent or progressive disease;and (4) to compare patient and tumor characteristics between KS that develops on and off ART. Recently completed work by our group (the AIDS Malignancy Consortium S001 study) has already demonstrated novel and important insights into KS biology in Malawi. This proposal seeks to build on these successes and collaborations to improve KS care.

Public Health Relevance

The UNC-Malawi Cancer Consortium will address herpesvirus-associated cancers in HIV-infected individuals. The second project will attempt to better understand heterogeneity among Kaposi sarcoma (KS) patients in Malawi. KS is the most common cancer in our setting, and identifying clinical and biologic subsets can lead to tailored, more effective treatment strategies to improve outcomes.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
1U54CA190152-01
Application #
8933166
Study Section
Special Emphasis Panel (ZCA1-RPRB-O (M2))
Program Officer
Dominguez, Geraldina
Project Start
2014-09-15
Project End
2019-08-31
Budget Start
2014-09-15
Budget End
2015-08-31
Support Year
1
Fiscal Year
2014
Total Cost
$189,417
Indirect Cost
$15,615
Name
University of North Carolina Chapel Hill
Department
Type
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Kohler, Racquel E; Tang, Jennifer; Gopal, Satish et al. (2016) High rates of cervical cancer among HIV-infected women at a referral hospital in Malawi. Int J STD AIDS 27:753-60
Heimlich, J Brett; Chipoka, Godwin; Kamthunzi, Portia et al. (2016) Establishing sickle cell diagnostics and characterizing a paediatric sickle cell disease cohort in Malawi. Br J Haematol 174:325-9
El-Mallawany, Nader Kim; Kamiyango, William; Slone, Jeremy S et al. (2016) Clinical Factors Associated with Long-Term Complete Remission versus Poor Response to Chemotherapy in HIV-Infected Children and Adolescents with Kaposi Sarcoma Receiving Bleomycin and Vincristine: A Retrospective Observational Study. PLoS One 11:e0153335
Gutnik, Lily; Moses, Agnes; Stanley, Christopher et al. (2016) From Community Laywomen to Breast Health Workers: A Pilot Training Model to Implement Clinical Breast Exam Screening in Malawi. PLoS One 11:e0151389
Gutnik, Lily; Lee, Clara; Msosa, Vanessa et al. (2016) Clinical breast examination screening by trained laywomen in Malawi integrated with other health services. J Surg Res 204:61-7
Montgomery, Nathan D; Liomba, N George; Kampani, Coxcilly et al. (2016) Accurate Real-Time Diagnosis of Lymphoproliferative Disorders in Malawi Through Clinicopathologic Teleconferences:  A Model for Pathology Services in Sub-Saharan Africa. Am J Clin Pathol 146:423-30
Gopal, Satish; Fedoriw, Yuri; Kaimila, Bongani et al. (2016) CHOP Chemotherapy for Aggressive Non-Hodgkin Lymphoma with and without HIV in the Antiretroviral Therapy Era in Malawi. PLoS One 11:e0150445
Gopal, Satish (2016) Moonshot to Malawi. N Engl J Med 374:1604-5
Stanley, Christopher C; Westmoreland, Kate D; Heimlich, Brett J et al. (2016) Outcomes for paediatric Burkitt lymphoma treated with anthracycline-based therapy in Malawi. Br J Haematol 173:705-12
Montgomery, Nathan D; Graham, Tiffany; Krysiak, Robert et al. (2015) Comparison of eosinophil density in staging bone marrow biopsies from Malawi and the United States. Pathol Int 65:671-3

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