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 (MOH), and University of Malawi College of Medicine (COM). 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 third research project undertaken by UNC-MCC attempts to develop risk-adapted, response-guided treatment concepts for HIV-associated lymphoma in Malawi. The project is led by three co-PIs, Drs. Satish Gopal (UNC Project-Malawi), Yohannie MIombe (COM), and Richard Nyasosela (MOH). Lymphoma is the most curable cancer among HIV-infected individuals in Malawi, and this project addresses the central problem that many patients likely receive more chemotherapy than is needed to cure them. This increases treatment-related complications in a setting where supportive care is limited, and compromises long-term survival. An ability to beti:er identify patients who are curable with less chemotherapy can optimize the balance between efficacy and toxicity. We will attempt to develop more risk-adapted and response-guided approaches to lymphoma treatment through the following aims: (1) to identify clinical variables and peripheral blood biomarkers associated with rapid achievement of durable clinical remission among HIV-associated lymphoma patients in Malawi;and (2) to identify tumor characteristics, including gene expression profiles, which are also associated with rapid achievement of durable clinical remission.
These aims will build on existing work in Lilongwe as part of the NIH-funded KCH Lymphoma Study, enhanced by collaborators from the UNC-CH Vironomics Core and sequencing infrastructure developed to support UNC-CH participation in The Cancer Genome Atlas (TCGA) project. Leveraging these ample resources, the proposed research will yield insights which are informative to care of HIV-associated lymphoma throughout sub-Saharan Africa.
The UNC-Malawi Cancer Consortium will address herpesvirus-associated cancers in HIV-infected individuals. Its third project aims to improve long-term survival for HIV-associated lymphoma, by identifying patients who can be cured with less chemotherapy, minimizing treatment-related toxicity in a setting where supportive care is extremely limited.
|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: â€‰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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