The purpose of this Preventive Oncology Academic Award is to enable Howard K. Koh MD, FACP to apply his background in public health, oncology, hematology, dermatology and internal medicine to build and lead a collaborative effort in cancer prevention and integrate it into the mainstream of medicine. Dr. Koh's educational goals are to: 1) Take additional courses in cancer-related fields as needed at the Boston University School of Public Health. 2) Expand ongoing cancer prevention activities at Boston University Schools of Medicine and Public Health by specifically: a) broadening curricula for the course """"""""Cancer Prevention as a Public Health Problem"""""""" at Boston University School of Public Health, and b) developing curricula for the systematic instruction of cancer prevention to medical students and housestaff at Boston University School Medicine 3) Participate in guided multidisciplinary cancer prevention research listed below. Dr. Koh's research goals are to: 1) Develop a model, in Massachusetts, for a comprehensive cancer control program for cutaneous malignant melanoma. To develop this model, Dr. Koh will integrate information from four separate studies that: a) clarify melanoma incidence figures in the state by testing the hypothesis that melanoma rates are underreported, b) obtain systematic followup data on participants in annual skin cancer screening in Massachusetts to determine critical screening parameters, such as sensitivity, specificity and predictive value, c) assess where future screening would be most effective by: 1) using clustering techniques to determine hot spots for melanoma in Massachusetts ii) using a population-based statewide survey to construct a profile of persons who present with advanced melanoma, and d) Train primary-care physicians to detect skin cancer and evaluate that training. 2) Develop, measure and characterize in humans, DNA-adducts to the chloroethylnitrosoureas, which are chemotherapeutic agents and carcinogens. Chemotherapy patients represent a unique population to test characteristics of DNA-adduct formation. This research will provide a pharmacokinetic basis for the investigation of clinically and environmentally exposed populations as well as a basis for primary cancer prevention. Specifically, Dr. Koh will: a) refine, in animal models, a previously developed monoclonal antibody recognizing chloroethylnitrosourea-modified DNA, b) determine whether such adducts are measurable in humans receiving this drug, and c) study the pharmacokinetics of adduct formation and removal in exposed cancer patients.
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