This proposal describes a combined effort of the Vanderbilt-Ingram Comprehensive Cancer Center (VICCC), the Vanderbilt University Medical Center (VUMC) and, eventually, the Meharry Medical Center (MMC), to expand ongoing efforts in Phase I clinical research and establish a Phase I Translational Research Program. The goals of this proposal are to conduct early phase, dose-ranging trials of new anticancer agents to characterize their toxicity and pharmacology as well as to explore their effects on molecular targets to provide new scientific insights into drug mechanisms of action and determinants of response. The Program brings together clinical investigators experienced in early phase clinical trials with basic scientists at Vanderbilt who are studying the biology of molecules, such as EGFR and COX-2, that are the focus of some of the most promising molecularly-targeted therapies. Working together, these researchers have taken advantage of complementary skills and interests to design and initiate innovative translational research studies. Pharmacokinetic analysis of novel compounds will be performed using highly sensitive and specific methods of drug quantitation including WLC, LCMS, and GCMS methodology. The excellent resources available at VICCC and VUMC will promote the expansion of pharmacogenetic analyses in early phase clinical trials of novel agents using hypothesis-testing as well as hypothesis-generating approaches. Pharmacodynamic relationships will be explored using PK as well as PG data. Data is presented that highlight recent accomplishments of the Phase I effort at Vanderbilt and establish the adequacy of patient resources needed to carry out 2-3 translational research studies per year under this cooperative agreement. Over the past 4 years there has been a 63% increase in the number of studies open, a 38% increase in the number of patients enrolled, more than a doubling of the number of physicians entering patients into Phase I studies, and a doubling of the number of physicians writing and chairing Phase I trials. Data is also presented demonstrating the regional impact of Vanderbilt's Phase I program in the Southeast United States, an area currently without an NCI-designated Phase I center. We describe our plan for the graduated involvement of MMC in this cooperative agreement that will enhance both the access of African-American patients to Phase I clinical trials and the involvement of clinical and basic researchers from Meharry in the design and conduct of these early phase translational research studies. In summary, we believe that the support from this cooperative agreement will significantly enhance our efforts to understand the clinical, pharmacologic, and molecular impact of important new anticancer agents and optimize their further development and utilization.
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