The objective of this grant application is to create a center to support and expand our ability to conduct full-spectrum clinical and translational research on various cancers. Establishing the Dakota Cancer Collaborative on Translational Activity (DACCOTA) will also allow us for the first time to apply our basic scientific and epidemiologic work to the clinical arena while training clinician-investigator partners to translate these discoveries. We will train basic scientists to conduct translational work, population health experts to understand the community determinants of cancer outcomes, and clinicians to collaborate. The DACCOTA will promote and facilitate interactions between clinicians and scientists with unique but complementary areas of expertise. Our goal is to develop a highly productive, collaborative, and sustainable translational research center that will focus on the cancers that most commonly and disproportionately afflict the citizens of our region, especially American Indians. We have proposed independent cores, all led by capable investigators, that will assist in building a competitive clinical and translational cancer research center. The DACCOTA will provide an academic home for clinical and translational scientists and trainees. These investigators will focus on understanding the mechanisms leading to the initiation and progression of cancer, which will facilitate the development of novel and effective treatments and improve disease surveillance. This is necessary due to the increase in cancer prevalence and mortality in the Dakota region and throughout the USA. The DACCOTA will have further impact by validating new ways of developing and supporting individuals to facilitate team-based science addressing critical issues affecting the region. Our Professional Development Core will develop aspiring investigators and train practicing real world? clinicians to become more avid and effective collaborators. Applicants for pilot grants will be required to propose teams including an investigator and clinician. The Community Enagement and Outreach Core will help recruit volunteers, seek advice about overall directions, and work with community leaders to designate specific cancer-related issues of community concern for RFA?s that will be funneled through the Pilot Projects Program. In addition to the community- based natures of the University of North Dakota (UND), North Dakota State University (NDSU), and the University of South Dakota (USD), the collaborating hospitals in this proposal cover more than 90% of the region and include multiple innovative departments of family and community medicine as well as rural and population health. There are also three MPH programs between these institutions. Thus, we are superbly positioned to conduct clinical research encompassing the entire region. Similarly, the Biostatistics, Epidemiology, and Research Design Core and the Clinical Research Resources and Facilites Core will combine their strengths and develop new resources to enhance clinical research. Finally, our Tracking and Evaluation Core will use innovative methods to evaluate these novel processes as well as provide suggestions to improve efficiency and ensure both cost-effectiveness and improved patient safety. UND, NDSU, USD, and all clinical partners are fully committed to ensuring the growth and sustainability of the DACCOTA even after the CTR grant ends.
DACCOTA-Overall Narrative Project Narrative Among the many challenges to health, cancer stands out for its profound impact on the human species. In the US, cancer is the second leading cause of death, accounting for ~600,000 deaths/per year (22.5% of total deaths in the US) and amounting to over $120 billion annually in costs for treatment and care. Additionally, the incidence rates for various cancers in North and South Dakota are higher than the national average and nearly double in our American Indian population. Cancer is the leading cause of death for men and women ages 35-64 in the Dakotas, and 1 out of 2 men and 1 out of 3 women will be diagnosed with cancer at some point in their lives. Although cancer research traditionally focused on individual pathways, recent data (including ours) suggests dysregulation of multiple pathways could influence the biology of cancer, so a concerted effort using a multidisciplinary approach is necessary. Furthermore, cancer outcomes are determined not only by patient biology but also by a broader class of social determinants of health, and this is particularly true for certain populations in our region. Therefore, clinical collaborators must understand the physiology and do the translational work so they can advocate for and implement change in our communities. Because of our success in developing focused research groups, as well as our expertise in rural and population health, we are now submitting this collaborative grant application. We will bring together researchers and clinicians from across the region with diverse expertise to establish a translational center that will pave the way for the development of unique and innovative means of combating cancer in the Dakota region. The research performed by our investigators, which will focus on understanding and controlling cancer growth and metastasis, will lead to new breakthroughs that will have far-reaching effects. We believe that success in controlling cancer will not come from isolated scientific triumphs by individual researchers, but rather from broad approaches by a collective group such as the one we have assembled. The number of training and research programs in this region has tripled over the last decade, and efforts to link various institutions in the Red River corridor (the University of North Dakota (UND), North Dakota State University (NDSU), and the University of South Dakota (USD)) have significantly increased our biomedical expertise. However, we currently lack clinical and translational partners for these basic biomedical discoveries. Therefore, in partnership with NDSU, USD, and regional hospital partners in both states as well as the strong support of the governments of North and South Dakota, we plan to establish a core of clinical cancer researchers who will conduct cutting-edge, team-focused research with a translational emphasis.