The Wayne State University School of Medicine has received a $2,997,215 federal grant to help determine why African Americans show poorer responses than whites when treated with one of the most advanced immunotherapies for lung cancer.
The focus of the grant is to study immune checkpoint inhibitor, or ICI, treatment for metastatic non-small cell lung cancer.
The grant is through the National Cancer Institutes’ SPORE, or Specialized Program of Research Excellence, which funds collaborative, interdisciplinary translational cancer research. The grant will fund two projects under the title “Reducing Cancer Health Disparities in Detroit.”
The first project will characterize race-specific immune profiles with respect to tumor environment and host genetic background to determine their contribution to response to ICIs The second will develop an understanding of racial differences in patient responses to ICI treatment.
The projects will be led by principal investigators Ann Schwartz, Ph.D., M.P.H., professor and associate chair of Oncology for the School of Medicine, and deputy center director of the Barbara Ann Karmanos Cancer Institute, and Gerold Bepler, M.D., Ph.D., chair of the WSU Department of Oncology and associate dean of Cancer Programs, and president and chief executive officer of the Karmanos Cancer Institute.
Recent breakthroughs in immunotherapy, particularly ICIs with U.S. Food and Drug Administration approval, have offered significant advancements in lung cancer treatment. African American patients have accounted for less than 4% of ICI clinical trial representation. In the limited data available, African Americans demonstrated poorer responses to ICIs than whites, contributing to racial disparities in cancer treatment.
Overall, African Americans continue to have worse outcomes after lung cancer diagnosis than whites. Poorer response to treatment and worse outcomes are compounded because lung and bronchus cancers were leading sites of cancer diagnosis among African American men and women from 2019 to 2021, according to the American Cancer Society. Lung and bronchus cancers were the second cause of cancer death in African American people, following prostate cancer in men and breast cancer in women.
Work funded by the grant will provide the basis to move toward a more race-inclusive, equity-focused, precision medicine approach to the use of ICIs and will serve as a model for future research on other cancer sites and new agents.
“With this grant, we will work to address racial disparities in metropolitan Detroit, a uniquely important underserved population where great cancer disparities exist,” Dr. Schwartz said. “Racial disparities in cancer outcomes will likely widen without a comprehensive understanding of the biologic mechanisms driving treatment response in diverse populations and the applicability of clinical guidelines to all populations.”
Researchers will evaluate sociodemographic, individual and disease-specific predictors of response to ICI treatment in African American and white patients. While ICIs hold promise for improved outcomes, little is known about whether potential predictors of patient-reported side effects and quality of life, and immune-related adverse events vary by race.
By identifying drivers of potential disparities, health care professionals can better identify patients at high risk for side effects and immune-related adverse events. Health care providers can also develop interventions to reduce risk factors, thereby improving patient quality of life and reducing racial disparities in outcomes.
The grant number is 1P20CA262735-01, funded by the National Cancer Institute of the National Institutes of Health.