“I feel a great responsibility,” Kimberly Leslie, MD, says about her uterine cancer grant.
A research professor at The University of New Mexico Comprehensive Cancer Center, Leslie leads the UNM portion of the Route 66 Specialized Program of Research Excellence (SPORE) grant. The $11 million grant is the only SPORE grant among the 65 National Cancer Institute’s SPORE grants to focus on uterine cancers.
Uterine cancer survival rates
Over the past 50 years, cancer survival rates have increased considerably for most types of cancers. But survival rates for uterine and endometrial cancer have stubbornly remained constant.
“We have a huge increase in the [incidence] rate of these cancers, endometrial cancer in particular,” Leslie says.
The endometrium lines the inside of the uterus and is shed every month during a woman’s fertile years. Too much bleeding or bleeding at the wrong time is an early sign of endometrial cancer. Women should have abnormal bleeding checked immediately, Leslie says.
The Route 66 SPORE grant aims to improve uterine cancer survival. The work is a collaboration between scientists at UNM Comprehensive Cancer Center, Siteman Cancer Center at Washington University in St. Louis, and Stephenson Cancer Center at University of Oklahoma. All three universities lie along Route 66, giving the grant its name.
Collaboration between the three institutions
The grant comprises three projects, two of which focus on high-risk cancers that arise from mutations, or changes, in cellular DNA. These uterine cancers are often found at late stages and are very hard to treat. The scientists at Siteman Cancer Center and Stephenson Cancer Center will focus on these projects.
Leslie’s team at UNM Cancer Center will focus on the third project, which will study treatments for early-stage uterine cancer. The incidence of this cancer has been increasing because of the obesity epidemic.
The UNM Cancer Center project addresses the rise of early endometrial cancers or precancers among the younger New Mexico population. The treatment for early-stage uterine cancer has been removal of the uterus, which is called a hysterectomy, and it has long been considered a cure. But many women may not want a hysterectomy.
“In our populations at the University of New Mexico, we’re seeing disparities,” Leslie says. “We’re seeing younger Hispanic women getting uterine cancer. [These are] women who normally would want to have families and not want to undergo hysterectomies.”
The UNM Cancer Center project will offer a clinical trial in which some women will be given the option of non-surgical treatment. These women will be treated with hormonal therapy in the hope of preserving their ability to have a family in the future.
In our populations at the University of New Mexico, we’re seeing disparities. We’re seeing younger Hispanic women getting uterine cancer. [These are] women who normally would want to have families and not want to undergo hysterectomies.
The UNM Cancer Center Route 66 SPORE clinical trial
Non-surgical treatments could not only help younger women preserve their ability to bear children but also could be easier on older women who might struggle to recover from a surgery.
“[We] can reverse approximately 70% of these cancers just with the correct hormone therapy,” Leslie says, adding that the UNM Cancer Center Gynecologic Oncology team are experts in hormone therapy for treating early-stage uterine cancer.
Leslie will work with Andrew Sussman, PhD, also at UNM Cancer Center, to address any diversity issues while recruiting New Mexico women for the clinical trial in a culturally appropriate way.
One goal of the clinical trial is to look for biomarkers that could allow doctors to know which women will respond to hormone therapy and which need surgery right away. Right now, doctors cannot know which women will respond to hormone therapy and which will not.
Leslie’s team includes gynecologic oncologists Carolyn Muller, MD, and Sarah Adams, MD, who will collect biological samples from the women in the UNM clinical trial; oncology pathologist Edgar Fischer, MD, PhD; and biostatistician, Jianrong Wu, PhD.
The teams at Washington University and University of Oklahoma will also collect samples from the women in their clinical trials. Leslie’s lab will then work with the UNM Human Tissue Repository to test all the samples.
Another goal of the clinical trial is to study other non-surgical ways to treat the uterine cancer. Leslie explains that studies have shown intensive exercise and diet control to have a positive effect on treatment outcomes. The clinical trial will hire a specialist to consult with the enrollees on these lifestyle choices.
The UNM Cancer Center clinical trial will include about 25 women; altogether, the three Route 66 SPORE projects will include more than 100 women. Leslie says that the clinical trials will follow up with the women for at least three years.
“I, personally, would like to thank all the administration at the UNM Cancer Center for helping us [support this SPORE grant at UNM],” Leslie says. “We’ve brought a lot [to this SPORE grant], and we want to help New Mexico a lot.”
About the Route 66 SPORE Grant
The National Cancer Institute of the National Institutes of Health supported the research reported in this publication under Award Number 1P50CA265793-01A1, Principal Investigators: Mutch, David G; Benbrook, Doris Mangiaracina; and Leslie, Kimberly K. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
UNM Comprehensive Cancer Center
The University of New Mexico Comprehensive Cancer Center is the Official Cancer Center of New Mexico and the only National Cancer Institute-designated Cancer Center in a 500-mile radius.
Its more than 136 board-certified oncology specialty physicians include cancer surgeons in every specialty (abdominal, thoracic, bone and soft tissue, neurosurgery, genitourinary, gynecology, and head and neck cancers), adult and pediatric hematologists/medical oncologists, gynecologic oncologists, and radiation oncologists. They, along with more than 600 other cancer healthcare professionals (nurses, pharmacists, nutritionists, navigators, psychologists and social workers), provide treatment to 65% of New Mexico’s cancer patients from all across the state and partner with community health systems statewide to provide cancer care closer to home. They treated almost 15,000 patients in more than 100,000 ambulatory clinic visits in addition to in-patient hospitalizations at UNM Hospital.
A total of nearly 1,855 patients participated in cancer clinical trials testing new cancer treatments that include tests of novel cancer prevention strategies and cancer genome sequencing.
The more than 123 cancer research scientists affiliated with the UNMCCC were awarded $38.2 million in federal and private grants and contracts for cancer research projects. Since 2015, they have published nearly 1000 manuscripts, and promoting economic development, they filed 136 new patents and launched 10 new biotechnology start-up companies.
Finally, the physicians, scientists and staff have provided education and training experiences to more than 500 high school, undergraduate, graduate, and postdoctoral fellowship students in cancer research and cancer health care delivery.