Two Houston Methodist cancer researchers have been awarded $3.4 million in funding from the Cancer Prevention and Research Institute of Texas (CPRIT).

 

Nestor F. Esnaola, M.D., M.P.H., M.B.A., chair and deputy director of the Dr. Mary and Ron Neal Cancer Center, received a prevention grant for cancer screening and early detection (PP240042) in the amount of $1,437,244 for “Cancer Prevention and Outreach for Individuals Disproportionately Affected by Cancer in Medically Underserved Regions (C-CUR).”

 

Esnaola’s research will focus on improving cancer screening and prevention education services in urban medically underserved areas (MUAs) within health-disparate populations in Texas, which has been the focus of significant and ongoing concern. Low-income individuals residing in medically underserved areas of Texas suffer from significantly higher cancer incidence and mortality rates.

 

Federally Qualified Health Centers (FQHCs), which are community-based organizations providing comprehensive primary and preventive care, help to address these issues and are a critical component of the health care safety net. FHQCs play an important role in reducing the cancer burden among the populations they serve via cancer education, screening and early detection.

 

With a community-led approach to make cancer-related preventive services available via Legacy Community Health, an FHQC, in collaboration with Houston Methodist Neal Cancer Center and Texas A&M Health Science Center, Esnaola and his collaborators hope to make substantial contributions to screening, early detection and reducing mortality rates of breast, cervical, colorectal and liver cancers, as well as the hepatitis C virus.

 

Esnaola, who is also division chief of surgical oncology and gastrointestinal surgery in the Houston Methodist Department of Surgery and professor of surgery with the Houston Methodist Research Institute, says the CPRIT project will create a link between the community and clinical providers to make cancer-related preventive services available via three Legacy Community Health FHQCs to patients in the service areas of the Greater Fifth Ward Lyons, Santa Clara and San Jacinto/Baytown over three years. The grant will also make collaboration possible with The Rose, enabling them to extend breast cancer mobile screening services to all three Legacy locations.

 

The proposed program made possible by this grant leverages well-established partnerships and incorporates dissemination and implementation of evidence-based cancer education, screening and early detection, as well as culturally appropriate education and patient navigation.

 

Qing Yi, M.D., Ph.D., professor of cancer biology in medicine with the Houston Methodist Research Institute and director for the Center for Translational Research in Hematological Malignancies, received an academic research award for individual investigator research for clinical translation (RP240075) in the amount of $1,921,388 for “Combination Therapy Using ATRA and Carfilzomib to Treat Proteasome Inhibitor Refractory Multiple Myeloma.”

 

Yi’s research will focus on multiple myeloma, which is a bone cancer characterized by an accumulation of tumor cells in the bone marrow of patients. Myeloma remains incurable despite large numbers of chemotherapy drugs available for patients. The major problem in the failure to cure these patients is that patients will become resistant to all clinically used myeloma drugs, including traditional chemotherapeutics and novel agents. Additionally, some patients exhibit initial resistance, never responding to chemotherapy drugs. Most, if not all, myeloma patients who do respond will relapse after treatment and die from the disease.

 

Yi, who is also associate director of Cancer Center Basic Research Programs in the Dr. Mary and Ron Neal Cancer Center, says there is a class of chemotherapy drugs, called proteasome inhibitors, that are commonly used to treat patients with multiple myeloma, and while these drugs (bortezomib and carfilzomib) have a good therapeutic efficacy, their response rate in myeloma patients who have never been treated with them is only 27- 48%, and even patients who respond well to the drugs initially become resistant when treated again after relapse.

 

To address the need for developing better methods or drugs to overcome drug resistance, Yi’s team did a high-throughput screening of 1,855 FDA-approved drugs and found that a treatment used to treat patients with acute promyelocytic leukemia, called all-trans retinoic acid (ATRA), can overcome human multiple myeloma cell resistance to the current standard of care drugs. ATRA, which alone does not kill myeloma cells, enhances human myeloma cell sensitivity to bortezomib and carfilzomib. Yi believes that ATRA may be used to treat patients with myeloma to restore their response to these two first-line-of-treatment drugs. The CPRIT grant will be used to conduct a first-in-human phase IB/II clinical trial to determine the safety, tolerability, efficacy and recommended phase II dosing of combination therapy using ATRA and carfilzomib to treat proteasome inhibitor resistance in multiple myeloma patients.

 

Esnaola and Yi both joined Houston Methodist as CPRIT recruits in 2018.