PHILADELPHIA (August 10, 2023) — Sanjeevani Arora, PhD, an Assistant Professor in the Cancer Prevention and Control Research Program at Fox Chase Cancer Center, has received a grant of $752,000 from the Department of Defense to study racial disparities in rectal cancer survival. This topic is of particular importance to the DOD because nearly one-third of active-duty service personnel are members of a racial/ethnic minority group that could be affected by such disparities.
“Receiving this grant holds significant importance for our research,” Arora said. “This opportunity allows us to explore a promising avenue and address the gaps in understanding racial disparities, specifically in locally advanced rectal cancer.”
Rectal cancer rates are increasing in the United States, especially among people under 50. About 60% of cases are identified at an advanced stage, when the primary tumor has spread to the lymph nodes or further in the body. This condition is known as locally advanced rectal cancer, or LARC.
There is a significant difference in the outcomes of African American LARC patients compared to European American LARC patients, with the former about 40% more likely to die of the disease. The complex causes of this disparity include socioeconomic factors such as income level and education, and other hindrances to patient care, including language barriers and lack of health insurance and transportation access. However, prior research by Arora and others suggests that these factors cannot fully explain the disparity, leaving a critical gap in understanding.
One explanation for the worse outcomes in African Americans is poor response to therapy. LARC patients are treated with chemotherapy and radiation prior to surgical removal of their tumor. This treatment is called neoadjuvant chemoradiation therapy, or nCRT. Recently, there have been advances in LARC treatment that present new ways to treat patients who don’t respond well to standard nCRT. However, the clinical trials establishing nCRT and the new treatment strategies included little or no racial/ethnic data.
Arora said the project will be highly collaborative, with multidisciplinary expertise contributed by colleagues in Cancer Prevention and Control, as well as the Department of Radiation Oncology and the Nuclear Dynamics and Cancer Research Program.
The study aims to investigate the biological differences in response to LARC therapies between African American and European American patients. The researchers seek to address the gaps in treatment and outcomes of African American patients by identifying predictive biomarkers that can help forecast who will or will not benefit from nCRT.
This is thought to be the first study in LARC to systematically investigate host genetics and association with treatment response within the context of race/ethnic cancer disparities. Arora said the ultimate goal is to develop a predictive biomarker that could be deployed clinically in LARC patients.
A predictive biomarker would aid in treatment decision-making and the stratification of patients based on their potential benefit from nCRT, ultimately helping to contribute to the elimination of racial disparities in LARC.
“The research may ultimately introduce a new treatment paradigm in LARC,” Arora said. That would particularly benefit the U.S. military and the veterans’ community, in which risk factors are over-represented. Most service members are under the age of 50, with about 31% of active-duty members in a racial/ethnic minority group. Smoking and radiation exposures also are over-represented. “Ultimately, this study will impact mission readiness,” Arora said.