Researchers with the Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center (UHCMC) have secured $5 million in funding from the National Institutes of Health (NIH)/National Cancer Institute (NCI) to establish an HIV-associated Malignancy Research Center (HAMRC) focused on lung cancer in East Africa.
The team will collaborate with Ugandan and Tanzanian researchers at the Joint Clinical Research Centre in Kampala, Makerere University Lung Institute, Uganda Cancer Institute, Mulago National Hospital, National Institute for Medical Research (NIMR), Muhumbili National Hospital and the Ocean Road Cancer Institute. The HAMRC will investigate novel approaches to characterize lung cancer epidemiology, somatic mutation burden, HIV and accelerated aging, and radiological features of lung cancer and the relationship to HIV-1 infection.
The focus of this new research center includes establishing national lung cancer diagnostic referral networks in Uganda and Tanzania, teleradiology telepathology, technology transference and training of early career investigators and personnel.
This cross-continental effort is led by Robert A. Salata, MD, Case Western Reserve/UHCMC; Stan Gerson, MD, Case Western Reserve; Bruce Kirenga, MD, Makerere University Lung Institute; and Sayoki Mfinanga, MD, PhD of the National Institute for Medical Research, Muhimbili Centre, Tanzania. The Case Comprehensive Cancer Center (Case CCC), which has a history of coordinating large, multi-institution projects, will provide administrative support, while the Joint Clinical Research Centre is the central site of research activity.
This five-year effort will take a comprehensive approach to better define the genetic and molecular determinants of lung cancer and how they impact—or are impacted by— HIV, a condition prevalent in these countries. This research aims to develop diagnostic computational imaging algorithms to discern lung cancer from other types of respiratory infections—especially tuberculosis, which is frequent in these African countries among patients with and without HIV.
The HAMRC will harness Case Western Reserve’s Center for Computational Imaging and Personalized Diagnostics (CCIPD) expertise in artificial intelligence (AI) to study lung cancer and the relationship to HIV-1 infection using radiological scans.
“We know from prior research that there are correlations between HIV and higher rates of lung cancer, and we hypothesize that HIV with its immunosuppression contributes to premature immunological aging, a known risk factor for lung cancer,” said Salata, chair of Case Western Reserve’s Department of Medicine and program director of the UH Roe Green Center for Travel Medicine & Global Health. “We will use advanced imaging capabilities coupled with novel AI and computational approaches to support accurate and timely diagnosis.”
Case Western Reserve and Makerere University have forged a research collaboration for 32 years, resulting in breakthroughs in characterizing the epidemiology and molecular-level mechanisms of conditions including tuberculosis, HIV and various forms of cancer.
“Collaborations like this one are part of the global priorities of the National Cancer Institute to advance the global medical community’s understanding of the interrelations between complex diseases and cancer, and how to treat them appropriately,” said Gerson, Case CCC director and interim dean of the School of Medicine. “While our focus for this series of projects is on the inter-relatedness of HIV, including increased risks for cancer, we anticipate that findings will inform diagnostic capabilities and personalized treatment for many types of cancer that present uniquely or that are accelerated in immunocompromised patients.”
Kirenga, director and pulmonologist at the Makerere University Lung Institute, and Mfinanga, NIMR director, have worked together on various large-scale, multi-country projects since 2009, notably on tuberculosis, which has informed the global community’s understanding of this and other infectious disease.
“This collaboration with CWRU and the Case Comprehensive Cancer Center builds on decades of relationships that have advanced understanding worldwide about diseases that do not recognize maps and borders,” Kirenga said. “The global community of cancer and infectious disease translational researchers recognize the importance of deepening our understanding of how complex conditions inform one another. This collaboration builds on a history of work that has resulted in better diagnostics and treatment for many conditions that touch thousands of lives worldwide.”
Research team leadership includes: Anant Madabhushi, PhD, director of CCIPD, Donnell Institute Professor of Biomedical Engineering, Case Western Reserve; Afshin Dowlati, MD, professor of medicine, Case Western Reserve, director, Thoracic Oncology Program, University Hospitals Seidman Cancer Center; Joseph Willis, MD, professor of medicine, Case Western Reserve, vice chairman, Pathology for Translational Research, University Hospitals Cleveland Medical Center; Simon Kasasa, PhD, senior lecturer of epidemiology and biostatistics, Makerere University.