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Cancer Chemoprevention

Where You Are:
VISION OF THE MOFFITT RESEARCH INSTITUTE:
The Moffitt Research Institute’s vision is to be the leader in understanding the complexity of cancer through team science and applying those insights for human benefit.

DEFINITION:
Prevention is the ultimate approach to controlling cancer. Prevention efforts require a thorough understanding of the mechanism of carcinogenesis. Knowledge of the molecular basis of carcinogenesis is critical, elucidating signaling, metabolic pathways and defining genetic progression models.

The use of this knowledge by transdisciplinary scientists to develop pharmacologic agents, including botanicals and biologics to reverse or halt the process of carcinogenesis is called Cancer Chemoprevention.

The use of natural, synthetic, or biologic compounds including vaccines to inhibitor reverse pre-invasive carcinogenesis before the development of clinical cancer, as signified by cellular invasion across the basement membrane is Cancer Chemoprevention. It is the prevention of cancer or treatment of identifiable precancers (histopathological or molecular intraepithelial neoplasia).

The aims of Cancer Chemoprevention is to produce regression of prevalent precursors of cancer, suppress recurrent precursors and prevent incident precursors and/or cancer.

CANCER CHEMOPREVENTION: THE PROMISE
The identification of chemopreventive agents holds tremendous promise in reducing the burden of cancer. Our experience from past trials of preventive agents offer important lessons that can inform the design and conduct of future trials. Trials of the past have clearly demonstrated the (a) need for more preclinical and early phase work before undertaking phase III trials; (b) imperative for broad, sensitive toxicological and human safety assessments; (c) safety can be improved in iterative generations of agents and trials; (d) synergy between agents can lead to lower doses, improved efficacy and fewer or less severe toxicities. Regarding cohorts, we have learned there are substantial benefits to employing germline, familial, or increased-risk cohorts, including, among others, more power over a shorter time frame. An assessment of endpoints in trials resulting in approval of a preventive agent reveals that nearly all have been approved on the basis of intraepithelial neoplasia, particularly in accessible organs. Lessons gleaned regarding the overall design of clinical trials underscore the importance of the randomized, placebo-controlled design and the need for long-term follow-up and monitoring to meet FDA requirements and promote acceptance in the marketplace.

GOAL:

The goals of the Cancer Chemoprevention Initiative are two-fold:

(a) Research:
In support of this mission and capitalizing on the transdisciplinary strengths of its members, the Cancer Chemoprevention initiative at the Moffitt Cancer Center will be dedicated to using a science-based approach, applying the valuable lessons learnt from past trials to the work in an interdisciplinary fashion to:
  1.  Identify, characterize and develop agents that can modulate carcinogenesis for cancer chemoprevention and evaluate the safety, efficacy and mechanisms of action using in vitro and preclinical models.
  2. Evaluate these agents for safety, efficacy in translational clinical trials targeting populations at risk due to exposure to carcinogenic agents, familial and genetic predisposition, or due to the presence of premalignant lesions, while validating intermediate end points of carcinogenesis and correlate these with clinical endpoints.
(b) Professional and Public Education
In addition to research, the Cancer Chemoprevention initiative will disseminate current and authoritative information to patients, public, and health professionals towards integrating findings into evidence-based clinical practice.

We will strive to utilize national and international resources and expertise to develop our faculty and stimulate interest, inform and increase the number of researchers and funding for this area of research.



Members:
Mark G. Alexandrow, PhD
Khaldoun Almhanna, MD, MPH
Scott J. Antonia, MD, PhD
Wenlong Bai, PhD
Lodovico Balducci, MD
Amer A. Beg, PhD
Domenico Coppola, MD
Julie Yin Djeu, PhD
Kathleen M. Egan, ScD
Martine Extermann, MD, PhD
Robert J. Gillies, PhD
Jhanelle Gray, MD
Shilpa Gupta, MD
Clement K. Gwede, PhD, MPH, RN
Heather Sook Han, MD
Eric B. Haura, MD
Lori A. Hazlehurst, PhD
John J. Heine, PhD
Roohi Ismail-Khan, MD
Heather S. Jim, PhD
Patricia Judson, MD
Nagi B. Kumar, PhD, RD, FADA
Ambuj Kumar, MD, MPH
Christine Laronga, MD, FACS
Ji-Hyun Lee, DrPH
Hui-Yi Lin, PhD
Alan F. List, MD
Nupam P. Mahajan, PhD
Mokenge P. Malafa, MD
Susan Elizabeth Minton, DO
Eric K. Outwater, MD
Tuya Pal, MD
Jong Y. Park, PhD
Catherine M. Phelan, PhD, MD, MMS
Michael A. Poch, MD
Julio M. Pow-Sang, MD
Gwendolyn P. Quinn, PhD
Kasia A. Rejniak, PhD
Brian M. Rivers, PhD, MPH
Matthew B. Schabath, PhD
Michael J. Schell, PhD
Said M. Sebti, PhD
Thomas A. Sellers, PhD, MPH
Erin M. Siegel, PhD, MPH
Brent J. Small, PhD
Philippe E. Spiess, MD
Gregory M. Springett, MD, PhD
Susan Thomas Vadaparampil, PhD, MPH
Jenny Permuth Wey, PhD
Jingsong Zhang, MD, PhD
 
 
 
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