A team of UNC researchers are partnering with colleagues at four institutions in Africa to study HIV-associated malignancies. With a five-year, $6 million grant from the NIH’s National Cancer Institute, the research consortium will look at screening and diagnosing innovations for three cancers common to people with HIV: Kaposi sarcoma, cervical cancer and lymphoma.
Leading the consortium is virologist Blossom Damania, PhD, Boshamer Distinguished Professor of Microbiology and Immunology, UNC School of Medicine, co-leader of the UNC Lineberger Comprehensive Cancer Center’s Tumor Virology Program and vice dean for research at UNC School of Medicine. Joining her as key investigators are:
- Dirk Dittmer, PhD, professor of microbiology and immunology, UNC School of Medicine, and co-director, Program in Global Oncology, UNC Lineberger;
- Yuri Fedoriw, MD, LabCorp Distinguished Professor of Pathology and Laboratory Medicine, UNC School of Medicine, co-director of UNC Project-Malawi Cancer Program, director of global cancer pathology, Institute for Global Health and Infectious Diseases (IGHID);
- Carla Chibwesha, MD, MSc, associate professor of OB-GYN, UNC School of Medicine, head of UNC Global Women’s Health South Africa Program, and visiting faculty at the University of the Witwatersrand (Wits), South Africa;
- Sam Phiri, PhD, MSc, professor of medicine and executive director of Lighthouse Trust at Kamuzu Central Hospital, Malawi; and
- Paul Ruff, MBBCh, MMed, professor and head of medical oncology, Wits University.
The new consortium, UMSACC, brings the investigators together with colleagues at four sites in Africa known for cancer and HIV research: the Institute’s UNC Project-Malawi in Lilongwe, Malawi; Lighthouse Trust, Malawi; Stellenbosch University in Cape Town, South Africa; and University of the Witwatersrand, Johannesburg, South Africa.
The National Cancer Institute is targeting sub-Saharan Africa because the region has the world’s highest prevalence of HIV as well as HIV-related cancers. “Individuals all over the globe are afflicted with these cancers, but individuals with HIV are at much increased risk to get these particular cancers,” Damania says. “Studying these malignancies in Africa, where their incidence is highly elevated, allows us to learn more about these cancers. We can then apply this knowledge to help individuals who get these cancers all over the world, including in Africa and the U.S. What we learn globally, helps us locally.”
Pairing Institute researchers in Malawi and South Africa with UNC cancer researchers represents “a true partnership between UNC’s Institute for Global Health and Infectious Diseases and Lineberger Comprehensive Cancer Center,” says Institute Director Myron Cohen, MD, “thanks to our deep investment in global research on both HIV and cancer. We have worked with many of these partners in Africa for over 20 years and have collaborated with them on multiple projects and publications. “
“By supporting project development and key infrastructure, IGHID and Lineberger continue to launch the careers of the next generation of dedicated clinician scientists and oncology caregivers who are advancing the field of global oncology in Africa,” says Shelley Earp, MD, director of UNC Lineberger.
For Kaposi sarcoma, the researchers will study the impact of different therapies on the disease’s progression and will seek to develop prognostic biomarkers of the disease. Investigators leading Kaposi sarcoma studies are Dittmer, Phiri, and Johann Schneider, MBChB, MMed, FCPath, professor and head of the anatomical pathology division at Stellenbosch University, South Africa.
The cervical cancer researchers will pilot urine screening for HPV infection and methylation testing for cervical cancer screening among women living with HIV in Malawi and South Africa. Chibwesha is leading the cervical cancer project and working together with Jennifer Smith, PhD, professor of epidemiology, UNC School of Medicine, and UNC Lineberger member; Jennifer Tang, MD, MSCR, associate professor of OB-GYN, UNC School of Medicine, and UNC Lineberger member; Lameck Chinula, MBBCh, MMed, UNC assistant professor of OB-GYN and clinical research site leader at UNC Project-Malawi and UNC Lineberger member; and Masangu Mulongo, MBBCh, a women’s health researcher at Wits.
The lymphoma researchers are working to identify and validate prognostic biomarkers, and understand molecular features of these cancers to better tailor treatment for this challenging and vulnerable population. Fedoriw is leading the project and working with Ruff; Tamiwe Tomoka, MBBS, director of the pathology laboratory at UNC Project-Malawi; and Mariza Tunmer, MBChB, an oncology researcher at Wits.
The consortium will also include:
- A developmental and mentoring core led by Chibwesha and Mina Hosseinipour, MD, MPH, professor of medicine, UNC School of Medicine, scientific director at UNC Project-Malawi and UNC Lineberger member. The aim of this core is to support the professional development of Malawian and South African investigators and build in-country capacity to conduct high quality HIV-associated cancer research;
- A pathology core led by Fedoriw with Schneider, Tomoka and Yvonne Perner, MBBCh, (Wits) will conduct centralized pathology review for the proposed KS, lymphoma, and cervical cancer studies and aims to develop regional diagnostic and research laboratory capacity;
- An analytical core to assist with data analysis will be led by Andy Olshan PhD, Barbara Hulka Distinguished Professor of Epidemiology at UNC Gillings School of Global Public Health and UNC Lineberger member, Maganizo Chagomerana, PhD, director of Analysis and Manuscript Unit, UNC Project-Malawi, and Charles Chasela, PhD, Chief Scientific Office, EQUIP, Right to Care and Associate Professor at Wits.