THE PROBLEM
The GYN Cancer Center of Excellence leverages innovative research to enhance gynecologic cancer care from prevention to survivorship for service members, beneficiaries, and the general public. We work to identify molecular alterations in gynecologic cancers and develop novel strategies for prevention, early detection, and precision treatment of these diseases to enhance the experience of care, ensure readiness of the fighting force, and improve beneficiary health adding value while decreasing DOD cost.
IMPACT ON THE MILITARY
Gynecological (GYN) cancers consist of cervical, ovarian, uterine/endometrial, vaginal and vulvar cancers, and they extract a substantial human, readiness, and economic toll on the military as women now comprise 15-20% of our military and there are nearly 2 million female veterans. The gynecologic cancer diagnosis is devastating and many will be discovered at advanced stages, many will lose their fertility, and a third will lose their life.
The degradation of readiness is obvious when it is the soldier, sailor, or airman undergoing treatment. The impact is also significant when it is a loved one undergoing treatment, because it’s hard to accomplish the mission while a wife or daughter is in the treatment chair. Beyond the human and readiness impact, gynecologic cancers are among the most expensive to treat, straining a healthcare system that does not have unlimited resources.
OUR WORK
CANCER MOONSHOT APOLLO
The GYN-COE has been tasked with leading quality assurance assessments of pathology, LCM preparations of samples and proteomics analysis for the 8,000 cancers planned for the Cancer Moonshot APOLLO program.
OVARIAN CANCER
Our group is working with the Cancer Moonshot APOLLO program as well as the M.D. Anderson Moonshot program to improve our understanding of these ovarian cancer subtypes to improve patient outcome. Preliminary data by our group and others suggests that tumors that are unresectable and/or with extensive spread have unique molecular profiles. We have published a series of papers summarizing GOG trials in ovarian cancer and have reaffirmed that disease distribution and residual disease following debulking are the two strongest determinants of patient outcome. Unfortunately, the Complexity of surgery does not seem to strongly impact outcome in many cases. These findings suggest that the extent of disease spread may be related to the biology of the tumor. It is our hope that improved understanding of proteogenomic alterations associated with aggressive ovarian cancer will facilitate development of innovational therapeutic strategies and modifications of current clinical practice.
ADDRESSING RACIAL DISPARITIES IN RESEARCH
Over the last two years, we have worked to address the relative lack of inclusion of minority patients in discovery proteogenomics by establishing the Proteogenomics Across Racial and Ethnic Disparities (PAIRED) network. The PAIRED network; and Detroit, Washington, DC, and North Carolina (for Blacks)) facilitates the retrieval of precancerous and cancer FFPE specimens from multiple institutions enabling inclusion of cases from underserved populations fostering identification of clinically actionable biomarkers that are generalizable and not specific to one particular racial or ethnic group.
Image: Located in Oklahoma, South Dakota, and Arizona (for Native Americans); Alaska (for Alaska Natives); Hawaii and San Francisco (for Asians, Native Hawaiians, and Pacific Islanders); and Detroit, Washington, DC, and North Carolina (for Blacks)