The Governor’s Office of Planning and Research (OPR) is pleased to announce the awardees for the California Initiative to Advance Precision Medicine (CIAPM) recent request for proposals (RFP), Reducing Cancer Disparities through Collaborative Precision Medicine Care.
Precision health and medicine approaches hold promise to more fully use data and computing tools to improve health and health care. This recent RFP targets proof-of-principle demonstration projects for patient populations that suffer from cancer health disparities with an aim to improve access, care, and outcomes through collaboration between academic, community, nonprofit, and private partners. These projects will each be awarded $3 million and will foster novel partnerships.
The three awardees include:
- “Integrated Machine-Learning Platform to Inform Precision Therapy in Underrepresented Triple-Negative Breast Cancer Patients.” University of California, San Diego
- “Improving Precision Medicine for Breast Cancer in Latinas: A Multi-Tiered Approach.” University of California, San Francisco
- “Reducing Cancer Disparities through Innovative Community-Academic Partnership to Advance Access and Delivery of Precision Medicine in Monterey County.” Stanford University
More information on teams and partners is listed below:
University of California, San Diego
“Integrated Machine-Learning Platform to Inform Precision Therapy in Underrepresented Triple-Negative Breast Cancer Patients.”
Principal Investigators: Dr. Pablo Tamayo, Dr. William Kim, Dr. Jill Mesirov, Dr. Elena Martinez, Dr. Barbara Parker, Dr. Warren Paroly, Dr. Hasnat Ahmed, Dr. Jesse Nodora, Dr. Rebecca Shatsky, Dr. Alfredo Molinolo, and Dr. James Murphy
Key Partners, Collaborators, and Supporters:
- American Cancer Society: Kay Clark
- Broad Institute: Dr. Paul Clemons
- Cancer patient and advocate: Bryce Olson, Sara Fainstein
- Cancer Resource Center of the Desert: Dr. Helen Palomino
- El Centro Regional Medical Center: Dr. Christian Tomaszweski, Dr. Kathy Toosie
- Galician Foundation of Genomic Medicine: Dr. Manuela Gago
- Health, Quality Partners: Nicole Howard
- La Jolla Institute: Dr. Stephen Schoenberger
- Michigan State University: Dr. Eran Andrechek
- Pfizer Oncology: Dr. Jadwiga Bienkowska
- Salk Institute: Dr. Geoff Wahl
- San Diego State University: Dr. Corinne Davidson
- Sanford Burnham Prebys Medical Institute: Dr. Robert Wechsler-Reya
- Stanford University: Dr. Hanlee Ji
- Tri-City Medical Center: Dr. Seung Gwon
- University of Guadalajara: Dr. Adrian Daneri-Navarro
- UCSD: Dr. Scott Lippman, Dr. Silvio Gutkind, Dr. Jing Yang, Dr. Trey Ideker, Dr. Ludmil Alexandrov, Dr. Ezra Cohen, Dr. Razelle Kurzrock, Dr. Judy Varner, Dr. Kun Zhang
Despite recent progress in the development of new cancer drugs, Triple-Negative Breast Cancers (TNBC) remain largely untreatable. These tumors lack traditional drug targets and are therefore associated with poor clinical outcomes. Because they are more prevalent among Hispanic women, this results in a major health disparity in cancer diagnosis and treatment. This project will bring together a community of researchers, clinicians, patients and community advocates who will join forces to apply genomic profiling to identify novel treatments and implement a more precise system to match TNBC tumors and cancer therapies.
University of California, San Francisco
“Improving Precision Medicine for Breast Cancer in Latinas: A Multi-Tiered Approach.”
Principal investigators: Dr. Elad Ziv, Dr. Niharika Dixit, Dr. Susan Neuhausen, and Dr. Luis Carvajal Carmona
Key Partners, Collaborators, and Supporters:
Laura Fejerman, PhD, Associate Professor of Medicine, will collaborate on germline and tumor genomics analyses and will lead outreach and education activities.
Henrik Bengtsson, PhD, Associate Professor of Epidemiology and Biostatistics, will oversee tumor genomics analyses.
Kathryn Phillips, PhD, Professor of Health Services Research and Economics, will oversee economic analyses.
Galen Joseph, PhD, Associate Professor of Anthropology, History and Social Medicine, will collaborate on risk communication.
Eric Collisson, MD, Associate Professor of Medicine, will collaborate on tumor genomics and clinical informatics interpretation.
City of Hope:
Jeffrey Weitzel, MD, Professor of Medical Oncology & Therapuetics Research and Population Sciences, will collaborate on genetic analyses, clinical interpretation and communication.
Daniel Schmolze, MD. Assistant Professor of Pathology, will collaborate on tumor and genomic analyses
Stacy Gray, MD, Associate Professor of Population Sciences and Medical Oncology & Therapeutics Research, will collaborate on clinical interpretation and communication.
- UC Davis: Dr. Carvajal Carmona and his team will collaborate on developing polygenic risk in Latinas. Dr. Carvajal Carmona, Director of Initiative for Health Equity in Latinos at the UC Davis Comprehensive Cancer Center, will also collaborate on outreach and education .
- Stanford University: Dr. Suzanne Tamang will serve as a consultant and collaborate on the development of tools to determine breast cancer outcomes using electronic health records.
- Visión y Compromiso will identify and help train promotoras on hereditary breast cancer. The promotoras will lead community educational events regarding hereditary cancer testing in the San Francisco Bay Area and Sacramento region. Ms. Miriam Hernandez will serve as a member of the advisory board.
- Promotores for Better Health will identify and help train pomorotas on the subject of hereditary breast cancer. The promotoras will lead educational events in the Los Angeles area. Ms. Alejandra Martinez will serve as a member of the advisory board.
- Bay Area Cancer Connections will help provide patient navigation services. Ms. Olivia Fe will serve as a member of the advisory board.
- Latino Cancer Institute: Ms. Ysabel Duron will serve as an advisory board member.
Breast cancer is the most common cancer among Latinas and is also the leading cause of cancer death among Latinas in California. Breast cancer mortality may be decreased by improved screening and earlier detection. Understanding hereditary cancer risk can help improve screening and detection since it will help identify women at particularly high risk who should start screening at an earlier age and should be screened more often and with better technologies (e.g. MRI). However, hereditary cancer testing in Latinas is limited for several reasons: 1) our understanding of what genetic variants cause Latinas to develop breast cancer is limited; and 2) community awareness of hereditary cancer and therefore use of genetic testing also is limited. In Aim 1, we propose to improve hereditary breast cancer care in Latinas. First, we will build on existing studies and expand them to determine which genetic variants may predispose Latinas to breast cancer. Second, we will build on existing educational and community outreach programs to train community educators (Promotoras) to do outreach and education among Latinas about hereditary breast cancer risk. In Aim 2, we propose to develop a comprehensive portrait of mutations in breast tumors in Latinas and its relationship to treatment outcomes. Mutations in breast tumors are increasingly being used by oncologists to identify treatments that may be effective. However, there is a lack of knowledge about the spectrum of mutations in Latinas with breast cancer. Therefore, we will sequence all genes in breast tumor samples from 500 Latinas and characterize what mutations are common and which specific treatments can be identified for Latina patients. Next, we will determine whether the mutations we find in Latinas are included in commonly used clinical cancer mutation tests. Lastly, we will integrate the tumor mutation data with clinical outcomes to determine how these mutations may affect treatment response and survival among Latinas with breast cancer.
“Reducing Cancer Disparities through Innovative Community-Academic Partnership to Advance Access and Delivery of Precision Medicine in Monterey County.”
Principal Investigators: Dr. Manali Patel, Dr. Lisa Goldman Rosas, Dr. Dale O’Brien, Ms. Ysabel Duron, and Dr. Zachary Koontz
- Cancer Patients Alliance (CPA): CPA, an organization focused on improving cancer care delivery for underserved populations in Monterey County, will be a key community partner in Monterey County and will provide overall supervision of community health workers and of local study activities.
- Community Hospital of Monterey Peninsula (CHOMP): CHOMP, a leading acute care facility in Monterey County with interest in implementing precision medicine for patients with cancer, will serve as a collaborating healthcare facility.
- The Latino Cancer Institute is a national network of Latino cancer service agencies and other stakeholders dedicated to reducing Latino cancer mortality. Headquartered in San Jose, California, the institute addresses the Latino cancer burden across the continuum by sharing best practices, collaborating in research, and supporting policy for health equity.
- Natividad Medical Center –Natividad Medical Center, the county hospital for Monterey County, will serve as a collaborating healthcare facility.
- Clinica de Salud del Valle de Salinas (CSVS): CSVS, a network of 12 clinics throughout Salinas Valley that serve predominantly Latino farmworker populations for primary care services, will hire community health workers who will be dedicated to prevention and screening efforts.
- Pacific Cancer Care (PCC): PCC is a major multi-physician oncology practice in Monterey County, providing comprehensive oncology and hematology services to Central California for over forty years.
Scientific contributors and supporters:
- Steven Artandi, MD, PhD, Director, Stanford Cancer Institute, Professor of Medicine and Biochemistry, Stanford School of Medicine
- Jay Bhattacharya, MD, Health Economist, Professor, Stanford School of Medicine
- James D. Brooks, MD, Associate Dean, Academic Affairs, Keith and Jan Hurbut Professor, Vice Chair, and Chief of Urologic Oncology, Division of Urology, Stanford School of Medicine
- Mark Cullen, MD, Director, Center for Population Health Sciences, Senior Associate Dean of Research, Stanford School of Medicine
- George A. Fisher, MD, PhD, Professor of Medicine, Division of Gastrointestinal Oncology, Stanford School of Medicine
- Kristi D. Graves, PhD, Associate Professor of Oncology, Director, Survivorship Research Initiative, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University
- Tina Hernandez Boussard, PhD, Associate Professor of Medicine and Biomedical Data Science, Stanford School of Medicine
- Allison W. Kurian, MD, M.Sc., Associate Professor of Medicine, Director, Women’s Clinical Cancer Genetics Program, Division of Breast Oncology and Health Research & Policy, Stanford School of Medicine
- Rhonda McClinton-Brown, MPH, Executive Director, Office of Community Engagement, Center for Population Health Sciences, Stanford School of Medicine
- Susan T. Vadaparampil, PhD, MPH, Senior Member & Professor, Health Outcomes and Behavior Program, Moffitt Cancer Center & Research Institute
- Heather Wakelee, MD, Professor of Medicine, Division of Thoracic Oncology, Stanford School of Medicine
Community contributors and supporters:
- Maximiliano Cuevas, MD, Chief Executive Officer, Clinica de Salud del Valle de Salinas
- Dolores Alvarado, MSW, MPH, Chief Executive Officer, Community Health Partnership
- Anna Caballero, Member, California State Senate, District 12, California
- Gloria De La Rosa, Member, Salinas City Council
- Jacqueline Peña, MSW, LCSW, Oncology Social Worker, Salinas Valley Memorial Health Care System
- Lluvia Del Rio, MBA, Patient Representative
- Joseph C. Grainger, Executive Director, Harden Foundation
- Gary Gray, DO, Chief Executive Director, Natividad Medical Center
- Honorable Jimmy Panetta, Member, U.S. Congress, 20th District, California
- Stephanie Sonnenshine, Chief Executive Officer, Central California Alliance for Health
- Grant Swanson, MD, Medical Director, Comprehensive Cancer Center, Community Hospital of the Monterey Peninsula
- Mike Witte, MD, Chief Medical Officer, California Primary Care Association
- Color Genomics
- Genome Medical
Low-income and minority populations experience a disproportionately greater burden of cancer compared with higher-income and non-minority patients. Precision medicine has potential to worsen these disparities if minority and low-income populations cannot access these innovative approaches. The objective of this project is to develop and test a community health worker (CHW) intervention to increase access to precision medicine approaches from cancer prevention and screening to diagnosis, treatment, survivorship, and end-of-life care. Our community-academic team will complete four aims: 1) Develop a community advisory board that will guide all phases of the project, 2) Optimize a CHW model to meet community needs and is aimed at increasing access to evidence-based precision cancer care, 3) Implement and test the CHW intervention in Monterey County with low-income and minority patients, and 4) Evaluate the economic impact of the CHW intervention. We will create a unique dataset comprised of electronic health records and administrative state-based, census level, and patient-reported data to support our evaluation and economic analyses. This demonstration project in Monterey County will provide enduring local capacity as well as a reproducible model that can be scaled and spread for use in diverse community settings.
Demonstration Projects were selected through a competitive peer-reviewed process with an external group of precision medicine expert reviewers. Reviewers used criteria for selection based on the National Institutes of Health process. Reviewers were asked to review proposals based on a number of factors including: 1) Significance; 2) Investigators; 3) Innovation; 4) Approach; and 5) Environment. They also had an overall impact score assigned. As per the statute and the Request for Proposals, at least one project had to be located in northern and southern California. Additionally, institutions could only receive one award.
- Utilizing multi-omics platforms to identify clinical biomarkers to better inform the treatment of breast cancer in Hispanic and Korean populations, Cedars-Sinai Medical Center
- The Integration of Genetic, Clinical Severity, and Patient Reported Complexity Variables to Predict Treatment Response and Disease Progression in a diverse population with Early Prostate Cancer, UC Irvine
- San Francisco Cancer Initiative to Advance Precision Population Health (SF CAN Advance), UCSF
- Digital Pathology and Artificial Intelligence (AI) to decrease health disparities in urologic cancers, Cedars-Sinai Medical Center
- California 4 Kids: A collaborative approach to advance precision cancer medicine and address health disparities for children, adolescent and young adults from diverse backgrounds, UCSF
- Addressing Disparities and Promoting Equity in Precision Prostate Cancer Treatment (ADEPPT) Study, UCSF
- The "Smart" Toilet: For Integrated Continuous Human Health Monitoring Cancer Diagnostics, Stanford University
- Engaging Cancer Patients in Self-Reporting: Strategic Inputs for Precision Medicine, Public Health Institute
- Grassroots Strategies for Advancing Inclusive Precision Medicine Research, Mentoring in Medicine and Science
- Precision dermatology to reduce cancer disparity in the Central Valley of California, UC Merced
- Early Detection of Aggressive Treatment-Resistant Prostate Cancer, Children’s Hospital Los Angeles
- Precision Health Navigators: Creating a Scalable, Sustainable Model for Underserved Los Angeles County Patients through Individually-Tailored, Risk-Stratified Cancer Screening and Prevention, UCLA
- Reducing Liver Cancer Disparities through Collaborative Precision Population Health: A Partnership to Leverage Academic/Community/Corporate Assets, UC Davis
- Genomic and Microbiomic Characteristics of NSCLC in Understanding Rising Incidence Among Hispanic Female Populations, UCSD
- Bringing Images into Precision Medicine to Reduce Cancer Disparities, UCSF
- Extending the Diversity, Reach, and Generalizability of the WISDOM Study, UCSF
- Addressing disparities in precision medicine skin cancer care in an underserved county population, UCSF
- Using Population-level Data to Guide Gene-specific Interventions for Metastatic Prostate Cancer, UCSF
- Liquid Biopsy & Epigenetic Drug Development for African American Men with Prostate Cancer, ARIZ Precision Medicine
- Predicting Chemotherapy Outcomes Using Remote Monitoring with Biosenors and Patient-Reported Outcomes, Cedars-Sinai Medical Center