P20CA262733

Improving Outcome Disparities for Latino Children and Adolescents with Acute Lymphoblastic Leukemia - Summary

Acute Lymphoblastic Leukemia (ALL) is the most common cancer in children. While cure rates have improved over the past 50 years, ethnic disparities continue to persist. Latinos, in particular, have the highest incidence and among the lowest survival rates for leukemia in the U.S. The causes of this disparity are multifactorial, including differences in tumor and host biology, as well as social/behavioral factors such as limited healthcare access.

Host pharmacogenomics and other biological factors resulting in increased treatment-related toxicities are a key and understudied cause of ethnic disparities in outcomes. Adverse outcomes result from both direct treatment-associated morbidity and mortality, and compromised ability to deliver sufficiently intensive anti-leukemic therapy.

The overall goals of this P20 program are to reduce outcome disparities among Latino children and adolescents by identifying host biological factors that result in increased toxicities, and to lay the groundwork for the establishment of the first Specialized Programs of Research Excellence (SPORE) devoted to pediatric leukemia.

The two primary research projects will identify factors associated with the risk for two key treatment-related toxicities: hepatotoxicity and neurotoxicity. These toxicities adversely impact treatment outcomes and occur disproportionately in Latinos. The eventual SPORE will expand upon this work by pursuing prevention and treatment strategies and investigating ethnic disparities in other clinically impactful treatment-related toxicities.

The program will be administered through the Administrative Core (Core A). Biospecimens will be processed by Core B, and statistical analysis will be provided by Core C. A Developmental Research Program will foster the development of innovative pilot projects that aim to understand and/or reduce ethnicity-based disparities in ALL outcomes.

We will leverage the Reducing Ethnic Disparities in Acute Leukemia (REDIAL) Consortium, comprising six cancer centers in the southwestern U.S. This consortium will provide clinical data from 3,000 children and adolescents with newly diagnosed ALL, as well as clinical data, bone marrow, blood, and cerebrospinal fluid samples from nearly 2,000 individuals. These resources will be used for the following two novel and integrated projects.

Our synergistically integrated team will define key biological factors associated with hepatotoxicity and neurotoxicity, which are important contributors to ethnic outcome disparities. More broadly, this program will further strengthen and expand the REDIAL Consortium, with its invaluable ethnically diverse dataset and biorepository, and model its use for the development of risk prediction models that identify Latino patients at risk for toxicities and illuminate the underlying biological mechanisms.

This work will form the foundation for a future SPORE that will investigate additional toxicities of ALL therapy and translate these findings into the development of effective intervention strategies. This efficient monetary investment will result in significant reductions in outcome disparities in Latino children and adolescents with ALL.

Baylor College Of Medicine

NOT APPLICABLE

93.399 - Cancer Control

National Cancer Institute (NCI) [HHS - NIH]

Houston, Texas 770303411 United States

Single Zip Code

Feasibility and Planning Studies for Development of Specialized Programs of Research Excellence (SPOREs) to Investigate Cancer Health Disparities (P20 Clinical Trial Optional) (RFA-CA-19-034)

Amendment Since initial award the total obligations have increased 185% from $1,122,866 to $3,199,335.