Cancers of the Digestive System
Presentation at the November 19, 2007 NCDD Meeting
Chair: John M. Carethers, MD
Vice Chair: Robert Sandler, MD, MPH
Research Goal 1
Develop population-based strategies for screening and prevention of digestive tract cancers.
Research Goal 1
Objectives
Research Goal 1
Objectives (continued)
Research Goal 2
Ascertain the importance, detection, and natural history of pre-malignant conditions progressing to digestive tract cancer.
Research Goal 2
Objectives
-
Characterize cancer syndromes for genetic defects and clinical behavior that predispose to digestive tract cancers.
-
Develop and study preclinical in vitro and in vivo models of digestive tract cancers to recapitulate the natural history seen in humans.
Research Goal 2
Objectives (continued)
-
Determine the natural history of premalignant lesions in the development of digestive tract cancer.
-
Define the role of inflammation in digestive tract cancer development.
-
Determine the role of the microbiome in the initiation or propagation of digestive tract cancers.
Research Goal 3
Evaluate disparities in digestive tract cancer etiology, risk, treatment management, and outcomes.
Research Goal 3
Objectives
-
Conduct clinical studies on access, utilization, treatment, and outcomes of patients with digestive tract cancers who belong to diverse ethnic, racial, or high risk groups.
-
Understand the influence of genetic factors on cancer risk,prognosis and response to therapy.
Research Goal 4
Develop biomarkers to predict presence, target therapy and evaluate therapeutic response in digestive tract cancers.
Research Goal 4
Objectives
-
Develop improved population-based assessment of risk for digestive tract cancers that can be detected in blood.
-
Utilize preclinical in vitro and in vivo models of digestive tract cancers to ascertain biomarkers that predict tumor behavior and response to therapy.
Research Goal 5
Evaluate nutriceutical, probiotic, chemopreventive, and targeted therapies in digestive tract cancers.
Research Goal 5
Objectives
-
Utilize preclinical in vitro and in vivo models of digestive tract cancers to ascertain potential effectiveness and mechanisms of preventive agents and small molecules.
-
Conduct large scale randomized clinical trials utilizing agents or targeted therapies to determine effectiveness in prevention or treatment of digestive tract cancers.
Research Goal 6
Understand the molecular and cellular mechanisms common to all digestive cancers.
Research Goal 6
Objectives
-
Define genetic and epigenetic mechanisms that characterize digestive tract cancers.
-
Characterize digestive tract cancer stem cells, and the local environment niche that supports and propagates the cancer.
Research Goal 6
Objectives (continued)
Research Goal 7
Identify genetic risk factors for esophageal cancer and usethat information to develop new tools for detection, diagnosis, and treatment.
Research Goal 7
Objectives
-
Perform comprehensive genetic analyses of esophageal squamous cell carcinoma and adenocarcinoma.
-
Develop non- or minimally invasive imaging and/or molecular techniques for pre-malignant changes in esophageal cancer.
Research Goal 7
Objectives (continued)
Research Goal 8
Understand the molecular profiles of various types of gastric cancer to improve risk stratification, prevention and treatment.
Research Goal 8
Objectives
-
Ascertain a complete molecular profiling of the histological types of gastric cancers from different locations within the stomach.
-
Develop a molecular roadmap for gastric cancer development that mirrors the known phenotypes.
Research Goal 8
Objectives (continued)
Research Goal 9
Define the genetics, familial inheritance patterns, detection and treatment of pancreatic cancer.
Research Goal 9
Objectives
-
Accelerate research into the genetics, familial inheritance patterns, and molecularly determined individual therapeutic options.
-
Improve imaging technologies to detect early malignant pancreatic cancers.
-
Facilitate collection of biospecimens linked to clinical data.
Research Goal 10
Identify genetic factors for risk stratification, and expand primary prevention and screening strategies for colorectal cancer.
Research Goal 10
Objectives
-
Evaluate chemopreventive and other primary prevention strategies.
-
Improve means to identify patients, colons, or pre-malignant lesions that give rise to the greatest risk for colorectal cancer.
Research Goal 10
Objectives (continued)
Research Goal 11
Understand the etiology, natural history, prevention and management of rare GI cancers.
Research Goal 11
Objectives
Research Goal 11
Objectives (continued)
-
Determine predictive factors or biomarkers that more accurately predict patient outcome, such as with MALT lymphoma and H. pylori eradication, anal carcinoma and immunosuppression or human papilloma virus infection, or the development and behavior of intra-abdominal desmoids in familial adenomatous polyposis.
Major Challenges/Steps To Achieve Goals
Major Challenges/Steps To Achieve Goals
Collaborative Research and Centralized Resources
-
Mechanisms for collaborative research
-
Multi-institutional repositories of samples and data from well-characterized patients for research on disparities among ethnic, racial, or high-risk groups
-
Facilities to complement the Cancer Genomic Anatomy Project (CGAP)
-
Centers to collect and maintain clinical information and epidemiological data linked to a repository of biological specimens and other data
-
High-throughput genomic and proteomic facilities to profile digestive tract cancers and their subtypes
-
High-throughput drug discovery programs based on targeted approaches to cancer biology as an opportunity for collaboration with industry
Major Challenges/Steps To Achieve Goals
Technology Development
Page last updated: January 07, 2008
