Solving Cancer, Together

Critical Mass: LSU Adds Key Expertise to Improve Cancer Outcomes in Louisiana

With investment by the state, LSU is attracting and supporting top research talent to solve some of the biggest challenges in cancer care for patients and families, starting with Louisianans. The effort builds on a historic $75 million investment in LSU by LCMC Health to rapidly advance cancer research, treatment and good outcomes in Louisiana and ensure a sustained talent pipeline for the state’s healthcare industry.

From New Orleans to Shreveport, LSU is recruiting world-class researchers to help fight cancer in Louisiana and advance the university toward National Cancer Institute, or NCI, designation for the state and region. As LSU’s lead clinical partner in this effort, LCMC Health is uniting assets and expertise with LSU to draw additional cancer-focused investigators and resources to the state and make the most of tactical investments. Such investments include $3 million in recent support from the Louisiana Legislature, which LSU quickly used to hire three leading experts who bring with them more than $9 million in grants and contracts—mainly federal money, including from NCI.

“For LCMC Health, partnering with LSU to build multidisciplinary teams is the fastest way to move lifesaving treatment from the research lab to the bedside, expand access to clinical trials and improve survivorship—all essential components of a comprehensive cancer center,” President and Chief Medical Officer for LCMC Health Dr. John Heaton said. “Meeting the high bar to achieve NCI designation with LSU will be truly transformational for our state—a model that’s been shown to improve outcomes and reduce disparities in care. Our partnership with LSU is our best way to fight back on a scope and scale commensurate with the toll cancer takes on the citizens of Louisiana.”

“The grant to LSU as part of NCI designation would actually be quite small, about $1 million, but the impact on the entire region could be up to $2 billion as we become a clinical destination, achieve excellence in cancer care and prevention, and every job in research creates several other well-paying jobs, including in spinoff biotechnology companies,” said Cancer Crusaders Endowed Professor in Cancer Research Dr. Lucio Miele, assistant dean for translational science at LSU Health New Orleans.  

Elevating biotechnology, biomedicine and cancer research in Louisiana is a priority of LSU’s Scholarship First Agenda, built to secure Louisiana’s future by bettering the lives of residents in every parish. Health is one of the state’s most critical needs: Louisiana ranks among the top five states in the nation for higher cancer incidence and cancer mortality. While outcomes for white Louisianans lag in comparison to other states, outcomes for Black residents are often even worse as an outcome of health disparities, including access to care and additional risk factors. This is why most of LSU’s recent cancer research hires focus specifically on fighting health disparities.

Meet the experts

Jiri Adamec, professor of interdisciplinary oncology at the LSU Stanley Scott Cancer Center and director of core laboratories at the LSU Health New Orleans School of Medicine, was recently recruited to LSU from University of Nebraska after spending several years at Yale, the Mayo Clinic and Purdue. He’s an expert on “omics,” disciplines in biology that analyze thousands of molecules simultaneously to study their influence on the structure and function of organisms. Many of these, called biomarkers, are indicators of health or disease, and can be measured in a single drop of blood. Adamec develops new technologies to discover biomarkers to effectively monitor cancer incidence and recurrence in large populations—especially those that are rural and underserved. Detection of biomarkers can help with early diagnosis, which is essential for positive cancer outcomes.

“If we can’t get the most vulnerable people into our clinics and can’t bring our clinics to them, then what—how do we help them?” Adamec asks. “This is the reason I’m focused on creating new technologies for screening that are affordable, easy to use and require no power or specialized equipment. Solutions that work for everyone.”

Dr. Omar Franco-Coronel, a new associate professor of biochemistry and molecular biology at LSU Health Shreveport and its Feist-Weiller Cancer Center, studies molecular differences in the tumor microenvironment—the “neighborhoods” that surround cancer cells. He’s discovering differences between white and Black men, who have the highest risk of developing and dying from prostate cancer. Most recently, he found new connections between cancer and obesity. The body’s inability to regulate fat on the molecular level can lead to rapid tumor progression as well as weight gain.

“Unfortunately, African American men in Louisiana have these highly aggressive types of cancer I didn’t see when I was at the University of Chicago,” Dr. Franco-Coronel said. “My goal is to find out why, and the best way to do that is to develop a comprehensive tissue biobank with germline, or normal, DNA as well as tumor DNA, including from patients with aggressive forms of the disease. This will add to currently available cancer research resources, such as the NCI-supported Louisiana Tumor Registry at LSU, which enhances our understanding of cancer.”

“Tumor progression depends on the tumor microenvironment, which is different for African American patients,” Dr. Franco-Coronel continued. “If we understand how these differences predispose or prime someone to develop cancer at a higher speed, it could give us new targets for treatment and have huge implications for personalized medicine. Differences we’re focused on right now have to do with lipid, or fat, metabolism. An approach we’re currently testing has dual beneficial effects for fighting cancer and reducing body weight.”

Although his research is focused on prostate cancer, his findings could lead to more effective treatments for any person with any type of cancer. His work to combat cancer health disparities is currently supported by the Department of Defense with a grant of $1.2 million as well as through a $2 million R01 grant from NCI—and he’s the primary investigator on both.

Another recent LSU hire is one of the nation’s leading experts on creating and using genetically modified animal models, which are an essential step in the medical research process between initial discovery—of a biological process, molecular signaling pathway, or drug target, for example—and approved treatments that are safe and effective for human patients. Bob Kesterson is professor of cancer precision medicine and director of the Genetically Engineered Models, or GEMs, core facility at LSU’s Pennington Biomedical Research Center. He works with mice, rats and fish to help scientists answer their research questions and find new and better ways to study cancer. As part of his own cancer research, he’s been able to create genetic mutations in mice and rats that mimic the exact mutations found in patients for completely personalized biomedical research while also developing nanoparticle delivery systems and other mechanisms that fix or compensate for faulty genes by hacking the genetic code. Exactly how to target mutated genes, or get drugs or treatments inside the right cells, is a major hurdle in cancer research around the world—a challenge Kesterson is working to solve.

“Coming to LSU and Pennington after working at NCI cancer centers at Vanderbilt University and the University of Alabama at Birmingham for over 25 years was a natural fit since there are numerous connections between my cancer research and metabolism, where Pennington is a leader,” Kesterson said. “I look forward to forging new collaborations, and we hope to soon have a preclinical MRI machine that will be available to not just Pennington researchers, but investigators throughout the LSU campuses.”

The kind of personalized gene rescue Kesterson is able to do relies on increasingly affordable genetic sequencing and can make the difference between life and death for people with rare diseases. Imagine, for example, that you have a rare mutation that causes thousands of tumors to grow along your nerves and under your skin, such as neurofibromatosis, caused by a problem in the NF1 gene. NF1 is classified as a rare disorder, which tend to be under-researched by large pharmacological companies due to the smaller patient populations (and fewer customers for a potential treatment or cure). In such situations, academic research can thrive by finding solutions. With sustained support from the Gilbert Family Foundation—over $10 million in recent years—Kesterson has been working on multiple ways to target and edit NF1 genetic typos.  

Interestingly, Kesterson and colleagues found that rats engineered with NF1 gene mutations develop mammary tumors. This led to the discovery that up to one-third of breast cancer patients also have acquired underlying “hits” or mutations in the NF1 gene.

“This was missed for many years until we discovered it in rats,” Kesterson said. “And something else that’s interesting is the connection between the NF1 gene and energy balance in the body. If you turn the gene off in a subset of neurons in mice, you can end up with a very obese and diabetic rodent.”

Why is cancer so difficult to cure?

The main reason scientists and doctors haven’t cured cancer yet is the complexity of the disease, which actually is many distinct diseases. Also, since cancer is created by a person’s own cells—each containing gigabytes of unique genetic information—tumors are as diverse as people. Treatments that work for a specific type of cancer in one person can fail entirely in another. The only common thread among cancers is uncontrolled cell growth, while the underlying reasons for this growth are still being discovered.

“The biggest challenge in cancer research is that we still don’t know what questions to ask or how to connect already known aspects,” Adamec said. “That’s the problem, and that’s why ‘omics’ matter. In ‘omics,’ we quantify as many molecules as possible, find patterns and establish cancer-related panels that can be used for diagnostic purposes—meaning, questions to ask. The panels cover both general disease biomarkers and highly specific cancer biomarkers.”

Adamec compares his work to the board game where you hold a card with the name of a famous person to your forehead while posing questions to the people around you who can see the card: “Am I dead or alive?” “Am I male or female?”

“Without ‘omics,’ cancer screening can be just like that game,” Adamec said. “Maybe you get 10 questions, but without luck, you might not be able to get specific enough to guess the name on the card. Our approach is different. We don’t look for well-defined things; we look at everything—5,000 or 10,000 proteins, or more. We use mass spectrometry to quantify each molecule and then we use statistics and big data analysis, including artificial intelligence and machine learning, to identify biomarkers with high specificity.”

Elevating LSU’s fight against cancer health disparities

Together with researchers at Purdue, Adamec holds a patent on a plasma separation device that looks like a credit card, called Telimmune. It has a small hole at the top for a drop of blood, which passes through a filter, separating the blood plasma from the red and white blood cells. Once separated, the plasma dries inside the card within a few minutes, creating a stable sample with thousands of molecules that can be transported even in high humidity and high temperature, such as in a pocket while walking through the rainforest—Adamec has done a lot of research with remote communities in the Amazon—or sent in a plain envelope in the mail. A simple finger-stick can produce enough blood, a single drop, for a full analysis.

“Louisiana, in particular, is perfect for this kind of research because we have huge diversity in terms of people,” Adamec said. “Being a melting pot isn’t just interesting from a cultural perspective, but also for effective and meaningful cancer research. With the Mississippi River, which drains 31 states in the U.S., this is also an environmental micro-cosmos that represents the globe. We have everything here, and as a researcher, LSU is a great opportunity, because we have two medical schools that connect theory with practice and gives us access to patients so we can translate our research and work as a big team to really help people.”

LSU’s recent hires are contributing to the building of the critical mass necessary for pursuing NCI designation to achieve cutting-edge cancer care in Louisiana. Before the arrival of Adamec, Kesterson and Dr. Franco-Coronel, the LSU system already had 19 researchers leading projects with more than $12 million in active NCI support. The largest project among them, led by Dr. Augusto Ochoa, chair of interdisciplinary oncology and Al Copeland Cancer Crusaders Chair in Neuroendocrine Cancer at LSU Health New Orleans as well as deputy director of the LSU Health-LCMC Cancer Center, is specifically focused on fighting health disparities by bringing advanced treatments to patients across the state through enrollment in clinical trials. His Gulf South Minority Underserved NCI Community Oncology Research Program is the only statewide cancer clinical trials program in Louisiana, and Dr. Ochoa’s leadership was recognized by the NCI last year with the Harry Hynes Award for Outstanding Contributions to Clinical Trials and Community Research. In 2021, the paper detailing his team’s breakthrough discovery that tumors develop ways of blocking the body’s immune response was deemed one of 24 Cancer Research Landmark Papers in recognition of the 50th anniversary of the National Cancer Act.

In 2022, with $1 million in additional support from the Louisiana Legislature, LSU President William F. Tate directed the development of a new Collaborative Cancer Research Initiative, or CCRI, for Louisiana. Matched by more than $2 million from LSU, including $500K from each of LSU Health New Orleans, LSU Shreveport and Pennington Biomedical, 11 research proposals from multi-campus teams were awarded seed funding with three goals: improve cancer care and prevention in Louisiana; launch research projects likely to attract federal funding from the National Institutes of Health and NCI; and ensure, through peer review by national cancer leaders, that all projects help advance LSU toward NCI designation.

Did You Know?

• Cancer is expected to surpass heart disease as the leading cause of death around the globe in 2030. As we get older, we’re more likely to develop mutations, or typos, in our genetic code, and as mutations accumulate, cancer becomes more likely.
• In Louisiana, even during the height of the COVID-19 pandemic, more people were dying from cancer than from coronavirus infection.

LSU continuously strives to achieve advances in cancer research. Read more news about the latest progress:  

• International Team Including Two Pennington Biomedical Faculty Awarded $25 Million for Cancer Research (Pennington Biomedical Research Center)  
• NCI Awards LSU Health’s Ochoa Most Prestigious Honor for His Leadership & Contributions to Community-Based Cancer Clinical Trials (LSU Health New Orleans) 
• TMIST Clinical Trials: Changing the Future of Breast Cancer Screening (LSU Health Shreveport) 
• LSU Vet Med Client and Supporter Offers Resources for Canine Cancer Patients (LSU School of Veterinary Medicine) 
• LSU ChE, SJA Students Study Breast Cancer in 3D Environment (LSU College of Engineering) 
• How Having Our Own High-resolution Avatar Could Transform Healthcare—In Cancer Clinics and in Space (LSU Office of Research & Economic Development)