Research Projects

Faculty: Northwestern MPI Chad Achenbach, MD

This project addresses a high-priority NIH research area and significant problem in sub-Saharan Africa because of the widespread HIV epidemic made worse by the high burden of oncogenic viral co-infections. Through this project, investigators are building a multidisciplinary research training program at Jos University Teaching Hospital and Lagos University Teaching Hospital — some of the largest providers of HIV care in Africa — to build infrastructure and increase capacity for cancer epidemiology, biostatistics, biomedical informatics and translational and laboratory research on AIDS-defining malignancies here.

This program is sponsored by National Cancer Institute and Fogarty International Center (D43TW009575).

Faculty: Northwestern MPIs Lifang Hou, MD, PhD, and Mamoudou Maiga, MD, PhD

In Mali, the eighth-largest African country, infection-associated cancers (IACs) are increasing and represent more than a quarter (27 percent) of all cancers. Few African scientists have the epidemiological, molecular pathology, biostatistics and bioinformatics training needed to design and conduct population-based and mechanistic studies on IACs. This research training program will capitalize on a decade of collaboration between Malian and U.S. investigators to create capacity to develop and implement new contextually appropriate and culturally adaptive strategies to reduce in incidence, morbidity and mortality of IAC in Mali and other LMICs in the region. 

This program is sponsored by the National Cancer Institute (D43CA260658).

Faculty: Northwestern MPIs Lifang Hou, MD, PhD, and Mamoudou Maiga, MD, PhD

This program leverages our decade-long, extensive and successful training partnership and research collaborations in Mali and Nigeria to implement a novel West African Self-Sampling Human Papillomavirus (HPV)-Based Cervical Cancer Control Program in these two countries. The project capitalizes on existing strengths and resources, including the HIV systems of care with community health workers who have established relationships with women living with HIV/AIDS and can provide HPV and cervical cancer education/counseling, guidance for self-sampling by women, rapid collection and transport of vaginal swab specimens to hospital laboratories, personalized delivery of test results directly to the women and facilitation of clinic referrals for those with high-risk HPV infection for advanced diagnostics and treatment. The study will conduct an in-depth assessment of barriers, challenges and needs to implement, contextually adapt and evaluate the effectiveness of the proposed program. 

This program is sponsored by the National Cancer Institute (U01CA275129).

Faculty: Northwestern MPIs Lifang Hou, MD, PhD, and Robert Murphy, MD

The EpOOCH study aims to better understand the epidemiology and biology of oral HPV infection, as well as its acquisition and persistence, in people living with HIV (PLWH) and elucidate mechanisms related to HPV-associated oral and oropharyngeal cancers (OOPC) in the context of HIV. This research project studies the role of epigenetic biomarkers in HPV-associated OOPC in PLWH in Nigeria, a country with high HIV prevalence, to help develop potential non-invasive screening and early detection biomarkers of OOPC in PLWH. Identifying epigenetic markers predictive of the progression of precancerous lesions into OOPC will also provide opportunities for developing future preventive and therapeutic targets for managing precancerous lesions and OOPC in PLWH. 

This project is sponsored by the National Cancer Institute (R01CA274952).

Faculty: Northwestern MPI Lifang Hou, MD, PhD

HPV associated cancers are rapidly increasing in Sub-Saharan Africa due to lack of HPV vaccination and cervical cancer screening programs like high income countries (HICs), as well as high prevalence of HIV/AIDS. This project builds on the parent grant R01CA27495201 that is investigating the epigenetic biological mechanism of HPV associated oral and oropharyngeal cancers in women to identify women that might also be at risk of having high-risk HPV in the cervix at the same time or near future. This mentored research supplement will train a junior investigator from Nigeria to gain new skills and expertise in epigenetic testing and data analysis, assay development and manuscript and grant writing for future funding. 

This project is sponsored by the National Cancer Institute (R01CA274952-02S1).

Faculty: Brian Joyce, PhD

The goal of this project is to conduct DNA methylation profiling in a group of African American men examined in Chicago and compare them to patients currently being recruited in West Africa. We will study DNA methylation in association with prostate cancer as well as aggressive and potentially lethal prostate cancer and interactions with genetic ancestry. We will also conduct a pilot study to examine the feasibility of using urinary samples for genetic and molecular epidemiology studies of PCa and develop an ancestry-specific risk calculator for African and African American populations and compare its accuracy to current methods. This study will help men diagnosed with metastatic prostate cancer and their families by identifying genetic and environmental contributions to and epigenetic mechanisms of prostate cancer development. This could help identify new early detection and risk stratification tools and potential treatment targets for prostate cancer. It will also facilitate future studies of prostate cancer with a less-invasive method for DNA collection to study prostate cancer in human populations and further improve its diagnosis, prevention, and treatment. This is a case-control study nested inside two ongoing studies funded by the National Cancer Institute and the Department of Defense, with a comparison cohort currently being recruited in Africa as part of a Northwestern University Institute of Global Health pilot project. 

This project is sponsored by a Bayer-Prostate Cancer Foundation Health Equity Research Award.

Faculty: Northwestern mentors are Lifang Hou, MD, PhD, and Mamoudou Maiga, MD, PhD. The project is awarded to Dr. Brehima Diakite, USTTB-Mali.

In Mali, the alarming statistic reveals that nearly a quarter of women diagnosed with breast cancer succumb to the disease within just 12 months, despite undergoing treatment. Among the medications commonly prescribed for breast cancer, tamoxifen stands out. However, its efficacy varies among individuals due to variances in the metabolism process, primarily controlled by enzymes such as cytochrome P450 (CYP450) and glutathione S-Transferase (GST). Diakite's research endeavors are focused on unraveling the intricate interplay between genetic polymorphisms of CYP450 and GST enzymes and the response to tamoxifen-based treatment. Employing advanced molecular techniques such as Allele-Specific Polymerase Chain Reaction and Reverse Transcription Polymerase Chain Reaction, Diakite aims to scrutinize the impact of genetic variations on treatment outcomes. Moreover, through the utilization of Next-Generation Sequencing, he aims to pinpoint novel biomarkers that play a crucial role in tamoxifen response. Ultimately, this research strives to enhance the prognosis and quality of life for breast cancer patients in Mali, offering hope for better outcomes and improved survival rates.

Faculty: Northwestern mentors are Lifang Hou, MD, PhD, and Robert Murphy, MD. The project is awarded to Dr. Imran Morhason-Bello, University of Ibadan, Nigeria

Recent research indicates a rising incidence of HPV-associated anal precancer and cancer, particularly among women with a history of high-risk HPV infections, premalignant cervical conditions or cervical cancer, despite having no reported history of anal intercourse. Morhason-Bello's investigative focus is on unraveling the intricate mechanisms underlying the presence of high-risk HPV in the anus of women who harbor the virus in their cervix. Through the application of cutting-edge techniques such as epigenome-wide association studies and gene-specific DNA methylation PCR, Morhason-Bello endeavors to identify potential biomarkers present in women with concurrent high-risk HPV infections in the cervix and anus. These biomarkers hold the promise of serving as reliable indicators for the early detection of anal precancer and cancer. By elucidating the underlying molecular pathways and genetic alterations associated with HPV transmission and disease progression, this research has the potential to revolutionize screening strategies and diagnostic approaches for anal malignancies.

Faculty: Northwestern PI Brian Joyce, PhD

In Africa, hepatocellular carcinoma (HCC) is the second most common cancer in men and third most common cancer in women. Africa has the youngest age at diagnosis (approximately median age 45) of HCC and the highest prevalence of Helicobacter pylori (H. pylori) infection worldwide. Increasing animal data and emerging human studies support an essential role of H.pylori infection in liver carcinogenesis, but relevant data in Africa are lacking. Clarifying the role of H. pylori infection and co-infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) with HCC risk has significant public health implications because intervention with existing H.pylori eradication treatment with antibiotics is simple, effective and more easily accessible. We propose to establish a multisite African Helicobacter Infection and Liver Outcome Research Network that will enable multidisciplinary and cutting-edge research to improve health outcomes and optimize patient care and treatment in Africa.

This innovation award will support the development of this network and be led by faculty at Yale and Northwestern Universities in full collaboration with African academic researchers in Mali and Nigeria, to respond to the key challenge of reducing the burden of liver cancer in Africa and provides the first comprehensive study to date of H. pylori and HCC risk in Africa. This proposed project has great potential to provide important information to help reduce the burden of liver cancer in Africa. Results from this proposed study will have novel etiologic relevance and global health impact by (1) identifying a novel, treatable bacterial infection for HCC; and (2) determining the extent to which coinfection between H. pylori and HBV/HCV contributes to HCC that will inform the design of new interventions to reduce the burden of liver cancer in Africa. These investigations will advance our current understanding liver cancer etiology, prevention, and treatment. The project also provides a collaborative research model that not only promotes global health education, but also enriches the existing global health research models in Africa by expanding international collaborations for advancing groundbreaking research on Africa's key challenges. 

This research is generously supported by the Robert J. Havey, MD Institute for Global Health's catalyzer fund at Northwestern University Feinberg School of Medicine.

Faculty: Northwestern PI Mamoudou Maiga, MD, PhD

Lung cancer is a major global cause of death, and studies have shown a significant connection between tuberculosis (TB) and an increased risk of developing lung cancer. The aim of this research is to improve early detection and prevention of lung cancer by identifying new epigenetic biomarkers and understanding how lung cancer and TB are linked. In low- and middle-income countries like Mali, diagnosing lung cancer is challenging, often leading to late diagnoses because of similar symptoms with TB. The cost of CT scans makes them less accessible, so invasive lung biopsies are common but have limited accuracy. Epigenetics, a key player in cancer development, offers potential diagnostic and personalized treatment opportunities. To make these tools widely available, comprehensive validation is needed. Africans and African Americans have a higher lung cancer rate despite lower smoking rates, suggesting unique factors. Previous TB infections also increase lung cancer risk. Analyzing the epigenetics of Malian lung cancer in the context of TB could reveal new genetic and epigenetic biomarkers. Our specific aims are: (1) Identify epigenetic biomarkers in Malian patients with lung cancer (LC) without previous TB disease compared to healthy participants, (2) Examine the epigenetic biomarkers in TB-associated LC.

This research is generously supported by the Robert J. Havey, MD Institute for Global Health's catalyzer fund at Northwestern University Feinberg School of Medicine.

Faculty: Northwestern PI Jian-Jun Wei, MD

In Nigeria and Mali, the lack of organized cervical cancer screening programs and other related health services factors aggravate the incidence and mortality due to cervical cancer. This project supports state-of-the-art HPV genotyping and digital slide scanner instruments on location at the University of Ibadan in Nigeria and the University of Sciences, Techniques, and Technologies in Mali, to greatly enhance local capacity for HPV testing, cytology, histology and molecular diagnostics of cervical cancer and oral/oropharyngeal cancers. In addition, this project aids our collaborators in Ibadan and Bamako to establish a basic telepathology system, to enhance education of HPV-associated cancers in Nigeria, Mali and beyond. This telepathology partnership leverages collaboration with Northwestern's pathology core facility, where a state-of-art digital imaging analysis laboratory — which contains instruments necessary for slide scanning, viewing and image analysis for telepathology — works with scientists and trainees in Mali and Nigeria.

This research is generously supported by the Robert J. Havey, MD Institute for Global Health’s catalyzer fund at Northwestern University Feinberg School of Medicine.

Faculty: Northwestern MPIs Lifang Hou, MD, PhD, and Mamoudou Maiga, MD, PhD

This consortium is designed to build capacity in order to promote self-sampling-based HPV testing for HPV associated cancers: cervical cancer, anal cancer and oral/oropharyngeal cancer. The aims of this project are to (1) Establish the African HAC Prevention and Control Network for equitable, feasible, culturally acceptable, cost-appropriate and sustainable early detection and screening for HACs; (2) Apply and disseminate new knowledge and skills through pilot implementation testing of (a) developing  processes for population-level SS-based HPV screening and referral of hr-HPV+ cases for advanced testing and treatment at clinical sites with an American Society of Clinical Pathologists-supported network; and (b) establishing a cartography of circulating HPV strains. In addition, this network will sponsor the training of two masters-level students for a master's in Genetic and Molecular Pathology through the University of Sciences, Techniques and Technologies of Bamako (USTTB) in Bamako, Mali. Between these objectives, this consortium will allow the Center for Global Oncology to build a strong network of HPV researchers and sites in Africa for a rapid development of preventive strategies that are contextually adapted to the low- and middle-income country environment. 

This research is generously supported by the Robert J. Havey, MD Institute for Global Health's catalyzer fund at Northwestern University Feinberg School of Medicine.

Faculty: Northwestern MPIs Lifang Hou, MD, PhD, and Mamoudou Maiga, MD, PhD

This program is in partnership with national and local governments in Mali, Nigeria and Senegal, as well as clinical, public health and research collaborators, to develop and launch an HPV-associated Cancers Prevention and Control Program. To date, limited resources and substantial individual and system-level barriers have hindered the implementation of country-wide HPV vaccination and screening programs for its associated cancers in low- and middle-income countries. Current screening approaches — exams from registered clinicians at one of the limited brick-and-mortar clinics — do not effectively address barriers or meet vaccination and screening needs, and therefore are not a feasible population-level option for HPV-associated cancer prevention. This generous funding is allowing us to build and deploy mobile clinics, which brings mobile HPV testing units directly to communities, in an exciting venture entitled "Clinique Mobile: Prévention et Contrôle Mobile du Cancer/Cancer Prevention on the Road." In addition to our mobile clinic initiative, this program will support community awareness campaigns in HPV-associated cancer prevention, train local experts in epidemiology, risk factors, screening and social and cultural factors of HPV and HPV-associated cancers and expand diagnostic capabilities through our established Northwestern University – West Africa Telepathology Program. 

This research is generously supported by the John R. Flanagan Foundation.