March 3, 2021:

This month, the Big Ten Cancer Research Consortium highlights our member, the University of Illinois Cancer Center at the University of Illinois at Chicago. In this member feature, we shine the spotlight on two University of Illinois at Chicago investigators who are actively involved in consortium studies and working groups: Irum Khan, MD, and Kent Hoskins, MD.

Irum Khan, MD

University of Illinois Cancer Center member
Co-chair, Big Ten CRC Myeloid Malignancies Clinical Trial Working Group

Educational background

  • MD, Aga Khan University, Karachi, Pakistan
  • Residency, Internal Medicine, University of Cincinnati, Ohio
  • Fellowship, Hematology/Oncology, Northwestern University, Chicago
  • MS, Clinical and Translational Science, University of Illinois Chicago

Research and Clinical Interests
Irum Khan, MD, is as comfortable in a laboratory as she is a hospital. As a clinician, Dr. Khan cares for patients with acute and chronic myeloid malignancies, including leukemia, myeloproliferative and myelodysplastic disorders. Her research is focused on translational studies in myeloid malignancies, identifying therapeutic targets in myeloid leukemia and serving as principal investigator on numerous clinical trials.

During a fellowship at Chicago’s Northwestern University, Dr. Khan was one of 20 fellows selected to participate in a year-long Translational Research Training in Hematology (TRTH) program sponsored by the American and European Hematology Societies. As a junior faculty member at the University of Illinois College of Medicine, she secured pilot cancer center and a KL2 training awards that allowed her to gain expertise in developing animal models of myeloid diseases and studying novel therapeutics. She has also helped to build UIC’s Hematology Cell Bank allowing her access to samples needed to test novel targets. Her recent work is focusing on disparities in leukemia specifically examining the intersection of social and molecular determinants of AML outcomes. She travels yearly to Pakistan to provide continuing medical education to hematologists.

Little-known facts about Dr. Khan

  • She spends a lot of time outdoors with her two sons, who are ages 8 and 12.
  • She is an amateur scuba diver.
  • She enjoys cooking and exploring ethnic cuisines.

 

Kent Hoskins, MD

University of Illinois Cancer Center member
Co-chair, Big Ten CRC Breast Cancer Clinical Trial Working Group

Educational background

  • MD, University of Iowa
  • Residency, University of Iowa
  • Fellowship, University of Michigan
  • Board Certifications, Internal Medicine and Medical Oncology

Hoskins finds racial disparities in breast cancer prognosis testing

Kent Hoskins, MD, has discovered that race plays an important role in women surviving certain types of breast cancer.

Black women have a higher recurrence and greater mortality rates than non-Hispanic white women with estrogen receptor-positive, axillary node-negative breast cancer, the most common subtype of the disease, according to a new study led by Dr. Hoskins that used data from more than 70,000 patients across the United States garnered from the national Surveillance, Epidemiology, and End Results (SEER) program.

Women with hormone-dependent breast cancer tend to have a better outlook in the short-term, said Dr. Hoskins, associate professor of hematology/oncology at the University of Illinois College of Medicine and co-leader of the Breast Cancer Research group in the University of Illinois Cancer Center. But even after adjusting for age at diagnosis, tumor stage, and treatment, there is still a significant mortality gap between Black and non-Hispanic white women with axillary node-negative, hormone-dependent tumors within risk categories defined by the Oncotype Recurrence Score, or RS.

RS is a 21-gene test that analyzes the activity of a group of genes that can affect how a cancer is likely to behave and respond to treatment. Dr. Hoskins and his colleagues also wanted to discover if race factors into the predictive accuracy of the RS.

“Our research also found that Black women are more likely to have a high-risk RS, indicating that they disproportionately develop biologically aggressive tumors,” Dr. Hoskins said. “The underlying cause of this is unknown, but this is an active area of research among UI Cancer Center investigators.”

Dr. Hoskins and his colleagues also found that the Oncotype test had lower prognostic accuracy in Black women, indicating that genomic tumor tests used to identify candidates for chemotherapy may require re-calibration in populations with greater racial and ethnic diversity.

The study included data on women 18 years and older diagnosed with a first primary breast cancer that was American Joint Committee on Cancer (AJCC) stage I to III, and estrogen receptor-positive between the years 2004-2015.

“This research highlights a widespread problem that may contribute to health disparities,” Hoskins said. “Research to develop and validate new medical tests often have inadequate representation of individuals from racial/ethnic minority groups. This may cause new tests to be less accurate in individuals who belong to minority groups.”

Since the RS is used by oncologists to make informed treatment decisions on whether chemotherapy is needed, he said the Oncotype RS model needs to be “recalibrated to reflect racial differences. The same lack of adequate representation of individuals from racial/ethnic minority groups plagues clinical trials of new cancer treatments, he said.

“Our study is just one more example of how exclusion of minority patients from research can lead to inequities in health outcomes.”

Hoskins’ research, published in the journal JAMA Oncology, concluded that there is a disparity in mortality among Black women with early-stage breast cancer, and further research is needed to understand the role of tumor biology and of structural violence in this disparity. Structural violence is defined as systematic ways in which social structures harm or otherwise disadvantage individuals. The next step, Dr. Hoskins said, is to study population health data and molecular data to determine the mechanisms driving the differences.

“We really think there is an intersection between social determinants of health and tumor biology, and that is what we are trying to understand with follow-up studies,” he said.

Hoskins was assisted in the study by, among others, Oana Danciu, MD, a member of the Big Ten Cancer Research Consortium’s steering committee and medical director at the University of Illinois Cancer Center’s Clinical Trials Office.

 

About the Big Ten Cancer Research Consortium: The Big Ten Cancer Research Consortium was created in 2013 to transform the conduct of cancer research through collaborative, hypothesis-driven, highly translational oncology trials that leverage the scientific and clinical expertise of Big Ten universities. The goal of the Big Ten Cancer Research Consortium is to create a unique team-research culture to drive science rapidly from ideas to new approaches to cancer treatment. Within this innovative environment, today’s research leaders collaborate with and mentor the research leaders of tomorrow with the unified goal of improving the lives of all patients with cancer.

About the Big Ten Conference: The Big Ten Conference is an association of world-class universities whose member institutions share a common mission of research, graduate, professional and undergraduate teaching and public service. Founded in 1896, the Big Ten has sustained a comprehensive set of shared practices and policies that enforce the priority of academics in the lives of students competing in intercollegiate athletics and emphasize the values of integrity, fairness and competitiveness. The broad-based programs of the 14 Big Ten institutions will provide over $200 million in direct financial support to more than 9,800 students for more than 11,000 participation opportunities on 350 teams in 42 different sports. The Big Ten sponsors 28 official conference sports, 14 for men and 14 for women, including the addition of men’s ice hockey and men’s and women’s lacrosse since 2013. For more information, visit www.bigten.org.