Lewis Roberts, M.B., Ch.B., Ph.D., and other Mayo Clinic researchers awarded U54 grant with strong implications for health disparities

Lewis Roberts, M.B., Ch.B., Ph.D.

Lewis Roberts, M.B., Ch.B., Ph.D., (I’ 95, GI ’98), Division of Gastroenterology and Hepatology at Mayo Clinic in Rochester, is part of a collaborative team of researchers from Mayo Clinic, Northwestern University, the University of Lagos and the University of Jos, who have been awarded a prestigious U54 Consortia grant entitled “Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria.”

The grant will fund research to understand epigenetic determinants of Nigeria’s two highest-priority HIV-associated cancers: hepatocellular carcinoma (HCC) and cervical cancer. The major scientific premise underlying the study is that cancer epigenetics and infections are inextricably linked, yet significantly understudied in low- and middle-income countries such as Nigeria, where there is a high combined burden of HIV, HCC and cervical cancer.

In Nigeria, the incidence of HCC (the sixth-most-common malignancy worldwide) is 15-20/100,000 persons. It is already the leading cause of cancer-related mortality among men and is emerging as a leading cause of morbidity and mortality in HIV-infected persons there. As life expectancy with HIV improves, the incidence and prevalence of HCC will continue to increase, making it a prominent non-AIDS defining cancer. HIV and its adverse effects on the immune system promote transmission and reactivation of oncogenic viral co-infections, such as human papilloma virus (HPV), and hepatitis B and C, greatly increasing the oncogenic potential of HIV-infected individuals. HIV-positive HCC patients generally present at a much younger age, at a more advanced stage of the disease, and the course of disease is highly aggressive, enabling very few patients to benefit from curative or life-prolonging therapies, even when they are available. In a resource-limited setting such as Nigeria, the need for novel biomarkers that can be used for early detection of HCC is urgent. The U54 study will build on emerging science — which has demonstrated that HCC tumors exhibit distinct DNA methylation alterations associated with HCC initiation, progression and metastases — and focus on identifying minimally-invasive, blood-based methylomic markers by comparing blood DNA methylation patterns in HIV-infected and uninfected HCC patients and in HIV-positive but HCC free patients.

Dr. Roberts also is a professor of medicine at Mayo Clinic College of Medicine and Science.