Fred Hutchinson Cancer Researcher Center Global Oncology’s annual report for fiscal year 2021 (July 1, 2020-June 30, 2021) provides an overview of scientific achievements, publications, grants and finances, and training and community efforts. This is the program’s second annual report during the time of the COVID-19 pandemic, and while there are some signs of hope, the SARS-CoV-2 virus continues to evolve and ravage many parts of the world. This report provides an update on operational impacts and our response to the pandemic in collaboration with the Uganda Cancer Institute.
We entered the fiscal year last summer as we always do, focused on how best to deliver on our promise to produce research, partner on training, and support clinical care to reduce the burden of cancer. As is true for much of the world, we were taken aback by the global toll of the SARS-COV-2 pandemic and had to quickly create an environment that allowed us to continue our critical work together despite the pandemic. In Kampala, Uganda, in collaboration with our colleagues at the Uganda Cancer Institute, led by Drs. Jackson Orem, executive director, and Victoria Walusansa, deputy director, we pivoted early to prioritize the safety of staff, patients and research communities by suspending temporarily our collaborative research studies while the country was in lockdown. In Seattle, we were in a state of high transmissibility, experiencing our own restrictions and hoping that a vaccine would become available to provide protection before the end of 2020. Although the pandemic was slow to reach the impact it had in the U.S., Uganda was unfortunately not spared and is now experiencing a third wave of COVID-19 that is far worse than the first two. During this very challenging year, we have truly been standing in solidarity with each other, despite a ten-hour time zone difference and over 8,000 miles separating us.
Though the pandemic has been at the center of the global perspective, our decade-long partners at the Uganda Cancer Institute continued to do everything they could to take care of cancer patients. To support moving forward critical participant research and clinical care, Fred Hutch supported the establishment of COVID-19 testing at the UCI campus and has provided this service to physicians, nurses, employees and patients throughout the pandemic. In addition, we have answered UCI’s request for protective equipment and medical supplies that allow them to safely continue to treat the most vulnerable.
Unfortunately, the global cancer burden continues to grow through this pandemic and is expected to be 28.4 million cases by 2040 — which is a 47% increase from 2020. The urgency to address the global cancer burden drives us to advance our mission through challenging times and continue to support cancer research and clinical capacity in Uganda. We are very fortunate to be able to share what this stellar international team has been able to accomplish together this year for the good of the research, clinical and patient community.
We thank the entire Fred Hutch community and all supporters who continue to champion our mission.
Global Oncology has five strategic objectives that guide us in pursuit of our mission.
Since the spring of 2020, Fred Hutch and the Uganda Cancer Institute worked closely to establish SARS-CoV-2 testing at the UCI-Fred Hutch Cancer Centre. The Ministry of Health of Uganda and the World Health Organization gave approval for testing after conducting site audits and inspections. The Ministry of Health ranked our facility as the top laboratory out of 12 laboratories participating in the national program. Laboratories participate in routine proficiency testing, inspections, and audits. The team offers two Real-Time PCR assays on site, the CDC Primer Probe Assay and the EUA-Real-Time-Fluroescent-SARS-2019 nCov Beijing Genomics Institute (BGI) kit.
Over 2,500 tests have been performed at the UCI-FHCC laboratories—marking a new milestone that demonstrates the team’s commitment to the UCI patients, staff, and wider community. The team has averaged <24 hours to turnaround results despite the increase in testing demand.
To keep the quality standards for testing, the lab team routinely participates in the National Proficiency Testing Program, with panels that are assigned through the Ugandan Ministry of Health and the African Society for Laboratory Medicine via the WHO for proficiency testing through “One World.” The lab welcomes these proficiency tests and have recently completed a 100% in the MOH testing panel in August 2021.
Our faculty, teams and collaborators have persevered during these challenging times to continue our research, including two ongoing clinical trials and launching new studies.
During the FY21 fiscal year, Global Oncology secured all institutional review board approvals in Seattle and Kampala to open to accrual seven studies based at the UCI-Fred Hutch Cancer Centre. In these studies, the research teams are investigating the following cancers and infections: colorectal cancer, breast cancer, nephroblastoma — a type of pediatric cancer that starts in the kidneys — KSHV infection, post-chemotherapy infections, antimicrobial resistance and stewardship, and acute myeloid leukemia.
Ongoing studies that remained open to accrual in FY21 include "Human Herpesvirus-8 (HHV-8) Replication and Kaposi Sarcoma Response to Treatment Suspended," and "Bacteremia in Hematologic Cancer Patients with Febrile Neutropenia in Uganda." These studies were discussed in Global Oncology’s fiscal year 2020 report. They are led by Drs. Warren Phipps (Fred Hutch) and Margaret Lubwama (UCI), respectively.
The Hutchinson Centre Research Institute of Uganda laboratory team continued to support research and implement the SARS-CoV-2 testing program.
L, Lakomy DS, Chiao EY, Strother RM, Wirth M, Cesarman E, Borok M, Busakhala N, Chibwesha CJ, Chinula L, Ndlovu N, Orem J*, Phipps W, Sewram V, Vogt SL, Sparano JA, Mitsuyasu RT, Krown SE, Gopal S. JCO Glob Oncol. 2020 Jul;6:1134-1146. doi: 10.1200/GO.20.00153. Read full publication.
Santiago JC, Goldman JD, Zhao H, Pankow AP, Okuku F, Schmitt MW, Chen LH, Hill CA, Casper C^, Phipps WT, Mullins JI. PLoS Pathog. 2021 Jan 19;17(1):e1008594. doi: 10.1371/journal.ppat.1008594. Read full publication.
Seremba E, Ocama P, Ssekitoleko R, Mayanja-Kizza H, Adams SV, Orem J*, Katabira E, Reynolds SJ, Nabatanzi R, Casper C^, Phipps W. Vaccine. 2021 Feb 22;39(8):1265-1271. doi: 10.1016/j.vaccine.2021.01.043. Epub 2021 Jan 28. Read full publication.
Byrne CM, Johnston C, Orem J*, Okuku F, Huang ML, Rahman H, Wald A, Corey L, Schiffer JT, Casper C^, Coombs D, Gantt S. PLoS Comput Biol. 2021 Jun 21;17(6):e1009072. doi: 10.1371/journal.pcbi.1009072. Read full publication.
Bold = Fred Hutch Global Oncology faculty or staff scientist
Underline = former or current trainee/fellow in Uganda
* = Collaborator in Uganda
^ = Former Fred Hutch Global Oncology faculty
Are you or your colleagues interested in research collaborations with Global Oncology or the UCI-Fred Hutch Collaboration? Learn more about our core services available.
Collaborations & Project Development: Provides an understanding of how a research or related project works within the UCI-Fred Hutch Collaboration.
Research Administration: Manages and administers all aspects of sponsored funding (grants, contracts, finance). Coordinates the administrative aspects of research with each core service.
Regulatory Affairs: Provides regulatory consultation and support to investigators and study staff throughout the life cycle of a study; including preparing and reviewing Fred Hutch and University of Washington Institutional Review Boards and Uganda Research and Ethics Committees submissions and correspondences.
Study/Research Support: Provides support and expertise in study start up, study management/implementation and study closure.
Laboratory Services: Offers state-of-the-art laboratory capabilities in molecular diagnostics, histopathology, specimen processing, biosafety level 2 and genomic analysis, as well as a biorepository.
Data Management & Analysis: Offers data services across all phases of a study, including case report form design, database design and buildout, data entry and quality control, reports, and statistical programming and analysis.
We completed a new level to our facility in Kampala, which houses administrative offices, a biorepository and a research records archive.
In November 2020, the UCI-Fred Hutch Collaboration completed the construction of the new ground level at the UCI-Fred Hutch Cancer Centre in Uganda. It adds over 2,600 square feet to the 16,000-square-foot, three-story research, training and clinical care facility that opened in 2015. The new space will house the remarkable biorepository, as well as dedicated, long-term storage and research records archive. It will bring together all Fred Hutch/Hutchinson Centre Research Institute of Uganda staff into one facility.
While many of the training activities pivoted to virtual spaces, training physician scientists continues to be an emphasis of our work in Uganda.
The first cohort of four fellows successfully completed the East African Adult Hematology Oncology (AHO) Fellowship — a two-year program that aims to train cancer specialists and future leaders in adult hematology and medical oncology in East Africa. The pioneering three medical oncology-track graduates were Drs. Innocent Mutyaba, Joanne Kayaga and Alex Bakenga, who have all joined the faculty at the UCI. Dr. Priscilla Namaganda, the first hematology-track graduate, took a faculty position at Kirudu Hospital in Kampala and is affiliated with the UCI.
The second cohort of three fellows started the program in the Fall of 2020: Drs. Erick Were, Naghib Bogere and Kenneth Kintu. All three current fellows are in the medical oncology track and have been enrolled in the American Society of Clinical Oncology Fellows Program. The three fellows have begun their inpatient rotations.
The COVID-19 pandemic has continued to impact the program, and the leaders continue to primarily offer virtual training. Other activities that have been impacted include:
A series of core lectures offered by UW and Fred Hutch faculty began in March 2021. Fortunately, half of the trainings planned for 2021 are in-person trainings offered by UCI or other local faculty, including some faculty or graduates of previous Fred Hutch training or the first cohort. The program continues to follow a "train the trainers" model to promote sustainability and build local oncology capacity. The AHO Fellowship Program launched in 2018, with support from the African Development Bank and Government of Uganda, and is implemented by Fred Hutch, the UCI and other partners. Accreditation of the program by the East, Central, and South Africa College of Physicians (ECSACOP) is underway. The program is co-directed by Drs. Abraham Omoding, UCI, and John Harlan, UW.
Dr. Fadhil Geriga, medical officer and research trainee, UCI, was awarded a second year as an AIDS Malignancy Consortium Fellow with Drs. Jackson Orem and Warren Phipps serving as mentors. His AMC project focuses on evaluating presentation and outcomes among pediatric Kaposi sarcoma patients in Uganda.
The monthly HIV-Associated Malignancies (HIVAM) Clinical Care & Teaching Conference provides a teaching and learning, clinical treatment and research forum for new and junior investigators and clinicians with an emphasis on the significant prevalence of HIVAM cases in Uganda. UCI colleagues typically present a clinical case and discuss the case with colleagues from Fred Hutch, SCCA or UW. There were 10 monthly conferences during FY21, with topics including all-trans retinoic acid differentiation syndrome; immune checkpoint inhibitors; nursing chemotherapy administration; radiotherapy timing with chemotherapy and side effects in cervical cancer; assessing the impact of pre-analytical, analytical and post-analytical processes on the quality of laboratory results; triple-negative breast cancer; COVID-19 and cancer; GIT neuroendocrine tumors; renal cell carcinoma; and American Society of Clinical Oncology Virtual Conference highlights. The conference series began in 2012.
Our teams have been committed to advancing the Global Oncology mission, whether at the forefront or behind the scenes.
Fred Hutch Global Oncology and HCRI-Uganda teams launched a new website in December dedicated to the UCI-Fred Hutch Collaboration. The website is most relevant to our team and UCI collaborators in Uganda, in addition to collaborators or partners interested in learning more about our research, core services, team and other initiatives in Uganda.
Global Oncology continued the longstanding Global Oncology Lecture Series, which remained in a virtual format that allows more collaborators to share their research and engage with colleagues worldwide. The virtual format started in 2020 due to the COVID-19 pandemic. We held 11 seminars over the fiscal year. We were privileged to have speakers representing a range of institutions, including the UCI, University of Washington, Fred Hutch, National Cancer Institute’s Center for Global Health, University of North Carolina School of Medicine, PhenoPath (A Quest Diagnostics Company), Icahn School of Medicine at Mount Sinai, Makerere University College of Health Sciences and the University of California, San Francisco. The program looks forward to another exciting year of seminars, beginning in September 2021.
Global Oncology leadership has been engaged in bias mitigation training through the Fred Hutch Office of Diversity, Equity and Inclusion, and employees are encouraged to participate in all offerings as they are made available. Global Oncology leadership is exploring a climate survey for our team in Uganda like a recent survey that was conducted with the Seattle team. In addition, our team has been engaged in several anti-racism discussions and learnings at every level and is committed to continuing to make it part of the culture of Global Oncology.
Together, we have shown resilience and advanced our goals, despite tremendous challenges, and aspire to continuing this path to conduct research with global impact.
While the world continues to respond and be nimble in the face of the pandemic, cancer and other diseases remain an urgent global health challenge. For instance, the National Cancer Institute predicts approximately 10,000 excess deaths from breast and colorectal cancers in the next ten years due to delays in accessing medical treatment. We believe it is critical to continue our mission and the broader mission of Fred Hutch. It is especially important to focus on the needs of cancer patients in the second year of the COVID-19 pandemic to reduce the suffering and death related to cancer and other diseases. The breakthroughs from cancer and infectious disease research should be available equitably. Global Oncology looks forward to continuing our clinical trials and research that has potential to improve the lives of cancer patients in Uganda and elsewhere.