2021 Global Oncology Annual Report
Perseverance to Further Global Research
Solidarity in Advancing Our Oncology and Related Research and Training in Response to the Evolving COVID-19 Pandemic
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.
Vision
Eliminate cancer as a cause of human suffering and death worldwide by ensuring that effective prevention and curative treatments are available to all patients.
Mission
Generate cancer research that has global impact and support the development of research capacity and clinical care to reduce the burden of cancer in low- and middle-income countries.
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 Leadership
Our leadership, along with our UCI collaborators, continued to prioritize employee and patient health and safety while upholding a commitment to purse critical cancer and infectious disease research
Fred Hutch Leadership
Edus H. Warren, M.D., Ph.D.
Global Oncology Head; Professor, Program in Immunology, Clinical Research Division; Professor, Vaccine and Infectious Disease Division
Warren T. Phipps, M.D., M.P.H.
Medical Director, UCI-Fred Hutch Collaboration; Associate Professor, Vaccine and Infectious Disease Division
Manoj Menon, M.D.
Associate Professor, Vaccine and Infectious Disease and Clinical Research divisions
UCI Leadership
Victoria Walusansa, M.B.Ch.B., M.Med.
Deputy Director, Uganda Cancer Institute
Strategic Objectives
Global Oncology has five strategic objectives that guide us in pursuit of our mission.
COVID-19 Continued Response
Our response to the pandemic has focused on conducting research safely, scaling up SARS-CoV-2 testing and securing personal protective equipment for our teams in Kampala.
Research Operations
Early in the pandemic, the government of Uganda suspended all research in the country that did not provide immediate benefit to participants. Our team developed risk management plans to promote the safety of research participants and their families, clinicians and staff at the UCI-Fred Hutch Cancer Centre. After approval of these plans from the Uganda National Council for Science and Technology, we resumed research activities in September 2020.
Continued infection-mitigation measures remain in place on the UCI-Fred Hutch Cancer Centre campus, especially given the rise of COVID-19 cases in Uganda and the region. These include daily symptom and temperature screening, masking, hand hygiene, physical distancing and isolation of suspected cases. Our highest priority is the safety of patients, participants and staff, while also ensuring access to SARS-CoV-2 testing and the continuation of critical and beneficial cancer and infectious disease research.
Launch of SARS-CoV-2 Testing
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 Hutchinson Centre Research Institute of Uganda staff wear masks and take other preventative measures at the UCI-Fred Hutch Cancer Centre, as our highest priority is the safety of patients, study participants and staff.
Securing Personal Protective Equipment for Our Colleagues in Uganda
Global Oncology continued to provide support, as possible, regarding PPE needs for our Hutchinson Centre Research Institute of Uganda team and collaborators in Uganda. Additionally, as COVID-19 cases were on the rise in Uganda in late spring 2021 and lockdowns were reinstated, Global Oncology supported the UCI-Fred Hutch Collaboration by maintaining a PPE inventory to ensure all clinical users of the facility are equipped effectively. We coordinate with our collaborators at UCI and donate equipment if their PPE stock is low to help ensure their safety as they continue to provide critical care and treatment to their patients.
In June, Fred Hutch donated a large shipment of PPE to the UCI. Andrea Towlerton, acting director of the UCI-Fred Hutch Collaboration, spearheaded this generous donation. You can read the story on Fred Hutch News. Uganda’s New Vision news covered the story on the donation to the UCI. You can read the article on the website.
Life and Work During the COVID-19 Era
It all started in March 2020. It was unexpected. The president announced a total lockdown. We had to put everything on hold. No more access to work premises, no more travels. The project driver, Isma Lubega, was very vigilant to ensure that we reached the site and attended to the patients. After the lockdown, the IRB [institutional review board] made it a requirement to have COVID-19 guidelines to enable the team as well as patients to work and live safely amidst the pandemic. Much appreciation to the PIs [principal investigators] and to the top management."
— Ruth Nakuya, study coordinator II, HCRI-Uganda
"At the beginning of March 2020, I was not certain that we would be able to provide reliable program support … to allow patients to receive care and treatment. [Since then] excellent facility management services have been ensured with infection control protocols maintained over and beyond the COVID-19 SOP requirements. ... Life for staff and all our building users [continue to be] our key priority."
— Magdalene Kintu, director, Administration & Operations, HCRI-Uganda
"The first [wave] saw us acquiring the community-spread COVID-19 as a family. Waking up to a feverish, muscle-ached morning after my leave, I reported to work and reported about the situation. What happened next was a roller coaster of events: testing positive, telling the children we have COVID to their disbelief. [Now] I have completed the second dose of the vaccine; hopefully, the third looming [wave] can find me [strong] like concrete and stone."
— Barbara Nabiryo, study coordinator I, HCRI-Uganda
"[It has been] an interesting experience that sometimes tests your patience levels. Imagine having a one-hour meeting in the bathroom because you are hiding from your screaming nieces who want to play hide and seek."
— Caroline Babirye, research and administration assistant, HCRI-Uganda
The COVID-19 era, this has been a hard and trying time for me and many others. To overcome these challenges, we have all made some adjustments that have made this new normal very bearable. At work, management was and has been very supportive, no one has lost their job or had a pay cut, protective gear is readily available, and working from home has been encouraged if one does not need to be on-site. At home, the children and I got involved in activities like baking, trying out new recipes, sewing, and these have made it more bearable. At the end of every tunnel, there is a light. The pandemic has strengthened the bond between my children, colleagues and me, I learned to appreciate the little things we take for granted and I know where over 10 of my workmates reside."
— Rosemary Namagembe, study coordinator, HCRI-Uganda
FY21 in Numbers
Learn more about our key research and financial metrics and other achievements over the past fiscal year.
Generating Research With
Global Impact
Our faculty, teams and collaborators have persevered during these challenging times to continue our research, including two ongoing clinical trials and launching new studies.
Clinical Trials
Launched in 2018 with $1.4 million in funding from GlaxoSmithKline through the African NCD Open Lab Programme, the study seeks to define the molecular profile of breast cancer in Uganda and explore the feasibility an all-oral cancer regimen. For the observational arm of the study, the research investigators recently met a new milestone: enrollment completion (100 patients enrolled). However, given increased access to breast cancer chemotherapy as well as the toll of the COVID-19 pandemic, enrollment for the interventional arm has been limited. The study is co-led by Dr. Manoj Menon (Fred Hutch) and Dr. Jackson Orem (UCI).
Launched in 2019, in partnership with Roche and the Uganda Cancer Institute, this early phase trial aims to improve cure rates for children and adults with two aggressive forms of lymphoma — Burkitt lymphoma and diffuse large B-cell lymphoma — as well as Kaposi sarcoma herpesvirus (KSHV)–associated multicentric Castleman’s disease. The study is evaluating a novel targeted treatment, rituximab, that can be administered subcutaneously, or under the skin, of both adult and pediatric patients with lymphoma. A successful data and safety monitoring board meeting held on May 2021 resulted in the recommendation to continue accrual in the adult cohort (cohort 1, group 2). This trial is led by Dr. Manoj Menon of Fred Hutch and Drs. Henry Ddungu, Joyce Balagadde Kambugu and Jackson Orem of the UCI.
UCI-Fred Hutch breast cancer clinical trial team together at the UCI-Fred Hutch Cancer Centre
New Studies Opened in FY21
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 Research
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.
Select Publications
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
Core Research Services
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.
UCI-Fred Hutch Cancer Centre
We completed a new level to our facility in Kampala, which houses administrative offices, a biorepository and a research records archive.
Opening of the Ground-Level Facility at UCI-Fred Hutch Cancer Centre
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.
Biorepository
The UCI-Fred Hutch Cancer Centre houses a state-of-the-art biorepository that has been curated since the inception of the UCI-Fred Hutch Collaboration over 15 years ago — hosting a wide range of specimens related to viral infections, host immunity and cancers. The biorepository offers an unprecedented opportunity for one-of-a-kind collaborations and research with approximately 600 square feet of space located on the sublevel of the UCI-Fred Hutch Cancer Centre, which was built and opened in 2020. It hosts over 150,000 biospecimens with the capacity to grow in Kampala and Seattle. The biorepository is managed and operated by the HCRI-Uganda laboratory team and Acting Laboratory Director Andrea Towlerton.
Training the Next Generation
While many of the training activities pivoted to virtual spaces, training physician scientists continues to be an emphasis of our work in Uganda.
East African Adult Hematology-Oncology Fellowship Program
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:
- The International Exchange Program was to provide in-person training in Seattle for the four fellows in the 2020 graduating class. Alternative training opportunities are being explored with the funder for future cohorts.
- No in-person didactic lectures at UCI by UW and Fred Hutch faculty during 2020. Virtual lectures have become the main tool for continuing training and evaluations.
- Recruitment of fellows from other East African countries was unsuccessful due to pandemic-related travel restrictions.
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.
“On a personal level, it's been exhilarating and fulfilling to see the evolution and growth of the adult hematology/oncology fellowship training program. It has been an enriching and gratifying experience, from curriculum drafting, faculty training, onboarding/offboarding of fellows, and seeing the graduates of the program join the ranks and becoming vanguards of the super-specialty. The program continues to scale up its visibility and subscription across the African continent during the call for applications. I am thankful to the UW/Fred Hutch, in-country institutions and faculty (UCI, Mulago, Makerere) for unwavering commitment and support to the AHO program.”
Dr. Abrahams Omoding, AHO Fellowsip, co-director
Continued Training Efforts by the UCI-Fred Hutch Collaboration
Dr. Maggie Lubwama, UCI-Fred Hutch Collaboration fellow at Makerere University, was awarded the Center for AIDS Research’s 2020 Mentored International Investigator Award. Through this award, Lubwama plans to expand her research on causes of fever among patients at the UCI by using next-generation sequencing to more fully characterize the mechanisms of antimicrobial resistance in bacterial isolates and to identify nonbacterial causes of fever in cancer patients. This work is being performed at the UCI-Fred Hutch Cancer Centre using recently established sequencing capacity. Dr. Warren Phipps, associate professor, VIDD, and medical director, UCI-Fred Hutch Collaboration, serves as her faculty mentor. The Mentored International Investigator Awards encourage international junior investigators to conduct independent research with close mentorship from senior faculty. This research should lead to the acquisition of preliminary data to obtain funding to continue their HIV/AIDS research careers. Learn more about Lubwama.
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.
HIVAM Clinical Care & Teaching Conference
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.
Community & Communications
Our teams have been committed to advancing the Global Oncology mission, whether at the forefront or behind the scenes.
Enjoy these stories about a few of our dedicated and essential colleagues who have been working tirelessly during the pandemic.
'We're all essential'
Andrea Towlerton is a project manager in the Warren Lab and acting lab director for the UCI-Fred Hutch Collaboration who has been working relentlessly throughout the pandemic as an essential worker at Fred Hutch, including playing an integral role in setting up SARS-CoV-2 testing at the UCI-Fred Hutch Cancer Centre.
The man behind the wheel: Isma Lubega's drive to support cancer research
Isma Lubega is the driver for the HCRI-Uganda staff and UCI-Fred Hutch Collaboration, and his role is vital in helping researchers and study participants get to and from the UCI campus and other regional clinics to work on cancer and infectious disease-related projects and receive treatments.
‘Part of the solution’: In Uganda, the 008 study clears obstacles in treatment, transportation
Peter Mooka, senior study coordinator, helps principal investigators conduct research on Kaposi sarcoma at the UCI-Fred Hutch Collaboration.
Read a few Global Oncology stories highlighted in Hutch News.
Uganda hospitals receive much-needed COVID-19 supplies from Seattle area
Donation of personal protective equipment from Fred Hutch, local community aids health workers in hard-hit country
'Tissues are data'
How biorepositories — and their people behind the scenes — enable next-gen data science
Learn about our initiatives and connect with us.
New UCI-Fred Hutch Collaboration Website
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 Virtual Lecture Series
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.
Diversity, Equity and Inclusion
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.
Looking Ahead
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.
Contact Us
We want to hear from you and connect with you.
Visit Global Oncology at fredhutch.org/go
Email: globaloncology@fredhutch.org
Mailing Address
Global Oncology
1100 Fairview Ave N.
Mail Stop M1-B140
Seattle, WA 98109