2022 Global Oncology Annual Report

Advancing Global Research With Local Impact

Determination to advance our research and training mission through challenging times

Fred Hutchinson Cancer Center Global Oncology’s annual report for fiscal year 2022 (July 1, 2021-June 30, 2022) provides an overview of research progress and scientific achievements, training initiatives, grants and finances, operations and the Global Oncology community. The report also provides an update on our local response to the COVID-19 pandemic.  

 

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.
 

A Message from Global Oncology Leadership

Dear colleagues,

As another fiscal year closes, we remain humbled by the evolving COVID-19 pandemic but committed to our work. Our critical cancer and infectious disease research and training efforts are informing and transforming research, care and treatment in limited-resource settings. We acknowledge the enormous toll that the pandemic and other global events have had — and continue to have — on our research and operations, teams, partners, patients, and the world. Despite these challenges, we have been inspired by the progress we have made. Through our collaboration with the Uganda Cancer Institute, and through the commitment of our faculty and staff in Kampala (part of the Hutchinson Centre Research Institute of Uganda, HCRI-U) and our entire Global Oncology program, our research has continued to advance. Most importantly, the overall standard of care delivered to patients at the UCI has been enhanced through our collaborative research.  

During FY22, we continued studies on Kaposi sarcoma, breast cancer, and lymphoma, which are among the top five cancers with the highest incidence rates in Uganda.1  We are studying the burden and management of infectious diseases among cancer patients. With our colleagues at the UCI, we continued to prioritize training initiatives, particularly through the East African Adult Hematology Oncology Fellowship Program and National Institutes of Health training grants focused on Ph.D.-level training. We look forward to expanding into new training areas. Further, the year was also a time to reflect and refine our mission and goals. We are committed to the pursuit of cancer and infectious disease research with global impact and to supporting research and clinical capacity in low-resource settings, particularly Uganda. Like many organizations, we experienced change and transitions, yet remain excited about the present and future of Global Oncology and our partnerships. We are eager to explore new opportunities through the UCI’s expansion into new satellite clinics. We also look forward to the opportunities presented by the formation of Fred Hutchinson Cancer Center, which brought together Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance into one organization that is a clinically integrated part of UW Medicine and UW Medicine’s cancer program.  

“It was wonderful to see firsthand the new ground floor of the UCI-Fred Hutch Cancer Centre, which was spectacular, and more importantly, to see the inspirational work going on inside.” 

In April, I had the privilege of returning to Kampala after more than two years. The progress that has been made in our research and training during these extraordinarily trying times has been remarkable. 

There continues to be urgency in conducting collaborative cancer research and training with a global lens — and in translating findings into clinical care and action. By 2040, there will be an estimated 27 million new cancer cases globally — with 19.3 million new cases estimated in Africa, Latin America and the Caribbean, and Asia, or roughly 70% of all new cases, and an estimated 12.4 million cancer deaths in the same region.2 The deep inequities in cancer progress between high-income and low- and middle- income countries (LMICs) underscore the importance of this work. The National Cancer Institute’s Center for Global Health recognizes this: The center updated its five-year strategy to renew its commitment to global cancer research and control and focus its research through collaborations on technologies for global cancer control, implementation science, global cancer health disparities, cancer clinical trials in LMICs, and cancer etiology and biology.3 

We are determined to advance our mission through challenging times because the call to action is urgent. On behalf of the entire HCRI-U and Global Oncology teams in Kampala and Seattle, thank you for your support and partnership that helps us move science forward and make a greater impact.

Sincerely,
 

Dr. Edus H. Warren, Global Oncology Program Head

Hootie Warren Leadership signature Hootie Warren Leadership signature Hootie Warren Leadership signature

Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2020). Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.fr/today, accessed [24 June 2022].

Ferlay J, Laversanne M, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2020). Global Cancer Observatory: Cancer Tomorrow. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.fr/tomorrow, accessed [24 June 2022].

Gopal S, Sharpless NE. Cancer as a Global Health Priority. JAMA. 2021;326(9):809–810. doi:10.1001/jama.2021.12778.

Global Oncology Leadership

We are thankful for our committed teams that are seeing through changes in leadership and programs and allowing for critical work to move forward. 

Global Oncology Leadership

Photo of Dr. Edus H. Warren

Edus H. Warren, M.D., Ph.D.
Global Oncology Head; Professor, Program in Immunology, Clinical Research Division; Professor, Vaccine and Infectious Disease Division

Photo of Stuart Tenney Director of Finance and Operations

Stuart Tenney
Senior Director of Finance and Operations, Global Oncology,
Research Administration, and Shared Resources

Photo of Dr. Warren T. Phipps

Warren T. Phipps, M.D., M.P.H.
Medical Director, UCI-Fred Hutch Collaboration; Associate Professor, Vaccine and Infectious Disease Division

Photo of Dr. Manoj Menon

Manoj Menon, M.D. 
Associate Professor, Vaccine and Infectious Disease and Clinical Research Divisions

UCI Leadership

Photo of Dr. Jackson Orem

Jackson Orem, M.B.Ch.B., M.Med., Ph.D.
Executive Director, Uganda Cancer Institute

Photo of Dr. Victoria Walusansa

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. 

FY22 Strategic objectives infographic FY22 Strategic objectives infographic FY22 Strategic objectives infographic

During this last fiscal year, Global Oncology reflected on and refined our mission, strategic goals and objectives to a) focus on our research and training partnership with the Uganda Cancer Institute and b) explore new opportunities that would enable us to build on our research expertise.

1. Develop cancer diagnostics, evaluate therapies suited for low-resource settings, and elucidate the pathogenesis of globally important cancers
2. Expand our research portfolio characterizing the burden and management of infectious diseases in cancer
3. Collaborate with the Uganda Cancer Institute to build research, clinical care and research administration capacity through training and infrastructure development
4. Expand our research portfolio by engaging new faculty and exploring collaborations with institutions or research networks
5. Implement the principles of diversity, equity and inclusion in all aspects of research and operations

FY22 in Numbers

Learn about some of our significant program metrics and other achievements during the past fiscal year. 

Global Oncology Research and Collaboration

21

Publications*
*Includes publications related to the UCI-Fred Hutch Collaboration, GO faculty authors only, and publications by Collaboration trainees

and publications by UCI-Fred Hutch Collaboration trainees (former or current)

8

Cancers
in current research portfolio (Breast, Burkitt lymphoma, Cervix, Diffuse large B-cell lymphoma, Kaposi sarcoma, Leukemia, Lung and Nephroblastoma)

6

Infections and Viruses
in current research portfolio (Bacteremia, Blood infections, HHV-8, HIV, KSHV-Multicentric Castleman's disease, Neutropenic fever)

7

Studies
open to accrual/enrollment (at the end of FY22)

6

Grants Awarded to our faculty and collaborators

1

New Study opened to accrual

3

Studies completed enrollment

8

Abstracts presented

52

Faculty Affiliated with Global Oncology

9

Global Oncology Lecture Series seminars

Global Oncology FY22 by the numbers infographic Global Oncology FY22 by the numbers infographic Global Oncology FY22 by the numbers infographic

Implementing Research with Local, Clinical Impact

Our research is impacting patient care in Uganda while also making valuable discoveries in the field of oncology globally. 

Although the world continues to grapple with the COVID-19 pandemic and other ongoing challenges, we saw a shift in momentum related to our studies at the UCI-Fred Hutch Cancer Centre, in a large part due to our dedicated team and a decrease in COVID-19 cases in Uganda, particularly in the last two quarters of the fiscal year. Our clinical studies continued relatively smoothly, despite the pandemic. Our study teams cross-trained on all protocols to provide backup support for each study. During this time, we enrolled an increasing number of participants in our studies, particularly in the latter half of the fiscal year.

We have learned from our colleagues in Kampala that patient care quality has been enhanced through participation or enrollment in our studies, for instance, by facilitating timely diagnosis of cancers and comorbidities. In one of our studies on Kaposi sarcoma, participant visits are synchronized with the standard of care visits at the UCI. If participants have challenges with transport to the UCI, this study will support their transport. This was a critical need during COVID-19 pandemic travel restrictions, and it enabled many patients to access chemotherapy visits and other standard of care reviews regularly and in a timely way. 

A few of our studies are focused on infections among cancer patients — a critical and growing area of our research portfolio. Findings from a 2022 study in The Lancet indicated that 1.2 million people died from antibiotic-resistant infections in 2019, making it a leading global cause of death.4 A study led by Dr. Margaret Lubwama on bacteremia among lymphoma patients and another study on infections in solid tumor patients, led by Dr. Elizabeth Gulleen,  advocated for improved temperature monitoring among study participants at the UCI. The team supporting the bacteremia study monitors febrile episodes in lymphoma patients, and according to Constance Namirembe, HCRI-Uganda clinical research project manager:

Constance Namirembe, HCRI-Uganda Clinical Research Project Manager
Constance Namirembe, HCRI-Uganda Clinical Research Project Manager
“[The study] supports tests for blood culture and sensitivity during a febrile episode; where if an organism is identified and is suspected to be causing the fever, it informs the standard of care in real time regarding the appropriate antibiotics to be given.”

In Gulleen’s study, the temperature monitoring has increased the ability to rapidly diagnose and treat infections among UCI patients receiving chemotherapy. Participants were provided with blood cultures as well as malaria and tuberculosis testing. The study results were given to the clinical teams in real time, which helped improve their ability to prescribe the correct antimicrobials for their patients. The results of this study were presented to UCI faculty and staff at multiple clinical care conferences. According to Gulleen, “We are currently working with the UCI pharmacists and clinicians to develop infection treatment protocols based on our study results with the goal of improving patient management and decreasing infection-related mortality.”  In a related study on antimicrobial stewardship, Gulleen and colleagues asked UCI clinicians about their experiences with diagnosis and treating patients with infections. The study team learned about current knowledge regarding antibiotic use and barriers to diagnosis and treating infections in their patients.

Elizabeth Gulleen photo, Senior Infectious Disease Fellow
Dr. Elizabeth Gulleen, Senior Infectious Disease Fellow
“We are using the results to build an antimicrobial stewardship program at the UCI and create educational sessions on infection management for clinicians,” Gulleen said.

Further details about these studies and our other research are below.

Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022 Feb 12;399(10325):629-655. doi: 10.1016/S0140-6736(21)02724-0. Epub 2022 Jan 19. PMID: 35065702; PMCID: PMC8841637. Accessed July 19, 2022.

Current Research and Clinical Trials

Learn about our research led by Global Oncology faculty, fellows, and collaborators at the UCI and elsewhere. 

Research Highlights

During the fiscal year, our investigators and collaborators led several research studies at the UCI-Fred Hutch Cancer Centre. Learn more below about studies that were actively enrolling/accruing and completed studies undergoing data analysis as of the end of FY22. Also, learn about our upcoming studies in the pipeline.

Studies Open to Enrollment/Accrual

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Phase I Study of Subcutaneous Rituximab Hyaluronidase Combined with Local Standard-of-Care Chemotherapy for the Treatment of Burkitt Lymphoma, Diffuse Large B-Cell Lymphoma or as Monotherapy for Kaposi Sarcoma Herpesvirus (KSHV)-Associated Multicentric Castleman Disease in Pediatrics and Adults in Uganda

Principal investigators: Dr. Manoj Menon (Fred Hutch), Dr. Henry Ddungu (UCI), Dr. Joyce Balagadde Kambugu (UCI) and Dr. Jackson Orem (UCI)

Launched in partnership with Roche and the UCI in late 2019, this early-phase trial aims to improve cure rates for adults and children with two aggressive forms of lymphoma and KSHV-associated multicentric Castleman’s disease. Intravenous administration of rituximab — a monoclonal antibody against CD20 — is challenging in limited-resource settings, which is one factor that impedes its widespread use. The team is evaluating a formulation of rituximab that can be administered subcutaneously, or under the skin, in cancer patients. The primary goal is to evaluate the safety and pharmacokinetics of the new formulation of rituximab, including the optimal dosage in children. The trial will also allow the research team to conduct a preliminary assessment of its efficacy as a platform for other translational studies to help us better understand the unique biology of Burkitt lymphoma in Africa. At the end of the fiscal year, 17 patients were enrolled, and the team aims to complete enrollment (target total enrollment between 36-40 patients) in FY23.  

Identifying Bacterial Causes of Neutropenic Fever Among Cancer Patients in Uganda

Principal Investigators: Dr. Margaret Lubwama (UCI), Dr. Warren Phipps (Fred Hutch)

Emerging antimicrobial resistance and changing local epidemiology of organisms complicates empiric management of infections. In this study, Dr. Margaret Lubwama, a UCI-Fred Hutch Ph.D. fellow through an NIH D43 training grant, aims to identify bacterial causes of neutropenic fever among UCI inpatients with hematologic malignancies. Specifically, the main objectives are to determine the antimicrobial susceptibility profiles of bacteria, risk factors and outcomes associated with bacteremia in hematologic cancer patients with febrile neutropenia in Uganda. Of 121 pathogens isolated, 92 (75%) are Gram-negative bacteria of which E. coli (44, 48%) and K. pneumoniae (31, 34%) were the most common. The proportion of extended-spectrum β-lactamases (ESBL) presence was high (65% and 75%, respectively, with CTX-M type enzymes (a group of class A ESBLs) dominating in both species. Among the 25 Gram-positive organisms isolated, Enterococcus spp. (16, 64%) were the most common. Half of the Enterococci (8, 50%) were vancomycin-resistant. Of the five S.aureus isolated, three (60%) were methicillin-resistant. Patients with acute leukemia and severe neutropenia were most likely to develop bacteremia. Findings indicate that multidrug-resistant bacteria are the main cause of bacteremia in hematologic cancer patients with febrile neutropenia at the UCI, and bacteremia was associated with reduced survival at 30 days from the onset of a febrile neutropenic episode.  

Characterizing the Determinants of Primary KSHV Infections Among Children and Adolescents in Uganda

Principal Investigators: Dr. Warren Phipps (Fred Hutch), Dr. Fadhil Geriga (UCI) and Dr. Joshua Schiffer (Fred Hutch)

KSHV, or human herpesvirus 9, is the infectious cause of Kaposi sarcoma — one of the most common cancers in Africa, and especially among people living with HIV. KSHV’s seroprevalence, or the proportion of a population that has antibodies to a virus, varies geographically: For instance, it is <5% in the U.S. and Europe while it is 60%-80% in Uganda and sub-Saharan Africa. In this NIH R01, the primary objective is to determine the incidence and to define the viral, immunologic and clinical features of primary KSHV infection. It is a prospective, observational study of up to 80 women and their children who are followed for one year. At the end of FY22, 37 mothers and 83 children were enrolled. Findings will guide the development improvement of antibody tests as well as a potential KSHV vaccine approach. 

Assessing the Clinical Utility (Benefit) of an Automated Molecular Diagnostic Test (GeneXpert Breast Cancer STRAT4 Assay) in the Diagnosis of Women With Breast Cancer in Uganda

Principal investigators: Dr. Manoj Menon (Fred Hutch), Dr. Jackson Orem (UCI) and Dr. Nixon Niyonzima (UCI)

Breast cancer is the second-most common cancer among women in Uganda, yet survival outcomes are poor. Various factors are associated with poor survival, including late stage at presentation, limited therapeutic options, and potentially biologically more-aggressive disease. It is also not well characterized, as the hormonal status is often unknown. Building from results of a recent study implemented by the UCI-Fred Hutch Collaboration that defined the molecular profile of breast cancer in Uganda and its clinical implications, the need for accurate and low-cost diagnostics is critical. In this prospective, observational study, the team is utilizing Cepheid’s GeneXpert’s real-time PCR and STRAT4 assay that measures estrogen receptor (ER), progesterone receptor (PR), HER2 and Ki62 to evaluate the potential to accurately diagnose the hormone receptor and HER2 status of patients diagnosed with breast cancer in Uganda. The investigators aim to evaluate the clinical utility, feasibility, sensitivity and specificity of the STRAT4 assay to detect the presence of ER, PR and HER2 in core needle biopsy specimens of patients with breast cancer at the UCI. Further, they aim to evaluate the clinical utility, feasibility, sensitivity and specificity of the STRAT4 assay to detect the presence of the ER, PR, and HER2 in fine-needle aspiration biopsy (FNA) specimens of patients with breast cancer at the UCI. Finally, the investigators aim to assess the concordance between STRAT4 results obtained on a core needle biopsy specimen with the STRAT4 results obtained on an FNA specimen. At the end of the fiscal year, 41 participants enrolled, with an enrollment target of 100 women. 

Optimizing Nephroblastoma Treatment Outcomes in Uganda

Principal investigators: Dr. Fadhil Geriga  (UCI), Dr. Soheil Meshinchi (Fred Hutch)
Co-investigators: Dr. Joyce Balagadde Kambugu (UCI), Dr. Jackson Orem (UCI), Dr. Scott Adams (VA Puget Sound Health Care System)

In this study, the primary objectives are 1) to determine the one-year survival of children with pathology-confirmed nephroblastoma treated with multidisciplinary, stage-based care in Uganda and 2) to assess the factors associated with morbidity and mortality among children with nephroblastoma. Additional objectives are to characterize the frequency and spectrum of other malignancies that present like nephroblastoma and to characterize the social needs and health literacy of nephroblastoma patients and their caregivers at the UCI. Researchers also aim to assess quality measures of multidisciplinary care, including treatment timing benchmarks following guidelines developed for UCI, adherence to treatment plans, and elimination of loss to follow-up. Lastly, the final objectives are to assess the social needs of families of children with nephroblastoma, provide them with a patient navigator, and reduce the nonclinical barriers to care for these children. At the close of FY22, over a quarter of patients (17 participants out of a goal of 40 participants) were enrolled in the study. 

Human Herpesvirus 8 Replication and Kaposi Sarcoma Response to Treatment

Principal Investigators: Dr. Warren Phipps (Fred Hutch), Dr. Jackson Orem (UCI)
Co-Investigator: Dr. Edus H. Warren (Fred Hutch)

In an observational, prospective cohort study, the study team is defining the relationship between HHV-8 replication and KS treatment outcomes and evaluating the potential of HHV-8 to serve as a prognostic biomarker in people with KS. The objectives are to: characterize HHV-8 replication in oral, plasma and lesion sites and define its relationship to the clinical manifestations of KS; determine if HHV-8 replication in oral, plasma and/or lesion sites predicts KS response to treatment; determine if HHV-8 replication in oral, plasma and/or lesion sites predicts KS relapse following treatment; and define the characteristics of effective immune responses to KS. In the next phase, the study team aims to enroll additional participants to explore pandemic-related impacts on access to clinical care. 

Integrating Cervical Cancer Screening in HIV Clinics and Assessing the Effect of Using a Modified Referral Protocol on Access to Cancer Services among HIV-Positive Women in Uganda

Principal Investigator: Dr. Noleb Mugisha (UCI)
Co-Investigators: Dr. Dan Kaye (Makerere University), Dr. Lynn Atuyambe (Makerere University), Dr. Ruanne Barnabas (University of Washington) and Dr. Warren Phipps (Fred Hutch)

Cervical cancer is the leading cause of cancer morbidity and mortality among women in sub-Saharan Africa, and infection with HIV increases a woman’s risk of suffering from the cancer fivefold. Where proper treatment is accessible, screening for cervical cancer dramatically improves survival. However, robust screening programs are lacking in many low- and middle-income countries, even among high-risk populations. Therefore, most patients with cervical cancer in these settings present with late-stage disease and inevitably have poor survival rates. Leveraging HIV care infrastructure to provide cervical screening services could lead to earlier diagnosis, not only among the HIV-positive women receiving their routine care through the infrastructure, but also among HIV-negative women. In this study, the investigators are introducing cervical cancer screening services in two existing HIV care clinics in Kampala, Uganda — Makerere University Joint AIDS Programme Mulago clinic and St. Balikuddembe (Owino) HIV clinic — and referring the women with abnormal screening results to the UCI cervical cancer screening clinic using a modified referral protocol. The investigators are providing screening services for cervical cancer in the same clinics where members of the target population receive their routine HIV care. The study team anticipates that uptake will be better than when patients are referred to seek cervical screening services in clinics outside their HIV clinic.

To date, the team has enrolled 374 participants (out of a target of 3,080, or approximately 12% of the target sample size). They plan to enroll the remaining patient participants and conduct 24 interviews with patient participants as well as key informant interviews with 28 health care providers at the HIV clinics in the first half of FY23. Dr. Noleb Mugisha aims to complete data analysis in FY23 to complete his Ph.D. program.  

enrollment open to accrual protocols fy22 Q4

Completed Studies or Closed to Accrual/Data Analysis

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Attitudes and Practices of Antimicrobial Resistance and Stewardship at the Uganda Cancer Institute

Principal investigators: Dr. Warren Phipps (Fred Hutch), Dr. Elizabeth Gulleen (Fred Hutch) and Dr. Margaret Lubwama (UCI) 
Co-investigators: Dr. Catherine Liu (Fred Hutch), Alfred Komakech (UCI) and Elizabeth Krantz (Fred Hutch) 

Infections are one of the most common complications during cancer treatment. Developing programs to enhance antibiotic stewardship, or the rational use of antibiotics, is a critical component of decreasing infection-related morbidity and mortality. In this study, the investigators aim to examine the current knowledge and attitudes of UCI health care providers towards antimicrobial resistance. They also aim to determine the current knowledge and attitudes of UCI health care providers towards antimicrobial stewardship. Finally, the investigators aim to understand perceived barriers to the diagnosis and management of infections in patients at UCI. The study met accrual targets (61 participants) in the second quarter of FY21. While all respondents had heard of the term “antimicrobial resistance,” only 73% had heard of the term “antimicrobial stewardship.” Nurses were less likely than pharmacists or physicians to be familiar with either term. The ability to obtain blood cultures and to regularly measure temperatures were identified as major barriers to diagnosing infections. The results of the study were published in Antimicrobial Stewardship and Hospital Epidemiology, volume 2, issue 1, 2022, e54.  

Post-Chemotherapy Infections in Uganda: Microbiology, Risk Factors and Outcomes

Principal Investigators: Dr. Warren Phipps (Fred Hutch), Dr. Elizabeth Gulleen (Fred Hutch), Dr. Abrahams Omoding (UCI) and Dr. Christopher Moore (University of Virginia) 
Co-Investigators: Dr. Scott Heysel (University of Virginia), Dr. Michael Keng (University of Virginia) and Elizabeth Krantz (Fred Hutch)  

Infection is a leading cause of morbidity and mortality among patients receiving chemotherapy for cancer treatment. Little is known about the microbiological causes of fever or associated outcomes among patients with solid tumors receiving chemotherapy in sub-Saharan Africa. Understanding the microbiological causes of fever could improve antibiotic selection and infection-related outcomes. The primary study objective is to determine the most common microbiologic causes of fever among hospitalized patients who are receiving chemotherapy for the treatment of solid tumors in Uganda. Secondary objectives include a) to determine predictors of in-hospital and 30-day mortality and b) to describe the antibiotic management of patients who develop fever while receiving chemotherapy for the treatment of solid tumors. 

The study met its accrual target (100 participants) in FY22 Q4. Preliminary analysis of the first 80 febrile events shows that 25% of participants had at least one microbiologic source of infection. Among these, 10% of participants with fever experienced a bacterial bloodstream infection. The most common causes of bacterial bloodstream infections were Escherichia coli and Klebsiella spp. For participants who underwent urinary lipoarabinomannan testing for tuberculosis, 17% were positive. This did not differ by HIV status. Thirty-day mortality was 23%. The results of this study were presented as an oral presentation at the European Congress of Clinical Microbiology in April 2022.  

Exploring the Molecular Spectrum of Colorectal Cancer in Uganda

Principal investigators: Dr. Amanda Phipps (Fred Hutch) and Dr. Victoria Walusansa (UCI)
Co-investigators: Dr. Scott Adams (VA Puget Sound Health Care System), Dr. Tom Uldrick (Regeneron; affiliate professor, Fred Hutch) and Dr. Robert Lukande (Makerere University)  

The primary objective of this study was to estimate the prevalence of BRAF and KRAS mutations, CpG island methylator phenotype (CIMP) and microsatellite instability (MSI) in colorectal tumors in the Kampala Cancer Registry (KCR). The secondary objectives were to: describe the demographic and clinical characteristics of colorectal cancer cases in the KCR; evaluate associations of demographic and clinical characteristics with the prevalence of BRAF and KRAS mutation, CIMP and MSI in colorectal cancer cases in the KCR; and evaluate associations of survival time with tumor molecular phenotypes (BRAF, KRAS, CIMP, MSI) and other participant information. Unfortunately, high levels of degradation in DNA specimens, likely due to initial tumor processing and storage conditions, compromised the researchers’ ability to identify BRAF and KRAS mutations and prompted us to forgo CIMP analyses. Greater success was observed in MSI analyses, where the team found 35% of tumors to exhibit MSI-high status (compared to 10%-20% typically observed in U.S. settings). Tumors exhibiting MSI-high status did not differ significantly from other tumors in tumor site or patient age at diagnosis. Despite technical challenges, our results have demonstrated a provocatively higher proportion of MSI-high status tumors among Ugandans with CRC, compared to U.S. cohorts.

Treatment Response and Treatment Related Mortality in Pediatric Patients With Acute Myeloid Leukemia at the Uganda Cancer Institute

Principal Investigators: Dr. Joyce Kambugu (UCI) and Dr. Soheil Meshinchi (Fred Hutch) 
Co-Investigators: Dr. Clement D. Okello (UCI), Dr. Fadhil Geriga (UCI), Dr. Henry Ddungu (UCI), Dr. Jackson Orem (UCI), Dr. Katherine Tarlock (Seattle Childrens), Dr. Cecilia Yeung (Fred Hutch) and Andrea Towlerton (Fred Hutch)

Investigators conducted a retrospective study of all patients with acute leukemias, therapies, and outcomes to understand the number of patients treated for acute lymphocytic leukemia and acute myeloid leukemia (AML) at the UCI over a five-year period. They also aimed to document relapse and survival rates. The retrospective review was completed in December 2021. The study of 186 patients with AML treated at the UCI with standard induction regimens over a 5-year period demonstrates a complete remission rate of 46.2% and an overall 30-day induction treatment-related mortality rate of 31.5%, which suggests the need for interventions to reduce treatment-related mortality and improve the outcome for patients with AMC in low- and middle-income countries. This study is funded by the Global Oncology Pilot Grants Initiative 2019.

Upcoming Studies

Our Global Oncology faculty and collaborators have several upcoming studies in the pipeline that we anticipate progress during the next fiscal year. 

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Utility of a Liquid Biopsy in Patients With Lung Cancer at the Uganda Cancer Institute

Principal Investigators: Dr. Alice Berger (Fred Hutch) and Dr. Nixon Niyonzima (UCI)
Co-Investigators: Dr. Gavin Ha (Fred Hutch), Dr. Manoj Menon (Fred Hutch), Dr. Alex Bakenga (UCI) and Dr. Sitapriya Moorthi (Fred Hutch)

The study team aims to understand if a liquid biopsy be used for diagnosis and biomarker profiling in Ugandan lung cancer patients. Specifically, they seek to compare circulating tumor DNA (ctDNA) sequencing to standard histopathologic diagnoses of lung cancer in patients with advanced-stage lung cancer at UCI. They will determine the prevalence of detectable ctDNA in 35 patients with confirmed lung cancer, prior to therapy. Further, the team will describe the tumor-specific molecular alterations present in lung cancer specimens and ctDNA in advanced-stage lung cancer patients at UCI. They will detect common cancer-associated mutations with a lung cancer next-generation sequencing panel and describe the frequency of EGFR mutations and other targetable mutations for the first time in the Ugandan population. The study received final regulatory approvals in late in FY22 with a plan to activate in early FY23. It is funded by the Global Oncology Pilot Grants Initiative 2019.

Acute Leukemia Banking and Biology Study for Patients at the Uganda Cancer Institute

Principal Investigators: Dr. Joyce Kambugu (UCI) and Dr. Soheil Meshinchi (Fred Hutch) 
Co-Investigators: Dr. Clement D. Okello (UCI), Dr. Fadhil Geriga (UCI), Dr. Henry Ddungu (UCI), Dr. Jackson Orem (UCI), Dr. Katherine Tarlock (Seattle Childrens), Dr. Cecilia Yeung (Fred Hutch) and Andrea Towlerton (Fred Hutch)

This is a prospective study of all patients enrolled with acute leukemias at the UCI, including each patient’s diagnosis, therapy, response to therapy, treatment toxicity and the outcome. The study team is developing infrastructure for clinical sequencing and a plan at the UCI for the rapid transition into clinical implementation upon assay validation. 

Utility of a Liquid Biopsy in the Detection of Metastatic Breast Cancer in Uganda 

Principal Investigators: Dr. Manoj Menon (Fred Hutch) and Dr. Nixon Niyonzima (UCI)
Co-Investigators: Dr. Scott Adams (VA Puget Sound Health Care System), Andrea Towlerton (Fred Hutch) and Dr. Molly Tokaz (Fred Hutch)

With funding from the Susan G. Komen Foundation, the study team aims to evaluate the liquid biopsy as an effective tool in the diagnosis and monitoring of women with metastatic breast cancer. The ability to accurately diagnose and monitor response to therapy (minimally invasive) could be critical in a limited-resource setting. If successful, the team anticipates that patients will be diagnosed and treated earlier, thereby reducing the health disparities between women with breast cancer in Uganda and in the U.S. 

Barriers to Timely Diagnosis and Treatment of Neutropenic Fever in Uganda Patients with Cancer and HIV  

Principal Investigators: Dr. Warren Phipps (Fred Hutch), Dr. Elizabeth Gulleen (Fred Hutch) and Dr. Jackson Orem (UCI) 
Co-Investigators: Dr. Johnblack Kabukye (UCI) and Dr. Catherine Liu (Fred Hutch)  

Between 50%-80% of patients receiving chemotherapy for cancer treatment experience an episode of neutropenic fever (NF) during treatment. Studies show that time from fever onset to administration of guideline-recommended antibiotics is an important predictor of mortality. A recent study from UCI showed that, for patients with hematologic malignancy who developed NF, it took a median of three days for guideline-recommended antibiotics to be prescribed. In this mixed-methods study, the team’s aims are as follows: 1) understand the current process of antibiotic initiation for patients with cancer at NF at the UCI; 2) identify factors that influence timely initiation of guideline-recommended antibiotics that can be addressed using targeted implementation strategies; 3) identify the unique barriers to diagnosing infections and initiating guideline-recommended antibiotics for patients with NF who are HIV seropositive. Using the results of this study, the team will then collaborate with UCI staff to design implementation studies to overcome the barriers. They will then prospectively test these strategies to determine whether they improve the time –to guideline-recommended antibiotics and decrease infection-related mortality.  

Identifying Predictors of Kaposi Sarcoma Immune Reconstitution Inflammatory Syndrome

Principal Investigators: Dr. Innocent Mutyaba (UCI) and Dr. Warren Phipps (Fred Hutch)

Kaposi sarcoma patients initiated on antiretroviral therapy (ART) have a life-threatening clinical worsening called KS immune reconstitution inflammatory syndrome (KS-IRIS). The scientists have shown that KS-IRIS is common in adults with late-stage KS in spite of concurrent ART and cancer chemotherapy. The team seeks to extend this work by evaluating predictors of KS-IRIS in a complementary cohort of KS patients initiating ART therapy curated by the AIDS and Cancer Specimen Repository. The study aims are 1) to identify baseline predictors of incident KS-IRIS among adults with early-stage KS initiating ART and 2) to determine if select clinical parameters, plasma cytokines and KSHV burden measured at the time of KS-IRIS symptom onset could serve as biomarkers of prevalent KS-IRIS.

Gastrointestinal Colonization with Drug Resistant Bacteria in Ugandan Patients With Cancer and HIV 

Principal Investigators: Dr. Warren Phipps (Fred Hutch), Dr. Elizabeth Gulleen (Fred Hutch) and Dr. Margaret Lubwama (Makerere University) 
Co-Investigators: Dr. Catherine Liu (Fred Hutch) 

Multidrug-resistant Gram-negative bacteria, including extended-spectrum beta-lactamases (ESBLs) and carbapenem-resistant Enterobacterales (CRE), are an increasing cause of bacterial bloodstream infection for patients receiving cancer treatment in sub-Saharan Africa (SSA). Bloodstream infections with these organisms are associated with high morbidity and mortality. Studies show that gastrointestinal colonization with ESBL or CRE increases the risk of developing bloodstream infections. In SSA, up to 35% of those with cancer are also co-infected with HIV. However, the association between HIV status and gastrointestinal colonization with multidrug-resistant bacteria is yet unknown. The team’s primary goal is to understand the association between HIV status and gastrointestinal colonization with multi-drug resistant organisms (MDROs) among patients who are receiving chemotherapy for treatment of cancer in Uganda. The secondary goals are to a) assess the factors associated with MDRO colonization within the first 30 days of initiating chemotherapy and b) investigate whether colonization with an MDRO is associated with an increased risk of developing a bacterial bloodstream infection with that organism. The team will use the results of this study to develop tailored antibiotic infection prevention and treatment protocols for patients with HIV with the goal of improving cancer treatment outcomes and decreasing infection-related mortality. 

The Impact of HIV on the Breast Cancer Tumor Microenvironment

Principal Investigators: Dr. Manoj Menon (Hutch) and Dr. Nixon Niyonzima (UCI)
Co-Investigators: Dr. Jamie Guenthoer (Hutch) and Dr. Eric Konnick (UW)

Breast cancer remains the most common non-AIDS-defining cancer among women living with HIV and is characterized by aggressive disease and poor outcomes. Immune cells in the tumor microenvironment (TME) have an essential role in tumor development, progression and response to therapy. The study team will investigate the extent and nature of HIV-associated immune dysfunction in tumor tissues and blood biospecimens from both HIV-positive and HIV-negative Ugandan women with breast cancer. Given the burdens of HIV and breast cancer in sub-Saharan Africa, clarity regarding the effect of HIV and associated immune dysfunction in the TME and blood are required to understand factors associated with cancer development and progression in this population. 

Research to Publication

Find a selection of our publications from FY22, including publications with several of our UCI-Fred Hutch fellows/trainees as authors.  In total, there were 21 publications, with 12 publications that were independent research by a former or current trainee. 

Expand All
Cytoreductive surgery for giant locally advanced intra-abdominal tumors in Uganda

Okello M, Nuwagaba J, Ddungu H*, Okuku FM. Cytoreductive surgery for giant locally advanced intra-abdominal tumors in Uganda. J Surg Case Rep. 2022 May 24;2022(5):rjac178. doi: 10.1093/jscr/rjac178. PMID: 35620232; PMCID: PMC9129259. 

Perceived risk and risk reduction behaviours of female first-degree relatives of breast cancer patients attending care at Uganda cancer institute.

Ainembabazi P, Abila DB, Manyangwa G, Anguzu G, Musaazi J, Mutyaba I*, Osingada CP, Mwaka AD. Perceived risk and risk reduction behaviours of female first-degree relatives of breast cancer patients attending care at Uganda cancer institute. Psychooncology. 2022 May 18. doi: 10.1002/pon.5963. Epub ahead of print. PMID: 35584282.

Serial Analysis of the T-Cell Receptor β-Chain Repertoire in People Living With HIV Reveals Incomplete Recovery After Long-Term Antiretroviral Therapy.

Towlerton AMH, Ravishankar S, Coffey DG, Puronen CE, Warren EH. Serial Analysis of the T-Cell Receptor β-Chain Repertoire in People Living With HIV Reveals Incomplete Recovery After Long-Term Antiretroviral Therapy. Front Immunol. 2022 May 2;13:879190. doi: 10.3389/fimmu.2022.879190. PMID: 35585986; PMCID: PMC9108698. 

Multiple High-Risk HPV Types Contribute to Cervical Dysplasia in Ugandan Women Living with HIV on Antiretroviral Therapy

Nakisige C, Adams SV^, Namirembe C, Okoche L, Ferrenberg J, Towlerton A, Larsen A, Orem J, Casper C^, Frenkel L, Uldrick TS^. Multiple High-Risk HPV Types Contribute to Cervical Dysplasia in Ugandan Women Living with HIV on Antiretroviral Therapy. J Acquir Immune Defic Syndr. 2022 Feb 21. doi: 10.1097/QAI.0000000000002941. Epub ahead of print. PMID: 35195571.

Precision Medicine in Low- and Middle-Income Countries

Radich JP, Briercheck E, Chiu DT, Menon MP, Sala Torra O, Yeung CCS, Warren EH. Precision Medicine in Low- and Middle-Income Countries. Annu Rev Pathol. 2022 Jan 24;17:387-402. doi: 10.1146/annurev-pathol-042320-034052. PMID: 35073168.

Haematological malignancies in sub-Saharan Africa: east Africa as an example for improving care

Okello CD, Niyonzima N, Ferraresso M, Kadhumbula S, Ddungu H*, Tarlock K, Balagadde-Kambugu J, Omoding A*, Ngendahayo L, Karagu A, Mwaiselage J, Harlan JM, Uldrick TS^, Turner SD, Orem J. Haematological malignancies in sub-Saharan Africa: east Africa as an example for improving care. Lancet Haematol. 2021 Oct;8(10):e756-e769. doi: 10.1016/S2352-3026(21)00198-8. Epub 2021 Sep 2. PMID: 34481552.

Efficacy of convalescent plasma for treatment of COVID-19 in Uganda

Kirenga B, Byakika-Kibwika P, Muttamba W, Kayongo A, Loryndah NO, Mugenyi L, Kiwanuka N, Lusiba J, Atukunda A, Mugume R, Ssali F, Ddungu H*, Katagira W, Sekibira R, Kityo C, Kyeyune D, Acana S, Aanyu-Tukamuhebwa H, Kabweru W, Nakwagala F, Bagaya BS, Kimuli I, Nantanda R, Buregyeya E, Byarugaba B, Olaro C, Mwebesa H, Joloba ML, Siddharthan T, Bazeyo W. Efficacy of convalescent plasma for treatment of COVID-19 in Uganda. BMJ Open Respir Res. 2021 Aug;8(1):e001017. doi: 10.1136/bmjresp-2021-001017. PMID: 34376401; PMCID: PMC8354811.

Factors and Outcomes Related to the Use of Guideline-Recommended Antibiotics in Patients With Neutropenic Fever at the Uganda Cancer Institute

Gulleen EA, Adams SV^, Chang BH, Falk L, Hazard R, Kabukye J, Scala J, Liu C, Phipps W, Abrahams O, Moore CC. Factors and Outcomes Related to the Use of Guideline-Recommended Antibiotics in Patients With Neutropenic Fever at the Uganda Cancer Institute. Open Forum Infect Dis. 2021 Jun 10;8(7):ofab307. doi: 10.1093/ofid/ofab307. PMID: 34262989; PMCID: PMC8275883.

Bold = Fred Hutch Global Oncology faculty
Underline = UCI collaborators
* = Current UCI-Fred Hutch Collaboration Trainee
Italics = U.S. research fellow
^ = Former Fred Hutch Global Oncology faculty and/or staff scientist  

UCI-Fred Hutch Collaboration Training Initiatives

Training the next generation of physician scientists continues to be an emphasis of our collaborative work in Uganda 

UCI-Fred Hutch Training Program
Dr. Edus Warren presenting at all staff meeting in Uganda

NIH D43 Training Program on HIV-Associated Malignancies

Our UCI-Fred Hutch Collaboration training initiatives remain a significant focus of work with the UCI. Over the past decade, we have had multiple NIH-funded training grants (two D43 grants and one U54). Our most current five-year NIH D43 is focused on training Ugandan scientific leaders who are conducting HIV-associated malignancies (HIVAM) research with independent research funding and fostering a community of scientists and research leaders who will cultivate and train the next generation of HIVAM researchers. In FY22, various training activities through this D43 program were reactivated as pandemic restrictions eased, including Research in Progress sessions, Journal Club meetings, ongoing tumor boards and clinical case conferences continued virtually, in-person or hybrid. Another important goal of the program is to prepare trainees to pursue independent research funding through mechanisms such as the NIH K43 award, which is the NIH Fogarty Emerging Global Leader Award for early career research scientists in LMICs who hold a junior faculty position at an LMIC institution. 

Three Ph.D. candidates were recently selected and supported by the current NIH D43 HIVAM training grant. These include Dr. Fadhil Geriga, associate director of Pediatric Oncology, UCI; Dr. Priscilla Namaganda, junior investigator and fellow, Adult Hematology Oncology Fellowship Program; and Dr. Solomon Kibudde, radiation oncologist at the UCI. The UCI-Fred Hutch Collaboration Ph.D. candidates supported by the previous D43 training grant included Drs. Margaret Lubwama, Innocent Mutyaba and Noleb Mugisha. 

Dr. Fadhil Geriga

Dr. Fadhil Geriga
Associate Director of Pediatric Oncology, UCI

Noleb Mugisha photo

Dr. Priscilla Namaganda
Junior Investigator and Fellow, Adult Hematology Oncology Fellowship Program

Dr. Solomon Kibudde photo

Dr. Solomon Kibudde
Radiation Oncologist, UCI

The NIH D43 training program activities are managed by our HCRI-Ug training project manage Olive Birungi, who joined the Global Oncology program in FY22, and led by Dr. Warren Phipps, medical director, UCI-Fred Hutch Collaboration. Interested in staying up-to-date about our training activities? Please email Olive Birungi if you would like to receive our monthly Training Program newsletter.  

 Adult Hematology Oncology Fellowship

The Adult Hematology Oncology Fellowship Program, launched in 2018 with funding from the African Development Bank to the East Africa Centre of Excellence in Oncology at the UCI, continued implementation while also navigating the COVID-19 pandemic. The program’s objectives are to provide high-quality clinical care, guide lower-level health workers, conduct research in adult hematology-oncology, and serve as mentors to the next generation of hematologists and oncologists. In FY22, UCI faculty gave six in-person lectures at the UCI-Fred Hutch Cancer Centre, while the UW and Fred Hutch faculty facilitated 29 virtual lectures by Zoom. 

The fall 2020 cohort of AHO fellows, Drs. Naghib Bogere, Kenneth Kintu and Erick Were, completed their one-year ward rotations and began the second year of clinic rotations in the second quarter. The clinical competency committee met in January to prepare a report on their performance in year one. Certification of the AHO Fellowship by the Uganda Medical and Dental Practitioners Council is underway, and two external reviewers evaluated the curriculum. The newest fellow, Dr. Anne Magdalene Amata, was accepted into the AHO Fellowship in March 2022 and is pursuing the medical oncology track.

The AHO Fellowship Program is co-directed by Dr. Abrahams Omoding, Uganda Cancer Institute, and Dr. John Harlan, University of Washington. Learn more about the AHO Fellowship on Global Oncology’s website and the UCI’s website. 

“I have been in this program for close to two years and will be finishing the fellowship in three months and can attest to the foundations and tireless efforts in leading and guiding us to improve the quality of care to cancer patients in Uganda and East Africa. The program is inspirational, engaging and hands-on with a diverse range of patients with different cancers. We see a different future for cancer care in Uganda because of the knowledge and experience we have acquired through the fellowship.”

— Naghib Bogere, Medical Oncology Track, Fall 2020 Cohort

“It has been a great honor to be part of the East African Adult Oncology and Hematology Fellowship Program offered by the Uganda Cancer Institute in collaboration with Fred Hutchinson Cancer Center. The East Africa Center of Excellence in Oncology has been so supportive at every step of this fellowship program … through one-on-one clinical experiences, tumor boards, joint clinical meetings and the didactic lectures. Before this program, access to cancer care has been a challenge because there are few cancer centers, yet the number of cancer patients is on the increase. This program is going to increase cancer care access to Ugandans locally through human resource development.”

— Erick Were, Medical Oncology Track, Fall 2020 Cohort

Highlights on Trainees & Fellows Activity

In FY22, the UCI and the Palliative Care Association of Uganda hosted the third annual conference from Sept. 23-24, 2021, with presentations by trainees including Dr. Innocent Mutyaba, Dr. Henry Ddungu, Dr. Geriga Fadhil and Dr. Noleb Mugisha. Dr. Victoria Walusansa, UCI deputy director, was also a panelist.

At IDWeek 2021 — a joint annual meeting of the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the HIV Medicine Association, the Pediatric Infectious Diseases Society and the Society of Infectious Diseases Pharmacists — two fellows, Dr. Margaret Lubwama and Dr. Elizabeth Gulleen, presented abstracts. Their abstracts were titled, “Multidrug-Resistant Polymicrobial Gram-Negative Bacteremia in Hematologic Cancer Patients With Febrile Neutropenia at the Uganda Cancer Institute” and “Knowledge and Perceptions of Antimicrobial Resistance and Antimicrobial Stewardship Among Staff Providing Cancer Care at the Uganda Cancer Institute,” respectively. This conference was held virtually in late September and early October 2021. 

Currently there are five Ugandan trainees/fellows as a principal investigator on one of our current or upcoming studies under institutional review board review. They include:

Noleb Mugisha M.B.Ch.B., MPH

Noleb Mugisha M.B.Ch.B., M.P.H.

Integrating Cervical Cancer Screening in HIV Clinics and Assessing the Effect of Using a Modified Referral Protocol on Access to Cancer Services Among HIV-Positive Women in Uganda

Margaret Lubwama M.B.Ch.B., M.Med.

  • Identifying Bacterial Causes of Neutropenic Fever Among Cancer Patients in Uganda 
  • Gastrointestinal Colonization with Drug Resistant Bacteria in Ugandan Patients with Cancer and HIV
Fadhil Geriga, M.B.Ch.B., M.Med.

Fadhil Geriga, M.B.Ch.B., M.Med.

  • Optimizing Nephroblastoma Treatment Outcomes in Uganda
  • Characterizing the Determinants of Primary KSHV Infections Among Children and Adolescents in Uganda
Innocent Mutyaba, M.B.Ch.B., M.Med.

Innocent Mutyaba, M.B.Ch.B., M.Med.

Identifying Predictors of Kaposi Sarcoma Immune Reconstitution Inflammatory Syndrome

Clement Okello, M.B.Ch.B., M.Med.

Clement Okello, M.B.Ch.B., M.Med.

Treatment Response and Treatment-Related Mortality in Pediatric Patients With Acute Myeloid Leukemia at the Uganda Cancer Institute

Tumor Boards

More than 200 tumor boards were held by the UCI-Fred Hutch Collaboration, in collaboration with other invited clinicians and experts. Below is a snapshot of the eight different tumor board topics and the number of sessions held over the year.
(Note: these figures include Q2-Q4.) 

32 Gastrointestinal Tumor Boards
26 Urology Tumor Boards
30 Lymphoma Tumor Boards
30 Gynecology Tumor Boards
30 Breast Oncology Tumor Boards
12 UCI CME/Virtual Lecture Series
Gynecology Tumor Fellowships
59 Pediatric Tumor Boards/Fellowships
 
 

Future Training in Cancer Genomics for East Africa 

Beginning in FY23, the UCI-Fred Hutch Collaboration will launch a new training program, “Cancer Genomics and Genomic Data Science for East Africa,” which is a recently awarded NIH D43 grant to the Collaboration’s co-directors, Drs. Jackson Orem (UCI) and Edus H. Warren (Fred Hutch). The goal is to establish a program to train Ugandan and East African graduate students in genomics and informatics to increase the capacity for high-quality cancer research, training and clinical care in the region. The five-year award of $1.25 million (total direct cost) will be effective starting July 1, 2022. East African trainees who will be selected for this program will engage in training in Kampala, Uganda, at the UCI-Fred Hutch Cancer Centre, Makerere University in partnership with the Infectious Disease Institute, and at Fred Hutch.

Laboratory & COVID-19 Updates

Continued to advance laboratory capabilities and support research while navigating the ongoing response to the pandemic through SARS-CoV-2 testing and risk mitigation protocols for participants and staff

HCRI Lab staff handling specimen

UCI-Fred Hutch Collaboration laboratory

The UCI-Fred Hutch Collaboration  laboratory recently acquired the new Cepheid XPRESS, COV-2/FLU/RSV PLUS cartridges for testing for SARS-CoV-2, influenza and respiratory syncytial virus. The team will begin providing this service in late summer 2022. Despite the ongoing pandemic, the laboratory at the UCI-Fred Hutch Cancer Centre continued to operate successfully under the leadership of Andrea Towlerton, laboratory director, HCRI-Uganda. The lab has processed greater than 11,000 biospecimens during the fiscal year — for several active studies, SARS-CoV-2 testing, and supporting clinical care at the UCI through tumor boards and fellowship training support. 

HCRI Lab staff

COVID-19 Testing

The HCRI-U laboratory team continues SARS-CoV-2 testing as part of the Ugandan Ministry of Health’s National Testing Program and operates at a <12-hour turnaround time for results. The seven-person lab team has performed nearly 4,000 tests since the program started in late 2020. Towlerton secured another donation of 2,500 tests and regents from the Beijing Genomics Institute in March 2022. The laboratory has also passed, at 100%, the OneWorld Accuracy EQA proficiency testing for SARS-CoV-2 testing.
 

Ongoing COVID-19 Response

In response to guidelines provided by the Uganda National Council for Science and Technology, we developed a risk management plan (RMP) in 2020 to ensure the safety of research participants and research teams during the ongoing COVID-19 pandemic as research activities supported by the UCI-Fred Hutch Collaboration and HCRI-Uganda resumed. The goal is to minimize transmission among research participants and staff and identify suspicious cases of COVID-19 to facilitate referral to Uganda Ministry of Health testing centers.  

In May 2022, HCRI-Uganda revised the RMP to align with Uganda Ministry of Health guidelines as national statistics indicated low COVID-19 transmission rates. Like other countries around the world, the COVID-19 situation evolves quickly as new variants result in surges of COVID-19 cases; thus, the RMP may be revised to reflect the changing pandemic or if local pandemic restrictions are reactivated. Yet, as of June 2022, the updated RMP outlines standard operating procedures at the facility (e.g., masking, physical distancing, handwashing) for all staff and participants. Staff were encouraged to get vaccinated against SARS-CoV-2, and vaccines are offered at the Uganda Cancer Institute for all staff and their immediate families.  

UCI-Fred Hutch Cancer Centre Updates

Learn about our operations that ensure state-of-the-art facilities for research and training

The more than 16,700-square-foot, state-of-the-art UCI-Fred Hutch Cancer Centre facility, which opened in May 2015, supports the research, clinical care and training activities of the UCI-Fred Hutch Collaboration.

Virtual Tour

The recently completed build-out of the ground floor of the UCI-Fred Hutch Cancer Centre in Kampala in the spring of 2021 — adding approximately 3,800 square feet — has allowed the program to bring all research and administrative functions under one roof. This video highlights the new ground floor space and other key areas of the facility. This project was led by Magdalene Kintu, director, Administration and Operations, HCRI-Uganda, and Jason Barrett, operations manager, Global Oncology. The video was created by Shot by Mu in 2021. 

UCI-Fred Hutch Cancer Centre Operations 

The associate director of Fred Hutch Facilities and Engineering visited the UCI-Fred Hutch Cancer Centre twice during FY22 to optimize facilities management and equipment with a special interest in the facility’s air handling systems. As a result of these site visits, and with the hard work of the administrative and facility management teams in Kampala, the systems are now functioning optimally. The associate director will plan for annual trips to the facility, with the next one scheduled for October 2022. The associate director and a senior technical engineer plan to evaluate how to renovate the second-floor pharmacy space and will provide options to Fred Hutch leadership.

Since the last annual report, the building oversight committee (BOC) was reconstituted with some new committee members from the UCI and HCRI-Uganda assigned. The Collaboration’s executive committee (EC) tasks the BOC to provide general oversight and monitoring of the UCI-Fred Hutch Cancer Centre operations and its use. The UCI-Fred Hutch Cancer Centre facility rules, originally developed by the previous BOC and ratified by the EC in 2018, define how the UCI and Fred Hutch/HCRI-Uganda operate and maintain the facility. The BOC is required to compile an annual report of the facility’s operations and present the report with recommended operational changes to the EC. The BOC has met frequently to review their charter as well as each focus area’s (e.g., laboratory, research, administration, etc.) section of the facility rules in preparation for the development of the fiscal year 2022 report.  

Community & Events

Our teams have been committed to advancing the Global Oncology mission, whether at the forefront or behind the scenes. 

Staff Spotlight

“[I’m] passionate about training and health promotion and hope to use my experience and background to coordinate and promote trainings under the UCI-Fred Hutch Collaboration efficiently.”

— Olive Birungi, training project manager, HCRI-Uganda

“In FY22, the lab team was most proud of the leadership in their commitment to support us to do more science. We were especially glad that we have the lab director on site. In this new FY, we are even more fascinated with the introduction of Nanopore sequencing.

— Lazarus Okoche, PCR lab manager, HCRI-Uganda

“I am passionate about human resources as I believe they are critical to the success of any entity. I am very happy to be part of this great team and look forward to a mutually challenging and fulfilling journey with us all.”

— Shiloh Mutabazi, human resources coordinator, HCRI-Uganda

“It was exciting to see everyone’s face in one place after the remote policy was lifted. I remember how gratifying our first physical meeting was after a year long of virtual connection and seeing everyone looking healthy and alive. A couple of months ago we had Hootie [Edus H. Warren] visit Uganda followed by Jason [Barrett] after two years. One happy family reunited! I am excited about Shiloh’s onboard and Sumayah’s, who are great additions to the team.

“I am looking forward to a very productive next year, especially for the HR department, with an extra hand in streamlining existing processes and introducing more exciting employee engagements."

— Andrew Okot, manager, Operations and Human Resources, HCRI-Uganda

“I joined the HCRI-Uganda family on 15 April 2022 as a quality assurance assistant. I will be supporting all data quality assurance issues related to research studies conducted by HCRI-Uganda. I ensure that studies are conducted in accordance with research protocols and other applicable guidelines.  I am privileged to join the HCRI-Uganda to contribute to the realization of its mission and vision by ensuring that high-quality research is conducted.”

— Enos Baghendaghe, quality assurance assistant, HCRI-Uganda

Learn about our initiatives and connect with us.

U.S. Ambassador’s visit to the UCI-Fred Hutch Cancer Centre

On April 25, 2022, the U.S. ambassador to Uganda, Natalie E. Brown, visited the UCI-Fred Hutch Cancer Centre. Dr. Edus H. Warren, the Global Oncology scientific director, was visiting the site and took part in the ambassador’s tour along with the UCI Executive Director Dr. Jackson Orem. Ambassador Brown shared the following Tweet after the visit.

The U.S. Ambassador to Uganda tours the UCI-Fred Hutch Cancer Centre
The U.S. Ambassador to Uganda tours the UCI-Fred Hutch Cancer Centre

Global Oncology Virtual Lecture Series

Throughout the year, we host a global oncology seminar series to bring in diverse voices about cancer research, programs or policies from across the globe. In FY22, we were fortunate to have the following experts present at the seminar series. To learn more about this seminar series and upcoming seminars, visit our Global Oncology events webpage. 

September 2021: Joyce Balagadde Kambugu, M.D., head of pediatric oncology, Uganda Cancer Institute

October 2021: Satish Gopal, M.D., Ph.D., director, Center for Global Health, National Cancer Institute 

November 2021: Leeya Pinder, M.D., M.P.H., fellow, Division of Gynecologic Oncology, University of Washington & research fellow, Galloway Lab, Fred Hutch

January 2022: Solomon Kibudde, M.B.Ch.B., M.Med., radiation oncologist, Uganda Cancer Institute 

February 2022: Dan Milner, M.D., M.Sc. (Epidemiology), MBA, FASCP, chief medical officer, American Society for Clinical Pathology

March 2022: Benjamin O. Anderson, M.D., FACS, medical officer, Cancer Control, World Health Organization  

April 2022: Julie Gralow, M.D., FACP, FASC, executive vice president and chief medical officer, American Society of Clinical Oncology

May 2022: Doug Pyle, vice president, International Affairs, American Society of Clinical Oncology 

June 2022: Clement Okello, M.B.Ch.B., M.Med., medical officer special grade/hematologist, Uganda Cancer Institute

Committed to DEI from Operations to Research  

Global Oncology has incorporated diversity, equity and inclusion, or DEI, principles into our FY22-27 five-year strategic plan. Our goal is to partner with the Fred Hutch Office of Diversity, Equity & Inclusion and/or other global programs and institutions to understand DEI in a global context for the upcoming fiscal year. Global Oncology leadership and staff have engaged in bias mitigation training through the Fred Hutch Office of Diversity, Equity & Inclusion and are committed to learning and applying these values in our work and culture. 

Looking Ahead

Inspired by research progress despite global challenges

While the world continues to respond and be nimble in the face of many challenges, cancer and other diseases remain an urgent global health priority. We have been inspired by the progress we have made, in particular, how our research is impacting the standard of care for cancer patients at the UCI. The UCI is opening satellite cancer clinics, and we are excited to learn about these sites and how we may collaborate on studies that can improve cancer care, especially locally. Breakthrough research findings should be available everywhere, equitably. We look forward to continuing our ongoing scientific training efforts with our outstanding fellows and to launching the new training program in cancer genomics. We aspire to continue these efforts and to translate findings into clinical care and action. We believe it is critical to pursue our mission and the broader mission of Fred Hutch in our everyday work. 

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Contact Us

We want to hear from you and connect with you.

Visit Global Oncology at fredhutch.org/go or or our UCI-Fred Hutch Collaboration website

Email: globaloncology@fredhutch.org

Mailing Address

Global Oncology
1100 Fairview Ave N.
Mail Stop M1-B140
Seattle, WA 98109