Hematology and Oncology, Inside Pediatrics

ICOS Research Advances to Benefit Survivors, Improve Outcomes

By numbers alone, the Institute for Cancer Outcomes and Survivorship at the University of Alabama School of Medicine has posted an impressive list of accomplishments: Just six years after its founding, ICOS has received funding or commitments for $40 million, up $30 million since 2019. Additionally, faculty members have published approximately 500 journal papers, 167 of those in just the last year.

But the mission of ICOS far transcends those numbers. In their quest to study cancer outcomes long-term and identify issues survivors face, institute members – who include epidemiologists, physician-scientists, behavioral scientists, molecular biologists and nurse-scientists – have aggressively pursued research questions aiming to help survivors prevent and manage long-term complications from cancer and its treatment.

“Institute members are asking some terrific, clinically pertinent questions and going after them like a dog after a bone,” said ICOS Director Smita Bhatia, M.D., M.P.H., who’s also the Gay and Bew White Endowed Chair in Pediatric Oncology at the University of Alabama at Birmingham (UAB). “Really changing practice to improve clinical outcomes – that’s our goal.”

Over the past two years, notable ICOS studies have produced clinically useful results as well as spawned new and related research. Bhatia offered updates on several key efforts:

  • Examining the molecular basis of long-term complications in pediatric cancer survivors: Boosted by a sizable 7-year grant from the National Institutes of Health, ICOS researchers have “unearthed some very interesting genes associated with chemotherapy that cause heart failure,” Bhatia reported. “They’ve also developed a risk prediction model that allows us to say, ‘If you have this genetic makeup, we can predict whether you’ll develop heart failure or not.’”
  • Testing strategies to improve adherence to oral chemotherapy among adolescents with acute lymphoblastic leukemia (ALL): Physicians texted patients each night to remind them to take their chemotherapy, with a duplicate text sent to parents. Parents were instructed to watch their children take the medication. Families also watched educational videos on the topic. “Among adolescents at baseline who were non-adherers, they benefited most with this intervention,” Bhatia said. “Those findings were published and we’re now taking this to the next level in a 2,000-patient trial.”
  • Understanding how to treat older cancer patients without undue toxicity: Geriatric assessment surveys were given to older adults with colorectal cancer, multiple myeloma and other malignancies that are pinpointing how a patient’s total fat and muscle tissue may be linked to treatment toxicity levels. “This is like a gold mine in terms of giving us so many good findings we can apply in clinic,” Bhatia said.
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