Closeup of a plastic model of lungs

While the link between certain conditions and cancer risk, such as tobacco smoke exposure and lung cancer, has been firmly established, for other conditions, the association and the biological mechanisms behind them remain murky.

To this end, the Frederick National Laboratory for Cancer Research (FNL) and Louisiana State University (LSU) Health Sciences Center New Orleans recently launched a new public health research effort to better understand the effects of obesity, diabetes, and metabolic syndrome on the risk, incidence, and outcomes of patients with lung cancer.

As the leading cause of cancer death among both men and women in the United States, lung cancer has long been the research focus of the laboratory of Ethan Dmitrovsky, M.D., director of the FNL, who is co-leading this effort with Augusto Ochoa, M.D., director of the LSU Health New Orleans Stanley Scott Cancer Center.

“The Frederick National Laboratory seeks to improve the public’s health through innovative cancer science,” said Dr. Dmitrovsky. “To do this we are eager to partner with experts in the extramural community like Dr. Ochoa and his team. This collaboration helps us elucidate the association between obesity and lung cancer outcomes,” he added.

Lung cancer and health disparities

The link between obesity and lung cancer remains uncertain. Although obesity is a well-established risk factor for multiple cancer types, cardiovascular diseases, and type 2 diabetes, a high body-mass index has been associated with improved clinical outcomes for lung cancer patients. This association, called the obesity paradox, and the biological mechanisms involved are poorly understood.

The investigators are also particularly interested in studying minority and underserved cancer patient populations. Obesity, diabetes, metabolic syndrome, and cancer—as well as many other diseases including COVID-19—disproportionately affect certain minority and underserved populations. Better understanding of these factors could improve public health practices for these affected groups, which have been historically underrepresented in research, as well as the broader U.S.  population.

A portrait in a circular frame
Ethan Dmitrovsky

A portrait in a circular frame
Xiaocheng Wu

A portrait in a circular frame
Augusto Ochoa

“Despite major advances in screening, early detection, and novel treatments with immunotherapeutic agents, lung cancer still represents a major health disparity in the population of the Gulf South of the United States,” noted Dr. Ochoa. “The impact of lung cancer is especially significant in the African American population and the underserved and rural communities. Part of the solution to this is increasing access to screening and advanced treatment, which our Cancer Center has led in this region. However, there still are major questions in lung cancer that remain unanswered, including the impact of obesity and metabolic syndrome, conditions that are common in our region, on lung cancer, and the response to treatment.

He added, “We are excited that the partnership with the Frederick National Laboratory will help us understand how these conditions impact the outcome of lung cancer patients in our region and therefore allow us to implement new and more effective treatment strategies. We look forward to many years of productive collaboration.”

Conducting this research in Louisiana is particularly valuable for reaching the desired populations. Louisiana ranks among the top 10 states in the U.S. for adult obesity, 11th for diabetes prevalence, and fifth for the age-adjusted cancer death rate.

The research project also takes advantage of data from LSU Health New Orleans’ Louisiana Tumor Registry, a population-based state cancer registry and one of only 19 population-based cancer registries in the country in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. The LSU Health New Orleans Louisiana Tumor Registry collects data on all reportable cancer cases occurring among Louisiana residents. Data include patient demographics, tobacco use, cancer type, stage at diagnosis, first course of treatment, and survival. It follows cancer patients from their time of diagnosis through  the rest of their lives. The Registry also has the infrastructure to obtain tumor tissues to support biospecimen research. Together, these capabilities provide the investigators with robust data on obesity, cancer, and other comorbidities and outcomes for patients with cancer.

“Lung cancer is a particularly heavy burden in communities having health disparity, and we hope this collaboration will help combat this problem,” said Dr. Dmitrovsky.