Research
Basic and Translational Science | BioSpecimen Network | Clinical Trials Program | Epidemiology | Institutional Review Board
USMCI is uniquely positioned to conduct leading-edge research. The Institute has resources both within and beyond the military medical system, resulting in a broad range of investigative capabilities.
USMCI has undertaken several initiatives to advance cancer research and treatment. Many of these initiatives will benefit not only military medicine, but also the entire field of cancer research.
Basic and Translational Science
The Basic and Translational Science Section of the USMCI is comprised of more than 20 investigators whose research is focused on four areas: Prostate Cancer, Signal Transduction and Tumor Suppressor Genes, Oxidative Stress and Drug Resistance, and Viral and Bacterial Carcinogenesis. The investigators are faculty members in the basic and clinical science departments at the Uniformed Services University of the Health Sciences or staff members at the Center for Prostate Disease Research (CPDR) or the Armed Forces Radiobiological Research Institute (AFRRI). Research in the Basic and Translational Science Program of the USMCI is supported by more than 2.5 million dollars in annual peer-reviewed funding (direct costs) to the investigators. This includes funding from the National Cancer Institute Extramural Program, the Congressionally Directed Medical Research Program and private foundations. More than 65 scientific articles were published by the members of the section in 2007 and representative references can be found via the USMCI Publications link.
The USMCI promotes the development of collaborative approaches to cancer research and the transition of bench research to the translational level among its member laboratories whenever possible. To accomplish these objectives the Basic and Translational Science Section sponsors seminars and meetings as well as administering a small grants program that funds collaborative translational research pilot projects.
BioSpecimen Network
Molecular studies are at the forefront of modern cancer investigation. USMCI's BioSpecimen Network (BSN) was created to collect malignant and pre-malignant tissues for genomic and proteomic analysis.
Clinical care programs allow USMCI researchers the rare opportunity to procure tissue samples before DNA/RNA degradation occurs. In the DoD beneficiary population, more than 355,000 patients undergo treatment or follow-up for cancer in any one year.
At Walter Reed Army Medical Center, a USMCI site, 35 percent of those being treated for cancer who are approached for a clinical trial consent to enroll. This is in sharp contrast to the two- to three-percent response rate in civilian treatment settings.
Through the BSN, researchers can utilize these clinical samples to link, anonymously, molecular changes detected in the laboratory with DoD's databases of longitudinal demographic and clinical data. The network is a unique resource, offering invaluable information on the relative roles of genes and the environment, as well as providing tremendous potential for answering critical questions regarding carcinogenesis.
These research advances may enhance the treatment of military service members and their dependents --a network of more than nine million people.
Clinical Trials Program
In its report of 21 September 2004, the SAB recommended the establishment of a clinical trials core, which will allow the conduct of cutting-edge clinical research in military medical centers. This will create an extraordinary research resource, which will again demonstrate the University and its cancer institute's involvement in research to enhance patient care. The Board also endorsed the participation of military clinicians and investigators around the country in the activities of the USMCI.
This recommendation was explored at length during the off-site Planning Conference for the USMCI on 8 December 2004. A panel of oncologists involved in clinical trials held discussions about strategy, and their conclusions were then analyzed by the plenary session participants. The exercise revealed that there was great enthusiasm for the concept of a clinical trails core. The group also observed that, while the military healthcare system provides a unique opportunity for the implementation of clinical trials, the effort should not be seen as an attempt to compete with the cooperative groups.
In 2005, a clinical trials coordinator was named. Additionally, a budget was approved to hire a clinical research nurse in 2006 and another in 2007. Military clinician-researchers from both medical and surgical subspecialties have been identified at MAMC, BAMC and WRAMC who have agreed to act as the site-specific PIs for the cooperative research trials. Additional centralized support will ultimately be required, but the infrastructure has been put in place to launch the first stage of the clinical trials program at these MTFs.
Two different areas of USMCI PI-directed research have been previously proposed as "proof of principle" clinical trials for the establishment and implementation of the USMCI Clinical Trials Program. Feasibility trials were designed, conducted and included in last year's report.
Feasibility Study I: The use of sentinel lymph node (SLN) mapping and assessment to better stage colon cancer.
Feasibility Study II: Testing of a HER2/neu vaccine for the prevention of recurrence in high-risk breast cancer patients.
Epidemiology
The Epidemiology Program of United States Military Cancer Institute (USMCI) is one of the important components of the Institute. While the Epidemiology Program conducts research with the Institute's goal to reduce the ravages of cancer in the military, it also provides statistical and epidemiological support to military cancer researchers within and outside the Institute.
Additionally, the Epidemiology Program has access to Military Health Data from M2, ACTUR and DoDCCR. If you'd like to develop a research project using these data, you need a research protocol that will be reviewed by the USMCI-NCI Epidemiology Steering Committee. Information about the databases can be obtained by contacting USMCI.
For Military Health Data Requests, please refer to the following documents:
For all statistical and epidemiological support, including requests for military health data, please review our policies and fill out the electronic form using Application for Statistical/Epidemiological Support
USMCI recruited a nationally recognized cancer epidemiologist to head this research group, and the team has initiated an analysis of DoD's cancer databases. The group is working in collaboration with scientists from the National Cancer Institute.
Institutional Review Board
USMCI has streamlined research efforts by establishing a multi-institutional IRB that has met with the approval of the regional commanders of all three services. The IRB will allow simultaneous protocol approval for all institutions that have signed the Memorandum of Understanding for the process. Both military and civilian cancer-focused programs are eligible to join the program.
Prior to the initiation of the USMCI IRB, military investigators had to obtain protocol approval at their own institution, as well as all other institutions at which they wished to enroll patients. This process was inefficient, expensive and time-consuming, and presented a substantial impediment to research. The new streamlined system will facilitate cancer research efforts and will promote the delivery of cutting-edge treatment to the military patient.