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Dean Henri R. Ford Launches Interdisciplinary Research Lecture Series

Emmanuel Thomas, M.D., Ph.D., a researcher at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, was the inaugural speaker in Dean Henri R. Ford’s Interdisciplinary Research Lecture Series.

From left, Henri R. Ford, M.D., MHA, Emmanuel Thomas, M.D., Ph.D., and CTSI Director Ralph L. Sacco, M.D., MS.

Dr. Thomas’s lecture, “An Integrated, Multidisciplinary Approach for the Prevention and Early Detection of Viral Hepatitis-induced Hepatocellular Carcinoma,” was given on February 14 at the Michael S. Gordon Center for Research in Medical Education. It was the first in a new monthly series launched by Dean Ford’s office and the Miami Clinical and Translational Science Institute (CTSI) to highlight the innovative, collaborative, translational research being conducted by University of Miami faculty across all of its disciplines.

“When I arrived at the Miller School, I was impressed by how much research excellence there was in so many different clusters,” Dean Ford said, “but if you were conducting research in one area, you may not have known about the work being done in others. This lecture series will be a forum to start that dialogue.”

Dr. Thomas, assistant professor of microbiology and immunology, is an alumnus of the Miller School’s M.D./Ph.D. program and a CTSI KL2 graduate. He is co-director of the Center for AIDS Research Comorbidities SAR, and a member of the Schiff Center for Liver Diseases and Sylvester’s Cancer Control Program.

He is also a Fellow of the American Association for the Study of Liver Diseases and serves on the National Board of the American Liver Foundation. He is funded through an NIH Outstanding Investigator Award (R35), a Bankhead Coley Clinical Cancer Research Grant and the Gilead FOCUS program.

Dr. Thomas began his presentation with some grim statistics about the relationship between Hepatitis Virus B (HBV) and Hepatitis Virus C (HCV) and liver cancer:

“About 20 percent of all cancers are caused by viruses,” he said, “and of those virus-associated cancers, 80 percent are comprised of only two types of cancer. Cervical cancer, which is associated with Human Papilloma Virus, is most common; liver cancer, which is associated with both HBV and HCV, is second. HCV is the most common blood-borne infection, and it infects 70 million people globally, including 3 million in the U.S. Of those patients who are exposed to HCV, only 30 percent recover. The remaining 70 percent typically develop chronic infections within six months, cirrhosis within the next 20 years, and liver cancer within the following 10 years.”

Why, he asked, is it important to conduct this research? Because the numbers aren’t getting any better.

“Every 30 seconds, one person in the world dies of liver cancer,” Dr. Thomas said. “Globally, it is the fifth-most-common cancer in men and the seventh in women, and worldwide it’s the second leading cause of death from cancer. In the U.S., HCV is the No. 1 chronic infection, with 3 million people infected.”

Liver cancer is not one disease, Dr. Thomas said, and it is both clinically diverse and molecularly diverse. His three research teams are each pursuing a different aspect of the link between viral hepatitis and liver cancer:

• Team 1: HCV screening and linkage to care.
• Team 2: Liver cancer surveillance and early detection.
• Team 3: Development of liver disease models and molecular biomarkers for liver cancer.

Dr. Thomas noted that recent therapeutic advances and continually updated expert guidelines have improved the prognosis of liver cancer from a death sentence to a cancer that can be detected and treated at an early stage with good outcomes. Still, because the prevalence of HCV is leading to increased incidence of cirrhosis — 630,000 Americans have it, although 69 percent are unaware of the diagnosis — the incidence and death rate of liver cancer are rising while many other cancer mortality rates are decreasing.

Dr. Thomas said the keys to turning the numbers around are prevention through better education, early detection through risk-stratified screening, and reduction of drug costs to make treatment available to more people. Much work lies ahead, including a longitudinal study of patients with advanced liver disease and collaborative research on a national level.

Tags: cirrhosis, fatty liver disease, HBV, HCV, hepatitis, hepatocellular carcinoma, liver cancer