The National Cancer Institute Early-Stage Surgeon Scientist Program award supports efforts to understand how opiates impact the gut microbiome and possibly exacerbate cancer.
Kristin Rojas, M.D., FACS, assistant professor of surgical oncology at Sylvester Comprehensive Cancer Center and the Dewitt Daughtry Department of Surgery at the University of Miami Miller School of Medicine, has been awarded a three-year, $375,000 grant from the National Cancer Institute’s Early-Stage Surgeon Scientist Program (ESSP). With this funding, Dr. Rojas and colleagues will investigate the role opioids may play in breast cancer.
“I feel quite honored to receive this grant,” said Dr. Rojas. “This Early-Stage Surgeon Scientist Program grant is funding our efforts to study how perioperative opioids may influence breast cancer progression through the gut microbiome, and could really impact patient care.”
For several years, research conducted by Sabita Roy, Ph.D., professor in the DeWitt Daughtry Family Department of Surgery and one of Dr. Rojas’s mentors, has shown that opioids can disrupt the gut microbiome, increasing systemic inflammation and other adverse effects. Dr. Roy has also shown that chronic opioid use can make the gut wall more permeable, allowing bacteria to escape into the bloodstream. These fugitive microbes could be influencing breast and other cancers far away from the gut.
At the same time, the ongoing opioid crisis has given surgeons and patients incentives to explore other analgesic options, both during and after surgery. As a result, breast cancer surgery patients have been subdivided into two groups — those who receive more surgical opioids and those who receive less — creating a unique opportunity to study how these drugs may impact breast cancer.
Opioids’ Effect on Gut Microbiome Composition
In 2021, the Bristol Myers Squibb Foundation and National Medical Fellowships awarded Dr. Rojas a $240,000 grant to study how opioids affect gut microbiome composition in breast cancer patients. Now she wants to take that work a step further.
“The ESSP-funded project is actually a continuation of our ongoing efforts to understand how opioids given at the time of surgery influence the gut microbiome in breast cancer patients,” said Dr. Rojas. “Now, we want to understand how opioids may dysregulate the gut microbiome to adversely influence hormone-sensitive breast cancer.”
Microbes often break down larger molecules into smaller, derivative molecules called metabolites. In a healthy microbiome, this process supports digestion and optimal health. However, a dysfunctional system can generate unhealthy metabolites that drive certain cancers or influence how patients respond to cancer treatment.
In addition to the funding, the ESSP supports additional training for Dr. Rojas, who will be working closely with Dr. Roy and Nipun Merchant, M.D., professor and associate director of translational research, on the project. Ultimately, Dr. Rojas hopes this grant will act as seed funding to provide crucial data and pave the way for more comprehensive NIH grants.
“Right now, we are only seeing the tip of the iceberg in opioids and breast cancer,” said Dr. Rojas. “By characterizing how opioid-induced changes in the gut microbiome impact cancer patients, we can eventually design interventions to prevent these adverse changes that may influence cancer outcome.”