Abstract PL05-02: Translational Epidemiology: Towards Personalized Risk Assessment, Prevention, and Therapy

Delivery of personalized cancer risk assessment, prevention, and therapy is challenged by the complex gene-gene, gene-environment, and gene-therapeutic agent interactions that differentially impact diverse populations. We have been using a translational epidemiologic approach to construct comprehensive, clinically applicable risk prediction models along the entire cancer continuum, from etiology to screening, prognosis, treatment response, progression, quality of life, and survivorship. We assimilate epidemiologic, genetic and clinical variables with genotypic and phenotypic biomarkers to develop robust personalized risk prediction models that inform clinical care and empower clinical risk stratification. I will present our ongoing strategies to integrate molecular epidemiology into the individualized clinical management of cancer, and highlight key aspects of our most prominent research that has employed various “Omic” platforms and cell-based phenotypic assays to address key issues in risk assessment, prevention, and treatment outcome across several malignancies. We are establishing several large prospective cohorts of general public, pre-cancer, and cancer patients, respectively, for integrative risk assessment along the cancer continuum. The MD Anderson Cancer Patient Cohort is comprised of all newly-presenting patients that seek care at our institution. The cohort infrastructure encompasses an all-inclusive blood biorepository that is linked to an electronic patient history database of core epidemiologic risk factors with networking to institutional clinical patient data resources. This clinically well-characterized patient cohort provides a rich resource to develop personalized risk assessment tools and clinically useful models that aid in treatment stratification. In another initiative, the Premalignant Genome Atlas (PGA) program is focusing on earlier aspects of the cancer continuum to assess the full spectrum of risk factors contributing to initiation and progression of precancerous lesions, such as Barrett's esophagus and colorectal polyps. We have produced preliminary data on molecular profiling to identify biomarkers of progression risk. Our goals to delineate targets for prevention intervention will be discussed, as will our strategies to develop integrative risk prediction models to identify individuals who may benefit most from such intervention trials. Finally, in collaboration with the MJ Health Management Institution, we are developing the large prospective MJ Cohort with over half a million individuals undergoing comprehensive health screening in Taiwan. I will highlight the key public health take-home messages that we have derived from our analyses of risk factors associated with cancer and other diseases. Overall, our mission is to integrate translational epidemiologic discoveries into fundamental clinical applications and public health initiatives to enable individualized strategies that improve patients' lives and reduce the global burden of cancer. Citation Format: Xifeng Wu. Translational epidemiology: Towards personalized risk assessment, prevention, and therapy. [abstract]. In: Proceedings of the Eleventh Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2012 Oct 16-19; Anaheim, CA. Philadelphia (PA): AACR; Cancer Prev Res 2012;5(11 Suppl):Abstract nr PL05-02.