An assessment of whether aspirin and/or vitamin D improves breast cancer outcomes in Black women and the modifying effect of genetic variants

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PROJECT SUMMARY/ABSTRACT The purpose of this K01 career development award submission is to support a period of didactic training and mentored research for Dr. Traci Bethea, Assistant Professor at Boston University School of Medicine, to increase her ability to carry out studies of cancer survivorship and to become an independent cancer researcher. Dr. Bethea’s long-term goal is to carry out studies that will result in a better understanding of factors that influence cancer survivorship and that will lead, ultimately, to higher survival among Black women affected by breast cancer and reduced cancer health disparities. She has already had training in environmental health and cancer epidemiology. Through the K01 training, she will develop expertise in cancer survivorship, statistical analyses of survival data, and molecular epidemiology, under the mentorship of a distinguished panel of researchers – Drs. Julie Palmer, Christine Ambrosone, Nancy Keating, Michael LaValley, and Edward Ruiz-Narváez. The mortality rate from breast cancer, the most commonly occurring cancer among women in the U.S., is 42% higher in Black women than White women. Dr. Bethea’s research will address an understudied topic, modifiable factors related to breast cancer survivorship in Black women. To this end, her proposed research utilizes data from the Black Women’s Health Study (BWHS), a longitudinal study of 59,000 African American women. During follow-up, more than 2,300 incident invasive breast cancer cases have occurred and they will be the subject of Dr. Bethea’s research. Dr. Bethea will assess several modifiable risk factors – post-diagnosis use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), and post- diagnosis use of vitamin D supplements and of predicted plasma vitamin D levels – in relation to breast cancer recurrence and breast cancer-specific mortality among breast cancer cases in the BWHS. She will create genetic risk scores using data on single nucleotide polymorphisms (SNPs) from candidate genes and will assess whether the associations of aspirin/other NSAIDs or of vitamin D supplementation and predicted plasma vitamin D levels with breast cancer recurrence and breast cancer-specific mortality are modified by genetic risk scores. Thus, Dr. Bethea will create a specific area of research in which she is highly proficient. As an independent researcher, it is anticipated that she will lead further BWHS research on cancer survivorship, which could be stand-alone studies or collaborative studies with other investigators. Dr. Bethea is an outstanding candidate. A K01 career development award will enable her to conduct important research as an independent investigator and put her on the path to obtaining NIH R01 and similar grant support and on a path to promotion. Importantly, it will also provide valuable information on factors related to breast cancer survival in Black women.