Addressing the Global Cancer Burden
By 2050, an estimated 35 million new cancer cases will occur globally, with 23 million, or approximately 65%, in Asia, Africa, and Latin America and the Caribbean.1, 2 This underscores the urgent need to better understand, diagnose and treat cancers in various settings to address the global cancer burden. Since 2008, Global Oncology at Fred Hutch Cancer Center has led research on globally relevant cancers and related diseases and trained new oncologists and researchers, primarily in collaboration with the Uganda Cancer Institute (UCI).
Our fiscal year 2024 annual report (July 1, 2023 – June 30, 2024) offers a snapshot of our scientific and training achievements over the year. We are grateful for our teams and collaborators, especially with the Uganda Cancer Institute and Fred Hutch, as well as our funders, donors and supporters. Thank you for your ongoing commitment.
Vision
Eliminate cancer and related infectious diseases as causes of human suffering and death worldwide.
Mission
Generate cancer and related infectious disease research with global impact and support the development of research and clinical capacity in low-resource settings.
Fred Hutch's Commitment to Diversity
Lifesaving research demands more than innovation and dedication. It requires curiosity, creativity and fresh and varied perspectives. That’s why diversity is a core Fred Hutch value that is integral to our work.
We were the first U.S. cancer center to pledge commitment to CEO Action for Diversity and Inclusion, and we cultivate a workplace that welcomes diverse perspectives and experiences. The DEI Core — in partnership with an executive council of senior leaders and an employee advisory group — leads our efforts to build a fully inclusive and informed workforce.
Fred Hutch is an equal opportunity employer that is committed to workforce diversity. We strongly encourage applications from women, minorities, individuals with disabilities and veterans.
Our five strategic goals for FY22 - FY27 are:
- Develop cancer diagnostics, evaluate therapies suited for low-resource settings, and elucidate the pathogenesis of globally important cancers
- Expand our research portfolio characterizing the burden and management of infectious diseases in cancer
- Collaborate with the Uganda Cancer Institute to build research, clinical care and research administration capacity through training and infrastructure development
- Expand our research portfolio by engaging new faculty and exploring collaborations with institutions or research networks
- Implement the principles of diversity, equity and inclusion in all aspects of research and operations
Scientific Achievements and Contributions
Below, we shine a spotlight on the studies that are a part of this growing body of work and the progress over the year. To learn more about the studies below or our other research, email us at globaloncology@fredhutch.org or visit our website.
Assessing the Clinical Utility (Benefit) of an Automated Molecular Diagnostic Test (GeneXpert Breast Cancer STRAT4 Assay) in the Diagnosis of Women with Breast Cancer in Uganda
Principal Investigators: Manoj P. Menon, MD, MPH (Fred Hutch), Jackson Orem, MBChB, MMed, PhD (UCI), and Nixon Niyonzima, MBChB, MMed, MSc, PhD (UCI)
Co-Investigators: Alex Bakenga, MBChB, MMed (UCI), and Barbra Natukunda, MBChB, MMed (UCI)
Building on a previous study on the molecular profile of breast cancer in Uganda, this prospective, observational study evaluated low-cost, accurate diagnostics for breast cancer patients in Uganda. The investigators used Cepheid’s GeneXpert’s real-time PCR and STRAT4 assay to measure estrogen receptor (ER), progesterone receptor (PR), HER2 and Ki62 and assess the accuracy in diagnosing the hormone receptor and HER2 status in patients. They also evaluated the clinical utility, feasibility, sensitivity and specificity of the STRAT4 assay in detecting ER, PR and HER2 in both core needle biopsy and fine-needle aspiration biopsy (FNA) specimens at the UCI. Additionally, they compared concordance between the STRAT4 results obtained by a core needle biopsy and by an FNA specimen.
Characterizing the Determinants of Primary KSHV Infections Among Children and Adolescents in Uganda
Principal Investigators: Warren T. Phipps, MD, MPH (Fred Hutch), Fadhil Geriga, MBChB, MMed (UCI), and Joshua Schiffer, MD, MSc (Fred Hutch)
Kaposi sarcoma, a common cancer in Africa, especially among people living with HIV, is caused by an infection with Kaposi sarcoma-associated herpesvirus (KSHV). KSHV’s seroprevalence, or the proportion of a population that has antibodies to a virus, varies geographically: <5% in the U.S. and Europe to 60%–80% in Uganda and sub-Saharan Africa. This NIH R01 study aimed to determine the incidence and to define the viral, immunologic and clinical features of primary KSHV infection. Using a prospective, observational design, the study followed 80 women and their children for one year. The findings will help develop and improve antibody tests and potentially guide a KSHV vaccine.
In 2019, Fred Hutch and UCI investigators launched a study to evaluate a subcutaneous formulation of the monoclonal antibody against CD20, rituximab, for patients with aggressive lymphomas at the UCI. The primary goal was to evaluate the safety and pharmacokinetics of this formulation of rituximab combined with standard-of-care chemotherapy. The findings showed subcutaneous rituximab to be safe, well-tolerated and effective for Ugandan patients with diffuse large B-cell lymphoma. Unique in its method of administering subcutaneous rituximab for all cycles of therapy, it demonstrated safety. It was led by Manoj P. Menon, MD, MPH; Henry Ddungu, MBChB, MMed; Joyce Balagadde Kambugu, MD; and Jackson Orem, MBChB, MMed, PhD. This study was funded by Roche and Fred Hutch and received supplemental funding from Burkitt’s Lymphoma Fund for Africa, Doug and Ruth McKnight, and Ned Palmer.
Shailender Bhatia, MD, received the FY23 Global Oncology Pilot Grant. With additional funding from the Kuni Foundation, Bhatia, Tachiki and the Fred Hutch and UCI team will launch the clinical trial at the UCI-Fred Hutch Cancer Centre in Uganda. If successful, the novel regimen could significantly reduce the cost of therapy and potentially improve access to immunotherapy in low-income countries. Bhatia is a professor of medical oncology at the University of Washington School of Medicine and a member of the Clinical Research Division at Fred Hutch. Tachiki is an assistant professor of hematology and oncology in the Renal/Melanoma/MCC Oncology Research Program at the University of Washington School of Medicine and at Fred Hutch.
UCI-Fred Hutch Collaboration Training Program Milestones
Margaret “Maggie” Lubwama received the best oral presentation award at AORTIC 2023
Margaret "Maggie" Lubwama, MBChB, MMed, a PhD fellow with the UCI-Fred Hutch Collaboration and medical microbiologist with Makerere University College of Health Sciences, received a prestigious award for best oral presentation at the 14th International Conference on Cancer in Africa in Dakar, Senegal, hosted by the African Organization for Research and Training in Cancer (AORTIC) in Dakar, Senegal, in November 2023. Lubwama presented her PhD research, "Bacteremia in hematologic cancer patients with febrile neutropenia at the Uganda Cancer Institute." The award is known as the Christopher Williams Award for Innovation in Cancer Care in Africa.
Fredrick Kakembo, BBLT, MSc, and Peter Sabakaki, BSc, MSc, two fellows with the cancer genomics and data science training program in Uganda, trained at Fred Hutch for five weeks with the Warren Lab
Our newest program trains professionals from East Africa to generate and analyze cancer genomic data to accelerate research in cancer genomics in the region, which is increasingly important as genomics and genomic data science rapidly transform oncology. It’s a partnership between the UCI-Fred Hutch Collaboration, Makerere University and the Infectious Disease Institute and is led by Jackson Orem, MBChB, MMed, PhD, executive director of the UCI, and Edus H. Warren, MD, PhD, Program Head of Global Oncology at Fred Hutch. The program is funded by the NCI and was awarded supplemental funding through the Goldstein Foundation.
“The brainstorming sessions with everyone helped me crystallize my PhD ideas. I appreciate your patience in answering my questions and encouraging me to explore more interesting avenues. The exposure to various projects across the institute was eye-opening. Meeting other lab members, attending seminars and learning about cutting-edge studies and genomic seq technologies have broadened my perspective. I'm inspired by everyone involved.”
Peter Sabakaki, BSc, MSc
Research to Publication
Select Publications
Natukunda, B., Omoding, A., Bongomin, F., Mubiru, K.^ R., Ddungu, H., Sekaggya-Wiltshire, C., & Mayanja-Kizza, H. (2023). One-Year Survival and Prognosticators of Adults With Acute Leukemia at the Uganda Cancer Institute. JCO global oncology, 9, e2200244.
Gulleen, E. A., Holte, S., Zhang, Y., Mbarusha, I., Mubiru, D., Pedun, B., Keng, M., Heysell, S. K., Omoding, A., Moore, C. C., & Phipps, W. (2023). Etiology of Fever and Associated Outcomes Among Adults Receiving Chemotherapy for the Treatment of Solid Tumors in Uganda. Open forum infectious diseases, 10(11), ofad508.
Ravishankar, S., Towlerton, A. M. H.^, Mooka, P.^, Kafeero, J., Coffey, D. G., Aicher, L. D., Mubiru, K.^ R., Okoche, L.^, Atwinirembabazi, P.^, Okonye, J.^, Phipps, W. T., & Warren, E. H. (2024). The signature of a T-cell response to KSHV persists across space and time in individuals with epidemic and endemic KS from Uganda. bioRxiv : the preprint server for biology, 2024.02.06.579223.
Lubwama, M.*, Kateete, D. P., Katende, G., Kigozi, E., Orem, J., Phipps, W., & Bwanga, F. (2024). CTX-M, TEM, and SHV Genes in Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp Isolated from Hematologic Cancer Patients with Bacteremia in Uganda. Infection and drug resistance, 17, 641–653.
Gulleen, E. A., & Lubwama, M.* (2024). How Should We Manage Antimicrobial Resistance in Resource-Limited Settings? AMA journal of ethics, 26(5), E373–E379.
Bold = Fred Hutch Global Oncology Faculty
Underline = UCI Collaborators
* = Current UCI-Fred Hutch Collaboration Trainee/Fellow
Italics = U.S. Research Fellow
^ = Global Oncology or HCRI-Uganda staff
Bold Italics = Fred Hutch Faculty Collaborator
International Meeting in Kenya
Warren Phipps, MD, MPH, and Manoj Menon, MD, MPH, two Fred Hutch faculty with Global Oncology, participated in an international meeting in Kenya in May 2024 to update resource-appropriate clinical cancer guidelines for sub-Saharan Africa, including for people with HIV and cancer, known as the National Comprehensive Cancer Network® (NCCN®) Harmonized Guidelines(TM) for Sub-Saharan Africa.
Bias Mitigation Training
The HCRI-Uganda team participated in a bias mitigation education training with Paul Buckley, vice president and chief diversity, equity and inclusion officer, Fred Hutch, in December 2023 as part of our ongoing commitment to living the values of diversity, equity and inclusion.
Regional Workshop
The HCRI-Uganda laboratory, led by Andrea Towlerton, co-hosted a regional workshop with Illumina and Medisell that included two week-long training courses on next-generation sequencing at the UCI-Fred Hutch Cancer Centre.
American Society for Clinical Pathology International Certification
Ruth Mirembe, histopathology technician with HCRI-Uganda, passed the American Society for Clinical Pathology International Certification.
New Deputy Director
Warren Phipps, MD, MPH, was appointed as deputy director of Global Oncology.
Ruth Mirembe, Histopathology Technician
Next Generation Sequencing Training
National Comprehensive Cancer Network® (NCCN®)
Ruth Mirembe, Histopathology Technician
Next Generation Sequencing Training
National Comprehensive Cancer Network® (NCCN®)
Contact Us
Mailing Address
Global Oncology
1100 Fairview Ave. N.
Mail Stop M1-B140
Seattle, WA 98109
1 Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024 May-Jun;74(3):229-263. doi: 10.3322/caac.21834. Epub 2024 Apr 4. PMID: 38572751.
2 Ferlay J, Laversanne M, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2024). Global Cancer Observatory: Cancer Tomorrow (version 1.1). Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.fr/tomorrow, accessed [21 May 2024].
Authored by: Heather Pitorak and with contributions from colleagues (Fred Hutch Global Oncology, HCRI-Uganda, and with the UCI-Fred Hutch Collaboration).
Designed by: Milly Jeffries