The National Institutes of Health Fogarty International Center has awarded Matthew Painschab, MD, a five-year International Research Scientist Development Award to lead research into improving treatment for multicentric Castleman disease in Malawi.
Working through the University of North Carolina Project-Malawi, a collaboration between UNC-Chapel Hill and the Malawi Ministry of Health, Painschab will lead a phase II clinical study for people in Malawi with multicentric Castleman disease (MCD). This disease is more prevalent in sub-Saharan Africa because of a higher prevalence of infections with two viruses that can cause it to develop – Kaposi sarcoma herpes virus and human immunodeficiency virus, or HIV.
“We feel that MCD will become an even bigger problem going forward because this disease tends to occur in patients with well controlled HIV,” said Painschab, who is a clinical instructor in the UNC School of Medicine Division of Hematology/Oncology. “With improvements in access to treatment, patients with HIV now have a relatively normal life expectancy but can develop comorbidities, like MCD, related to chronic HIV and its treatment. MCD is different from the vast majority of HIV-associated diseases, like Kaposi sarcoma and cryptococcal meningitis, which tend to develop when HIV is poorly controlled.”
Painschab will use the grant funding, which provides $143,993 each year, to study the use of rituximab to treat patients with multicentric Castleman disease. Rituximab, which targets certain immune cells, has been shown to be effective in controlling the disease in small studies in high income countries. The researchers will now investigate whether they can safely administer this treatment in a Malawian environment where patients often have limited supportive care and live great distances from health care services.
“This study will also allow us to gain important insights into the basic biology and immunology of MCD which may provide critical insights with importance across a number of diseases,” Painschab said, adding that the findings will be clinically relevant in both Malawi as well as the United States.
Of note, the UNC Project-Malawi Cancer Program recently completed one of the first prospective clinical trials of rituximab for diffuse large B-cell lymphoma in sub-Saharan Africa. These initial results will be presented as an oral abstract by Painschab at the NCI International Conference on Malignancies in HIV/AIDS, and will provide essential data to inform the implementation of this key targeted cancer medicine throughout the region.
Painschab will primarily be based in Malawi and will also continue to work at the N.C. Cancer Hospital.