University of North Carolina’s Kate Westmoreland, MD, has been amazed and excited by a surge of support for her work to improve treatment for adolescents and young adults with Burkitt lymphoma in Malawi, a country in Sub-Saharan Africa where this type of blood cancer is more common and deadly than in the United States.
Westmoreland recently received a five-year International Research Scientist Development Award for $714,155 from the National Institutes of Health’s Fogarty International Center that was co-funded by the National Cancer Institute. The award will help support her research to improve treatment and survival for adolescents and young adults with Burkitt lymphoma in Malawi. She will move to Malawi on July 23 to launch a clinical study of a treatment regimen that she believes could improve survival.
She also recently received an outpouring of support from the internationally renowned and Grammy-nominated musician Porter Robinson, who is from Chapel Hill. During an electronic dance music festival he produced in Oakland, California June 15-16, Robinson raised awareness and funds for Westmoreland’s research. Westmoreland attended the festival that drew 30,000 people and worked alongside the Robinson family to staff an information tent for about 12 hours each day.
The Second Sky festival was “absolutely spectacular,” Westmoreland said, and she was blown away by the talent of the artists. Porter’s “Worlds” set was “an amazing and captivating musical and visual experience live.” Working in a donation booth with the Robinson family and others, she was touched by her interactions with fans.
“So many fans expressed how Porter’s music has had such an impact on their lives and got them through dark and difficult times, and this is their way to give back,” she said an email thanking supporters and others. “Other fans told stories of either their own or a close family member’s struggle with cancer and they chose to donate in their honor.”
Robinson was inspired to act after his brother Mark Robinson was treated for Burkitt lymphoma at UNC Medical Center. Westmoreland was on in-patient clinical service and on-call when Mark was initially diagnosed. She took the lead on Mark’s clinical care team throughout his treatment alongside John Hipps, MD, associate professor in the UNC School of Medicine Division of Pediatric Hematology/Oncology, and other pediatric hematology/oncology team members. It was during that time that Porter learned that survival rates for Burkitt lymphoma are much lower in Malawi.
Four months earlier, Westmoreland had returned to Chapel Hill from Malawi, where she had lived for a year conducting research and clinical care for patients with Burkitt lymphoma at UNC Project-Malawi. Before that, she had lived in Botswana for two years. She returned to Chapel Hill to complete her fellowship training in pediatric hematology/oncology, but continued her involvement with the Malawi program. It was through her work in Malawi researching and caring for patients with Burkitt lymphoma that she developed expertise in managing the disease that aided her work in the United States.
She was also honored as one of recipients of the 2018 Pope Clinical Trainee Awards based on her dedication to clinical practice, and her efforts to improve cancer care through research. The awards, supported by the John William Pope Foundation, are given to emerging physician-researchers in training.
Westmoreland got to know Mark and his family even more while working over the winter holiday in 2016 when Mark was receiving treatment. Mark had a great spirit, and took his treatment in stride, she said, and his family was a joy be around.
“The entire Robinson family is truly remarkable; they’re the most compassionate, empathetic and altruistic people I have ever met,” Westmoreland said, “We got to know each other while Mark was in the hospital for treatment, and they were asking questions about my work (in Malawi) …you could see how devastated they were to learn about the lower survival rate and hear about the conditions patients in Malawi faced with the exact same cancer as Mark. They were inspired to come together as a family and form the Robinson Malawi Fund to support my work in Malawi so we can work toward giving every child the same chance for cure, no matter where they are born.”
According to Westmoreland’s previous studies in Malawi, the five-year survival rates for Burkitt lymphoma are estimated to be between 30 and 50 percent, similar to the rates in sub-Saharan Africa as a whole. In the United States, the five-year survival is reported to be more than 90 percent for patients treated with intensive chemotherapy, typically including high doses of the drug methotrexate. Westmoreland said there are multiple factors that make it more difficult to administer high-dose chemotherapy in Malawi, including issues with ensuring infection control, availability of blood transfusions, and transportation issues for the majority of her patients who live in rural areas.
“The toxicities from these medicines can be dangerous in resource-limited settings like Malawi,” Westmoreland said, explaining her research will include a dose escalation clinical trial to examine safe administration of higher doses of methotrexate in Malawi. “We are working to optimize treatment, and try to figure out the ideal dosing for patients there, and also look into measures of quality of life and symptom management.”
After completing her training, Westmoreland is joining the faculty in the UNC School of Medicine Division of Pediatric Hematology/Oncology, in the Department of Pediatrics, as an assistant professor, and she is becoming a member of the UNC Institute for Global Health & Infectious Diseases and UNC Lineberger Comprehensive Cancer Center.
She will lead the pediatric and adolescent oncology program for the Malawi Cancer Consortium at UNC Project-Malawi, a partnership between the UNC Lineberger, the UNC Institute for Global Health & Infectious Diseases, the Malawi Ministry of Health, the University of Malawi College of Medicine and others. For the duration of the five-year research grant, she plans to spend at least the first three years full-time in Malawi with her husband, Rodrigo Costa Liao, who recently graduated from the UNC Gillings School of Global Public Health, and then go back and forth to Chapel Hill.
UNC physicians and researchers have been collaborating with Malawian health leaders to improve clinical care and conduct cancer research as part of UNC Project-Malawi, a collaboration launched initially to help with HIV management. As HIV survival rates have improved, and due to other factors, cancer has emerged as a growing health concern.
Satish Gopal, MD, MPH, cancer program director for UNC Project-Malawi, said part of the success of the program is reflected in the number of young investigators from both the United States and Malawi — like Westmoreland — who have been able to develop their own independent cancer research careers. He also emphasized the importance of patient advocacy, as exemplified by the Robinson family, in addition to scientific efforts, for catalyzing global health progress around the world. Gopal will continue to serve as the primary mentor for Westmoreland’s work in Malawi.
“Kate’s project is a natural extension of our work together over the last several years, and hopefully will use what we have learned to generate progress for what should theoretically be a highly curable cancer,” said Gopal, who is an associate professor in the UNC School of Medicine Division of Hematology/Oncology and a member of UNC Lineberger and the UNC Institute for Global Health & Infectious Diseases.