More than 69,000 women in the U.S. are expected to be diagnosed with endometrial cancer this year, making it the fourth most common cancer in women, and more than 13,900 are projected to die from it.
Unlike most cancers, both incidence and mortality rates for endometrial cancer are rising. It also represents a significant health disparity, with Black women having a five-year survival rate of 63%, compared with 84% for white women.
To better understand and improve outcomes for people with endometrial cancer, the National Cancer Institute has awarded a five-year, $11.2 million Cancer Health Disparities Specialized Program of Research Excellence (SPORE) in Endometrial Cancer grant to Victoria Bae-Jump, MD, PhD, and Hazel Nichols, PhD, at the University of North Carolina Lineberger Comprehensive Cancer Center.
“The overall mission of our SPORE is to define key biological factors—such as epigenetic aging, the microbiome, innate immunity, and metabolic reprogramming—alongside measurable social factors that may drive more aggressive disease or lead to worse outcomes,” said Bae-Jump, professor of gynecologic oncology at the UNC School of Medicine and director of the UNC Lineberger Endometrial Cancer Center of Excellence. “Our ultimate goal is to develop clinical interventions tailored to improving outcomes for women with endometrial cancer.”
“We believe that both social and biological factors help explain why outcomes differ among women with endometrial cancer,” said Nichols, professor of epidemiology at the UNC Gillings School of Global Public Health. “These include chronic stress, changes in the immune system, metabolism, gut bacteria and how cells age.”
SPORE grants are highly competitive and considered a major career milestone. They provide substantial, long-term funding to support translational research, foster collaboration between laboratory and clinical investigators, and accelerate the development of new tools for cancer prevention, diagnosis and treatment.
UNC Lineberger is one of only 12 institutions nationwide to hold three or more SPORE grants, and the only one in North Carolina. In addition to the endometrial cancer SPORE, the cancer center also leads the UNC Breast SPORE and the Selective Targeting of Pancreatic (SToP) Cancer SPORE. UNC Lineberger is also a member of the Yale Head and Neck Cancer SPORE.
The endometrial cancer SPORE team will build on UNC Lineberger’s Carolina Endometrial Cancer Study (CECS), a statewide, population-based study of more than 1,700 patients. CECS assesses survey and medical record data, tumor samples, and ongoing follow-up on treatment response and survival, with the goal of identifying factors that contribute to worse outcomes.
The SPORE will focus on three main research projects:
- Project 1: Social and environmental measures, epigenetic aging, and endometrial cancer disparities
- Project 2: Interplay between disparities, the microbiome, the immune system, and response to immunotherapy
- Project 3: Obesity-related metabolic changes in endometrial cancer disparities
The overall goal is to better understand and improve outcomes for people with endometrial cancer, especially those at higher risk for aggressive disease or poor treatment response. Researchers will examine how factors like stress, immune function, metabolism, and gut health contribute to disparities.
They will also develop biomarkers to identify patients at higher risk and discover new treatment and prevention targets, including drugs and lifestyle-based interventions. The project will support new researchers and promote collaboration to speed up clinical trials and share findings broadly.
The team will partner with UNC Lineberger’s Community Outreach and Engagement team to identify cancer disparities across North Carolina. They aim to improve care by listening to patients and communities, expanding partnerships with healthcare and advocacy groups, promoting research participation, and sharing findings widely to benefit both local and broader communities.
In addition to Bae-Jump and Nichols, the research team project leaders include Ganga Bey, PhD, MPH; Rebecca Fry, PhD; Temitope Keku, PhD, MSPH; William Zamboni, PharmD, PhD; John A. Batsis, MD; and Melinda Yates, PhD.
Research core leaders are David Corcoran, PhD, and Feng-Chang Lin, PhD, for Bioinformatics; Russell Broaddus, MD, PhD, and Adam Pfefferle, PhD, for Biospecimen and Pathology; and Marjory Charlot, MD, MPH, MS, and Stephanie Wheeler, PhD, MPH, for the Community Outreach and Engagement Core.
Melinda Yates, PhD, will lead the Career Enhancement Program, while Nichols will direct the Developmental Research Program.
“This SPORE grant is an incredible opportunity to transform how we understand and treat endometrial cancer, especially for those most affected by disparities,” Bae-Jump said. “By combining cutting-edge science with real-world community insight, we’re working toward a future where we can offer every woman with endometrial cancer access to better, more personalized care. This, ideally, will result in better outcomes.”