St. David's Office of Research

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Oncology

St. David’s HealthCare is actively involved with a number of oncology research studies, ranging from brain-tumor genetics to novel therapies for blood cancers. Our active research frequently involves collaborations with community partners such as The University of Texas at Austin, Texas Oncology, and other organizations. See below for an overview of our active areas of research.

Brain Tumor Genetics

Cancer Mutations and Gene Regulation

Cancer is a consequence of a breakdown in gene regulation. Dysregulation of gene expression in cancers may be driven by inherited mutations or by somatic mutations in specific tissues. Our research team has carried out several studies on tumor-specific patterns of gene expression in Glioblastoma multiforme (GBM) and other primary brain tumors. One study identified several thousand mutations, which significantly covaried with patterns of gene dysregulation in GBM, while another compared tumor gene expression patterns between long-term GBM survivors to those in the general patient population. More recently, we have contributed samples and collaborated in a study of regulatory elements in the cancer genome with researchers at The University of Texas at Austin.

Somatic Mutations in Cancer

Cancer cells are characterized by unique somatic mutations that distinguish them from healthy cells. Some of these mutations can be beneficial to the cancer cells, increasing their fitness by enhancing their rates of growth or proliferation relative to normal cells. Cancer progression is an evolutionary process whereby competition among cell lines favors those mutations that enhance the performance of tumor cells. In order to identify mutations subject to selection in tumors, we compare the rates of synonymous and non-synonymous mutations (i.e., “silent” mutations vs. those that lead to amino acid substitution) in GBM, low-grade glioma, and meningioma genomes. We have also used “deep sequence” data to study the genetic heterogeneity with tumors. Such data will facilitate the application of more sensitive tests for detecting natural selection between cell lineages, and the identification of key genes responsible for tumor progression.

Modeling Somatic Selection

Tumor progression entails competition among cell lines, both between cancer cells and healthy cell types, and among cancer cells within a tumor. This process leads to selection for cancer-specific mutations, and potentially selection for genes that modify mutation rates. We use population genetics-based models to understand how mutation rates evolve in cancer cells, and analyze the statistical properties of next generation sequence data sampled within and among tumors.

Blood & Marrow Transplant

Approximately every 9 minutes, someone in the U.S. dies from a blood cancer (American Cancer Society; 2017). The high incidence and mortality rates highlight the need for the development of novel and effective treatments. St. David’s Blood and Marrow Transplant Center, in affiliation with the Texas Transplant Institute at Methodist Hospital in San Antonio, the Sarah Cannon Blood Cancer Network and Texas Oncology, is the area’s only blood and marrow transplant program. This Center, located at St. David’s South Austin Medical Center, will house a wide range of research studies investigating novel treatments for blood cancers.

Chimeric antigen receptor T-cells (CAR-T)

After decades of research and development, we are on the brink of a new era in the treatment of blood cancer. The treatment known as chimeric antigen receptor T-cell (CAR-T) therapy has produced a remarkable response in adult and pediatric patients for whom all other treatments had stopped working. The U.S. FDA Oncologic Drugs Advisory Committee unanimously recommended approval of an investigational CAR-T therapy in July 2017. The BMT Program in Austin will be the first in the area to offer the leading-edge CAR-T cell therapy to its patients.

Please contact the Office of Research if you have interest in collaboration: Info@stdavidsresearch.com