Multidisciplinary faculty team to study link between colorectal cancer and obesity with major NIH award

Published: Sep 27, 2022 1:45 PM

By Cassie Montgomery

There is an established link between colorectal cancer diagnosis and obesity, but understanding why that link is present and how best to treat such a dual diagnosis is still not fully understood by doctors and researchers. Thanks to a nearly $2.5 million R01 research award from the National Institutes of Health (NIH), an interdisciplinary team from three universities led by Elizabeth Lipke, the Mary and John H. Sanders Professor in Auburn Engineering’s Department of Chemical Engineering, and Michael Greene, associate professor in Auburn’s Department of Nutritional Sciences in the College of Human Sciences, will examine this link and aim to understand how best to treat these patients to improve clinical outcomes.

Colorectal cancer is the third most common non-skin-related cancer and the third leading cause of cancer-related mortality in the United States. Obesity is directly linked to an increased risk of death from colorectal cancer. Although overall colorectal cancer incidence rates declined from 1991 to 2011, they have risen recently in younger age groups and remain high in states with a high incidence of obesity.

“This is a very collaborative approach working both on the engineering side and on the biological side to make paired models of colorectal cancer,” Lipke said.

Lipke, whose expertise lies in tissue engineering, and Greene, whose research focuses on metabolic diseases, are co-principal investigators on the project and have enlisted the partnership of collaborators Xu Wang, assistant professor of pathology at Auburn’s College of Veterinary Medicine; Amit Mitra, assistant professor of drug discovery and development in Auburn’s Harrison College of Pharmacy; Dr. Drew Gunnels (Department of Surgery), Robert Oster (Department of Medicine) and Jim Mobley (Division of Molecular and Translational Biomedicine) of the University of Alabama at Birmingham; and Dr. Marty Heslin, executive director of the Mitchell Cancer Center at the University of South Alabama.

Further collaboration and support for the work was provided by the Auburn University Research Initiative in Cancer, prior NIH funding and the University of Alabama at Birmingham Center for Clinical and Translational Science, of which Auburn University is a member. Additionally, graduate and undergraduate students in chemical engineering and nutrition have been and will continue to be engaged at all levels of the project.

Through their combined expertise, the team aims to develop a toolset for explaining a pathological link between obesity and colorectal cancer tumor progression.

“The physiology is different between people with obesity and those without. Not only is there a physical difference, but there’s a physiological difference and so maybe we can treat obese patients better if we better understood the link between obesity and the cancer,” said Greene. “What we want to do is build new models that are better for drug testing, but also new models that can give us insight into the mechanisms between the link. We’re really trying to understand, mechanistically, why is obesity linked to colorectal cancer?”

According to Lipke, the project directly addresses a specific need identified by the National Cancer Institute to expand research into the link between the two diseases.

“There’s a need for people to build these types of models to move understanding and treatment of cancer forward,” she said. “It’s not just us that think it’s really important, but NCI as well.”

While the research behind this work has been ongoing for several years, for this new stage of the project, the research team is expanding their data collection through hospital partnerships to include actual patient data. Combined with information gleaned from studying how the tumors behave in laboratory settings in animals and in 3D engineered tissues in petri dishes, this expanded approach has the potential to provide a better understanding of the role of obesity associated factors in modulating the tumor microenvironment in colorectal cancer disease progression.

“We have a hypothesis that it’s not simply obesity and colorectal cancer, but there are different types of colorectal cancer. So it could be that obesity is driving different types of colorectal cancer in different ways,” Greene said. “One possible outcome of this work is personalizing treatment. Understanding the disease better for personalized treatment would definitely be a big picture outcome of this work from a physiological point of view.”

Lipke agreed and expanded on the potential impact on how patients are treated in the future.

“Being able to understand if we can create models that replicate the patient tumor microenvironment closely enough to inform treatment decision making is important,” Lipke said. “Every patient wishes that there was an answer to the question, ‘What’s going to be the outcome of this treatment for me?’ Up until now, most of the model systems for trying to predict individual outcomes haven’t been very helpful. We have to be really careful in model design and characterization to see how far we can get in making that a possibility. By using engineered tissues, we can refine the environment that the cells are experiencing in the dish, making it more like what they experienced in the human body.”

Improving patient outcomes is a primary goal of their work but the two also aim to address health disparities associated with both colon cancer and obesity based on geographic populations in the future.

“When you look at drug testing, and you think about who is being treated and who is not, the people who are typically engaged in clinical trials are people who are able to make it to major cancer centers for their treatment and those people tend to be fairly privileged, affluent and white,” Lipke said. “One of the holes in improving cancer treatment is understanding how different treatment regiments impact distinctive populations differently.” 

Greene seconded that notion, highlighting possible next steps in their research.

“We want to expand the diversity and representation in our models. Whether they respond identically or not, we don’t know. Testing them would be a critical next step,” he said.

Media Contact: Cassie Montgomery, cmontgomery@auburn.edu, 334.844.3668
Michael Greene and Elizabeth Lipke

Michael Greene and Elizabeth Lipke

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