Joel Walker, an adult with FA, passed away from complications of head and neck cancer in November 2016, at the age of 33. Joel was a talented student, good at sports, sociable and happy. Research into treatment for FA was a high priority for Joel, along with the hope that he could help others, so he left a large part of his estate to the Fanconi Anemia Research Fund. In honor of their son, Joel’s parents, Nigel and Ann Walker, created the Joel Walker Cancer Series. The goal of the series is to bring experts from various fields together to focus on research and treatment specific to cancer in FA. The generous bequest from Joel’s estate and on-going support from the Walker family make this important series of scientific meetings possible.
Individuals with FA have an extraordinarily high lifetime risk of developing squamous cell cancers of oral mucosa, and of the epithelial lining of the proximal esophagus, vulva and anus. The origin(s) and natural history of these cancers is not yet understood. Novel preventions and better therapies are desperately needed, and surgery remains the only safe curative option.
In order to address this challenge, FARF hosted a virtual FA Cancer Ideas Lab in Fall 2021 with the generous support of the Joel Walker family.
The goal of the FA Cancer Ideas Lab was to bring scientists from all areas of expertise together to brainstorm out-of-the-box ideas that have the power to shift the paradigm of how we currently approach FA cancer. The Ideas Lab offered scientists a chance to form interdisciplinary and highly collaborative teams pitched their ideas to win $500,000 in grant funding from FARF.
The project that won is entitled Modeling the Role of Environmental Responses in Fanconi Anemia Epithelial Stem and Progenitor Cells in FA Squamous Cell Carcinoma. This grant will develop models to better understand squamous cell carcinoma in individuals with FA using non-primate animal models and organoids created from FA patient cells. These models will allow the research team to develop a deeper understanding of the influences of external environmental factors and internal elements that contribute to the onset and progression of FA cancer. The models will also be used to test cancer prevention modalities that target aldehyde or retinoid metabolism and immune factors.
The research team is comprised of Ken Weinberg and Daria Mochly-Rosen from Stanford University, Hiro Nakagawa from Columbia University, Frank Ondrey from University of Minnesota, and Craig Elmets from University of Alabama at Birmingham. Markus Grompe from Oregon Health and Science University serves as a collaborator.
The third Joel Walker Meeting took place April 23, 2020. Forty researchers, doctors, FA family members and FARF staff members joined a webinar to talk about head and neck cancer in Fanconi anemia. They sat in their home offices, second bedrooms, and living rooms to spend the day sharing their research, throwing out ideas, and piecing together a roadmap to detect, treat and prevent head and neck cancer in those with FA. Building on the framework established at previous meetings, the group included head and neck cancer experts newer to the FA community.
This year, clinicians and researchers focused largely on the following:
FARF will continue working with this focused group (including members of the FA Adult Council and FARF Scientific Advisory Board) to expedite ways to prevent, detect, and treat HNSCC. Next steps include:
The second Joel Walker Meeting occurred April 18, 2019 in San Francisco. The aim of this day-long summit was to again bring the experts in the head and neck cancer field together to cross-pollinate ideas and build a strategy to combat HNSCC in FA patients. The program covered a wide range of topics, including treatment, early diagnosis, and emerging trends in managing head and neck cancers. The two overarching outcomes of the summit that FARF has now implemented included: (1) the development of a virtual tumor board to inform treatment; and (2) the establishment of a tissue sample system to identify effective therapies.
The virtual tumor board (VTB) is a group of medical care specialists who meet through a virtual platform to discuss individual cancer cases and determine the best possible treatment plan for the patient. A concern of the FA population is the lack of doctors experienced with adults with FA. The VTB will help address this issue.
While the virtual tumor board provides a platform to advise potential treatments, we also need a process to collect tissue samples from individuals with FA who have surgery. The bottleneck in this process has not been patient willingness or finding researchers and labs to store and analyze the samples. Instead, it has been getting the tissue from the operating room to the lab. FARF is working with a nonprofit organization that was created to enable cancer patients to direct their tumor tissue to researchers working on building cancer models. Once the patient has notified them of an upcoming surgery, FARF, along with this organization, will work directly with the hospital to obtain the tissue and transfer it to a lab. We continue to explore what a partnership with this organization will look like and feel optimistic it may provide a solution to this challenge.
These initiatives are possible thanks to the generosity of donors who give to the Joel Walker Scientific Meeting Series.
The first meeting, Head and Neck Cancer in FA: Developing Guidelines to Maximize Therapeutic Outcomes, took place in April 2018 at the University of Pittsburgh Medical Center. Below is a link to an overview of head and neck cancer in Fanconi anemia, gathered at the first meeting.