Nicole Urban

Ovarian cancer
Breast cancer
Cancer screening
Biomarkers
Cost-effectiveness analysis
Diagnostic imaging
Health economics

Dr. Urban heads the Translational and Outcomes Research (TOR) group at Fred Hutchinson Cancer Research Center. TOR spans the process of discovery, development, and evaluation of targets and interventions to improve outcomes for individuals at risk for cancer. The translational component involves working closely with clinical as well as laboratory researchers, and with patients as well as with healthy individuals. It involves comparative genomics and proteomics and the development of statistical methods to analyze gene expression and biomarker data. Our emphasis is on early detection and immunotherapy for prevention of cancer and/or recurrence of cancer, particularly ovarian and breast cancer. The outcomes component emphasizes modeling and cost-effectiveness analysis, including mathematical modeling of disease progression, modeling of the behavior of biomarkers in the absence and presence of cancer, and measurement and analysis of costs and quality-of-life. The work of TOR investigators includes interventions for current patients, both preventing recurrence (for example, vaccines to prevent recurrence of ovarian cancer) and improving quality of life in cancer survivors. It includes intervention trials, both randomized and Phase I.

Dr. Urban is also the Co-Program Head of the Women's Cancer Research Program (WCRP) at the Fred Hutchinson Cancer Research Center. The WCRP focuses on improving clinical outcomes in patients with reproductive malignancies at every stage of disease. The themes of the program are (1) developing novel treatments based on identification of genetic alterations involved in the malignant transformation, (2) prevention of relapse and eventually primary disease using immunotherapeutic strategies, and (3) early detection of disease.

In September 1999, Dr. Urban and colleagues at several West Coast collaborating research institutions were awarded an NCI Specialized Program of Research Excellence (SPORE) grant in ovarian cancer, which was renewed in July, 2004. The "Pacific Ovarian Cancer Research Consortium/SPORE in Ovarian Cancer" is a community-based, multidisciplinary, translational research program that involves clinicians, laboratory scientists and public health scientists. Its broad based approach takes full advantage of the scientific expertise available locally and allows the pooling of clinical resources, thus facilitating population-based studies despite the low incidence of ovarian cancer. POCRC research projects include: discovering genes that influence the responsiveness of ovarian cancer to chemotherapy treatments, creating an ovarian cancer vaccine that would attack ovarian cancer cells as soon as they develop, developing a statistical model that can estimate a woman's risk for developing ovarian cancer, and refining and improving the use of blood tests used to detect ovarian cancer. The POCRC also includes a Developmental Research Program and a Career Development Program. The group has established a well-characterized ovarian specimen repository housing over 200,000 individually identified specimens, and shared their findings with the broader research community through numerous presentations and publications.

In 2002, Dr. Urban was awarded by the DOD a "Center for the Evaluation of Biomarkers for the Early Detection of Breast Cancer." Investigators from 10 institutions are working together to evaluate breast cancer biomarkers for their contribution to the early detection of breast cancer. The study's goal is to define a biomarker panel that can be used in conjunction with current screening methods to improve early detection of all breast cancers, particularly aggressive cancers and those missed by mammography. Blood and tissue specimens for biomarker analysis are collected from women having annual mammograms and breast-related biopsies or surgery. This study utilizes the ongoing Mammography Tumor Registry for Breast Cancer Research to follow participants throughout the study and monitor their mammography data and breast cancer outcomes.

Her R01 awarded in 2002, "Modeling Ovarian Cancer Screening for CEA," allowed her to improve the accuracy of a previously developed microsimulation model of ovarian cancer screening by accounting for heterogeneity in the disease and in the population screened, in order to evaluate the cost-effectiveness of using a marker panel longitudinally to detect developing disease. The model now accommodates use of (1) a panel of serum markers for screening and (2) risk-based screening, incorporates QOL effects of both screening and disease, and incorporates updated screening and treatment costs. These efforts enable us to identify the potentially most efficient strategies for ovarian cancer screening and to report their cost-effectiveness.