Team SAMBAI Tackles Cancer Disparities in African Heritage

An international team of researchers aim to combine social determinants of health with genomics, immune profiling, and exposomics data to tackle cancer inequities at an unprecedented scale.

Prostate, breast, and pancreatic cancers disproportionately affect people of recent African heritage, manifesting as more aggressive tumour types and earlier onset compared to other populations. For example, Black women in the US are 2.7 times more likely to be diagnosed with triple-negative breast cancer, a particularly aggressive form of the disease. Similarly, Black men face twice the risk of dying from prostate cancer compared to age-matched White men. This disparity highlights a critical health issue and an urgent need for targeted research and intervention strategies to address these inequities.

An ambitious, new team called Societal, Ancestry, Molecular and Biological Analyses of Inequalities (SAMBAI), will strive to address this challenge. The team of researchers involved in this project come from institutions across the UK, USA, and Africa. The genomics work will be co-led by Isidro Cortes-Ciriano from EMBL's European Bioinformatics Institute (EMBL-EBI). The team is funded by Cancer Research UK and the National Cancer Institute in the US through Cancer Grand Challenges.

Cancer Grand Challenges is an initiative designed to unite the global research community to tackle some of the most complex and persistent cancer-related problems through collaborative approaches. Project SAMBAI has been awarded $25 million (€23 million) over five years to help address the disparities in cancer outcomes among people of recent African heritage through the analysis of social, environmental, genetic, and immunological factors.

"Project SAMBAI is a major step forward for understanding and tackling cancer inequities," said Isidro Cortes-Ciriano, Group Leader at EMBL-EBI. "Our team at EMBL-EBI brings to the table a unique set of skills in genomics and computational biology. This is crucial for dissecting the complex interplay of social, genetic, and environmental factors contributing to cancer. This project will advance our understanding of cancer in people of recent African descent and help to make a difference in the lives of those disproportionately affected by this disease."

"SAMBAI will also establish new concepts and methods that will help us study cancer inequities in other underserved populations, and build capacity in limited-resource settings, which is very exciting and a major leap forward towards realising the vision of global access to personalised cancer medicine," Cortes-Ciriano added.

A multidimensional approach

By uniting a broad range of expertise and resources, the team aims to create the SAMBAI Biobank and Data Repository for Cancer Equity Research. This repository will house data related to social, environmental, genetic, and immunological factors to help researchers identify the underlying causes leading to disparate outcomes in cancer.

In order to do this, the SAMBAI project will employ a range of methodologies to compile different types of data from recent African heritage populations in the UK, USA, and multiple African countries, including:

• Social determinants of health assessed using qualitative and quantitative metrics, including individual and lifestyle behaviours; socio-cultural experiences, such as social interactions, social support, caregiving roles, and encounters of racism; characteristics of the immediate environment, including housing quality, neighbourhood safety, and access to healthy food; and structural-political determinants, such as government policies, laws, economic and healthcare systems, and employment opportunities,
• Genomic sequencing techniques on germline and tumour tissue including long-read whole genome sequencing and epigenetic analysis,
• Exposomics using high-resolution mass spectrometry to quantify environmental exposures that impact cancer risk and progression, such as pollutants and metabolites, found in blood plasma samples, and
• Immune profiling by looking at the immune cells present in tumours to identify social and environmental factors that influence cancer immunological profiles and systemic markers of immune activation and inflammation.

To maximise the effectiveness of this research, it is important to acknowledge and address the current lack of diversity in genomic data. Genomics and tumour profiling data collected to date predominantly represent individuals of European ancestry. Obtaining data to further understand the genomic diversity in populations of recent African descent is a key goal of SAMBAI. Understanding these diverse genetic backgrounds will enable more inclusive research, ultimately contributing to the global effort to achieve cancer equity.

Capacity building

"Our work will be a catalyst for exponential change," said Melissa Davis, Project SAMBAI Team Lead and Director of the Institute of Translational Genomic Medicine at the Morehouse School of Medicine. "In partnership with patients, the resources we will create can galvanise the work of many other groups. We will reposition important research questions in a better scope, with comprehensive data, that represents a global context."

SAMBAI's data repository will be the first dataset encompassing this breadth of information for populations of recent African descent, led in partnership with African co-investigators. This collaborative effort underscores a commitment to building capacity, enhancing local research capabilities, and ensuring equitable participation and benefit for African research institutions and communities.

"SAMBAI will also help to enhance research capacity in under-resourced countries, aiming to establish equitable access to crucial data," explained Cortes-Ciriano. "Our strategy encompasses not only the development of an open-access biobank and data repository but also the implementation of training programs and knowledge exchange in these regions. By collaborating with local scientists and institutions, we aim to better equip communities with the tools and knowledge necessary for ongoing cancer research."