SPHG 101 - Biostatistics

Current Role of Biostatistics
- Discusses the importance of biostatistics in public health.
- Originates from the speaker's work at a comprehensive cancer center, particularly at Lineberger focusing on cancer.

Personal Journey and Education
- Grew up in Maryland.
- Internship at NIH during high school ignited interest in cancer research.
- Attended Duke University, majoring in biology and math, became interested in bioinformatics and genomics during genomics’ rise in the early 2000s.
- Completed training grant in biostatistics at UNC, focusing on cancers.
- Further research conducted at Harvard School of Public Health and Dana Farber Cancer Institute on using genomic information for patient prognosis.
Current Position at UNC
- Leads cancer clinical trial designs to evaluate new treatments.
- Director of the biostatistics core at Lineberger cancer center, aiding faculty in study design and statistical consultations.
- Teaches Bio 735: Basic Coding in R, software implementation, and machine learning in biostatistics.

Why Pursue Biostatistics
- Definition: Applications of statistics in human health, public health, and biology.
- Distinction from traditional statisticians, focusing on health data and analyses.
- Career prospects for biostatistics graduates:
- Significant placements in pharmaceutical, technology firms, academic positions.
- Strong track record of graduates advancing to medical and graduate schools or directly into the workforce.

Current Research Areas
- Emphasis on precision medicine and cancer subtyping.
- Developing biomarkers to subcategorize patients for tailored treatments.
- Investigating machine learning methods to handle missing entries in electronic health record datasets.
- Funding for the development of large language models to recommend clinical trials for pancreatic cancer patients.

Genomic Insights
- Genomics defined: Measuring cellular activities via assays.
- DNA sequencing for mutations, RNA sequencing for gene expression, investigation of proteins that regulate gene expression.
- Aberrations at DNA/RNA levels lead to cancer through cellular state changes.
Biochemical Examinations in Cancer
- During diagnosis, assays help determine tumor characteristics and potential treatments.
- Uses genomic data from multiple patients to correlate markers indicating treatment efficacy.
Long-standing Role of UNC Cancer Research
- Historical contributions to the subtyping of breast and pancreatic cancers.
- Clinical tests developed based on these studies integrated into clinical practice.
- Ongoing studies to address cancer disparity based on subtypes and demographics.

Challenges in Pancreatic Cancer
- Poor survival rates (5-year survival: 10%; median survival under 11 months) due to late-stage diagnosis.
- Silent nature of the disease complicates early detection.
Research Developments
- Identification of pancreatic cancer subtypes using gene expression data through non-negative matrix factorization and consensus clustering identified two main subtypes:
- "Basal-like" (orange) and "Classical" (blue).
- Differences in survival rates observed depending on subtype; basal-like patients show a higher rate of aggressive disease with lower survival.
Statistical Models for Treatment Prediction
- Developed the PUREST model for predicting pancreatic cancer subtypes using penalized logistic regression.
- Outcome validation: basal-like subtype patients exhibit poor tumor response to standard therapies compared to classical subtype.

Current Clinical Trial Work
- Engagement in designing adaptive trials in response to patient tumor changes during treatment.
- Collaboration with physician experts to develop frameworks for real-time monitoring and treatment adaptation.
ARPA-H Program Contribution
- Funding of $28-30 million for a clinical trial focused on responding to evolving tumor environments in metastatic cancer.
Trial Design Innovations
- Patient samples used to determine treatment eligibility and randomization based on biomarkers; allows real-time treatment adjustments.

Student Research Opportunities
- Examples include a student analyzing mutations in colorectal cancer impacting treatment efficacy and leading to publications and potential industry collaborations.
Statistical Method Development
- Students worked on developing new statistical models and software for cancer research outcomes.

Public Health Perspective
- Discussion on preventive measures receiving less funding; need for robust research on early detection methods for various cancers.
- National Cancer Institute initiative for early detection to combat late-stage diagnoses and enhance treatment efficiency.
Innovative Screenings
- Blood and imaging-based early detection methods being explored.

Overall Contributions of Biostatistics
- Empowering research efforts to tackle complex health questions and improve patient outcomes through collaboration between statisticians and subject matter experts.
- Critical role of biostatisticians in advancing public health, clinical applications, and the utilization of technology in cancer research.

Interaction with Patients
- Limited direct contact with patients; key insights gained through advisory roles enhancing research focus.
- Calls to leverage computational tools to improve patient access to clinical trial information.
Patient-Centric Research
- Emphasis on the necessity for public education on cancer prevention as a vital aspect of healthcare.