Key Dates

NOT-CA-21-091 - Notice of Intent to Publish a Funding Opportunity Announcement for Mechanisms that Impact Cancer Risk after Bariatric Surgery (R21 Clinical Trial Not Allowed)

National Cancer Institute (NCI)

The National Cancer Institute (NCI) intends to promote a new initiative by publishing a Funding Opportunity Announcement (FOA) with special receipt, referral, and review (PAR) to solicit applications for research projects addressing mechanisms that impact cancer risk after bariatric surgery. The goal of the proposed funding announcements is twofold, to promote studies examining the mechanism(s) through which bariatric surgery impacts cancer risk, and to draw in talented scientists who study bariatric surgery to investigate its effects on cancer, rather than shorter term outcomes such as weight loss and diabetes.

This Notice of Intent to Publish (NOITP) is being provided to allow potential applicants sufficient time to develop meaningful collaborations and responsive projects. Furthermore, applications that include collaborators from fields outside of cancer research will be given special programmatic consideration. A companion R21 PAR will be issued that encompasses a similar research focus but will emphasize exploratory projects with high risk and high payoff.

The FOA is expected to be published in late Summer 2021 with an anticipated application due date in Fall 2021. Details of the planned pre-application webinar will be announced after publication of the FOA.

This FOA will utilize the R01 activity code with clinical trial optional. Details of the planned FOA are provided below.

Obese patients undergo bariatric surgery for a variety of reasons, including weight loss and improvement in metabolic dysfunction. Physician advise regarding the potential benefit of bariatric surgery and cancer risk reduction can currently only be given in generalities based on large scale studies, not targeted to the individual. Many but not all bariatric surgery investigations document an overall cancer risk reduction among women but not men. Some but not all bariatric surgery studies have found that both women and men undergoing bariatric surgery have an increased risk of colorectal cancer (CRC). Older studies, which assessed bariatric surgery and cancer risk may not be useful to guide targeted advice to patients, as one of the most common procedures performed in the past, gastric banding, is only performed in 1% of bariatric surgery procedures today. The two most common bariatric surgery procedures currently performed are sleeve gastrectomy and Roux-en-Y Gastric Bypass (RYGB). As such, planned animal and/or human studies should focus on the mechanistic effects of the two procedures that are currently in common use. Human biospecimens and/or data may be available from cohorts to enhance the studies proposed including the Longitudinal Assessment of Bariatric surgery (LABS), Adolescent Bariatrics: Assessing Health Benefits & Risks (Teen-LABS), and NCI Cohort Consortium Members.

Questions that would be considered responsive include, but are not limited to:

• Do alterations in cancer risk biomarkers occur before weight loss? If so, in what organ, tissue, or cell type do they originate?
• Is maximum weight loss or long term weight loss more important for cancer risk reduction? If so, how do the two differ at a cellular and/or biochemical level?
• What mechanism(s) explain the evidence that bariatric surgery is more beneficial in cancer risk reduction in women than men?
• Does bariatric surgery increase or decrease the risk of CRC, and if so, what are the mechanism(s)?
• Which cancers are favorably impacted by bariatric surgery, and what are the mechanism(s) that explain the effect?
• Does the specific bariatric surgery procedure influence cancer impact? If so, what are the mechanism(s) driving the difference in impact?
• Does racial or ethnic background influence the cancer impact of bariatric surgery, and if so, what are the mechanism(s) involved?
• How does bariatric surgery affect the penetrance of high risk genetic cancer predisposition?

Responsive proposals may investigate animal models, human studies, or a combination of both. A project which focuses entirely on in vitro investigations is not responsive to this PAR.

The PAR will be open to all qualified applicants, including new and early-stage investigators, who can establish and lead a multi-disciplinary research project to enable the fulfillment of the intended program goals.

More details will be outlined in the forthcoming FOA.

Applications are not being solicited at this time. 

Please direct all inquiries to:

Edward Sauter, M.D., Ph.D.

Division of Cancer Prevention
National Cancer Institute (NCI)

240-276-7657

Email: edward.sauter@nih.gov

Kristine Willis, Ph.D.
Division of Cancer Biology
National Cancer Institute (NCI)
Telephone: 240-276-6213
Email: kristine.willis@nih.gov

Philip Daschner, Ph.D.
Division of Cancer Biology
National Cancer Institute (NCI)
Telephone: 240-276-6227
Email:pd93u@nih.gov