Cancer & Tumor Biology

The Department of Surgery dedicates significant resources to understanding why and how cancer develops and progresses. Our basic science and translational studies identify the many pathways, mechanisms and molecules involved. Our clinical trials test novel therapeutic agents and approaches, and our health services research helps to continually improve the care we deliver. 

Our research efforts address cancers of many types — adrenal, breast, gastrointestinal and colorectal, melanoma, pancreatic, pediatric neuroblastoma, and others. One shared goal motivates everything our surgeon-scientists and basic science investigators do in their laboratories: Improve early diagnosis, staging, treatment — and ultimately prevention — to reduce cancer-related morbidity and mortality. 

Tumor Immunology

Cancer immunology has been a longstanding strength of the Department of Surgery and remains an important focus of our research. Many efforts center on the body's immune response to cancer and how immune-based therapies can better harness this defense system to fight the disease. 

Immunotherapy has proven effective for many patients and, still, its potential has yet to be fully realized. Our faculty, renowned for their work in this field, aim to do just that, investigating the mechanisms of cancer immunosuppression and treatment resistance, such as:

• Strategies cancer cells use to avoid immune detection, and the molecular mechanisms and markers, including PD-L1, PD-1 and regulatory and other types of T cells, that contribute to immune suppression and tumor response, and resistance, to immunotherapy
• Novel drug compounds that synergize with immunotherapy to improve efficacy and lower resistance
• Biomarker discovery to improve the immune recognition of cancer, including through cryoablation, or freezing of tumors. The approach has shown promise in early clinical trials in patients with breast cancer

• How tumor cells interact with their microenvironment, which includes many types of immune cells that cancer cells recruit to support their growth

Additional Molecular Biology Work

Department of Surgery faculty are working on many other facets of cancer and tumor biology, including:

• Identifying diagnostic and predictive markers using serum proteomic and tissue microarray strategies. These markers can aid risk stratification and treatment planning and evaluation in multiple types of cancers

• Understanding changes in gene expression that lead to development of lung and esophageal cancers and identification of markers of early-stage, aggressive disease to help guide more personalized treatment for patients

• Discovery and development of novel therapeutic agents, including several based upon natural compounds
• Exploration of drug resistance pathways using exosomes and long non-coding RNAs to create move effective combination therapies as well as discern the best treatment strategies to utilize novel drug compounds for clinical translation

• Development of implantable scaffolds to attract and trap metastatic circulating tumor cells to slow cancer's spread

• Fertility preservation techniques for young breast cancer patients

• Discovery of the pathways that cancer cells use to repair their DNA — a key survival mechanism — in treatment-resistant pediatric neuroblastoma. This insight now is providing a new target for drug development efforts.

Improving Care Delivery and Outcomes

Health services research within the Department and through numerous collaborations and partnerships probes a wide range of issues that impact patient care and outcomes. Current investigations focus on: 

• Primary care and specialist communications, patient decision-making, resource utilization, the impact of policy changes, and disparities in care and outcomes

• Outcomes and comparison of different treatment approaches, such as hyperthermal intraperitoneal chemotherapy, and new strategies to improve nutrition before and after surgery for esophageal cancer

• Prediction of complications and prognosis after cancer surgery as well as the use of analytical morphomics, that is, computer algorithms and image analyses to predict surgical outcomes and help patients improve readiness for surgical procedures 

• Outcomes and patient-centered, value-based care for colorectal cancer

• Reducing opioid prescriptions and the risk of addiction in surgical patients

Research Training for the Future

With support from a National Institutes of Health T32 Training Grant, our faculty help ensure ongoing discovery through our Surgical Oncology Research Training Program, which includes training in tumor biology and fundamentals of surgery research.

Faculty pursuing cancer and tumor biology research work collaboratively across the U-M Medical School, the U-M campus and the nation. Sharing data and best practices helps speed discovery, translation and outcomes. Within the U-M community, faculty actively partner with investigators in the Rogel Cancer Center, the College of Pharmacy and the Department of Pharmacology, the Center for Healthcare Outcomes and Policy, the departments of Biomedical Engineering and Chemical Engineering within the College of Engineering and many other units. 

Our Section of Oral & Maxillofacial Surgery houses the Maxillofacial Oncology and Reconstructive Surgery National Database for head and neck cancer, an important resource for surgeons and oncologists at partner institutions nationwide. Our Section of Thoracic Surgery maintains one of the largest genetic databases of esophageal and lung cancers in the world, helping us to understand how cancer starts and progresses and to develop new tests for early detection. 

Several members of the Department of Surgery participate in the Pancreatic Cancer Research Initiative (PCRI), a multidisciplinary, multi-institution collaboration. Faculty also participate in a consortium funded by the National Cancer Institute, PAncreatic Cancer MicroENvironment Network (PACMEN), to investigate how the tumor microenvironment contributes to immunotherapy treatment resistance. 

Department of Surgery faculty member Weiping Zou directs the Michigan Center of Excellence for Cancer Immunology and Immunotherapy. This collaboration promotes the translation of scientific discoveries into clinical solutions that help patients. In addition, Dr. Zou co-leads the Cancer Hematopoiesis and Immunology Program at the Rogel Cancer Center.