Her grant project, titled “Salivary biomarkers for oral cancer in lichen planus patients,” will receive more than $380,000 over the next two years from the NIH’s National Institute of Dental and Craniofacial Research. The funding is coming through the American Recovery and Reinvestment Act, the economic stimulus package passed by Congress in February.
“The project was inspired by my personal experience of seeing the suffering of lichen planus patients in the Stomatology Center over the past nine years,” Cheng says, referring to HSC-BCD’s specialized clinic that focuses on unusual and debilitating diseases of the mouth, one of only three such specialty centers nationwide.
Oral lichen planus is an uncomfortable and chronic condition characterized by lesions that form in the mouth and on the skin. The cause of the disease is unknown and, so far, no cure has been found. It can only be managed, usually by treating with steroids, when the symptoms flare up. Once patients are diagnosed with lichen planus, Cheng says, they are advised to get check-ups at least once a year for the rest of their lives because oral lichen planus increases their risk of developing oral cancer. Furthermore, the lesions from oral lichen planus themselves sometimes resemble precancerous lesions.
“Currently the only way to determine whether a lesion is cancerous is through a painful biopsy,” says Cheng. “Therefore, lichen planus patients often need to endure repeated oral biopsies in the effort to catch any malignancy in its beginning stages.”
Witnessing patients in this cycle of inflammation and biopsies made Cheng curious if a non-invasive method could determine the early stages of oral cancer for these patients. Her hoped-for solution is to measure biomarkers present in saliva.
Biomarkers are molecules in the body that are indicators of a particular physical or pathological process. Biomarkers can be measured and used in medicine to evaluate if a disease is progressing or if a treatment is working. Currently the published medical literature shows that more than 22 possible salivary biomarkers for oral cancer have been identified in research studies. Most of them are proteins and nucleic acids.
Cheng will investigate the feasibility of using biomarkers for early cancer detection in oral lichen planus patients. Her project, which started in May, is composed of three stages. First, saliva samples will be collected from oral cancer patients before and after treatment, and the levels of possible biomarkers will be measured both times. Second, these levels will be compared to those present in oral lichen planus patients with no history of oral cancer, specifically to determine if the biomarkers have already become elevated due to oral lichen planus. If these biomarkers are not elevated, then Cheng’s idea of using them to detect early development of oral cancer may be feasible. This will be tested in the third phase, which will measure the biomarkers in the saliva of oral lichen planus patients who already are known to have precancerous mouth lesions, to see if their biomarker levels have indeed increased as would be predicted.
Cheng will lead a team of researchers on the project, including co-investigator Dr. Terry Rees, director of the college’s Stomatology Center. The project also includes, as a consultant, Dr. David Wong, who is associate dean for research at the UCLA School of Dentistry and a prominent research leader in the field of salivary diagnostics; and biostatistician Dr. Huey-Shys Chen, associate professor at the University of Medicine & Dentistry of New Jersey, who will do the statistical analyses for the study. Patients will be recruited for the study mainly with the help of Dallas-Fort Worth area surgeons. The Oral Cancer Foundation, along with the nonprofit group Support for People with Oral and Head and Neck Cancer, also will assist by posting information about the study on their Web sites and in their member newsletters.
“Receiving this grant is great news,” Cheng says. “We’ve been working on the design and proposal for this project for two years, and I’m glad we can finally begin to work on the actual research.”
Cheng joined HSC-BCD in 2002. In addition to her research and clinical work at the Stomatology Center, she teaches oral pathology to students in dentistry, dental hygiene and the graduate level programs in diagnostic sciences and biomedical sciences. Cheng earned a dental degree from Kaohsiung Medical University’s School of Dentistry in Taiwan. She holds a Ph.D. and a master’s degree in biomedical sciences from Baylor University in Waco, Texas.