Navuluri Receives NCCN Young Investigator Award
The National Comprehensive Cancer Network (NCCN) announced today that Neelima Navuluri, MD, MPH, has been selected to receive a 2021 NCCN Foundation Young Investigator Award — an award that “fosters emerging talent and explores promising areas for study.”
A medical instructor in the Duke Department of Medicine and in Global Health and practicing pulmonologist at Duke University Hospital and Duke Raleigh Hospital, Navuluri is one of only six early-career investigators from NCCN’s 31 Member Institutions to have been selected to receive this prestigious award.
Honorees, per NCCN, will receive up to $150,000 in funding, over two years, “to advance important research on important issues in oncology." "They represent tomorrow’s leaders for advancing cancer care."
“The NCCN Foundation Young Investigator Award recipients over the years have contributed an impactful body of work to improve quality, effectiveness and efficiency in cancer care and we’re happy to continue that this year,” said Patrick Delaney, Executive Director, NCCN Foundation, in a press release announcing the six award winners. “We’re eager to see how these leading young researchers improve outcomes for future cancer patients.”
Navuluri’s winning project — “Intervention Mapping to Improve Lung Cancer Screening Among Black Veterans” — is an implementation science study.
“We hope to utilize DCI’s qualitative research expertise and work with the VA Health Services Research & Development (HSR&D) group to design, at the end of the two-year period, an intervention informed by patients and providers that will reduce disparities in lung cancer screening among Black patients,” said Navuluri, who, with the other awardees, will present their research during the NCCN 2023 Annual Conference.
Dr. Navuluri’s primary mentor on the project is Scott Shofer, MD, PhD, an associate professor in the Duke Department of Medicine, Duke Cancer Institute member, and pulmonologist who sees patients at the Thoracic Oncology Clinic at Duke Cancer Center, the Duke Pulmonary and Specialty Services Clinic, and the Durham VA Health Care System.
Navuluri’s co-mentors are: Christopher Cox, MD, MHA, MPH, a professor in the Duke Department of Medicine and practicing critical care specialist, palliative medicine specialist and pulmonologist; Isaretta Riley, MD, an assistant professor in the Duke Department of Medicine and practicing pulmonologist at the Durham VA Health Care System; and Leah Zullig, PhD, MPH, co-leader of DCI’s Cancer Prevention, Outcomes and Survivorship Research Program, an associate professor in the Duke Department of Population Health Sciences, and an investigator with the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham VA Health Care System.
Born and raised in Hobbs, New Mexico, Navuluri first came to Duke University in 2006 as an undergraduate. During that time, she was selected for the Alice M. Baldwin Scholars Program, which inspires and supports female-identified undergraduate students to become engaged, confident and connected leaders in the Duke community and beyond.
Navuluri graduated from Duke in 2010 with a Bachelor of Arts in International Comparative Studies and went on to earn her MD at the University of Texas Health Science Center in San Antonio and her Master’s in Public Health (MPH) through UT Houston School of Public Health.
She did her Internal Medicine residency training at New York Presbyterian Hospital — Columbia University and in 2017 returned to Duke as a fellow in Pulmonary and Critical Care and Global Health. Navuluri was selected for the NIH T32 Interdisciplinary Training Program in Lung Disease at Duke (Division of Pulmonary, Allergy, and Critical Care in the Department of Medicine) and spent most of her final fellowship year (2019-20) in western Kenya conducting a study assessing the prevalence of chronic hypoxemia and its risk factors — a project jointly funded by National Heart, Lung, and Blood Institute, the Fogarty International Center, and CHEST Foundation. Her time in Kenya was cut short in March 2020 due to the pandemic and she returned to the U.S., but data collection for her study remains ongoing.
Navuluri completed her fellowship in June 2020 and joined the Duke University School of Medicine faculty in July 2020 as a medical instructor.
“I’m really pleased to have the opportunity to work with Neelima on this project. From the time I met her during her fellowship interview until now, she has been clear in her passion for working with underserved communities. Throughout her fellowship she has been incredibly resourceful in organizing the people around her to develop ideas and implement studies and interventions to improve the lives of those she is working with,” said Shofer. “Her work looking at chronic hypoxia in western Kenya is unique and what she has accomplished there is a testament to her dedication to understanding the causes of respiratory failure in that population. I’m looking forward to having her energy and determination focused on helping our Veterans at risk for developing lung cancer.”
Q & A with Neelima Navuluri, MD, MPH
What inspired you to pursue this particular research project? How did you become interested in cancer screening?
My career goals are to develop and implement interventions to improve the respiratory health outcomes of medically underserved populations in the U.S. and abroad.
My interest in lung cancer screening stems from my experiences as a fellow observing the ways that two different health systems (Duke and the Durham VA Health Care System) had implemented lung cancer screening programs and the disparities I saw in those respective clinics. A disproportionate number of patients presenting to the clinic with early stage, curable lung cancer was White, while many of the Black patients I saw often had a more advanced stage malignancy. This led me to want to better understand why that was, what factors were influencing that disparity, and figure out ways to address it.
Why focus in on Black Veterans? Are there even more disparities in this specific population?
Black men have the highest rates of age-adjusted lung cancer incidence and the highest lung cancer mortality among all US racial and ethnic groups. They are also more likely to develop cancer at an earlier age or present with advanced stage disease.
In addition, we know that a significant proportion of new invasive lung cancer diagnoses in the U.S. occur among VA Health Care System (VAHCS) users. These individuals are more likely to be African American, unemployed, have a lower annual income, have a higher comorbidity burden, and are more likely to smoke than the general population.
We also know that African Americans are three times less likely to be screened for lung cancer compared to Caucasians.
The Durham VA Health Care System has a well-established screening program, led by my mentor Dr. Shofer. The program offers lung cancer screening at low or no-cost to Veterans. This allows us to assess for and address barriers to screening outside of cost which may be more widely applicable. We hope this will help us identify interventions that can reduce racial disparities in lung cancer diagnosis, treatment and mortality, ultimately having a significant impact on the lives and health of Veterans.
The VA is an interesting place to perform disparities work because many of the financial barriers to care common in the U.S. healthcare system are minimized within the Veterans Healthcare Administration system. However, even in this financially leveled healthcare environment, we still see significant racial differences in lung cancer screening utilization. This project is unique in that we plan to move past simply documenting the disparities among Black Veterans, but will work to understand the barriers to care for these Veterans through patient and provider interviews.
Finally, we will develop, and hopefully implement a pilot intervention to remove the barriers we identify and improve lung cancer screening in this very high-risk population.
We’ll seek further funding for that implementation and testing phase.
Will your project be connected in any way with DCI’s Community Outreach and Engagement efforts, including DCI’s Office of Health Equity, which does a lot of work in the Black community?
I hope so! We as a research team would greatly benefit from their expertise and we plan to engage them as we further develop our research protocol, interview questions, and begin to recruit patients. We also plan to work with the Veteran Research Engagement Panel (VetREP) to get their feedback on our study and research materials and as we move into intervention design.
Above: Neelima Navuluri, MD, MPH (center) and her mentors on her NCCN-awarded project (clockwise from bottom left)Scott Shofer, MD, PhD, Isaretta Riley, MD, Leah Zullig, PhD, MPH, and Christopher Cox, MD, MHA, MPH.
The 2021 NCCN Foundation YIA recipients are:
*Esra Akbay, PhD, UT Southwestern Simmons Comprehensive Cancer Center
"Activating Anti-Tumor Innate Immunity to Overcome Checkpoint Blockade Resistance in NSCLC"
*William C. Jackson, MD, University of Michigan Rogel Cancer Center
"A Phase II Randomized Trial of Moderate versus Ultra-Hypofractionated Post-Prostatectomy Radiation Therapy"
*Everett Moding, MD, PhD, Stanford Cancer Institute
"Resolving Sarcoma Evolution During Tumor Development and Radiation Therapy"
*Neelima Navuluri, MD, MPH, Duke Cancer Institute
"Intervention Mapping to Improve Lung Cancer Screening Among Black Veterans"
*Deborah Stephens, DO, Huntsman Cancer Institute at the University of Utah
"Non-melanoma Skin Cancer (NMSC) in Patients with Chronic Lymphocytic Leukemia (CLL): Biology and Prevention"
*Caitlin Zebley, MD, PhD, St. Jude Children’s Research Hospital
"Epigenetic Reprogramming of CAR T-Cell Therapy"
The NCCN Foundation has awarded $8.1 million since 2011 through the YIA program, to a total of 57 researchers.