Do you work at the Brigham? Having trouble with something and not sure who to ask?
Four projects. One winner. $100,000.
Since 2012, we have awarded ten research projects with $100,000 BRIght Futures Prizes, supported by the philanthropic contributions to the BRIght Futures Fund. These are just some of the exciting ideas and projects that have been transformed in large part due to donor support.
You will have a chance to ask your own questions as well as to vote for the winning project which will get a $100,000 award!
Join us virtually on Wednesday, April 26th from 4-5pm for the Bright Futures Prize Showcase.
Step 1 Read about each project to learn more about their incredible research, then decide which project gets your vote.
Step 2 Cast Your Vote! Your votes will decide which of the projects receives the $100,000 Bright Futures Prize.
Step 3 Register to attend the Virtual Bright Futures Prize Showcase on April 26th at 4pm where we will announce the winner live.
Step 4 Share the Bright Futures Prize competition so that others can vote for the projects that spark their curiosity, too!
There have been major advances in cancer treatments. But we still encounter two barriers to completely successful treatments. These are the spread of cancer cells (“metastasis”) from the original tumor site to other body parts and the presence of some “resistant” tumors which usually have very few immune cells present and are surrounded by a dense tissue layer that makes it hard for drugs to reach these tumors.
“Tumor-draining lymph nodes” or “TLDN” serve as a common pathway by which cancer cells metastasize. These nodes are also the major sites where the body mounts specific immune responses directed against cancer cells. A significant amount of research has shown that treating cancer cells that have spread to these TLDN is crucial.
Our research has shown that there is an excessive build-up of a supportive network of proteins known as the extracellular matrix around the TLDN and additionally at sites elsewhere around the body that the cancer has spread to. This dense matrix is what makes it difficult for drugs to directly target cancer cells leading to poor treatment outcomes. On top of that, the lack of specificity of most current cancer therapeutics can cause serious side effects, leading to subsequent treatments and hospitalizations that can increase the cost for cancer patients exponentially.
Recently, there has been much excitement among researchers about a novel platform for delivering cancer drugs, known as an antibody-drug conjugate (ADC). Conventional ADCs work by using an antibody to find and attach to antigens on cancer cells before initiating cancer cell death. However, it is difficult for these ADCs to access treatment-resistant tumors. To date, no ADC can target the tumor, TLDNs, and distant metastatic sites with one injection.
We aim to develop a novel approach to treating treatment-resistance cancer using a system capable of targeting all three of these sites simultaneously with one shot.
Through our work, we strive to develop an effective means of targeting highly treatment-resistant forms of cancer with a single injection. This approach not only could increase a drug’s ability to penetrate directly to the three primary cancer targeting sites, but may also reduce the toxicity a patient experiences upon administration of the drug due to our one injection approach.
To our knowledge, despite progress in ADC development, a treatment strategy that can target the three pivotal sites of the tumor, TDLNs and distant metastatic sites is not currently available. To this end, our primary goal is to develop, for the first time, a delivery system that simultaneously targets these three sites with one injection.
To do this, we target a specialized class of veins known to be exclusively present in the lymph nodes. Our data indicates that this class of veins is also formed in the tumor and distant metastatic sites.
A targeted therapy platform using a simple intravenous (IV) injection that delivers a drug simultaneously to the primary tumor, TDLNs, and distant metastases would represent a major paradigm-shifting strategy to improve the outcomes of lethal cancers.
Developing and testing this novel approach to treating cancer will require an abundance of resources. The BRIght Futures Prize will serve as a launch pad for us to collect preliminary data on this drug delivery system, which will then allow us to secure additional funding with the goal of eventually testing this system clinically.
Bullying. Shaming. Discrimination. People with large bodies encounter anti-fat bias and weight stigma in nearly every aspect of their lives – including in the offices of well-meaning medical professionals.
Doctors, nurses, and clinic staff who are unaware of the trauma resulting from lifetime experiences of anti-fat bias and internalized stigma may unintentionally retraumatize patients, which can lead to poorer physical and mental health outcomes for this vulnerable population. Unconscious attitudes among health care providers about large-bodied patients can undermine patient-provider trust and result in communication failures and misdiagnosis. When patients perceive that clinicians are overly focused on weight loss, this perception can ignite fear of mistreatment which can lead to decreased healthcare engagement such as missed preventive screenings and deferred treatment for optimal health maintenance.
Despite the detrimental effects that these biases can have on health outcomes, medical professionals receive minimal instruction on the science of weight management during their training. We see addressing the gap in clinical knowledge, which encompasses understanding of the impact of anti-fat bias on patients, as an importance opportunity to enhance health equity for millions of patients.
“Doctors stopped seeing me. So I stopped seeing them.” – Aubrey Gordon, author of What We Don’t Talk About When We Talk About Fat
“[Healthcare for people with large bodies] is an issue that causes me so much anxiety and in the last few years has been one of my largest barriers to thriving.” – Anonymous
Anti-fat bias is not only deeply painful and dehumanizing, but it remains pervasive in our society. It intersects with racial, gender, and sexual minority discrimination, so that some communities are especially affected by anti-fat bias.
Our aim is to decrease the discrimination that people with large bodies experience in clinical settings and promote a welcoming healthcare environment that offers a patient-centered approach to decisions regarding their medical care. We anticipate that our project will result in increased patient, provider, and staff satisfaction, improved patient retention and referrals, and enhanced communication leading to more accurate diagnoses.
We propose to develop and test the effectiveness of an e-course aimed at clinicians, clinic staff and medical students to raise awareness of anti-fat bias in health care and inform how clinical services can be redesigned to better serve the needs of patients with large bodies. The program will be grounded in trauma-informed care (TIC) principles. These principles focus on maintaining an awareness of patient trauma and understanding trauma’s impact on individual health outcomes, while keeping the patient’s unique experiences and needs at the center of their care.
This interactive e-course will incorporate the perspectives and literal voices of patients and providers regarding their experiences of the clinical encounter and spotlighting best practices. This course will feature unique tracks for each member of the healthcare team, including dedicated tracks for clinicians, medical assistants and front office staff.
Importantly, the TIC framework has never been applied specifically to the care of patients with large bodies. We have worked with national and local experts to identify productive and compassionate ways that clinicians can improve the medical encounter while helping patients meet their own health goals – whether or not they involve weight loss.
The BRIght Futures Prize will allow us to work closely with community advisors, patient advocates and clinicians to transform our foundational curriculum into a state-of-the-art e-course. We will use this prize to test the program’s effectiveness in changing knowledge and attitudes of healthcare teams at three primary care clinics and among medical school students. Our goal is to make the final product and evaluation results available nationally, in a free, open-source platform.
The program is designed to advance our mission to eliminate discrimination and promote equity across the Brigham. We envision that program will transform the health care of millions of people with large bodies and help them achieve their own health goals.
BWH Center for Community Health and Health Equity:
BWH Center for Diversity and Inclusion:
BWH Division of Women’s Health, Department of Medicine
Brigham Circle Medical Associates
The Phyllis Jen Center for Primary Care
The Fish Center for Women’s Health
Interested in learning more about this project? View the Resource Dropbox
Opioid drugs are among the top ten most frequently prescribed medications in the United States. Prescription opioids are powerful pain-reducing medications that can be highly addictive. Side effects of opioid drug use can include respiratory depression, euphoria, tranquility, and sedation. In the early 1990s, opioid prescriptions increased significantly for pain management, leading to a series of health complications and a period often referred to as the “opioid crisis.” In the United States, up to three million people have a history of an opioid use disorder. It is also estimated that 80,816 deaths were related to opioid overdoses in 2021.
The decision-making process underlying opioid drug prescription practices can be complicated. The major steps include choosing between opioids, then determining dosage and duration of use. Currently, this process is still largely based on clinician judgement and regulatory oversight.
Previous studies have shown patients’ response to opioid medications can be impacted by both clinical factors and genetic susceptibility. Nonetheless, patient genotyping information is rarely utilized to predict individuals’ response to opioid drugs and facilitate analgesic strategies with reduced opioid use, while still effectively controlling pain.
To date, there are no data-informed clinical guidelines that leverage patient-level genomic information alongside clinical criteria to inform opioid prescribing. A better system is needed to guide the clinical usage of patients’ genetic data and to identify the added value of genetic information to facilitate opioid prescribing practices.
The availability of genomic and clinical datasets in large national and international data repositories, including the All of Us Research Program and UK Biobank, has enabled researchers to perform more powerful clinically driven genomic research. Through these studies, information from both genomic and clinical perspectives can be combined in statistical and machine learning models to predict disease risk in association with strong genetic susceptibilities.
Multiple studies have showed that combining genetic and clinical variables can significantly improve the performance of models to predict the risks of complex diseases. However, there is no genetic-based applications for opioid response prediction in current clinical use.
The results of this proposal with help us identify vulnerable patient populations to harmful opioid-related outcomes, while also allowing us to gain a better understanding of the biological basis of opioid addiction.
Specifically, the algorithm developed in this project will facilitate personalized opioid prescriptions by integrating patients’ clinical and genetic information. The gained knowledge will guide further efforts to develop actionable tools for clinicians’ daily work with the potential to benefit patients with opioid addiction.
With the support of the BRIght Futures Prize, we will conduct the early-stage development of a clinically applicable genetic tool to predict patients’ responses to opioid drugs.
Patients’ medication and diagnostic information will be used to create phenotypes (patients’ condition measurements) for opioid responses. We will then develop a genetic risk score algorithm to predict high risk patients for opioid addiction based on these phenotypes.
We will use large-scale clinical and genomic databases from the Mass General Brigham (MGB) healthcare system, including multiple hospitals that share a centralized database, for algorithm development.
The BRIght Futures Prize will allow us to initiate the early stages of this study, and allocate the time required to test our models. While we have some preliminary results, we now need seed funding to launch this project and gain support from the National Institutes of Health to achieve our long-term goal of creating guidelines that better inform opioid prescriptions in clinical settings.
Inflammatory bowel disease (IBD) is one of the most common and severe chronic conditions in the gastrointestinal (GI) tract. Currently, there is no cure. Instead, available treatments focus on inflammation suppression and temporary relief of symptoms, and they often have debilitating side effects. No treatments to date successfully address the underlying causes of IBD, particularly the disrupted mucosal lining.
A damaged mucosal barrier is a hallmark of IBD. Healing of the mucosa has been associated with long-term remission in patients. As such, mucosal healing has emerged as a primary therapeutic goal for IBD treatment. Yet, the proportion of patients who achieve mucosal healing with current therapies is low.
One promising treatment to promote mucosal healing is a gene therapy-based approach. Gene therapy has already been shown to be effective at expressing anti-inflammatory agents locally in the gut in preclinical studies. We think that gene therapy could work to both modulate inflammation and heal the mucosa.
A major challenge for gene therapy in the GI tract is that the gene delivery technology may only be retained in the gut for a short time, resulting in suboptimal gene delivery. Additionally, rapid turnover of gut epithelium limits the duration of therapeutic protein expression and thus overall efficacy. A large dose or repeated administration may compensate for these shortcomings, but they may also increase the related toxicity. Localizing and retaining gene therapies specifically at the site of gut injury is essential to overcome these limitations and reduce the associated side effects.
The burden of IBD is rising in the US and worldwide. Between 1990 and 2017, the number of IBD patients increased from 3.7 million to more than 6.8 million globally, an 85.1% increase in disease prevalence. The increasing incidence and prevalence of IBD around the world highlight the urgency to address this disease.
Our goal is to benefit IBD patients by resolving ulcerations and promoting healthy gut mucosa. We hope this research will lead to a curative therapy.
Ultimately, we anticipate that our strategy can significantly improve the quality of life for IBD patients. In the long run, the results emerging from this work may also be applicable to the treatment of other chronic inflammatory conditions.
Our proposal is to develop a system that promotes mucosal healing in the inflamed gut by delivering a gene therapy treatment precisely to the site of inflammation and retaining it there for optimal gene delivery.
This therapy uses an replication-incompetent viral vector containing two genes that are important for treating the physical manifestations of IBD in the GI tract. The vector will transfer the genes locally to the site of inflammation, leading to mucosal repair.
Notably, we employ strategies to optimize gene delivery with a synthetic biomaterial-formulated carrier, enabling inflammation-site-specific expression of therapeutic agents.
We aim to treat IBD patients precisely at the damaged mucosa to regulate the overactive inflammation locally and re-seal the mucosal barrier.
By localizing and retaining the gene therapy at the site of disease in the gut, this system is uniquely designed to increase therapeutic gene expression levels over a longer period of time and prevent adverse effects associated with systemic administration of gene therapy vector.
The BRIght Futures Prize will allow us to optimize our localized gene therapy platform and demonstrate both proof-of-principle and safety in preclinical models of IBD. As such, our work is an immediate step toward a curative therapy for IBD patients.
After you’ve learned a bit about each project, we welcome you to cast your vote for the project you think should receive the $100,000 Bright Futures Prize this year.
We will be announcing the winner at a Bright Futures Prize Showcase on April 26th from 4-5pm. This virtual event will be viewed around the world as the final votes come in, so be sure to register to attend the virtual event and see the winner announced live.
Voting opened on April 12th and close on April 26th. Voting will close during the live event before the announcement of the winner, at approximately 4:50PM ET.