Dr. Thomas Odeny grew up in rural Kenya during the height of the HIV epidemic in sub-Saharan Africa. After graduating from medical school at the University of Nairobi, he decided to begin his career in HIV care as a way to give back to his community.
“My home district had the highest prevalence of HIV in Kenya at the time,” says Thomas. “I had one brother living with HIV and one who died from it, so I felt this is where I was needed.”
Thomas initially saw a lot of late-stage HIV and witnessed the cancers that were prevalent in the early stages of the HIV epidemic, such as Kaposi sarcoma. He ultimately decided to pursue a career in internal medicine and medical oncology, and he notes that while rates of HIV-related cancers have declined in many patient populations over the years, Black communities worldwide have seen unchanged or increased incidence. In fact, Black people with cancers such as Kaposi sarcoma have significantly higher mortality than other groups.
“In addition, people living with HIV and cancer are excluded from clinical trials for reasons not clinically sound,” he says. “Thus, I am working to reverse this trend, and my research is helping address other barriers to care.”
Today, Thomas treats patients at the Siteman Cancer Center at Barnes-Jewish Hospital and at Washington University School of Medicine, St. Louis. He is one of ten Gilead-sponsored scholars who received the Winn Career Development Award (CDA) last fall through the Robert A. Winn Diversity in Clinical Trials Award Program (known as the Winn Awards). His clinical research grant focuses on expanding clinical trials and treatment options for cancer in underrepresented people living with HIV in underserved regions.
Dr. Joannie Ivory, Assistant Professor of Medicine at University of North Carolina, Chapel Hill (UNC) and UNC Lineberger Comprehensive Cancer Center, is part of the same Winn CDA cohort as Thomas. Her grandmother’s personal battle with colon cancer helped shaped her medical career path.
“What better way for me to show up for my grandmother and support her in her journey with colon cancer than to become an oncologist,” says Joannie.
As a Black physician, Joannie is all too familiar with the health inequities Black women with breast cancer face, such as having twice the incidence rate of triple-negative breast cancer (TNBC) and a 40% greater risk of mortality than white women.
“Black women are not asked to join research studies to the degree they should be,” she says. Joannie believes there are unconscious biases where providers assume certain people don’t want to participate in trials or target patient populations that are easiest to enroll.
Her research team recently closed their trial to non-Black participants when the preset target accrual was reached, leaving the trial open to only Black participants. When given the opportunity, enrollment among her target demographic of Black women increased, supporting her hypothesis that the barrier is not solely a trust issue.
Winn Awards and Gilead’s Commitment to Health Equity
The Winn Awards aim to address the longstanding lack of diversity in clinical trials by training, developing and mentoring early-stage investigator physicians from diverse backgrounds, as well as physicians who have a demonstrated commitment to increasing diversity in clinical research. The program was started by the Bristol Myers Squibb Foundation in 2020 and gained Gilead’s support when Chief Medical Officer Merdad Parsey learned of it.
“The program aligns perfectly to Gilead’s deep commitment to health equity, inclusion and representation in clinical trials,” Merdad says. “With this third cohort of physicians, we are looking forward to continuing to increase awareness, education and investment in diverse clinical trials.”
Winn CDA recipients receive a $120,000 annual grant for two years, in addition to mentorship from a seasoned clinical investigator at the sponsoring institutions. They go through training in trial design and community engagement methods and actively participate in their mentor’s clinical trial.
Thomas feels the program paired him with the ideal mentor. “In the 80s, my mentor, Dr. Lee Ratner of Washington University School of Medicine, published the first sequences of the HIV-1 virus before becoming an oncologist,” he says. “He also started the only clinic in the Midwest for cancer in people living with HIV, and now I’m helping run the clinic with him.”
For Joannie, receiving this award means she can advance one of her goals of bringing resources to underserved areas by achieving not only equality, but equity. “Equality means we’re dispersing all of the resources to everyone evenly and equity is shifting resources to areas that need it the most,” she says.
Joannie and Thomas both say they’re grateful to have the extra support to help improve health equity and benefit more people living with cancer and HIV through their research.
“When we include those who are normally not represented, we help everyone,” Thomas says.