The major research goal for the Hepatobiliary Cancer Laboratory of Lewis R. Roberts, M.B., Ch.B., Ph.D., is to understand the mechanisms by which liver and biliary cancers develop, grow and spread. Dr. Roberts' laboratory is particularly interested in identifying the critical pathways needed for the growth of individual cancers. The laboratory's second goal is to develop and validate methods for early detection, diagnosis and treatment of primary liver, biliary and pancreas cancers. In support of these goals, Dr. Roberts also coordinates the International Hepatobiliary Neoplasia Registry and Biorepository (IHNB). IHNB is a collaborative effort by many medical centers to collect clinical and risk factor information as well as blood and tissue samples to support research on liver and biliary cancers.

As a clinician, Dr. Roberts' expertise is in the diagnosis and multidisciplinary management of benign and malignant liver masses, including hepatic adenomas, hepatocellular carcinomas, bile duct cancers (cholangiocarcinomas) and gallbladder cancers.

Focus areas

• Understanding the development and progression of liver and biliary cancers. One current project in this area studies the mechanisms by which a new family of carbohydrate-modifying sulfatases regulates the growth of liver cancers through effects on both the cancer cells and the liver tumor environment. A second project works toward the identification and characterization of the genetic alterations that occur at the site of integration of hepatitis B virus into the host liver cell genome, which may contribute to the development of liver cancer in many cases.
• Understanding the genetic risk factors for liver and biliary cancers. Dr. Roberts' group is collaborating with other researchers to determine the inherited genetic variations that are associated with increased risk of development of liver and biliary cancers.
• Early detection and diagnosis of liver, biliary and pancreatic cancers. Dr. Roberts' work in this area includes validation studies of new tumor markers for early diagnosis of liver cancer; studies to optimize a novel method that uses fluorescence in situ hybridization in diagnosis of biliary and pancreas cancers; and studies to identify new blood, urine or stool markers of liver, biliary and pancreas cancers.
• Novel treatments for liver and biliary cancers. Dr. Roberts' group is actively developing patient-derived xenografts or "tumor avatars," which are tumors removed from patients at surgery or by biopsy that are grown in immunodeficient mice. New treatments against the specific patient's cancer can then be tested to determine the best treatment for each patient.
• Health care disparities related to viral hepatitis and liver cancer. Dr. Roberts' work in this area includes community-based participatory research studies of viral hepatitis and liver cancer in immigrant African communities to prevent liver disease, identify individuals with chronic hepatitis who are at risk of liver cancer, provide linkage to care and improve the early detection of liver cancer.
• Building health care capabilities to improve the delivery of medical care in sub-Saharan Africa. Dr. Roberts has had a long-standing focus on improving the delivery of health care in sub-Saharan Africa. He has been instrumental in establishing programs for continuing medical education in Ghana and Nigeria. He has also contributed to the establishment of a postgraduate training program in gastroenterology and hepatology in Ghana. Current activities include a collaboration with investigators in Global Health and Biomedical Engineering at Northwestern University to develop low-cost biomarker tests to improve the care of patients with viral hepatitis who are at risk of developing liver cancer in sub-Saharan Africa. The project is funded by the National Cancer Institute's Center for Global Health.

Significance to patient care

The long-term research goal of Dr. Roberts' laboratory is to be able to provide the necessary information so that a doctor treating a patient with liver or biliary cancer can select specific treatments targeted at the growth signaling pathways that are most critical for the individual patient's cancer. The doctor can then tailor the treatment design to most effectively control or eliminate that specific cancer. This individualized or personalized medicine will allow effective treatment of cancer with minimal side effects.