Chemtai Mungo, MD, MPH, FACOG, has been awarded $2.5M over five years by the National Institutes of Health for her research focused on improving human papillomavirus (HPV) treatment outcomes in women living with HIV (WWH) in Africa. Dr. Mungo is an Assistant Professor in the UNC Department of Obstetrics and Gynecology, Affiliate Faculty in Lineberger Comprehensive Cancer Center, and a member of the UNC Institute for Global Health and Infectious Diseases.
Dr. Mungo’s primary research is centered on increasing access to effective, evidence-based cervical cancer prevention in low-income countries, including investigating resource-appropriate and effective methods of treating cervical precancer. Learn more about her research profile.
“My journey began witnessing the devastating effects of preventable cervical cancer deaths in rural Kenya, where poverty and fragile health systems make cancer care unattainable,” says Dr. Mungo.
WWH, most of whom reside in low- and middle-income countries (LMICs), bear a disproportionate burden of cervical cancer – accounting for 85% of new cases and 90% of deaths worldwide – and urgently need effective and accessible prevention strategies. Thermal ablation, a minimally invasive treatment that uses heat or extreme cold to destroy tumor cells, is the most accessible cervical precancer treatment in LMICs but is limited by unacceptably high recurrence rates among WWH.
To address this gap, Dr. Mungo proposed a trial of 140 WWH in Kenya to investigate an affordable, self-administered medical therapy following thermal ablation to improve precancer treatment outcomes. Drawing on evidence from U.S.-based randomized trials and a recent pilot study in Kenya, Dr. Mungo will research the use of 5-Fluorouracil (5FU), an affordable, widely available chemotherapeutic agent, as a patient-administrated intravaginal therapy following thermal ablation to improve HPV treatment outcomes.
In 2018, the World Health Organization launched the 90/70/90 global strategy to eliminate cervical cancer. This strategy aims to vaccinate 90% of girls against HPV by age 15, screen 70% of women worldwide, and ensure that 90% of those diagnosed with precancer or cancer receive adequate treatment by 2030. To achieve these goals, innovative, evidence-based, and scalable strategies are crucial.
If proven safe, effective, and acceptable, self-administered 5FU could offer a widely scalable approach to improve secondary prevention of cervical cancer for millions of WWH globally for whom accessible prevention tools are limited and cervical cancer risk is high, helping to move closer to the global goal of eliminating this preventable cancer.
Dr. Mungo’s research is also supported by the UNC Women’s Reproductive Health Research Program (an NIH K12 Career Development grant), a UNC Center for AIDS Research Developmental Award, and a Lineberger Comprehensive Care Center Pilot Award.
This project, “Expanded Safety and Preliminary Efficacy of Adjuvant 5-Fluorouracil Following Thermal Ablation to Improve HPV Treatment Outcomes in Women with HIV in Africa,” is funded through the National Cancer Institute of the National Institutes of Health as an R37 MERIT Award (award number: R37CA306827).
Source : UNC School of Medicine