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This broad category includes discovery research that will increase our knowledge and understanding of early, pre-cancer stages – research that will identify and characterize molecular biological and cellular changes that occur during early stages of inherited cancer following the initial genetic lesion and as well as mechanisms restraining precancer stages.

We hope that successful completion of research in this category will generate knowledge that helps to identify novel biomarkers for early detection and risk assessment and novel targets that can be exploited for the development of preventive agents.

Research could include, but is not limited to, study of oncogenic targets and signaling pathways; genetic/epigenetic, proteomic, and metabolomic changes related to transformation; the immune microenvironment of pre- and early-cancer; contributions of the microbiome to transformation. We will prioritize studies that can fill knowledge gaps that have hindered early detection and the development of preventive measures. Projects may also include those that propose the development of preclinical assays and models to understand mechanisms of transformation.

Development of technologies that could enable early detection of cancer at preneoplastic or premalignant stages. Development of tests to distinguish malignant vs benign preneoplastic lesions. May include projects that could help stratify the risk for cancer in individuals with genetic predispositions. Projects could include, but are not limited to, research that could lead to the discovery and validation of biomarkers and the development of diagnostic tests.

Development of interventions to intercept early tumorigenic events to reduce cancer risk. May include projects that propose to develop predictive preclinical assays for effective and efficient screening; further the scientific insights into the mechanisms of cancer prevention by the agents examined; characterize the effects of known or potential preventive agents on their molecular targets and on any biological events associated with cancer development; functionally validate targets that can be potentially exploited for the development of cancer preventive therapies.

• Chemoprevention: Develop and test new pharmacologic agents or re-purpose existing agents for early interception of cancer.
• Immunoprevention: Develop strategies to harness the anti-cancer activities of the immune system and to suppress the cancer-promoting functions of the immune system to eliminate cancer cells early.