With that geographical assignment came a challenge: how to localize cancer research—a complex and often global endeavor—and connect it meaningfully to the community. 

The UVM Cancer Center may be steeped in complex academic research, but it’s no ivory tower. As with many areas of research at the University of Vermont, UVMCC grounds scientific inquiry in the lived experiences of people here, its researchers asking questions that matter locally: How do we improve Vermont’s low screening rates for lung cancer—the state’s deadliest cancer? Why are melanoma rates so high here, and what can be done about it? When can we safely dial back treatment to preserve quality of life without compromising outcomes?

This approach doesn’t just serve Vermont; it strengthens the national cancer research landscape, which depends on insights from every corner of the country. And while the Cancer Center benefits from its connection to a global network of scientific discovery, its mission remains rooted in place: to pursue research that makes cancer care better, more accessible, and more attuned to the communities it serves. 

Here are three studies putting that mission into action.

Study 1: Can Less Treatment Still Cure HPV+ Cancer?

Among the human papilloma virus- (HPV) related cancers on the rise is oropharyngeal cancer, a kind of throat cancer that typically begins in the squamous cells that line the throat. And whereas throat cancer was once dominated by smoking-related tumors found mostly in older populations, the HPV positive kind tends to affect younger patients who are often otherwise healthy. 

But that’s not the only difference. HPV-positive throat cancers also respond better to treatment and have higher cure rates than their HPV-negative counterparts—a shift that’s reshaping the field of head and neck oncology. 

That shift has prompted a new clinical trial at the University of Vermont Cancer Center, led by member Mirabelle Sajisevi, M.D., a Larner associate professor and a specialist in robotic head and neck surgery at UVM Health. The trial, formally titled “De-Intensified Adjuvant Therapy for HPV+ OPSCC,” asks a critical question: If these cancers are more responsive, can we safely dial back treatment?

“Many of these patients will live for decades after treatment,” says Sajisevi. “But the side effects—dry mouth, loss of taste, difficulty swallowing—can be long-lasting and life-altering. We wanted to know if we could reduce those impacts without compromising outcomes.”

The trial’s approach builds upon prior work to stratify patients by risk. Patients undergo surgery first; their pathology results guide the next steps. Some receive a lower dose of radiation to the pharyngeal constrictor muscles and reduce the risk of dysphagia. Others may skip radiation entirely. The goal is to move away from a one-size-fits all treatment approach, instead tailoring treatment to the tumor. 

Opening this trial at the UVM Cancer Center not only reduces toxicity; it can also lower barriers for patients in Vermont and northern New York, for whom long travel times to treatment centers can be a major hurdle. “We wanted to make sure patients could access this kind of care without leaving their communities,” Sajisevi says. That also meant streamlining the trial itself— minimizing extra paperwork and visits and designing it to mirror the standard care process.

“But the side effects—dry mouth, loss of taste, difficulty swallowing—can be long-lasting and life-altering. We wanted to know if we could reduce those impacts without compromising outcomes.” – Mirabelle Sajisevi, M.D. 
 

Surveillance looks different too. In addition to regular exams and imaging, participants can opt for blood tests that detect circulating HPV tumor DNA—an advanced and highly sensitive method that enables earlier and more precise detection of cancer recurrence. This adds a layer of safety to the reduced treatment approach and offers clinicians an effective way to closely follow patients.  

Since opening in January 2025, the trial has seen a strong enrollment. “I think this reflects patients’ desire to be part of clinical protocols that offer state-of-the-art, personalized cancer care in a practical way,” says Sajisevi. “We designed it to be easy to take part in—and that’s made all the difference for our patients.”

Study 2: Skin Deep: Tracing the DNA Clues Behind Skin Cancer

UVM Health dermatologist and Larner associate professor Melanie Bui, M.D., Ph.D., spends a lot of time looking at precancerous and cancerous growths on her patients’ skin. But her interests are more than skin deep. Every skin cancer she diagnoses is the result of DNA mutations—often triggered by ultraviolet (UV) radiation, but sometimes by smoking, welding, radiation, topical chemotherapy, or a combination of exposures. 

“It’s fascinating to me that you can tell what the carcinogen might be just by looking at the mutations,” says Bui, a member of the UVM Cancer Center. “If you sequence a tumor, you can see what the patient was exposed to. It’s like detective work.” 

That investigative instinct led Bui to team up with geneticist and Larner associate professor Steve Roberts, Ph.D., also a Cancer Center member, for a pilot study exploring the DNA of UV-exposed skin. Their goal: to uncover mutational patterns that might be unique to Vermont, which has one of the country’s highest rates of melanoma, the most dangerous form of skin cancer. 

The study involves analyzing skin samples from Bui’s patients and comparing them with others taken at partner research programs in Florida and Washington State—two regions with dramatically different climates and UV profiles. If the mutational fingerprints vary by location, it could point to environmental or geographic factors unique to Vermont that influence how skin cancer develops here.

This foundational cancer research has the potential to open a new door in personalized medicine. By decoding mutational signatures in cancer, researchers can pinpoint the carcinogens that caused them in the first place. Not only would this enable dermatologists to offer patients customized prevention strategies; it could also inform their ability to tailor therapies that target each patient’s unique constellation of mutations.

For Bui, the population science aspect of the study feels especially close to home.

“My patients are literally donating a piece of themselves to help others avoid getting skin cancer—or to receive more personalized, effective treatment if they do get it,” she says. “People can be incredibly generous.”

Study 3: A Personalized Approach to Brain Metastases

Radiation therapy has long been part of the default treatment for patients with brain metastases—tumors that started somewhere in the body and spread to the brain. But what if it didn’t have to be? Radiation oncologist and Larner professor Chris Anker, M.D., and his colleagues are challenging conventional wisdom with three integrated clinical trials aimed at reimagining care with more personalized, less intensive approaches. 

The trials are designed with UVM Cancer Center’s (UVMCC) catchment area in mind, nearly 78% of whom live in rural communities in Vermont and northern New York and often travel long distances for treatment. Moreover, rural patients are statistically more likely to experience worse outcomes than their urban counterparts—making flexibility, reduced toxicity, and quality of life even more critical.

“Less really can be more,” says Anker, UVMCC’s research program co-leader who leads one of the trials. “Less radiation can mean more good days due to fewer side effects, and potentially even a longer life,” he adds. 

The standard approach to treating brain metastases typically includes either a focused, high-precision dose of radiation to the brain metastases, or radiation to the whole brain (if there are too many metastases), followed by other systemic therapies (chemotherapy, targeted therapy, and/or immunotherapy). The ACTION trial takes a different tack. Funded through a UVMCC grant and led by Anker, this clinical trial starts the patient on several systemic therapies and monitors impact through MRI brain scans. If the brain metastases shrink, patients can defer or avoid radiation. 

If a patient’s brain metastases continue to grow and radiation is needed, they might be eligible for a complementary national trial led by Nataniel Lester-Coll, M.D., UVMCC member, UVM Health Network Chair of radiation oncology, and Larner associate professor. This phase III trial explores whether dividing radiation treatment from one high-dose treatment into three treatments is not only easier on the brain in terms of side effects, but potentially more effective in preventing further tumor growth. This trial is also offered to patients who don’t want or aren’t eligible for the ACTION trial, but desire a different, less intense approach to radiation treatment.

Whichever path they choose, patients can also participate in a third study, which is funded by UVMCC and offers coordinated, enhanced care team support and palliative care integration to increase the efficiency and impact of their clinic visits. Led by Alissa Thomas, M.D., UVMCC member, UVM Health division chief of neuro-oncology, and a Larner associate professor, this study explores how brain metastases patients understand their condition and options, and how they feel about their care experience when they receive wrap-around support. 

Collaborative and customizable, this trio of interrelated studies at UVMCC reflects a broader shift toward more collaborative, personalized cancer care. “Patients appreciate having a menu of good options they can choose from, with detailed discussions about the pros and cons of each,” Anker notes. “It’s not just about reducing toxicity—it’s about trust, collaboration, and evolving how we care.”