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Physician Patient

Knight Biobehavioral Oncology Lab

Dr. Knight’s research program aims to investigate biological risk and interventions – both pharmacologic and behavioral – for social health disparities in cancer, specifically among transplantation and cellular therapy (TCT) recipients. Our lab does this by investigating how variations in immune function based on socioeconomic status (SES) – among other social health variables including depression, stress, sleep quality, and anxiety – contribute to differential patient responses and outcomes following TCT. Reciprocally, we also investigate how these cancer therapies affect central nervous system function.

To accomplish these goals, we study biobehavioral mechanisms of cancer progression. Candidate mechanisms include the conserved transcriptional response to adversity (CTRA) transcriptome profile and associated molecular changes, inflammation, sympathetic nervous system activation, neurotoxic metabolites, biological aging, and the endocannabinoid system, among others. These pathways are investigated as potential mediators of social health disparities among TCT recipients and have identified that increased CTRA-related transcriptome dynamics are associated with low SES as well as adverse clinical outcomes among hematopoietic transplantation (HCT) recipients.

Dr. Knight’s group has identified a potential effective candidate pharmacologic intervention for such social health disparities – propranolol. They have identified propranolol as an effective pharmacologic mitigator of CTRA gene expression among a cohort of patients with multiple myeloma undergoing autologous HCT. Subsequent future research goals involve investigating whether propranolol is effective in ameliorating adverse clinical outcomes associated with reduced expression of these potential biomarkers. Examples of ongoing and future work include investigating the following:

  • Biobehavioral implications of chimeric antigen receptor (CAR) T cell therapy
  • Mindfulness to improve sleep and related symptomatology and inflammatory markers among hospitalized HCT recipients
  • Effect of donor SES and adversity-related biological mechanisms on recipient HCT outcomes
  • Propranolol as an intervention to reduce cancer progression

Our research program continues to inform the clinical field of Psycho-Oncology as we increasingly understand how the central nervous system regulates cancer disease and progression.

Meet the Director | Jennifer M. Knight, MD, MS, FACLP

Jennifer M. Knight, MD, MS, FACLPThe purpose of my research is to investigate biological risk and pharmacologic interventions for social health disparities in cancer, specifically among transplant and cellular therapy (TCT) recipients. I investigate how variations in immune function based on socioeconomic status (SES), among other social health variables, contribute to different patient responses to hematopoietic cell transplantation (HCT) and chimeric antigen receptor (CAR) T cell therapy as cancer treatments. I do this by studying biobehavioral mechanisms of cancer progression; specifically, I have investigated the conserved transcriptional response to adversity (CTRA) transcriptome profile and its associated molecular changes as a potential mediator of social health disparities among HCT recipients. We have identified CTRA-related transcriptome dynamics to be associated with adverse clinical outcomes among HCT recipients. I have identified propranolol as a pharmacologic mitigator of CTRA overexpression, thus identifying it as a candidate intervention to ameliorate adverse clinical outcomes associated with social health disparities. I have extended my work to understanding social health disparities among CAR T cell recipients while additionally exploring other biobehavioral mechanisms of disparities of relevance to TCT.

View Jennifer M. Knight Bio

Lab Publications and Activities

Dr. Knight’s research has been funded by the National Cancer Institute and National Institutes of Health (R01 CA238562; R21 CA279935; T32CA269115), the American Cancer Society, the Advancing a Healthier Wisconsin Endowment, and the Laura Gralton Philanthropic Fund.

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Key Publications

Psychoneuroendocrinology (2013)

Knight, J. M., Lyness, J. M., Sahler, O. J. Z., Liesveld, J. L., & Moynihan, J. A. (2013). Psychosocial factors and hematopoietic stem cell transplantation: potential biobehavioral pathways. Psychoneuroendocrinology, 38(11), 2383-2393.

Clinical Cancer Research (2016)

Knight, J. M., Rizzo, J. D., Logan, B. R., Wang, T., Arevalo, J. M., Ma, J., & Cole, S. W. (2016). Low Socioeconomic Status, Adverse Gene Expression Profiles, and Clinical Outcomes in Hematopoietic Stem Cell Transplant Recipients Low SES, Gene Expression, and Outcomes in HCT. Clinical Cancer Research, 22(1), 69-78.

Blood Advances

Knight, J. M., Rizzo, J. D., Hari, P., Pasquini, M. C., Giles, K. E., D’Souza, A., ... & Cole, S. W. (2020). Propranolol inhibits molecular risk markers in HCT recipients: a phase 2 randomized controlled biomarker trial. Blood Advances, 4(3), 467-476.

Taylor, M. R., Cole, S. W., Strom, J., Brazauskas, R., Baker, K. S., Phelan, R., ... & Knight, J. M. (2023). Unfavorable transcriptome profiles and social disadvantage in hematopoietic cell transplantation: a CIBMTR analysis. Blood Advances, 7(22), 6830-6838.

Transplantation and Cellular Therapy

Kelly, D. L., Syrjala, K., Taylor, M., Rentscher, K. E., Hashmi, S., Wood, W. A., ... & Knight, J. M. (2021). Biobehavioral research and hematopoietic stem cell transplantation: expert review from the Biobehavioral Research Special Interest Group of the American Society for Transplantation and Cellular Therapy. Transplantation and Cellular Therapy, 27(9), 747-757.

Taylor, M. R., Steineck, A., Lahijani, S., Hall, A. G., Jim, H. S., Phelan, R., & Knight, J. M. (2023). Biobehavioral implications of chimeric antigen receptor T-cell therapy: current state and future directions. Transplantation and Cellular Therapy, 29(1), 19-26

Haematologica (2023)

Knight, J. M., Hackett, E., Szabo, A., Wu, R., Sauber, G., Johnson, B., ... & Shah, N. N. (2023). Associations between socioeconomic status and bispecific LV20. 19 CAR T-cell therapy outcomes. Haematologica, 108(2), 588.

Frontiers in Immunology (2022)

Knight, J. M., Taylor, M. R., Rentscher, K. E., Henley, E. C., Uttley, H. A., Nelson, A. M., ... & Costanzo, E. S. (2022). Biobehavioral implications of COVID-19 for transplantation and cellular therapy recipients. Frontiers in Immunology, 13, 877558.

Communications Medicine

Knight, J. M., Szabo, A., Arapi, I., Wu, R., Emmrich, A., Hackett, E., ... & Shah, N. N. (2022). Patient-reported outcomes and neurotoxicity markers in patients treated with bispecific LV20. 19 CAR T cell therapy. Communications Medicine, 2(1), 49.

Psycho-Oncology

Molinaro, J., Banerjee, A., Lyndon, S., Slocum, S., Danhieux‐Poole, C., Restivo‐Pritzl, C., ... & Knight, J. M. (2021). Reducing distress and depression in cancer patients during survivorship. ʲ⳦‐OԳDZDz, 30(6), 962-969.

McAndrew, N. S., Strong, Y., Morris, K. J., Sannes, T. S., Pirl, W. F., Cole, S., ... & Knight, J. M. (2022). Impact of the COVID‐19 pandemic on cancer patients and psycho‐oncology providers: Perspectives, observations, and experiences of the American Psychosocial Oncology Society membership. ʲ⳦‐OԳDZDz, 31(6), 1031-1040.

Recent Publications

Awoyinka, I., Tovar, M., Young, S., Beyer, K., Kwarteng, J., Knight, J., & Stolley, M. (2024). Examining the role of social relationships on health and health behaviors in African American men with prostate cancer: a qualitative analysis. Supportive Care in Cancer, 32(3), 1-9.

Bird, C. M., Webb, E. K., Cole, S. W., Tomas, C. W., Knight, J. M., Timmer-Murillo, S. C., ... & Torres, L. (2024). Experiences of racial discrimination and adverse gene expression among black individuals in a level 1 trauma center sample. Brain, Behavior, and Immunity, 116, 229-236.

Taylor, M. R., Cole, S. W., Strom, J., Brazauskas, R., Baker, K. S., Phelan, R., ... & Knight, J. M. (2023). Unfavorable transcriptome profiles and social disadvantage in hematopoietic cell transplantation: a CIBMTR analysis. Blood Advances, 7(22), 6830-6838.

Blue, B. J., Brazauskas, R., Chen, K., Patel, J., Zeidan, A. M., Steinberg, A., ... & Majhail, N. S. (2023). Racial and Socioeconomic Disparities in Long-Term Outcomes in≥ 1 Year Allogeneic Hematopoietic Cell Transplantation Survivors: A CIBMTR Analysis. Transplantation and Cellular Therapy, 29(11), 709-e1.

Kleman, A., Singavi, A., Pommert, L., Mathison, A. J., Hari, P., Dhakal, B., ... & Carlson, K. (2023). A timeline of genetic variant enrichment: from multiple myeloma diagnosis to myeloma-associated myeloid malignancy. Blood Advances, 7(18), 5549-5553.

Current Projects

Donor socioeconomic status as a predictor of altered immune function and treatment response following hematopoietic cell transplantation for hematologic malignancy
The goal of this research study is to determine whether donor immunologic characteristics associated with socioeconomic factors worsen hematopoietic cell transplant recipient outcomes. We will also look to see whether donor and recipient SES factors will impact genetic expression statuses among these patients.

Role: PI; MPI: Dr. Lucie Turcotte
Funding: R01 – CA238562

Determining the role of the SDF-1/CXCR4 pathway and its intersection with chronic stress to establish novel precision approaches to head and neck cancer management
The goal of this research study is to explore the relationship between cancer progression and chronic stress in HPV-negative head and neck cancer (HNC) patients. We will investigate the impact of chronic stress on increased tumor growth and metastases using mice who were engineered to have human immune systems and HNC xenografts.

Role: Co-PI; PI: Dr. Joseph Zenga
Funding: R21 – CA279935

Mindfulness meditation and sleep disturbance in hematopoietic cell transplant patients: inflammatory mechanisms
The goal of this research study is to evaluate whether mindfulness techniques are helpful and easy for autologous hematopoietic stem cell transplant (HCT) recipients. We want to find out if behavioral techniques such as the Mindfulness Awareness Practices for Insomnia (MAP-I) and Sleep Health Education (SHE) are easy to learn and practice and help with sleep.

Role: PI
Funding: ǿ޴ýCancer Center Team Science Pilot Grant, ǿ޴ýCancer Center, Laura Gralton Philanthropic Fund

Studies of kynurenine metabolites as a link between socioenvironmental disparities and poor outcomes in CAR T therapy
The purpose of this research study is to examine the associations between socioeconomic status (SES), kynurenine (KYN) and its metabolites, and neurotoxicity in CAR T-cell therapy patients. Using mouse models, we will investigate underlying mechanisms connecting KYN metabolites, inflammation, and chronic stress. Future research will explore potential interventions to reduce neurotoxicity and improve outcomes for CAR T-cell therapy patients, especially those of lower SES.

Role: Co-PI; PI: Dr. Cecilia Hillard
Funding: ǿ޴ýCancer Center Idea Award

Socioenvironmental disparities and accelerated aging in CAR T cell therapy recipients
The goal of this research study is to examine whether there is an association between socioenvironmental disparities (low socioeconomic status (SES), financial toxicity, and racial group) and accelerated aging in CAR T-cell therapy patients. The study will also investigate relationships between patient-reported outcomes, adverse effects, and clinical outcomes following CAR T-cell therapy.

Role: Co-PI; PI: Dr. Kelly Rentscher
Funding: MCW-American Cancer Society Research Grant

Associations Between Socioeconomic Status and CAR T-cell therapy Biomarkers and Outcomes
The purpose of this research is to examine associations between socioeconomic status and CAR T-cell therapy changes in neurotoxicity biomarkers, clinical outcomes, and quality of life with the goal of further understanding the biological basis of cancer disparities.

Role: PI

Financial Toxicity Associated with CAR-T Cell Therapy
The purpose of this research is to understand financial toxicity (distress from out-of-pocket expenses, opportunity costs, treatment compliance, and survivorship) among CAR-T cell therapy patients with relapsed and refractory B cell lymphoma. Using interviews and questionnaires through multiple time points, we hope to understand how financial stressors play a part in CAR-T cell therapy clinical outcomes.

Role: PI

Effect of Tocilizumab on Quality of Life and Inflammatory Based Biomarkers Among Allogenic Transplant Recipients
The goal of this research study is to determine whether the anti-interleukin (IL)-6 receptor antibody Tocilizumab improves quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation (HCT). The study compares two groups of patients; the intervention group received Tocilizumab with HCT while the comparison group underwent standard of care HCT treatment and did not receive Tocilizumab. Patient reported outcomes (PRO) measures will inform us of any quality of life changes patients experienced over the course of treatment until 180 days following treatment completion.

Role: PI

Recent Presentations

Knight JM. The biological impact of social health disparities in the transplantation and cellular therapy setting. BMT/SCT Seminar Series, Columbia University, New York, NY (4/2024)

Knight JM, Cole SW, Beyer KM, Wang T, Spellman SR, Allbee-Johnson M, Zhou Y, Verneris MR, Rizzo JD, Turcotte LM. Transcriptional indicators of social determinants of health and cancer outcomes: Donor socioeconomic disadvantage and recipient mortality following allogeneic hematopoietic cell transplantation. Oral Paper Presentation, American Society of Preventive Oncology, Chicago, IL (3/2024)

Knight JM. The biology of socioeconomic disparities and adverse outcomes following CAR T cell therapy. Part of Spotlight Session “Social determinants of health and cancer disparities in TCT recipients: mechanisms and interventions”. Oral Presentation, Tandem Meetings | Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR, San Antonio, TX (2/2024)

Knight JM & Shah NN. Building a Comprehensive CAR T-Cell Program: Clinical outcomes, disparities, and biological vulnerability research in LV20.19 CAR T-cell therapy recipients. ǿ޴ýCancer Control Research Program and Discovery & Drug Developmental Therapeutics Research Program Collaborative Retreat (2/2024)

Knight JM, Cole SW, Beyer KM, Wang T, Spellman SR, Allbee-Johnson M, Zhou Y, Verneris MR, Rizzo JD, Henley EC, Turcotte LM. Dlin-Fischer Clinical Research Award: Social disparities and cancer - The biologic fingerprint of stress is transplantable and associated with worse clinical outcomes. Academy of Consultation-Liaison Psychiatry (ACLP) Webinar Series (1/2024)

Media

(Video: 1:40:35)


Healio News | April 26, 2022


Preclinical research shows that stress-induced activation of the sympathetic nervous system can promote hematopoietic malignancies via β-adrenoreceptor–mediated molecular pathways.
Science Magazine

Close up female goggles near microscope

Knight Biobehavioral Oncology Lab Partner Organizations

Lab Members

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Iwalola Awoyinka, PhD

Postdoctoral Fellow

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Peyton Bendis

Clinical Research Coordinator I

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Nikhil Desai

Medical Student

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Jessica R. Molinaro, MD

Assistant Professor

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Keayra Morris, MD

Internal Medicine/Psychiatry Resident

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Kristin Seidler

Medical Student

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Hannah Uttley, BA

Research Technologist I

NCI T32 Biobehavioral Oncology Training Program

This fellowship is a two-year postdoctoral research training program that integrates 1) the biology of stress and disparities on cancer, and 2) social determinants of health, behavior, and outcomes. The program is supported by an NCI T32 award.

Qualified BBOT program candidates will have an advanced degree with clear interest and focus in research. Successful PhD applicants will have obtained their doctoral degree from a PhD program with a strong foundation in basic, clinical, behavioral, or social science with documented research training. MD/DO trainees will enter the BBOT Program after their clinical training is complete and will have demonstrated an interest in research through prior participation in labs, specialized research tracks, summer research programs, publications, or scientific presentations.

Learn more about this postdoctoral fellowship

Join Our Lab

Please contact us if you are a medical student, resident, fellow, faculty, post-doctoral associate, or graduate student interested in pursuing further training or research in biobehavioral oncology, at either or both a scientific or clinical level.

Jennifer M. Knight, MD, MS, FACLP, FABMR

Program Director

Publications

  • (Steineck A, Silbert SK, Palm K, Nepper J, Vaughn D, Shipman K, Shalabi H, Wiener L, Comiskey L, Knight JM, Levine D.) Pediatr Blood Cancer. 2024 Sep;71(9):e31092 PMID: 38867358 PMCID: PMC11269012 SCOPUS ID: 2-s2.0-85195666643 06/13/2024

  • (Turcotte LM, Wang T, Beyer KM, Cole SW, Spellman SR, Allbee-Johnson M, Williams E, Zhou Y, Verneris MR, Rizzo JD, Knight JM.) Proc Natl Acad Sci U S A. 2024 Jul 23;121(30):e2404108121 PMID: 39008669 PMCID: PMC11287259 SCOPUS ID: 2-s2.0-85199015473 07/15/2024

  • (Ballen K, Wang T, He N, Knight JM, Hong S, Frangoul H, Verdonck LF, Steinberg A, Diaz MA, LeMaistre CF, Badawy SM, Pu JJ, Hashem H, Savani B, Sharma A, Lazarus HM, Abid MB, Tay J, Rangarajan HG, Kindwall-Keller T, Freytes CO, Beitinjaneh A, Winestone LE, Gergis U, Farhadfar N, Bhatt NS, Schears RM, Gómez-Almaguer D, Aljurf M, Agrawal V, Kuwatsuka Y, Seo S, Marks DI, Lehmann L, Wood WA, Hashmi S, Saber W.) Transplant Cell Ther. 2024 Jul 20 PMID: 39033978 SCOPUS ID: 2-s2.0-85200332491 07/22/2024

  • (Khera N, Ailawadhi S, Brazauskas R, Patel J, Jacobs B, Ustun C, Ballen K, Abid MB, Diaz Perez MA, Al-Homsi AS, Hashem H, Hong S, Munker R, Schears RM, Lazarus HM, Ciurea S, Badawy SM, Savani BN, Wirk B, LeMaistre CF, Bhatt NS, Beitinjaneh A, Aljurf M, Sharma A, Cerny J, Knight JM, Kelkar AH, Yared JA, Kindwall-Keller T, Winestone LE, Steinberg A, Arnold SD, Seo S, Preussler JM, Hossain NM, Fingrut WB, Agrawal V, Hashmi S, Lehmann LE, Wood WA, Rangarajan HG, Saber W, Hahn T.) Blood Adv. 2024 Jul 09;8(13):3497-3506 PMID: 38661372 PMCID: PMC11260842 SCOPUS ID: 2-s2.0-85198087831 04/25/2024

  • (Awoyinka I, Tovar M, Young S, Beyer K, Kwarteng J, Knight J, Stolley M.) Support Care Cancer. 2024 Feb 21;32(3):178 PMID: 38381216 SCOPUS ID: 2-s2.0-85185668818 02/21/2024

  • (Bird CM, Kate Webb E, Cole SW, Tomas CW, Knight JM, Timmer-Murillo SC, Larson CL, deRoon-Cassini TA, Torres L.) Brain Behav Immun. 2024 Feb;116:229-236 PMID: 38070623 PMCID: PMC10872243 SCOPUS ID: 2-s2.0-85180086979 12/10/2023

  • (Taylor MR, Cole SW, Strom J, Brazauskas R, Baker KS, Phelan R, Buchbinder D, Hamilton B, Schoemans H, Shaw BE, Sharma A, Bhatt NS, Badawy SM, Winestone LE, Preussler JM, Mayo S, Jamani K, Nishihori T, Lee MA, Knight JM.) Blood Adv. 2023 Nov 28;7(22):6830-6838 PMID: 37773924 PMCID: PMC10679811 SCOPUS ID: 2-s2.0-85178332888 09/29/2023

  • (Blue BJ, Brazauskas R, Chen K, Patel J, Zeidan AM, Steinberg A, Ballen K, Kwok J, Rotz SJ, Perez MAD, Kelkar AH, Ganguly S, Wingard JR, Lad D, Sharma A, Badawy SM, Lazarus HM, Hashem H, Szwajcer D, Knight JM, Bhatt NS, Page K, Beattie S, Arai Y, Liu H, Arnold SD, Freytes CO, Abid MB, Beitinjaneh A, Farhadfar N, Wirk B, Winestone LE, Agrawal V, Preussler JM, Seo S, Hashmi S, Lehmann L, Wood WA, Rangarajan HG, Saber W, Majhail NS.) Transplant Cell Ther. 2023 Nov;29(11):709.e1-709.e11 PMID: 37482244 PMCID: PMC11258715 SCOPUS ID: 2-s2.0-85173143416 07/24/2023

  • (Nelson AM, Erdmann AA, Coe CL, Juckett MB, Morris K, Knight JM, Hematti P, Costanzo ES.) Brain Behav Immun. 2023 Aug;112:11-17 PMID: 37236325 PMCID: PMC10524437 SCOPUS ID: 2-s2.0-85160562513 05/27/2023

  • (Cusatis R, Ibrahim A, Knight JM, D'Souza A, Shaw BE.) Hematol Oncol Stem Cell Ther. 2023 May 23;16(4):366-369 PMID: 37363976 SCOPUS ID: 2-s2.0-85163346266 06/26/2023