Treating Precancer in Low-Resource Settings to Prevent Cervical Cancer 

Leeya Pinder, M.D., M.P.H., of the University of Cincinnati, knows how to bridge divergent cultures—geographical, social, and professional—and thrive in them. She grew up in Queens, New York, for the first half of her childhood and then adapted to being a teenager in Charleston, South Carolina. At age 7, Leeya decided to become a doctor and let nothing stand in her way.

Encouraged by various teachers who made learning science fun, she majored in chemistry and pursued medicine at the Medical University of South Carolina. After working for 5 years as a gynecologist in a private practice, Leeya realized that she wanted to practice medicine differently, and she pivoted to global health and gynecologic oncology.

This decision led her to Kenya, where she witnessed the daily struggles of living in a place without access to adequate health care. She developed programs that integrated cervical cancer screening into HIV clinics. Reflecting on the gynecological services she provided, Leeya mused, “Being in Kenya was my first understanding of: ‘Live in the place in which you work, if you really want to affect change.’ ” Her time there motivated her to make a difference in medically underserved communities and solidified her focus on cervical cancer research. She saw the need for more effective, less invasive, and scalable interventions for cancer prevention and treatment in low-resource settings.

Leeya excelled in global health work and gained further insights from mentors and through several fellowships, conducting research in the United States and Zambia.

In 2023, she joined the University of Cincinnati as associate professor and director of the Center for Global Cancer Control, where she focuses on increasing cervical cancer prevention in Cincinnati and across sub-Saharan Africa. She also advocates for HPV self-testing in appropriate settings, both in the United States and abroad, and her work in Zambia informs her research in Cincinnati.

Cancer Moonshot Scholar R37 award

Bolstered by her work in Kenya and Zambia, Leeya submitted her first R01 grant application to NCI’s Cancer Moonshot Scholars program. The program is designed to diversify the cancer research workforce while advancing science. Applicants must be supported by their institution. She was thrilled to be selected for the inaugural Cancer Moonshot Scholars cohort and awarded the R01 grant in 2023. She was further elated that it was converted to an R37 MERIT Award, which brings with it the possibility of an additional 2 years of funding. “This grant has changed a lot for me,” Leeya remarked. “It’s given me the freedom to be a scientist primarily, as well as the confidence that what I do actually matters.”

Reflecting on NCI’s support of early-stage investigators, particularly groups underrepresented in biomedical research, Leeya said: “This support gives us the opportunity to step into a space where we can actually make a difference and leverage our ideas. And to be in one of the first cohorts of this program—it’s an incredible opportunity.”

A recent White House Cancer Moonshot Scholars event provided such an opportunity, where people from different research disciplines met to discuss potential collaborations that could move science forward in meaningful ways. At the event, Leeya connected with an engineer from MIT, and they discussed Leeya’s work with cervical precancer and the vaginal microbiome.

“She is a device person, and I’m a science person,” Leeya stated. “We’re now partnering to make a difference in women’s health. I think this kind of collaboration is what will be transformational in the future.”

The POLESA trial 

Leeya’s R37 research on “Repurposed Antiretroviral Therapies to Eliminate Cervical Cancer” addresses a challenge of treating cervical precancer, particularly in low-resource settings. Her earlier work in Zambia showed that women living with HIV do not respond as well as women who do not have HIV to the three standard methods for treating cervical precancer: freezing, heating, or removing. However, in previously published research, she discovered that an older antiretroviral medicine may help.

As part of the work supported by her R37 grant, she is testing the antiretroviral medicine in combination with one of the three standard treatment options for cervical precancer in women living with or without HIV in Zambia. The clinical trial is called POLESA, which means “to heal” in the native Nyanja language.

“My goal is to try to heal the cervix so that this disease doesn’t progress to cervical cancer,” Leeya explained.

An important advantage of the medicine is that it is self-administered. “This is a treatment that women can do in the comfort of their own home without having an invasive procedure performed,” she explained.

Enrollment in the trial was postponed by a delay in obtaining the study drug. Leeya was undeterred by the pause, and continued to study behavioral aspects, such as women’s vaginal hygiene routines, which might affect the response to treatment. She uses surveys to gather behavioral information and devotes time to hear ideas and feedback from the community and local advisory boards: “Listening is essential for success in low-resource settings.”

By gathering the behavioral surveys first, followed by examination of the vaginal microenvironment, Leeya is better able to tailor the treatment for each patient. And through this approach, she can learn what factors will affect the outcome in her effort to eliminate a patient’s cervical precancer.

She looks forward to the day when multiple tools—such as artificial intelligence, immunotherapy, and vaccines—establish a universal, affordable solution to prevent and treat cancer. Until that happens, whether in Zambia, Cincinnati, or elsewhere, Leeya will continue to help address challenges in cervical cancer prevention in low-resource settings, one woman at a time.