Medicine and Health Sciences Commons^™

16th Annual Pancreatic Cancer And Related Diseases Patient Symposium, Charles Yeo, Md, Facs, Adam C. Mueller, Md, Phd, Harish Lavu, Md, Facs, Theresa Yeo, Phd, Aochp, Acnp-Bc, Faanp, Avinoam Nevler, Md, Daniel Lin, Md, Msc, Wilbur Bowne, Md, Ira Sharp, Md

Pancreatic Cancer & Related Diseases Symposium

On November 13, 2021, Charles J. Yeo, MD, FACS, and the multidisciplinary team of clinicians and scientists hosted the 16th Annual Pancreatic Cancer & Related Diseases Symposium.

The video of the event is available here: vimeo.com/646517712/36786afe68.

View our Pancreatic Cancer Program 2021 Update to learn more about Dr. Yeo and the team’s great work!

PROGRAM

Welcome and Program Overview
Charles J. Yeo, MD, FACS
Samuel D. Gross Professor and Chair of Surgery

Advances in FT in Treating Pancreatic Cancer
Adam Mueller, MD, PhD
Instructor, Radiation Oncology

KRAS Mutation Allele Frequency Impacts Prognosis in Pancreatic Ductal Adenocarcinoma Using Next-Generation Sequencing …

Stage Ii Endometrial Carcinoma With False Positive Para-Aortic Lymphadenopathy: The Importance Of Pretest Probability., John Cooper, Agustin A. Garcia

Medical Student Research Poster Symposium

Purpose: Case report to increase awareness of pretest probability in the presence of abnormal imaging findings Methods: Review of Electronic Health Records and literature review Results: This patient is a 61-year-old female with a history of intermittent vaginal spotting since her early 50’s. On physical exam, normal vaginal atrophy was observed, and bi-manual recto-vaginal exam showed normal-sized uterus without adnexal masses or nodularity. A Pap-smear with dilation and curettage revealed endometrial carcinoma, endometrioid type with squamous differentiation. Hysterectomy with bilateral salpingo-oophorectomy, bilateral pelvic sentinel biopsy, and bilateral pelvic lymphadenectomy was performed. Pathology showed a grade 1 endometrioid carcinoma with greater …

Disparities In Treatment Of Hepatocellular Carcinoma In Hepatitis C Positive Patients, José Decastro-Vázquez, Stacey Rhodes, John Hutchings, Evrim Oral, Lisa Moreno- Walton

Medical Student Research Poster Symposium

BACKGROUND: Primary liver cancer is the sixth most diagnosed cancer and the third leading cause of cancer death worldwide in 2020, with approximately 906,000 new cases and 830,000 deaths.1 Hepatocellular Carcinoma (HCC) comprises 85-90% of primary liver cancers. Risk factors for HCC vary by region. According to recent data, Hepatitis C Virus (HCV) accounts for approximately one-third of HCC cases in the United States (US). Studies have shown HCC and HCV disproportionally impact racial/ethnic minorities in the US. This population is encouraged to perform screening in 6-months intervals to avoid delays in diagnosis and progression of the disease.2 Moreover, socioeconomic …

Notch Dependency In Triple Negative Breast Cancer Mitochondrial Metabolism, Christine Edomwande, Deniz Ucar, Giulia Monticone, Samarpan Majumder, Lucio Miele, Fokhrul Hossain

Medical Student Research Poster Symposium

Introduction: Triple Negative Breast Cancer (TNBC) makes up 15 – 20% of breast cancers. It has the worst prognosis amongst the breast cancer carcinomas. TNBC lacks expression of human epidermal growth factor receptor 2 (HER2) and the endocrine receptors for estrogen and progesterone. Because it is negative for all three therapeutic targets, TNBC is difficult to treat. Chemotherapy is the standard for treatment of TNBC, however, about 80% of TNBC patients do not completely respond to chemotherapy. Resistance to therapy and the recurrence of breast cancer is thought to be caused by breast cancer stem cells. Notch signaling (canonical) is …

Joint Pain: Keeping All Differentials In Mind, Hira Hasan, Sara Javadi, Erin Hauck, Lauren Raney, Emily Klepper

Medical Student Research Poster Symposium

Introduction: Acute lymphoblastic leukemia (ALL) results from the clonal proliferation of lymphoblasts. ALL is the most common pediatric cancer, accounting for one more than 25% of all pediatric malignancies. It primarily affects children between the ages of 1 and 5, with males being slightly more affected than females. A definitive diagnosis of ALL is made by the presence of ≥20% blasts on bone marrow biopsy. The prodromal stage of ALL may last from weeks to months and presents with nonspecific symptoms such as fever and fatigue. Infiltration of the bone marrow leads to decreased production of other cell lines, leading …

Investigating The Epigenetic Role Of Spdef In Prostate Cancer Through Identification Ofproteins Involved In Spdef Function, Margaret E. Larsen, Virginia Ronchi, Mousa Vatanmakanian, Jennifer Klein, Hari K. Koul

Medical Student Research Poster Symposium

Prostate cancer (PCa) is the most non-cutaneous cancer diagnosed in men, and results in approximately 30,000 deaths each year in the United States. Therapy resistant PCa, known as castration-resistant prostate cancer (CRPC), does not fully respond to common therapeutics. Most of the deaths from prostate cancer are due to metastatic CRPC indicating the importance of studying PCa to formulate more effective treatments. Previous studies have shown that the SAM pointed domain containing ETS transcription factor (SPDEF) protein plays a key role in the inhibition of prostate cancer metastasis; however, the mechanism for how SPDEF regulates metastasis is still poorly understood. …

Obese Microenvironment Contributes To Mdsc Phenotype Throughepigenetic Mechanisms, Rose Luder, Ramesh Thyur Puttalingaiah, Augusto Ochoa, Maria D. Sanchez Pino

Medical Student Research Poster Symposium

Obese patients are more susceptible to developing several different types of cancer. Myeloid derived suppressor cells (MDSC) promote tumor growth by blocking anti-tumor T cell responses. The expanded number and heightened function of MDSC have been found in mouse models of obesity. Our preliminary data show that patients with morbid obesity (body mass index [BMI] > 40 kg/m2) also have increased numbers of MDSC in peripheral blood, which could contribute to the cancer risk. Here, we investigate in vitro whether the cholesterol, as a factor of obese microenvironment, regulates the immunosuppressive phenotype of MDSC via epigenetic mechanisms. MDSC exert their immunosuppressive …

Oligometastatic (Ogm) Disease: An Emerging Concept In Oncology, Humza Malik, Tanner Dawson, James Ellia, Agustin Garcia

Medical Student Research Poster Symposium

A 46-year old presented with pain in her right axilla. Medical history was significant for stage II triple negative breast cancer (TNBC) diagnosed in 2008 treated with surgery (SRG), radiation (XRT) and chemotherapy (CTX). In 2014 she had a recurrence in the axilla treated with SRG and CTX. In 2016 she was found to have a chest wall recurrence treated with CTX and XRT. In 2018 she had a new unresectable chest wall recurrence and due to prior XRT she was considered to be at high risk for tissue necrosis with additional treatment. She was then treated with chest wall …

How The Level Of Subspecialty Of Faculty Involved In An Emergency Departmentencounter Affects The Time Until Diagnosis And Time Until Initiation Of Treatment Ingynecologic Oncology, Whitney Sternfels, Taylor Lambert, Navya Nair, Tara Castellano, Andrew Chapple, Amelia Jernigan

Medical Student Research Poster Symposium

Background: An emergency room visit is an opportunity to intervene and provide the needed care in a timely fashion. However, there is great variability in the level of subspecialty of the medical professionals involved in emergency visits. We aimed to determine if different levels of subspecialty involvement during an emergency visit had an affect on the time until first interaction with a gynecologic oncologist, time until cancer diagnosis, and time until the initiation of treatment. Methods: A retrospective chart review was conducted that included women who were referred from the emergency department (ED) to gynecologic oncology at Touro Infirmary, University …

Evaluation Of Oridonin Derivatives With Protacs Against Triple-Negative Breast Cancer, Gabrielle Vontz, Doerte Raphi Fricke, Ruixia Ma, Junhai Xu, Qiang Shen

Medical Student Research Poster Symposium

Oridonin, a natural kaurene-type diterpenoid enriched in the traditional Chinese medicinal herb Rabdosia rubescens, is a promising anticancer agent that has been shown to improve survival rates of cancer patients. Although oridonin exhibits antiproliferative capabilities including induction of apoptosis and cell cycle arrest, its low potency against aggressive cancers including triple-negative breast cancer (TNBC) and poor bioavailability limit its incorporation into standard chemotherapeutic regimens. To improve oridonin’s chemotherapeutic efficacy, several derivatives containing a thiazole ring were previously synthesized and assessed. Oridonin derivative compound CYD0618 was identified as a potent anticancer agent inhibiting cancer growth both in vitro and in vivo. …

Identification Of Copy Number Variants In Hereditary Lung Cancer Families, John Waldron, Kirsten W. Termine, Anthony M. Musolf, Mariza De Andrade, Colette Gaba, Ramaswamy Govindan, Ping Yang, Ming You, Marshall W. Anderson, Ann G. Schwartz, Susan M. Pinney, Christopher I. Amos, Joan E. Bailey-Wilson, Diptasri Mandal

Medical Student Research Poster Symposium

Lung cancer is the most common cause of cancer mortality and the third most common cancer by incidence in the United States. While environmental factors (e.g. tobacco smoke) play an important role in its development, lung cancer risk also exhibits a high degree of heritability. Linkage analyses and genome-wide association studies have identified multiple loci associated with increased lung cancer risk; however, much of the heritability has yet to be explained by these loci. Structural mutations, including a gain or loss of DNA (copy number variants or CNVs), contribute to phenotypic diversity through dosage and/or cis-regulatory effects. CNVs are important …

Reported Lvsi And Survival Outcomes For Stage I-Ii Endometrial Cancers In A Region With Limited Access To Formal Gynecologic Pathology Review., Jessica Anderson, Kyla Maupin, Hannah Sibley, Nicole Catalano, Rebecca Maitski, Navya Nair, Tara Castellano, Andrew Chapple, Amelia Jernigan

Medical Student Research Poster Symposium

Approximately 1 in 5 women with early-stage endometrial cancer (EC) will have lymphovascular space invasion (LVI). LVI reporting requires skilled evaluation and has prognostic implications that impact adjuvant treatment. Access to gynecologic pathologists (GPath) may contribute to disparate healthcare outcomes. From the practice setting of a deep south institution with no employed GPath, we aim to describe reporting rate and survival outcomes of LVI in stage I-II EC. A multicenter, IRB-approved retrospective chart review was performed at 3 hospitals with no employed GPath. Women with stage I-II EC treated with hysterectomy from 2013-2019 were included. Women were excluded if they …

Improving The Chemotherapy Experience Through Telephone Communications: The Follow-Up Phone Call, Kathy Keener, Msn, Rn, Ocn

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Understanding The Role Of Rhamm In Tumor Load– Mediated Tumor Invasiveness Of Triple Negative Breast Cancer, Ashwin Sritharan, Britney Messam

Undergraduate Student Research Internships Conference

1.Compare the levels of proliferation between RHAMM+/+ and RHAMM -/- MDA-MB-231 spheroids as determined by ki67 and Caspase 3 signaling 2.Compare levels of RHAMM, CD44, Has2, and p-ERK activation between RHAMM+/+ and RHAMM -/- MDA-MB-231 spheroids

Characterizing Cancer Associated Fibroblasts From Pancreatic Ductal Adenocarcinoma Patient Samples, Rachel Lu

Undergraduate Student Research Internships Conference

No abstract provided.

Team-Based Outreach To Improve Colorectal Cancer Screening Rates In An Urban Family Medicine Practice, Alexa Waters, Md, Olivia Seecof, Md, Graham Stratton, Md, Caitlyn Haines, Md, Brittany Hozick, Md, Jose Medina, Md, Kathryn Topalis, Md, Hannah Facey, Md, Chelsea Salas-Tam, Md, David Peters, Md

Health Equity and Quality Improvement (HEQI) Summit

Aims for Improvement

• Aim to increase CRCS rates for our resident team patients by 5% by May, 2021
• Target Population (n=99): Age 50-74, due for CRCS, office visit within last 2 years, team resident listed as PCP, active on MyChart, and speak English

Adolescent And Young Adult Oncology Patient And Provider Perspectives In Philadelphia (Aya-4p), Christoher Terry, Md, Miriam Pomerantz, Lsw, Jodi Sandos, Lcsw, Lindsay Wilde, Md

Health Equity and Quality Improvement (HEQI) Summit

Primary Objectives

• To assess the current perspective of AYA patients regarding medical services and psychosocial support delivered to AYAs in Philadelphia
• To assess the current knowledge and perspective of healthcare providers at the SKCC about the care and services needed by AYA patients

Increasing The Rate Of Excisional Lymph Node Biopsies At Easily Accessible Sites When Ruling Out Lymphoma, Catherine M. Tucker, Md, Xiangyun Ye, Christopher Gardner, Austin Redilla, Guldeep K. Uppal, Md, Adam F. Binder, Md

Health Equity and Quality Improvement (HEQI) Summit

The aim of this study is to increase the rate of excisional lymph node biopsies from 78% to 95% in patients presenting to the Center City campus with lymphadenopathy at easily accessible sites by September 2021.

A New Paradigm: Ecmo Therapy In Pediatric Hematology/Oncology Patients, Igor Areinamo

Research Days

Background: The use of extracorporeal membrane oxygenation (ECMO) for support of pediatric patients has significantly increased in the past years. Patients with known oncologic diseases, immunodeficiencies, or bone marrow transplants (BMT) have traditionally not been considered candidates for Extracorporeal membrane oxygenation (ECMO) due to perceived high risk for mortality. Ongoing advances have continued to push the boundaries of ECMO use and we report our recent experience with this patient population

Objectives/Goal: To evaluate survival to discharge of pediatric patients who require ECMO support and who also have an underlying hematologic or oncologic disease process. To determine specific patient characteristics that …

Changes In Family Functioning During The First Year Of Pediatric Cancer Treatment: A Mixed-Method Pilot Study, Carolyn Bates

Research Days

Background: A new diagnosis of pediatric cancer presents a sudden and tremendous stressor for families of all backgrounds and circumstances (Long & Marsland, 2011; Bemis et al., 2015). Although many families are resilient in the context of new cancer diagnosis, approximately 33% are at risk for negative outcomes due to psychosocial distress and difficulties with effective coping (Kazak et al., 2020; Pai et al., 2008), supporting the need for systematic assessment of psychosocial health as a standard of care in pediatric oncology (Kazak et al., 2015). Alongside heightened stress within the first year of diagnosis, parents may relax family rules …

A Pediatric Case Of Treatment-Related Myelodysplastic Syndrome While On Therapy For Pre-B All, Sara Mcelroy

Research Days

Background: Treatment-related myelodysplastic syndrome (t-MDS) is a known, but rare, late effect of cancer therapy, specifically radiation, alkylating agents or topoisomerase II inhibitors. When secondary to treatment with alkylating agents, t-MDS typically occurs 4 to 7 years after therapy, and common cytogenetics include chromosomes 5 and 7 abnormalities. Treatment in children with t-MDS is typically allogeneic stem cell transplant, but the prognosis remains poor.

Objectives/Goal: To describe a rare case of a pediatric patient who developed t-MDS while receiving treatment for Pre-B Cell Acute Lymphoblastic Leukemia (pre-B ALL) and to outline the treatment regimen that he received.

Methods/Design: Case Report …

Impact Of Covid-19 On Families With A Child In Cancer Treatment, Mirae J. Fornander

Research Days

Background: A new diagnosis of pediatric cancer diagnosis is a sudden and tremendous stressor to families (Long & Marsland, 2011). The COVID-19 pandemic presented an acute, universal stressor that impacted daily life around the world (Brooks et al., 2020). The impact of the COVID-19 pandemic on children with cancer and their families is not yet known.

Objectives/Goal: The current study is a pilot investigation of COVID-19 exposure and impact among a sample of families with a child being treated for cancer.

Methods/Design: Primary caregivers (N=22) of a child (M age=7.4, SD=4.6) who was diagnosed with cancer within the last 18 …

Levofloxacin Versus Ciprofloxacin Prophylaxis In Pediatric Cancer Patients At High Risk Of Infection, Chandni Dargan Md, Amy Johnson Md, Mba

Research Days

Background: Patients with cancer and those undergoing chemotherapy are at risk of developing bacterial infections due to myelosuppression. Patients undergoing the most intensive chemotherapy regimens are at a higher risk for morbidity and mortality due to profound neutropenia. Antibacterial prophylaxis is given to reduce the incidence of infection in those at highest risk. Starting March 1, 2016 our institution used ciprofloxacin for antibacterial prophylaxis however recent literature, including the COG trial ACCL0934, supports using levofloxacin in certain high risk (HR) populations due to greater efficacy in reducing neutropenic fever (NF) and bacteremia. Therefore, we switched to this April 1, 2019. …

Standardization Of Fertility Preservation Discussion Amongst Pediatric Oncology And Bone Marrow Transplant Patients: A Single Institution Experience, Chandni Dargan, Sarah E. Mc Dermott, Shelby Chesbro

Research Days

Background/Project Intent (Aim Statement): As treatment for pediatric malignancies improves long term survival, physicians are shifting focus to late effects of therapy such as infertility. Currently, options for fertility preservation include cryopreservation of mature oocytes, sperm, and gonadal tissue, although barriers remain present. Within our division, we lacked a standard approach to discussing fertility preservation options prior to initiation of treatment.

Methods (include PDSA cycles): Records from 474 pediatric patients with new oncologic diagnoses at CMH from 2014- 2020 were retrospectively reviewed. We evaluated the frequency that reproductive health discussions were documented in pubertal males and females requiring chemotherapy or …

Metastatic Adenocarcinoma Of The Prostate To The Brain Initially Diagnosed As Meningioma By Craniotomy: A Case Report, Julia T. Scali, Young Son, Paul Chialastri, Thomas Mueller

Rowan-Virtua Research Day

Prostate cancer is the second leading cause of cancer death in men after lung cancer. The most common site of prostate metastasis is bone (84%), lymph node (10.6%), liver (10.2%), and thorax (9.1%), with 18.4% to multiple metastatic sites [1]. Prostate metastasis to the brain is rare, with less than 1% documented cases from M.D. Anderson Cancer Center [2]. It is estimated that 1%-6% of prostate cancer metastasis is found in post mortem examination [3]. Parenchymal brain metastasis has a mean survival of 9.2 months after discovery of brain metastasis [4]. Acute neurological symptoms of metastatic prostate cancer are observed …

Assessment Of Factors Preventing Adequate Decline In Cervical Cancer Rates Amongst Minority Women In New Jersey, Rosie Wenrich, Jillian Baker

Rowan-Virtua Research Day

Background

• Nationally declining cervical cancer rates are still high amongst minority women in NJ, with Hispanic women being affected the most.

• The Human Papilloma Virus (HPV) is the most common sexually transmitted infection and can lead to cervical cancer

• Administration of the 9-valent HPV vaccine can prevent infection and progression to cancer

• Regular cervical cancer screenings allow for better outcomes

• Various barriers prevent people with a cervix receiving the vaccine

• Various barriers prevent people with a cervix aged >/= 30 from receiving regular cervical cancer screenings

Conclusions

• Improved physician recommendation is required for the …

The Effect Of Carfilzomib And Bortezomib Based Regimes On Cardiotoxicity In Multiple Myeloma Patients At Cooper University Hospital, Ami Patel, Tulin Budak-Alpdogan, Stalam Tapati

Rowan-Virtua Research Day

Introduction

• Multiple myeloma (MM) is a cancer of plasma cells, which is a white blood cell that normally produces antibodies
• Treatment in patients younger than 65 years old is typically high dose chemotherapy, usually with bortezomib based regimens or lenalidomide dexamethasone, followed by a stem cell transplant
• For patients with relapsed myeloma, carfilzomib is usually the treatment of choice
• Carfilzomib is a highly selective, irreversible proteasome inhibitor that binds to the 20 S proteasome. Several studies have illustrated that carfilzomib has been associated with cardiovascular adverse events (CVAE).
• Current literature on the role and effect of bortezomib on cardiotoxicity is …

Barriers To Lung Cancer Screening Among African American Males Aged 50-70 In The United States, Edward Marines

Rowan-Virtua Research Day

Objectives:

• Identify the different barriers to lung cancer screening among African American males
• Examine potential methods of increasing access and participation within this population

Phyllodes Tumor Containing Invasive Ductal Carcinoma: A Rare Case Description & Review Of Literature, Kathryn Eckert, John Ground, Alyssa Imperatore, Victoria Tiedemann, Linda Szczurek

Rowan-Virtua Research Day

Phyllodes tumors are uncommon, often benign, malignancies of the breast and account for approximately 0.5% of all breast malignancies. These tumors were first described in 1838 by Johannes Muller as cystosarcoma phyllodes and were later more aptly renamed phyllodes tumors (as they were neither cystic nor sarcomatous).(1) As a mixed connective tissue and epithelial tumor, these behave similar to benign fibroadenomas, though their growth is much more rapid and they tend to occur in older patients.(2) Hallmarked by their large size at presentation, these tumors average between 4 and 7 cm at the time of diagnosis. The only known risk …

Multiple Myeloma With Dual Expression Of Kappa And Lambda Light Chains, Monica Patel, Akash Patel, Yvette Wang

Rowan-Virtua Research Day

Multiple myeloma (MM) is a malignancy of plasma cells that accounts for approximately 1 to 2 percent of all cancers and about 17% of all hematologic malignancies.

Plasma cells normally produce antibodies and provide a defense mechanism for the body to fight infections.

Antibodies typically consist of two heavy chains (IgG, IgA, IgM, IgD and IgE) and two light chains (kappa and lambda).

Most cases of MM have malignant plasma cells producing monoclonal (M) proteins, most common being IgG about 52% of the time (1).

Only about 2% of these myeloma cases were also found to secrete more than one …