Medicine and Health Sciences Commons^™

Distinct Nrf2 Signaling Thresholds Mediate Lung Tumor Initiation And Progression, Janine M. Deblasi

USF Tampa Graduate Theses and Dissertations

NRF2 is a redox-responsive transcription factor the directs the antioxidant program and several critical metabolic processes. Mutations in NRF2 or its negative regulator KEAP1 occur in up to one third of non-small cell lung cancers (NSCLCs) and are often associated with resistance to therapy and poor outcomes. In the present studies, murine alleles of the Keap1 and Nrf2 mutations found in human NSCLC were developed and I comprehensively investigated their impact on tumor initiation and progression. I observed that chronic Nrf2 stabilization by Keap1 loss-of-function or Nrf2 activating mutation was not sufficient to cause lung tumor initiation, even when p53 …

Understanding How Cancer Adapts To Stress And Therapy Using Evolutionary Game Theory, Mariyah Pressley

USF Tampa Graduate Theses and Dissertations

Adaptive responses in cancer promote disease initiation, progression, and resistance to treatment. Understanding the underlying evolutionary dynamics behind these adaptive responses is crucial for developing effective therapeutic strategies. Evolutionary game theory (EGT) has proven a useful tool in analyzing how different cellular behaviors and evolutionary forces shape the dynamics of tumor growth, response to therapy, and the emergence of resistance. In this dissertation, we utilize EGT to understand the adaptive responses of cancer through the lens of ecology and evolution. By employing fitness-generating models and exploring various ecological contexts, we aimed to unveil critical factors influencing aggressive cell phenotypes, treatment …

Withaferin A And Immune Checkpoint Blocker Therapy For The Treatment Of Non-Small Cell Lung Cancer, Roukiah Khalil

USF Tampa Graduate Theses and Dissertations

Lung cancer is the first cause of cancer-related deaths in both men and women with an overall five-year survival rate of 28%. Although immune checkpoint blockers (ICBs) are currently FDA-approved for the treatment of non-small cell lung cancer (NSCLC), only 17-20% of patients achieve durable responses by the induction of immunologic memory. The lack of response in most patients can be attributed to the tumor-intrinsic or tumor-extrinsic immune resistance mechanisms. A biomarker of importance is the Programmed Death Ligand-1 (PD-L1), as higher PD-L1 expression is usually associated with a better response to ICBs. Although studies have attempted to combine ICBs …

Role Of Hla-Drb1 Fucosylation In Anti-Melanoma Immunity, Daniel K. Lester

USF Tampa Graduate Theses and Dissertations

Melanoma is the one of the most lethal skin malignancies due to its ability to rapidly metastasize and evade the immune system. One factor that influences melanoma’s ability to metastasize and evade the immune system is the tumor microenvironment. The tumor microenvironment is a complex ecosystem that consists of melanoma cells interacting with different proteins and cell types such as cytokines, extra cellular matrix proteins, and various immune cells. While different immune cells can have various implications in the tumor microenvironment, some tumor infiltrating lymphocytes (TIL) have the potential to suppress these tumors. Recent therapeutic strategies aim to enhance TILs …

Histone Deacetylase 8 Is A Novel Therapeutic Target For Mantle Cell Lymphoma And Preserves Natural Killer Cell Cytotoxic Function, January M. Watters

USF Tampa Graduate Theses and Dissertations

This study demonstrates for the first time that HDAC8 function is critical for MCL survival, and abrogating its activity in human primary NK cells does not interfere with NK IgG antibody directed ADCC therapies ex vivo. Human NK cells, isolated from healthy donors, are highly resistant to HDAC8 inhibitor treatment with PCI-34051. Even at the highest concentration, 20uM, no toxicity was observed. Conversely, MCL cell lines representative of the aggressive MCL subtype, classical MCL, were especially sensitive to PCI-34051, an HDAC8 selective inhibitor, treatment. Blocking HDAC8 activity and/or abrogating expression through shRNA silencing induced significant DNA damage, hyperacetylation of SMC3, …

Apkcs Role In Neuroblastoma Cell Signaling Cascades And Implications Of Apkcs Inhibitors As Potential Therapeutics, Sloan Breedy

USF Tampa Graduate Theses and Dissertations

Neuroblastoma (NB) is a cancer that develops in the neuroblasts. It is the most common cancer in children under the age of 1 year, accounting for approximately 6% of all cancers. The prognosis of NB is linked to both age and degree of cell differentiation. This results in a range of survival rates for patients, with outcomes ranging from recurrence and mortality to high survival rates and tumor regression. Our previous work indicated that PKC-ι promotes cell proliferation in NB cells through the PKC-ι/Cdk7/Cdk2 cascade. We report on two atypical protein kinase inhibitors as potential therapeutic candidates against BE(2)-C and …

Young Adult Cancer Patients And Survivors’ Adherence To Healthy Eating And Physical Activity Guidelines, Sandra Soca Lozano

USF Tampa Graduate Theses and Dissertations

Many Adolescents and Young Adult (AYA) cancer patients/survivors do not engage in healthy eating and physical activity recommendations. The present study assessed the role of race/ethnicity, health literacy, and home environmental influences and its association with adherence to healthy eating and physical activity. AYA patients/survivors from Moffitt Cancer Center (n = 273) completed an anonymous online survey. Self-reported measures about eating habits, physical activity, health literacy, and social support were used. Black/African Americans reported worse eating habits than White and Hispanic participants. Obese participants showed a similar trend compared to all other Body Mass Index groups. Adherence to physical activity …

Accelerating Multiparametric Mri For Adaptive Radiotherapy, Shraddha Pandey

USF Tampa Graduate Theses and Dissertations

MR guided Radiotherapy (MRgRT) marks an important paradigm shift in the field of radiotherapy. Superior tissue contrast of MRI offers better visualization of the abnormal lesions, as a result precise radiation dose delivery is possible. In case of online treatment planning, MRgRT offers better control of intratumoral motion and quick adaptation to changes in the gross tumor volume. Nonetheless, the MRgRT process flow does suffer from some challenges that limit its clinical usability. The primary aspects of MRgRT workflow are MRI acquisition, tumor delineation, dose map prediction and administering treatment. It is estimated that the acquisition of MRI takes around …

Going Flat: Challenging Gender, Stigma, And Cure Through Lesbian Breast Cancer Experience, Beth Gaines

USF Tampa Graduate Theses and Dissertations

This paper explores the decision-making process of reconstruction surgery among lesbian breast cancer patients to better understand how identity impacts healthcare decisions. Breast cancer patients experience the disease in unique ways due to gender, sexuality, race, and class, impacting their individual decisions regarding treatment plans. Many breast cancer patients face mastectomy surgery as the first plan of treatment after diagnosis. By exploring the impact of gender, sexuality, stigma, and ideas of cure, this research aims to advance research about breast cancer by recognizing why some lesbian breast cancer patients forego reconstruction surgery and instead choose to “go flat.

Determining The Role Of Dendritic Cells During Response To Treatment With Paclitaxel/Anti-Tim-3, Alycia Gardner

USF Tampa Graduate Theses and Dissertations

Intratumoral CD103+ dendritic cells (cDC1) are required for anti-tumor immune responses. In tumors that are poorly responsive to immunotherapeutic approaches targeting T cells, targeting cDC1 represents an alternative approach that may be useful in improving patient response rates. As such, it is critical to understand cDC1 function within tumors, and what may be preventing optimal function of cDC1. TIM-3 is a receptor that is highly expressed by cDC1 in murine and human mammary tumors, and TIM-3 blocking antibodies are currently being evaluated in clinical trials for a number of solid and hematological malignancies. In order to best design combinatorial therapeutic …

Evolution Of Targeted Therapy Resistance In Eml4-Alk Positive Non-Small Cell Lung Cancer, Robert Vander Velde

USF Tampa Graduate Theses and Dissertations

Targeted therapies have emerged as potent treatments that lead to the remission of many tumors. However, they rarely cure cancers in advanced, metastatic settings. This is due to the evolution of resistance, which in turn can be ascribed to the survival of small subpopulations of tolerant and/or resistant cells. Here we investigated the evolution of resistance to EML4-ALK inhibitors in non-small cell lung cancer (NSCLC) and demonstrated that resistance evolves gradually, from unique pre-treatment sub-populations, as multiple resistance mechanisms accumulate in a Darwinian fashion. Despite accumulating multiple changes, cells evolved, in parallel, toward similar inhibitor specific phenotypes. Evolving cells have …

The Relationship Of Hope To Goals And Psychological Outcomes In Patients With Advanced Lung Cancer: A Test Of Hope Theory, Kelly A. Hyland

USF Tampa Graduate Theses and Dissertations

Background. Hope is an important positive psychological construct that may help to explain how individuals cope in the context of life-threatening illness. Snyder’s hope theory states that humans are goal-oriented, and that goals link hope to psychological outcomes. The purpose of the current study was to investigate the relationship of hope to emotional well-being, meaning and purpose in life, and positive and negative affect in a sample of patients with advanced stage lung cancer. The study also sought to identify how hope relates to patients’ goals and to explore whether goal characteristics and progress in achieving goals mediated the relationship …

Bone Microenvironmental Control Of Skeletal Malignancy, Chen Hao Lo

USF Tampa Graduate Theses and Dissertations

Bone is a common site of metastasis for many solid malignancies. Bone-metastatic cancers pose a significant clinical problem worldwide and is among the main causes for cancer patient morbidity and mortality. Patients with advanced bone-metastatic diseases often present with either osteolytic or osteogenic bone diseases as their cancers progress. These bone pathologies are products of the cancer co-opting the local bone remodeling stroma to yield important growth nutrients and factors. Unfortunately, skeletal metastases remain incurable and are fatal. Identifying and understanding the causal multicellular and molecular interactions underlying skeletal malignancies can yield crucial ideas for targeting and inhibiting disease progression. …

The Impact Of Myeloid-Mediated Co-Stimulation And Immunosuppression On The Anti-Tumor Efficacy Of Adoptive T Cell Therapy, Pasquale Patrick Innamarato

USF Tampa Graduate Theses and Dissertations

Adoptive T cell therapy (ACT) in combination with lymphodepleting chemotherapy is an effective strategy to induce the eradication of tumors, providing long-term regression in cancer patients. However, only a minority of patients that receive ACT with tumor infiltrating lymphocytes (TILs) exhibit durable benefit. Thus, there is an urgent need to define strategies that potentiate anti-tumor activity conducted by adoptively transferred T cells. In these studies, we aimed to identify novel strategies to enhance the therapeutic efficacy of ACT. Accordingly, we describe the disparate roles of myeloid cells in the context of ACT characterized by the augmentation of TIL proliferation in …

Mechanistic And Translational Studies On Skeletal Malignancies, Jeremy Mcguire

USF Tampa Graduate Theses and Dissertations

New treatment strategies are desperately needed for treating skeletal malignancy. Skeletal malignancies can be either primary cancer that originated in the bone, such as osteosarcoma, or metastatic cancer that spread from another organ to the skeleton, as in the case of breast or prostate cancer. In this thesis, I will detail two projects that focus on the discovery of new treatment strategies for both primary skeletal malignancy and metastatic skeletal malignancy.

The first project focuses on the primary skeletal malignancy, osteosarcoma, a rare cancer that is commonly diagnosed in children and young adults and metastasizes to the lungs. The survival …

Diffuse Intrasinusoidal Hepatic Metastasis From Breast Cancer Presenting As Liver Failure: Effective And Rapid Treatment With Weekly Low-Dose Adriamycin, Thanh-Phuong N. Afiat, Timothy N. Hembree, Erin A. Dean, Cyrillo Araujo, Luis R. Pena, Marilin Rosa, Hyo S. Han, Kaitlin Hendrix, Asha Ramsakal

Oncologic Sciences Faculty Publications

Background: Hepatic metastasis is well known in breast cancer. Approximately 12–20% of breast cancer patients will develop liver metastasis, which usually presents as discrete mass lesions. Rarely, metastatic spread can be so diffuse that it is unidentifiable on imaging but can progress to fulminant hepatic failure. Our case report suggests that clinicians need to have a high index of suspicion when patients present with rapidly decompensating liver failure in the absence of discrete radiologic hepatic lesions, and that weekly Adriamycin should be considered as a first-line therapeutic option.

Case Report: A 28-year-old African American woman with a history of locally …

Observational Study Of Talimogene Laherparepvec Use In The Anti-Pd-1 Era For Melanoma In The Us (Cosmus-2), James Sun, Brian R. Gastman, Lucy Mccahon, Elizabeth I. Buchbinder, Igor Puzanov, Michele Nanni, James M. Lewis, Richard D. Carvajal, Shahnaz Singh-Kandah, Anupam M. Desai, Leon Raskin, Carrie M. Nielson, Rubina Ismail, Jonathan S. Zager

Oncologic Sciences Faculty Publications

Aim: Talimogene laherparepvec (T-VEC) is an intralesional therapy for unresectable, metastatic melanoma. T-VEC real-world use in the context of anti-PD1-based therapy requires further characterization.

Materials & methods: A retrospective review of T-VEC use from 1 January 2017 and 31 March 2018 for melanoma patients was conducted at seven US institutions.

Results: Among 83 patients, three categories of T-VEC and anti-PD-1 therapy were identified: T-VEC used without anti-PD-1 (n = 29, 35%), T-VEC after anti-PD-1-based therapy (n = 22, 27%) and concurrent T-VEC and anti-PD-1-based therapy (n = 32, 39%). 25% of patients discontinued T-VEC therapy due to no remaining injectable …

The Role Of Atypical Protein Kinase C In Colorectal Cancer Cells Carcinogenesis, S M Anisul Islam

USF Tampa Graduate Theses and Dissertations

Colorectal cancer (CRC) is the third most common malignancy and the fourth most common cause of cancer-related death worldwide. CRC is a life-threatening disease due to therapy-resistant cancerous cells. The exact mechanisms of cell growth, survival, metastasis and inter & intracellular signaling pathways involved in CRC are still a significant challenge. Moreover, the treatment of metastatic CRC considered palliative for many years aimed for an improved life, with little hope of a cure, highlighting the need for developing novel targeted therapy for CRC. Hence, investigating new molecular mechanism(s) that lead to colorectal carcinogenesis may give insight into the therapeutic target. …

Multimodal Treatment And Neoadjuvant Chemotherapy Trends, Utilization And Survival Effects In Intrahepatic Cholangiocarcinoma – A Propensity Score Analysis, Ovie Utuama

USF Tampa Graduate Theses and Dissertations

Intrahepatic Cholangiocarcinomas (ICC) are fatal malignancies common among the elderly. Patients are diagnosed late and often relapse, even after curative-intent surgery (CIS). In this context, additional systemic chemotherapy (multimodal treatment) is recommended for most patients but reported survival benefits are minimal and are limited to small single institutional studies. For this reason, using a national cancer registry, we sought to characterize multimodal treatment trends and utilization in general and neoadjuvant chemotherapy, specifically, as well as evaluate their survival effects among the larger population. We hypothesized that, 1). Elderly ICC patients would have survival benefits equivalent to younger patients, 2). Neoadjuvant …

Understanding The Influence Of The Cancer Microenvironment On Metabolism And Metastasis, Shonagh Russell

USF Tampa Graduate Theses and Dissertations

Cancer is a complex and heterogeneous disease. Not only is there considerable variability between different cancer types, but there is enormous variability between and within patients who have the same type of cancer. Within tumors, there are multiple cell types, including cancer cells, stromal cells, and immune cells. The tumor microenvironment often induces the healthy cells to become pro-tumorigenic. Cell metabolism is exquisitely sensitive to changes in the tumor microenvironment and can be measured to infer the aggressiveness of cancer and predict response to therapy. In this dissertation, we aim to understand how the microenvironment, specifically low pH, affects the …

Contribution Of Retrotransposons To Breast Cancer Malignancy, Isaac D. Raplee

USF Tampa Graduate Theses and Dissertations

The components contributing to cancer progression, especially the transition from early to invasive are unknown. Consequently, the biological reasons are unclear as to why some patients diagnosed with atypia and ductal carcinoma in situ (DCIS) never progress into invasive breast cancer. The “one gene at a time” approach does not sufficiently predict progression. To elucidate the early stage progression to invasive ductal cancer, expression signature of transcripts and transposable elements in micropunched samples of formalin-fixed, paraffin embedded (FFPE) tissue was conducted. A bioinformatics pipeline to analyze poor quality, short reads (>36 nts) from RNA-Seq data was created to compare …

Medical Decision Making Among Individuals With A Variant Of Uncertain Significance In A Hereditary Cancer Gene And Those With A Chek2 Pathogenic Variant, Deanna J. Almanza

USF Tampa Graduate Theses and Dissertations

Despite national guidelines, women with a BRCA VUS or CHEK2 pathogenic variant are choosing to have risk-reducing surgeries such as bilateral mastectomies which are not aligned with their level of cancer risk based on genetic test results alone. Semi-structured telephone interviews were conducted with 6 women with a BRCA VUS and 12 with a CHEK2 pathogenic variant exploring the factors influencing their decision-making process when considering medical management options. Patients from a cancer registry agreed to a recorded telephone interview. Coding was performed using the main constructs from the Ottawa Patient Decision Guide including: knowledge, uncertainty, values, and support. Iterative …

Comparing Family Sharing Behaviors In Brca Carriers With Palb2 Carriers, Joy E. Kechik

USF Tampa Graduate Theses and Dissertations

Identifying individuals with hereditary cancer predisposition can improve health outcomes for patients and their family members through early cancer detection and prevention strategies. Prior research about family sharing of genetic test results among those with hereditary breast cancer has overwhelmingly been limited to the BRCA1 and BRCA2 genes. The present study sought to compare family sharing behaviors in women with pathogenic BRCA variants to women with pathogenic variants in the more recently identified and characterized PALB2 gene. A total of 18 BRCA carriers and 13 PALB2 carriers were interviewed about family sharing practices using a semi-structured guide based on the …

Actinomycin D And Telmisartan Combination Therapy Targets Lung Cancer Stem Cells, Ryan Green

USF Tampa Graduate Theses and Dissertations

The failure of lung cancer treatments has been attributed partly to the development of drug resistance, however the underlying cellular and molecular mechanisms are poorly understood. It has been suggested that a very small group of specific cells within the heterogeneous tumors, cancer initiating stem cells (CSC), develop resistance to treatment, survive and later initiate the growth of new tumors. Due to their pivotal role in maintenance and relapse of tumors following the acquisition of drug resistance, we reasoned that novel drugs targeting cancer cells and CSC might provide the most effective treatments, if not a cure. To this end, …

Fatigue-Related Symptom Clusters And Their Relationship With Depression, And Functional Status In Older Adults Hospice Patients With Cancer., Suzan Fouad Abduljawad

USF Tampa Graduate Theses and Dissertations

The hospice care population with cancer are often older adults who report many cancer-related symptoms experienced often in clusters. Most prevalent of these symptoms is fatigue and often it co-occurs with depressive symptoms and poor physical functioning. This dissertation examined fatigue, symptom clusters, depression, physical activity, and functional status in older adults with cancer. The aims of the literature review were to understand the relationship among physical functioning, cancer fatigue, fatigue-related symptom clusters, and their relationship with functional status In older adults. The literature related to these associations is insufficient and inconclusive. The methods section aimed to investigate the reliability …

The Moderating Effect Of Religion On Death Distress And Quality Of Life Between Christian Cancer Patients In The United States With Muslim Cancer Patients In Saudi Arabia, Doaa Almostadi

USF Tampa Graduate Theses and Dissertations

Cancer is an illness that knows no international boundaries. There are more than eight million global cancer deaths each year. A life-threatening diagnosis generates significant emotional problems for many patients across cultures. Death distress—consisting of death depression, death anxiety and death obsession—often results in poorer treatment adherence and lower overall health and quality of life. The purpose of this study was to determine whether religiosity has a moderating effect on the relationship between death distress and quality of life among patients facing a life-threatening cancer diagnosis.

The study sample consisted of 118 cancer patients: 82 cancer patients from a National …

Personalizing Radiation Treatment Delivery In The Management Of Breast Cancer, Kamran A. Ahmed, G. Daniel Grass, Amber G. Orman, Casey Liveringhouse, Michael E. Montejo, Hatem H. Soliman, Heather S. Han, Brian J. Czerniecki, Javier F. Torres-Roca, Roberto Diaz

Oncologic Sciences Faculty Publications

Long-term data establishes the efficacy of radiotherapy in the adjuvant management of breast cancer. New dose and fractionation schemas have evolved and are available, each with unique risks and rewards. Current efforts are ongoing to tailor radiotherapy to the unique biology of breast cancer. In this review, we discuss our efforts to personalize radiotherapy dosing using genomic data and the implications for future clinical trials. We also explore immune mechanisms that may contribute to a tumor’s unique radiation sensitivity or resistance.

Sb Driver Analysis: A Sleeping Beauty Cancer Driver Analysis Framework For Identifying And Prioritizing Experimentally Actionable Oncogenes And Tumor Suppressors, Justin Y. Newberg, Michael A. Black, Nancy A. Jenkins, Neal G. Copeland, Karen M. Mann, Michael B. Mann

Oncologic Sciences Faculty Publications

Cancer driver prioritization for functional analysis of potential actionable therapeutic targets is a significant challenge. Meta-analyses of mutated genes across different human cancer types for driver prioritization has reaffirmed the role of major players in cancer, including KRAS, TP53 and EGFR, but has had limited success in prioritizing genes with non-recurrent mutations in specific cancer types. Sleeping Beauty (SB) insertional mutagenesis is a powerful experimental gene discovery framework to define driver genes in mouse models of human cancers. Meta-analyses of SB datasets across multiple tumor types is a potentially informative approach to prioritize drivers, and complements efforts …

Role Of Heat Shock Transcription Factor 1 In Ovarian Cancer Epithelial-Mesenchymal Transition And Drug Sensitivity, Chase David Powell

USF Tampa Graduate Theses and Dissertations

The heat shock response (HSR) is a robust cellular reaction to mitigate protein damage from heat and other challenges to the proteome. This protective molecular program in humans is controlled by heat shock transcription factor 1 (HSF1). Activation of HSF1 leads to the induction of an array of cytoprotective genes, many of which code for chaperones. These chaperones, known as heat shock proteins (HSPs), are responsible for maintaining the functional integrity of the proteome. HSPs achieve this by promoting proper folding and assembly of nascent proteins, refolding denatured proteins, and processing for degradation proteins and aggregates which cannot be returned …

The Relationship Between Total Neuropathy Score-Reduced, Neuropathy Symptoms And Function., Ashraf Abulhaija

USF Tampa Graduate Theses and Dissertations

Chemotherapy Induced Peripheral Neuropathy (CIPN) is a common problem among cancer patients who receive a wide range of chemotherapy. This problem causes a decline in quality of life and increased disabilities. CIPN assessment instruments are either subjective, objective, or a combination of both. So far, there is no agreement on the best way for assessment. The goal of this study was to explore the relationships among subjective and objective CIPN assessment instruments. Specifically, this study aimed to 1) evaluate the relationship between the Total Neuropathy Score-reduced (mainly objective) and patients’ function, as measured by the interference scale of the Chemotherapy-Induced …