Medicine and Health Sciences Commons^™

Internal Lead Shielding For Clinical Electron Treatments, Patrick N. Mcdermott

Conference Presentation Abstracts

Purpose: Electron beams are often used to treat superficial lesions of the lip, cheek, nose and ear. Lead is frequently used to block distal structures. It is customary to place an internal bolus of low atomic number in between the tissue and the lead to reduce electron backscatter from the lead. Space for the lead and the internal bolus is quite limited. The current method, recommended by TG25, for estimating the thickness of the lead plus internal bolus is not self-consistent and leads to a larger than necessary thickness. Furthermore, this method uses an older expression for the electron backscatter …

A Novel Planning Framework For The Efficient Spot-Scanning Proton Arc Therapy Via The Particle Swarm Optimization (Sparc-Particle Swarm), Y Qian, R Dao, G Liu, Xiaoqiang Li, H Quan, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: The delivery efficiency is the bottleneck of spot-scanning proton arc therapy (SPArc) because of the numerous energy layers (EL) ascending switches. This study aims to develop a new algorithm to mitigate the need of EL ascending via water equivalent thickness (WET) sector selection followed by the particle swarm optimization (SPArc- particle swarm). Methods: SPArc- particle swarm divided the full arc trajectory into the optimal sectors based on the K-means clustering analysis of the relative mean WET. Within the sector, particle swarm optimization was used to minimize the total energy switch time, in which it optimized the energy selection integrated …

Individual Vmat Beam Complexity Indices Have Limited Predictive Value For Qa Pass-Rates, Jian Liang, Q Liu, David T. To, Michael G. Snyder

Conference Presentation Abstracts

Purpose: Previous studies with sample sizes <400 have indicated that VMAT beam complexity indices may have a relationship with measured QA pass-rates. The aim of this study is to evaluate such relationships on a large scale to further investigate their strength. Methods: Total of 17,273 VMAT QA results across 8 Elekta Agility machines were used in this study. All beams were flattened 6MV or 10MV. Sun Nuclear ArcCheck was used for QA measurements with γ-analysis parameters of 10% threshold, 3% dose difference, 2mm distance to agreement, and 95% passing threshold. A total 214 Beams (1.23%) failed QA. QA distributions in Pinnacle were calculated with 2 degree gantry intervals and a dose grid of 2mm. Four complexity indices (MCSv, MU weighted Segment Area, Segment Area/Perimeter, and Average Leaf Gap) were computed. Spearman’s correlations were evaluated for each, and cut-off values for the indices were sought to indicate values above which no QA failures would be expected. Results: Evaluation of the 4 complexity metrics showed weak correlation with QA pass rates (< ±0.42) with high significance (p < 0.001). When metrics were evaluated independently, cut-off values from correlation plots separated only 0.67%, 0.72%, 2.2%, 6.3% guaranteed passing beams from the total sample, respectively. When evaluating whether anymetric for a given beam exceeded its cut-off, the fraction of guaranteed passing beams rose to only 6.6%. However, when cut-off values for one metric were allowed to be functionally dependent upon another, the fraction of guaranteed passing beams increased. For MU weighted Segment Area andAverage Leaf Gap, a dependent approach separated 19.1% guaranteed passing beams from the sample. Conclusion: Individual complexity metrics have weak predictive utility in assessing plan performance. However, using multiple complexity cut-off functions with dependence upon more than one metric increased the fraction of predicted passing beams by around 300%.

Predicting Tumor Voxel Dose-Response Using Deep Learning On Serial Fdg-Pet Feedback Images, Shupeng Chen, Di Yan, An Qin, Rohan Deraniyagala, Daniel Krauss, Peter Chen, Craig Stevens

Conference Presentation Abstracts

Purpose: Tumor voxel dose-response matrix (DRM) can be assessed using a series of FDG-PET/CT feedback images acquired during radiotherapy. Predicting the tumor voxel DRM earlier is crucial for treatment adaptation. However, it is also challenging due to FDG fluctuation in tumor cells. This study investigated the feasibility of predicting DRM during early treatment weeks using deep learning (DL). Methods: FDG-PET images were acquired at the pretreatment (preTx), the 2nd and 4th weeks during chemo-radiotherapy (35×2Gy) from 50 head and neck patients. The reference value of tumor voxel DRM (DRMref), representing the average metabolic change ratio during the treatment, was determined …

Elevated Inos And 3′-Nitrotyrosine In Kaposi's Sarcoma Tumors And Mouse Model, Olga Vladimirova, Samantha Soldan, Chenhe Su, Andrew Kossenkov, Owen Ngalamika, For Yue Tso, John T. West, Charles Wood, Paul M. Lieberman

School of Medicine Faculty Publications

Kaposi's Sarcoma (KS) is a heterogenous, multifocal vascular malignancy caused by the human herpesvirus 8 (HHV8), also known as Kaposi's Sarcoma-Associated Herpesvirus (KSHV). Here, we show that KS lesions express iNOS/NOS2 broadly throughout KS lesions, with enrichment in LANA positive spindle cells. The iNOS byproduct 3-nitrotyrosine is also enriched in LANA positive tumor cells and colocalizes with a fraction of LANA-nuclear bodies. We show that iNOS is highly expressed in the L1T3/mSLK tumor model of KS. iNOS expression correlated with KSHV lytic cycle gene expression, which was elevated in late-stage tumors (>4 weeks) but to a lesser degree in …

Impact Of An Expanded Definition Of Family History On Outcomes Of Active Surveillance For Prostate Cancer, Adam C. Schneider, Thenappan Chandrasekar, Nicholas Bowler, Ryan Fogg, Joon Yau Leong, Andrew Gusev, Linda H. Rodgers, Shelley R. Mccormick, Douglas M. Dahl, Jason A. Efstathiou, Michael L. Blute, Anthony L. Zietman, Chin-Lee Wu, Matthew R. Smith, Eliezer M. Van Allen, Adam S. Feldman, Keyan Salari

Department of Urology Faculty Papers

PURPOSE: Despite family history being an established risk factor for prostate cancer, the role of a broader definition of family history inclusive of not just prostate cancer but other genetically related malignancies has not been investigated in the active surveillance population. Here, we evaluate the impact of an expanded definition of family history on active surveillance outcomes.

MATERIALS AND METHODS: Patients undergoing active surveillance for prostate cancer at Massachusetts General Hospital from 1997-2019 with detailed data available on family cancer history were identified. Primary outcome was biopsy progression-free survival, and secondary outcomes were treatment-free survival, adverse pathological features at prostatectomy, …

Develop A Novel Beam Orientation Optimization Algorithm For Let (Linear Energy Transfer) Incorporated Impt (Intensity Modulated Proton Therapy) (Imptlet, R Dao, Y Qian, Xiaoqiang Li, H Quan, Xuanfeng Ding, G Liu

Conference Presentation Abstracts

Purpose: To improve the dose and LET distribution in the IMPTLET, we introduce a new optimization algorithm to search for the optimal beam orientation and count through the arc trajectory (BOC-IMPTLET). Methods: We introduce kmeans clustering analysis in the BOC-IMPTLET algorithm by analyzing the distribution of LET in the target from the full arc trajectory. The optimal of cluster count was used as beam count, which was determined based on the SSE (Sum of Square Error) value and the angle of the corresponding centroid of each cluster was used as beam orientation, respectively. The BOC-IMPTLET algorithm was implemented in the …

Comparison Of Vmat Beam Complexity With Different Mlc Collimator Rotation And Their Impact On Psqa Pass Rates, David T. To, Michael G. Snyder, Jian Liang

Conference Presentation Abstracts

Purpose: I t has been previously shown that utilizing a collimator angle of ±45° has demonstrated a reduction in MU and VMAT beam complexity. Studies have demonstrated this for VMAT prostate plans with small sample size. In this study we evaluate multiple collimator angles with a larger sample size and different treatment sites. Methods: A total of 17273 VMAT beams were evaluated with beam collimator rotations of 0°, ±5°, ±10°, ±15°, ±30°, ±45°, and ±90°. QA Gamma pass rates for our institution use a 3%/2mm criteria 10% threshold with 95% limit pass rate utilizing Sun Nuclear ArcCheck (helical diode array). …

Measurable Residual Disease And Fusion Partner Independently Predict Survival And Relapse Risk In Childhood Kmt2a-Rearranged Acute Myeloid Leukemia: A Study By The International Berlin-Frankfurt-Münster Study Group, Romy E. Van Weelderen, Kim Klein, Christine J. Harrison, Yilin Jiang, Jonas Abrahamsson, Nira Arad-Cohen, Emmanuelle Bart-Delabesse, Barbara Buldini, Barbara De Moerloose, Michael N. Dworzak, Sarah Elitzur, José M. Fernández Navarro, Robert B. Gerbing, Bianca F. Goemans, Hester A. De Groot-Kruseman, Erin M. Guest, Shau-Yin Ha, Henrik Hasle, Charikleia Kelaidi, Hélène Lapillonne, Guy Leverger, Franco Locatelli, Riccardo Masetti, Takako Miyamura, Ulrika Norén-Nyström, Sophia Polychronopoulou, Mareike Rasche, Jeffrey E. Rubnitz, Jan Stary, Anne Tierens, Daisuke Tomizawa, C Michel Zwaan, Gertjan J L Kaspers

Manuscripts, Articles, Book Chapters and Other Papers

Purpose: A previous study by the International Berlin-Frankfurt-Münster Study Group (I-BFM-SG) on childhood KMT2A-rearranged (KMT2A-r) AML demonstrated the prognostic value of the fusion partner. This I-BFM-SG study investigated the value of flow cytometry-based measurable residual disease (flow-MRD) and evaluated the benefit of allogeneic stem-cell transplantation (allo-SCT) in first complete remission (CR1) in this disease.

Methods: A total of 1,130 children with KMT2A-r AML, diagnosed between January 2005 and December 2016, were assigned to high-risk (n = 402; 35.6%) or non-high-risk (n = 728; 64.4%) fusion partner-based groups. Flow-MRD levels at both end of induction 1 (EOI1) …

A Comprehensive Investigation Of Linear Energy Transfer Optimization Effectiveness In Intensity-Modulated Proton Therapy Via Alternating Direction Method Of Multipliers (Impt Let-Admm), Q Fan, G Liu, Lili Zhao, Xiaoqiang Li, Xuanfeng Ding, S Dai

Conference Presentation Abstracts

Linear energy transfer (LET)-guided optimization in intensity-modulated proton therapy (IMPT) via alternating direction method of multipliers (ADMM) has the potential to improve its biological effectiveness (IMPTLET- ADMM), in which the LET distribution in target can be escalated, while the LET distribution in the organs at risk can be mitigated. This study aims to quantitatively investigate the effectiveness of LET optimization in IMPT via ADMM with different solvers in its iteration loop. Methods: The clinical dose-volume-histogram (DVH) constraint noted dose sub-problem and clinical LET -volume-histogram (LVH) constraint noted LET sub-problem are combined to generate a composite objective function, which is available …

An Analytic Model Of The External Beam Dose Rate Effect On Immune Cells In Blood Dosimetry, Lili Zhao, Peilin Liu, G Liu, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: Radiation therapy is a double-edged sword with regard to its immunomodulatory effect. It is critical to find how it is affected by dose rate. Thus, we developed an analytic model for calculating the number of immune cells receiving radiation. Methods: Suppose the blood is received radiation by constant dose rate. The blood is one-way flow without circulation in the radiation delivery at a constant velocity. Two kinds of lung treatment regimens were considered standard delivery 2Gy per fx total 30fx and hypo-fractionation SBRT 12 Gy per fx total 5 fx. Two different dose rates were simulated for standard treatment: …

Particle Arc Single-Isocenter Stereotactic Radiosurgery Of Multiple Brain Metastases, L Volz, S Mein, T Tessonnier, Peilin Liu, A Mairani, M Durante, Xuanfeng Ding, C Graeff, T Li

Conference Presentation Abstracts

Purpose: To develop spot-scanning proton (SPArc) and heavy ion (SHArc) arc therapy for single-isocenter stereotatic radiosurgery (SISRS) of multiple brain metastases (MBMs). First results achieved with dedicated planning infrastructure are compared to state-of-the -art volumetric modulated photon arc therapy (HA-VMAT). Methods: A multi-institutional collaboration was established to develop bespoke SPArc and SHArc SISRS infrastructure with available research and commercial treatment planning systems. Devised planning and delivery methods considered dedicated energy, spot, and multi-arc selection strategies. SPArc and SHArc (carbon and helium ions) plans were generated for MBM patients exhibiting 3-12 intracranial lesions with GTV volumes between 0.03ccm and 19.8ccm, at …

Investigate The Delivery Efficiency Improvement For Sparc Compared To Impt, Peilin Liu, B A. De Jong, S Chang, Lili Zhao, G Liu, Craig Stevens, Rohan Deraniyagala, E W. Korevaar, J A. Langendijk, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: To assess the efficiency improvement of SPArc compared to IMPT in proton clinical operation.Methods: A random clinical operation day at a proton therapy center with a two room system. Aa total of 10 Head & Neck cancer cases treated on Jan 6th, 2021were selected and SPArc plans were generated for all the cases with similar target coverage and dose constraints of organ at risk (OARs). 3% range uncertainties and 3mm setup uncertainties were applied for robust optimization. The log files of clinical IMPT were exported to calculate true treatment delivery time. The machine-specific delivery sequence model was utilized to …

Does Proton Arc Therapy Has Potential Clinical Benefits For Hepatocellular Carcinoma?, Peilin Liu, R Dalfsen, M Soukup, Shupeng Chen, Lili Zhao, Z Wang, X S. Gao, Thomas Quinn, Craig Stevens, Rohan Deraniyagala, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: To investigate the potential clinical benefits and dose-averaged Linear Energy Transfer (LETd) sparing, utilizing proton arc plan for Hepatocellular carcinoma (HCC) patients in comparison with Intensity Modulated Proton Therapy (IMPT). Methods: Ten HCC patients have been retrospectively selected. Two planning groups were created: Proton Arc plans using Monaco ver. 6 and the clinical IMPT plan. Both planning groups used the same robustness parameters. The prescription dose is 67.5 Gy (RBE) in 15 fractions/ 66 GyE in 10 fractions of the Clinical Target Volume (CTV) following clinical IMPT plan. Robustness evaluations were performed to ensure target dose coverage. Normal Tissue …

Moderators Of Resistance-Based Exercise Programs' Effect On Sarcopenia-Related Measures In Men With Prostate Cancer Previously Or Currently Undergoing Androgen Deprivation Therapy: An Individual Patient Data Meta-Analysis, Pedro Lopez, Robert U. Newton, Dennis R. Taaffe, Kerri Winters-Stone, Daniel A. Galvão, Laurien M. Buffart

Research outputs 2022 to 2026

Introduction: Older men with prostate cancer are commonly affected by reductions in lean mass and physical function following androgen deprivation therapy (ADT). Resistance-based exercise programs are critical to counteract the musculoskeletal toxicities derived from prostate cancer treatment and aging. However, there is significant variability in the effects of exercise interventions. Examining demographic and clinical moderators of exercise effects in this patient group can assist in identifying which subgroups of patients benefit most. Therefore, we examined the effects and moderators of resistance-based exercise programs on sarcopenia-related outcomes that included lean mass, skeletal muscle index, physical function, and muscle strength in older …

Recalcitrant Cutaneous Mastocytosis Treated With Genetically Informed Targeted Therapy: A Case Report, Laura Gleason, Volkan Tekmen, Alexa Cohen, Safiyyah Bhatti, Burcu Beksac, Jisun Cha, Pierluigi Porcu, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

Introduction:

Mastocytosis, a clonal proliferation of mast cells commonly involving the skin and bone marrow, has a varied clinical presentation ranging from cutaneous lesions to systemic disease. Cutaneous mastocytosis is managed symptomatically, but systemic mastocytosis is treated with targeted therapy against the mutated receptor tyrosine kinase c-KIT, the pathogenic driver of mastocytosis. However, there are no guidelines for the treatment of cutaneous mastocytosis refractory to symptomatic management.

We herein report a method to select genetically informed therapy for symptomatic and recalcitrant cutaneous mastocytosis.

Case presentation:

We performed a mutational analysis of dermal mast cells after enrichment by laser capture in …

Selective Immune Suppression Using Interleukin-6 Receptor Inhibitors For Management Of Immune-Related Adverse Events, Faisal Fa'ak, Maryam Buni, Adewunmi Falohun, Huifang Lu, Juhee Song, Daniel H Johnson, Chrystia M Zobniw, Van A Trinh, Muhammad Osama Awiwi, Nourel Hoda Tahon, Khaled M Elsayes, Kaysia Ludford, Emma J Montazari, Julia Chernis, Maya Dimitrova, Sabina Sandigursky, Jeffrey A Sparks, Osama Abu-Shawer, Osama Rahma, Uma Thanarajasingam, Ashley M Zeman, Rafee Talukder, Namrata Singh, Sarah H Chung, Petros Grivas, May Daher, Ala Abudayyeh, Iman Osman, Jeffrey Weber, Jean H Tayar, Maria E Suarez-Almazor, Noha Abdel-Wahab, Adi Diab

Journal Articles

BACKGROUND: Management of immune-related adverse events (irAEs) is important as they cause treatment interruption or discontinuation, more often seen with combination immune checkpoint inhibitor (ICI) therapy. Here, we retrospectively evaluated the safety and effectiveness of anti-interleukin-6 receptor (anti-IL-6R) as therapy for irAEs.

METHODS: We performed a retrospective multicenter study evaluating patients diagnosed with de novo irAEs or flare of pre-existing autoimmune disease following ICI and were treated with anti-IL-6R. Our objectives were to assess the improvement of irAEs as well as the overall tumor response rate (ORR) before and after anti-IL-6R treatment.

RESULTS: We identified a total of 92 patients …

Improving Surgeon-Patient Communication In Thyroid Cancer Diagnosis And Treatment Discussions: A Narrative Review, Lauren Schlegel, Roberta S. Perry, Elizabeth Cottrill

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Background and Objective: Patient experience is greatly influenced by physician-patient communication. Yet, unmet communication needs continue to be well documented in patients with thyroid cancer. This review discusses factors that may impact this communication and presents communication interventions that are currently being used with thyroid cancer patients.

Methods: A narrative review of articles on the physician-patient relationship and communication in thyroid cancer published between 1985 and 2022 was conducted through PubMed and Google. An additional review of the articles referenced in the bibliography of the included articles was performed.

Key Content and Findings: This review discusses communication components impacting the …

A Clinical Practice Review Of Percutaneous Ethanol Injection For Thyroid Nodules: State Of The Art For Benign, Cystic Lesions, Robert D.E. Clark, Xinyi Luo, Peter P. Issa, Ralph P. Tufano, Emad Kandil

School of Medicine Faculty Publications

Percutaneous ethanol injection (PEI) is a widely used treatment option for cystic and predominantly cystic thyroid nodules. It has several advantages over other treatment modalities. Compared to surgery, PEI is less painful, can be performed in the outpatient setting, and carries less risk of transient or permanent side effects. Compared to other minimally invasive techniques such as radiofrequency ablation (RFA), PEI is less expensive and does not require specialized equipment. PEI performs well in the context of cystic nodules. PEI does not perform as well as other techniques in solid nodules, so its use as a primary treatment is limited …

The Role Of Bispecific Antibodies In Relapsed Refractory Multiple Myeloma: A Systematic Review, Razwana Khanam, Omer S. Ashruf, Syed Hamza Bin Waqar, Zunairah Shah, Saba Batool, Rameesha Mehreen, Pranali Pachika, Zinath Roksana, Mohammad Ebad Ur Rehman, Faiz Anwer

Abington Jefferson Health Papers

Multiple myeloma is a heterogeneous clonal malignant plasma cell disorder, which remains incurable despite the therapeutic armamentarium's evolution. Bispecific antibodies (BsAbs) can bind simultaneously to the CD3 T-cell receptor and tumor antigen of myeloma cells, causing cell lysis. This systematic review of phase I/II/III clinical trials aimed to analyze the efficacy and safety of BsAbs in relapsed refractory multiple myeloma (RRMM). A thorough literature search was performed using PubMed, Cochrane Library, EMBASE, and major conference abstracts. A total of 18 phase I/II/III studies, including 1283 patients, met the inclusion criteria. Among the B-cell maturation antigen (BCMA)-targeting agents across 13 studies, …

Association Of Smoking And Respiratory Disease History With Pancreatic Pathologies Requiring Surgical Resection, Carolyn Ream, Matthew Sabitsky, Rachel Huang, Emma Hammelef, Theresa P. Yeo, Harish Lavu, Charles J. Yeo, Wilbur Bowne, Avinoam Nevler

Student Papers, Posters & Projects

Background: The purpose of this study was to examine the relationship between various respiratory conditions, including hypercapnic respiratory disease, and a multitude of resected pancreatic lesions. Methods: This retrospective case-control study queried a prospectively maintained database of patients who underwent pancreaticoduodenectomy between January 2015 and October 2021. Patient data, including smoking history, medical history, and pathology reports, were recorded. Patients with no smoking history and no concomitant respiratory conditions were designated as the control group. Results: A total of 723 patients with complete clinical and pathological data were identified. Male current smokers showed increased rates of PDAC (OR 2.33, 95% …

Is There Really A Difference In Outcomes Between Men And Women With Hepatocellular Cancer?, Andrea Fa, Denise M. Danos, Lauren Maniscalco, Yong Yi, Xiao Cheng Wu, Mary A. Maluccio, Quyen D. Chu, John M. Lyons

School of Public Health Faculty Publications

Hepatocellular carcinoma (HCC) is a male-dominated disease. Currently, gender differences remain incompletely defined. Data from the state tumor registry were used to investigate differences in demographics, comorbidities, treatment patterns, and cancer-specific survival (HSS) among HCC patients according to gender. Additional analyses were performed to evaluate racial differences among women with HCC. 2627 patients with HCC were included; 498 (19%) were women. Women were mostly white (58%) or African American (39%)—only 3.8% were of another or unknown race. Women were older (65.1 vs. 61.3 years), more obese (33.7% vs. 24.2%), and diagnosed at an earlier stage (31.7% vs. 28.4%) than men. …

Design, Synthesis, And Antiproliferative Activity Of Benzopyran-4-One-Isoxazole Hybrid Compounds, Shilpi Gupta, Shang Eun Park, Saghar Mozaffari, Bishoy El-Aarag, Keykavous Parang, Rakesh Kumar Tiwari

Pharmacy Faculty Articles and Research

The biological significance of benzopyran-4-ones as cytotoxic agents against multi-drug resistant cancer cell lines and isoxazoles as anti-inflammatory agents in cellular assays prompted us to design and synthesize their hybrid compounds and explore their antiproliferative activity against a panel of six cancer cell lines and two normal cell lines. Compounds 5a–d displayed significant antiproliferative activities against all the cancer cell lines tested, and IC₅₀ values were in the range of 5.2–22.2 μM against MDA-MB-231 cancer cells, while they were minimally cytotoxic to the HEK-293 and LLC-PK1 normal cell lines. The IC₅₀ values of 5a–d …

Immunometabolic Reprogramming, Another Cancer Hallmark, Vijay Kumar, John H. Stewart

School of Medicine Faculty Publications

Molecular carcinogenesis is a multistep process that involves acquired abnormalities in key biological processes. The complexity of cancer pathogenesis is best illustrated in the six hallmarks of the cancer: (1) the development of self-sufficient growth signals, (2) the emergence of clones that are resistant to apoptosis, (3) resistance to the antigrowth signals, (4) neo-angiogenesis, (5) the invasion of normal tissue or spread to the distant organs, and (6) limitless replicative potential. It also appears that non-resolving inflammation leads to the dysregulation of immune cell metabolism and subsequent cancer progression. The present article delineates immunometabolic reprogramming as a critical hallmark of …

Guaranteed Income And Financial Treatment Trial (Gift Trial Or Giftt): A 12-Month, Randomized Controlled Trial To Compare The Effectiveness Of Monthly Unconditional Cash Transfers To Treatment As Usual In Reducing Financial Toxicity In People With Cancer Who Have Low Incomes, Meredith Doherty, Jonathan Heintz, Amy Leader, David Wittenburg, Yonatan Ben-Shalom, Jessica Jacoby, Amy Castro, Stacia West

Department of Medical Oncology Faculty Papers

Cancer-related financial hardship (i.e., financial toxicity) has been associated with anxiety and depression, greater pain and symptom burden, treatment nonadherence, and mortality. Out-of-pocket healthcare costs and lost income are primary drivers of financial toxicity, however, income loss is a pronounced risk factor for cancer patients with low incomes. There has been little progress in developing an income intervention to alleviate financial toxicity cancer patients with low incomes. Unconditional cash transfers (UCT), or guaranteed income, have produced positive health effects in experiments with general low-income populations, but have not yet been evaluated in people with cancer. The Guaranteed Income and Financial …

Review Of Gynaecological Cancer Among Aboriginal And/Or Torres Strait Islander People In Australia, Aime Powell, Ami Morseu-Diop, Maya Morton Ninomiya, Uday Narayan Yadav, Emily Phillips, Devendra Raj Singh, Tamara Butler, Emma Allanson, Lisa J. Whop

Journal of the Australian Indigenous HealthInfoNet

Gynaecological cancers bear a significant burden on the health of Australians. Whilst Australia has made great strides in reducing the overall gynaecological cancer burden nationally, Aboriginal and/or Torres Strait Islander women continue to experience disproportionately high rates of gynaecological cancers.

This review focuses on the social, cultural, and historical contexts that contribute to inequitable gynaecological cancer rates among Aboriginal and/or Torres Strait Islander women. An in-depth discussion on cervical cancer, ovarian cancer, and uterine cancer are described; including the incidence, mortality, survival, and management of these diseases for Aboriginal and/or Torres Strait Islander women.

It highlights both the persistent barriers …

Fiducial Markers Allow Accurate And Reproducible Delivery Of Liver Stereotactic Body Radiation Therapy, Marina Moskalenko, Bernard L. Jones, Adam Mueller, Shirley Lewis, Jay C. Shiao, Sara J. Zakem, Tyler P. Robin, Karyn A. Goodman

Department of Radiation Oncology Faculty Papers

Fiducial markers are utilized for image guided radiotherapy (IGRT) alignment during the delivery of liver stereotactic body radiosurgery (SBRT). There are limited data demonstrating the impact of matching fiducials on the accuracy of liver SBRT. This study quantifies the benefit of fiducial-based alignment and improvements in inter-observer reliability. Nineteen patients with 24 liver lesions were treated with SBRT. Target localization was performed using fiducial markers on cone-beam computed tomography (CBCT). Each CBCT procedure was retrospectively realigned to match both the liver edge and fiducial markers. The shifts were recorded by seven independent observers. Inter-observer variability was analyzed by calculating the …

Cancer Stem Cell Assay-Guided Chemotherapy Improves Survival Of Patients With Recurrent Glioblastoma In A Randomized Trial, Tulika Ranjan, Soma Sengupta, Michael J. Glantz, Richard M. Green, Alexander Yu, Dawit Aregawi, Rekha Chaudhary, Ricky Chen, Mario Zuccarello, Christine Lu-Emerson, Hugh D. Moulding, Neil Belman, Jon Glass, Aaron Mammoser, Mark Anderson, Jagan Valluri, Nicholas Marko, Jason Schroeder, Steven Jubelirer, Frances Chow, Pier Paolo Claudio, Anthony M. Alberico, Seth T. Lirette, Krista L. Denning, Candace M. Howard

School of Medicine Faculty Publications

Therapy-resistant cancer stem cells (CSCs) contribute to the poor clinical outcomes of patients with recurrent glioblastoma (rGBM) who fail standard of care (SOC) therapy. ChemoID is a clinically validated assay for identifying CSC-targeted cytotoxic therapies in solid tumors. In a randomized clinical trial (NCT03632135), the ChemoID assay, a personalized approach for selecting the most effective treatment from FDA-approved chemotherapies, improves the survival of patients with rGBM (2016 WHO classification) over physician-chosen chemotherapy. In the ChemoID assay-guided group, median survival is 12.5 months (95% confidence interval [CI], 10.2–14.7) compared with 9 months (95% CI, 4.2–13.8) in the physician-choice group (p = …

Dynamic Role Of Exosome Micrornas In Cancer Cell Signaling And Their Emerging Role As Noninvasive Biomarkers, Jaya Aseervatham

Department of Neurology Faculty Papers

Exosomes are extracellular vesicles that originate from endosomes and are released by all cells irrespective of their origin or type. They play an important role in cell communication and can act in an autocrine, endocrine, or paracrine fashion. They are 40–150 nm in diameter and have a similar composition to the cell of origin. An exosome released by a particular cell is unique since it carries information about the state of the cell in pathological conditions such as cancer. miRNAs carried by cancer-derived exosomes play a multifaceted role by taking part in cell proliferation, invasion, metastasis, epithelial–mesenchymal transition, angiogenesis, apoptosis, …

Upper Urinary Tract Transitional Cell Carcinoma And Lymph Node Involvement: Pre And Post Operative Outcomes, Brittney Henderson, Son Young, Mark Quiring, Scott Serpico, Edward Wu, Emma Troyer, Ryan Moriarty, Thomas Mueller, Gordon Brown

Research Day

Background: Upper urinary tract transitional cell carcinomas (UUT-TCC) comprise any malignancy arising from the renal pelvis to distal ureter. These cancers account for approximately 5-10% of all urothelial tumors. Two-thirds of cases are invasive with an estimated 5-year survival rate less than 50%. Pathologic staging, invasion into local structures, and lymph node involvement influence the overall survival rate. Lymph node dissection (LND) is associated with higher overall survival rates in UUT-TCC patients, likely by decreasing regional lymph node metastasis. Current literature suggests that removing eight to ten regional lymph nodes may improve survival. The outcomes of upper urinary tract malignancies …