Medical Specialties Commons^™

Recent Advances In The Understanding And Management Of Primary Hyperparathyroidism., Melanie Goldfarb, Frederick R Singer

Articles, Abstracts, and Reports

Primary hyperparathyroidism is a hormonal disorder whose prevalence is approximately 1-2% in the United States of America. The disease has become more recognizable to clinicians in an earlier phase and, at present, patients can be diagnosed with "classic", "normocalcemic", "normohormonal", or "mild, asymptomatic" primary hyperparathyroidism. Surgery, with a focused parathyroidectomy when possible, or a four-gland exploration, is the only way to cure the disease. Cure is determined by use of intra-operative parathyroid hormone monitoring with long-term cure rates ranging from 90-95%. Newer adjuncts to surgery include CT or PET imaging and near-infrared immunofluorescence. This article highlights updates in parathyroid disease …

Robot-Assisted Laparoscopic Retroperitoneal Lymph Node Dissection: A Minimally Invasive Surgical Approach For Testicular Cancer., Harsha R Mittakanti, James R Porter

Articles, Abstracts, and Reports

Retroperitoneal lymph node dissection (RPLND) can been employed as primary treatment for stage I non-seminomatous germ cell tumor (NSGCT) as well as for treatment of post-chemotherapy masses. Open RPLND (O-RPLND) has long been the standard approach for lymphadenectomy, but is associated with significant morbidity. Laparoscopic RPLND (L-RPLND) was developed to mitigate the morbidity associated with O-RPLND, but is a technically challenging procedure requiring significant experience with laparoscopic dissection and suturing to remove lymph nodes behind the great vessels and to control vascular injury. Robotic RPLND (R-RPLND) has gained traction in recent years as an alternative to both O-RPLND and L-RPLND. …

Angiogenin Mrna Expression Levels In Prostate Cancer Tissue, Bowen Yao, Megumi Shigematsu, Phd, Kamlesh Ganesh Pawar, Phd, Venetia Pliatsika, Ms, Yohei Kirino, Phd

Phase 1

Introduction: Prostate cancer is the most commonly diagnosed cancer in men and second leading cause of cancer deaths. Studies have shown that tRNA fragments are upregulated in prostate cancers and play important roles in carcinogenesis. This project looks at how tRNA cleaving enzyme angiogenin expression is regulated in prostate cancer tissues.

Methods: Clinical data and mRNA expression levels of selected tRNA cleaving enzymes were extracted from the TCGA website. mRNAs were sequenced using IlluminaGA_RNASeqV2 at University of North Carolina.

Results: 546 samples from 494 patients, with normal tissue from 53 patients were collected. ANG mRNA levels were lower in patients …

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 …

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 …

Defining Current Gaps In Quality Measures For Cancer Immunotherapy: Consensus Report From The Society For Immunotherapy Of Cancer (Sitc) 2019 Quality Summit, Sara Pai, David Blaisdell, Rachel Brodie, Robert G. Carlson, Heidi Finnes, Michele Galioto, Roxanne E. Jensen, Tom Valuck, Antonia R. Sepulveda, Howard L. Kaufman

Population and Public Health Sciences Faculty Publications

Background Quality measures are important because they can help improve and standardize the delivery of cancer care among healthcare providers and across tumor types. In an environment characterized by a rapidly shifting immunotherapeutic landscape and lack of associated long-term outcome data, defining quality measures for cancer immunotherapy is a high priority yet fraught with many challenges. Methods Thus, the Society for Immunotherapy of Cancer convened a multistakeholder expert panel to, first, identify the current gaps in measures of quality cancer care delivery as it relates to immunotherapy and to, second, advance priority concepts surrounding quality measures that could be developed …

Effect Of Hemolysis On Fourier Transform Infrared And Raman Spectra Of Blood Plasma, Dinesh Medipally, Daniel Cullen, Valérie Untereiner, Jane Bryant, Ganesh D. Sockalingum, Thi Nguyet Que Nguyen, Emma Noone, Shirley Bradshaw, Marie Finn, Mary Dunne, Aoife M. Shannon, John Armstrong, Aidan Meade, Fiona Lyng

Articles

Hemolysis is a very common phenomenon and is referred as the release of intracellular components from red blood cells to the extracellular fluid. Hemolyzed samples are often rejected in clinics due to the interference of hemoglobin and intracellular components in laboratory measurements. Plasma and serum based vibrational spectroscopy studies are extensively applied to generate spectral biomarkers for various diseases. However, no studies have reported the effect of hemolysis in blood based vibrational spectroscopy studies. This study was undertaken to evaluate the effect of hemolysis on infrared and Raman spectra of blood plasma. In this study, prostate cancer plasma samples (n …

Spatially Fractionated Radiation Therapy: History, Present And The Future, Weisi Yan, Mohammad K. Khan, Xiaodong Wu, Charles B. Simone Ii, Jiajin Fan, Eric Gressen, Xin Zhang, Charles L. Limoli, Houda Bahig, Slavisa Tubin, Waleed F. Mourad

Department of Radiation Oncology Faculty Papers

No abstract provided.

Surgical Resection Of Convexity Meningiomas: A Single Center Retrospective Analysis, Haley Wendt, Michael Baldassari, Donald Ye, Kevin Judy

Phase 1

Introduction: Dural convexity meningiomas (CMs) are the most common primary intracranial tumors. Although surgical resection carries relatively low risk, it is necessary to quantify perioperative risks from a large patient cohort and identify factors contributing to short-term and long-term outcomes.

Methods: Patients who underwent craniotomy for resection of CMs between January 2012-December 2018 at a single large academic center were reviewed for pre-operative demographics, radiographic characteristics, and post-operative outcomes.

Results: 122 cases of CMs were identified. Common presenting symptoms included headache (39.3%), seizure (27.0%) and weakness/paralysis (18%). CMs were located over frontal, parietal, temporal, and occipital lobes in 57.4%, …

The Presence Of Gc-C In Extracellular Vesicles Secreted By Colorectal Cancer Cells, Alexandre Martinez, Adam E. Snook

Phase 1

Background: Guanylyl Cyclase C (GC-C) is a membrane-bound protein found on intestinal epithelial cells involved in the activation of CFTR. This protein has previously been involved in the development of colorectal cancer.

Extracellular vesicles (EVs) are bilayered vesicles of varying size (30 to 1,000 + nm in diameter) that believed to be secreted by all cells in the human body. In the past decade, EVs have garnered attention due to their impact in the field of oncology, where they have been shown to potentially serve as biomarkers for various cancers.

In this study, we looked at the EVs secreted …

Statistics Of Tumor Micro-Environment, Brenton Maisel, Inna Chervoneva

Phase 1

Introduction: Immune cells play a prominent role in keeping tumors suppressed, but how the distribution of these immune cells within a tumor’s microenvironment remains poorly understood. The long-term goal of this project is to study how statistical spatial distributions of different immune cells is associated with clinical outcome. The first objective is developing an algorithm for identifying different types of immune cells.

Methods: The data motivating this project includes spatial localization information (x-y coordinates) and expression levels of immune cell CD markers quantified by immunofluorescence immunohistochemistry (IF-IHC) in ~1,500 cases of invasive breast cancer. Using expression levels of CD markers …

Impact Of In-House Specialty Pharmacy On Access To Novel Androgen Axis Inhibitors In Men With Advanced Prostate Cancer, Anna Driscoll, Nathan Handley, Md, Mba, Adam Binder, Siobhan Henry, W. Kevin Kelly, Do

Phase 1

Introduction: Novel androgen axis inhibitors are standard of care treatments in advanced prostate cancer. The billed amounts for these medications are often very high, which may create significant financial toxicity for patients and lead to delays in treatment. Our institution implemented an in-house specialty pharmacy in 2014, that provides these medications and evaluates copay assistance options for all patients. We evaluated the program’s impact on out of pocket cost (OOP) and turnaround time (TAT).

Methods: We reviewed available internal specialty pharmacy records to identify prescriptions for abiraterone or enzalutamide filled between 1/1/17 and 12/31/18. Payments were stratified by primary payment …

Examining The Role Of Metabolic Pathways As Therapeutic Modalities For Triple Negative Breast Cancer, Jeremy Andrew Johnson

Theses and Dissertations--Toxicology and Cancer Biology

Triple negative breast cancer (TNBC) comprises 15-20% of breast cancers, affects a younger patient population than other subtypes, and is very aggressive. TNBC is comprised of a diverse group of tumors that have proven refractory to targeted therapy and can be difficult to treat. Patients generally receive neoadjuvant chemotherapy (NAC), surgery, and radiotherapy. The standard of care for NAC includes a taxane, an anthracycline, and/or cyclophosphamide, and administration of NAC has resulted in pathological complete response (pCR) in 30-40% of patients. However, a majority of TNBC patients will not reach pCR and instead have residual disease (RD), which is associated …

Individual And Joint Effects Of Metformin And Statins On Mortality Among Patients With High-Risk Prostate Cancer., Xiang-Lin Tan, Jian-Yu E, Yong Lin, Timothy R Rebbeck, Shou-En Lu, Mingyi Shang, William K Kelly, Anthony D'Amico, Mark N Stein, Lanjing Zhang, Thomas L Jang, Isaac Yi Kim, Kitaw Demissie, Anna Ferrari, Grace Lu-Yao

Department of Medical Oncology Faculty Papers

BACKGROUND: Pre-clinical studies suggest that metformin and statins may delay prostate cancer (PCa) metastases; however, data in humans are limited. To the best of our knowledge, this is the first human study aimed to quantify the individual and joint effects of statin and metformin use among patients with high-risk PCa.

METHODS: This population-based retrospective cohort study identified patients from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Exposure to metformin and statins was ascertained from Medicare Prescription Drug Event files. The association with all-cause and PCa mortality were evaluated using Cox proportional hazard model with competing causes of death, …

Incidence Of Female Breast Cancer In The United States By Race And Region, Tiffany Le

Scholarship in Medicine - All Papers

Objective: Assess the distribution and incidence of female breast cancer in the United States in different races and regions of the United States. Methods: Collect and analyze CDC WONDER data from the Center for Disease and Control to see if there are varying rates of female breast cancer incidence between races and in different regions of the United States. Results: The results are expected to show a significant difference in female breast cancer incidence between races and a non-significant difference in female breast cancer incidence among different regions of the United States.

Long-Term Survival Of Bladder Cancer Metastatic To Femoral Neck Treated With Chemotherapy, Radiation, And Arthroplasty: A Case Report, John Defant, Scott Huff, Joseph D. Henningsen, Anil Krishnamurthy

Scholarship in Medicine - All Papers

Case: A 64-year-old male suffered a pathologic left femoral neck fracture. Biopsy demonstrated metastatic urothelial cancer with a non-muscle invasive bladder cancer primary confirmed by cystoscopy. Patient underwent hemiarthroplasty, chemotherapy, radiation, and eventually, a conversion to total hip arthroplasty. Today, over a decade from initial surgery, the patient remains alive and highly functional. To our knowledge, this is the only report of bone metastatic bladder cancer with over 10-year survival. Conclusion: Bladder cancer metastatic to bone has a 5-year survival rate of 3%. Surgical resection of metastasis with reconstruction may confer a survival benefit in bony oligometastatic bladder cancer.

1. President's Office Records, 1941-1998, The University Of Texas Md Anderson Cancer Center

Director's Office Records: Ernst Bertner and R. Lee Clark Archives

The President's Office Records include materials generated and received by the President of the institution, and his staff, during his time in office. The early records also include the materials generated and received by the Director of the institution, and his staff, prior to the time the position of President existed. Additionally, there are records from the President Emeritus office included in the record group.

Rural Disparities In Lung Cancer Mortality: An Ecologic Study In Florida, Batel Amouyal

Honors Undergraduate Theses

Lung cancer is the leading cause of cancer death in the United States and worldwide. The higher mortality among patients with lung cancer is related to cases being diagnosed in late stage where treatment is limited. Urban and rural health outcomes are potentially influenced by differences in accessibility to health care services. We are unaware of existing research examining geographic differences in or factors related to lung cancer mortality in Florida. Therefore, this study aims to examine lung cancer mortality differences between urban and rural counties in Florida. We examined all 67 counties in Florida to investigate if a rural …

The Effect Of Interventions On Radiotherapy-Induced Skin Toxicity: A Systematic Review, Claudia R. Figueroa

Honors Undergraduate Theses

Various studies show a variety of interventions for radiotherapy-induced skin toxicity. Radiotherapy-induced skin toxicity is the most common side effect for women with breast cancer who undergo radiotherapy sessions. Intervention agents include topical creams, barrier films, oral agents, as well as laser therapy. However, despite the variety of intervention agents available, there is still a lack of accepted guidelines to manage radiotherapy-induced skin toxicity. This thesis aims to conduct a systematic review and meta-analysis of published randomized controlled trials with the primary purpose of exploring the available intervention methods to prevent radiotherapy-induced skin toxicity and evaluate the effects of different …

Residential Radon Exposure, Its Contribution To Lung Cancer, And Social Determinants Of Radon Testing, Stacy Stanifer

Theses and Dissertations--Nursing

Lung cancer is a highly preventable form of cancer. Cigarette smoking is the leading cause of lung cancer followed by radon gas exposure and exposure to secondhand smoke. Kentucky leads the nation in both incidence and mortality from lung cancer. Tobacco use in Kentucky continues to be a major public health concern as nearly one-quarter of adults report current tobacco use and just over one-third of Kentucky homes with children lack rules which prohibit smoking in the home. Radon, a colorless, odorless radioactive gas, occurs naturally from the decay of uranium found in rocks and soil and is harmful when …

Antiresorptive Bone Therapy Use In Advanced Lung Cancer And Associated Outcomes, Noor Naffakh

Theses and Dissertations--Pharmacy

Background/Rationale: Studies have shown antiresorptive agents decrease skeletal related events in metastatic non-small cell lung cancer. However, two prevalence studies have found low utilization rates of antiresorptive therapy in advanced lung cancer. The first study reported a rate of 14.8% during the 1995-2009 time period, while the second study reported a 33% usage rate during the time frame of 2002-2011. We believe these low utilization rates are associated with the poor prognosis of these patients. The prognosis of advanced lung cancer has improved significantly since these trials were conducted, and the utilization of denosumab has not been evaluated. We hypothesize …

Dynamic Conformal Arcs For Lung Stereotactic Body Radiation Therapy: A Comparison With Volumetric-Modulated Arc Therapy., Rasmus Bokrantz, Minna Wedenberg, Peter Sandwall

Oncology Articles

This study constitutes a feasibility assessment of dynamic conformal arc (DCA) therapy as an alternative to volumetric-modulated arc therapy (VMAT) for stereotactic body radiation therapy (SBRT) of lung cancer. The rationale for DCA is lower geometric complexity and hence reduced risk for interplay errors induced by respiratory motion. Forward planned DCA and inverse planned DCA based on segment-weight optimization were compared to VMAT for single arc treatments of five lung patients. Analysis of dose-volume histograms and clinical goal fulfillment revealed that DCA can generate satisfactory and near equivalent dosimetric quality to VMAT, except for complex tumor geometries. Segment-weight optimized DCA …

Gynecologic Large Cell Neuroendocrine Carcinoma: A Review, Grant Burkeen, Aman Chauhan, Rohitashva Agrawal, Riva Raiker, Jill M. Kolesar, Lowell B. Anthony, B. Mark Evers, Susanne Arnold

Internal Medicine Faculty Publications

Large cell neuroendocrine carcinomas (LCNEC) are rare, aggressive high-grade neuroendocrine neoplasms within the neuroendocrine cell lineage spectrum. This manuscript provides a detailed review of published literature on LCNEC of gynecological origin. We performed a PubMed search for material available on gynecologic LCNEC. We analyzed 104 unique cases of gynecologic LCNECs, of which 45 were cervical primary, 45 were ovarian, 13 were uterine, and 1 was vaginal. A total of 45 cases of cervical LCNEC were identified with a median age of 36 years. Median overall survival was 16 months. We identified 45 ovarian LCNEC cases in the published literature with …

The Write Stuff - Winter 2020 (Vol. 17, No. 1), Research Medical Library

Write Stuff 2020

• Best practices for sharing confidential materials outside MD Anderson
• 11th edition of the AMA Manual of Style to be published this month
• MD Anderson’s policies on disclosure of foreign relationships
• New NIH grant application instructions and forms coming in spring 2020
• Cabell’s Blacklist
• Unusual terms used in scientific writing and publishing: Hybrid journal and mirror journal

The Financial And Psychosocial Impact Of Medicinal Cannabis, Andrew Lee, Chris Ahmed, Amanda Campbell, Gregory Garber, Msw, Lcsw, Neil D. Palmisiano, Md, Brooke Worster, Md

Phase 1

Introduction: The use of medicinal cannabis for symptom management in cancer patients is a growing area of clinical interest. Past studies have demonstrated cannabis’s potential as an antiemetic and analgesic, but there is still much research to be done on its clinical efficacy. Our study hypothesizes that cancer patients using medicinal cannabis experience subjective improvements in pain, chemotherapy-induced nausea and vomiting (CINV), and quality of life (QOL) that justify related out-of-pocket costs.

Methods: Cancer patients are surveyed by phone three to six months after certification for access to medicinal cannabis. The survey assesses patient-reported changes in pain, CINV, QOL, and …

Exercise And Nutrition Induced Weight Loss For Prostate Cancer Patients, Rebekah Louise Wilson

Theses: Doctorates and Masters

This thesis encompasses six main chapters - two reviews and four experimental chapters, in addition to a general introduction and discussion.

Review 1 (Chapter 2) is a discussion of the negative impact of obesity on prostate cancer prognosis and common prostate cancer treatments.

Review 2 (Chapter 3) is an evaluation of the current literature examining prostate cancer patients receiving androgen deprivation therapy (ADT) and how exercise and nutrition interventions can be used to induce fat loss, while preserving or improving lean mass.

Study 1 (Chapter 4) is an examination of the efficacy of a weight loss program in altering body …

An Outcome Assessment Of A Single Institution's Longitudinal Experience With Uveal Melanoma Patients With Liver Metastasis., Rino S. Seedor, David J. Eschelman, Carin F. Gonsalves, Robert D. Adamo, Marlana Orloff, Anjum Amjad, Erin Sharpe-Mills, Inna Chervoneva, Carol L. Shields, Jerry A. Shields, Michael Mastrangelo, Takami Sato

Department of Medical Oncology Faculty Papers

There is no FDA-approved treatment for metastatic uveal melanoma (UM) and overall outcomes are generally poor for those who develop liver metastasis. We performed a retrospective single-institution chart review on consecutive series of UM patients with liver metastasis who were treated at Thomas Jefferson University Hospital between 1971–1993 (Cohort 1, n = 80), 1998–2007 (Cohort 2, n = 198), and 2008–2017 (Cohort 3, n = 452). In total, 70% of patients in Cohort 1 received only systemic therapies as their treatment modality for liver metastasis, while 98% of patients in Cohort 2 and Cohort 3 received liver-directed treatment either alone …

Prospective Molecular Profiling Of Circulating Tumor Cells From Patients With Melanoma Receiving Combinatorial Immunotherapy., Selena Y Lin, Shu-Ching Chang, Stella Lam, Romela Irene Ramos, Kevin Tran, Shuichi Ohe, Matthew P Salomon, Ali Asgar S Bhagat, Chwee Teck Lim, Trevan D Fischer, Leland J Foshag, Christine L Boley, Steven J O'Day, Dave Hoon

Articles, Abstracts, and Reports

BACKGROUND: Blood molecular profiling of circulating tumor cells (CTCs) can enable monitoring of patients with metastatic melanoma during checkpoint inhibitor immunotherapy (CII) and in combination with targeted therapies. We developed a microfluidics-based CTC platform to explore CTC profiling utility in CII-treated patients with melanoma using a melanoma messenger RNA (mRNA)/DNA biomarker panel.

METHODS: Blood samples (n = 213) were collected prospectively from 75 American Joint Committee on Cancer-staged III/IV melanoma patients during CII treatment and those enriched for CTCs. CTC profiling was performed using 5 known melanoma mRNA biomarkers and BRAF V600E DNA mutation. CTC biomarker status associations with clinical …

Knowledge Of Breast Cancer And Screening Methods Among Rural Women In Southwest Nigeria: A Mixed Method Analysis, Rowland Edet, Oluwayimika Ekundina, Obasanjo Afolabi Bolarinwa, Julianah Babajide, Juliet Amarachukwu Nwafor

Department of Sociology: Faculty Publications

The objective of this study was to assess the awareness of rural women on breast cancer and its screening methods in Southwest Nigeria. Descriptive cross-sectional survey design with the aid of a semi-structured questionnaire was used to generate data among 422 rural women in selected communities in Egbeda local government area of Ibadan. The qualitative data was generated through in-depth interviews among rural women and key informant interviews among health workers in the communities. The study revealed that only 63.7% were aware of breast cancer screening methods compared to 31.6% who were not aware of it. The commonly known screening …

The Incidence Of Chemotherapy Extravasation In The Inpatient And Ambulatory Infusion Areas Of A Community Cancer Center, Nancy Ehmke Mn, Rn, Aocn

Nursing Active Studies

Few studies have been conducted in non-National Cancer Institute (non-NCI) designated cancer centers and even less have included both the inpatient and outpatient settings. This study is being conducted in order to establish a benchmark for the incidence of chemotherapy extravasation in an inpatient oncology unit and outpatient infusion center at a non-NCI-designated community cancer center. This retrospective review is to determine the common chemotherapy agents involved in extravasation, patient factors contributing to the extravasation, and severity of extravasations.

PI: Nancy Ehmke MN, RN, AOCN

Contact: [email protected]