Medical Specialties Commons^™

The Oncology Care Model: Oncology's First Foray Away From Volume And Toward Value-Based Care., Andrew Song, Valerie P. Csik, Amy Leader, Vittorio Maio

Department of Radiation Oncology Faculty Papers

No abstract provided.

Demethylation By Low-Dose 5-Aza-2'-Deoxycytidine Impairs 3d Melanoma Invasion Partially Through Mir-199a-3p Expression Revealing The Role Of This Mir In Melanoma., Cécile Desjobert, Arnaud Carrier, Audrey Delmas, Diego M Marzese, Antoine Daunay, Florence Busato, Arnaud Pillon, Jörg Tost, Joëlle Riond, Gilles Favre, Chantal Etievant, Paola B Arimondo

Articles, Abstracts, and Reports

BACKGROUND: Efficient treatments against metastatic melanoma dissemination are still lacking. Here, we report that low-cytotoxic concentrations of 5-aza-2'-deoxycytidine, a DNA demethylating agent, prevent in vitro 3D invasiveness of metastatic melanoma cells and reduce lung metastasis formation in vivo.

RESULTS: We unravelled that this beneficial effect is in part due to MIR-199A2 re-expression by promoter demethylation. Alone, this miR showed an anti-invasive and anti-metastatic effect. Throughout integration of micro-RNA target prediction databases with transcriptomic analysis after 5-aza-2'-deoxycytidine treatments, we found that miR-199a-3p downregulates set of genes significantly involved in invasion/migration processes. In addition, analysis of data from melanoma patients showed a …

Excluding Ptv From Lung Volume May Better Predict Radiation Pneumonitis For Intensity Modulated Radiation Therapy In Lung Cancer Patients, Yinnan Meng, Haihua Yang, Wei Wang, Xingni Tang, Caiping Jiang, Yichao Shen, Wei Luo

Radiation Medicine Faculty Publications

Background: Lung dose-volume histogram (DVH) in radiotherapy could be calculated from multiple normal lung definitions. The lung dosimetric parameters generated from various approaches are significantly different. However, limited evidence shows which definition should be used to more accurately predict radiation pneumonitis (RP). We aimed to compare the RP prediction accuracy of dosimetric parameters from three lung volume methods in lung cancer patients treated with Intensity-Modulated Radiation Therapy (IMRT).

Methods: We retrospectively reviewed 183 consecutive lung cancer patients treated with IMRT from January 2014 to October 2017. The normal lungs were defined by total bilateral lung volume (Total Lung), excluding PTV …

Allogeneic Hematopoietic Cell Transplantation Provides Effective Salvage Despite Refractory Disease Or Failed Prior Autologous Transplant In Angioimmunoblastic T-Cell Lymphoma: A Cibmtr Analysis, Narendranath Epperla, Kwang W. Ahn, Carlos Litovich, Sairah Ahmed, Minoo Battiwalla, Jonathon B. Cohen, Parastoo Dahi, Nosha Farhadfar, Umar Farooq, Cesar O. Freytes, Nilanjan Ghosh, Bradley Haverkos, Alex Herrera, Mark Hertzberg, Gerhard C. Hildebrandt, David Inwards, Mohamed A. Kharfan-Dabaja, Farhad Khimani, Hillard Lazarus, Aleksandr Lazaryan, Lazaros Lekakis, Hemant Murthy, Sunita Nathan, Taiga Nishihori, Attaphol Pawarode, Tim Prestidge, Praveen Ramakrishnan, Andrew R. Rezvani, Rizwan Romee, Nirav N. Shah

Internal Medicine Faculty Publications

Background: There is a paucity of data on the role of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with angioimmunoblastic T-cell lymphoma (AITL). Using the CIBMTR registry, we report here the outcomes of AITL patients undergoing an allo-HCT.

Methods: We evaluated 249 adult AITL patients who received their first allo-HCT during 2000–2016.

Results: The median patient age was 56 years (range = 21–77). Majority of the patients were Caucasians (86%), with a male predominance (60%). Graft-versus-host disease (GVHD) prophylaxis was predominantly calcineurin inhibitor-based approaches while the most common graft source was peripheral blood (97%). Median follow-up of survivors was 49 …

Enhancing Cognitive Engagement Of Pre-Clinical Undergraduate Medical Students Via Video Cases And Interactive Quizzes In Problem-Based Learning, Syeda Sadia Fatima, Kulsoom Ghias, Kauser Jabeen, Saniya Sabzwari

Department of Biological & Biomedical Sciences

Background: Problem-based learning (PBL) is one of the main pedagogical approaches utilized in the undergraduate medical education (UGME) program at a private medical college in Karachi, Pakistan. Video-enhanced cases and formative assessments were introduced at the end of PBL sessions to evaluate their effectiveness in enhancing student engagement.
Methods: A mixed methods study was conducted with Year 2 medical students (n=102; divided into 11 groups) and faculty (n=11) facilitating the PBL process. Of the 10 PBL cases, five were converted to video-enhanced cases and five were kept as paper-based, “traditional” cases. “Micro” videos were used to introduce clinical scenarios, augmented …

Star-Related Lipid Transfer Protein 10 (Stard10): A Novel Key Player In Alcohol-Induced Breast Cancer Progression, Andrea Floris, Jia Luo, Jacqueline A. Frank, Jennifer Zhou, Sandro Orrù, Michela Biancolella, Sabina Pucci, Augusto Orlandi, Paolo Campagna, Antonella Balzano, Komal Ramani, Maria Lauda Tomasi

Pharmacology and Nutritional Sciences Faculty Publications

Background: Ethanol abuse promotes breast cancer development, metastasis and recurrence stimulating mammary tumorigenesis by mechanisms that remain unclear. Normally, 35% of breast cancer is Erb-B2 Receptor Tyrosine Kinase 2 (ERBB2)-positive that predisposes to poor prognosis and relapse, while ethanol drinking leads to invasion of their ERBB2 positive cells triggering the phosphorylation status of mitogen-activated protein kinase. StAR-related lipid transfer protein 10 (STARD10) is a lipid transporter of phosphatidylcholine (PC) and phosphatidylethanolamine (PE); changes on membrane composition of PC and PE occur before the morphological tumorigenic events. Interestingly, STARD10 has been described to be highly expressed in 35–40% of ERBB2-positive breast …

Incidental Renal Cell Carcinoma In Pelvic Malignancies, Fatima Shaukat, Muhammad Atif Mansha, Nasir Ali, Agha Muhammad Hammad Khan, Ahmed Nadeem Abbasi

Department of Radiation Oncology

Simultaneous diagnosis of renal cell carcinoma with pelvic malignancies is rare but a well-documented phenomenon. It is not uncommon to have incidental renal masses on imaging done for investigating other tumors. There are no established guidelines for the treatment of patients with dual malignancies. The management of such patients is challenging and requires a multidisciplinary approach. We present a series of three cases with a diagnosed pelvic malignancy but further workup revealed a kidney tumor. Both the malignancies were evaluated individually and diagnosed as two different primary neoplastic lesions. This case series examines each distinct patient's presentation, discusses the diagnosis, …

Assessing The Use Of Pre-Treatment Medications In The Management Of Infusion-Related Reactions In An Outpatient Infusion Center, Alyssa Boesche, Alyssa Augst, Bill Kuhlman

Pharmacy Posters

Introduction

• Infusion-related reactions (IRRs) are well-known adverse drug reactions of many biological agents and antineoplastic medications
• While typically mild-to-moderate in intensity, IRRs can be severe, with potentially life-threatening consequences requiring urgent interventions
• Appropriate use of pre-treatment medications, such as corticosteroids, antihistamines, intravenous fluids, and antiemetics reduces the incidence and severity of IRRs

Purpose

• Evaluate the use of pre-treatment medications in patients with experienced IRRs at an outpatient infusion center
• Identify opportunities to improve treatment plans and reduce the occurrence of IRRs

Overall Survival And Histology-Specific Subgroup Analyses From A Phase 3, Randomized Controlled Study Of Trabectedin Or Dacarbazine In Patients With Advanced Liposarcoma Or Leiomyosarcoma, S. Patel, M. Von Mehren, D. R. Reed, P. Kaiser, J. Charlson, C. W. Ryan, D. Rushing, M. Livingston, R. G. Maki, G. D. Demetri, +10 Additional Authors

Journal Articles

No abstract provided.

An Irak1-Pin1 Signalling Axis Drives Intrinsic Tumour Resistance To Radiation Therapy, P. H. Liu, R. B. Shah, Y. Li, A. Arora, P. M. Ung, R. Raman, A. Gorbatenko, S. Kozono, R. G. Maki, S. Sidi, +13 Additional Authors

Journal Articles

No abstract provided.

Complex Karyotype In De Novo Acute Myeloid Leukemia: Typical And Atypical Subtypes Differ Molecularly And Clinically, K. Mrózek, A. K. Eisfeld, J. Kohlschmidt, A. J. Carroll, C. J. Walker, D. Nicolet, J. S. Blachly, M. Bill, J. E. Kolitz, C. D. Bloomfield, +7 Additional Authors

Journal Articles

© 2019, Springer Nature Limited. Complex karyotype (CK) with ≥ 3 abnormalities is detected in 10–12% of patients with acute myeloid leukemia (AML) and associated with poor prognosis. The most common unbalanced abnormalities found in CK result in loss of material from the 5q, 7q, and/or 17p chromosome arms. The presence of 5q, 7q, and/or 17p abnormalities denotes typical CK and their absence denotes atypical CK. Since molecular features of CK-AML are not well characterized, we investigated mutational status of 81 leukemia/cancer-associated genes in 160 clinically well-characterized patients. They included 136 patients with ≥ 3 exclusively unbalanced chromosome abnormalities, 96 …

Eribulin Versus Dacarbazine In Patients With Leiomyosarcoma: Subgroup Analysis From A Phase 3, Open-Label, Randomised Study, J. Blay, P. Schoffski, S. Bauer, A. Krarup-Hansen, C. Benson, D. R. D'Adamo, Y. Jia, R. G. Maki

Journal Articles

No abstract provided.

An Atypical Presentation Of Lichen Planus-Like Reaction From Pembrolizumab., M. Lee, N. Seetharamu

Journal Articles

Introduction:With the advent of immunotherapy, a new subtype of side effects called IRAEs or immune related adverse effects have become more common. They may present in various organ systems as colitis, pneumonitis, hypophysitis, and thyroiditis and commonly as dermatological reactions. Case:This is a case report of a lung cancer patient that was started on Pembrolizumab and developed shortly after what appeared to be clinically at first pustular psoriasis but on biopsy was confirmed to be lichen planus. She was discontinued on the Pembrolizumab and treated with both systemic and topical steroids and improved. Conclusion:This case highlights a cutaneous reaction from …

Older-Patient-Specific Cancer Trials: A Pooled Analysis Of 2,277 Patients (A151715)., D. Dao, T. Zemla, A. Jatoi, R. A. Freedman, A. Hurria, H. Muss, H. J. Cohen, M. Citron, D. Budman, J. G. Le-Rademacher, +6 Additional Authors

Journal Articles

BACKGROUND: Less than 3% of older patients with cancer are enrolled in clinical trials. To reverse this underrepresentation, we compared older patients enrolled with older-patient-specific trials, defined as those designed for older patients with cancer, with those enrolled in age-unspecified trials.

MATERIALS AND METHODS: We focused on individual patient data from those ≥65 years (younger patients excluded) and included all Alliance phase III adjuvant breast cancer trials from 1985-2012.

RESULTS: Among 2,277 patients, 1,014 had been enrolled to older-patient-specific and 1,263 to age-unspecified trials. The median age (range) in the older-patient-specific trials was 72 (65-89) years compared with 68 (65-84) …

The Mitochondrial Deoxyguanosine Kinase Is Required For Cancer Cell Stemness In Lung Adenocarcinoma, Shengchen Lin, Chongbiao Huang, Jianwei Sun, Oana Bollt, Xiuchao Wang, Eric Martine, Jiaxin Kang, Matthew D. Taylor, Bin Fang, Pankaj K. Singh, John Koomen, Jihui Hao, Shengyu Yang

Journal Articles: Eppley Institute

The mitochondrial deoxynucleotide triphosphate (dNTP) is maintained by the mitochondrial deoxynucleoside salvage pathway and dedicated for the mtDNA homeostasis, and the mitochondrial deoxyguanosine kinase (DGUOK) is a rate-limiting enzyme in this pathway. Here, we investigated the role of the DGUOK in the self-renewal of lung cancer stem-like cells (CSC). Our data support that DGUOK overexpression strongly correlates with cancer progression and patient survival. The depletion of DGUOK robustly inhibited lung adenocarcinoma tumor growth, metastasis, and CSC self-renewal. Mechanistically, DGUOK is required for the biogenesis of respiratory complex I and mitochondrial OXPHOS, which in turn regulates CSC self-renewal through AMPK-YAP1 signaling. …

Potential Applications Of Capsaicinoids In Small Cell Lung Cancer Therapy, Jamie Rae Friedman

Theses, Dissertations and Capstones

Lung cancer continues to be the leading cause of cancer related mortality worldwide. Lung cancer is not a single disease but an umbrella that encompasses two major classifications, nonsmall cell lung cancer (NSCLC) and small cell lung cancer (SCLC). SCLC represents about 15- 20% of all lung cancer cases and is almost exclusively diagnosed in smokers. Typically, patients will respond very well to first line treatment, but face inevitable relapse. The fact that SCLC still carries a grim 5-year survival rate of less than 5% highlights the lack of advancement in treatment options to effectively improve patient response and survival. …

Investigational Monoclonal Antibodies In The Treatment Of Multiple Myeloma: A Systematic Review Of Agents Under Clinical Development, Ahmad Iftikhar, Hamza Hassan, Nimra Iftikhar, Adeela Mushtaq, Atif Sohail, Nathaniel Rosko, Rajshekhar Chakraborty, Faryal Razzaq, Sonia Sandeep, Jason Neil Valent, Abraham Sebastian Kanate, Faiz Anwer

Faculty & Staff Scholarship

Background: Immunotherapy for multiple myeloma (MM) has been the focus in recent years due to its myeloma-specific immune responses. We reviewed the literature on non-Food and Drug Administration (FDA) approved monoclonal antibodies (mAbs) to highlight future perspectives. We searched PubMed, EMBASE, Web of Science, Cochrane Library and ClinicalTrials.gov to include phase I/II clinical trials. Data from 39 studies (1906 patients) were included. Of all the agents, Isatuximab (Isa, anti-CD38) and F50067 (anti-CXCR4) were the only mAbs to produce encouraging results as monotherapy with overall response rates (ORRs) of 66.7% and 32% respectively. Isa showed activity when used in combination with …

Unforeseen Computed Tomography Resimulation For Initial Radiation Planning: Associated Factors And Clinical Impact, April Metzger, Paul Renz, Shaakir Hasan, Stephen Karlovits, Jason Sohn, Steven Gresswell

Faculty & Staff Scholarship

Purpose: Repeat computed tomography (CT) simulation is problematic because of additional expense of clinic resources, patient inconvenience, additional radiation exposure, and treatment delay. We investigated the factors and clinical impact of unplanned CT resimulations in our network. Methods and Materials: We used the billing records of 18,170 patients treated at 5 clinics. A total of 213 patients were resimulated before their first treatment. The disease site, location, use of 4- dimensional CT (4DCT), contrast, image fusion, and cause for resimulation were recorded. Odds ratios determined statistical significance. Results: Our total rate of resimulation was 1.2%. Anal/colorectal (P < .001) and head and neck (P < .001) disease sites had higher rates of resimulation. Brain (P Z .001) and lung/thorax (P Z .008) had lower rates of resimulation. The most common causes for resimulation were setup change (11.7%), change in patient anatomy (9.8%), and rectal filling (8.5%). The resimulation rate for 4DCTs was 3.03% compared with 1.0% for non-4DCTs (P < .001). Median time between simulations was 7 days. Conclusions: The most common sites for resimulation were anal/colorectal and head and neck, largely because of change in setup or changes in anatomy. The 4DCT technique correlated with higher resimulation rates. The resimulation rate was 1.2%, and median treatment delay was 7 days. Further studies are warranted to limit the rate of resimulation.

Excellent Response To Nivolumab And Ipilimumab In Metastatic Gastroesophageal Junction Squamous Carcinoma., N. Sadagopan, C. Devoe

Journal Articles

Unresectable gastroesophageal junction (GEJ) cancers have a poor prognosis and limited treatment options. We report the case of a patient with a Siewert class III gastroesophageal junction squamous carcinoma with metastatic spread into the liver who had an exceptional response to a combination therapy of nivolumab and ipilimumab despite being programmed death-ligand 1 (PD-L1) negative, microsatellite stable (MSS), and having a low tumor mutational burden. He initially experienced disease progression on the chemotherapy regimens modified DCF and FOLFIRI resulting in limited functional status, esophageal stent placement, and feeding tube placement. After about 6 months on nivolumab and ipilimumab, he had …

Phase Ii Randomised Discontinuation Trial Of Brivanib In Patients With Advanced Solid Tumours, R. L. Jones, M. J. Ratain, P. J. O'Dwyer, L. L. Siu, J. Jassem, J. Medioni, M. Dejonge, C. Rudin, R. Maki, G. Schwartz, +20 Additional Authors

Journal Articles

© 2019 The Author(s) Background: Brivanib is a selective inhibitor of vascular endothelial growth factor and fibroblast growth factor (FGF) signalling. We performed a phase II randomised discontinuation trial of brivanib in 7 tumour types (soft-tissue sarcomas [STS], ovarian cancer, breast cancer, pancreatic cancer, non-small-cell lung cancer [NSCLC], gastric/esophageal cancer and transitional cell carcinoma [TCC]). Patients and methods: During a 12-week open-label lead-in period, patients received brivanib 800 mg daily and were evaluated for FGF2 status by immunohistochemistry. Patients with stable disease at week 12 were randomised to brivanib or placebo. A study steering committee evaluated week 12 response to …

Radiation Recall Pneumonitis In The Setting Of Immunotherapy And Radiation: A Focused Review, K. Mcgovern, M. Ghaly, M. Esposito, K. Barnaby, N. Seetharamu

Journal Articles

© 2019 Nagashree Seetharamu. Radiation recall pneumonitis (RRP) is an entity described as pneumonitis localized to a previously irradiated field after exposure to a systemic agent. It has previously been described in the literature in the context of chemotherapeutic agents as well as certain biologics. With immunotherapy taking a more prominent role in the treatment of several different malignancies and its own baseline risk of pneumonitis, it is important to explore the likelihood of RRP, specifically in those patients who have been previously treated with radiation therapy. The current literature regarding RRP with checkpoint inhibitors is reviewed in this article. …

Related Peripheral Blood Stem Cell Donors Experience More Severe Symptoms And Less Complete Recovery At One Year Compared To Unrelated Donors, M. A. Pulsipher, B. R. Logan, D. M. Kiefer, P. Chitphakdithai, M. L. Riches, D. Rizzo, P. Anderlini, R. Bayer, I. Sahdev, B. E. Shaw, +51 Additional Authors

Journal Articles

No abstract provided.

Probabilistic Modeling Of Personalized Drug Combinations From Integrated Chemical Screen And Molecular Data In Sarcoma, N. E. Berlow, R. Rikhi, M. Geltzeiler, J. Abraham, M. N. Svalina, L. E. Davis, E. Wise, M. Mancini, R. G. Maki, C. Keller, +19 Additional Authors

Journal Articles

No abstract provided.

A Phase 1 And Randomized Controlled Phase 2 Trial Of The Safety And Efficacy Of The Combination Of Gemcitabine And Docetaxel With Ontuxizumab (Morab-004) In Metastatic Soft-Tissue Sarcomas, R. L. Jones, S. P. Chawla, S. Attia, P. Schoffski, H. Gelderblom, B. Chmielowski, A. Le Cesne, B. A. Van Tine, J. C. Trent, R. G. Maki, +7 Additional Authors

Journal Articles

No abstract provided.

Delivering Challenging News: An Illness-Trajectory Communication Curriculum For Multispecialty Oncology Residents And Fellows, D. Cannone, M. Atlas, A. Fornari, M. L. Barilla-Labarca, M. Hoffman

Journal Articles

Introduction: Published curricula to teach communication skills for postgraduate fellows in oncology are few in number despite the fact that oncologists conduct many difficult discussions with their patients and their families. Such discussions may include disclosing initial diagnosis or relapse of a patient's cancer or relaying a poor prognosis or change to palliative care. Methods: An eight-module course on communication in oncology practice was delivered over 2 months for palliative and oncology fellows and radiation oncology residents. Learners were given a precourse survey in which they were asked to rate their proficiency in various communication tasks. Each learner then participated …

Cancer Care Annual Report 2018-2019, Children's Mercy Hospital

Cancer Center Annual Reports

Annual report of cancer care and oncology services at the Children's Mercy Hospital, Kansas City MO, a pediatric medical center.

Pelvic Examinations For Ovarian Cancer Screening In Asymptomatic Adult Women, Riann Collar

Physician Assistant Scholarly Project Posters

There is discrepancy amongst organizations and the medical community whether bimanual pelvic examinations should be performed in asymptomatic women for routine screening. The purpose of this literature review was to determine whether bimanual pelvic examinations are beneficial for screening for ovarian cancer in comparison to no screening. In addition, research was conducted to see if healthcare providers’ professional beliefs align with the evidence and national recommendations, to determine women’s thoughts and beliefs regarding pelvic examinations, and identify other screening methods if bimanual pelvic exams are determined to be an invalid screening tool. Throughout reviewing peer reviewed articles and high-quality evidence, …

Use Of Beta-Antagonists Or Hmg-Coa Reductase Inhibitors For Cardioprotection During Chemotherapy In Oncology Patients, Nicole Streich

Physician Assistant Scholarly Project Posters

Over the years, oncologists are better able to fight cancer and have increased cancer survival, but we are also finding that these lifesaving therapies can affect the heart and other parts of the body in a negative way. Chemotherapy is excellent at destroying cancer cells, but it also causes collateral damage to other healthy cells. There are certain chemotherapeutic agents that are known to cause cardiotoxicity. Currently we are monitoring the heart function of the patients who are receiving these cardiotoxic drugs prior to starting the chemotherapy as well as during and after treatment. However, there are currently no recommendations …

The Role Of Activin A Signaling In Gastric Reflux-Related Diseases And The Progression To Esophageal Adenocarcinoma, Cedric J. Roudebush

Honors Undergraduate Theses

Gastroesophageal reflux disease (GERD), or acid reflux, affects 6-9 million people in the United States. It is characterized by a reflux of gastric acid and bile salts from the stomach into the esophagus, causing injuries to the esophagus known as Barrett's esophagus (BE). BE is the main risk factor for the development of esophageal adenocarcinoma (EAC), a devastating cancer in the esophagus whose molecular roots remain poorly understood. In recent years, evidence points to the esophageal epithelium itself as responsible for causing and promoting inflammation upon injury by gastric reflux, namely via an increase in inflammatory cytokine secretion. This project …

Erratum: Author Correction: Surgical Standards For Management Of The Axilla In Breast Cancer Clinical Trials With Pathological Complete Response Endpoint., Judy C Boughey, Michael D Alvarado, Rachael B Lancaster, W Fraser Symmans, Rita Mukhtar, Jasmine M Wong, Cheryl A Ewing, David A Potter, Todd M Tuttle, Tina J Hieken, Jodi M Carter, James W Jakub, Henry G Kaplan, Claire L Buchanan, Nora T Jaskowiak, Husain A Sattar, Jeffrey Mueller, Rita Nanda, Claudine J Isaacs, Paula R Pohlmann, Filipa Lynce, Eleni A Tousimis, Jay C Zeck, M Catherine Lee, Julie E Lang, Paulette Mhawech-Fauceglia, Roshni Rao, Bret Taback, Constantine Goodellas, Margaret Chen, Kevin M Kalinsky, Hanina Hibshoosh, Brigid Killelea, Tara Sanft, Gillian L Hirst, Smita Asare, Jeffrey B Matthews, Jane Perlmutter, Laura J Esserman

Articles, Abstracts, and Reports

[This corrects the article DOI: 10.1038/s41523-018-0074-6.].