VINCENT FELLOWS IN GYNECOLOGIC ONCOLOGY
Pursuing Women’s Cancers
Each year, approximately 95,000 women in the United States are diagnosed with gynecologic cancer including the five main types — ovarian, cervical, uterine, vaginal and vulvar cancer. More than 30,000 will die. With support from The Vincent Memorial Hospital Foundation, Vincent fellows in Gynecologic Oncology are seeking new ways to improve outcomes and save lives.
What Endometrial Cancer Treatments Are on the Horizon?
Amanda Ramos, MD, a fellow in Gynecologic Oncology, is deciphering the complex relationships in the tumor that allow uterine cancer cells to escape detection and targeting by the immune system. Using a novel RNA profiling approach, her primary focus has been investigating mechanisms of direct communication between the cancer cells and the immune cells that can locally repress immune function. This work has identified distinct mechanisms of immune escape that are largely prevalent in a subset of endometrial cancers that are the most genetically and structurally abnormal. An important finding has been the complexity of these mechanisms at play in a given individual’s tumor, indicating the presence of concurrent therapeutic targets. Her current work involves the use of multispectral fluorescence imaging that can display spatial relationships of these targets within the tumor as a means of identifying the most appropriate immunotherapy combinations for any given patient to improve therapeutic response.
What Can We Glean from ‘Big Data’ to Combat Ovarian Cancer?
Alexander Melamed, MD, MPH, a fellow in Gynecologic Oncology, is leveraging information contained in large clinical databases to identify strategies to improve treatment of ovarian cancer. Among sources are the National Cancer Database, a U.S. cancer registry with approximately 180,000 records of women diagnosed with ovarian cancer since 2004; also Medicare claims, which contain data on 42,000 elderly ovarian cancer patients since 2000. He is investigating the effect of minimally invasive surgery in early- and late-stage ovarian cancer, the risks and benefits of extensive surgical resection, and whether changing the sequence of chemotherapy and surgery can improve postoperative outcomes.
- Effect of adoption of neoadjuvant chemotherapy for advanced ovarian cancer on all cause mortality: quasi-experimental study.
- All-cause mortality after fertility-sparing surgery for stage I epithelial ovarian cancer.
- Laparoscopy compared with laparotomy for debulking ovarian cancer after neoadjuvant chemotherapy.
How Can We Arrest Aggressive Forms of Endometrial Cancer?
Amy Bregar, MD, MS, a fellow in Gynecologic Oncology, is studying genes that drive an aggressive form of endometrial cancer, amplified by the HER2 gene. Her studies show that another gene, called Notch, may provide resistance to HER2. Compared with breast or gastric cancer, this beneficial effect of Notch may be more pronounced in endometrial cancer, potentially leading to new therapies to combat HER2-positive endometrial cancer, which commonly doesn’t respond to conventional chemotherapy.