Publications by authors named "Nicole Nevadunsky"

Objectives: Part 1 of the RUBY trial (NCT03981796) demonstrated improved survival in patients with primary advanced or recurrent endometrial cancer (EC) treated with dostarlimab plus carboplatin-paclitaxel versus placebo plus carboplatin-paclitaxel. Here, we examine additional efficacy and safety data from patients with mismatch repair deficient/microsatellite instability-high (dMMR/MSI-H) EC in the RUBY trial.

Methods: Patients were randomized 1:1 to dostarlimab 500 mg or placebo plus carboplatin-paclitaxel every 3 weeks for 6 cycles followed by dostarlimab or placebo every 6 weeks for up to 3 years.

View Article and Find Full Text PDF

Background: In Part 1 of the phase III RUBY trial (NCT03981796) in patients with primary advanced or recurrent endometrial cancer (EC), dostarlimab plus carboplatin-paclitaxel (CP) significantly improved progression-free survival and overall survival compared with CP alone. Limited safety data have been reported for the combination of immunotherapies plus chemotherapy in this setting.

Objectives: The objective of this analysis was to identify the occurrence of treatment-related adverse events (TRAEs) and immune-related adverse events (irAEs) and to describe irAE management in Part 1 of the RUBY trial.

View Article and Find Full Text PDF

Objective: We aimed to characterize delays to care in patients with endometrioid endometrial cancer and the role healthcare access plays in these delays.

Methods: A chart review was performed of patients with endometrioid endometrial cancer who presented with postmenopausal bleeding at a diverse, urban medical center between 2006 and 2018. The time from symptom onset to treatment was abstracted from the medical record.

View Article and Find Full Text PDF

Purpose: Evaluate perceptions of a 12-week in-person physical activity intervention for endometrial cancer survivors with obesity.

Methods: Sixteen endometrial cancer survivors (Age: 64 ± 8 yrs) with obesity (BMI: 34 ± 8 kg·m) who completed a 12-week comprehensive physical activity program completed semi-structured interviews regarding perceptions of physical activity participation. Transcripts were analyzed using thematic analysis and were confirmed by multiple authors.

View Article and Find Full Text PDF

Ovarian cancer is known for its poor neoantigen expression and strong immunosuppression. Here, we utilized an attenuated non-pathogenic bacterium Listeria monocytogenes to deliver a highly immunogenic Tetanus Toxoid protein (Listeria-TT), as a neoantigen surrogate, into tumor cells through infection in a metastatic mouse ovarian cancer model (Id8p53-/-Luc). Gemcitabine (GEM) was added to reduce immune suppression.

View Article and Find Full Text PDF
Article Synopsis
  • Cancer-associated venous thromboembolism (VTE) poses serious health risks, and direct oral anticoagulants (DOACs) are becoming popular alternatives to traditional injectable treatments for VTE management in high-risk patients.
  • A survey conducted among members of the Society of Gynecologic Oncology (SGO) and the American Society of Clinical Oncology (ASCO) found that most physicians are familiar with prescribing DOACs, but variations in treatment preferences exist between the two groups, with ASCO members favoring DOACs over low molecular weight heparin (LMWH).
  • The findings reveal that while many physicians recognize the equal safety of DOACs and LMWH, ASCO members are more likely to endorse DO
View Article and Find Full Text PDF

Objectives: The purpose of this report was to present the diagnosis and management of an unusual case of a woman with ovarian carcinoma who developed an isolated recurrence to the adrenal gland six years after initial diagnosis.

Case: A 79-year-old woman was diagnosed with stage IVa high-grade serous carcinoma of the ovary with malignant pleural effusion in January 2014. She received six cycles of carboplatin and paclitaxel and underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and optimal tumor debulking in May 2014.

View Article and Find Full Text PDF

The use of opioids across all specialties has increased greatly over the last 2 decades and along with it, opioid misuse, overdose and death. The contribution of opioids prescribed for gynecologic cancers to this problem is unknown. Data from other surgical specialties show prescriber factors including gender, geographic location, board certification, experience, and fellowship training influence opioid prescribing.

View Article and Find Full Text PDF

Purpose: Uterine-serous-carcinoma (USC) is an aggressive variant of endometrial cancer. On the basis of preliminary results of a multicenter, randomized phase II trial, trastuzumab (T), a humanized-mAb targeting Her2/Neu, in combination with carboplatin/paclitaxel (C/P), is recognized as an alternative in treating advanced/recurrent HER2/Neu-positive USC. We report the updated survival analysis of NCT01367002.

View Article and Find Full Text PDF

Background: The risk factors for extended length of stay (LOS) have not been examined in a cohort of patients with complex social and medical barriers who undergo robotic assisted (RA) surgery for gynecologic malignancies. We sought to identify those patients with a LOS > 24 h after robotic surgery and the risk factors associated with delayed discharge. Then we aimed to develop a predictive model for clinical care and identify modifiable pre-operative risk factors.

View Article and Find Full Text PDF

Cervical carcinogenesis, the second leading cause of cancer death in women worldwide, is caused by multiple types of human papillomaviruses (HPVs). To investigate a possible role for HPV in a cervical carcinoma that was HPV-negative by PCR testing, we performed HPV DNA hybridization capture plus massively parallel sequencing. This detected a subgenomic, URR-E6-E7-E1 segment of HPV70 DNA, a type not generally associated with cervical cancer, inserted in an intron of the B-cell lymphoma/leukemia 11B (BCL11B) gene in the human genome.

View Article and Find Full Text PDF

Background: Obesity confers an overall increased risk for development of endometrial cancer. However there are conflicting reports regarding the effect of obesity on patients' overall and disease specific survival. The purpose of this study was to evaluate the effect of obesity on survival in women with endometrial cancer.

View Article and Find Full Text PDF

Objective: The Patient-Reported Outcomes Measurement Information System (PROMIS®) Network has developed a comprehensive repository of electronic patient reported outcomes measures (ePROs) of major symptom domains that have been validated in cancer patients. Their use for patients with gynecologic cancer has been understudied. Our objective was to establish feasibility and acceptability of PROMIS ePRO integration in a gynecologic oncology outpatient clinic and assess if it can help identify severely symptomatic patients and increase referral to supportive services.

View Article and Find Full Text PDF

•Diabetes mellitus confers worse survival in women with granulosa cell tumors.•Routine lymphadenectomy does not improve survival in women with granulosa cell tumors.•Women in this cohort had a high prevalence of concurrent breast cancer.

View Article and Find Full Text PDF

The purpose of this article is to review data supporting the benefit of palliative care, specifically for women with advanced ovarian cancer. Authors discuss barriers to implementation of palliative care, including confusion with hospice and challenges of prognostication. Generalist-level palliative techniques for treatment of pain, shortness of breath, bowel obstruction, and ascites are described.

View Article and Find Full Text PDF

Objective: To characterize risk factors and timing of venous thromboembolism in women with uterine serous carcinoma.

Methods: A retrospective cohort study was performed including all women diagnosed with uterine serous carcinoma from 1999 to 2016 at our institution. Clinicopathologic data and information regarding timing of venous thromboembolism were abstracted from the medical record.

View Article and Find Full Text PDF
Article Synopsis
  • * Data from 217 patients revealed that factors like body mass index, hypertension, race, and aspirin use were predictive of readmission, with significant differences in disease-free and overall survival between those admitted and those who were not.
  • * The findings suggest that readmission rates in this population were higher than previously reported, highlighting the need to identify at-risk patients to improve chemotherapy planning and resource allocation for patient care.
View Article and Find Full Text PDF

Background: Venous thromboembolism after open gynecologic surgery is not uncommon, especially in the presence of other risk factors such as obesity, prolonged surgical time or gynecologic malignancy.

Case: We present the case of a 62 y.o.

View Article and Find Full Text PDF

Objective: Endometrial cancer survivors are the least physically active of all cancer survivor groups and exhibit up to 70% obesity. While studies suggest lifestyle interventions result in improved health outcomes, recruitment and availability of these programs are limited. The purpose was to evaluate the acceptability and validity of the Fitbit Alta™ physical activity monitor (Fitbit) for socioculturally diverse endometrial cancer survivors.

View Article and Find Full Text PDF

Purpose Uterine serous carcinoma is a rare, aggressive variant of endometrial cancer. Trastuzumab is a humanized monoclonal antibody that targets human epidermal growth factor receptor 2 (HER2)/neu, a receptor overexpressed in 30% of uterine serous carcinoma. This multicenter, randomized phase II trial compared carboplatin-paclitaxel with and without trastuzumab in patients with advanced or recurrent uterine serous carcinoma who overexpress HER2/neu.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to analyze differences in ovarian cancer survival rates among various racial and ethnic groups in a diverse population from 2005 to 2015.
  • Among 344 patients, black women were more likely to present with advanced stage IV disease and had poorer recurrence-free survival compared to white women, although race's effect on survival was mitigated by treatment and stage.
  • The findings suggest that further research is needed to understand how factors like access to care and tumor biology may contribute to late-stage diagnosis and treatment disparities in black ovarian cancer patients.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to compare the effectiveness of intraperitoneal (IV/IP) chemotherapy versus intravenous (IV) chemotherapy in patients with advanced stage ovarian cancer.
  • A total of 96 patients were analyzed, with similar racial representation; results showed that IV/IP chemotherapy significantly increased overall survival (median 76 months) compared to IV chemotherapy alone (median 38 months).
  • The research highlights the need for further investigation into the barriers preventing the wider use of IV/IP chemotherapy, despite its benefits in improving patient outcomes.
View Article and Find Full Text PDF

The application and interview process for gynecologic oncology fellowship is highly competitive, time-consuming and expensive for applicants. We conducted a survey of successfully matched gynecologic oncology fellowship applicants to assess problems associated with the interview process and identify areas for improvement. All Society of Gynecologic Oncology (SGO) list-serve members who have participated in the match program for gynecologic oncology fellowship were asked to complete an online survey regarding the interview process.

View Article and Find Full Text PDF

Purpose: The purpose of this study was to describe physical activity-related differences in body composition, quality of life, and behavioral variables among a socioculturally diverse sample of endometrial cancer survivors.

Methods: Ambulatory, English-speaking endometrial cancer survivors (6 months to 5 years post-treatment), who were residents of Bronx, NY, were recruited to complete questionnaires about physical activity (PA), quality of life (QoL), and psychosocial characteristics. Body weight and height were obtained from medical records to determine body mass index (BMI).

View Article and Find Full Text PDF

Purpose: Determine the feasibility of a 12-week physical activity intervention for obese, socioculturally diverse endometrial cancer survivors and to evaluate whether the intervention improves physical activity behavior, physical function, waist circumference, and quality of life.

Methods: Obese endometrial cancer survivors from Bronx, NY were assigned to either a 12-week physical activity intervention of behavioral counseling, physical activity and home-based walking (n=25), or wait-list control group (n=15). Mixed-design ANOVA (2 groups×2 time points) were analyzed to determine differences between the intervention and the control for the Yale Physical Activity Survey, six-minute walk test, 30-second chair stand test, waist circumference, and Functional Assessment of Cancer Therapy-Endometrial questionnaire.

View Article and Find Full Text PDF