A5005335857- Bladder and Urothelial Cancer Treatments
- Multiple and Secondary Primary Cancers
- Epigenetics and DNA Methylation
- Genetic factors in colorectal cancer
- Urinary and Genital Oncology Studies
- Renal cell carcinoma treatment
- Lung Cancer Treatments and Mutations
- Cancer Genomics and Diagnostics
- Cancer Immunotherapy and Biomarkers
- Homelessness and Social Issues
- Criminal Justice and Corrections Analysis
- Family and Patient Care in Intensive Care Units
- Ferroptosis and cancer prognosis
- DNA Repair Mechanisms
- COVID-19 and healthcare impacts
- Cancer Diagnosis and Treatment
- Emergency and Acute Care Studies
- Telemedicine and Telehealth Implementation
- Mast cells and histamine
- Racial and Ethnic Identity Research
- Patient Satisfaction in Healthcare
- Healthcare professionals’ stress and burnout
- Sexuality, Behavior, and Technology
- LGBTQ Health, Identity, and Policy
- Migration, Health and Trauma
University of California, San Francisco
2017-2025
San Francisco VA Medical Center
2022-2023
Memorial Sloan Kettering Cancer Center
2011-2020
New York Proton Center
2013-2014
Cornell University
2013
Gallagher (United States)
2013
National Cancer Institute
2013
American Cancer Society
2012
National Institutes of Health
2011
National Cancer Institute
2011
Cisplatin-based chemotherapy is the standard of care for patients with muscle-invasive urothelial carcinoma. Pathologic downstaging to pT0/pTis after neoadjuvant cisplatin-based associated improved survival, although molecular determinants cisplatin response are incompletely understood. We performed whole-exome sequencing on pretreatment tumor and germline DNA from 50 carcinoma who received followed by cystectomy (25 "responders," 25 pT2+ "nonresponders") identify somatic mutations that...
Purpose We sought to define the prevalence and co-occurrence of actionable genomic alterations in patients with high-grade bladder cancer serve as a platform for therapeutic drug discovery. Patients Methods An integrative analysis 97 tumors was conducted identify targets, which are defined that have been clinically validated another type (eg, BRAF mutation) or selective inhibitor target pathway is under clinical investigation. DNA copy number (CNAs) were by using array comparative...
What's known on the subject? and What does study add? No recent advances have been made in treatment of patients with advanced bladder cancer and, to date, targeted therapies not resulted an improvement outcome. The mammalian target rapamycin pathway has shown be up‐regulated represents a rational for therapeutic intervention. In present phase II everolimus, one near‐complete response, partial response several minor responses suggest that everolimus possesses biological activity subset...
Although incarcerated older adults experience higher rates of chronic disease and geriatric syndromes, it is unknown whether community-dwelling with a history incarceration are also at risk for worse health outcomes.To evaluate the association between outcomes, including conditions in age.This cross-sectional study using population-based data from nationally representative Health Retirement Study included US aged 50 years or who completed 2012 2014 survey waves assessing self-reported...
Purpose Although gemcitabine and carboplatin (GCa) is a standard option for patients with advanced urothelial cancer (UC) who are ineligible cisplatin, outcomes remain poor. This trial evaluated the efficacy safety of bevacizumab GCa in UC. Patients Methods Karnofsky performance status 60% to 70%, creatinine clearance less than 60 mL/min, visceral metastasis, or solitary kidney were eligible received lead-in dose 10 mg/kg followed 2 weeks later by 1,000 mg/m on days 1 8 at area under...
Being transgender is associated with numerous health disparities, and individuals face mistreatment discrimination in healthcare settings. At the same time, professionals report inadequate preparation to care for people, patients often have teach their own medical providers about care. Our study aimed evaluate impact of an elective course profession students that was implemented address these gaps provider knowledge.Students participated a 10-session, lunch-hour during spring 2015. To...
Purpose Prisons are associated with poor health outcomes for incarcerated people and correctional staff. Efforts to remedy harmful prison conditions typically focus on litigation, legislation administrative policy changes; however, implementing these top-down mandates is often impeded by cultural barriers among The purpose of this study was evaluate a novel intervention grounded in public international principles, educate motivate frontline staff lead culture change initiatives US prisons....
Abstract Background. Pemetrexed is a commonly used treatment for platinum-resistant advanced urothelial carcinoma (UC) based on objective response rates of 8% and 28% in two small phase II studies. To address the discrepancy reported to assess efficacy toxicity outside clinical trial setting, we performed large retrospective analysis pemetrexed use at Memorial Sloan Kettering Cancer Center. We also investigated candidate prognostic factors overall survival this setting explore whether...
Background The phosphatidyl 3‐inositol kinase (PI3K)/Akt/mechanistic target of rapamycin (mTOR) pathway frequently is activated in patients with urothelial carcinoma (UC). In the current study, authors performed a phase 2 study evaluating efficacy pan‐isoform class I PI3K inhibitor buparlisib platinum‐refractory metastatic UC. Methods Two cohorts were recruited: an initial genetically unselected cohort and subsequent expansion PI3K/Akt/mTOR pathway–altered tumors. primary endpoint was...
4581^ Background: Response to neoadjuvant chemotherapy (NC) prior radical cystectomy (RC) predicts improved overall survival (OS) in MIBC. Associations with enhanced include complete pathologic response (pT0; Grossman, NEJM 2003) and eradication of the muscle-invasive component (<pT2; Splinter, J Urol 1992). Sunitinib (S) is active pretreated pts advanced disease. We tested if S added GC was safe, rate pT0, <pT2. Methods: Cisplatin-eligible cT2-4aN0 bladder cancer received G 1000 mg/m...
Many patients who are at high risk of HIV transmission do not receive pre-exposure prophylaxis (PrEP). counselling and PrEP initiation have historically been limited to outpatient settings. Here we describe a novel quality improvement project San Francisco's main safety-net hospital designed incorporate universal screening for active factors into standard inpatient care. Interventions included education sessions dissemination clinical materials increase providers' knowledge comfort with...
324 Background: PI3 kinase (PI3K) pathway alterations are found in 39% of urothelial carcinoma (UC) (TCGA). Prior reports have shown significant responses metastatic UC patients (pts) whose tumors harbor PI3K treated with mTOR inhibitors, providing a rationale to investigate BKM120 mUC. Methods: This phase II study enrolled mUC pts progressing on platinum-based chemotherapy (up 4 prior agents). The primary and secondary endpoints were proportion progression-free at 2 months response rate...
The number of older adults (age fifty-five or older) incarcerated in US prisons reached an all-time high just as COVID-19 entered correctional facilities 2020. However, little is known about COVID-19's impact on adults. We compared outcomes between and younger California state from March 1, 2020, to October 9, 2021. Adjusted odds ratios (aORs) revealed increasing risk for adverse among age groups (ages 55–64, 65–74, 75 with adults, including documented infection (aOR, 1.3, 1.4, respectively)...
4606 Background: Second-line chemotherapy has limited activity in advanced TCC with a median progression free survival (PFS) of 2-3 months. We have previously demonstrated the over-expression activated mTOR pathway markers invasive specimens (BJU Int. 2010 Jul 26). Everolimus selectively inhibits mTOR, central regulator cell growth, proliferation, survival, and angiogenesis. This trial was designed to assess efficacy everolimus patients (pts) TCC. Methods: The primary objectives this single...
236 Background: Platinum-based therapy improves outcome in neoadjuvant and metastatic UC. Since cell-line human subject studies other cancers show germline associations with platinum response, we hypothesized that variation also identifies genes determine UC response to platinum-based therapy. Methods: Saliva or blood was prospectively collected from 651 patients (pts) diagnosed between 1984 2010. SNPs (n=80) were selected based on previously reported and/or genotyped using Sequenom...
245 Background: Second-line chemotherapy has limited activity in advanced TCC with a median progression free survival (PFS) of 2-3 months. We have previously demonstrated the overexpression activated mTOR pathway markers invasive specimens (BJU Int. 2010 Jul 26). Everolimus selectively inhibits mTOR, central regulator cell growth, proliferation, survival, and angiogenesis. This trial was designed to assess efficacy everolimus patients (pts) TCC. Methods: The primary objectives this...
As COVID-19 spread across the globe, hospitals restricted visitors to protect patients and healthcare providers.1 The absence of in-person visitors, who play a central role in patient well-being clinical decision making by clarifying medical histories bridging linguistic cultural divides, left vulnerable social isolation, delirium fragmented care.2 With ongoing infections, health systems continue grapple with how support loved ones during visitor restrictions.3 Many technology-driven...
248 Background: Effective treatment for pts with advanced UC unfit to receive cisplatin-based therapy remains an unmet need. A recent phase III study showed limited benefit of gemcitabine-carboplatin (GC) alone (median OS 9.3 months) (DeSantis ASCO 2010). We recently identified the VEGF-axis as a viable pathway (JCO 2010;Mar 10). propose that bevacizumab, monoclonal antibody against VEGFR, may be safely added GC and improve time progression (TTP) in UC. Methods: Primary endpoints (N=47...
4566 Background: Effective treatment for pts with advanced UC unfit to receive cisplatin (C) is an unmet need. A phase III study showed limited benefit of gemcitabine (G) and carboplatin (Ca) a median overall survival (OS) 9.3 months (DeSantis ASCO 2010). The VEGF-axis viable pathway (Gallagher JCO We sought test whether Bev, monoclonal antibody against VEGF, could be safely added GCa improve outcomes. Methods: Primary endpoints (N=47) were 50% improvement over 4.8 (mos) time progression...
277 Background: Activating mutations in PIK3CA have been associated with improved outcomes patients (pts) breast cancer (Kalinsky, Clin Cancer Res 2009). Molecular profiling of invasive high-grade UC demonstrates that PI3K/Akt pathway alterations occur up to 15% cases. The prognostic value is unknown. Methods: Clinically annotated archival frozen surgical specimens from 95 pts (94 cystectomies, 1 nephroureterectomy) were genotyped for all coding exons PIK3CA, PIK3R1, TSC1, PTEN and the AKT...