Researchers from Roswell Park Comprehensive Cancer Center and five partner institutions are shedding light on how body composition at the time of diagnosis relates to mortality in patients with epithelial ovarian cancer (EOC), a subject about which little is known. The team’s findings are reported in a new study published in the 

Led by principal investigator and senior author Rikki Cannioto, PhD, EdD, MS, Assistant Professor of Oncology, Department of Cancer Prevention & Control, the study analyzed pre-chemotherapy clinical data and CT image-based body composition data from 500 EOC patients in the ongoing Body Composition and Epithelial Ovarian Cancer Survival (BComES) study at Roswell Park, also led by Dr. Cannioto.

While adiposity, or obesity, increases the risk of developing at least 13 types of cancer — including EOC — some data from previous studies suggested that obese patients with ovarian cancer tended to survive longer than their non-obese peers — an obesity paradox. This work calls into question the conclusions of previous ovarian cancer studies on obesity and survival that reported either no association between the two or an “overweight or obesity paradox.”

But Dr. Cannioto points out that the results of previous studies may be skewed, because they did not account for skeletal muscle mass when gauging the impact of excess adiposity on patient survival. “It is likely that in prior reports, many patients in the healthy-weight comparison group also had low muscle mass, or sarcopenia — an age-related condition known to be associated with increased mortality in cancer patients,” she says. “As a result, both skeletal muscle mass and adiposity need to be considered to disentangle the association between high versus low adiposity and cancer outcomes.”

To solve the problem, she and her colleagues assigned patients to one of four body phenotype categories based on their body imaging records. Each category factored in both high or low skeletal muscle index (SMI) and high or low adiposity, making it easier to identify those who had low SMI (sarcopenia) so their higher mortality rates could be considered separately. “We compared patients with any combination of excess adiposity and/or low muscle mass to patients who had low adiposity but normal skeletal muscle mass,” adds Dr. Cannioto. “That’s what’s unique about it.”

The four body phenotype categories and percentage of patients in each included:


Fit/reference (normal SMI/low adiposity) — 16.2%

Overweight/obese (normal SMI/high adiposity) — 51.2%

Sarcopenia/overweight-obese (low SMI/high adiposity) — 15.6%

Sarcopenia/cachexia (low SMI/low adiposity) — 17%

“Our work, which accounts for both skeletal muscle mass and adiposity, shows no evidence of an overweight or obesity paradox when patients with low muscle mass are removed from the healthy comparison group. Rather, we show that EOC patients with any combination of high adiposity and/or low muscle had up to a twofold increased risk of mortality in comparison with patients with optimal muscle and low adiposity — a “fit” phenotype, with the greatest increases in mortality seen in patients with high-grade serous ovarian cancer (HGSOC), the most common and fatal EOC tumor,” says Dr. Cannioto.

Mortality rates were recorded for each category, both for EOC overall and HGSOC, which has a median overall survival of only 40 months.

Data analysis showed that when compared to the Fit/reference group:

Overweight/obesity was associated with up to 51% higher mortality for EOC and 104% higher mortality for HGSOC.

Sarcopenia/overweight-obesity was associated with up to 66% higher mortality for EOC and 67% higher mortality for HGSOC.

Sarcopenia/cachexia was associated with up to 73% higher mortality for EOC and 109% higher mortality for HGSOC.

Authors of the study note that the strong association of overweight and obesity with increased mortality in EOC and HGSOC correlates with preclinical evidence linking obesity to worse tumor outcomes, and that obesity and physical inactivity may be associated with a suppressed tumor immune microenvironment, resulting in increased tumor aggressiveness.

Results of the study could lay the foundation for future research to determine whether interventional exercise programs and nutritional evaluations might help improve survival in patients after an ovarian cancer diagnosis. “Body composition can be modified through lifestyle,” says Dr. Cannioto. “Targeted lifestyle interventions for patients with high adiposity or low muscle phenotypes may be safe and feasible approaches for mitigating the deleterious changes in body composition that occur as a result of aging, inactivity or a cancer diagnosis and its treatment.”

The research team also included collaborators from the Lake Erie College of Osteopathic Medicine in Elmira, New York; the Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; the University of Utah School of Medicine; Huntsman Cancer Institute at the University of Utah; and the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida.

The research was supported with funding from the National Cancer Institute, the Roswell Park/University of Pittsburgh Cancer Institute Ovarian Cancer Specialized Program of Research Excellence (SPORE) grant and the Roswell Park/University of Chicago Ovarian Cancer SPORE.

Articles

Researchers have found that body composition at diagnosis significantly impacts mortality in epithelial ovarian cancer (EOC) patients. By analyzing pre-chemotherapy clinical data and CT images, they identified four body phenotype categories based on skeletal muscle index (SMI) and adiposity. The study revealed that patients with high adiposity and/or low muscle mass had increased mortality rates, challenging the previously suggested "obesity paradox." These findings suggest that targeted lifestyle interventions could potentially improve survival outcomes for EOC patients.

Roswell Park researchers and partners shed light on how body composition at the time of diagnosis relates to mortality in epithelial ovarian cancer.

Roswell Park-Led Research Shows Muscle & Fat Strongly Linked to Survival in Epithelial Ovarian Cancer

In an effort to improve access to lung cancer screening across New York State, Roswell Park Comprehensive Cancer Center experts have launched a comprehensive online provider registry, available at 

, that is now live and accessible to the public.

Roswell Park Chief of Screening, Survivorship and Mentorship 

, alongside a team of passionate advocates and the NY State Cancer Consortium’s Lung Cancer Screening Action Team (NYSLCSAT), spent the last two years compiling the list of nearly 400 locations offering lung cancer screening as well as confirming services, contact information and more.

Sponsored through a corporate membership with biotechnology company Genentech — a member of the Roche Group — and NYSLCSAT, the website is the most comprehensive resource of its kind for New York State. It allows visitors to search for lung cancer screening facilities based on ZIP code, with results sorted by distance. Listings also include contact information for scheduling teams as well as directions to help guide people to each facility.

“Open access and transparency are key for successful cancer screening outreach,” explains Roswell Park research scientist Christina Crabtree-Ide, PhD. “With this new list, we break down online search barriers and give eligible New York residents the chance to look up screening providers right in their own backyard.”

 is the second-most common cause of cancer in both men and women and is the nation’s leading cause of cancer deaths. Screening for the disease — utilizing a quick and painless low-dose CT scan — can help detect it at earlier stages and save lives. In New York State, only 6% of eligible people have been screened for lung cancer. And while access barriers persist in both urban and rural communities, Roswell Park analysis shows that more than 36% of New York State residents living in counties with the highest rates of lung cancer deaths must drive at least an hour to get a low-dose CT scan.

“Through this registry and continued efforts like our 

 mobile CT unit, we hope to close the health inequity gap and make it easier for folks to get the care they need and deserve,” says Dr Reid, who has pioneered Roswell Park’s screening efforts across two decades of research and advocacy.

“We anticipate the website to continually be updated with new locations as information becomes available,” says Roswell Park researcher 

, who also helped develop the new resource. “We are thankful to work with Genentech in our efforts to reach and educate all New Yorkers on the importance of this life-saving screening.”

Roswell Park Comprehensive Cancer Center has launched an online provider registry to improve access to lung cancer screening in New York State. The registry, available at nylungcancerscreening.com, lists nearly 400 screening locations and is supported by Genentech and the NY State Cancer Consortium’s Lung Cancer Screening Action Team. The website allows users to search for facilities by ZIP code and includes contact information and directions. This initiative aims to address access barriers and increase screening rates, which are currently at only 6% for eligible New Yorkers.

To improve access to lung cancer screening, Roswell Park Comprehensive Cancer Center experts have launched an online provider registry.

Roswell Park Experts Launch Comprehensive Lung Cancer Screening List for New York State

Data from a large prospective cohort study reveal that a polygenic risk score has the potential to predict survival outcomes in patients with breast cancer. 

, Hematology/Oncology Fellow (Class of 2024) at Roswell Park Comprehensive Cancer Center, will share the results of that study as the first and presenting author of “

Breast cancer polygenic risk score and patient survival outcomes in the Pathways study

” at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, May 31-June 4.

A polygenic risk score (PGS) helps estimate a person’s risk of developing specific diseases. It is based on a genome-wide association study (GWAS), which scans the individual’s DNA to identify variants, or mutations, associated with those diseases. “It is a mathematical value calculated by combining the effects of hundreds to thousands of genetic markers carried by each person to predict their risk,” explains Dr. Roy.

These include lower-penetrance gene variants, which individually may or may not lead to the disease. However, when several common, lower-penetrance gene variants are combined, they significantly increase the risk. A PGS is already a valuable tool for calculating the risk of developing breast cancer, and the current study indicates that it might be equally valuable for prognosis.

Conducted at Kaiser Permanente Northern California between 2006-2013, 

 provided genome-wide genotype data from 3,995 patients who enrolled shortly after a diagnosis of invasive breast cancer. It is led by Principal Investigators 

, Distinguished Professor of Oncology, Senior Vice President for Population Sciences and Chair of Cancer Prevention and Control at Roswell Park, and Lawrence Kushi, ScD, Research Scientist and Director of Scientific Policy at the Kaiser Permanente Northern California Division of Research.

The Roswell Park study drew on the resulting data to compile four polygenic scores for each patient: PGS313 and PGS4k, PGS5k and PGS6m. Investigators then followed the participants to document their survival outcomes. By the end of the 2021 calendar year, the patients had been followed for a median of 10.5 years (0.2-14.2 years).

Investigators recorded the association between low (T1), medium (T2) and high (T3) polygenic scores within each self-reported racial and ethnic group to seven documented survival outcomes: overall survival, breast cancer-specific survival, recurrence-free survival, second primary cancer-free survival, disease-free survival, invasive disease-free survival and breast cancer event-free survival.

Of the four PGSs measured, only PGS313 was associated with the survival outcomes. Patients with medium (T2) and high (T3) PGS313 had a greater risk of recurrence, death from any cause, total breast cancer events and invasive disease compared with those who had low (T1) PGS313. Higher PGS313 was not associated with contralateral second primary breast cancer, breast cancer-specific death or any other second primary cancer.

“Our analysis showed that women with a higher PGS that was predictive of a higher risk of breast cancer also have an increased likelihood of experiencing a second breast-related event, such as cancer recurrence and death,” says 

, Professor of Oncology and Vice Chair of the Department of Cancer Prevention & Control at Roswell Park, and co-senior author of the study, along with Drs. Ambrosone and Kushi. He says the findings highlight the potential role of breast cancer PGS as a prognostic tool, warranting further exploration.

Dr. Roy will be honored at the annual meeting with a 2024 ASCO Merit Award, given to a student or trainee who is first author and presenter of a top-ranking abstract. She is also first author and presenter of “International Medical Graduates (IMG) representation at International Oncology Conference Meetings,” to be presented during a Clinical Science Symposium, “Conflicts (of Interest) and Conundrums: Perspectives from the Global Oncology Community,” during the ASCO Annual Meeting.

International medical graduates (IMG) representation at international oncology conference meetings

Abstract 9000, Clinical Science Symposium

Data from a large prospective cohort study suggest that a polygenic risk score (PGS) can predict survival outcomes in breast cancer patients. The study, conducted at Kaiser Permanente Northern California, involved 3,995 patients and followed them for a median of 10.5 years. Of the four PGSs measured, only PGS313 was significantly associated with survival outcomes, indicating higher risks of recurrence and death in patients with medium and high PGS313. These findings highlight the potential of PGS as a prognostic tool in breast cancer management.

Study Shows Polygenic Risk Score (PGS) Could Predict Breast Cancer Survival Outcomes

Roswell Park Comprehensive Cancer Center has appointed Sai Yendamuri, MD, MBA, FACS, as Chief Strategy Officer and Senior Vice President of Business Development and Outreach.

Dr. Yendamuri has worked tirelessly to improve lung cancer care and outcomes both in the clinic and laboratory since his start at Roswell Park in 2007. Appointed Chair of Thoracic Surgery in 2015, he leads a grant portfolio of more than $6 million in peer-reviewed funding with focuses on understanding the connections between obesity cancer as well as care for patients undergoing lung resection. In this elevated role, Dr. Yendamuri will supervise Roswell Park’s overall strategic development and identify potential for growth on national and international levels.

“Sai is a brilliant physician-scientist who has shown tremendous dedication in his care for patients as well as leadership in guiding clinical and program initiatives,” says Candace S. Johnson, PhD, President & CEO and M&T Bank Presidential Chair in Leadership at Roswell Park. “Accomplishments across clinical care, research and leadership make Dr. Yendamuri the right person to take on these additional responsibilities at our cancer center.”

Dr. Yendamuri holds a medical degree from All India Institute of Medical Sciences and an executive MBA from the University of Pennsylvania Wharton School of Business, and his training included residencies with MD Anderson Cancer Center, New York Hospital Medical Center of Queens/Cornell University and the Christiana Care Health System. He currently sits on the American Lung Association Local Leadership Board of Directors in Buffalo and is an executive council member of the Eastern Cardiothoracic Surgical Society. He recently received a 2023 Surgical Leaders Fellowship Grant from the American Surgical Association and Society of Asian Academic Surgeons.

Sai Yendamuri, MD, MBA, FACS, has been appointed Chief Strategy Officer and Senior Vice President of Business Development and Outreach at Roswell Park Comprehensive Cancer Center. Dr. Yendamuri, who has been with Roswell Park since 2007, has significantly contributed to lung cancer care and research, managing a $6 million grant portfolio. His new role will involve overseeing strategic development and identifying growth opportunities. Dr. Yendamuri's extensive background includes a medical degree, an executive MBA, and numerous leadership positions in prominent medical organizations.

Sai Yendamuri, MD, MBA, FACS, has been appointed as Chief Strategy Officer and Senior Vice President of Business Development and Outreach. 

Roswell Park Thoracic Chair Tapped as Chief Strategy Officer, Senior VP of Business Development & Outreach

Following an extensive survey, the Human Rights Campaign Foundation (HRC) has once again named Roswell Park Comprehensive Cancer Center an LGBTQ+ Healthcare Equality Leader on its 2024 Healthcare Equality Index (HEI). Now in its 16th edition, the HEI is a national benchmarking tool that evaluates healthcare facilities’ policies and practices related to the equity and inclusion of their LGBTQ+ patients, visitors and employees. 

Among nearly 2,400 healthcare facilities evaluated nationwide, Roswell Park is one of 384 participating healthcare employers that earned “Leader” distinction after receiving a top score of 100 on the index based on their work to provide safe and high-quality experiences for all staff and patients, including those in the LGBTQ+ community. The HRC is America’s largest civil-rights organization working to achieve equality for lesbian, gay, bisexual, transgender and queer people.

“With continued recognition as a Healthcare Equality Leader from the Human Rights Campaign, we reaffirm our commitment each and every day to our LGBTQIA2S+ patients and employees, working to make sure that every person is treated with dignity and respect and is receiving the best cancer care and services possible,” says 

, LGBTQIA2S+ Task Force Chair at Roswell Park and also a faculty researcher in Health Behavior at the cancer center.

In the two years since Roswell Park was last named a Healthcare Equality Leader by HEI, Roswell Park has expanded staff training on cultural competency, continued to update its policies and practices to be more inclusive, and deepened its engagement in LGBTQ+ community events to help increase awareness of cancer-specific needs in this community.

“The Healthcare Equality Index is helping people find facilities where welcoming policies and practices are the standard,” says Kelley Robinson, President of the Human Rights Campaign. “We know that LGBTQ+ people – especially our trans family – continue to face discrimination in the doctor’s office. No one should have to put their health on the backburner for fear of mistreatment in a healthcare facility or by their doctor.”

For more on Roswell Park’s commitment to LGBTQ+ health, please visit roswellpark.org/cancer-care/support/lgbtq-health.

Roswell Park Comprehensive Cancer Center has been named an LGBTQ+ Healthcare Equality Leader by the Human Rights Campaign Foundation for 2024. This recognition, part of the 16th edition of the Healthcare Equality Index (HEI), highlights healthcare facilities' policies and practices for LGBTQ+ equity and inclusion. Roswell Park earned a top score of 100 among nearly 2,400 evaluated facilities. The center has enhanced staff training, updated inclusive policies, and increased community engagement to better serve LGBTQ+ patients and employees.

Roswell Park Comprehensive Cancer Center earned top score of 100 on Human Rights Campaign Foundation survey.

Roswell Park Again Named an ‘LGBTQ+ Healthcare Equality Leader’

A targeted therapy for children with high-risk Hodgkin lymphoma (HL) was shown to significantly reduce relapse rates when tested in a large multicenter clinical trial conducted by the 

 (COG) and led by pediatric oncologists at Roswell Park Comprehensive Cancer Center, Children’s Healthcare of Atlanta and Winship Cancer Institute of Emory University. By combining the targeted antibody-drug conjugate (ADC) brentuximab vedotin (BV) with the standard chemotherapy regimen, children were 10% less likely to relapse. The findings were 

 in the New England Journal of Medicine (NEJM).*

“We saw a 10% improvement in event-free survival — a real breakthrough,” says study senior author 

, Chair of the Roswell Park Oishei Children’s Cancer and Blood Disorders Program, Waldemar J. Kaminski Endowed Chair of Pediatrics at Roswell Park and also Division Chief of Hematology/Oncology in the Department of Pediatrics at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. “That’s quite a big gain, especially in this field. We expect that this treatment regimen will soon become standard of care for pediatric patients with high-risk Hodgkin lymphoma.”

), was funded by the National Cancer Institute (NCI) of the National Institutes of Health and conducted at 153 COG sites. The study was also supported by Seagen, formerly known as Seattle Genetics, and the St. Baldrick’s Foundation. The study was sponsored by the Division of Cancer Treatment and Diagnosis, NCI, and the brentuximab vedotin was provided by Seagen under a Cooperative Research and Development Agreement with NCI.

“This trial reflects a paradigm shift for advanced-stage Hodgkin lymphoma in children, and an introduction of the first targeted approach for initial therapy in pediatric Hodgkin lymphoma and the first new regimen in two decades,” says study first author 

, Director of the Leukemia and Lymphoma Program at the Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta, Professor of Pediatrics at Emory University School of Medicine, and a research member at Winship Cancer Institute of Emory University. Dr Castellino succeeded Dr Kelly this year as COG Hodgkin Committee Chair. “We are optimistic that this trial will set the stage for FDA approval of this targeted antibody drug conjugate for children and adolescents.”

, Pediatric Hematologist/Oncologist at the Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta and Professor of Pediatrics at Emory University School of Medicine, adds: “The demonstration of the effectiveness of a highly targeted treatment directed against the malignant cell population in newly diagnosed pediatric and young adult patients with high-risk Hodgkin lymphoma is a significant step forward toward improving cure rates and may do so without adding significant long-term toxicity for this young population with many years of life remaining.”

HL is the most common cancer in patients 12-29 years old. Although it has a high five-year survival rate — 97% of those under 19 are alive five years after diagnosis — about one-third of survivors are classified as high risk; of those, approximately 15-20% will relapse.

The COG study — the largest and only randomized phase 3 trial with the CD-30 targeted ADC ever conducted with newly diagnosed high-risk HL pediatric patients — involved 587 patients ages 2-21 with previously untreated disease.

Patients were randomized to one of two arms, both arms receiving treatment over five 21-day cycles. Those in the control group received the standard pediatric chemotherapy regimen.

The second group received the standard pediatric chemotherapy regimen, plus brentuximab vedotin. Brentuximab vedotin (BV) is an antibody-drug conjugate that specifically targets the CD30 protein on the surface of HL cancer cells, destroying them while mostly sparing healthy cells.

Both groups received site radiation therapy based on responses assessed after two cycles of treatment.

Follow-up at about three and a half years after treatment showed 92.1% event free survival in the brentuximab vedotin group, compared with 82.5% for the control group — an overall risk reduction of 59% of relapse, death or a second malignant neoplasm.

Lower risk of relapse could possibly eliminate the need for re-treatment with additional toxic therapies. Over the long term, treatment toxicity puts HL survivors at very high risk of breast cancer, stroke, myocardial infarction, restrictive pulmonary disease, infertility and shortened lifespan.

“Brentuximab vedotin is not anticipated to have long-term toxicity,” says Dr Kelly, noting that during the treatment phase of the clinical trial, less than 10% of patients who received it needed a dose reduction. “Because the drug could be given more consistently, its efficacy improved with no increase in neuropathy or serious infection.”

Dr Kelly, Dr Castellino and colleagues will build on these findings in a new clinical trial set to open in early 2023 with support from the National Cancer Institute. The phase 3 randomized study will enroll approximately 1,900 children and adults ages 5-60 with medium- and low-risk HL. The goal: to determine whether the combination of the the CD30 targeted ADC brentuximab vedotin and immunotherapy agent nivolumab can prolong progression-free survival and further reduce patients’ exposure to standard chemotherapy and radiation. Patients will be followed for 12 years to monitor their progress and gauge the results.

Allison Brashear, MD, Vice President for Health Sciences at the University at Buffalo and Dean of the Jacobs School of Medicine and Biomedical Sciences, says results of the study “mean a greatly improved quality of life for the most vulnerable and courageous patients — children with cancer.

“As one of the largest demonstrations of a successful immuno-oncologic approach in children with cancer,” Dr Brashear notes, “it is a powerful example of what happens when extraordinary institutions decide that collaboration is key to their success.”

Lucky Jain, MD, MBA, Pediatrician-in-Chief for Children’s Healthcare of Atlanta, and Chair of the Department of Pediatrics for Emory University School of Medicine, says, “A 10 percent reduction in relapse among children with high-risk Hodgkin lymphoma is a significant milestone for the field of pediatric cancer. Children’s Healthcare of Atlanta and Emory University are proud of this incredible leap forward led by our physicians, Dr Sharon Castellino and Dr Frank Keller, along with their collaborators and the Children’s Oncology Group.”

*Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number NCTN Operations Center Grant U10CA180886 and NCTN Statistics & Data Center Grant U10CA180899. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

A targeted therapy for children with high-risk Hodgkin lymphoma was shown to significantly reduce relapse rates when tested in a clinical trial conducted by the Children’s Oncology Group and led by pediatric oncologists at Roswell Park Comprehensive Cancer Center, Children’s Healthcare of Atlanta and Winship Cancer Institute of Emory University. 