- Associate Professor, Medicine
- Associate Professor, Cancer Biology - GIDP
Dr. Chalasani completed her medical school at Gandhi Medical College in India and completed her Internship, Residency and Fellowship in Hematology-Oncology at the University of Arizona. Dr. Chalasani is an Associate Professor on staff at the University of Arizona Cancer Center. As a faculty member in the breast medical oncology section at the University of Arizona cancer center, Dr. Chalasani's goal is to initiate and complete important clinical trials that will ultimately lead to a better understanding of breast cancer biology and lead to improved therapies and care for patients with breast cancer. She has developed research collaborations with translational laboratories focused on biomarker detection. Dr. Chalasani is active in the translational and clinical trials research at UACC. She is the Principal Investigator on several industry sponsored, and co-operative group protocols, and Principal Investigator for several newly started investigator initiated trials.
Her key research interest is to develop biomarkers (or markers in breast cancer) which can predict response- that way patients can be treated with therapies which work and avoid therapies (and unnecessary toxicities) which do not.
In addition to research, she has an active clinical practice. She sees patients with breast cancer for treatment decisions regarding hormonal therapy (anti-estrogen therapy), chemotherapy, and second opinions.
- University of Massachusetts, Amherst, Massachusetts, United States
- Gandhi Medical College, Secunderabad, India
- University of Ariozona (2019 - Ongoing)
- University of Arizona Cancer Center (2012 - 2019)
- Influential Health and Medical Leader Award
- Inside Tucson Business, Summer 2019
- Career Development Award
- Arizona Health Sciences Center, Fall 2014
- Outstanding Reviewer
- American Journal of Medicine, Fall 2014
- Certificate of Excellence in Reviewing
- American Journal of Medicine, Fall 2013
- American Journal of Medicine, Spring 2013
- Methods in clinical Cancer Research Workshop
- ASCO/AACR, Spring 2012
- Workshop Methods in Clinical Cancer Research
- ASCO/AACR, Spring 2012
- Chief Fellow - Hematology/Oncology Fellowship
- University of Arizona, Fall 2011
- University of Arizona, Summer 2011
- Young Investigator Award
- HTRS, Fall 2011
- HTRS Young Investigator Award
- HTRS, Summer 2011
- Hematology Fellows Consortium
- South Carolina, Spring 2011
- Internal Medicine Associates Clinic Award
- Advocate Masonic Medical Center, Spring 2005
Licensure & Certification
- Hematology, American Board of Internal Medicine (2009)
- Arizona Medical License, State of Arizona (2009)
- Medical Oncology, American Board of Internal Medicine (2012)
- Internal Medicine, American Board of Internal Medicine (2009)
Breast cancer, bleeding and clotting disorders
development of biomarkers for breast cancer, development of novel therapeutics for treatment of breast cancer
Hemo/Onco Inpatient CareMEDI 850H (Fall 2018)
- Streff, A., Chu-Pilli, M., Stopeck, A., & Chalasani, P. (2021). Changes in serum estradiol levels with Estring in postmenopausal women with breast cancer treated with aromatase inhibitors. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 29(1), 187-191.More infoAnti-estrogen therapy is an effective intervention for preventing reoccurrence of hormone receptor-positive breast cancer in women. However, the side effects of anti-estrogen therapy, including urogenital symptoms, have been reported to cause significant morbidity. There is controversial data, mainly due to small sample sizes, reporting on the safety and efficacy of using vaginal estrogen to treat urogenital symptoms in patients on aromatase inhibitor therapy.
- Badger, T. A., Segrin, C., Sikorskii, A., Pasvogel, A., Weihs, K., Lopez, A. M., & Chalasani, P. (2020). Randomized controlled trial of supportive care interventions to manage psychological distress and symptoms in Latinas with breast cancer and their informal caregivers. Psychology & health, 35(1), 87-106.More infoThe purpose of this study was to test two 2-month psychosocial interventions (Telephone Interpersonal Counseling [TIPC] and Supportive Health Education [SHE]) to improve quality of life (QOL) outcomes for Latinas with breast cancer and their informal caregivers. Two hundred and forty-one Latinas with breast cancer and their caregivers were assessed at baseline, immediately after the 2-month intervention, at 4 and 6 months after baseline. QOL outcomes were psychological distress, symptoms and social support. Linear mixed effects models showed that for cancer survivors at 2 months, TIPC produced lower adjusted mean depression scores compared to SHE. At 4 months, SHE had reduced total number of symptoms, global symptom distress, and social isolation compared to TIPC. Only total number of symptoms was lower in SHE than in TIPC at 6 months. Among caregivers at 2 months, total number of symptoms, global symptom distress, and anxiety were lower, and self-efficacy for symptom management was higher in SHE compared to TIPC. Caregiver depression was lower in TIPC compared to SHE at 4 months. These telephone delivered interventions improved different outcomes. TIPC demonstrated superior benefits for depression management and SHE was more successful in anxiety and cancer-related symptom management.
- Chalasani, P. (2020). Phase II trial in breast cancer patients with leptomeningeal carcinomatosis and recurrent brain metastases. Clinical Cancer Research. doi:10.1158/1078-0432
- Chalasani, P., Taljanovic, M., Segar, J., Farr, K., Win, H., Wertheim, B. C., Chu-Pilli, M., Ehsani, S., Roe, D. J., & Gimber, L. (2020). Diffuse tensor imaging of lower extremities: a novel MR imaging technique for chemotherapy-induced peripheral neuropathy. Breast cancer research and treatment, 184(3), 771-778.More infoChemotherapy-induced peripheral neuropathy (CIPN) is caused by drug-induced damage to the axons which is not detected easily due to lack of reliable, clinically applicable modalities. Diffuse tensor imaging (DTI) allows for quantitative measurements of fractional anisotropy (FA) and apparent diffusion coefficient (ADC), which have been shown to detect nerve injury by Magnetic Resonance Imaging (MRI).
- Chien, H. C., Kao Yang, Y. H., Kwoh, C. K., Chalasani, P., Wilson, D. L., & Lo-Ciganic, W. H. (2020). Aromatase Inhibitors and Risk of Arthritis and Carpal Tunnel Syndrome among Taiwanese Women with Breast Cancer: A Nationwide Claims Data Analysis. Journal of clinical medicine, 9(2).More infoTamoxifen or aromatase inhibitor (AI) therapy may prevent breast cancer recurrence, however, adverse effects may lead to treatment discontinuation. Evidence regarding the occurrence of AI-associated musculoskeletal problems among Asians is scarce. We identified women with breast cancer-initiating tamoxifen or AIs from the Taiwan National Health Insurance Research Database (2007-2012). Using multivariable cause-specific hazard models, we examined the association between endocrine therapy and the risk of any arthritis and carpal tunnel syndrome, adjusting for age, prior cancer treatment, and other health status factors. Among 32,055 eligible women with breast cancer (mean age = 52.6 ± 11.5 years), 87.4% initiated tamoxifen, 3.9% initiated anastrozole, 8.0% initiated letrozole, and 0.7% initiated exemestane. AI users had a higher 1-year cumulative incidence for any arthritis (13.0% vs. 8.2%, < 0.0001) and carpal tunnel syndrome (1.4% vs. 0.8%, = 0.008). Compared to tamoxifen users, AI users had a higher risk of any arthritis [adjusted hazard ratio (aHR) = 1.21, 95%CI = 1.09-1.34] and carpal tunnel syndrome (aHR = 1.68, 95%CI = 1.22-2.32). No significant difference was observed in the risks of any arthritis and carpal tunnel syndrome across different AIs. Taxane use was not associated with any arthritis (aHR = 0.92, 95%CI = 0.81-1.05) or carpal tunnel syndrome (aHR = 0.97, 95%CI = 0.67-1.40) compared to other chemotherapies. Taiwanese women with breast cancer-initiating AIs had an increased risk of arthritis and carpal tunnel syndrome compared to those who initiated tamoxifen.
- Kumthekar, P., Tang, S. C., Brenner, A. J., Kesari, S., Piccioni, D. E., Anders, C., Carrillo, J., Chalasani, P., Kabos, P., Puhalla, S., Tkaczuk, K., Garcia, A. A., Ahluwalia, M. S., Wefel, J. S., Lakhani, N., & Ibrahim, N. (2020). ANG1005, a Brain-Penetrating Peptide-Drug Conjugate, Shows Activity in Patients with Breast Cancer with Leptomeningeal Carcinomatosis and Recurrent Brain Metastases. Clinical cancer research : an official journal of the American Association for Cancer Research, 26(12), 2789-2799.More infoANG1005, a novel taxane derivative, consists of three paclitaxel molecules covalently linked to Angiopep-2, designed to cross the blood-brain and blood-cerebrospinal barriers and to penetrate malignant cells via LRP1 transport system. Preclinical and clinical evidence of efficacy with ANG1005 has been previously shown.
- Segar, J. M., Pandey, R., Farr, K. J., Nagle, R., LeBeau, L., Gonzalez, V. J., & Chalasani, P. (2020). Clinicopathological and Molecular Characteristics of Pleomorphic Invasive Lobular Carcinoma. International journal of breast cancer, 2020, 8816824.More infoPleomorphic invasive lobular carcinoma (PILC) is a distinct morphological and biologically aggressive variant of invasive lobular carcinoma (ILC). We hypothesized that was due to de novo activation of PI3K/Akt/mTOR pathway in PILC resulting in higher proliferation rate and markers of cell cycle activation. We identified PILC and ILC tumors and tested for PI3K/Akt/mTOR pathway activation by immunohistochemistry (PTEN and pS6K1) and gene expression analysis (by Nanostring nCounter system). Proliferation index (Ki67) was elevated in 85% of PILCs compared to 20% of ILCs ( < 0.007). PTEN expression was high in all while pS6K1 was high in 8/9 PILCs compared to 3/9 ILCs ( < 0.007). Gene expression analysis shows that PILCs have overexpression of genes involved in cell cycle proliferation, cellular proliferation, DNA damage, and repair genes but no difference in PI3K/Akt/mTOR pathway genes. PILCs are a biologically distinct group of ILC, and clinicopathological characteristics suggest they would have a more clinically aggressive behavior. In addition, our results indicate that PI3k/Akt/mTOR pathway and cell cycle proliferation are activated in majority of these tumors. Further studies are needed to investigate these mechanisms as there are approved therapies available that may benefit PILCs.
- Sprissler, R., Perkins, B., Johnstone, L., Babiker, H. M., Chalasani, P., Lau, B., Hammer, M., & Mahadevan, D. (2020). Rare Tumor-Normal Matched Whole Exome Sequencing Identifies Novel Genomic Pathogenic Germline and Somatic Aberrations. Cancers, 12(6).More infoWhole exome sequencing (WES) of matched tumor-normal pairs in rare tumors has the potential to identify genome-wide mutations and copy number alterations (CNAs). We evaluated 27 rare cancer patients with tumor-normal matching by WES and tumor-only next generation sequencing (NGS) as a comparator. Our goal was to: 1) identify known and novel variants and CNAs in rare cancers with comparison to common cancers; 2) examine differences between germline and somatic variants and how that functionally impacts rare tumors; 3) detect and characterize alleles in biologically relevant genes-pathways that may be of clinical importance but not represented in classical cancer genes. We identified 3343 germline single nucleotide variants (SNVs) and small indel variants-1670 in oncogenes and 1673 in tumor suppressor genes-generating an average of 124 germline variants/case. The number of somatic SNVs and small indels detected in all cases was 523:306 in oncogenes and 217 in tumor suppressor genes. Of the germline variants, six were identified to be pathogenic or likely pathogenic. In the 27 analyzed rare cancer cases, CNAs are variable depending on tumor type, germline pathogenic variants are more common. Cell fate pathway mutations (e.g., Hippo, Notch, Wnt) dominate pathogenesis and double hit (mutation + CNV) represent ~18% cases.
- Lalezari, S., Reding, M. T., Pabinger, I., Holme, P. A., Negrier, C., Chalasani, P., Shin, H. J., Wang, M., Tseneklidou-Stoeter, D., & Maas Enriquez, M. (2019). BAY 94-9027 prophylaxis is efficacious and well tolerated for up to >5 years with extended dosing intervals: PROTECT VIII extension interim results. Haemophilia : the official journal of the World Federation of Hemophilia, 25(6), 1011-1019.More infoBAY 94-9027 is an extended-half-life, site-specifically PEGylated, B-domain-deleted recombinant factor VIII (FVIII). The PROTECT VIII main study demonstrated efficacy of bleed control using extended-interval prophylaxis with BAY 94-9027 for 36 weeks.
- Segar, J. M., Reed, D., Stopeck, A., Livingston, R. B., & Chalasani, P. (2019). A Phase II Study of Irinotecan and Etoposide as Treatment for Refractory Metastatic Breast Cancer. The oncologist, 24(12), 1512-e1267.More infoThe combination of irinotecan and etoposide showed modest efficacy in terms of response rate in the refractory setting for patients with metastatic breast cancer.The studied dose and schedule of irinotecan and etoposide is very toxic, with >70% grade 3 or 4 treatment-related adverse events.
- Segrin, C., Badger, T. A., Sikorskii, A., Pasvogel, A., Weihs, K., Lopez, A. M., & Chalasani, P. (2019). Longitudinal dyadic interdependence in psychological distress among Latinas with breast cancer and their caregivers. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer.More infoCancer diagnosis and treatment can generate substantial distress for both survivors and their family caregivers. The primary aim of this investigation is to test a model of dyadic interdependence in distress experienced by cancer survivors and their caregivers to determine if each influences the other.
- Chalasani, P. (2017). Optimizing Quality of Life in Patients with Hormone Receptor-Positive Metastatic Breast Cancer: Treatment Options and Considerations. Oncology, 93(3), 143-156.More infoThe treatment landscape for hormone receptor-positive metastatic breast cancer continues to evolve as the molecular mechanisms of this heterogeneous disease are better understood and targeted treatment strategies are developed. Patients are now living for extended periods of time with this disease as they progress through sequential lines of treatment. With a rapidly expanding therapeutic armamentarium, the prevalence of metastatic breast cancer patients with prolonged survival is expected to increase, as is the duration of survival. Practice guidelines recommend endocrine therapy alone as first-line therapy for the majority of patients with metastatic hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer. The approval of new agents and expanded combination options has extended their use beyond first line, but endocrine therapy is not used as widely in clinical practice as recommended. As all treatments are palliative, even as survival is prolonged, optimizing and maintaining patient quality of life is crucial. This article surveys data relevant to the use of endocrine therapy in the setting of hormone receptor-positive metastatic breast cancer, including key clinical evidence regarding approved therapies and the impact of these therapies on patient quality of life.
- Chalasani, P., Chalasani, P., Segar, J., Segar, J., Pandey, R., Pandey, R., Nagle, R. B., Nagle, R. B., Lebeau, L. G., Lebeau, L. G., MacKerricher, W., MacKerricher, W., Viscusi, R. K., Viscusi, R. K., Gonzalez, V., Gonzalez, V., Schroeder, J. A., Schroeder, J. A., Livingston, R. B., , Livingston, R. B., et al. (2017). Clinicopathological and Molecular Characteristics of Pleomorphic Invasive Lobular Carcinoma. Breast Cancer Research.
- Goyal, U., Goyal, U., Goyal, U., Skrepnik, T., Skrepnik, T., Skrepnik, T., Davuluri, R., Davuluri, R., Davuluri, R., Ley, M., Ley, M., Ley, M., Chalasani, P., Chalasani, P., Chalasani, P., Viscusi, R. K., Viscusi, R. K., Viscusi, R. K., Lebeau, L. G., , Lebeau, L. G., et al. (2017). Concurrent capecitabine and radiation therapy for high-risk breast cancer. Oncomedicine.
- Jones, K. M., Randtke, E. A., Yoshimaru, E. S., Howison, C. M., Chalasani, P., Klein, R. R., Chambers, S. K., Kuo, P. H., & Pagel, M. D. (2017). Clinical Translation of Tumor Acidosis Measurements with AcidoCEST MRI. Molecular imaging and biology : MIB : the official publication of the Academy of Molecular Imaging, 19(4), 617-625.More infoWe optimized acido-chemical exchange saturation transfer (acidoCEST) magnetic resonance imaging (MRI), a method that measures extracellular pH (pHe), and translated this method to the radiology clinic to evaluate tumor acidosis.
- Thomson, C. A., Chow, H. H., Wertheim, B. C., Roe, D. J., Stopeck, A., Maskarinec, G., Altbach, M., Chalasani, P., Huang, C., Strom, M. B., Galons, J. P., & Thompson, P. A. (2017). A randomized, placebo-controlled trial of diindolylmethane for breast cancer biomarker modulation in patients taking tamoxifen. Breast cancer research and treatment, 165(1), 97-107.More infoDiindolylmethane (DIM), a bioactive metabolite of indole-3-carbinol found in cruciferous vegetables, has proposed cancer chemoprevention activity in the breast. There is limited evidence of clinically relevant activity of DIM or long-term safety data of its regular use. A randomized, double-blind, placebo-controlled trial was conducted to determine the activity and safety of combined use of BioResponse DIM® (BR-DIM) with tamoxifen.
- Brown-Glaberman, U., Marron, M., Chalasani, P., Livingston, R., Iannone, M., Specht, J., & Stopeck, A. T. (2016). Circulating Carbonic Anhydrase IX and Antiangiogenic Therapy in Breast Cancer. Disease markers, 2016, 9810383.More infoIntroduction. Carbonic anhydrase IX (CAIX) is a hypoxia regulated metalloenzyme integral to maintaining cellular pH. Increased CAIX expression is associated with poor prognosis in breast cancer. To explore CAIX as a biomarker for breast cancer therapies, we measured plasma CAIX levels in healthy control subjects and in breast cancer patients. Methods. In control subjects we evaluated plasma CAIX stability via commercially available ELISA. We then similarly quantified plasma CAIX levels in (1) locally advanced breast cancer (LABC) patients treated with neoadjuvant paclitaxel + sunitinib (T + S) followed by doxorubicin and cyclophosphamide (AC); (2) metastatic breast cancer (MBC) patients treated with systemic chemotherapy. Results. Plasma CAIX levels were stable at room temperature for at least 48 hours in control subjects. Mean baseline plasma CAIX levels were lower in controls compared to patients with LABC or MBC. In LABC, CAIX levels rose significantly in response to administration of antiangiogenic therapy (T + S) (p = 0.02) but not AC (p = 0.37). In patients with MBC treated without an antiangiogenic agent CAIX levels did not change with therapy. Conclusions. Our results suggest that CAIX may be an easily obtained, stable measure of tumor associated hypoxia as well as a useful pharmacodynamic biomarker for antiangiogenic therapy.
- Chalasani, P., Segar, J. M., Marron, M., & Stopeck, A. (2016). Pathophysiology of tumour-induced microangiopathic haemolytic anaemia. BMJ case reports, 2016.More infoCancer-associated microangiopathic haemolytic anaemia (CA-MAHA) is a syndrome characterised by Coombs-negative haemolytic anaemia and thrombocytopenia. It is primarily seen in advanced solid tumours and is distinct from thrombotic thrombocytopenic purpura/haemolytic uraemic syndrome. Diagnosis is often delayed and patients have a high mortality. We present the case of CA-MAHA in a patient with metastatic breast cancer treated successfully with early initiation of chemotherapy. In addition, we report longitudinal laboratory evaluation of circulating tumour cells and microparticles and suggest a hypothesis for the mechanism behind CA-MAHA.
- Jones, K. M., Radntke, E. A., Yoshimara, E. s., Howison, C. M., Chalasani, P., Chambers, S. K., Kuo, P. K., & Pagel, M. D. (2016). Clinical Translation of Tumor Acidosis Measurements with AcidoCEST MRI.. BMC Cancer.
- Martinez, J. A., Chalasani, P., Thomson, C. A., Roe, D., Altbach, M., Galons, J., Stopeck, A., Thompson, P. A., Villa-Guillen, D. E., & Chow, H. S. (2016). Phase II study of metformin for reduction of obesity-associated breast cancer risk: a randomized controlled trial protocol. BMC cancer, 16, 500.More infoTwo-thirds of U.S. adult women are overweight or obese. High body mass index (BMI) and adult weight gain are risk factors for a number of chronic diseases, including postmenopausal breast cancer. The higher postmenopausal breast cancer risk in women with elevated BMI is likely to be attributable to related metabolic disturbances including altered circulating sex steroid hormones and adipokines, elevated pro-inflammatory cytokines, and insulin resistance. Metformin is a widely used antidiabetic drug that has demonstrated favorable effects on metabolic disturbances and as such may lead to lower breast cancer risk in obese women. Further, the anti-proliferative effects of metformin suggest it may decrease breast density, an accepted biomarker of breast cancer risk.
- Chahal, J., Stopeck, A., Clarke, K., Livingston, R. B., & Chalasani, P. (2015). Intravenous thiotepa for treatment of breast cancer-related leptomeningeal carcinomatosis: case series. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 36(9), 1691-3.More infoLeptomeningeal carcinomatosis (LMC) secondary to metastatic breast cancer (MBC) has increased in incidence with improved systemic disease control. Current treatment options include radiation therapy (to symptomatic sites) and systemic treatment [intrathecal (IT) or intravenous (IV) chemotherapy]. Methotrexate (MTX), thiotepa and cytarabine are the most commonly used IT agents, while high-dose MTX is the most common IV regimen. While IT treatments are generally well tolerated, complications like chemical meningitis, leukoencephalopathy, etc. occur. LMC may cause a breakdown in the blood-brain barrier and thus allow systemic agents to penetrate; however, efficacy is reported only for agents administered at high doses (MTX). We report our institution's experience in using IV thiotepa as treatment for LMC secondary to MBC. We conducted a retrospective chart review of 13 patients with MBC who developed LMC and treated with IV thiotepa at our institution. It was administered at 40 mg/m(2) every 21 days; median number of thiotepa cycles administered was 5 with the major dose-limiting toxicity being myelosuppression. Four had partial response, 3 had stable disease and 6 had progressive disease. The 6-month survival rate was 69 % and 1-year survival rate was 31 %. Despite retrospective nature of our case series, we found the use of IV thiotepa as sole treatment for LMC in patients with MBC to be well tolerated, easily administered in the ambulatory setting, and with efficacy comparable to the other chemotherapeutic agents commonly used in the treatment of LMC. This regimen warrants further investigation in prospective studies.
- Chalasani, P., Marron, M., Roe, D., Clarke, K., Iannone, M., Livingston, R. B., Shan, J. S., & Stopeck, A. T. (2015). A phase I clinical trial of bavituximab and paclitaxel in patients with HER2 negative metastatic breast cancer. Cancer medicine, 4(7), 1051-9.More infoBavituximab is a chimeric monoclonal antibody that targets phosphatidylserine (PS). PS is externalized on cells in the tumor microenvironment when exposed to hypoxia and/or other physiological stressors. On attaching to PS, bavituximab is thought to promote antitumor immunity through its effects on PS receptors in monocytes, and myeloid-derived suppressor cells, as well as trigger antitumor effects by inducing an antibody-dependent cellular cytotoxicity on tumor-associated endothelial cells. We conducted a phase I clinical trial of bavituximab in combination with paclitaxel in patients with HER2-negative metastatic breast cancer. Patients were treated with weekly paclitaxel (80 mg/m(2) for 3/4 weeks) and weekly bavituximab (3 mg/kg for 4/4 weeks). Correlative studies included the measurement of circulating microparticles, endothelial cells, and apoptotic tumor cells by flow cytometry. Fourteen patients with metastatic breast cancer were enrolled; all were evaluable for toxicity and 13 were evaluable for response. Treatment resulted in an overall response rate (RR) of 85% with a median progression-free survival (PFS) of 7.3 months. Bone pain, fatigue, headache, and neutropenia were the most common adverse effects. Infusion-related reactions were the most common adverse event related to bavituximab therapy. Correlative studies showed an increase in the PS-expressing apoptotic circulating tumor cells in response to bavituximab, but not with paclitaxel. No changes in the number of circulating endothelial cells or apoptotic endothelial cells were observed with therapy. Platelet and monocyte-derived microparticles decreased after initiation of bavituximab. Bavituximab in combination with paclitaxel is well tolerated for treatment of patients with metastatic breast cancer with promising results observed in terms of clinical RRs and PFS. The toxicity profile of bavituximab is notable for manageable infusion-related reactions with no evidence for increased thrombogenicity. Recent preclinical data suggest that bavituximab can also promote antitumor immune activity that should be explored in future clinical trials.
- Yan, J., Walker, C., & Chalasani, P. (2015). Spontaneous Paraesophageal Hematoma. ACG case reports journal, 3(1), 29-30.More infoSpontaneous paraesophageal hematoma (SPH) likely shares a common etiology with spontaneous intramural esophageal hematoma (IEH). Patients with IEH typically present with hematemesis or melena leading to early detection and management, but patients with SPH do not have overt gastrointestinal bleeding on presentation. Management depends on the correction of the underlying causative factor. We present the first case of a spontaneous paraesophageal hematoma in a patient with hemophilia B. Awareness of this complication of hemophilia, its clinical manifestations, and imaging findings, allows for a timely diagnosis and appropriate management.
- Chalasani, P., Stopeck, A., Clarke, K., & Livingston, R. (2014). A pilot study of estradiol followed by exemestane for reversing endocrine resistance in postmenopausal women with hormone receptor-positive metastatic breast cancer. The oncologist, 19(11), 1127-8.More infoEndocrine resistance is a frequent complication, and strategies to reverse it are a high research priority for metastatic breast cancer (MBC) that is hormone receptor positive. Preclinical data suggest re-exposure to estrogen induces tumor regression in tamoxifen-resistant tumors. We conducted a pilot study to determine whether short-term estradiol exposure would reverse endocrine resistance and resensitize tumors
- Chalasani, P., & Livingston, R. (2013). Differential chemotherapeutic sensitivity for breast tumors with "BRCAness": a review. The oncologist, 18(8), 909-16.More infoBRCA1 or BRCA2 mutations predispose to cancer development, primarily through their loss of role in the repair of DNA double-strand breaks. They play a key role in homologous recombination repair, which is a conservative, error-free DNA repair mechanism. When mutated, other alternative, error-prone mechanisms for DNA repair take over, leading to genomic instability. Somatic mutations are rare in sporadic breast tumors, but expression of BRCA1 and BRCA2 genes can be downregulated in other mechanistic ways. These tumors have similar features in terms of their phenotypic and genotypic profiles, which are normally regulated by these genes, and mutations lead to defective DNA repair capacity, called "BRCAness." Attempts have been made to exploit this differentially expressed feature between tumors and normal tissues by treatment with DNA-damaging chemotherapy agents. Cells with this functional BRCA deficiency should be selectively susceptible to DNA-damaging drugs. Preclinical and early clinical (primarily retrospective) evidence supports this approach. In contrast, there is emerging evidence of relative resistance of tumors containing BRCA1 or BRCA2 mutations (or BRCAness) to taxanes. In this review, we summarize the data supporting differential chemotherapeutic sensitivity on the basis of defective DNA repair. If confirmed with available, clinically applicable techniques, this differential chemosensitivity could lead to treatment choices in breast cancer that have a more individualized biologic basis.
- Mahadevan, D., Chalasani, P., Rensvold, D., Kurtin, S., Pretzinger, C., Jolivet, J., Ramanathan, R. K., Von Hoff, D. D., & Weiss, G. J. (2013). Phase I trial of AEG35156 an antisense oligonucleotide to XIAP plus gemcitabine in patients with metastatic pancreatic ductal adenocarcinoma. American journal of clinical oncology, 36(3), 239-43.More infoAEG35156 is an antisense oligonucleotide (ASO) that targets the X-linked inhibitor of apoptosis mRNA. Preclinical studies showed potent activity of AEG35156 in combination with gemcitabine in pancreatic ductal adenocarcinoma (PDA). A phase I study was conducted to establish the maximum-tolerated dose, safety, and antitumor activity of AEG35156 plus gemcitabine in metastatic PDA.
- Mahadevan, D., Northfelt, D. W., Chalasani, P., Rensvold, D., Kurtin, S., Von Hoff, D. D., Borad, M. J., & Tibes, R. (2013). Phase I trial of UNBS5162, a novel naphthalimide in patients with advanced solid tumors or lymphoma. International journal of clinical oncology, 18(5), 934-41.More infoUNBS5162 is a novel naphthalimide that binds to DNA by intercalation and suppresses CXCL chemokine elaboration. A Phase I study of UNBS5162 was conducted to establish pharmacokinetics (PK), maximum tolerated dose (MTD), dose-limiting toxicity, safety and anti-tumor activity in patients with advanced solid tumors or lymphoma.
- Gottlieb, R. H., Krupinski, E., Chalasani, P., & Cranmer, L. (2012). Quantified visual scoring of metastatic melanoma patient treatment response using computed tomography: improving on the current standard. Journal of digital imaging, 25(2), 258-65.More infoTo assess whether quantitative visual scoring (QVS) is a better early predictor of progression-free survival (PFS) in patients on chemotherapy for metastatic melanoma using CT than the currently used Response Evaluation Criteria in Solid Tumors (RECIST) standard. Retrospective evaluation of 65 consecutive patients with metastatic melanoma on treatment who had a baseline and follow-up CT after two cycles of therapy. QVS was used to code imaging findings on the radiology reports considering size change, brain metastases, new lesions, mixed lesion response, and the number of organ systems involved. RECIST 1.1 criteria placed patients in the progressive disease, stable disease, or partial response groups. Multiple regression analysis was used to correlate the various independent variables with PFS. The Cox hazard proportions ratio, median survival, and Kaplan-Meier curves of the different prognostic groups were calculated. QVS of size change was found more sensitive in detecting patients deteriorating (57.1% versus 37.5%) or improving (23.8% versus 10.7%), more correlated with the median PFS for the deteriorating (1.8 versus 1.7 months), stable (5.6 versus 4.0 month), and improving (8.3 versus 5.5 months) categories and more predictive of PFS (Cox hazard proportion ratio of 3.070 versus 1.860) than RECIST 1.1 categorization. Multiple regression analysis demonstrated QVS of lesion size correlated most closely with PFS among the variables assessed (r = 0.519, p
- Chalasani, P., Downey, L., & Stopeck, A. T. (2010). Caring for the breast cancer survivor: a guide for primary care physicians. The American journal of medicine, 123(6), 489-95.More infoBreast cancer accounts for more than 25% of cancers in women. Because of improved screening and treatment modalities, mortality has decreased significantly. Currently, over 2.5 million breast cancer survivors live in the US and receive care from a primary care provider. Providers need to be aware of common and serious complications of breast cancer treatment. In this review we discuss complications of local and systemic treatment for breast cancer, including lymphedema, osteoporosis, cardiovascular disease, and vasomotor symptoms. Current strategies for screening, monitoring, and treating these complications also are outlined.
- Chalasani, P., Shtivelband, M. I., & Cranmer, L. D. (2009). Advanced desmoplastic small round cell tumor: near complete response with trastuzumab-based chemotherapy. Clinical advances in hematology & oncology : H&O, 7(7), 473-5.
- Chalasani, P., Kurtin, S., & Dragovich, T. (2008). Response to a third-line mitomycin C (MMC)-based chemotherapy in a patient with metastatic pancreatic adenocarcinoma carrying germline BRCA2 mutation. JOP : Journal of the pancreas, 9(3), 305-8.More infoGemcitabine remains the mainstay of palliative chemotherapy for those patients with unresectable or metastatic pancreatic cancer. Objective radiological responses to gemcitabine are rare and reported median survival is only about six months. New therapeutic concepts and strategies are needed in order to improve those dismal statistics.
- Chalasani, P., Vohra, M., & Sheagren, J. N. (2005). An association of sarcoidosis with hepatocellular carcinoma. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO, 16(10), 1714-5.
- Goyal, U., Livingston, R. B., Ley, M. L., Chalasani, P., Viscusi, R. K., Lebeau, L. G., & Gonzalez, V. J. (2015, June). Concurrent capecitabine and radiation therapy for high-risk breast cancer. ASCO annual meeting. Chicago, IL: American Society of Clinical Oncology.
- Michele, L., Livingston, R. B., Larson, E., Hurst, C., Chalasani, P., Gonzalez, V., Waer, A. L., Viscusi, R. K., & Selyne, S. (2014, October). Nipple sparing mastectomy: Risks of wound complication in the setting of neo-adjuvant or adjuvant chemotherapy and/or radiation therapy. San Antonio Breast Cancer Symposium. San Antonio, TX: AACR.
- Tapia, E., Villa Guillen, D., Chalasani, P., Centuori, S., Roe, D., Guillen-Rodriguez, J., Huang, C., Galons, J., Thomson, C. A., Altbach, M. I., Trujillo, J., Pinto, L., Martinez, J. A., Algotar, A., & Chow, H. (2020, Fall). Effects of metformin on breast density and anthropometric measurements in premenopausal women with components of metabolic syndrome: Findings from a Phase II randomized, double-blind, placebo-controlled trial.. University of Arizona Cancer Center Fall Retreat.More infoTapia E, Villa Guillen D, Chalasani P, Centuori S, Roe D, Guillen-Rodriguez J, Huang C, Galons JP, Thomson CA, Altbach M, Trujillo J1, Pinto L, Martinez JA, Algotar AM,, Chow S. Effects of metformin on breast density and anthropometric measurements in premenopausal women with components of metabolic syndrome: Findings from a Phase II randomized, double-blind, placebo-controlled trial. UACC Fall Retreat. (November 2020).
- Chalasani, P. (2019, May/Spring). Tucatinib, palbociclib, and letrozole in HR+/HER2+ metastatic breast cancer: Report of phase IB safety cohort. ASCO.
- Chalasani, P. (2018, May/Spring). Rare tumor with matched germline whole exome sequencing to identify somatic and inherited variants of clinical significance. ASCO/Poster Presentation.
- Trujillo, J. S., Chow, H., Villa-Guillen, D. E., Algotar, A., Tapia, E., Roe, D., Cordova, C., Miller, J., Gallons, J. P., Chalasani, P., Altbach, M., Thomson, C. A., Altbach, M., Thomson, C. A., Gallons, J. P., Chalasani, P., Miller, J., Cordova, C., Tapia, E., , Roe, D., et al. (2018, March 2018). The potential for metformin to reduce obesity-associated breast cancer risk. American Society for Preventive Oncology, 42nd Annual Conference. New York: American Society for Preventive Oncology.
- Trujillo, J., Trujillo, J., Tapia, E. O., Tapia, E. O., Villa Guillen, D. E., Villa Guillen, D. E., Chalasani, P., Chalasani, P., Martinez, J. A., Martinez, J. A., Guillen-Rodriguez, J. M., Guillen-Rodriguez, J. M., Thomson, C. A., Thomson, C. A., Roe, D., Roe, D., Galons, J., Galons, J., Altbach, M. I., , Altbach, M. I., et al. (2018, Fall). Abstract: Phase II clinical study of metformin for breast cancer prevention. UACC Scientific Retreat. UACC Scientific Retreat. Tucson, AZ.
- Yessenia, P., Lang, L., Hsu, C., Gomez, J., Calhoun, E., Chalasani, P., & Macpherson, A. J. (2018, January). Breast Cancer Screening Strategies for Latin American Women. Arizona Community Healthcare Outreach Workers (AzCHOW) 15th Annual Conference. Tucson, AZ: Breast Cancer Research Association.
- Ibrahim, N., Tang, S. C., Brenner, A., Kesari, S., Piccioni, D., Anders, C., Carrillo, J., Chalasani, P., Kabos, P., Puhalla, S., Garcia, A., Tkaczuk, K., Ahluwalia, M. S., Lakhani, N., & Kumthekar, P. (2016, December/Winter). A Phase II, Open-Label, Multi-Center Study of ANG1005, A Novel Brain-penetrant Peptide-Drug Conjugate, in Breast Cancer Patients with Recurrent CNS Metastases. San Antonio Breast Cancer Symposium.
- Kumthekar, P., Tang, S. C., Brenner, A., Kesari, S., Piccioni, S., Anders, C., Carrillo, J., Chalasani, P., Kabos, P., Puhalla, S., Garcia, A., Tkaczuk, K., Ahluwalia, M. S., Lakhani, N., & Ibrahim, N. (2016, June/Summer). ANG1005, A Novel Brain-Penetrant Taxane Derivative, for the Treatment of Recurrent Brain Metastases and Leptomeningeal Carcinomatosis from Breast Cancer. ASCO.
- Kumthekar, P., Tang, S., Brenner, A., Kesari, S., Anders, C. K., Carrillo, J. A., Chalasani, P., Kabos, P., Ahluwalia, M. S., & Ibrahim, N. K. (2016, October/Winter). A Phase II Study of ANG1005, a novel BBB/BCB Penetratant Taxane in Patients with Recurrent Brain Metastases and Leptomeningeal Carcinomatosis from Breast Cancer. European Association of Neuro-Oncology.
- Martinez, J. A., Chalasani, P., Witte, R. S., Kwoh, C. K., Hadden, A., & Taljanovic, M. (2016, April). Imaging Biomarkers of Aromatase-Inhibitor Induced Joint Pain. University of Arizona, Cancer Center Retreat. Banner University Medical Center, Tucson, AZ.
- Tang, S. C., Brenner, A. J., Kesari, S., Piccioni, D. E., Anders, C., Carrillo, J., Kumthekar, P., Chalasani, P., Kabos, P., Puhalla, S., Garcia, A., Tkaczuk, K. H., Ahluwalia, M. S., Lakhani, N. J., & Ibrahim, N. K. (2016, June/Summer). ANG1005, a novel brain-penetrant taxane derivative, for the treatment of recurrent brain metastases and leptomeningeal carcinomatosis from breast cancer. ASCO.
- Tang, S. C., Brenner, A., Kesari, S., Piccioni, D., Anders, C., Carrillo, J., Kumthekar, P., Chalasani, P., Kabos, P., Ahluwalia, M. S., & Ibrahim, N. (2016, November/Winter). The novel brain penetrating peptide-drug conjugate of ANG1005 shows acrivity in LC subset of paitents with recurrent CNS metastasis from breast cancer. Society for Neuro-Oncology.
- Tang, S. C., Kumthekar, P., Brenner, A. J., Kesari, S., Piccioni, D., Anders, C. K., Carrillo, J. A., Chalasani, P., Kabos, P., Puhalla, S. L., Garcia, A., Tkaczuk, K., Ahluwalia, M. S., Lakhani, N., & Ibrahim, N. (2016, October/Fall). ANG1005, a novel peptide-paclitaxel conjugate crosses the BBB and shows activity in patients with recurrent CNS metastasis from breast cancer, results from a Phase II Clinical Study.. European Society for Medical Oncology.
- Chalasani, P., Lebeau, L. G., Gonzalez, V., Viscusi, R. K., Ley, M. B., Clarke, K., Livingston, R. B., Nagle, R. B., MacKerricher, W., Baker, A. F., & Segar, J. (2015, December). Abstract P6-04-10: Clinicopathological and molecular characteristics of pleomorphic invasive lobular carcinoma of breast. San Antonio Breast Cancer Symposium. San Antonio, TX.: AACR.
- Chalasani, P., Nagy, D., Livingston, R., Weterings, E., Nagle, R., Singh, S., Barnes, M., Gorgan, T., Baker, A., & Shanmugam, K. (2015, December). Evaluating RAD51/Geminin protein expression as an indicator of homologous recombination deficiency. San Antonio Breast Cancer Symposium. San Antonio, Texas: San Antonio Breast Cancer Symposium.
- Trujillo, J. S., Chow, H., Villa-Guillen, D. E., Algotar, A., Tapia, E., Roe, D., Cordova, C., Miller, J., Gallons, J. P., Chalasani, P., Altbach, M., Thomson, C. A., Altbach, M., Thomson, C. A., Gallons, J. P., Chalasani, P., Cordova, C., Miller, J., Tapia, E., , Roe, D., et al. (2018, March 2018). The potential for metformin to reduce obesity-associated breast cancer risk. American Society for Preventive Oncology, 42nd Annual Conference. New York: American Society for Preventive Oncology.
- Samuel, S., Viscusi, R. K., Waer, A. L., Hurst, C., Larson, E., Gonzalez, V., Chalasani, P., Lebeau, L. G., Livingston, R. B., & Ley, M. (2014, December). Nipple sparing mastectomy: Risks of wound complication in the setting of neo-adjuvant chemotherapy. San Antonio Breast Cancer Symposium.
- Viscusi, R. K., Lebeau, L. G., Gonzalez, V., Chalasani, P., Stopeck, A. T., Livingston, R. B., Waer, A. L., Ley, M. B., Lundberg, T., & Lee, E. S. (2013, October). Abstract P1-12-03: A Retrospective Case Series of Primary squamous cell carcinoma of the breast. San Antonio Breast Cancer Symposium. San Antonio, TX.
- Martinez, J. A., Chalasani, P., Witte, R. S., Kwoh, C. K., Hadden, A., & Taljanovic, M. (2016, April). Imaging Biomarkers of Aromatase-Inhibitor Induced Joint Pain. University of Arizona, Cancer Center Retreat.