Elena Elimova

Elena Elimova
The Princess Margaret Hospital

About

196
Publications
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Introduction

Publications

Publications (196)
Article
Background: Metastatic gastroesophageal adenocarcinoma (GEA) is a heterogeneous disease with an overall poor prognosis. The impact of sites of metastatic dissemination on survival is not well characterized. This study aims to evaluate whether certain sites of metastatic disease impacts survival. Methods: A retrospective analysis of 375 patients...
Article
Background: CheckMate 649, a randomized phase 3 study in advanced GC/GEJC/EAC, showed superior overall survival (OS) and an acceptable safety profile with 1L NIVO + chemo vs chemo, leading to approval in multiple countries. We present exploratory efficacy analyses by baseline tumor mutational burden (TMB) and gene expression signatures (GES) from C...
Article
4057 Background: While several clinical scoring systems exist to aid prognostication and patient (pt) selection for clinical trials in oncology, none are standardly used. We compared the ability of four prognostic scores to predict overall survival (OS) in pts with advanced gastric and esophageal (GE) cancer. Methods: Pts with advanced (unresectabl...
Article
Purpose: The aim of this study was to determine if radiomic features combined with sarcopenia measurements on pretreatment 18F-FDG PET/CT can improve outcome prediction in surgically treated adenocarcinoma esophagogastric cancer patients. Patients and methods: One hundred forty-five esophageal adenocarcinoma patients with curative therapeutic in...
Chapter
KEY CONCEPTS Gastric cancer remains the third most common cause of cancer-related death worldwide. Two different pathogeneses of gastric cancer have been proposed, correlating to two histologic types: intestinal and diffuse. Gastrectomy is the recommended treatment in relatively early localized gastric cancer (T1b); however, in more advanced gastri...
Article
Full-text available
Standard first-line chemotherapy results in disease progression and death within one year in most patients with human epidermal growth factor receptor 2 (HER2)-negative gastro-oesophageal adenocarcinoma1–4. Nivolumab plus chemotherapy demonstrated superior overall survival versus chemotherapy at 12-month follow-up in gastric, gastro-oesophageal jun...
Article
Background: Despite the availability of multiple HER2-targeted therapies, most patients (pts) with advanced HER2-positive BC experience disease progression, and an unmet medical need remains. Zanidatamab (zani) binds to HER2 across a range of expression levels and induces formation of receptor clusters, resulting in receptor internalization and dow...
Article
Full-text available
PurposeTo determine the prognostic value of sarcopenia measurements done on staging 2-[18F] FDG PET/CT together with metabolic activity of the tumor in patients with adenocarcinoma esophagogastric cancer with surgical treatment.Methods Patients with early-stage, surgically treated esophageal adenocarcinoma and available pre-treatment 2-[18F] FDG PE...
Article
240 Background: CheckMate 649 is a randomized, global phase 3 study of 1L programmed death-1 (PD-1) inhibitor–based therapies in advanced non-HER2-positive GC/GEJC/EAC that demonstrated superior overall survival (OS) with NIVO + chemo vs chemo, leading to approvals in the US and other countries. Clinically meaningful long-term survival benefit with...
Article
TPS363 Background: ADP-A2M4CD8 is an autologous specific peptide enhanced affinity receptor (SPEAR) mixed CD4 and CD8 T-cell product that expresses an engineered T-cell receptor (TCR) designed to target the MAGE-A4 antigen in HLA-A*02-positive patients. These SPEAR T-cells also express wild-type CD8α co-receptors, designed to provide additional fun...
Article
357 Background: Radiomic characterisation of tumour phenotypes can generate image-driven biomarkers that potentially aid in clinical decision-making. We sought to identify radiomic features in metastatic GEA that may be predictive for survival outcomes. Methods: A retrospective analysis between 2009-20 identified patients (pts) with metastatic GEA....
Article
TPS635 Background: Over 70% of patients with pancreatic ductal adenocarcinoma (PDAC) present with metastatic disease where the mainstay of treatment is combination chemotherapy. Two pivotal phase III trials showed survival benefit of mFOLFIRINOX (mFFX) and gemcitabine/nab-paclitaxel (GnP), respectively, compared to gemcitabine alone. Both are consi...
Article
Gastroesophageal cancers carry poor prognoses, and are a leading cause of cancer-related morbidity and mortality worldwide. Even in those with resectable disease, more than half of patients treated with surgery alone experience disease recurrence. Multimodality approaches using preoperative and postoperative chemotherapy and/or radiotherapy have be...
Article
167 Background: CheckMate 649 (NCT02872116) is a randomized, open label phase 3 study in first line (1L) treatment of pts with advanced GC/GEJC/EAC. Primary analysis results showed statistically significant improvement in overall survival (OS) for NIVO+chemo vs. chemo in all randomized pts. We present HRQOL results for these pts, included as an exp...
Article
The presence of neuroendocrine (NE) differentiation has been previously reported in both morphological subtypes, (intestinal and diffuse), of esophageal adenocarcinoma, (EAC). This is more commonly seen in the post-treatment setting and is thought to confer a more aggressive phenotype. However, the molecular underpinning and therapeutic implication...
Article
Barrett’s esophagus (BE) is the primary precursor lesion of esophageal adenocarcinoma (EAC), which not only resembles the intestinal mucosa morphologically but also expresses various intestinal stem cell (ISC) markers. We hypothesized that ISC markers, Lgr5 (also a cancer stem cell marker), Ascl2 (fate determinator of ISC),Bmi1 (quiescent counterpa...
Preprint
Full-text available
Purpose To determine the prognostic value of sarcopenia measurements done on staging [¹⁸F] FDG PET/CT together with metabolic activity of the tumor in patients with adenocarcinoma esophagogastric cancer with surgical treatment. Methods Patients with early stage, surgically treated esophageal adenocarcinoma and available pre-treatment PET/CT were i...
Article
e16060 Background: Recurrent gastroesophageal (GE) carcinomas carry a poor prognosis and are usually treated with palliative chemotherapy (CTX). However, recent studies suggest that certain patients with oligometastatic recurrence can have long term survival after metastasectomy. Appropriate patient selection for metastasectomy remains a challenge,...
Article
4066 Background: CheckMate 649 (NCT02872116) is a randomized, open label phase 3 study in first line (1L) GC/GEJC/EAC. Prespecified interim results showed statistically significant improvement in overall survival (OS) and progression-free survival (PFS) for N+C vs C in all randomized pts and pts whose tumors expressed programmed death-ligand 1 comb...
Article
4003 Background: In CheckMate 577 (NCT02743494), NIVO demonstrated a significant and clinically meaningful improvement in disease-free survival (DFS; primary endpoint) vs placebo (PBO) and was well tolerated in patients (pts) with resected (R0) stage II/III EC/GEJC who received neoadjuvant CRT and had residual pathologic disease. Median DFS doubled...
Article
Background No adjuvant treatment has been established for patients who remain at high risk for recurrence after neoadjuvant chemoradiotherapy and surgery for esophageal or gastroesophageal junction cancer. Methods Download a PDF of the Research Summary. We conducted CheckMate 577, a global, randomized, double-blind, placebo-controlled phase 3 tria...
Preprint
Full-text available
Purpose: Stem cell markers play a significant role in esophageal adenocarcinoma carcinogenesis via Barrett’s esophagus; however, its utility as a prognostic biomarker has not been established. Methods: We analyzed the immunohistochemical expression of Ascl2 and Lgr5 utilizing whole slides (WS; 35 cases) and tissue microarray (TMA; 64 cases of esoph...
Article
Importance: Phase 3 randomized clinical trials (RCTs) are usually reported after a predetermined number of events (death or disease progression) have occurred, when survival curves remain poorly defined. Updated reports are important in providing mature data. Objectives: To evaluate the proportion of phase 3 RCTs for cancer that are updated and...
Article
193 Background: Although age is a non-modifiable risk factor for most cancers, alone it is not very helpful in deciding on the best treatment for patients. Insufficient data exist in the oldest old ( > 75 years) compared to young-old (65-75 years) and to younger ( < 65 years) patients with de novo metastatic GEC regarding which factors influence re...
Article
164 Background: For patients with human epidermal growth factor receptor 2 (HER2)-overexpressing GEA, trastuzumab in combination with chemotherapy is the only approved HER2-targeted therapy, and they have limited treatment options after progression. Zanidatamab, a HER2-targeted bispecific antibody, has shown durable anti-tumor activity with good to...
Article
167 Background: NIVO is the first adjuvant therapy to provide a statistically significant and clinically meaningful improvement in disease-free survival (DFS) versus PBO in resected EC/GEJC following neoadjuvant chemoradiotherapy as demonstrated by CheckMate 577. NIVO was well tolerated with an acceptable safety profile. This analysis provides addi...
Article
224 Background: Perioperative FLOT is standard-of-care for locally advanced resectable gastric and gastroesophageal (GEJ) adenocarcinoma. Completion of perioperative chemotherapy (8 cycles) is potentially jeopardised by significant toxicity and intolerance. Only 46% of patients completed all cycles in the initial phase 2/3 trial (FLOT-AIO). We soug...
Article
Full-text available
Background Malnutrition and sarcopenia are poor prognostic factors in many cancers. Studies in gastric and esophageal (GE) cancer have focused on curative intent patients. This study aims to evaluate the prognostic utility of malnutrition and sarcopenia in de novo metastatic GE adenocarcinoma. Methods Patients with de novo metastatic GE adenocarci...
Article
Full-text available
Background: Trimodality therapy (TMT) with neoadjuvant chemoradiotherapy (nCRT) using concurrent carboplatin plus paclitaxel (CP) followed by surgery is the standard of care for locoregional esophageal or gastroesophageal junction (GEJ) cancers. Alternatively, nCRT with cisplatin plus fluorouracil (CF) can be used. Definitive chemoradiotherapy (dC...
Article
4557 Background: Malnutrition and sarcopenia (defined as low skeletal muscle mass) are recognized as poor prognostic factors in many cancers. Studies to date in gastroesophageal cancer have largely focused on patients (pts) undergoing curative intent surgery. This study aims to evaluate the prognostic utility of nutritional markers and sarcopenia i...
Article
e16539 Background: Combination paclitaxel (PTX) and ramucirumab (RAM) is standard second-line treatment for gastric and GEJ cancers. Peripheral neuropathy (PN) is considered a potential obstacle to administering a maximal dose of PTX, potentially limiting efficacy. We sought to determine the dose-intensity and outcomes for patients receiving this t...
Presentation
e16577 Background: Gastric and esophageal (GE) cancers most commonly occur in older adults in their 60’s.However, there are inconsistent reports about prognosis in adolescent and young adult (AYA) pts, and treatment patterns and outcomes in this population have not been well characterized. Methods: A retrospective analysis was performed for AYA (ag...
Article
4544 Background: Body fat and muscle influence prognosis in many cancer types. However, this association is unclear for real-world MEC pts, who are often in worse performance status than their previous baseline. In addition, the relationship of BM at presentation and QoL is unknown. We used real-world MEC pts to assess the importance of BM in OS an...
Article
Full-text available
Background: A microscopically positive (R1) resection margin following resection for gastric and esophageal cancers has been documented to be a poor prognostic factor. The optimal strategy and impact of different modalities of adjuvant treatment for an R1 resection margin remain unclear. Methods: A retrospective analysis was performed for patien...
Article
Full-text available
Background: The goal of surveillance testing is to enable curative salvage therapy through early disease detection, however supporting evidence in gastroesophageal adenocarcinoma is limited. We evaluated frequency of successful salvage therapy and outcomes in patients who underwent surveillance. Methods: A single-site, retrospective cohort study...
Article
325 Background: Gastric and esophageal (GE) cancers most commonly occur in older adults in their 60’s. There are inconsistent reports about prognosis in adolescent and young adult (AYA) pts, and treatment patterns and outcomes in this population have not been well characterized. Methods: A retrospective analysis was performed for AYA (age < 40) pts...
Article
747 Background: It is unclear whether locally advanced pancreatic cancer (LAPC) should be treated similarly to metastatic pancreatic cancer (MPC). Clinical trials often exclude LAPC. We compare clinical and genomic characteristics of LAPC and MPC. Methods: Patients with LAPC and MPC were enrolled in the COMPASS trial (NCT02750657). Clinical, demogr...
Article
328 Background: Esophageal cancer arising within a previous radiation treatment field (ECRF) is rare. The patterns of disease, treatment and outcomes in these patients (pts) have not been well characterized. Methods: A retrospective analysis was performed for pts treated for esophageal cancer at the Princess Margaret Cancer Centre from 2002-2016. E...
Article
324 Background: Blood-based-inflammation-markers (BBIM) and Body Mass Index (BMI) have been associated with overall survival (OS) in a number of cancers. Inflammation and obesity have biological interactions. We evaluated the role of Neutrophil-to-Lymphocyte-Ratio (NLR), Platelet-to-Lymphocyte-Ratio (PLR) and Systemic-Inflammation-Index (SII) in co...
Conference Paper
Background: There is a paucity of predictive genomic biomarkers in pancreas cancer (PDA) that can direct personalized treatment. Patients with tumors that are deficient in homologous recombination repair deficiency (HRD) may benefit from platinum and/or PARP inhibition. Biallelic inactivation of BRCA1 can result in a tumor with characteristics of H...
Conference Paper
Introduction: Patients with locally advanced pancreatic adenocarcinoma (LAPC) historically have a poor outcome despite having localized disease. The disease course of LAPC as compared to metastatic pancreatic adenocarcinoma (MPC) is unclear. SMAD4 mutational status has been postulated as a prognostic marker in this group. Molecular characteristics...
Article
Full-text available
PurposeThere is a wide range in tumor response following preoperative chemotherapy in locally advanced gastric or gastroesophageal junction cancers. We investigated the relationship between tumor platinum levels and pathological responses in these patients. Methods Tumor and adjacent normal tissues were retrieved. Pathological responses were assess...
Article
Full-text available
Background ZW25, a novel IgG1 bispecific antibody, targets HER2 domains ECD2 and ECD4, resulting in multiple differentiated and unique mechanisms of action, including improved receptor internalization and downregulation relative to trastuzumab. Safety, anti-tumor activity, and biomarker data from an ongoing phase 1 trial of ZW25 monotherapy in soli...
Article
Background Multiple mechanisms can directly influence body compositions (bcomp) in cancer: tumor-dependent chronic inflammation, leading to (a) anorexia and multiple neuroendocrine changes, (b) patient-dependent treatment related effects, and (c) in esophageal cancer, mechanical alterations with weight loss. Supportive management depends on underst...
Article
Full-text available
Background Locally advanced pancreatic adenocarcinoma (LAPC) is treated similarly to metastatic pancreatic cancer (MPC). It has previously been thought that SMAD4 is wildtype (WT) in LAPC. We describe results of whole genome (WGS) and RNA sequencing (RNAseq) of LAPC and MPC tumours. Methods Patients with LAPC and MPC were enrolled in the COMPASS c...
Article
Background Few studies have assessed the differences in outcomes between phase II versus III landmark studies in gastrointestinal (GI) malignancies. The primary aim of this study was to determine differences in overall survival (OS) and overall response rate (ORR) between phase III studies and their preceeding phase II studies and to assess for dif...
Article
Full-text available
Background ZW25, a novel IgG1 bispecific antibody, targets HER2 domains ECD2 and ECD4, resulting in multiple differentiated and unique mechanisms of action, including improved receptor internalization and downregulation relative to trastuzumab. Safety, anti-tumor activity, and biomarker data from an ongoing phase 1 trial of ZW25 monotherapy in soli...
Article
4068 Background: Sarcopenia is defined as low skeletal muscle mass and represents a quantifiable marker of frailty. Disease related symptoms of anorexia, nausea and dysphagia, in addition to reduced physical activity contribute to muscle wasting in metastatic esophageal squamous cell cancer (MESCC) patients. This study set out to evaluate the progn...
Article
4069 Background: A microscopically positive (R1) resection margin following resection for gastroesophageal (GE) cancer has been documented to be a poor prognostic factor. The optimal strategy and impact of different modalities of adjuvant treatment for an R1 resection margin remain unclear. Methods: A retrospective analysis was performed for patien...
Article
e14595 Background: MEC, associated with fatigue and dysphagia, leads to loss of skeletal muscle mass, malnutrition, subcutaneous and visceral adiposity. Cancer inflammation mobilizes muscle and adipose tissue, potentially leading to cachexia and sarcopenia. Supportive management depends on understanding the cancer frailty determinants that lead to...
Article
e15579 Background: Although commonly performed, evidence supporting routine surveillance testing (SvT) in patients (pts) with resected GEAC is lacking. We evaluated patterns of relapse, frequency of salvage therapy and outcomes among pts with resected GEAC who underwent surveillance. Methods: Between 2011 and 2016, 210 consecutive pts with GEAC fol...
Article
Background: The RAINBOW trial established ramucirumab combined with paclitaxel as a second-line option in metastatic gastric and gastroesophageal junction (GEJ) adenocarcinoma. Ramucirumab was given on days 1 and 15 with paclitaxel on days 1, 8, and 15 of a 28-day cycle. The median overall survival (OS) was significantly longer with ramuciru-mab p...
Article
Full-text available
Background The cost of new anticancer drugs is rising. We aimed to assess the clinical benefit and price of anti‐cancer drugs approved by the US Food and Drug Administration (FDA) for advanced gastrointestinal cancers. Methods Drugs approved between 2006 and 2017 for advanced GI malignancies were identified from FDA.gov, and their updated supporti...
Article
164 Background: A microscopically positive (R1) resection margin following resection for gastroesophageal (GE) cancer has been documented to be a poor prognostic factor. The optimal strategy and impact of different modalities of adjuvant treatment for an R1 resection margin remain unclear. Methods: A retrospective analysis was performed for patient...
Article
444 Background: Patients with pancreatic ductal adenocarcinoma (PDAC) have limited treatment options. Management of complex symptoms and psychosocial implications requires an interprofessional approach as prognosis is often measured in months. A multidisciplinary approach has been associated with improvement in clinical outcomes including survival....
Article
171 Background: Disease related symptoms including anorexia, nausea and dysphagia lead patients with esophageal cancer to become malnourished. Malnourishment can result in systemic inflammation, reduced treatment tolerance, poorer quality of life and decreased overall survival. Currently weight loss is the main clinical measure of malnutrition, and...
Article
162 Background: Although commonly performed, the benefit of routine surveillance testing (SvT) following curative resection of GEAC is undefined. We aimed to determine frequency of successful salvage therapy (SST) in patients (pts) with relapsed GEAC who were surveyed post curative therapy. Methods: Between 2011 and 2016, 210 consecutive pts with l...
Article
188 Background: Predictive mutational and transcriptional features in advanced PDAC are needed for improved patient stratification and treatment selection. Methods: Patients (pts) on the COMPASS trial with advanced PDAC are prospectively recruited prior to first-line chemotherapy for WGS and RNAseq. Tumor tissue undergoes enrichment by laser captur...
Article
37 Background: Systematic symptom monitoring improves quality of life, and possibly overall survival in cancer outpatients receiving chemotherapy. To reduce patient, staff, and resource burden, combining research surveys with electronic PRO assessments in a multidisciplinary academic esophageal cancer clinic may allow dual clinical-research goals t...
Article
Full-text available
Background: We aimed to assess current treatment patterns and outcomes in elderly patients with localized gastric and esophageal (ge) cancers. Methods: This retrospective analysis considered patients 75 years of age or older with ge cancers treated during 2012-2014. Patient demographics and tumour characteristics were collected. Overall survival...
Article
Mucin glycoproteins on the ocular surface are rich in O-glycans and have important roles in the protection from physical, chemical and microbial impact. In this work, we have cultured human corneal and conjunctival epithelial cells to examine the glycosyltransferase activities that synthesize the O-glycans of mucins. The results indicate that ocula...