Nicole L Simone

Thomas Jefferson University | Jefferson · Department of Radiation Oncology

The circadian system, a vital temporal regulator influencing physiological processes, has implications for cancer development and treatment response. Our study assessed circadian timing’s impact on whole-brain radiotherapy outcomes in brain metastases for personalized cancer therapy insights. The aim of the study was to evaluate circadian influence...

PURPOSE Traditional methods of evaluating cardiotoxicity focus on radiation doses to the heart. Functional imaging has the potential to provide improved prediction for cardiotoxicity for patients with lung cancer. Fluorine-18 ( ¹⁸ F) fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) imaging is routinely obtained i...

Background: The circadian system, a vital temporal regulator influencing physiological processes, has implications for cancer development and treatment response. Our study assesses circadian timing's impact on whole-brain radiotherapy outcomes in brain metastases for personalized cancer therapy insights. Aim: Evaluate circadian influence on radiati...

Simple Summary Because systemic barriers contribute to the cancer disparities seen among LGBTQ+ patients, we asked physicians about their perceptions on cancer screenings for different subpopulations of this community. We also asked how many of these physicians had received LGBTQ+-specific training, whether they acknowledged that a patient’s LGBTQ+...

Community-based breast cancer prevention efforts often focus on women who live in the same neighborhoods, as they tend to have similar demographic characteristics, health behaviors, and environmental exposures; yet little research describes methods of selecting neighborhoods of focus for community-based cancer prevention interventions. Studies freq...

Purpose: This study examined the gender composition of career development award applicants and grant review panels during the pandemic compared with that beforehand. Methods: Data were collected from 14 Health Research Alliance (HRA) organizations, which fund biomedical research and training. HRA members provided the gender of grant applicants and...

Access to green space has been shown to be associated with decreased incidence of cancer. The goal of this study is to identify associations between neighborhood green space indicators and breast cancer outcomes at the neighborhood level in Philadelphia. Green space indicators were sourced from the National Land Cover Database (2006-2016), VT Spati...

It is important to establish if exposure to green space provides a protective effect for breast cancer development and progression to advocate for expanded access to green space areas for 1) those at-risk and 2) cancer patients receiving treatment. There is an association of residential proximity to green space with decreased breast cancer incidenc...

Background: Although the U.S. cancer death rate has declined significantly over three decades, health disparities continue to exist. Factors such as the environment in which our patients work, live, and play, also known as social determinants of health (SDoH), may play a role. Adverse SDoH are associated with increased cancer risk factors and negat...

Background: Social determinants of health (SDOH) are social barriers that stratify health status. Specifically, socioeconomic status, education level, minority and immigration status correlate with higher risk of onset and severity of chronic disease. We sought to understand how SDOH affect a patient’s belief regarding autonomy over cancer risk and...

Purpose A disparity exists in cancer screening rates for the Sexual and Gender Minority (SGM) community. We sought to understand the perceptions and baseline knowledge of cancer screening among SGM community members. Methods Survey administered via social media from June 2018 to October 2018. We asked 31 questions focused on cancer screening, huma...

Purpose/Objectives: Circadian clock dysregulation has been implicated in cancer risk such that The World Health Organization classifies circadian disruption as a probable carcinogen following several reports of night shift workers with an increased risk of breast cancer. There are studies which outline a link between time of day a patient receives...

Introduction: Precision breast intraoperative radiation therapy (PB-IORT) is a novel approach to adjuvant radiation therapy for early-stage breast cancer performed as part of a phase II clinical trial at two institutions. One institution performs the entire procedure in an integrated brachytherapy suite which contains a CT-on-rails imaging unit an...

Circadian disruption has been linked to cancer development, progression, and radiation response. Clinical evidence to date shows that circadian genetic variation and time of treatment affect radiation response and toxicity for women with breast cancer. At the molecular level, there is interplay between circadian clock regulators such as PER1, which...

Introduction: Health disparities in breast cancer outcomes exist for African American (AA) women who are noted to present with more aggressive cancer with worse survival. Although the underlying reason for this disparity is not apparent, it is likely multifactorial. Interestingly, type 1 insulin-like growth factor receptor (IGF-1R) expression, whic...

Background: Social determinants of health directly affect cancer survival. Driven by advances in technology and recent demands due to COVID-19, telemedicine has the ability to improve patient access to care, lower health care costs, and increase workflow efficiency. The role of telemedicine in radiation oncology is not established. Materials and Me...

Simple Summary miR-21 is an oncogenic microRNA that has been associated with breast tumor growth and metastasis in vitro and is also noted to be upregulated by cytotoxic stressors in model systems and in breast cancer patients who have undergone radiation. In the present study, our findings demonstrate the novel role of miR-21 in vivo for breast ca...

Background The COVID-19 pandemic challenges our ability to safely treat breast cancer patients and requires revisiting current techniques to evaluate optimal strategies. Potential long-term sequelae of breast radiation have been addressed by deep inspiration breath-hold (DIBH), prone positioning, and four-dimensional computed tomography (4DCT) aver...

Outcomes for triple negative breast cancer (TNBC) are poor and may be improved by increasing CD8+ tumor infiltrating lymphocytes (TIL) to augment anti-tumor immunity. Radiation (RT) can promote immunogenic cell death with increased anti-tumor T-cell activity but also stimulates suppressive regulatory T-cells (Tregs). Since metabolic alterations aff...

Background: Metastatic cancer is incurable and understanding the molecular underpinnings is crucial to improving survival for our patients. The IGF-1/Akt signaling pathway is often impaired in cancer leading to its progression and metastases. Diet modification is known to alter the IGF-1/Akt pathway and affect the expression of microRNA involved i...

BACKGROUND: The LGBTQ+ community is noted to experiences worse cancer outcomes, and the NCI has therefore designated this population as medically underserved. The reasons for this disparity are likely multifactorial, due in part to lower screening rates from emotional distress surrounding medical encounters and gaps in health knowledge. Therefore,...

For the past 100 years, oncologists have relentlessly pursued the destruction of tumor cells by surgical, chemotherapeutic or radiation oncological means. Consistent with this focus, treatment plans are typically based on key characteristics of the tumor itself such as disease site, histology and staging based on local, regional and systemic dissem...

The COVID-19 pandemic has resulted in school closures and distancing requirements that have disrupted both work and family life for many. Concerns exist that these disruptions caused by the pandemic may not have influenced men and women researchers equally. Many medical journals have published papers on the pandemic, which were generated by researc...

The COVID-19 pandemic has resulted in school closures and distancing requirements that have disrupted both work and family life for many. Concerns exist that these disruptions caused by the pandemic may not have influenced men and women researchers equally. Many medical journals have published papers on the pandemic, which were generated by researc...

The COVID-19 pandemic has resulted in school closures and distancing requirements that have disrupted both work and family life for many. Concerns exist that these disruptions caused by the pandemic may not have influenced men and women researchers equally. Many medical journals have published papers on the pandemic, which were generated by researc...

Purpose Intraoperative radiation therapy (IORT), a form of accelerated partial breast irradiation (APBI), is an appealing alternative to postoperative whole breast irradiation for early-stage breast cancer. The purpose of this study was to examine the toxicity and cosmetic outcomes of patients treated with a novel form of breast IORT (precision bre...

The COVID-19 pandemic has affected work and family life for many, including academic researchers. Anecdotal evidence suggests that university shutdowns have influenced the article submission rates of men and women differently. Here we present a timely analysis that compares the proportion of men and women medical researchers publishing on the coron...

Background: Chest wall recurrences represent a significant source of morbidity for breast cancer patients causing symptoms including bleeding, ulceration, infection and pain. Approximately 5 to 10% of breast cancer patients undergoing a mastectomy will have a chest wall or nodal recurrence within ten years after surgery. Loco-regional recurrence is...

The collection of microbes that live in and on the human body - the human microbiome - can impact on cancer initiation, progression, and response to therapy, including cancer immunotherapy. The mechanisms by which microbiomes impact on cancers can yield new diagnostics and treatments, but much remains unknown. The interactions between microbes, die...

Introduction: Obesity is associated with a higher incidence of cancer, increased cancer mortality, impaired responses to radiation therapy (RT), and worse toxicity after RT. Paradoxically, recent studies suggest that obese patients may actually have improved outcomes with immunotherapy (IO), such as programmed death (PD)-1 inhibition, highlighting...

Introduction: Obesity is associated with a higher incidence of cancer, increased cancer mortality, impaired responses to radiation therapy (RT), and worse toxicity after RT. Paradoxically, recent studies suggest that obese patients may actually have improved outcomes with immunotherapy (IO), such as programmed death (PD)-1 inhibition, highlighting...

p>Background: Recent studies have shown that these sexual and gender minorities often forgo care due to difficulties accessing health insurance coverage or fear of physician stigmatization. Therefore, using a nation-wide survey of providers and members of the LGBTQ+ community, we understand opinions on cancer screening since national guidelines hav...

Purpose: African American (AA) women have a lower incidence of breast cancer however, their mortality rate is significantly higher compared to Caucasian (C) women. It is postulated that this is in part, due to the increased prevalence of chronic metabolic syndromes such as obesity and diabetes in the AA population. Also, cytotoxic therapies such as...

Purpose: Radiation therapy is an essential intervention used in the treatment of more than half of cancer patients. With the increasing use of hypofractionated radiation regimens, concurrent use of radiation and chemotherapy, targeted agents and immunotherapy, the risk of radiation-induced toxicities is increased. However, much remains unknown abo...

Using a recently developed matrix‐assisted laser desorption/ionization imaging mass spectrometry (MALDI‐IMS) method, we have spatially profiled N‐linked glycans in human breast cancer formalin‐fixed paraffin‐embedded (FFPE) tissue sections and tissue microarrays (TMA). Routinely, 50 or more individual N‐glycan species are detected per FFPE tissue,...

Purpose: Metabolic dysregulation has been implicated as a molecular driver of breast cancer in preclinical studies, especially with respect to metastases. We hypothesized that abnormalities in patient metabolism, such as obesity and diabetes, may drive outcomes in breast cancer patients with brain metastases. Methods: We retrospectively identifi...

Tumor-associated macrophages (TAMs) are the most abundant inflammatory cells in the breast cancer (BC) tumor microenvironment (TME) and suppress antitumor immune function, contributing to treatment resistance. These M2-polarized macrophages are characterized by fatty acid oxidation as opposed to the glycolytic pathways associated with M1-polarizati...

Triple negative breast cancer (TNBC) is a heterogeneous disease that has no available targeted therapies. Previously, we have shown that caloric restriction (CR) can augment the effects of radiation therapy in a TNBC mouse model. To build upon this, we now present data regarding the combination of chemotherapy and CR in the same 4T1 model. Chemothe...

Purpose: Discordances between the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), expression between primary breast tumors and their subsequent brain metastases (BM) were investigated in breast cancer patients. Methods: We collected retrospective data from 11 institutions in 8 countries in...

Background: miRNA-21, a well-known onco-miR, has been found to be up-regulated in over 18 major cancer types and is linked to radiation and chemotherapy resistance. It has been widely reported that radiation induces mir-21 expression levels in several different types of cancer and is also associated with cancer recurrence. Our laboratory has demons...

Purpose Trial**** is a prospective phase II trial of 3D-CRT PBrI following repeat lumpectomy for in-breast recurrence following previous whole breast irradiation (WBI). The primary goal of the trial was to determine the associated toxicity, tolerance and safety of PBrI. Materials and Methods Eligibility criteria included in-breast recurrence occur...

Introduction: The purpose of this study is to assess the effect of caloric restriction (CR) on prostate cancer (PCa) tumor burden, proliferation, and overall survival with and without radiation treatment (RT). Additionally, we determined if the beneficial effect of CR noted are due to a reduction in pro-inflammatory markers hypothesized to enhance...

Purpose: Triple negative breast cancers (TNBC) are a highly aggressive subtype of breast cancer, linked with a poor prognosis. TNBC tumors have a higher propensity for metastasis and unfortunately have fewer treatment options due to their lack of estrogen, progesterone or Her-2/neu receptors. We sought to determine if caloric restriction (CR) could...

Purpose:Recently an ultrafast automatic planning system for breast irradiation using tangential beams was developed by modeling relationships between patient anatomy and achieved dose distribution. This study evaluates the performance of this system when applied to a different patient population and dose calculation algorithm. Methods:The system an...

Purpose of review: This article reviews the impact the obese state has on malignancy through inflammation and immune dysregulation using recent excerpts from the medical literature. Recent findings: The obese state creates a proinflammatory endocrinologic milieu altering cellular signaling between adipocytes, immunologic cells, and epithelial ce...

Panobinostat is an oral HDAC inhibitor with radiosensitizing activity. We investigated the safety, tolerability and preliminary efficacy of panobinostat combined with fractionated stereotactic re-irradiation therapy (FSRT) for recurrent high grade gliomas. Patients with recurrent high grade gliomas were enrolled in a 3 + 3 dose escalation study to...

Purpose: Metastatic breast cancer is devastating and triple negative breast cancers (TNBC) have a higher propensity for metastasis. Improved local control upfront in this aggressive cancer could potentially decrease its propensity toward metastasis. We sought to determine if using caloric restriction (CR) as a systemic therapy, combined with radia...

16 Background: Locally advanced prostate cancers (LAPC) are aggressive, have poor prognosis, and are associated with high recurrence rates and conversion to castrate resistance. The molecular underpinnings of LAPC are being investigated to identify novel therapeutics. Animal models have shown that caloric restriction (CR) can potentially prevent th...

Purpose: The Next Accreditation System (NAS) requires radiation oncology residents to do a formal quality improvement project during their residency. The American Board of Radiology (ABR) Maintenance of Certification (MOC) program requires certified physicians to complete a Practice Quality Improvement (PQI) project approximately every 3 years. Th...

Conventional wisdom holds that only one of the two strands in a microRNA (miRNA) precursor duplex is selected as the active guide strand. The complementary passenger strand is thought to be inactive. In triple negative breast cancer (TNBC), high levels of the miRNA guide strand called miR-17-5p inhibits ribosomal translation of tumor suppressor gen...

Locally advanced prostate cancers (LAPC) are aggressive, have poor prognosis, and are associated with high recurrence rates and conversion to castrate resistance. The molecular underpinnings of LAPC are being investigated to identify novel therapeutics. Animal models have shown that caloric restriction (CR) can potentially prevent the initiation of...

Micro-RNA 21 (miR-21) is a well-known onco-miR found to be up-regulated in over 18 major cancer types and is linked to radiation and chemotherapy resistance. It is hypothesized that dysregulation of miR-21 may contribute to treatment resistance through multiple DNA damage response pathways by enhancing DNA repair and increasing DNA damage tolerance...

Purpose: Deep inspiration breath hold (DIBH) dramatically reduces radiation dose to the heart during radiation therapy (RT) for left-sided breast cancer, but the subsequent risk of radiation-related ischemic heart disease (IHD) is unknown. Our primary objective was to quantify the risk of IHD following RT with DIBH using modeled risk estimates (MR...

INTRODUCTION The primary aim in the management of DCIS is the prevention of recurrence and contralateral tumor (CT). Previous studies reported that younger patients and African Americans (AAs) experience a higher risk of recurrence, second tumors and show worse overall survival. Nevertheless, risk factors for DCIS recurrence, treatments and outcome...

Incidental radiation dose to the heart and lung during breast radiation therapy (RT) has been associated with an increased risk of cardiopulmonary morbidity. We conducted a prospective trial to determine if RT with the Active Breathing Coordinator (ABC) can reduce the mean heart dose (MHD) by ≥20% and dose to the lung. Patients with stages 0-III le...

Aim: The primary aim in the management of DCIS is the prevention of ipsilateral and contralateral invasive tumors. African American (AA) women and younger age experience a higher incidence of disease recurrence and worse overall survival. The use of endocrine treatment significantly reduces recurrence rate and contralateral disease in hormone recep...