Nithya Krishnamurthy

Icahn School of Medicine at Mount Sinai | MSSM · Department of Medicine

189 Background: Machine learning (ML) models can predict mortality and guide end-of-life (EOL) care for patients with advanced solid cancers. Early advanced care planning (ACP) leads to more goal-concordant care, yet many patients, especially from minoritized groups, do not engage in serious illness conversations (SIC). Reasons for delay include in...

Legislative agendas aimed at regulating nurse staffing in US hospitals have intensified after acute workforce disruptions triggered by COVID-19. Emerging evidence consistently demonstrates the benefits of higher nurse staffing levels, although uncertainty remains regarding whether and which legislative approaches can achieve this outcome. The purpo...

Background: Estrogen exposure is a known risk factor for the development of breast cancer in women. Less clear is the risk posed by gender affirming hormone therapy (GAHT) in both transgender men and transgender women. We aimed to characterize the breast cancers that have arisen in our institution’s transgender patient population including biomarke...

Context Despite efforts to enhance equity, disparities in early palliative care (PC) access for historically minoritized patients with advanced breast cancer (ABC) persist. Insight into patient and clinician perspectives are needed to inform future models aimed at improving equity in PC access and outcomes. Objectives To explore qualitative barrie...

Background CTLA-4 impedes the immune system’s antitumor response. There are two Food and Drug Administration-approved anti-CTLA-4 agents – ipilimumab and tremelimumab – both used together with anti-PD-1/PD-L1 agents. Objective To assess the prognostic implications and immunologic correlates of high CTLA-4 in tumors of patients on immunotherapy and...

Context Studies have found a variable incidence of erythrocytosis among people using testosterone as part of gender-affirming hormone therapy (GAHT). Objective To examine the effect of using exogenous testosterone as GAHT on hematocrit in a large North American cohort. Methods We conducted a cross-sectional analysis of testosterone and hematocrit...

88 Background: Black and Latina women with metastatic breast cancer (MBC) experience more severe distress, unaddressed symptom burden, and discordant provider communication relative to White women. Adequate care coordination has the potential to mitigate disparities in care access and outcomes, yet little is known regarding palliative care (PC) coo...

Background CTLA-4 is a membrane glycoprotein expressed by activated effector T cells that impedes the immune system’s antitumor response. There are two FDA-approved anti-CTLA-4 agents—ipilimumab and tremelimumab, both used together with anti-PD-1/PDL1 agents. Methods We evaluated RNA expression levels (OmniSeq (https://www.omniseq.com)) and clinic...

Disclosure: D. Slack: None. N. Krishnamurthy: None. F. Contreras-Castro: None. J.D. Safer: None. For feminizing gender affirming hormone therapy (GAHT), the Endocrine Society and WPATH SOC 8 suggest targeting testosterone (T) levels below 50 ng/dL and estradiol (E2) levels in the range of 100-200 pg/mL. However, studies have shown variability in co...

This study investigated the outcomes and follow-up behaviors of participants from two free skin cancer screening events in the United States. This survey, with 296 participants and a 31% response rate, gathered information on participant demographics, personal history of skin cancer, knowledge of skin screening practices, and follow-up behaviors. T...

Chromatin regulation involves four subfamilies composed of ATP-dependent multifunctional protein complexes that remodel the way DNA is packaged. The SWItch/Sucrose Non-Fermentable (SWI/SNF) chromatin remodeling complex subfamily mediates nucleosome reorganization and hence activation/repression of critical genes. The SWI/SNF complex is composed of...

Background Repurposing is a drug development strategy receiving heightened attention after the Food and Drug Administration granted emergency use authorization of several repurposed drugs to treat Covid-19. There remain knowledge gaps on the root causes, facilitators and barriers for repurposing. Method This systematic review used controlled vocab...

Background: Repurposing is a drug development strategy receiving heightened attention after the FDA granted emergency use authorization of several repurposed drugs to treat Covid-19. There remain knowledge gaps on facilitators and barriers for repurposing and why promising drug candidates get shelved in the outset. Method: This systematic literatur...

Co-signaling receptors for the T cell receptor are important therapeutic targets, with blockade of co-inhibitory receptors such as PD-1 now central in immuno-oncology. Advancing additional therapeutic immune modulation approaches requires understanding ligand regulation of other co-signaling receptors. One poorly understood potential therapeutic ta...

Co-signaling receptors for the T cell receptor are important therapeutic targets, with blocking co-inhibitory receptors such as PD-1 now central in immuno-oncology. Advancing additional therapeutic immune modulation approaches requires understanding ligand regulation of other co-signaling receptors. One poorly understood therapeutic target is TIM-3...

Background STK11 is an important tumour suppressor gene reported to confer immunotherapy resistance in non–small-cell lung cancers (NSCLC) especially in the presence of KRAS co-alterations. Methods This study analysed 4446 patients for whom next-generation sequencing of tissue and/or circulating tumour DNA (ctDNA) had been performed. Results Over...

Immune responses have been successfully reactivated in cancer by targeting inhibitory receptors such as PD-1 on exhausted T cells to block immune checkpoints. Many patients do not respond, however, and a key challenge in immuno-oncology is to identify and understand new immune-regulatory targets to increase response rates. One other co-inhibitory r...

Background Immune checkpoint blockade has proven effective in targeting exhausted T-cells to reactivate the immune system against cancer. However, the majority of patients fail to respond to currently available therapies, which primarily target PD-1. Thus, a key challenge for checkpoint blockade therapy is to identify and understand new therapeutic...

The rapid advances in the understanding of oncogenic process and the maturation of affordable precision diagnostic tools have enabled the development of targeted therapeutic agents, such as those targeting BCR-ABL, epithelial growth factor receptor L858R, EML4-anaplastic lymphoma kinase, and BRAF V600E, to treat cancers that harbor specific molecul...

BACKGROUND Telomerase reverse transcriptase (TERT) promoter mutations that may affect telomerase activity have recently been described in human malignancies. The purpose of this study was to investigate the clinical correlates of TERT promoter abnormalities in a large cohort of patients with diverse cancers. METHODS This study analyzed TERT promot...

The Wnt/beta-catenin pathway is a family of proteins that is implicated in many vital cellular functions like stem cell regeneration and organogenesis. Several intra-cellular signal transduction pathways are induced by Wnt, notably the Wnt/beta-catenin dependent pathway or canonical pathway and the non-canonical or beta-catenin-independent pathway,...

Carcinoma of unknown primary (CUP) is a rare and difficult-to-treat malignancy, the management of which might be improved by the identification of actionable driver mutations. We interrogated interrogated 54-70 genes in 442 patients with CUP using targeted clinical-grade, next-generation sequencing (NGS) of circulating tumor DNA (ctDNA). Overall, 8...

11511 Background: Carcinoma of unknown primary (CUP) is a rare, difficult-to-treat malignancy. To further understand the genomic landscape of CUP, next-generation sequencing (NGS) of circulating tumor DNA (ctDNA) from patient plasma was performed. To our knowledge, this is the largest cohort of patients with CUP interrogated by liquid biopsy. Metho...

The use of circulating tumor DNA (ctDNA) as a novel and non-invasive test for the diagnosis and surveillance of cancer is a rapidly growing area of interest, with sequencing of ctDNA acting as a potential surrogate for tissue biopsy. Circulating tumor DNA has been detected incidentally during noninvasive prenatal testing and additionally in more th...