Sewanti Limaye's research while affiliated with Sir H. N. Hospital and Research Centre and other places
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Publications (70)
e18872
Background: Tumor Mutation Burden has been correlated with therapy outcomes in patients receiving immune checkpoint inhibitors (ICI). However, tumor specific TMB cut-offs are not well established in the Indian cohort. Genomic alterations are shown to be vital determinants of response, resistance, and hyper-progression post-ICI administration...
e21202
Background: Circulating tumor DNA (ctDNA) encompasses spatial and temporal heterogeneity, tumor evolution, and is ideal for repeat sampling and predictive therapeutic course corrections whereas tissue is the first choice for molecular profiling. We report the mutational landscape of an Indian NSCLC cohort, with focus on liquid biopsy and val...
e13080
Background: Breast cancer is a genetically and clinically heterogeneous entity, with high prevalence in the Indian population. The primary objective of this study was to characterize the somatic mutational landscape of metastatic breast cancer in Indian patients from tumor and liquid specimens. Methods: We performed molecular profiling of 34...
e17505
Background: Cisplatin based concurrent chemoradiation therapy (CCRT) has been recognized as the standard treatment for locally advanced cervical cancer. Although patients treated with CCRT have better chances of survival and prognosis, over 30–40% of patients do not achieve a complete response and may develop locoregional recurrence. Hence p...
e21177
Background: Enumeration of circulating tumor cells (CTCs) is rapidly emerging as a minimally invasive and reliable technique for monitoring disease progression and patient’s response to treatment. However, its utility beyond enumeration in clinical management of cancer remains scarcely explored. Being biologically similar to both primary and...
Background:
The low specificity of serum PSA resulting in the inability to effectively differentiate prostate cancer from benign prostate conditions is a persistent clinical challenge. The low sensitivity of serum PSA results in false negatives and can miss high-grade prostate cancers. We describe a non-invasive test for detection of prostate canc...
Background
Olaparib is approved as maintenance therapy in patients with platinum-sensitive relapsed (PSR) ovarian cancer (OC). Currently, sparse information is available on the safety of maintenance olaparib in Indian patients
Methods
In this prospective, single-arm, multicentre, phase 4 study in India (ClinicalTrials.gov Identifier: NCT04330040),...
Purpose
Advanced gall bladder cancer (GBC) is an aggressive disease, and there is no consensus on treatment options beyond first-line chemotherapy. We report a case of an elderly male with FGFR2-altered advanced adenocarcinoma of the gallbladder who failed two prior lines of chemotherapy but had sustained response and stable disease on sequential F...
Treatment failure is one of the main hurdles in treating cervical cancer, despite significant breakthroughs in both conventional and targeted therapy. The one-year survival of patients with advanced or recurrent cervical cancer globally is less than 30%. Chemotherapy, radiation, and concurrent chemoradiotherapy are among the therapeutic modalities...
Tongue squamous cell carcinoma is an aggressive oral cancer with a high incidence of metastasis and poor prognosis. Most of the oral cavity cancer patients present in clinics with locally advanced unresectable tumors. Neoadjuvant treatment is beneficial for these individuals as it reduces the tumor size aiding complete resection. However, patients...
Advanced gall bladder cancer (aGBC) is an aggressive disease with no consensus on treatment options beyond first line chemotherapy. We report a case of an elderly male with FGFR2 altered advanced adenocarcinoma of the gallbladder who failed two prior lines of chemotherapy but had sustained response and stable disease on sequential FGFR directed tar...
Backround
Diagnosis of primary glial malignancies (GLI-M) in individuals presenting with Intracranial Space Occupying Lesions (ICSOL) is based on histopathological evaluation (HPE) of tissue obtained by surgical resection or biopsy with attendant resource implications and risks. Approximately 70% of ICSOLs have non-malignant etiology and distinctio...
Background:
The early detection of breast cancer (BrC) is associated with improved survival. We describe a blood-based breast cancer detection test based on functional enrichment of breast-adenocarcinoma-associated circulating tumor cells (BrAD-CTCs) and their identification via multiplexed fluorescence immunocytochemistry (ICC) profiling for GCDF...
Background
Evaluation of serum prostate specific antigen (PSA) is a part of standard prostate cancer diagnostic work-up in symptomatic males as well as for elective prostate cancer screening in asymptomatic males. The low specificity of serum PSA leading to an inability to effectively differentiate prostate cancer from benign prostate conditions is...
BACKGROUND
Screening of asymptomatic women for early detection of Breast Cancer (BrC) is associated with improved survival. Presently, mammography is the standard of care (SoC) for BrC screening but has lower accuracy for invasive cancers as well as in women with higher breast tissue density.
METHODS
In this manuscript, we describe an accurate blo...
Standard therapy for advanced ovarian cancer (OC) consists of radical debulking cytoreductive surgery followed by adjuvant chemotherapy. An important risk factor for OC is genetic predisposition, with BRCA1 or BRCA2 mutations accounting for the majority of hereditary OC. Mutation in BRCA ultimately causes accumulation of genetic alterations because...
Background:
A Phase IV, single-arm study was conducted to assess the safety of osimertinib in Indian patients with epidermal growth factor receptor (EGFR) T790M mutation-positive stage IV non-small cell lung cancer (NSCLC).
Methods:
Enrolled patients received 80 mg osimertinib for six cycles or until disease progression or unacceptable toxicity...
Angiogenesis inhibitors (AGI) are not presently used for the treatment of gastric cancers. This report demonstrates that angiogenesis inhibitor can be safely and effectively used in combination with cytotoxic anti-cancer agents for treatment of Gastric cancers.
We report a case of an advanced refractory Gastric AD which responded favourably to a combination regimen of AGI and other chemotherapy agents which were selected on the basis of multi-analyte tumor profiling. The treatment was well tolerated with transient manageable adverse events and yielded radiological partial response.
Background: Angiogenic factors are commonly activated in solid tumors and present a viable therapeutic target. However, anticancer treatment with angiogenesis inhibitors (AGI) is limited to a few cancers, mostly as monotherapy and not selected based on molecular indications. We aimed to determine whether patient-specific combination regimens with A...
We provide the South Asian Declaration, containing the consensus guidelines for coronavirus disease 2019 (COVID-19) vaccination in cancer patients.
Immune checkpoint inhibitors, such as pembrolizumab and nivolumab, act by inhibiting programmed death-1 and activating the T cells against cancer. An imbalance in this immune response, however, could lead to immune-related adverse events (irAEs) involving multiple organs like rash, fatigue, hypo and hyperthyroidism, pneumonitis, hepatitis, and coli...
There is limited data on management of metastatic nonsmall cell lung cancer (NSCLC) in the elderly population due to lack of representation of this subset in clinical trials. The projected representation of elderly population of patients globally is expected to rise significantly in the years to come. It is imperative to understand the specific cha...
Background: Activation of the mTOR signaling pathway is ubiquitous in cancers and a favourable therapeutic target. However, presently approved mTOR inhibitor monotherapies have modest benefits in labeled indications while poor outcomes have been reported for mTOR inhibitor monotherapy when administered in a label-agnostic setting based on univariat...
Background
Angiogenic factors are commonly activated in solid tumors and present a viable therapeutic target. However, anticancer treatment with angiogenesis inhibitors (AGI) is limited to a few cancers, mostly as monotherapy and not selected based on molecular indications. We aimed to determine whether patient-specific combination regimens with AG...
Background: Diagnosis of lung cancer in suspected individuals is based on histopathological examination (HPE) of tumor tissue obtained by an invasive biopsy. However, lung biopsies are associated with various procedural risks and may often not be possible owing to anatomical considerations as well as patient co-morbidities. It is also estimated tha...
Purpose
Selection of cytotoxic chemotherapy agents (CCA) based on pre-treatment evaluation of drug sensitivities is a desirable but unmet goal for personalized anticancer treatment strategies. Prior attempts to correlate in vitro Chemo-Response Profiles (CRP) of tumor explants or Circulating Tumor Cells (CTCs) with clinical outcomes have been large...
Ovarian cancer is common gynaecological malignancy and a leading cause of death among women. Despite the advances in treatment strategies, majority of patients present with recurrence after first- or second-line treatment. Targeted therapy that has proven to be effective in other advanced or metastatic solid tumors have also demonstrated its effica...
Periampullary adenocarcinomas are rare neoplasm that originates from the pancreatic head, the ampulla of vater, the distal bile duct or the duodenum. Surgical resection followed by adjuvant therapy is considered as the standard of care treatment for these carcinomas. Despite several advances in diagnostics and therapeutics, only 5% of these patient...
We have previously shown that circulating ensembles of tumor-associated cells (C-ETACs) are a systemic hallmark of cancer based on analysis of blood samples from 16,134 individuals including 10,625 asymptomatic individuals and 5,509 diagnosed cases of cancer. C-ETACs were ubiquitously (90%) detected across all cancer types and were rare (3.6%) amon...
Background:
Histopathologic examination (HPE) of tumor tissue obtained by invasive biopsy is the standard for cancer diagnosis but is resource-intensive and has been associated with procedural risks. The authors demonstrate that immunocytochemistry (ICC) profiling of circulating ensembles of tumor-associated cells (C-ETACs) can noninvasively provi...
The success of treatment in solid organ cancers is ascertained by radiologic imaging as per standard-of-care protocol, with PET-CT being the modality of choice. However, even in cases where complete resolution of the disease is noted radiologically, recurrence or emergence of new metastases is not uncommon. To explore the underlying cause of such r...
3525
Background: Despite the development of targeted therapy agents and immune checkpoint inhibitors (ICI), cytotoxic anticancer agents remain the mainstay of treatment in several solid organ cancers. However, instances of innate and acquired resistance towards these anticancer agents can lead to treatment failures, which remain undetectable until...
e15623
Background: Tumor tissue profiling following invasive biopsies is presently the standard approach for indication-based therapy management in solid organ cancers. However, challenges in biopsy are traditionally described due to proximity to vital organs, or patients’ co-morbidities or unwillingness for an invasive procedure. Liquid biopsies f...
e15624
Background: Treatment of advanced refractory cancers face challenges in non-availability of systemic therapy regimens with evidenced benefit. Post failure of two to three lines of systemic treatments, patients with such cancers are usually considered for palliation or clinical trials. Prior attempts at label-agnostic treatment regimens (prec...
3544
Background: There are presently no accepted non-invasive means for detection of cancers in asymptomatic individuals or suspected cases. Radiological and serological investigations, though non-invasive, are not confirmatory and necessitate an invasive biopsy to establish malignant status of suspected findings. Invasive biopsies, in turn, face c...
194
Background: Resistance to combination regimens of fluorouracil, oxaliplatin and irinotecan are commonly observed in Colorectal cancers (CRC). There are presently no viable approaches for ‘real-time’ monitoring of innate and acquired chemoresistance. We used a novel method for chemo-interrogation (CI) by harvesting from peripheral blood sufficie...
808
Background: CEA and CA19-9 are non-specific markers for Gastrointestinal (GI) cancers. Molecular analysis of fecal blood is of limited utility in colorectal cancers. A non-invasive pan-GI-cancer blood-based test with high specificity and sensitivity is an unmet medical need. Considering that unprovoked thromboembolism is a significant risk in m...
799
Background: Definitive diagnosis of gastrointestinal (GI) malignancies is reliant on histopathological examination of tumor tissue obtained by invasive biopsies. However, invasive biopsies are associated with procedural risks, complications and expenses. A non-invasive technique for diagnosis of GI cancers is presently unavailable. Here we pres...
Rapid progress in next generation sequencing technologies provided deeper insights into the mechanism underlying disease pathology. It has broadened our horizon to understand the cellular processes at individual cell level. Single-cell analysis allowed uncovering new dimensions that could track the trajectories of distant cell lineage in tumor deve...
Abstract
Background
Selection of Checkpoint Inhibitor therapies in several cancers are based on PD-L1 expression in tumor tissue determined by IHC. Invasive biopsy to obtain tumor tissue is associated with procedural risks, sequelae and expenses. Though PD-L1 profiling of Circulating Tumor Cells (CTCs) has been attempted previously, limitations ari...
Circulating Ensembles of Tumor Associated Cells (C-ETACs) which comprise tumor emboli, immune cells and fibroblasts pose well-recognized risks of thrombosis and aggressive metastasis. However, the detection, prevalence and characterization of C-ETACs has been impaired due to methodological difficulties. Our findings show extensive pan-cancer preval...
Background
Innate and acquired chemoresistance to anticancer therapies are a well-known phenomenon in Esophageal Squamous Cell Carcinomas (ESCC). There are presently no viable approaches for real-time monitoring of resistance in ESCC. We used a novel method for chemo-interrogation (CI) by harvesting sufficient number of Circulating-Tumor Associated...
Background
Refractory cancers pose formidable management challenges. We hypothesized that such malignancies have unexplored vulnerabilities that can be identified using Encyclopedic Tumor Analysis (ETA) and effectively targeted using conventional agents in a label- and organ-agnostic manner to yield treatment benefit. The pan-cancer RESILIENT trial...
Background
Hormone and Growth Factor Receptors (HR) such as ER, PR, HER2 and AR are involved in the pathogenesis of various cancers and are commonly targeted in treatment regimens. HR antagonists Standard of Care (SoC) are often administered as monotherapy or as combinations with selected cytotoxic or targeted agents. In the SHIVA trial, monotherap...
Background
Though mTOR inhibition is considered an attractive strategy for cancer management, anti-mTOR monotherapies have not shown meaningful benefits. We hypothesized that an Encyclopedic Tumor Analysis (ETA) can identify vulnerabilities in the tumor in addition to mTOR activation. We further hypothesized that tandem synergistic targeting of the...
Citations
... This persists despite breakthroughs in therapeutic options, including surgery, resection, chemotherapy and radiotherapy used individually or in combination [3]. Additionally, 10-20% of patients with early-stage CC and up to 70% of those with locally advanced CC experience cancer reoccurrence following surgery or radiation therapy [4]. This cancer recurrence may stem from tumor cells losing their sensitivity to chemotherapy and radiation treatment, ultimately contributing to unfavorable prognoses and heightened recurrence risks. ...
... The latter surgical approach removes the interface zone in its entirety. We believe this observation is related to the emerging understanding that breast cancer is a systemic disease, even in its early stages, as supported by the detection of circulating tumor cells [3]. These cells, when reactivated, can infiltrate the index breast quadrant and cause local recurrence near the interface zone. ...
... The oral medicine in question has been produced by Pfizer and is employed for the therapeutic management of specific forms of cancer, including HER2-negative advanced breast cancer characterized by distinct genetic alterations. Talzenna (Talazoparib) functions in a manner akin to other inhibitors of PARP-1, effectively impeding the enzymatic activity of PARP enzymes, specifically PARP-1, which play a crucial role in the process of DNA repair [43]. The suppression of PARP in cancer cells harboring certain genetic abnormalities, such as BRCA1 or BRCA2 mutations, or other impairments in DNA repair pathways, results in the accumulation of DNA damage and subsequent cell death [44]. ...
... However, parental VQ-D2 cells show little to no expression of FGFR1-4 at the mRNA level, comparable to control plasma cells ( Figure S6A) and do not harbor any mutations in FGFR1-4 either (our unpublished results). To determine if FGFR inhibition plays a role in Pon efficacy, we next tested the FGFR1 inhibitor sorafenib 17 , the FGFR1-3 inhibitor pazopanib 18 , and the pan-FGFR inhibitors dovitinib and lenvatinib 19,20 in our VQ MM cell lines. Similar as other TKIs tested in the AOD IX panel, none of the FGFR inhibitors displayed single agent efficacy at 100 nM and 1000 nM or in combination with Tra ( Figure S6B), suggesting that the efficacy of Pon in VQ MM cells is not primarily mediated through FGFR signaling. ...
... Inhibitors targeting PDGFR, VEGFR, or FGFR family receptors and Ret: Tumor angiogenesis is a hallmark of cancer. Several growth factors and their receptors, such as platelet-derived growth factor (PDGF)/PDGFR, vascular endothelial growth factor (VEGF)/VEGFR, fibroblast growth factor (FGF)/FGFR, stem cell factor (SCF)/c-Kit, glial cell line-derived neurotrophic factor (GDNF)-family ligands/ rearranged during transfection (RET), and angiopoietin/Tie 22,111 , regulate the growth, differentiation and migration of cancer cells and angiogenic activities of vascular endothelial cells 22,111 . PDGFs are members of the 'cysteine knot' growth factor superfamily, the members of which contain at least three disulfide bridges and forms homo-or heterodimers 112 . ...
... They have followed a step-by-step process (modified Delphi) that is both transparent and fair. 2 Most authors focus on numbers. In the development of guidelines, they sometimes forget that the document will finally be used by the community oncologists who otherwise may not have access to the expertise and mentorship of a senior experienced colleague. ...
... 2 Obtaining an adequate tumor sample can be clinically challenging due to an inaccessible tumor location or late presentation with metastatic disease at diagnosis. 2 The quality of one-third of core biopsy specimens was not found to be appropriate for novel immune biomarker discovery, NGS, and histopathologic testing. 25 It is now imperative that, whenever possible, the aim of any diagnostic biopsy/tissue sampling procedure performed should be to maximize the amount of tissue acquired without compromising patient safety. 26 The quality of the biospecimens depends on the expertise of the surgeons and interventional radiologists in tissue collection. ...
... In another study using alpelisib, the objective response rate (ORR) of recurrent/advanced cervical cancer patients carrying the PIK3CA mutation was 33% [27]. Several cancers show PIK3CA gene mutations and these mutations make them therapeutic targets [26,30,31]. To better understand the potential mechanisms, more research is still needed. ...
... The outcome of the trail was that the combination therapy exhibits better clinical response in patients diagnosed with sarcoma and adrenocortical carcinoma than when temsirolimus was used alone [141]. In another clinical trial, CTRI/2018/05/014178, conducted by Timothy Crook and co-workers in 2020, it was demonstrated that mTOR-based drug combination improved treatment outcomes, like response rate and disease control rate [142]. ...
... Although oral mucositis is a very rare ADR (occurrence rate of less than 10%) arising due to immunotherapy, it was observed in this case. 17,18 This ADR is more commonly seen with the use of anti-PD-1 inhibitors than with the use of CTLA-4 inhibitors. 19 Informed consent was obtained from the patient before the submission of this case report for publication including the use of images. ...