Amina Chaudhry, MD

All Publications

• Systemic Treatment for Brain Metastasis and Leptomeningeal Disease in Breast Cancer Patients. Current oncology reports Puri, S., Chaudhry, A., Bayable, A., Ganesh, A., Daher, A., Gadi, V. K., Maraka, S. 2023

  Abstract

  Breast cancer with brain metastasis (BCBM) and leptomeningeal disease (LMD) are important clinical problems. Traditionally, patients with metastases to the brain and meninges were excluded from clinical trials; hence, robust, evidence-based treatment recommendations are lacking. In this review, we outline the systemic treatment options and ongoing clinical trials.Several recent studies have added to the systemic treatment options available. Antibody-drug conjugates have changed the therapeutic landscape. Combination treatment modalities that target multiple mechanisms including disruption of the blood brain barrier are increasingly being studied. Breast cancer with brain metastases and LMD is a heterogenous disease. While the prognosis remains grim, with more systemic treatment options, patients with BCBM are now living longer. Many ongoing clinical trials hold promise to further improve outcomes.

  View details for DOI 10.1007/s11912-023-01468-4

  View details for PubMedID 37924439

  View details for PubMedCentralID 4657380

• High-grade B-cell lymphoma, not otherwise specified: a multi-institutional retrospective study. Blood advances Zayac, A. S., Landsburg, D. J., Hughes, M. E., Bock, A. M., Nowakowski, G. S., Ayers, E. C., Girton, M. R., Hu, M., Beckman, A. K., Li, S., Medeiros, L. J., Chang, J. E., Stepanovic, A., Kurt, H., Sandoval-Sus, J., Ansari-Lari, M. A., Kothari, S. K., Kress, A., Xu, M. L., Torka, P., Sundaram, S., Smith, S. D., Naresh, K. N., Karimi, Y. H., Epperla, N., Bond, D. A., Farooq, U., Saad, M., Evens, A. M., Pandya, K., Naik, S. G., Kamdar, M., Haverkos, B. M., Karmali, R., Oh, T. S., Vose, J. M., Nutsch, H. R., Rubinstein, P. G., Chaudhry, A., Olszewski, A. J. 2023

  Abstract

  In this multi-institutional retrospective study, we examined characteristics and outcomes of 160 patients with high-grade B-cell lymphoma, not otherwise specified (HGBL-NOS). This rare lymphoma category is defined by high-grade morphologic features, most commonly Burkitt-like, and lack of MYC rearrangements with BCL2 and/or BCL6 rearrangements (so-called double-hit). Our results show that HGBL-NOS tumors are heterogeneous: 83% had a germinal center B-cell immunophenotype, 37% a dual expressor immunophenotype (MYC and BCL2 expression), 28% (single-hit) MYC rearrangement, 13% BCL2 rearrangement, and 11% BCL6 rearrangement. Most patients presented with stage 4 disease, a high serum lactate dehydrogenase, and other high-risk clinical factors. Most frequent first-line regimens included DA-EPOCH-R (43%), R-CHOP (33%), or other intensive chemotherapy programs (11%). We found no significant differences in the rates of complete response (CR, P=0.32), progression-free (PFS, P=0.82), or overall survival (OS, P=0.60) between these chemotherapy regimens. CR was attained by 69% of patients. PFS at 2 years was 55.2% (95%CI, 46.9-62.7), and OS was 68.1% (95%CI, 59.7-75.0). In a multivariable model, the main prognostic factors for PFS and OS were poor performance status, lactate dehydrogenase >3x upper limit of normal, and a dual expressor immunophenotype. Age >60 years or presence of MYC rearrangement were not prognostic, but patients with TP53 alterations had a dismal PFS (13% at 2 years). Presence of MYC rearrangement was not predictive of better PFS in patients treated with DA-EPOCH-R versus R-CHOP. Improvements in the diagnostic criteria and therapeutic approaches beyond dose-intense chemotherapy are needed to overcome the unfavorable prognosis of patients with HGBL-NOS.

  View details for DOI 10.1182/bloodadvances.2023009731

  View details for PubMedID 37171397

• Association of a novel 27-gene immuno-oncology assay with efficacy of immune checkpoint inhibitors in advanced non-small cell lung cancer. BMC cancer Ranganath, H., Jain, A. L., Smith, J. R., Ryder, J., Chaudry, A., Miller, E., Hare, F., Valasareddy, P., Seitz, R. S., Hout, D. R., Varga, M. G., Schweitzer, B. L., Nielsen, T. J., Mullins, J., Ross, D. T., Gandara, D. R., Vidal, G. A. 2022; 22 (1): 407

  Abstract

  Immune checkpoint inhibitor (ICI) therapies represent a major advance in treating a variety of advanced-stage malignancies. Nevertheless, only a subset of patients benefit, even when selected based on approved biomarkers such as PD-L1 and tumor mutational burden. New biomarkers are needed to maximize the therapeutic ratio of these therapies.In this retrospective cohort, we assessed a 27-gene RT-qPCR immuno-oncology (IO) gene expression assay of the tumor immune microenvironment and determined its association with the efficacy of ICI therapy in 67 advanced-stage NSCLC patients. The 27-gene IO test score (IO score), programmed cell death ligand 1 immunohistochemistry tumor proportion score (PD-L1 TPS), and tumor mutational burden (TMB) were analyzed as continuous variables for response and as binary variables for one-year progression free survival. The threshold for the IO score was prospectively set based upon a previously described training cohort. Prognostic implications of the IO score were evaluated in a separate cohort of 104 advanced-stage NSCLC patients from The Cancer Genome Atlas (TCGA) who received non-ICI therapy.The IO score was significantly different between responders or non-responders (p = 0.007) and associated with progression-free survival (p = 0.001). Bivariate analysis established that the IO score was independent of PD-L1 TPS and TMB in identifying patients benefiting from ICI therapy. In a separate cohort of late-stage NSCLC patients from TCGA, the IO score was not prognostic of outcome from non-ICI-treated patients.This study is the first application of this 27-gene IO RT-qPCR assay in a clinical cohort with outcome data. IO scores were significantly associated with response to ICI therapy and prolonged progression-free survival. Together, these data suggest the IO score should be further studied to define its role in informing clinical decision-making for ICI treatment in NSCLC.

  View details for DOI 10.1186/s12885-022-09470-y

  View details for PubMedID 35421940

  View details for PubMedCentralID PMC9008990

• Analysis of germline mutations in malignancies with concurrent pathogenic mutations in BRCA1, BRCA2, PALB2, ATM, CHEK2, and RAD51C/D Chaudhry, A., Jain, A., Mullins, J., Hare, F., Valasareddy, P., Ranganath, V. Annals of Oncology. 2021
• Usefulness of patient-reported outcomes to assess the effectiveness of topical hormonal therapy for gynecologic symptoms after antihormonal treatment for breast cancer Jain, A., Chaudhry, A., Schwartzberg, L., Vidal, G. Proc (Baylor Univ Med Cent). 2020
• Unusual Case Of A Recurrent Metastasizing Benign Breast Papilloma Jain, A., Chaudhry, A., Schwartzberg, L., Vidal, G. Journal of Medical Case Reports. 2020
• Outcomes with CDK4/6 inhibitors based on endocrine sensitivity in hormone receptor-positive metastatic breast cancer (HR MBC) Jain , A., Chaudhry, A., Vidal, G. Journal of Clinical Oncology. 2019
• Safety and efficacy of switching from unfractionated heparin to bivalirudin during primary percutaneous coronary intervention Chaudhry, A., Shah, R. Catheterization and Cardiovascular Interventions. 2018
• Bivalirudin versus Heparin without Glycoprotein IIB/IIIA Inhibitors for the Prevention of Stent Thrombosis: A Meta-Analysis Shah, R., Chaudhry, A. Journal of the American College of Cardiology. 2018
• High-volume forced diuresis with matched hydration using the RenalGuard System to prevent contrast-induced nephropathy: A meta-analysis of randomized trials. Clinical cardiology Shah, R., Wood, S. J., Khan, S. A., Chaudhry, A., Rehan Khan, M., Morsy, M. S. 2017; 40 (12): 1242-1246

  Abstract

  Contrast-induced nephropathy (CIN) is a well-recognized complication of coronary angiography that is associated with poor outcomes. Several small randomized controlled trials (RCTs) have recently shown that in patients with chronic kidney disease (CKD), furosemide-induced forced diuresis with matched hydration using the RenalGuard system can prevent its occurrence. However, individual studies have been underpowered and thus cannot show significant differences in major clinical endpoints.Forced diuresis with matched hydration using the RenalGuard system improves clinical outcomes in patients undergoing coronary angiography.Scientific databases and websites were searched for relevant RCTs. The pooled risk ratios were calculated using random-effects models. The primary endpoint was CIN, and the secondary endpoints were major adverse clinical events (MACEs) and the need for renal replacement therapy.Data from 3 trials including 586 patients were analyzed. High-volume forced diuresis with matched hydration using the RenalGuard system decreased risk of CIN by 60% (risk ratio: 0.40, 95% confidence interval: 0.25 to 0.65, P < 0.001), MACE rate by 59%, and the need for renal replacement therapy by 78%, compared with the standard of care.In patients with CKD undergoing coronary angiography, high-volume forced diuresis with matched hydration using the RenalGuard system significantly reduces the risk of CIN, MACE rate, and the need for renal replacement therapy. Larger RCTs with sufficient power are needed to confirm these findings.

  View details for DOI 10.1002/clc.22817

  View details for PubMedID 29247527

  View details for PubMedCentralID PMC6490568