Clinical Focus


  • Pediatric Hematology
  • Health Equity
  • Medical Education
  • Pediatric Hematology-Oncology

Academic Appointments


Honors & Awards


  • David Geffen Scholar Class of 2018, Annual Merit Based Scholarship (2014-2018)
  • Gold Humanism Honor Society, DGSOM at UCLA (2017)
  • Alpha Omega Alpha Honor Medical Society, DGSOM at UCLA (2017)

Professional Education


  • Fellowship: Stanford University Pediatric Hematology Oncology Fellowship (2024) CA
  • Board Certification: American Board of Pediatrics, Pediatrics (2021)
  • Residency: Stanford University Pediatric Residency at Lucile Packard Children's Hospital (2021) CA
  • Medical Education: UCLA David Geffen School Of Medicine Registrar (2018) CA
  • BA, University of Chicago, Biology with Specialization in Endocrinology

All Publications


  • Inflammatory Pathways and the Bone Marrow Microenvironment in Inherited Bone Marrow Failure Syndromes. Stem cells (Dayton, Ohio) Neoman, N., Kim, H. N., Viduya, J., Goyal, A., Liu, Y. L., Sakamoto, K. M. 2025

    Abstract

    Inherited Bone Marrow Failure Syndromes (IBMFS) are a diverse group of genetic disorders characterized by insufficient hematopoietic cell production due to blood stem cell dysfunction. The most common syndromes are Fanconi Anemia, Diamond-Blackfan Anemia, and Shwachman-Diamond Syndrome. These conditions share a theme of chronically producing pro-inflammatory cytokines such as TNF-α, IL-1β, IL-6, TGF-β, IFN-I, and IFN-γ. Each of these cytokines can impact the bone marrow microenvironment and drive the pathophysiology of IBMFS. This review aims to provide the latest progress in the field regarding the mechanistic underpinnings of inflammation in these IBMFS, as well as the effect of inflammation on the bone marrow microenvironment. A comprehensive understanding of the inflammation in IBMFS will open new avenues for intervention to restore bone marrow stability and improve patient prognosis. Future research must include targeting these mechanisms to develop novel therapies that can potentially mitigate the effects of chronic inflammation in IBMFS.

    View details for DOI 10.1093/stmcls/sxaf021

    View details for PubMedID 40296192

  • A qualitative study of childhood cancer families' post-treatment needs and the impact of a community-based organization in a rural, socioeconomically disadvantaged, majority Hispanic/Latino region. Pediatric blood & cancer Smith, S. M., Teer, A., Tolamatl Ariceaga, E., Billman, E., Benedict, C., Goyal, A., Pang, E. M., Pecos-Duarte, C., Lewinsohn, R., Smith, M., Boynton, H., Montes, S., Rivera, E., Ramirez, D., Schapira, L. 2023: e30798

    Abstract

    Individual- and population-level socioeconomic disadvantages contribute to unequal outcomes among childhood cancer survivors. Reducing health disparities requires understanding experiences of survivors from historically marginalized communities, including those with non-English language preference.We partnered with a community-based organization (CBO) serving families of children with cancer in a rural region in California with low socioeconomic status and majority Hispanic/Latino (H/L) residents. We interviewed English- and Spanish-speaking adolescent/young adult (AYA) childhood cancer survivors (≥15 years old, ≥5 years from diagnosis), parents, and CBO staff to evaluate post-treatment needs and impact of CBO support. Data were analyzed qualitatively using applied thematic analysis. Themes were refined through team discussions with our community partners.Twelve AYAs (11 H/L, 11 bilingual), 11 parents (eight H/L, seven non-English preferred), and seven CBO staff (five H/L, five bilingual) participated. AYAs (five female, seven male) were of median (min-max) age 20 (16-32) and 9 (5-19) years post diagnosis; parents (nine female, two male) were age 48 (40-60) and 14 (6-23) years post child's diagnosis. Themes included challenges navigating healthcare, communication barriers among the parent-AYA-clinician triad, and lasting effects of childhood cancer on family dynamics and mental health. Subthemes illustrated that language and rurality may contribute to health disparities. CBO support impacted families by serving as a safety-net, fostering community, and facilitating H/L families' communication.Childhood cancer has long-lasting effects on families, and those with non-English language preference face additional burdens. Community-based support buffers some of the negative effects of childhood cancer and may reduce disparities.

    View details for DOI 10.1002/pbc.30798

    View details for PubMedID 38053230

  • Leveraging a community-academic partnership to evaluate the needs of Latinx AYA cancer survivors Smith, S. M., Teer, A., Ariceaga, E., Billman, E., Goyal, A., Benedict, C., Pecos-Duarte, C., Smith, M., Montes, S., Luna, E., Ramirez, D., Boynton, H., Schapira, L. LIPPINCOTT WILLIAMS & WILKINS. 2023
  • Development of a text messaging system to improve receipt of survivorship care in adolescent and young adult survivors of childhood cancer. Journal of cancer survivorship : research and practice Casillas, J., Goyal, A., Bryman, J., Alquaddoomi, F., Ganz, P. A., Lidington, E., Macadangdang, J., Estrin, D. 2017; 11 (4): 505-516

    Abstract

    This study aimed to develop and examine the acceptability, feasibility, and usability of a text messaging, or Short Message Service (SMS), system for improving the receipt of survivorship care for adolescent and young adult (AYA) survivors of childhood cancer.Researchers developed and refined the text messaging system based on qualitative data from AYA survivors in an iterative three-stage process. In stage 1, a focus group (n = 4) addressed acceptability; in stage 2, key informant interviews (n = 10) following a 6-week trial addressed feasibility; and in stage 3, key informant interviews (n = 23) following a 6-week trial addressed usability. Qualitative data were analyzed using a constant comparative analytic approach exploring in-depth themes.The final system includes programmed reminders to schedule and attend late effect screening appointments, tailored suggestions for community resources for cancer survivors, and messages prompting participant feedback regarding the appointments and resources. Participants found the text messaging system an acceptable form of communication, the screening reminders and feedback prompts feasible for improving the receipt of survivorship care, and the tailored suggestions for community resources usable for connecting survivors to relevant services. Participants suggested supplementing survivorship care visits and forming AYA survivor social networks as future implementations for the text messaging system.The text messaging system may assist AYA survivors by coordinating late effect screening appointments, facilitating a partnership with the survivorship care team, and connecting survivors with relevant community resources.The text messaging system has the potential to improve the receipt of survivorship care.

    View details for DOI 10.1007/s11764-017-0609-0

    View details for PubMedID 28364263

    View details for PubMedCentralID PMC5933434

  • Glucocorticoid receptor antagonism as a novel therapy for triple-negative breast cancer. Clinical cancer research : an official journal of the American Association for Cancer Research Skor, M. N., Wonder, E. L., Kocherginsky, M., Goyal, A., Hall, B. A., Cai, Y., Conzen, S. D. 2013; 19 (22): 6163-72

    Abstract

    Triple-negative breast cancer (TNBC) accounts for 10% to 20% of newly diagnosed invasive breast cancer. Finding effective targets for chemotherapy-resistant TNBC has proven difficult in part because of TNBC's molecular heterogeneity. We have previously reported that likely because of the antiapoptotic activity of glucocorticoid receptor (GR) in estrogen receptor (ER)-negative breast epithelial and cancer cells, high GR expression/activity in early-stage TNBC significantly correlates with chemotherapy resistance and increased recurrence. We hypothesized that pretreatment with mifepristone, a GR antagonist, would potentiate the efficacy of chemotherapy in GR+ TNBCs by inhibiting the antiapoptotic signaling pathways of GR and increasing the cytotoxic efficiency of chemotherapy.TNBC cell apoptosis was examined in the context of physiologic glucocorticoid concentrations, chemotherapy, and/or pharmacologic concentrations of mifepristone. We used high-throughput live microscopy with continuous recording to measure apoptotic cells stained with a fluorescent dye and Western blot analysis to detect caspase-3 and PARP cleavage. The effect of mifepristone on GR-mediated gene expression was also measured. TNBC xenograft studies were performed in female severe combined immunodeficient (SCID) mice and tumors were measured following treatment with vehicle, paclitaxel, or mifepristone/paclitaxel.We found that although mifepristone treatment alone had no significant effect on TNBC cell viability or clonogenicity in the absence of chemotherapy, the addition of mifepristone to dexamethasone/paclitaxel treatment significantly increased cytotoxicity and caspase-3/PARP cleavage. Mifepristone also antagonized GR-induced SGK1 and MKP1/DUSP1 gene expression while significantly augmenting paclitaxel-induced GR+ MDA-MB-231 xenograft tumor shrinkage in vivo.These results suggest that mifepristone pretreatment could be a useful strategy for increasing tumor cell apoptosis in chemotherapy-resistant GR+ TNBC.

    View details for DOI 10.1158/1078-0432.CCR-12-3826

    View details for PubMedID 24016618

    View details for PubMedCentralID PMC3860283