Yuan James Rao, MD

All Publications

• Radiotherapy in Men with De Novo Metastatic Prostate Cancer. The Urologic clinics of North America Messing, I., Rao, Y. J., Goyal, S. 2026; 53 (2): 285-301

  Abstract

  Systemic therapy intensification has improved outcomes for patients with de novo metastatic prostate cancer. Retrospective studies highlighted the benefits of radiotherapy to the local tumor, prompting prospective evaluation via the HORRAD, STAMPEDE, and PEACE-1 trials. While the HORRAD trial suggested a trend toward improved survival, the STAMPEDE trial demonstrated a statistically significant overall survival benefit in patients with lower-risk or lower-volume disease. The PEACE-1 trial investigated local radiotherapy in the era of intensified systemic therapy. Benefits including improved radiographic progression-free survival, castrate resistance-free survival, and genitourinary side effects make local radiotherapy a valuable therapy for subgroups of patients.

  View details for DOI 10.1016/j.ucl.2026.02.011

  View details for PubMedID 41986024

• Clinical characteristics, racial inequities, and outcomes in patients with breast cancer and COVID-19: a COVID-19 and cancer consortium (CCC19) cohort study. eLife Nagaraj, G., Vinayak, S., Khaki, A. R., Sun, T., Kuderer, N. M., Aboulafia, D. M., Acoba, J. D., Awosika, J., Bakouny, Z., Balmaceda, N. B., Bao, T., Bashir, B., Berg, S., Bilen, M. A., Bindal, P., Blau, S., Bodin, B. E., Borno, H. T., Castellano, C., Choi, H., Deeken, J., Desai, A., Edwin, N., Feldman, L. E., Flora, D. B., Friese, C. R., Galsky, M. D., Gonzalez, C. J., Grivas, P., Gupta, S., Haynam, M., Heilman, H., Hershman, D. L., Hwang, C., Jani, C., Jhawar, S. R., Joshi, M., Kaklamani, V., Klein, E. J., Knox, N., Koshkin, V. S., Kulkarni, A. A., Kwon, D. H., Labaki, C., Lammers, P. E., Lathrop, K. I., Lewis, M. A., Li, X., Lopes, G. d., Lyman, G. H., Makower, D. F., Mansoor, A. H., Markham, M. J., Mashru, S. H., McKay, R. R., Messing, I., Mico, V., Nadkarni, R., Namburi, S., Nguyen, R. H., Nonato, T. K., O'Connor, T. L., Panagiotou, O. A., Park, K., Patel, J. M., Patel, K. G., Peppercorn, J., Polimera, H., Puc, M., Rao, Y. J., Razavi, P., Reid, S. A., Riess, J. W., Rivera, D. R., Robson, M., Rose, S. J., Russ, A. D., Schapira, L., Shah, P. K., Shanahan, M. K., Shapiro, L. C., Smits, M., Stover, D. G., Streckfuss, M., Tachiki, L., Thompson, M. A., Tolaney, S. M., Weissmann, L. B., Wilson, G., Wotman, M. T., Wulff-Burchfield, E. M., Mishra, S., French, B., Warner, J. L., Lustberg, M. B., Accordino, M. K., Shah, D. P. 2023; 12

  Abstract

  Background: Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations. Methods: This is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity. Results: 1,383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32 -1.67]); Black patients (aOR 1.74; 95 CI 1.24-2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70 - 6.79) and Other (aOR 2.97; 95 CI 1.71-5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83 - 12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63 - 3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20 - 2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66 - 3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89 - 22.6]). Hispanic ethnicity, timing and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status. Conclusions: Using one of the largest registries on cancer and COVID-19, we identified patient and BC related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to Non-Hispanic White patients. Funding: This study was partly supported by National Cancer Institute grant number P30 CA068485 to Tianyi Sun, Sanjay Mishra, Benjamin French, Jeremy L. Warner; P30-CA046592 to Christopher R. Friese; P30 CA023100 for Rana R McKay; P30-CA054174 for Pankil K. Shah and Dimpy P. Shah; and the American Cancer Society and Hope Foundation for Cancer Research (MRSG-16-152-01 -CCE) and P30-CA054174 for Dimpy P. Shah. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH). The funding sources had no role in the writing of the manuscript or the decision to submit it for publication. Clinical Trial Number: CCC19 registry is registered on ClinicalTrials.gov, NCT04354701.

  View details for DOI 10.7554/eLife.82618

  View details for PubMedID 37846664

• Clinical Characteristics, Racial Inequities, and Outcomes in Patients with Breast Cancer and COVID-19: A COVID-19 and Cancer Consortium (CCC19) Cohort Study. medRxiv : the preprint server for health sciences Nagaraj, G., Vinayak, S., Khaki, A. R., Sun, T., Kuderer, N. M., Aboulafia, D. M., Acoba, J. D., Awosika, J., Bakouny, Z., Balmaceda, N. B., Bao, T., Bashir, B., Berg, S., Bilen, M. A., Bindal, P., Blau, S., Bodin, B. E., Borno, H. T., Castellano, C., Choi, H., Deeken, J., Desai, A., Edwin, N., Feldman, L. E., Flora, D. B., Friese, C. R., Galsky, M. D., Gonzalez, C. J., Grivas, P., Gupta, S., Haynam, M., Heilman, H., Hershman, D. L., Hwang, C., Jani, C., Jhawar, S. R., Joshi, M., Kaklamani, V., Klein, E. J., Knox, N., Koshkin, V. S., Kulkarni, A. A., Kwon, D. H., Labaki, C., Lammers, P. E., Lathrop, K. I., Lewis, M. A., Li, X., de Lima Lopes, G., Lyman, G. H., Makower, D. F., Mansoor, A. H., Markham, M. J., Mashru, S. H., McKay, R. R., Messing, I., Mico, V., Nadkarni, R., Namburi, S., Nguyen, R. H., Nonato, T. K., O'Connor, T. L., Panagiotou, O. A., Park, K., Patel, J. M., Patel, K. G., Peppercorn, J., Polimera, H., Puc, M., Rao, Y. J., Razavi, P., Reid, S. A., Riess, J. W., Rivera, D. R., Robson, M., Rose, S. J., Russ, A. D., Schapira, L., Shah, P. K., Shanahan, M. K., Shapiro, L. C., Smits, M., Stover, D. G., Streckfuss, M., Tachiki, L., Thompson, M. A., Tolaney, S. M., Weissmann, L. B., Wilson, G., Wotman, M. T., Wulff-Burchfield, E. M., Mishra, S., French, B., Warner, J. L., Lustberg, M. B., Accordino, M. K., Shah, D. P. 2023

  Abstract

  Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations.This is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity.1,383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32 - 1.67]); Black patients (aOR 1.74; 95 CI 1.24-2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70 - 6.79) and Other (aOR 2.97; 95 CI 1.71-5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83 - 12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63 - 3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20 - 2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66 - 3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89 - 22.6]). Hispanic ethnicity, timing and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status.Using one of the largest registries on cancer and COVID-19, we identified patient and BC related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to Non-Hispanic White patients.

  View details for DOI 10.1101/2023.03.09.23287038

  View details for PubMedID 37205429

  View details for PubMedCentralID PMC10187350

• Machine Learning Algorithm Accuracy Using Single- versus Multi-Institutional Image Data in the Classification of Prostate MRI Lesions APPLIED SCIENCES-BASEL Provenzano, D., Melnyk, O., Imtiaz, D., McSweeney, B., Nemirovsky, D., Wynne, M., Whalen, M., Rao, Y., Loew, M., Haji-Momenian, S. 2023; 13 (2)

  View details for DOI 10.3390/app13021088

  View details for Web of Science ID 000914485600001

• Interplay of Immunosuppression and Immunotherapy Among Patients With Cancer and COVID-19. JAMA oncology Bakouny, Z., Labaki, C., Grover, P., Awosika, J., Gulati, S., Hsu, C. Y., Alimohamed, S. I., Bashir, B., Berg, S., Bilen, M. A., Bowles, D., Castellano, C., Desai, A., Elkrief, A., Eton, O. E., Fecher, L. A., Flora, D., Galsky, M. D., Gatti-Mays, M. E., Gesenhues, A., Glover, M. J., Gopalakrishnan, D., Gupta, S., Halfdanarson, T. R., Hayes-Lattin, B., Hendawi, M., Hsu, E., Hwang, C., Jandarov, R., Jani, C., Johnson, D. B., Joshi, M., Khan, H., Khan, S. A., Knox, N., Koshkin, V. S., Kulkarni, A. A., Kwon, D. H., Matar, S., McKay, R. R., Mishra, S., Moria, F. A., Nizam, A., Nock, N. L., Nonato, T. K., Panasci, J., Pomerantz, L., Portuguese, A. J., Provenzano, D., Puc, M., Rao, Y. J., Rhodes, T. D., Riely, G. J., Ripp, J. J., Rivera, A. V., Ruiz-Garcia, E., Schmidt, A. L., Schoenfeld, A. J., Schwartz, G. K., Shah, S. A., Shaya, J., Subbiah, S., Tachiki, L. M., Tucker, M. D., Valdez-Reyes, M., Weissmann, L. B., Wotman, M. T., Wulff-Burchfield, E. M., Xie, Z., Yang, Y. J., Thompson, M. A., Shah, D. P., Warner, J. L., Shyr, Y., Choueiri, T. K., Wise-Draper, T. M. 2022

  Abstract

  Cytokine storm due to COVID-19 can cause high morbidity and mortality and may be more common in patients with cancer treated with immunotherapy (IO) due to immune system activation.To determine the association of baseline immunosuppression and/or IO-based therapies with COVID-19 severity and cytokine storm in patients with cancer.This registry-based retrospective cohort study included 12 046 patients reported to the COVID-19 and Cancer Consortium (CCC19) registry from March 2020 to May 2022. The CCC19 registry is a centralized international multi-institutional registry of patients with COVID-19 with a current or past diagnosis of cancer. Records analyzed included patients with active or previous cancer who had a laboratory-confirmed infection with SARS-CoV-2 by polymerase chain reaction and/or serologic findings.Immunosuppression due to therapy; systemic anticancer therapy (IO or non-IO).The primary outcome was a 5-level ordinal scale of COVID-19 severity: no complications; hospitalized without requiring oxygen; hospitalized and required oxygen; intensive care unit admission and/or mechanical ventilation; death. The secondary outcome was the occurrence of cytokine storm.The median age of the entire cohort was 65 years (interquartile range [IQR], 54-74) years and 6359 patients were female (52.8%) and 6598 (54.8%) were non-Hispanic White. A total of 599 (5.0%) patients received IO, whereas 4327 (35.9%) received non-IO systemic anticancer therapies, and 7120 (59.1%) did not receive any antineoplastic regimen within 3 months prior to COVID-19 diagnosis. Although no difference in COVID-19 severity and cytokine storm was found in the IO group compared with the untreated group in the total cohort (adjusted odds ratio [aOR], 0.80; 95% CI, 0.56-1.13, and aOR, 0.89; 95% CI, 0.41-1.93, respectively), patients with baseline immunosuppression treated with IO (vs untreated) had worse COVID-19 severity and cytokine storm (aOR, 3.33; 95% CI, 1.38-8.01, and aOR, 4.41; 95% CI, 1.71-11.38, respectively). Patients with immunosuppression receiving non-IO therapies (vs untreated) also had worse COVID-19 severity (aOR, 1.79; 95% CI, 1.36-2.35) and cytokine storm (aOR, 2.32; 95% CI, 1.42-3.79).This cohort study found that in patients with cancer and COVID-19, administration of systemic anticancer therapies, especially IO, in the context of baseline immunosuppression was associated with severe clinical outcomes and the development of cytokine storm.ClinicalTrials.gov Identifier: NCT04354701.

  View details for DOI 10.1001/jamaoncol.2022.5357

  View details for PubMedID 36326731