In a new study published in JAMA, the diagnostic yield of transbronchial lung biopsy was significantly higher when using a cryoprobe versus forceps in a group of patients with pulmonary nodules or masses, recent lung transplant, and diffuse parenchymal lung disease.

A transbronchial lung biopsy is a minimally invasive procedure in which a bronchoscope — a thin, lighted tube — is guided through the nose or mouth into the lungs. Tools are then passed through the scope to collect tissue for laboratory analysis to diagnose lung conditions. A cryoprobe is a medical instrument that uses localized freezing to extract tissue. Forceps are used to pinch off tissue for removal, which can be faster but also crushes a portion of the tissue sample.

The FROSTBITE-2 randomized trial showed diagnostic yield during transbronchial biopsy was nearly 10 percentage points higher when performed using a 1.1-millimeter cryoprobe rather than with 2.0-millimeter forceps (88.6% vs 78.8%). The difference was particularly great among patients with pulmonary nodules or masses (83.2% vs 70.1%). In a secondary safety analysis, there were four pneumothoraces (collapsed lungs) requiring chest tube placement in the forceps group (1.6%) compared to none in the cryoprobe group. No patients experienced significant bleeding or respiratory failure events.

“A structurally intact, sufficiently large tissue sample from a targeted area in the lung increases the likelihood of an accurate diagnosis, which is what we strive for every time we perform a transbronchial lung biopsy,” said interventional pulmonologist Fabien Maldonado, MD, MSc, Professor of Medicine and Thoracic Surgery, and Director of Interventional Pulmonology at the Vanderbilt Lung Institute.

“We’re continually investigating ways we can improve these procedures, as accurate diagnoses up-front save time, which may help get patients the treatment they need faster. Evaluating the tools we use, particularly as innovations in this area occur, is an important avenue of investigation.

“Individuals who have known or suspected lung issues deserve to have the best possible diagnostic procedures, so they and their clinical teams have clear evidence of what is occurring in their lungs so informed treatment decisions can be made.”

Previous studies using a 1.9-millimeter cryoprobe have yielded larger lung tissue specimens at higher quality without crushing the sample, but there were also more bleeding and pneumothorax events. The FROSTBITE-2 trial used the 1.1-millimeter cryoprobe probe which, unlike the larger probes, is small enough to remove the biopsy specimen through the working channel without having to remove the scope, which increases safety.

Certain lots of the cryoprobe went under a Food and Drug Administration Class I recall in March due to reports of rupturing or bursting during activation; none of these events were reported in this trial.

The study was conducted under the auspices of the Interventional Pulmonary Outcomes Group, an international collaborative of clinical experts dedicated to improving patient care in interventional pulmonology through multicenter clinical trials and research. Maldonado, who holds the Pierre Massion Directorship in Lung Cancer Research at Vanderbilt Health, is vice chair of this group.

The trial was completed at nine U.S. medical centers including Vanderbilt Health that perform at least 100 transbronchial biopsies annually and have affiliated institutional centers for lung cancer, lung transplant and interstitial lung disease. Patients enrolled were 18 or older and scheduled to undergo transbronchial biopsy for lung nodules or masses, lung transplant, or diffuse parenchymal lung disease. Five hundred individuals were randomly assigned to either the 1.1-millimeter cryoprobe or the 2.0-millimeter forceps for the biopsy.

“These promising results bring us one step closer to making these vital diagnostic procedures even more safe, accurate and effective,” said Vanderbilt Health interventional pulmonologist Robert Lentz, MD, Associate Professor of Medicine and Thoracic Surgery. “Our team is currently conducting FROSTBITE-3, a randomized controlled trial comparing the 1.1-millimeter cryoprobe with instruments for lymph node biopsies, to determine whether this novel tool may help with molecular testing in patients diagnosed with lung cancer.

The FROSTBITE-2 study is an investigator-initiated trial. It was funded by Erbe, an international business that develops, manufactures and markets surgical systems. The funder had no role in trial design, data collection, data analysis, manuscript preparation, or the decision to publish.

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Vanderbilt-Ingram Cancer Center hosted its 27th Annual Scientific Symposium, themed “Cancer and Environment at Every Scale,” last month. More than 300 people attended, including faculty, trainees, staff, community advisory board members, and cancer survivors from across Vanderbilt, Meharry Medical College, Tennessee State University and the broader community.  

This year’s event highlighted research examining the many factors that influence cancer development, progression and patient outcomes — from molecular mechanisms to neighborhood-level data that reveal patterns across communities.   

For the second consecutive year, it was organized by a trainee-led steering committee and included four co-chairs: Yash Pershad, a student in the Medical Scientist Training Program; Michael Robinson, MD, MSCI, Instructor in Pediatrics; Molly Talman, MD, Pediatric Hematology Clinical Fellow; and Jared Rhodes, PhD candidate. The symposium is faculty-mentored by Christopher Williams, MD, PhD, Associate Director for Research Education at Vanderbilt-Ingram, and Kim Dahlman, PhD, Assistant Director for Research Education.  

“Our goal is to build an environment where not only do our trainees participate in cutting-edge, impactful scientific research, but they actually help shape it,” said Williams, who holds the MSTP Directorship. “Watching this committee take full ownership of the planning for a second consecutive year has been extremely rewarding.”  

Vanderbilt-Ingram Director Ben Ho Park, MD, PhD, the Benjamin F. Byrd Jr. Professor of Oncology, gave opening remarks and introduced the Mission Moment speaker, Roberta Casanova, a breast cancer patient and Research Advocate. Casanova shared her personal experience with breast cancer and highlighted both the challenges of treatment and the ongoing complexities of survivorship.  

Attendees heard from two nationally recognized keynote speakers:  

• Mikala Egeblad, PhD, Bloomberg Distinguished Professor and Co-Director of the Johns Hopkins Kimmel Cancer Center Breast and Gynecologic Cancer Program, talked about how environmental stressors — such as microplastics — can trigger inflammation and influence cancer progression.  

• Scarlett Lin Gomez, PhD, MPH, Professor of Epidemiology and Biostatistics and Co-Leader of the Cancer Control Program at the University of California, San Francisco, discussed how neighborhood-level data can reveal differences in cancer incidence and outcomes, underscoring the role of nonmedical factors that impact health.  

Another highlight was the presentation of annual scholar awards for exceptional contributions to cancer research and care:  

• Yash Pershad received the Graduate Student of the Year award for his work on the mutation-specific risk of clonal hematopoiesis in the laboratory of Alex Bick, MD, PhD, Associate Professor of Medicine, Director of the Division of Genetic Medicine and Clinical Pharmacology, and holder of the Edward Claiborne Stahlman Chair. Pershad’s research has significantly advanced understanding of the condition, its progression toward malignancy, and opportunities for cancer interception. He is the author of nearly a dozen first-author publications in journals including Blood, JAMA Oncology and the Journal of Clinical Investigation.   

• Youngmin Kwon, PhD, was named Postdoctoral Scholar of the Year. Recognized as an outstanding collaborator, mentor and educator, he authored 22 peer-reviewed publications in journals including Health Services Research and JAMA Health Forum. His research focuses on access to cancer care in Medicare, and he is mentored by Stacie Dusetzina, PhD, Professor of Health Policy and Ingram Professor of Cancer Research.  

A cornerstone of the symposium, the poster session featured 106 presentations. Biochemistry PhD candidate Gabriela Gonzalez-Vasquez received the overall exceptional poster award for her research on ATR signaling in DNA replication.   

Other poster honorees were:

Basic Science  

• Sydney Henriques   
• Brandon Goldstein   
• Alyssa Jarabek   

Population Science  

• Marin Arnoletti, MPH   
• Guochong Jia, PhD, MPH  
• Duc Huy Le, MD, MBA   

Clinical/Translational Science  

• Sarah Ginther   
• Julia Steele   
• Breelyn Karno   

Shared Resources  

• Kevin Schey, PhD   

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Early clinical research by Vanderbilt Health and Cumberland Pharmaceuticals Inc. suggests that an investigational drug originally developed to treat cardiovascular disease may reduce the risk of metastasis — or spread — of breast, lung and other solid tumors.

The pilot clinical trial of 29 patients with solid tumors at high risk of early metastatic recurrence confirmed that ifetroban, a thromboxane A2 receptor antagonist, was safe and well tolerated, and supported further development of the drug to prevent cancer metastasis.

While not statistically powered for efficacy, the randomized, double-blind, and placebo-controlled Phase 2a clinical trial also compared the percentage of patients who experienced a distant metastatic recurrence 12 months after completion of the study.

Seventeen percent of participants who received ifetroban experienced a distant metastatic recurrence, compared to 50% of those who received an inactive placebo. No deaths due to distant metastatic disease occurred among those who received ifetroban, while three deaths occurred in the placebo group.

“We are encouraged that ifetroban demonstrated a favorable safety profile in this patient population and the potential efficacy trends are promising, supporting further clinical development,” said Cumberland Pharmaceuticals Chief Executive Officer A.J. Kazimi.

Cumberland Pharmaceuticals is a Nashville-based specialty pharmaceutical company focused on developing new products for rare diseases.

“A therapeutic intervention aimed at metastasis prevention for cancer patients with high risk of recurrence that is given during the period of ‘watchful waiting’ could be groundbreaking if proven beneficial in larger scale investigations,” said Ben Ho Park, MD, PhD, the Benjamin F. Byrd Jr. Professor of Oncology, professor of Medicine, and director of Vanderbilt-Ingram Cancer Center.

The study is a project of Vanderbilt Health’s Drug Repurposing program, which was established in 2016 under the Vanderbilt Institute for Clinical and Translational Research (VICTR).

The program uses human genetic data from BioVU, Vanderbilt Health’s DNA biobank, which is linked to de-identified electronic health records, to find new indications for drugs that are already approved or have passed Phase 1 and Phase 2 clinical safety studies. For example, the drug repurposing team has found that adding guanfacine, a drug used to treat high blood pressure, to routine trigeminal nerve block injections can enhance pain relief in patients with trigeminal neuralgia, intense, sudden facial pain.

Earlier this year, they reported that EG501, an investigational drug developed by Evergreen Therapeutics Inc. which targets a receptor in the brain involved in learning and memory, improved cognitive function in patients with lupus, an auto-immune disease.

For the past 20 years, Vanderbilt Health researchers have been studying ifetroban for its potential to treat conditions ranging from fibrotic lung disease to heart failure in patients with Duchene muscular dystrophy.

The thromboxane A2 receptor plays a variety of roles in different cell types throughout the body, including the activation and aggregation of platelets, a type of blood cell involved in clotting. In turn, malignant cells that escape cancer treatment can stick to platelets and “ride” to distant parts of the body.

A phenome-wide association study (PheWAS) of BioVU’s genetic and health records database conducted by Vanderbilt Health investigators linked a variant in the receptor gene to an increased risk of metastatic disease across multiple primary cancers.

Preclinical studies demonstrated that ifetroban reduced metastasis in several animal models without affecting tumor growth.

By blocking platelet activation and aggregation through its action on the thromboxane A2 receptor, ifetroban is thought to limit the ability of tumor cells to migrate across blood vessel walls, invade other organs, and evade detection by the immune system.

After completing cancer therapy, patients at high risk of recurrence who were enrolled in the clinical trial received daily oral doses of ifetroban or placebo for 12 months, then were followed for another 12 months.

Kazimi praised the contributions of the Vanderbilt Health research team, which he said, “have been essential to this advance in oncology patient care.”

Results of this study will be used to guide the design of larger human trials verifying efficacy and further demonstrating safety.

“We look forward to pursuing those pivotal studies as we relentlessly look for treatments to benefit patients living with cancer,” Park said.

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Early bird registration is open for the 5^th Annual Clip In 4 the Cure. Clip In 4 the Cure is a team cycling event that benefits cancer research and initiatives at Vanderbilt-Ingram Cancer Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt.  

This year’s event will be held on Saturday, Oct. 3, from 8 a.m.–noon at Geodis Park, home of the Nashville Soccer Club. 

Early bird pricing offers a 50% discount on the registration fee and runs until Tuesday, June 30.  

Led by some of Nashville’s top spin instructors, the high-energy, relay-style ride also has live DJs, vendors, and giveaways. Every dollar raised supports lifesaving cancer research and innovative patient care, helping move us closer to a world without cancer.  

To learn more, visit clipin4thecure.org. 

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Gayle Knoop doesn’t post about her cancer on social media, so most people didn’t even know she had been diagnosed with Stage 4 colon cancer with liver metastases in October 2024, or that the cancer had returned after nine months, or that she was preparing for Christmas 2025 to be her last with her family.  

She was trying to stay upbeat.  

“I’m at home over the holidays thinking this is probably my last Christmas with my family,” said Knoop, who has a husband, 22-year-old daughter, three dogs, and an older brother. “It was miserable.”  

After treatment, she had been cancer-free for nine months, but the cancer returned in her liver. Her hometown doctor told her the clinical team had met about her case, and she wasn’t a candidate for surgery. She could do Y90 radiation, which she did not want to do.  

Knoop said she finally “dug deep” and started going down all the rabbit holes and doing her research.  

It was different than the pressures she felt growing up playing volleyball, softball and basketball. This one was medical, and she felt hopeless, but she had a hunch there could be something out there for her.  

“I want to be here for my daughter. I want to see her graduate from medical school. I want to see her get married,” she said. “And I’m like, OK, get up off your ***, start digging. You’ve done it before. You can do it again. And it led me to Vanderbilt. And, to me, that was my answered prayer for God to put the right people in my path, and he did.”  

A better option than expected

With a little sleuthing and perseverance, she found something online with good reviews about Sekhar Padmanabhan, MD, just two-and-a-half hours away from her home in Louisville, Kentucky, at Vanderbilt-Ingram Cancer Center in Nashville. And it was in network for her insurance.  

She came to Vanderbilt-Ingram in search of the histotripsy surgery she read about online, but Padmanabhan instead performed robotic-assisted laparoscopic surgery on Knoop to remove the left lobe of her liver and two tumors from the right lobe.  

“The patient sheet just said she was there to discuss histotripsy, which she had read about online. Histotripsy was not what she needed; we had a better option than that,” said Padmanabhan, Assistant Professor of Surgery, who came to Vanderbilt-Ingram in 2021 to help build the robotic liver and pancreas program.  

“Obviously she was shocked when I said, ‘I think we can remove these tumors and potentially put you on a path for a curative-intent option,’” he said.  

Prior to 2022, there had not been a robotic liver resection done at Vanderbilt Health or in Nashville. There have now been more than 100 robotic liver resections at Vanderbilt Health.  

A word no one says with Stage 4 cancer

Padmanabhan said Knoop’s story amplifies the importance of educating not only community oncologists but also patients about new therapies and technologies available to them.  

“Gayle has a certain level of grit and is someone who will not be a defeatist … would not take ‘no’ for an answer. I am thankful that mentality is a part of her, because otherwise she wouldn’t have ended up here,” he said.  

“As I was looking through her labs and her scans and her history, in my mind, I was saying, ‘What are we missing here? Why are we not operating on her? She has a chance at a curative option, and why are we not offering that?’”  

Knoop required a couple of visits to Vanderbilt-Ingram to repeat scans, make sure her blood work looked good, and make sure her liver was healthy before she could have the robotic-assisted liver resection.  

“He offered me a 20% chance of a cure. You know, nobody ever says ‘cure’ with Stage 4 cancer, and he offered me a 20% chance at a cure,” she said. “And, for the first time, I had hope, and it wasn’t false hope. I had hope, and I had confidence in the people that I was dealing with.”  

The surgery also allowed her to go back to Louisville the next day instead of a more invasive surgery that would have included five days in an intensive care unit and a roughly 10-day hospital stay.  

“These successes need to be shared with the world”

Padmanabhan said he saw her in the clinic two to three weeks after her surgery, and she looked great and was back to her usual day-to-day activities. At a later follow-up with Justin Lo, MD, PhD, Assistant Professor of Medicine, her scans and blood work continued to look great.  

“When an institution and the people who make it up are this special, it deserves to be recognized,” Knoop said. “Tunnel vision is inevitable when this is your day-to-day life, but I truly believe Dr. Padmanabhan and his team at Vanderbilt-Ingram saved my life and could save the life of so many others. It is imperative that these successes are shared with the world.   

“I was more than a patient or cancer case. I was a wife, mom and sister who needed his incredible knowledge of advanced technology and his surgical skills to spend more time in these roles with my family,” she said.  

Padmanabhan said Vanderbilt-Ingram is “pushing the envelope” with new technologies like histotripsy and new programs like robotic liver surgery and robotic pancreas surgery, serving patients not only from Tennessee, but also parts of Kentucky, Alabama and Georgia.  

“Gayle’s story is obviously unique to her and very personal for her but, unfortunately, that is the story that we hear a lot, especially in this area,” he said.  

“Folks don’t necessarily have access to that care close to their home, so I would encourage people to see if there are newer drugs, treatments, surgeries, therapies and technologies that we can offer you that could extend your life, perhaps cure you in certain instances, but also ensure that we do all those things while maintaining your quality of life.” 

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Genome-wide association studies (GWAS) have discovered thousands of “spots” in the genome associated with diseases, including cancer, but understanding how genetic changes contribute to disease remains a challenge.

Artificial intelligence deep-learning models, such as Enformer, can predict how DNA changes might affect gene regulation. Because these models are trained on broad datasets, however, they do not capture tissue-specific contexts.

A research team led by Qing Li, PhD, and Xingyi Guo, PhD, at Vanderbilt Health, and Quan Long, PhD, at the University of Calgary, has now developed an AI transfer learning approach to adapt Enformer for breast and prostate cancer. Transfer learning is an AI technique that uses a pretrained model (in this case Enformer) as the starting point for a new task. The researchers retrained Enformer using tissue-specific transcription factor chromatin immunoprecipitation sequencing datasets (275 for breast and 357 for prostate).

With the new models, they computed regulatory scores for millions of GWAS genetic variants and identified those most likely to affect cancer risk. They further linked the genes to cancer risk through transcriptome-wide association study analyses and showed that many of the identified genes are important for cancer cell growth and are potential drug targets.

The study, reported in PLOS Genetics, showed that the transfer learning models outperformed the base model in identifying clinically relevant, disease-associated genes. The approach offers a generalizable framework for tailoring foundation models to disease-relevant contexts.

“Our findings demonstrate how adapting existing models to more disease-relevant data can significantly improve our ability to uncover genes and variants involved in cancer,” the authors stated.

Guo and Li are in the Department of Medicine Division of Epidemiology at Vanderbilt Health. The research was supported in part by a Canada Foundation for Innovation John R. Evans Leaders Fund grant to Long.

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As temperatures rise and more time is spent outdoors, dermatologists urge everyone to pay closer attention to their skin. According to the American Cancer Society, melanoma — the deadliest form of skin cancer — is expected to be diagnosed in more than 112,000 Americans this year as invasive disease, a figure that has climbed nearly 47% in the past decade. When caught early, melanoma is among the most treatable cancers, with a five-year survival rate around 99% for localized disease. 

A vast majority of melanoma cases are linked to ultraviolet exposure from sunlight, making it largely preventable. Risk factors include fair skin, a history of sunburns (especially in childhood), numerous moles, and a family history of melanoma. But melanoma does not discriminate; it can develop in people of all skin tones and in areas that rarely see the sun. 

Dermatologists recommend the ABCDE rule as a guide for self-examination: 

• Look for Asymmetry (one half of a mole doesn’t match the other),
• irregular Borders,
• uneven Color,
• a Diameter larger than a pencil eraser, and
• an Evolving shape, size or color.

Any spot that looks different from the moles around it — the so-called ugly duckling — also warrants professional evaluation. The most important step you can take is scheduling a routine skin check with a board-certified dermatologist. 

“Early detection saves lives, and it starts with knowing your own skin,” says Allison Hanlon, MD, PhD, Professor and Chair of the Department of Dermatology at Vanderbilt Health. “When melanoma or another skin cancer is found early, our Mohs surgery team can often remove it completely in a single outpatient visit while preserving as much healthy tissue as possible.” 

Mohs micrographic surgery is widely considered the gold standard for treating many skin cancers. Unlike standard excision, the Mohs technique examines 100% of the tissue margin under a microscope, layer by layer, until no cancer cells remain. The result is a cure rate of up to 99% for new skin cancers and the smallest possible wound, which is especially important for tumors on the face, ears, hands, and other cosmetically or functionally sensitive areas. 

Vanderbilt Health’s Mohs Micrographic Surgery program brings together a fellowship-trained team of four Mohs surgeons: Hanlon; Anna Clayton, MD, Associate Professor of Dermatology and Director of the Micrographic Surgery and Dermatologic Oncology Fellowship; Stacy McMurray, MD, Assistant Professor of Dermatology and Associate Program Director for the Mohs Fellowship; and Emily Merkel, MD, Assistant Professor of Dermatology. The team collaborates with surgical and medical oncology specialists to develop individualized plans for even the most complex cases. 

Mohs surgery at Vanderbilt Health is performed at Vanderbilt Dermatology, located at Vanderbilt Health One Hundred Oaks, 719 Thompson Lane in Nashville. 

To schedule a skin cancer screening or learn more about Mohs surgery services, call 615-322-6485 or visit the Vanderbilt Health Dermatology website. 

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Vanderbilt-Ingram Cancer Center has named Richard Peek Jr., MD, a Co-Leader of its Gastrointestinal (GI) Cancer Research Program, joining Kristen Ciombor, MD, MSCI, who assumed leadership of the program in 2025.

Peek is Professor of Medicine and Director of the Division of Gastroenterology, Hepatology and Nutrition at Vanderbilt Health, where he holds the Mina Cobb Wallace Chair in Immunology. He is an internationally recognized expert in Helicobacter pylori pathogenesis and host-microbial interactions. Peek has led the Division of Gastroenterology, Hepatology and Nutrition since 2004, during which time it has tripled in size and grown its National Institutes of Health (NIH) research portfolio to more than $11 million annually.

“I am beyond excited to be able to serve in this role for the Vanderbilt-Ingram Cancer Center and to have the opportunity to work with such an exceptionally talented and dedicated physician as Kristen Ciombor,” Peek said. “Vanderbilt-Ingram has always supported my career unequivocally, particularly when they provided pilot funding that presaged our successful P01 grant on Helicobacter pylori and gastric cancer. I am honored to take on this responsibility.”

Peek’s individual research program has been funded by the NIH for more than 30 years and includes R01 and P01 funding from the National Cancer Institute. He has been elected to the American Society for Clinical Investigation, the Association of American Physicians, the American Association for the Advancement of Science, the American Clinical and Climatological Association, and was a charter member of the NIH Gastrointestinal Mucosal Pathobiology Study Section.

He also served as chair of the American Gastroenterological Association (AGA) Council, co-editor-in-chief of Gastroenterology, as a member of the NIH National Institute of Diabetes and Digestive and Kidney Disease Advisory Council and was recently selected to be president President-Elect of the AGA World Gastroenterology Organization.

Ciombor is Associate Professor of Medicine in the Division of Hematology and Oncology at Vanderbilt, where she has been a faculty member since 2017. A board-certified medical oncologist specializing in gastrointestinal cancers, she leads multiple national investigator-initiated clinical trials in colorectal cancer. She is a co-investigator on the Vanderbilt-Ingram GI SPORE grant and leads the National Clinical Trials Network Lead Academic Participating Site grant at Vanderbilt. She also serves as chair of the Colorectal/Anal Working Group for the Eastern Cooperative Oncology Group and is a member of the NCI GI Steering Committee, among other roles.

“I am delighted that Dr. Peek has been selected to co-lead the Vanderbilt-Ingram GI Cancer Research Program,” Ciombor said. “He is a world-renowned gastroenterologist and expert in H. pylori pathogenesis and a true asset to the Vanderbilt research community. I am thrilled to work with him as we continue to strengthen the GI cancer research collaborations at Vanderbilt.”

“GI cancer incidence and mortality rates in our catchment area are worse than the national average, and screening for diseases like colorectal cancer also are lower in Tennessee than in many other states,” said Ben Ho Park, MD, PhD, the Benjamin F. Byrd Jr. Professor of Oncology and Director of Vanderbilt-Ingram. “GI cancers have been a long-standing priority of the Vanderbilt-Ingram Cancer Center, in part because of the burden of GI cancers in our area, but also because of the exceptional expertise here at Vanderbilt.

“Together, Drs. Peek and Ciombor bring deep knowledge and experience to optimize and personalize the prevention, diagnosis and treatment of GI malignancies. The GI cancer research program at Vanderbilt-Ingram will flourish under their strong co-leadership.”

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Vanderbilt-Ingram Cancer Center has named Fabien Maldonado, MD, MSc, and Evan Osmundson, MD, PhD, as co-leaders of its Thoracic Oncology Program, reflecting the center’s commitment to expanding disease-specific cancer care for patients across the region.

As co-leaders, Maldonado and Osmundson will identify gaps and opportunities to improve prevention, detection and treatment of lung cancer. They will build collaborative bridges across thoracic specialties — including thoracic surgery, pulmonology, radiology, pathology, and medical and radiation oncology — recognizing that lung cancer treatment frequently requires a coordinated, multimodal approach.

They will also work to expand access to innovative technologies, including robotic bronchoscopy, which enables biopsy of previously unreachable areas of the lung; advanced local therapies such as minimally invasive surgery and adaptive radiotherapy; and targeted systemic treatments tailored to each patient’s tumor. This work will reduce wait times, improve diagnostic accuracy, lower toxicity and deliver personalized therapy within a multidisciplinary, team-based model of care.

“Lung cancer is a top priority for our cancer center because Tennessee has among the highest rates of lung cancer mortality in the country,” said Ben Ho Park, MD, PhD, the Benjamin F. Byrd Jr. Professor of Oncology and Director of Vanderbilt-Ingram. “The number of Tennesseans who smoke is higher than the national average, and our screening rates are lower — a combination that disproportionately affects our communities. The best way to cure lung cancer is to catch it early. Under the leadership of Drs. Maldonado and Osmundson, we are rebooting our Thoracic Oncology Program to bring together lung cancer researchers, care providers and trainees across Vanderbilt-Ingram in an even more collaborative way. That collaboration will drive higher-impact research and discoveries that translate quickly into meaningful benefit for our patients and the people of Tennessee.”

Maldonado, Professor of Medicine, Thoracic Surgery and Mechanical Engineering, focuses his research on clinical trials in interventional pulmonology, CT-based quantitative imaging for lung cancer and robotic bronchoscopy.

“Major advances in lung cancer care, including lung cancer screening and minimally invasive diagnostic and therapeutic interventions, have improved lung cancer survival rates by more than 25% over the past five years; however, much work remains, and we are excited to continue building the most patient-centered, data-driven, and technologically advanced lung cancer program in the state of Tennessee,” said Maldonado, who holds the Pierre Massion Directorship in Lung Cancer Research.

Osmundson, Associate Professor and Vice Chair of Clinical Operations in the Department of Radiation Oncology, where he serves as medical director, is board-certified in radiation oncology. He specializes in thoracic malignancies and lymphoma and leads several investigator-initiated clinical trials designed to enhance the synergy between radiation therapy and immunotherapy, with funding from the National Institutes of Health and other entities. He has also become a leading voice for patients facing barriers to care, with research advocating for prior authorization reform to reduce treatment delays in oncology.

“Thoracic oncology has entered a remarkable era of personalized medicine, in which therapies tailored to each patient’s individual cancer are producing outcomes we couldn’t have imagined even a decade ago. Patients are living longer and, importantly, living better than ever before, yet we know there’s still much further to go,” said Osmundson. “At Vanderbilt, our innovative research and clinical programs have helped drive this revolution, and our team-based care brings these discoveries to patients today. I’m more excited than ever to extend this care across our region and to discover what comes next.”

Together, the co-leaders bring complementary expertise aimed at delivering the most innovative and advanced options for patients at all stages of lung and other thoracic cancers. The goal of the Thoracic Oncology Program is to improve survival and quality of life — personalizing treatment for every patient, regardless of when they arrive at Vanderbilt-Ingram.

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A new urine test performed better than PSA-based testing and MRI for monitoring low-risk prostate cancers on active surveillance. Use of the test to determine the need for repeat “monitoring” biopsies would have avoided up to 64% of unnecessary biopsies while maintaining timely detection of higher-grade cancers that merit treatment, according to a study published in The Journal of Urology.

The test, called MyProstateScore 2.0 – Active Surveillance (MPS2-AS), was evaluated in over 300 patients on active surveillance for Grade Group (GG) 1 prostate cancer, according to lead author Jeffrey Tosoian, MD, MPH, assistant professor in the Department of Urology at Vanderbilt Health.

“For patients undergoing monitoring of low-grade prostate cancer, these findings suggest that use of the urine test can reduce the need for invasive biopsies without compromising prompt detection of higher-grade cancers that require treatment,” Tosoian said.

Active surveillance is widely used in men with low-risk prostate cancer to avoid unnecessary treatment of cancers unlikely to cause harm. Because some patients will later be found to “upgrade” to higher-risk cancers, however, surveillance entails careful monitoring. Due to the limitations of existing tools, the current approach to surveillance requires repeat prostate biopsies, usually every two to three years. The urine test offers a noninvasive option to determine which patients truly need to undergo a biopsy and which can avoid a potentially unnecessary and invasive procedure.

Other noninvasive tests have been studied in active surveillance, but none have had sufficient accuracy to rule out the need for repeat biopsies. Tosoian said the study team is optimistic that these findings reflect a significant step forward for the field, and, most importantly, for patients. 

Prostate cancer grading uses the Gleason score (6-10) and Grade Group (1-5) systems to estimate cancer aggressiveness based on how the cells look under a microscope. Higher numbers indicate faster-growing, more aggressive cancer.

In patients previously diagnosed with low-grade cancers (Gleason score 6, Grade Group 1) pursuing active surveillance, MPS2-AS correctly predicted the presence of high-grade (GG≥3) cancer in 97% of cases. The test was found to have a 99% negative predictive value for GG≥3 upgrading, meaning that patients with a negative test had only a 1% chance of having GG≥3 cancer detected on biopsy. For the vast majority of patients, that is low enough to confidently forgo the biopsy altogether, Tosoian said.

Tosoian, also the director of Translational Cancer Research in the Department of Urology, said next steps for the collaborative research team will include studying the use of this testing approach to improve other aspects of prostate cancer care, such as detecting recurrence after treatment.

The study was supported by the National Institutes of Health (grant U2CCA271854).

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