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4. A phase 1/2 study of ixazomib in place of bortezomib or carfilzomib in a subsequent line of therapy for patients with multiple myeloma refractory to their last bortezomib or carfilzomib combination regimen

Author

Daniely, David, Forouzan, Eli, Spektor, Tanya M., Cohen, Alexa, Bitran, Jacob D., Chen, Gigi, Moezi, Mehdi M., Bessudo, Alberto, Hrom, John, Eshaghian, Shahrooz, Swift, Regina A., Eades, Benjamin M., Kim, Clara, Lim, Stephen, and Berenson, James R.

Published
2022
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10. 573 Does the addition of MRI in antenatal management of suspected PAS impact maternal surgical outcome?

Author

Rosenberg, Henri M., primary, Tavella, Nicola F., additional, Mills, Alexandra N., additional, Cohen, Alexa, additional, Griffin, Myah, additional, Futterman, Itamar, additional, Owens, Thomas, additional, Brustman, Lois, additional, Dar, Pe'er, additional, Limaye, Meghana, additional, Bianco, Angela, additional, Doulaveris, Georgios, additional, and Jessel, Rebecca H., additional

Published
2024
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12. 653 Timing of antenatal placenta accreta spectrum diagnosis and impact on clinical outcomes: a multicenter study

Author

Cohen, Alexa, primary, Rosenberg, Henri M., additional, Griffin, Myah, additional, Futterman, Itamar, additional, Owens, Thomas, additional, Tavella, Nicola F., additional, Bianco, Angela, additional, Haberman, Shoshana, additional, Brustman, Lois, additional, Limaye, Meghana, additional, Jessel, Rebecca H., additional, Dar, Pe'er, additional, and Doulaveris, Georgios, additional

Published
2024
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13. 614 Childhood Opportunity Index and Severe Morbidity in a cohort complicated by Placenta Accreta Spectrum Disorder

Author

Tavella, Nicola F., primary, Rosenberg, Henri M., additional, Mills, Alexandra N., additional, Cohen, Alexa, additional, Griffin, Myah, additional, Futterman, Itamar, additional, Owens, Thomas, additional, Brustman, Lois, additional, Janevic, Teresa, additional, Limaye, Meghana, additional, Doulaveris, Georgios, additional, Dar, Pe'er, additional, Haberman, Shoshana, additional, Bianco, Angela, additional, and Jessel, Rebecca H., additional

Published
2024
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14. 1099 Placenta accreta spectrum (PAS) diagnosis timing and its effect on maternal and neonatal outcomes

Author

Owens, Thomas, primary, Rosenberg, Henri M., additional, Reynolds, Eric, additional, Cohen, Alexa, additional, Tavella, Nicola F., additional, Griffin, Myah, additional, Futterman, Itamar, additional, Dar, Pe'er, additional, Limaye, Meghana, additional, Bianco, Angela, additional, Doulaveris, Georgios, additional, Brustman, Lois, additional, and Jessel, Rebecca H., additional

Published
2024
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15. 165 Machine learning for the prediction of surgical morbidity in placenta accreta spectrum

Author

Futterman, Itamar, primary, Sher, Olivia, additional, Saroff, Chaskin Wells, additional, Cohen, Alexa, additional, Doulaveris, Georgios, additional, Dar, Pe'er, additional, Griffin, Myah, additional, Limaye, Meghana, additional, Owens, Thomas, additional, Brustman, Lois, additional, Rosenberg, Henri M., additional, Tavella, Nicola F., additional, Jessel, Rebecca H., additional, Bianco, Angela, additional, and Haberman, Shoshana, additional

Published
2024
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17. The Role of CD44 in Glucose Metabolism in Prostatic Small Cell Neuroendocrine Carcinoma

Author

Li, Wei, Cohen, Alexa, Sun, Yin, Squires, Jill, Braas, Daniel, Graeber, Thomas G, Du, Lin, Li, Gang, Li, Zhen, Xu, Xiang, Chen, Xufeng, and Huang, Jiaoti

Subjects
Biochemistry and Cell Biology, Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Biological Sciences, Biotechnology, Cancer, Lung, Urologic Diseases, Prostate Cancer, Lung Cancer, Nutrition, Aging, Carcinoma, Neuroendocrine, Carcinoma, Small Cell, Cell Line, Tumor, Cell Proliferation, Cell Survival, Gene Expression Regulation, Neoplastic, Glucose, Glycolysis, Humans, Hyaluronan Receptors, Lactic Acid, Male, Phosphofructokinase-2, Prostatic Neoplasms, Reactive Oxygen Species, Tissue Array Analysis, Developmental Biology, Oncology & Carcinogenesis, Biochemistry and cell biology, Oncology and carcinogenesis
Abstract

UnlabelledWhile prostatic adenocarcinomas are relatively indolent, some patients with advanced adenocarcinomas recur with small cell neuroendocrine carcinoma which is highly aggressive and lethal. Because glycolysis is a feature of malignancy and the degree of glycolysis generally correlates with tumor aggressiveness, we wanted to compare the metabolic differences and the molecular mechanisms involved between the two tumor types. In this study, and based on previous characterization, LNCaP and PC-3 prostate cancer cell lines were selected as models of prostatic adenocarcinoma and small cell neuroendocrine carcinoma, respectively. In addition to measuring glucose consumption, lactate secretion, and reactive oxygen species (ROS) levels, we performed metabolic profiling in these two model systems. The role of CD44 was studied by RNAi and lentivirus-mediated overexpression. Expression of key enzymes in glycolysis was studied using human tissue microarrays containing benign prostate, adenocarcinoma, and small cell neuroendocrine carcinoma. Results showed that glycolytic features of PC-3 cells were higher than that of LNCaP cells. PFKFB4 was overexpressed in human small cell carcinoma tissue versus adenocarcinoma tissue. CD44 regulated glucose metabolism, intracellular ROS, and cell proliferation in PC-3 cells. Inhibition of CD44 also sensitized PC-3 cells to carboplatin. In conclusion, this study suggests different pathways of glucose metabolism contribute to the disparate biologic behaviors of these two tumor types.ImplicationsCD44 is an important regulator of glucose metabolism in small cell neuroendocrine carcinoma and may be an important therapeutic target.

Published
2016

19. SARS-CoV-2 Infection in Unvaccinated High-Risk Pregnant Women in the Bronx, NY, USA Is Associated with Decreased Apgar Scores and Placental Villous Infarcts

Author

Reznik, Sandra E., primary, Vuguin, Patricia M., additional, Cohen, Alexa, additional, Khoury, Rasha, additional, Loudig, Olivier, additional, Balakrishnan, Ridin, additional, Fineberg, Susan A., additional, Hughes, Francine, additional, Harigopal, Malini, additional, and Charron, Maureen J., additional

Published
2023
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27. Recalcitrant Cutaneous Mastocytosis Treated With Genetically Informed Targeted Therapy: A Case Report

Author

Gleason, Laura, Tekmen, Volkan, Cohen, Alexa, Bhatti, Safiyyah, Beksac, Burcu, Cha, Jisun, Porcu, Pierluigi, Nikbakht, Neda, Gleason, Laura, Tekmen, Volkan, Cohen, Alexa, Bhatti, Safiyyah, Beksac, Burcu, Cha, Jisun, Porcu, Pierluigi, and Nikbakht, Neda

Abstract

Introduction: Mastocytosis, a clonal proliferation of mast cells commonly involving the skin and bone marrow, has a varied clinical presentation ranging from cutaneous lesions to systemic disease. Cutaneous mastocytosis is managed symptomatically, but systemic mastocytosis is treated with targeted therapy against the mutated receptor tyrosine kinase c-KIT, the pathogenic driver of mastocytosis. However, there are no guidelines for the treatment of cutaneous mastocytosis refractory to symptomatic management. We herein report a method to select genetically informed therapy for symptomatic and recalcitrant cutaneous mastocytosis. Case presentation: We performed a mutational analysis of dermal mast cells after enrichment by laser capture in a 23-year-old woman with recalcitrant cutaneous mastocytosis. The analysis revealed a aspartic acid to valine substitution at codon 816 (D816V) mutation in the protein c-KIT. Based on these results, we initiated treatment with the multi-kinase/KIT inhibitor midostaurin, a treatment effective against the D816V c-KIT mutation. After 3 months of treatment, the patient exhibited a reduction in the number and size of cutaneous lesions and reported resolution of pruritus and decreased severity of other mast cell-related symptoms. Discussion: The treatment of mastocytosis relies heavily on whether the disease is limited to the skin or systemic. However, there are no guidelines for cutaneous mastocytosis that does not respond to symptomatic management. In the present report describing a patient with recalcitrant cutaneous mastocytosis, we describe a strategy in which skin mutational analysis is used to guide the selection of targeted therapy. Conclusion: Performing mast cell mutational analyses in the skin provides a means to select targeted therapy for symptomatic and refractory cutaneous mastocytosis.

Published
2023

28. Atezolizumab-Induced Psoriasiform Drug Eruption Successfully Treated with Ixekizumab: A Case Report and Literature Review

Author

Gleason, Laura, Hunter, E, Cohen, Alexa J., Suriano, Jayson, Nikbakht, Neda, Gleason, Laura, Hunter, E, Cohen, Alexa J., Suriano, Jayson, and Nikbakht, Neda

Abstract

Immune-related cutaneous adverse events (ircAE) are commonly seen with immune checkpoint inhibitors such as atezolizumab. Atezolizumab-induced psoriasis has been previously reported as an ircAE, especially in patients with pre-existing psoriasis. The severity of the reaction influences treatment of the cutaneous eruption. Biologics should be considered as a treatment option for severe refractory psoriasiform eruptions even in patients with complex medical conditions like chronic infections and malignancy. This is the first reported case of successful treatment of atezolizumab-induced psoriasiform eruption with ixekizumab, a neutralizing IL17A monoclonal antibody, to the best of our knowledge. Herein, we present a 63-year-old man with a history of human immunodeficiency virus and psoriasis who presented with atezolizumab-induced psoriasiform eruption while being treated for metastatic hepatocellular carcinoma. After initiating ixekizumab, atezolizumab was restarted without cutaneous eruption.

Published
2023

43. Combination cryotherapy and intralesional corticosteroid versus steroid monotherapy in the treatment of keloids.

Author

Cohen, Alexa J., Talasila, Sahithi, Lazarevic, Bojan, Banner, Lauren, Gleason, Laura, Malkani, Kabir, Uitto, Jouni, and Nikbakht, Neda

Subjects
*KELOIDS, *COLD therapy, *TRIAMCINOLONE acetonide, *TREATMENT effectiveness, *LIKERT scale, *CORTICOSTEROIDS
Abstract

Background: Keloids are common and have significant negative effects on quality of life. There is a need for more effective treatment approaches for keloids. Aims: We investigated treatment outcomes of intralesional triamcinolone acetonide (IL TAC) compared with combination IL TAC and cryotherapy, including changes in pruritus, pain, and keloid size. Patients/Methods: We performed a prospective study of patients referred to one provider who treated patients with combination therapy and compared them to a historic control cohort treated with IL TAC alone. All patients were seen at Thomas Jefferson University between 2019 and 2021. Patient demographics, location of keloids, and inciting events were recorded. Pruritus and pain scores were self‐reported by patients using a 10‐point Likert scale administered as standard of care. Changes in keloid size were denoted as "No change," "up to 50% decrease," "more than 50% decrease," and "completely flattened." Results: While both treatments produced a significant reduction in mean pruritus and pain scores, there was no difference between the two treatment groups (p = 0.3933 and p = 0.2123, respectively). A greater percentage of keloids in the combination therapy group had a post‐treatment size difference greater than 50% compared with those in the IL TAC only treatment group (p = 0.0021). In the subgroup of pubic keloids, all lesions treated with combination IL TAC and cryotherapy responded remarkably well to treatment. Conclusions: While both IL TAC and IL TAC with cryotherapy were effective at reducing pruritus and pain, combination therapy was more effective in reducing keloid size, specifically for pubic keloids. [ABSTRACT FROM AUTHOR]

Published
2023
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47. Coronavirus Disease 2019 (COVID-19) Perinatal Outcomes Across the Pandemic at an Academic Medical Center in New York City.

Author

Seaton, Christine Leinbach, Cohen, Alexa, Henninger, Erin M., Gendlina, Inessa, Hou, Wei, Bernstein, Peter S., and Duong, Tim Q.

Subjects
*SARS-CoV-2, *COVID-19, *ACADEMIC medical centers, *CORONAVIRUS diseases, *TEENAGE pregnancy, *SARS-CoV-2 Omicron variant, *LOW birth weight
Abstract

The preterm birth rate among patients with coronavirus disease 2019 (COVID-19) significantly decreased across the pandemic, and low birth weight, cesarean delivery, and preeclampsia trended lower across the pandemic. OBJECTIVE: To investigate perinatal complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy in the four major waves of the coronavirus disease 2019 (COVID-19) pandemic in the Bronx, New York. METHODS: This retrospective cohort study included all patients who delivered at a single academic medical center between March 1, 2020, and February 13, 2022. SARS-CoV-2 positivity was defined as a positive SARS-CoV-2 test result during pregnancy. Primary outcomes were preterm birth, low birth weight, stillbirth, cesarean delivery, and preeclampsia associated with SARS-CoV-2 infection. Secondary analyses examined outcomes by predominant variant at the time of infection. Group differences in categorical variables were tested using χ2 tests. RESULTS: Of the 8,983 patients who delivered, 638 (7.1%) tested positive for SARS-CoV-2 infection during pregnancy. Age, race, ethnicity, and major comorbidities did not differ significantly between the SARS-CoV-2–positive and SARS-CoV-2–negative cohorts (P >.05). Primary outcomes did not differ between the SARS-CoV-2–positive and SARS-CoV-2–negative cohorts (P >.05). There was a marked increase in positive SARS-CoV-2 test results in individuals who gave birth during the Omicron wave (140/449, 31.2%). However, among patients who tested positive for SARS-CoV-2 infection, the preterm birth rate during the Omicron wave (9.9%) was significantly lower than during the original wave (20.3%) and the Alpha (18.4%) wave (P <.05). Vaccination rates were low before the Omicron wave and rose to 47.2% during the Omicron wave among individuals hospitalized with SARS-CoV-2 infection. Finally, second-trimester infection was significantly associated with worse perinatal outcomes compared with third-trimester infection (P <.05). CONCLUSION: There was a general trend toward improvement in preterm birth rates across the pandemic among pregnant patients with SARS-CoV-2 infection. The Omicron variant was more infectious, but the preterm birth rate during the Omicron wave was low compared with that during the original wave and the Alpha wave. [ABSTRACT FROM AUTHOR]

Published
2023
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48. Glucose Metabolism and CD44 in Small Cell Neuroendocrine Carcinoma of the Prostate

Author

Cohen, Alexa Nichelle

Subjects
Pharmacology
Abstract

Prostatic adenocarcinomas can recur with aggressive and lethal small cell neuroendocrine carcinoma (SCNC). Since glycolysis is a feature of malignancy and the degree generally correlates with tumor aggressiveness, glucose metabolism and the molecular mechanisms involved between the two tumor types was studied. LNCaP and PC-3 cell lines modeled adenocarcinoma and SCNC, respectively, to compare glycolytic features and metabolomics. CD44’s role was studied by RNA knockdown and overexpression. Human tissue microarrays were analyzed for glycolytic enzyme expression. Glycolytic features were found to be higher in PC-3 over LNCaP cells. PFKFB4 was overexpressed in SCNC. CD44 regulated glucose metabolism, intracellular ROS, and cell proliferation in PC-3 cells. CD44 inhibition sensitized PC-3 cells to carboplatin. The data suggests different pathways of glucose metabolism may contribute to the differing biological behaviors of the two tumor types. CD44 was found to be an important regulator of glucose metabolism in SCNC and potential therapeutic target.

Published
2015

50. Mepivacaine versus Bupivacaine Spinal Anesthesia for Early Postoperative Ambulation.

Author

Schwenk, Eric S., Kasper, Vincent P., Smoker, Jordan D., Mendelson, Andrew M., Austin, Mathew S., Brown, Scot A., Hozack, William J., Cohen, Alexa J., Li, Jonathan J., Wahal, Christopher S., Baratta, Jaime L., Torjman, Marc, Nemeth, Alyson C., Czerwinski, Eric E., Schwenk, Eric S., Kasper, Vincent P., Smoker, Jordan D., Mendelson, Andrew M., Austin, Mathew S., Brown, Scot A., Hozack, William J., Cohen, Alexa J., Li, Jonathan J., Wahal, Christopher S., Baratta, Jaime L., Torjman, Marc, Nemeth, Alyson C., and Czerwinski, Eric E.

Abstract

BACKGROUND: Early ambulation after total hip arthroplasty predicts early discharge. Spinal anesthesia is preferred by many practices but can delay ambulation, especially with bupivacaine. Mepivacaine, an intermediate-acting local anesthetic, could enable earlier ambulation than bupivacaine. This study was designed to test the hypothesis that patients who received mepivacaine would ambulate earlier than those who received hyperbaric or isobaric bupivacaine for primary total hip arthroplasty. METHODS: This randomized controlled trial included American Society of Anesthesiologists Physical Status I to III patients undergoing primary total hip arthroplasty. The patients were randomized 1:1:1 to 52.5 mg of mepivacaine, 11.25 mg of hyperbaric bupivacaine, or 12.5 mg of isobaric bupivacaine for spinal anesthesia. The primary outcome was ambulation between 3 and 3.5 h. Secondary outcomes included return of motor and sensory function, postoperative pain, opioid consumption, transient neurologic symptoms, urinary retention, intraoperative hypotension, intraoperative muscle tension, same-day discharge, length of stay, and 30-day readmissions. RESULTS: Of 154 patients, 50 received mepivacaine, 53 received hyperbaric bupivacaine, and 51 received isobaric bupivacaine. Patient characteristics were similar among groups. For ambulation at 3 to 3.5 h, 35 of 50 (70.0%) of patients met this endpoint in the mepivacaine group, followed by 20 of 53 (37.7%) in the hyperbaric bupivacaine group, and 9 of 51 (17.6%) in the isobaric bupivacaine group (P < 0.001). Return of motor function occurred earlier with mepivacaine. Pain and opioid consumption were higher for mepivacaine patients in the early postoperative period only. For ambulatory status, 23 of 50 (46.0%) of mepivacaine, 13 of 53 (24.5%) of hyperbaric bupivacaine, and 11 of 51 (21.5%) of isobaric bupivacaine patients had same-day discharge (P = 0.014). Length of stay was shortest in mepivacaine patients. There were no differences in t

Published
2020

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