Next-generation sequencing technologies developed in the last ten years have dramatically widened our view into the many kinds of events that are driving tumor biology. Gene fusions, copy number alterations, mutations, epigenetic changes and transcript level alterations can all be ascertained via the knife of DNA and RNA sequencing. Single cell sequencing of early cancer and molecular testing of circulating blood will allow us to better understand the pathogenesis of early cancer and discover early molecular changes that may allow for an early detection test for ovarian cancer. Statistical methods, factor analysis, insights from evolutionary biology and an understanding of mutation processes at work in early cancer can help us distill out the important driver events and give us useful insights into the processes driving tumor evoluation.
I am specifically interested in using these integrated approaches to help understand the early events in the pathogenesis of ovarian, fallopian tube and peritoneal cancer (ovarian cancer) to improve our understanding of the development of this disease and to find novel ways of early detection. New discoveries regarding the carcinogenesis of BRCA-associated ovarian cancer have illuminated an opportunity to detect early-stage disease using molecular signals in circulation. As such, I have developed a prospective clinical trial to test whether detection of these molecular changes can predict early ovarian cancer and I am collaborating with clinicians and scientists across disciplines and across institutions with a goal to further our understanding of the early events in pelvic HGSC.
My clinical research interests involve optimizing the rational and economical delivery of medical care to our gynecologic oncology patients. To this end, we have piloted the successful implementation of clinical pathways to reduce hospital stays post-operatively. Such process improvement involves multi-disciplinary efforts and cross-discipline collaboration. Our current efforts are focused at improving the patient education experience related to peri-operative care in partnership with our Gynecologic Oncology nursing team. Previous process improvements have involved implementing post-operative immunonutrition with a demonstrable reduction in post-operative wound complications and implementation of post-surgical pathways with a demonstrable reduction in hospital length of stay.