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UCSF

ObGyn&RS

Gynecologic Oncology

UCSF Gynecology Oncology Division

Gynecologic Oncology Research

Basic Science Research

Karen Smith-McCune, M.D., Ph.D
Angiogenesis Project

Dr. Smith-McCune has discovered that an early event of dysplasia is abnormal angiogenesis, associated with altered gene regulation and VEGF expression in cervical cells. She is studying the efficacy of an anti-angiogenic agent as a therapy for CIN 3 lesions in a Phase 2 trial.

Marker discovery Project
To use transcriptional profiling to identify groups of gene transcripts that distinguish between normal and abnormal cervical cytological samples. The results from gene expression arrays will be validated by in situ hybridization and immunohistochemistry.

Mucosal immunity Project
To characterize the cervical mucosal immune response in women with CIN and invasive cancer compared to normal cervix. This work has led to the observation of a robust local secondary immune response directed at least in part against HPV E6 and E7. However, in cancer samples, the local immune response develops immunosuppressive characteristics as evidenced by recruitment on regulatory T cells, immunosuppressive dendritic cells, and polarized macrophages. These results suggest that immunotherapies for cervical cancer will have to overcome local immune tolerance to be effective.

Cancer Risk Program Research

Lee-may Chen, M.D.
Hereditary Nonpolyposis Colorectal Cancer / Lynch Syndrome Project
The cost-effectiveness of various surveillance and risk-reduction strategies with regards to gynecologic cancer risk will be determined. The factors associated with decision making in women with Lynch Syndrome will be investigated, and endometrial cancer patients at risk for Lynch Syndrome will be identified through evaluation of pathology specimens.

Hereditary Breast / Ovarian Cancer Syndrome Project
The surgical outcomes of combining risk reducing gynecologic surgery with breast and reconstructive surgery will be evaluated, along with outcomes of specific histopathologies of ovarian/peritoneal/tubal carcinoma as they may relate to BRCA1 and BRCA2 germline mutations.

Hereditary Gynecologic Cancer Risk Clinic 
A multidisciplinary clinic will be established offering consultation to families at high genetic risk for gynecologic cancers, assess familial pedigrees and test members for specific gene mutations. This program will investigate the benefit of risk reduction surgeries and management programs and will also train medical residents in risk identification.   A large database of identified families with hereditary risk will be maintained.

Intervention Research

Karen Smith-McCune, M.D., Ph.D
HPV Interventions to reduce the burden of HPV infection in African women
In collaboration with Dr. George Sawaya and Dr. Nancy Padian, the role of female-controlled barrier contraceptive (diaphragm plus lubricant gel) on acquisition and clearance of HPV in a large cohort of 2040 women has been studied in Zimbabwe, Africa. The possible role of HPV as a co-factor for risk HIV transmission is under investigation.

Medical Education Research

Lee-may Chen, M.D.
Medical Education Project
The most highly valued characteristics in selecting surgical residents will be determined, along with the relative values of these characteristics. The career outcomes of top-ranked residency applicants to the UCSF obstetrics & gynecology residency program will be evaluated. A validated healthcare matrix will be developed and applied for linking gynecologic oncology quality assurance with educational competencies in an Obstetrics & Gynecology training program.

Symptom Management Program

Lee-may Chen, M.D.
Symptom Management Program project
This study aims to determine whether perioperative epidural analgesia in gynecologic oncology patients, when compared to PCA, improves the management of postoperative pain and is associated with a change in postoperative outcomes.