Gynecologic Cancer Research

Henry Ford Cancer established our gynecologic cancer research program in 2010 to better understand, cure and help prevent gynecologic cancers. Our vision is to create an integrated clinical, translational and basic science research program for women with gynecologic (ovarian, uterine, cervical, vaginal and vulvar) cancers.

Our gynecologic cancer research

Our researchers conduct prospective studies (watching for a disease to occur) and retrospective analysis (studying people with a known condition) of the patient population. We also perform laboratory-based research to understand the molecular aspects of tumor cells. For example, we study immune dysfunction (changes in how immune cells function) and the metabolic differences of cancer cells that can reveal new and better therapeutic targets.

As part of those efforts, we are:

• Establishing biorepositories (collections of tissue) for uterine and ovarian cancer
• Building tissue microarray (TMA), a new technique that allows researchers to study information from many patients at once
• Studying the interaction of metformin and ovarian cancer cell lines
• Investigating ways to improve immunotherapy and tumor immunity
• Targeting chemoresistant cells by studying metabolic differences

Spotlight: ovarian cancer research

Ovarian cancer is known as a silent killer, because it can develop without symptoms. Because doctors typically diagnose it at a late stage, it is the fifth-leading cause of cancer death in women.

Our ovarian cancer research focuses on understanding how cancer cells differ metabolically (in the structure of the cell itself) from host cells. We know that cancer cells metastasize (spread to other parts of the body) faster by using metabolic elements that a normal cell wouldn’t use. We want to know how cancer cells “kidnap” the host system for their own benefit. Our current research focuses on:

• Decoding why immune response against ovarian cancer becomes ineffective: Immune therapy helps the patient’s immune response effectively attack cancer cells. However, suppression of the immune system by the cancer cells and the tumor environment may negate the immunotherapy treatment. We are studying how the absence of a protein called AMP-activated protein kinase (AMPK) results in an immune-suppressive environment around the tumor. AMPK is an enzyme that is present in every cell of the body and maintains the energy balance required for normal functioning. Activation of this enzyme by various drugs (such as metformin) slows the growth of ovarian and other cancers. The absence of AMPK allows ovarian cancer cells to escape the immune attack against them. We are investigating whether activating the AMPK enzyme (via drugs, diet or exercise) in certain immune cells that cause immune suppression will allow us to target ovarian cancer more effectively by increasing immune activity against it.
• How adipocytes (fat cells) help ovarian cancer cells grow: Ovarian cancer cells use adipocytes as the first landing site for metastatic spread. We have shown that in patients who are overweight or obese, ovarian cancer progresses faster and spreads more aggressively. Now, we are studying how adipocytes attract ovarian cancer cells and help them grow and spread. We are using various approaches to inhibit the adipocyte-ovarian cancer cell relationship to restrain the metastatic spread of ovarian cancer.
• Identifying platinum resistance: About 70 percent of tumors respond at first to chemotherapy treatment. But within two years, 80 percent of tumors will reoccur. We’re seeking a metabolic biomarker that can tell doctors if a tumor is resistant to chemotherapy. With this knowledge, doctors will be able to choose more effective treatments. Our putative biomarker is based on the different way that a resistant cell conducts its metabolism to survive chemotherapy insult. Studying how resistant cells differ from sensitive ovarian tumor cells at the molecular level, we can find targets that can be used specifically to select and kill chemo-resistant cancer cells.
• Studying the ovarian cancer patient population: One of Henry Ford’s strengths is our collection of patient data. We have created a database of information on patients whom we have treated for ovarian cancer. Our ovarian cancer database brings patient information together in one place. Researchers and clinicians use this data to conduct epidemiology (studies of how a disease appears in a patient population) and retrospective patient studies (studies that evaluate data of patients who have received previous treatment). Data comes from Henry Ford medical records, as well as Social Security and Michigan death records, which inform researchers about patients’ survival. The database will provide a comprehensive picture of how treatments and other factors affect patient outcomes. Read more about cancer epidemiology, prevention and control. 

Spotlight: uterine cancer research

The Henry Ford Cancer Institute is considered one of only a few academic institutions across the country to significantly contribute to uterine (endometrial) cancer clinical research through many research projects. Our work in uterine cancer research includes:

• Building an endometrial cancer database: We’re creating one of the largest and most comprehensive databases in the country for women with endometrial cancer, with more than 2,400 women. This detailed database not only has helped our research group answer some of the important clinical questions of endometrial cancer, but also has allowed us to collaborate with many national and international academic institutions. This work has resulted in more than 100 published presentations at national and international meetings, as well as numerous publications in peer-reviewed reputable medical journals.
• Engaging in national research: Members of our research group are principal and co-investigators in many nationally funded studies, including studying racial disparity in women with endometrial cancer. Our researchers have received a NIH R01 grant for this work. We’re also studying MRI simulation in preparation for radiation treatment in women with cervical cancer, thanks to another NIH R01 grant. Learn more about cancer imaging research.
• Studying brachytherapy (radiation treatment): Our researchers are conducting prospective studies for women with endometrial cancer receiving brachytherapy as part of their treatment.
• Studying the spread of endometrial cancer in the blood: We are conducting a prospective study to measure circulating tumor cells in the blood of women with endometrial cancer.
• Creating national guidelines for uterine cancer treatment: Members of our research group are part of an expert panel of gynecologic radiation oncologists who are writing national guidelines for uterine cancer treatment as part of the American College of Radiology (ACR)

Get involved with gynecologic cancer research

Our gynecologic cancer research depends on the participation of patients as well as talented researchers.

• Find a clinical trial: Henry Ford offers numerous clinical trials. Clinical trial opportunities bring new techniques and treatments to patients before they are available to the general public. Learn more about clinical trials.
• Become a Henry Ford researcher: Find out if we are seeking researchers to assist with gynecologic cancer research. Join our research team.
• Support cancer research: Henry Ford’s Cancer Research Advisory Group (CRAG) provides funding and resources to assist our researchers in their work. Learn how to support cancer research.

Our researchers

Our gynecologic cancer researchers include both research specialists and doctors who work directly with patients. Since our program’s inception, several outstanding research fellows have selected our lab to do their research.

Below, you can learn more about our current researchers. You also can read more about how to join our research team.

Gynecologic cancer research leaders

• Elshaikh, Mohamed, M.D., for clinical research
• Rattan, Ramandeep, Ph.D., for basic science research

Gynecologic cancer research members

• Buekers, Thomas, M.D.
• Hanna, Rabbie K., M.D.
• Munkarah, Adnan, M.D.
• Rasool, Nabila, M.D.

Publications in gynecologic cancer research

We share our work regularly with the medical research community through publication in scientific journals. Search the publications below for topics that interest you.

Publications by Henry Ford gynecologic cancer researchers

Al Feghali KA and Elshaikh MA. Why brachytherapy boost is the treatment of choice for most women with locally advanced cervical carcinoma? Brachytherapy. 2016.

Al Feghali KA, Robbins JR, Mahan M, Burmeister C, Khan NT, Rasool N, Munkarah A and Elshaikh MA. Predictive capacity of 3 comorbidity indices in estimating survival endpoints in women with early-stage endometrial carcinoma. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 2016.

Barton KN, Bellon M, Crosby S, McEveney M and Elshaikh M. Quantification & dosimetric consequences of air gaps surrounding vaginal cylinders in women undergoing vaginal HDR brachytherapy. Final report of a prospective study. Brachytherapy. 2016; 15:S125-S126.

Elshaikh MA, Vance S, Gaffney DK, Biagioli M, Jhingran A, Jolly S, Kidd E, Lee LJ, Li L, Moore DH, Rao GG, Wahl AO, Williams NL, Yashar CM and Small W, Jr. ACR appropriateness criteria management of recurrent endometrial cancer. American journal of clinical oncology. 2016.

Elshaikh MA. Adult comorbidity evaluation 27 score in endometrial cancer patient. American journal of obstetrics and gynecology. 2016.

Elshaikh MA. In reply to Binder et al "adult comorbidity evaluation 27 score in endometrial cancer patient". American journal of obstetrics and gynecology. 2016.

Feldman AM, Zhang Z, Buekers T and Elshaikh MA. Management of gynaecologic plasmacytoma: A review article. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 2016:1-6.

Ghanem AI, Khan N, Mahan M, Buekers T and Elshaikh MA. Survival endpoints with or without lymphadenectomy in women with stage I endometrial carcinoma: A matched-pair analysis. J Clin Oncol. 2016; 34.

Guttmann DM, Li H, Sevak P, Grover S, Jacobson G, Feldman A, Rubin S, Chu C, Bhatia S, Elshaikh MA and Lin LL. The impact of adjuvant therapy on survival and recurrence patterns in women with early-stage uterine carcinosarcoma: A multi-institutional study. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 2016; 26(1):141-148.

Haley L, Buekers TE, Burmeister C and Elshaikh MA. Older age is no longer an adverse prognostic factor in women with early-stage endometrial carcinoma: A matched analysis. Gynecol Oncol. 2016; 141:70-71.

Hijaz M, Chhina J, Mert I, Taylor M, Dar S, Al-Wahab Z, Ali-Fehmi R, Buekers T, Munkarah AR and Rattan R. Preclinical evaluation of olaparib and metformin combination in BRCA1 wildtype ovarian cancer. Gynecol Oncol. 2016.

Hijaz M, Das S, Mert I, Chhina J, Tebbe C, Dar S, Seal S, Munkarah AR and Rattan R. Targeting ovarian cancer by folic acid conjugated nanoceria. Gynecol Oncol. 2016; 141:184-185.

Hijaz M, Das S, Mert I, Gupta A, Al-Wahab Z, Tebbe C, Dar S, Chhina J, Giri S, Munkarah A, Seal S and Rattan R. Folic acid tagged nanoceria as a novel therapeutic agent in ovarian cancer. BMC cancer. 2016; 16(1):220.

Hinshaw HD, Boggess JF, Kowalski LD, Scalici JM, Cantrell LA, Schuler KM, Hanna RK, Ivanova A, Matei D and Rossi EC. The relationship between endometrial cancer sentinel lymph node micro and macro metastases and uterine pathology features. Gynecol Oncol. 2016; 141:30.

Isrow D, Burmeister C, Munkarah AR and Elshaikh MA. Survival endpoints for young women with early-stage uterine endometrioid carcinoma: A matched analysis. Gynecol Oncol. 2016; 141:62.

Jaber S, Hensley Alford S, Munkarah AR and Rasool N. Ovarian cancer in elderly women ≥ 70 years of age: Our clinical experience. Gynecol Oncol. 2016; 141:60-61.

Jaber S, Winer I and Rasool N. Recurrent omental hemangiopericytoma: A therapeutic challenge. Case reports in obstetrics and gynecology. 2016; 2016:2075157.

Lee JK, Mahan M, Khan N, Hanna R and Elshaikh MA. Survival outcomes in women with international federation of gynecology and obstetrics stage IIIC2 endometrial carcinoma. International journal of radiation oncology, biology, physics. 2016; 96(2s):E308.

Mahmoud OM, Gabel M, Gibbon D, Leiser A, Isani S, Cracchiolo B, Khan AJ and Elshaikh MA. Can chemotherapy boost the survival benefit of adjuvant radiation therapy in early-stage cervical cancer with intermediate risk factors: A population-based study. International journal of radiation oncology, biology, physics. 2016; 96(2s):E287.

Mahmoud OM, Gabel M, Jhawar S, Gibbon D, Cracchiolo B, Leiser A, Isani S, Khan AJ and Elshaikh MA. How important is chemotherapy timing and treatment duration in the adjuvant management of cervical cancer? International journal of radiation oncology, biology, physics. 2016; 96(2s):E290.

Mahmoud OM, Green WR, Gabel M, Gibbon D, Leiser A, Isani S, Cracchiolo B, Khan AJ and Elshaikh MA. Replicating landoni's study in the era of chemotherapy: Postoperative or radical concurrent chemoradiation therapy in early-stage cervical cancer? International journal of radiation oncology, biology, physics. 2016; 96(2s):E300.

Mangalam AK, Rattan R, Suhail H, Singh J, Hoda MN, Deshpande M, Fulzele S, Denic A, Shridhar V, Kumar A, Viollet B, Rodriguez M and Giri S. AMP-activated protein kinase suppresses autoimmune central nervous system disease by regulating m1-type macrophage-th17 axis. Journal of immunology (Baltimore, Md : 1950). 2016.

Mayadev JS, Elshaikh MA, Christie A, Nagel C, Khan N, Kennedy V, Lea J, Ghanem A, Miller DS, Xie XJ, Folkert M and Albuquerque KV. Prognostic significance of nodal location in stage IIIC endometrial carcinoma: Implications for optimal adjuvant therapy. International journal of radiation oncology, biology, physics. 2016; 96(2s):E303.

Mert I, Munkarah AR, Hanna RK, Chhina J, Carey MS, Llaurado M and Rattan R. Is it time to repurpose metformin for the treatment of low-grade ovarian cancer? Gynecol Oncol. 2016; 141:55-56.

Meyer JE, Dilling TJ, Amdur RJ, Strasser JF, Tendulkar R, Lee WR, Jani AB, Elshaikh M, Poppe MM, Takita C, Currey A, Cheng SK, Jagsi R, Kuo JV, Chen AM, Dragun AE, et al. In regard to Wu and Vapiwala et al. International journal of radiation oncology, biology, physics. 2016; 94(4):858-859.

Modh A, Ghanem AI, Burmeister C, Rasool N and Elshaikh MA. Trends in the utilization of adjuvant vaginal brachytherapy in women with early-stage endometrial carcinoma: Results of an updated period analysis of SEER data. Brachytherapy. 2016.

Munkarah A, Hamid S, Chhina J, Mert I, Jackson L, Hensley-Alford S, Chitale D, Giri S and Rattan R. Targeting of free fatty acid signaling in ovarian cancer may serve as a potential therapeutic approach. Clin Cancer Res. 2016; 22.

Munkarah A, Mert I, Chhina J, Hamid S, Poisson L, Hensley-Alford S, Giri S and Rattan R. Targeting of free fatty acid receptor 1 in EOC: A novel strategy to restrict the adipocyte-EOC dependence. Gynecol Oncol. 2016; 141(1):72-79.

Munkarah AR, Kim S, Buekers TE, Chhina J, Poisson L, Giri S and Rattan R. Metabolic effects of metformin treatment in ovarian cancer cell lines. Gynecol Oncol. 2016; 141:168.

Rana S, Blowers EC, Tebbe C, Contreras JI, Radhakrishnan P, Kizhake S, Zhou T, Rajule RN, Arnst JL, Munkarah AR, Rattan R and Natarajan A. Isatin derived spirocyclic analogues with alpha-methylene-gamma-butyrolactone as anticancer agents: A structure-activity relationship study. Journal of medicinal chemistry. 2016.

Rattan R, Mert I, Chhina J, Hamid S, Hijaz M, Poisson L, Hensley Alford S, Giri S and Munkarah AR. Targeting of free fatty acid receptor 1 in EOC: A novel strategy to restrict the adipocyte-EOC dependence. Gynecol Oncol. 2016; 141:47.

Roquiz W, Pardeshi V, Hassan O, Abdulfatah E, Modh A, Salem N, Daaboul M, Schultz D, Elshaikh MA, Bandyopadhyay S and Ali-Fehmi R. The impact of androgen receptor expression on endometrial carcinoma. Lab Invest. 2016; 96:306A-307A.

Ross Green W, Hathout L, Khan AJ, Elshaikh MA, Beriwal S, Small W, Jr. and Mahmoud O. Revisiting Milan cervical cancer study: Do the original findings hold in the era of chemotherapy? Gynecol Oncol. 2016.

Sakr S, Abdulfatah E, Munkarah AR, Morris RT, Elshaikh MA, Pardeshi V and Ali-Fehmi R. Prognostic value of loss of MMR protein expression in endometrial carcinoma in African American and White women. Gynecol Oncol. 2016; 141:112.

Sakr S, Giri S, Rattan R, Abdulfatah E, Pardeshi V, Morris RT, Munkarah AR and Ali-Fehmi R. Expression of alcohol dehydrogenase 5 in ovarian carcinoma: Effect on prognosis and therapeutic potential. Gynecol Oncol. 2016; 141:67.

Singh J, Deshpande M, Suhail H, Rattan R and Giri S. Targeted stage-specific inflammatory microrna profiling in urine during disease progression in experimental autoimmune encephalomyelitis: Markers of disease progression and drug response. J Neuroimmune Pharmacol. 2016; 11(1):84-97.

Taylor M, Mert I, Hijaz M, Chhina J, Morris RT, Giri S, Rattan R and Munkarah AR. Effects of an olaparib and metformin combination on the AMPK and DNA-damage pathways in ovarian cancer. Gynecol Oncol. 2016; 141:197-198.

Tran AM, Yang W, Boggess JF, Kowalski LD, Scalici JM, Cantrell LA, Schuler KM, Ivanova A, Hanna RK and Rossi EC. Bilateral SLN mapping for cervical cancer with ICG and robotic fluorescence imaging is associated with greater accuracy in detecting metastatic disease. Gynecol Oncol. 2016; 141:21.

Tsafrir Z, Aoun J, Hanna R, Papalekas E, Schiff L, Theoharis E and Eisenstein D. Robotic trachelectomy after supracervical hysterectomy for benign gynecologic disease. JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons. 2016; 20(3).

Vance S, Burmeister C, Rasool N, Buekers T and Elshaikh MA. Salvage versus adjuvant radiation treatment for women with early-stage endometrial carcinoma: A matched analysis. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 2016; 26(2):307-312.

Wahl AO, Gaffney DK, Jhingran A, Yashar CM, Biagioli M, Elshaikh MA, Jolly S, Kidd E, Lee LJ, Li L, Moore DH, Rao GG, Williams NL and Small W, Jr. Acr appropriateness criteria(r) adjuvant management of early-stage endometrial cancer. Oncology (Williston Park, NY). 2016; 30(9).

Wang W, Kryczek I, Dostal L, Lin H, Tan L, Zhao L, Lu F, Wei S, Maj T, Peng D, He G, Vatan L, Szeliga W, Kuick R, Kotarski J, Tarkowski R, et al. Effector t cells abrogate stroma-mediated chemoresistance in ovarian cancer. Cell. 2016; 165(5):1092-1105.

Wen N, Bagher-Ebadian H, Pantelic M, Hearshen D, Elshaikh MA, Chetty IJ and Movsas B. A physiologically nested pharmacokinetic model in dynamic contrast-enhanced magnetic resonance imaging for detection of dominant intraprostatic lesions in patients with prostate cancer. International journal of radiation oncology, biology, physics. 2016; 96(2s):E619.

Xu Y, Burmeister C, Hanna RK, Munkarah A and Elshaikh MA. Predictors of survival after recurrence in women with early-stage endometrial carcinoma. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 2016.

Xu Y, Hanna RK, Burmeister C, Munkarah AR and Elshaikh MA. Predictors of survival after recurrence in women with early-stage endometrial carcinoma. Gynecol Oncol. 2016; 141:70.