Emese Zsiros

Research Overview:

I am a well-trained clinician scientist with a strong clinical and research background that extends across continents, who is involved in direct patient care for women with gynecological malignancies, who has a successful translational research laboratory, who is heavily involved in clinical trial conduct, infrastructure, development, negotiation and budgeting, who has established statewide, national, and international collaborations, who has spearheaded attempts to better manage narcotics during a rampant opioid epidemic, and who is committed to training the next generation of gynecological oncology physicians conducting clinical trial research.

I joined Roswell Park Comprehensive Cancer Center in 2014 as gynecologic oncologist and physician scientist. My current time contribution is 50% clinical and 50% research and I have my own laboratory and postdoctoral fellow focusing on ovarian cancer tumor microenvironment and microbiome research. I am also interested in developing novel therapeutic targets that offer better clinical outcomes and quality of life to our patients with gynecological cancers. I have designed and successfully executed several interventional clinical trials in which I gained a lot of experience on trial design, management, and data analysis.

I have recently led a successful investigator-initiated clinical trial (NCT02853318) sponsored by Merck &Co, where I designed and successfully enrolled 40 patients with recurrent ovarian cancer to receive pembrolizumab combined with bevacizumab and oral cyclophosphamide. This clinical trial showed a remarkable response rate in a heavily pretreated patient population with an overall response rate of 47.5% and a disease control rate of 95%. Interestingly, we saw 12 patients on this clinical trial who were outstanding responders with a very durable clinical response (>18 months). We have collected numerous biospecimens during this clinical trial and our major goal is to understand the factors that led to durable disease control in 30% of our patients by analyzing all of the collected translational specimens.

My ultimate goal is to develop new treatment approaches that optimize the tumor microenvironment and augment existing immunotherapy approaches, thus, to improve the quality of life of our patients and extend their survival. Currently, we have several new immunotherapy clinical trials in development for patients with recurrent ovarian and endometrial cancer.

Another portion of my research focuses on immunotherapy and quality of life interventions to improve the lives of our cancer patients. Our patients often live for years and sometimes decades with their cancer diagnosis, which frequently alters their level of activity and engagement in the society. I have designed and executed 2 clinical trials to understand the relationship between physical activity, microbiome, antitumor immune response, as well as the quality of life in our ovarian and endometrial cancer patients using state of the art wearable devices to monitor physical activity, sleep, and heart rate while collecting serial biospecimens. With these 2 trials, we have demonstrated the wearable activity tracking devices are feasible for research in both ovarian and endometrial cancer patients and the activity level of our patients is very low. We are actively working to develop new applications that could be further used to motivate our cancer patients to increase their activity level and also to maintain the lifestyle change for years or as long as physically possible with their diagnosis.

Besides my interest in basic and translational science, I am also interested in quality improvements projects, which improve the lives of our patients and our community. I have designed and implemented a restrictive opioid prescription policy in our institution, which led to significant decrease in perioperative opioid use across all surgical services without compromising patient recovery.  I serve as a Quality Officer at Roswell Park and my goal is to further extend opioid-sparing approaches to other medical centers across the country and continue to develop evidence-based guidelines for opioid prescribing.

As an associate program director, I actively participate mentoring all fellows with their research projects and help them prepare for national meetings, as well I assist them with writing research protocols, scientific reports, book chapters, and peer-reviewed manuscripts. I am passionate about training the next generation of gynecologic oncologists and physician scientist.

Lab Members:

Shanmuga Chilakapati, PhD, Postdoctoral researcher
Area of study: Role of human microbiome in antitumor immune responses; Role of SEMA4D on ovarian cancer progression

Aaron Varghese, MD, Clinical fellow
Research project: Understanding the role of opioids in cancer immunotherapy; Translational data analysis for phase II clinical trial of pembrolizumab with bevacizumab and oral cyclophosphamide