Wen Foo

Positions:

Associate Professor of Pathology

Pathology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2008

Duke University School of Medicine

Anatomic and Clinical Pathology, Pathology

Duke University School of Medicine

Cytopathology Fellowship, Pathology

Harvard Medical School

Grants:

Publications:

Multiparametric Ultrasound for the Targeting of Prostate Cancer using ARFI, SWEI, B-mode, and QUS

© 2019 IEEE. Prostate cancer diagnosis using standard transrectal ultrasound (TRUS) and systematic biopsy is challenging. To improve the performance of TRUS imaging, we combined it with acoustic radiation force impulse (ARFI) imaging and shear wave elasticity imaging (SWEI) to enhance lesion contrast into a multiparametric ultrasound (mpUS) synthesized image using a linear support vector machine (SVM). The SVM was trained on one subset of patients (N=15) and applied to a second subset (N=15) imaged with a different transducer. mpUS imaging identified 79% of clinically significant PCa in the second cohort with a PPV of 95%.
Authors
Morris, DC; Chan, DY; Chen, H; Palmeri, ML; Polascik, TJ; Foo, WC; Huang, J; Mamou, J; Nightingale, KR
MLA Citation
Morris, D. C., et al. “Multiparametric Ultrasound for the Targeting of Prostate Cancer using ARFI, SWEI, B-mode, and QUS.” Ieee International Ultrasonics Symposium, Ius, vol. 2019-October, 2019, pp. 880–83. Scopus, doi:10.1109/ULTSYM.2019.8926035.
URI
https://scholars.duke.edu/individual/pub1427968
Source
scopus
Published In
Ieee International Ultrasonics Symposium, Ius
Volume
2019-October
Published Date
Start Page
880
End Page
883
DOI
10.1109/ULTSYM.2019.8926035

Discordant and heterogeneous clinically relevant genomic alterations in circulating tumor cells vs plasma DNA from men with metastatic castration resistant prostate cancer.

Circulating tumor cell (CTC) and cell-free (cf) DNA-based genomic alterations are increasingly being used for clinical decision-making in oncology. However, the concordance and discordance between paired CTC and cfDNA genomic profiles remain largely unknown. We performed comparative genomic hybridization (CGH) on CTCs and cfDNA, and low-pass whole genome sequencing (lpWGS) on cfDNA to characterize genomic alterations (CNA) and tumor content in two independent prospective studies of 93 men with mCRPC treated with enzalutamide/abiraterone, or radium-223. Comprehensive analysis of 69 patient CTCs and 72 cfDNA samples from 93 men with mCRPC, including 64 paired samples, identified common concordant gains in FOXA1, AR, and MYC, and losses in BRCA1, PTEN, and RB1 between CTCs and cfDNA. Concordant PTEN loss and discordant BRCA2 gain were associated with significantly worse outcomes in Epic AR-V7 negative men with mCRPC treated with abiraterone/enzalutamide. We identified and externally validated CTC-specific genomic alternations that were discordant in paired cfDNA, even in samples with high tumor content. These CTC/cfDNA-discordant regions included key genomic regulators of lineage plasticity, osteomimicry, and cellular differentiation, including MYCN gain in CTCs (31%) that was rarely detected in cfDNA. CTC MYCN gain was associated with poor clinical outcomes in AR-V7 negative men and small cell transformation. In conclusion, we demonstrated concordance of multiple genomic alterations across CTC and cfDNA platforms; however, some genomic alterations displayed substantial discordance between CTC DNA and cfDNA despite the use of identical copy number analysis methods, suggesting tumor heterogeneity and divergent evolution associated with poor clinical outcomes.
Authors
Gupta, S; Hovelson, DH; Kemeny, G; Halabi, S; Foo, W-C; Anand, M; Somarelli, JA; Tomlins, SA; Antonarakis, ES; Luo, J; Dittamore, RV; George, DJ; Rothwell, C; Nanus, DM; Armstrong, AJ; Gregory, SG
MLA Citation
Gupta, Santosh, et al. “Discordant and heterogeneous clinically relevant genomic alterations in circulating tumor cells vs plasma DNA from men with metastatic castration resistant prostate cancer.Genes Chromosomes Cancer, vol. 59, no. 4, Apr. 2020, pp. 225–39. Pubmed, doi:10.1002/gcc.22824.
URI
https://scholars.duke.edu/individual/pub1421556
PMID
31705765
Source
pubmed
Published In
Genes Chromosomes Cancer
Volume
59
Published Date
Start Page
225
End Page
239
DOI
10.1002/gcc.22824

The NLRP3 Inflammasome Mediates Inflammation Produced by Bladder Outlet Obstruction.

PURPOSE: While bladder outlet obstruction is well established to elicit an inflammatory reaction in the bladder that leads to overactive bladder and fibrosis, little is known about the mechanism by which this is initiated. NLRs (NOD-like receptors) and the structures that they form (inflammasomes) have been identified as sensors of cellular damage, including pressure induced damage, and triggers of inflammation. Recently we identified these structures in the urothelium. In this study we assessed the role of the NLRP3 (NACHT, LRR and PYD domains-containing protein 3) inflammasome in bladder dysfunction resulting from bladder outlet obstruction. MATERIALS AND METHODS: Bladder outlet obstruction was created in female rats by inserting a 1 mm outer diameter transurethral catheter, tying a silk ligature around the urethra and removing the catheter. Untreated and sham operated rats served as controls. Rats with bladder outlet obstruction were given vehicle (10% ethanol) or 10 mg/kg glyburide (a NLRP3 inhibitor) orally daily for 12 days. Inflammasome activity, bladder hypertrophy, inflammation and bladder function (urodynamics) were assessed. RESULTS: Bladder outlet obstruction increased urothelial inflammasome activity, bladder hypertrophy and inflammation, and decreased voided volume. Glyburide blocked inflammasome activation, reduced hypertrophy and prevented inflammation. The decrease in voided volume was also attenuated by glyburide mechanistically as an increase in detrusor contraction duration and voiding period. CONCLUSION: Results suggest the importance of the NLRP3 inflammasome in the induction of inflammation and bladder dysfunction secondary to bladder outlet obstruction. Arresting these processes with NLRP3 inhibitors may prove useful to treat the symptoms that they produce.
Authors
Hughes, FM; Hill, HM; Wood, CM; Edmondson, AT; Dumas, A; Foo, W-C; Oelsen, JM; Rac, G; Purves, JT
MLA Citation
Hughes, Francis M., et al. “The NLRP3 Inflammasome Mediates Inflammation Produced by Bladder Outlet Obstruction.J Urol, vol. 195, no. 5, May 2016, pp. 1598–605. Pubmed, doi:10.1016/j.juro.2015.12.068.
URI
https://scholars.duke.edu/individual/pub1129708
PMID
26707508
Source
pubmed
Published In
The Journal of Urology
Volume
195
Published Date
Start Page
1598
End Page
1605
DOI
10.1016/j.juro.2015.12.068

Image-guided fine-needle aspiration of secondary pancreatic neoplasms: A case series and review of the literature

© 2015 Wolters Kluwer Health, Inc. All rights reserved. Background Endoscopic ultrasound-guided fine-needle aspiration (FNA) has become a well-established diagnostic method for evaluation of focal lesions in the pancreas. While the majority of malignant lesions evaluated are primary pancreatic adenocarcinomas, rarely, metastatic lesions to the pancreas are discovered, altering treatment and prognosis for patients. In this retrospective case series study, we describe the 22-year experience with cytologic diagnosis of secondary pancreatic neoplasms in a tertiary medical center. Methods A search of the electronic pathology database at Duke University Medical Center was performed to identify all patients who had image-guided FNA biopsy of the pancreas diagnosed with secondary neoplasms from 1990 to 2012. Clinical information including sex, age, prior history of malignancy, imaging features of pancreatic mass(es), cytology diagnosis, treatment, and survival was collected. Descriptive statistics were performed. Results Fifty-three patients had a secondary malignancy of the pancreas from 11 primary sites diagnosed on FNA. The most common primary site was hematopoietic (36%), followed by renal (19%), melanocytic (11%), pulmonary (11%), ovarian (6%), breast (4%), esophageal (4%), and soft tissue (4%). Colorectal (2%), prostatic (2%), and nasopharyngeal (2%) metastases were also identified. No specific imaging features reliably differentiated secondary lesions from primary lesions. The majority of patients (75%) had a prior history of malignancy. Of those without a prior history of malignancy, greater than 90% had a secondary malignancy of hematopoietic origin. Conclusions Cytologic diagnosis of secondary pancreatic neoplasms is rare. The most common secondary neoplasm of the pancreas was of hematopoietic origin. Imaging characteristics of secondary neoplasms are variable and nonspecific.
Authors
Foo, WC; Youens, KE; Jowell, PS; Bean, SM
MLA Citation
Foo, W. C., et al. “Image-guided fine-needle aspiration of secondary pancreatic neoplasms: A case series and review of the literature.” Pathology Case Reviews, vol. 20, no. 4, Jan. 2015, pp. 175–81. Scopus, doi:10.1097/PCR.0000000000000096.
URI
https://scholars.duke.edu/individual/pub1079920
Source
scopus
Published In
Pathology Case Reviews
Volume
20
Published Date
Start Page
175
End Page
181
DOI
10.1097/PCR.0000000000000096

Diagnosis of metastatic renal cell carcinoma on fine-needle aspiration cytology.

Fine-needle aspiration has assumed an increasingly important role in the diagnosis and management of patients with advanced stage cancer. Given its predilection for metastases to distant sites and organs at the time of presentation, metastatic renal cell carcinoma (RCC) is not infrequently encountered in the setting of fine-needle aspiration for initial diagnosis. In some instances, fine-needle aspiration may be the only opportunity to obtain diagnostic tissue to diagnose and subclassify RCC. Therefore, cytopathologists and cytotechnologists should be familiar with and recognize the cytomorphology of RCC and the ancillary studies that can be used to confirm and subclassify RCC. Herein, we describe a case of metastatic RCC initially diagnosed on fine-needle aspiration, discuss the cytomorphologic features of RCC subtypes, and review pertinent ancillary immunohistochemical and cytogenetic adjuncts.
Authors
Lew, M; Foo, W-C; Roh, MH
MLA Citation
Lew, Madelyn, et al. “Diagnosis of metastatic renal cell carcinoma on fine-needle aspiration cytology.Arch Pathol Lab Med, vol. 138, no. 10, Oct. 2014, pp. 1278–85. Pubmed, doi:10.5858/arpa.2014-0283-CC.
URI
https://scholars.duke.edu/individual/pub1048831
PMID
25268189
Source
pubmed
Published In
Arch Pathol Lab Med
Volume
138
Published Date
Start Page
1278
End Page
1285
DOI
10.5858/arpa.2014-0283-CC