Rajan Gupta

Overview:

Abdominal Imaging; Multiparametric MR imaging of prostate cancer; MR imaging of the hepatobiliary system; Applications of dual energy CT in the abdomen and pelvis

Positions:

Associate Professor of Radiology

Radiology, Abdominal Imaging
School of Medicine

Assistant Professor in the Department of Surgery

Surgery, Urology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2003

Northwestern University

Grants:

Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) of Bone Marrow In Acute Myeloid Leukemia

Administered By
Radiology, Abdominal Imaging
Awarded By
Bayer Healthcare Pharmaceuticals Inc
Role
Principal Investigator
Start Date
End Date

Publications:

Correction

MLA Citation
Correction.” American Journal of Roentgenology, vol. 210, no. 1, American Roentgen Ray Society, Jan. 2018, pp. 235–235. Crossref, doi:10.2214/ajr.17.19352.
URI
https://scholars.duke.edu/individual/pub1445203
Source
crossref
Published In
Ajr. American Journal of Roentgenology
Volume
210
Published Date
Start Page
235
End Page
235
DOI
10.2214/ajr.17.19352

Prospects of a Fellowship Match for Abdominal Imaging: A National Survey by the Society of Abdominal Radiology.

PURPOSE: After the Society of Chairs of Academic Radiology Departments timeline and guidelines were released for the 2021 through 2022 fellowship application cycle, the Society of Abdominal Radiology conducted a survey of residents, fellows, and abdominal imaging fellowship program directors (PDs) to assess stakeholders' perceptions of changes in the fellowship application process. METHODS: Eligible study participants included fellowship PDs of all US abdominal imaging programs and Society of Abdominal Radiology members-in-training. A questionnaire was developed by content and survey experts, pilot-tested, and administered from August to October 2019. RESULTS: Survey response rates were 51.4% among PDs (54 of 103) and 24.2% among trainees (67 of 279), with an overall response rate of 31.8%. Attitudes regarding the abdominal imaging fellowship application process were overall similar between PDs and trainees, including expressed support for a common application. Although trainees and PDs agreed that the Society of Chairs of Academic Radiology Departments 2021 through 2022 cycle timeline is preferable to the prior unstructured system, only 42.4% of PDs and 40.7% of trainees supported moving to a formal match, with a significant number of respondents undecided. Both PDs and trainees favored timing fellowship interviews during the fall of the third year of residency (R3 year), with a 1- to 2-month buffer between the start of interviews and offers. CONCLUSIONS: PDs and trainees demonstrate similar attitudes in support of the Society of Chairs of Academic Radiology Departments 2021 through 2022 cycle timeline and a common abdominal imaging fellowship application. Shifting the interview season from winter to fall of R3 year could be considered to meet the preferences of PDs and trainees alike. Moving to a formal match remains controversial.
Authors
Magudia, K; Sugi, MD; Balthazar, P; Donelan, K; Bay, CP; Gupta, R; Maturen, K
MLA Citation
Magudia, Kirti, et al. “Prospects of a Fellowship Match for Abdominal Imaging: A National Survey by the Society of Abdominal Radiology.J Am Coll Radiol, vol. 17, no. 6, June 2020, pp. 804–11. Pubmed, doi:10.1016/j.jacr.2020.02.003.
URI
https://scholars.duke.edu/individual/pub1451273
PMID
32105644
Source
pubmed
Published In
Journal of the American College of Radiology : Jacr
Volume
17
Published Date
Start Page
804
End Page
811
DOI
10.1016/j.jacr.2020.02.003

Proliferative potential and response to nivolumab in clear cell renal cell carcinoma patients

© 2020, © 2020 The Author(s). Published with license by Taylor & Francis Group, LLC. Background: Biomarkers predicting immunotherapy response in metastatic renal cell cancer (mRCC) are lacking. PD-L1 immunohistochemistry is a complementary diagnostic for immune checkpoint inhibitors (ICIs) in mRCC, but has shown minimal clinical utility and is not used in routine clinical practice. Methods: Tumor specimens from 56 patients with mRCC who received nivolumab were evaluated for PD-L1, cell proliferation (targeted RNA-seq), and outcome. Results: For 56 patients treated with nivolumab as a standard of care, there were 2 complete responses and 8 partial responses for a response rate of 17.9%. Dividing cell proliferation into tertiles, derived from the mean expression of 10 proliferation-associated genes in a reference set of tumors, poorly proliferative tumors (62.5%) were more common than moderately (30.4%) or highly proliferative (8.9%) counterparts. Moderately proliferative tumors were enriched for PD-L1 positive (41.2%), compared to poorly proliferative counterparts (11.4%). Objective response for moderately proliferative (29.4%) tumors was higher than that of poorly (11.4%) proliferative counterparts, but not statistically significant (p = .11). When cell proliferation and negative PD-L1 tumor proportion scores were combined statistically significant results were achieved (p = .048), showing that patients with poorly proliferative and PD-L1 negative tumors have a very low response rate (6.5%) compared to moderately proliferative PD-L1 negative tumors (30%). Conclusions: Cell proliferation has value in predicting response to nivolumab in clear cell mRCC patients, especially when combined with PD-L1 expression. Further studies which include the addition of progression-free survival (PFS) along with sufficiently powered subgroups are required to further support these findings.
Authors
Zhang, T; Pabla, S; Lenzo, FL; Conroy, JM; Nesline, MK; Glenn, ST; Papanicolau-Sengos, A; Burgher, B; Giamo, V; Andreas, J; Wang, Y; Bshara, W; Madden, KG; Shirai, K; Dragnev, K; Tafe, LJ; Gupta, R; Zhu, J; Labriola, M; McCall, S; George, DJ; Ghatalia, P; Dayyani, F; Edwards, R; Park, MS; Singh, R; Jacob, R; George, S; Xu, B; Zibelman, M; Kurzrock, R; Morrison, C
MLA Citation
Zhang, T., et al. “Proliferative potential and response to nivolumab in clear cell renal cell carcinoma patients.” Oncoimmunology, vol. 9, no. 1, Jan. 2020. Scopus, doi:10.1080/2162402X.2020.1773200.
URI
https://scholars.duke.edu/individual/pub1449567
Source
scopus
Published In
Oncoimmunology
Volume
9
Published Date
DOI
10.1080/2162402X.2020.1773200

PROSPER: A phase III randomized study comparing perioperative nivolumab (nivo) versus observation in patients with localized renal cell carcinoma (RCC) undergoing nephrectomy (ECOG-ACRIN 8143).

<jats:p> TPS684 </jats:p><jats:p> Background: The anti-PD-1 antibody nivo improves overall survival in metastatic RCC and is well tolerated. There is no standard adjuvant systemic therapy that increases overall survival (OS) over surgery alone for non-metastatic RCC. Priming the immune system prior to surgery with anti-PD-1 has shown an OS benefit compared to a pure adjuvant approach in mouse solid tumor models. The PROSPER RCC trial aims to improve clinical outcomes by priming the immune system prior to nephrectomy with neoadjuvant nivo and continued engagement with adjuvant blockade in patients with high risk M0 RCC compared to surgery alone. Methods: This global, unblinded, phase 3 National Clinical Trials Network study is currently accruing patients with clinical stage ≥T2 or node positive M0 RCC of any histology. Tumor biopsy prior to randomization is mandatory to ensure RCC and permits in depth correlative science. The investigational arm will receive two doses of nivo 240mg prior to surgery followed by adjuvant nivo for 9 months (q2 wks x 3 mo followed by 480mg q4 wks x 6 mo). The control arm will undergo standard nephrectomy followed by observation. Randomized patients are stratified by clinical T stage, node positivity, and histology. To enhance accrual and patient quality of life, key upcoming amendments are being instituted. These include biopsy only in the nivo arm, allowance of oligometastatic disease and bilateral renal masses that can be fully resected/ablated, and change of nivo dosing to q4 wks (1 neoadj; 9 adj). With accrual of 766 patients, there is 84.2% power to detect a 14.4% absolute benefit in recurrence-free survival (RFS) at 5 years assuming the ASSURE historical control of ~56% to 70% (HR = 0.70). The study is also powered to evaluate a significant increase in overall survival (HR 0.67). Safety, feasibility, and quality of life endpoints critical to adjuvant therapy considerations are incorporated. PROSPER RCC embeds a wealth of translational work aimed at investigating the impact of the baseline immune milieu, the changes induced by neoadjuvant anti-PD-1 priming, and how both correlate with clinical outcomes. Clinical trial information: NCT03055013. </jats:p>
Authors
Harshman, LC; Puligandla, M; Haas, NB; Allaf, M; Drake, CG; McDermott, DF; Signoretti, S; Cella, D; Gupta, RT; Shuch, BM; Choueiri, TK; Lara, P; Kapoor, A; Heng, DYC; Jewett, MAS; Master, VA; Michaelson, MD; Leibovich, BC; Maskens, D; Carducci, MA
MLA Citation
Harshman, Lauren Christine, et al. “PROSPER: A phase III randomized study comparing perioperative nivolumab (nivo) versus observation in patients with localized renal cell carcinoma (RCC) undergoing nephrectomy (ECOG-ACRIN 8143).Journal of Clinical Oncology, vol. 37, no. 7_suppl, American Society of Clinical Oncology (ASCO), 2019, pp. TPS684–TPS684. Crossref, doi:10.1200/jco.2019.37.7_suppl.tps684.
URI
https://scholars.duke.edu/individual/pub1417283
Source
crossref
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
37
Published Date
Start Page
TPS684
End Page
TPS684
DOI
10.1200/jco.2019.37.7_suppl.tps684

Characterization of Adrenal Masses: Can Dual Energy CT Improve Differentiation Between Adenomas and Metastases?

Authors
Gupta, R; Ho, L; Marin, D; Boll, D; Nelson, R
MLA Citation
Gupta, R., et al. “Characterization of Adrenal Masses: Can Dual Energy CT Improve Differentiation Between Adenomas and Metastases?American Journal of Roentgenology, vol. 192, no. 5, AMER ROENTGEN RAY SOC, 2009.
URI
https://scholars.duke.edu/individual/pub896331
Source
wos
Published In
Ajr. American Journal of Roentgenology
Volume
192
Published Date