Junzo Chino

Overview:

Clinical Research in Gynecologic Malignancies, Breast Malignancies, Radiation Oncology Resident Education, Stereotactic Radiation Therapy, and Brachytherapy

Positions:

Associate Professor of Radiation Oncology

Radiation Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2004

Indiana University at Indianapolis

Director of Brachytherapy, Radiation Oncology

Duke University School of Medicine

Intern

Indiana University School of Medicine

Resident, Radiation Oncology

Duke University School of Medicine

Chief Resident, Radiation Oncology

Duke University School of Medicine

American Board of Radiology (ABR)

American Board of Radiology

Publications:

SAbR as an Alternative Boost Modality for Cervical Cancer: A Cautionary Exercise.

Authors
Kamrava, M; Chino, JP; Beriwal, S
MLA Citation
Kamrava, Mitchell, et al. “SAbR as an Alternative Boost Modality for Cervical Cancer: A Cautionary Exercise.Int J Radiat Oncol Biol Phys, vol. 106, no. 3, Mar. 2020, pp. 472–74. Pubmed, doi:10.1016/j.ijrobp.2019.11.026.
URI
https://scholars.duke.edu/individual/pub1431695
PMID
32014146
Source
pubmed
Published In
Int J Radiat Oncol Biol Phys
Volume
106
Published Date
Start Page
472
End Page
474
DOI
10.1016/j.ijrobp.2019.11.026

Off-study utilization of experimental therapies: Analysis of GOG249-eligible cohorts using real world data.

OBJECTIVE: Adjuvant management of women with high-intermediate- and high-risk early-stage endometrial cancer remains controversial. Recently published results of GOG 249 revealed that vaginal brachytherapy plus chemotherapy (VBT + CT) was not superior to whole pelvic radiation therapy (WPRT) and was associated with more toxicities and higher nodal recurrences. This study examined off-study utilization of VBT + CT among women who met criteria for GOG 249 in the period prior to study publication. METHODS: Women diagnosed with FIGO IA-IIB endometrioid, serous, or clear cell uterine cancer between 2004-2015 and treated with hysterectomy and radiotherapy (RT) were identified in the National Cancer Database. Cochrane-Armitrage trend test was used to assess trends over time. Univariate and multivariate Cox analyses were performed to calculate odds ratio (OR) of VBT + CT receipt and hazard ratio (HR) of OS. Propensity-score matched analysis was conducted to account for baseline differences. RESULTS: 9956 women met inclusion criteria. 7548 women (75.8%) received WPRT while 2408 (24.2%) received VBT + CT in the study period. From 2004-2015, there was a significant increase in VBT + CT use (p < 0.001) with the largest overall increase occurring in 2009 to 22%. Factors significantly associated with VBT + CT receipt included higher socioeconomic status (p < 0.001), higher grade endometrioid cancer (p < 0.001), and aggressive histology (p < 0.001). After propensity-score matching, VBT + CT was associated with improved OS (HR 0.74, 95% CI 0.58-0.93); however, when stratified by FIGO stage, VBT + CT was only associated with improved OS for FIGO stage 1B (HR 0.62, 95% CI 0.44-0.87). CONCLUSIONS: There was significant use of experimental arm off-study treatment in the United States prior to report of GOG 249 results. Providers should be cautious when offering off-study treatment utilizing an experimental regimen given uncertainty about efficacy and toxicity.
Authors
Chodavadia, PA; Jacobs, CD; Wang, F; Havrilesky, LJ; Chino, JP; Suneja, G
MLA Citation
Chodavadia, Parth A., et al. “Off-study utilization of experimental therapies: Analysis of GOG249-eligible cohorts using real world data.Gynecol Oncol, vol. 156, no. 1, Jan. 2020, pp. 154–61. Pubmed, doi:10.1016/j.ygyno.2019.09.017.
URI
https://scholars.duke.edu/individual/pub1422344
PMID
31759772
Source
pubmed
Published In
Gynecol Oncol
Volume
156
Published Date
Start Page
154
End Page
161
DOI
10.1016/j.ygyno.2019.09.017

Association of human papilloma virus status and response to radiotherapy in vulvar squamous cell carcinoma.

INTRODUCTION: Vulvar squamous cell carcinoma develops through two separate pathways, associated with the presence or absence of high-risk human papilloma virus (HPV). The objective of this study was to evaluate treatment response and clinical outcomes in women with HPV-associated versus HPV-independent vulvar squamous cell carcinoma treated with primary radiation therapy, in order to determine the ability to use HPV status as a predictor of response to radiation therapy. METHODS: This was a retrospective cohort study combining data from British Columbia Cancer, Canada and Duke University, USA. Patients were included who had been treated with radiation therapy but excluded if they had received major surgical interventions. Immunohistochemistry for p16 (as a surrogate for high-risk HPV infection) and p53 was performed. We analyzed the univariable association between p16 status and clinico-pathological features and performed univariable survival analysis for p16. RESULTS: Forty-eight patients with vulvar squamous cell carcinoma treated with primary radiation therapy were identified: 26 p16 positive/HPV-associated patients and 22 p16 negative/HPV-independent patients. p16 positive vulvar squamous cell carcinoma demonstrated a significantly improved overall survival (HR 0.39, p=0.03) and progression-free survival (HR 0.35, p=0.02). In women treated with definitive radiation therapy, p16 positivity was associated with improved overall survival (HR 0.29, p<0.01) and progression-free survival (HR 0.21, p<0.01). Among patients who received sensitizing chemotherapy, a significant association was observed with p16 positive tumors and overall survival (HR 0.25, p=0.03) and progression-free survival (HR 0.09, p<0.01). CONCLUSION: This study suggests that HPV status in vulvar squamous cell carcinoma has both prognostic and predictive implications, with increased radiosensitivity demonstrated in HPV-associated vulvar squamous cell carcinoma. Implications may include radiation dose de-escalation for HPV-associated vulvar squamous cell carcinoma and increased surgical aggressiveness for HPV-independent vulvar squamous cell carcinoma.
Authors
Proctor, L; Hoang, L; Moore, J; Thompson, E; Leung, S; Natesan, D; Chino, J; Gilks, B; McAlpine, JN
MLA Citation
Proctor, Lily, et al. “Association of human papilloma virus status and response to radiotherapy in vulvar squamous cell carcinoma.Int J Gynecol Cancer, vol. 30, no. 1, Jan. 2020, pp. 100–06. Pubmed, doi:10.1136/ijgc-2019-000793.
URI
https://scholars.duke.edu/individual/pub1422450
PMID
31771962
Source
pubmed
Published In
Int J Gynecol Cancer
Volume
30
Published Date
Start Page
100
End Page
106
DOI
10.1136/ijgc-2019-000793

HIV, Cancer, and Coping: The Cumulative Burden of a Cancer Diagnosis Among People Living with HIV

Authors
Knettel, BA; Corrigan, KL; Cherenack, EM; Ho, N; Carr, S; Cahill, J; Chino, JP; Ubel, P; Watt, MH; Suneja, G
URI
https://scholars.duke.edu/individual/pub1423745
Source
ssrn

The impact of the Patient Protection and Affordable Care Act on insurance coverage and cancer-directed treatment in HIV-infected patients with cancer in the United States.

BACKGROUND: To the authors' knowledge, little is known regarding the impact of the Patient Protection and Affordable Care Act (ACA) on people living with HIV and cancer (PLWHC), who have lower cancer treatment rates and worse cancer outcomes. To investigate this research gap, the authors examined the effects of the ACA on insurance coverage and receipt of cancer treatment among PLWHC in the United States. METHODS: HIV-infected individuals aged 18 to 64 years old with cancer diagnosed between 2011 and 2015 were identified in the National Cancer Data Base. Health insurance coverage and cancer treatment receipt were compared before and after implementation of the ACA in non-Medicaid expansion and Medicaid expansion states using difference-in-differences analysis. RESULTS: Of the 4794 PLWHC analyzed, approximately 49% resided in nonexpansion states and were more often uninsured (16.7% vs 4.2%), nonwhite (65.2% vs 60.2%), and of low income (36.3% vs 26.9%) compared with those in Medicaid expansion states. After 2014, the percentage of uninsured individuals decreased in expansion states (from 4.9% to 3%; P = .01) and nonexpansion states (from 17.6% to 14.6%; P = .06), possibly due to increased Medicaid coverage in expansion states (from 36.9% to 39.2%) and increased private insurance coverage in nonexpansion states (from 29.5% to 34.7%). There was no significant difference in cancer treatment receipt noted between Medicaid expansion and nonexpansion states. However, the percentage of PLWHC treated at academic facilities increased significantly only in expansion states (from 40.2% to 46.7% [P < .0001]; difference-in-differences analysis: 7.2 percentage points [P = .02]). CONCLUSIONS: The implementation of the ACA was associated with improved insurance coverage among PLWHC. Lack of insurance still is common in non-Medicaid expansion states. Patients with minority or low socioeconomic status more often resided in nonexpansion states, thereby highlighting the need for further insurance expansion.
Authors
Corrigan, KL; Nogueira, L; Yabroff, KR; Lin, CC; Han, X; Chino, JP; Coghill, AE; Shiels, M; Jemal, A; Suneja, G
MLA Citation
Corrigan, Kelsey L., et al. “The impact of the Patient Protection and Affordable Care Act on insurance coverage and cancer-directed treatment in HIV-infected patients with cancer in the United States.Cancer, vol. 126, no. 3, Feb. 2020, pp. 559–66. Pubmed, doi:10.1002/cncr.32563.
URI
https://scholars.duke.edu/individual/pub1421660
PMID
31709523
Source
pubmed
Published In
Cancer
Volume
126
Published Date
Start Page
559
End Page
566
DOI
10.1002/cncr.32563