Noah Kauff

Positions:

Instructor, Temporary in the Obstetrics and Gynecology

Obstetrics and Gynecology, Gynecologic Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1993

University of Pennsylvania

Grants:

Publications:

Genetic/familial high-risk assessment: Breast and ovarian, version 2.2017: Featured updates to the NCCN guidelines

© JNCCN-Journal of the National Comprehensive Cancer Network. The NCCN Clinical Practice Guidelines in Oncology for Genetic/Familial High-Risk Assessment: Breast and Ovarian provide recommendations for genetic testing and counseling for hereditary cancer syndromes and risk management recommendations for patients who are diagnosed with a syndrome. Guidelines focus on syndromes associated with an increased risk of breast and/ or ovarian cancer. The NCCN Genetic/Familial High-Risk Assessment: Breast and Ovarian panel meets at least annually to review comments from reviewers within their institutions, examine relevant new data from publications and abstracts, and reevaluate and update their recommendations. The NCCN Guidelines Insights summarize the panel's discussion and most recent recommendations regarding risk management for carriers of moderately penetrant genetic mutations associated with breast and/or ovarian cancer.
Authors
Daly, MB; Pilarski, R; Berry, M; Buys, SS; Farmer, M; Friedman, S; Garber, JE; Kauff, ND; Khan, S; Klein, C; Kohlmann, W; Kurian, A; Litton, JK; Madlensky, L; Merajver, SD; Offit, K; Pal, T; Reiser, G; Shannon, KM; Swisher, E; Vinayak, S; Voian, NC; Weitzel, JN; Wick, MJ; Wiesner, GL; Dwyer, M; Darlow, S
MLA Citation
Daly, M. B., et al. “Genetic/familial high-risk assessment: Breast and ovarian, version 2.2017: Featured updates to the NCCN guidelines.” Jnccn Journal of the National Comprehensive Cancer Network, vol. 15, no. 1, Jan. 2017, pp. 9–20.
URI
https://scholars.duke.edu/individual/pub1248956
Source
scopus
Published In
Jnccn Journal of the National Comprehensive Cancer Network
Volume
15
Published Date
Start Page
9
End Page
20

Duration of tamoxifen use and the risk of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers.

Women with a mutation in BRCA1 or BRCA2 face a lifetime risk of breast cancer of approximately 80 %. Tamoxifen treatment of the first cancer has been associated with a reduction in the risk of a subsequent contralateral cancer. We studied 1,504 women with a known BRCA1 or BRCA2 mutation, 411 women with bilateral breast cancer (cases) and 1,093 women with unilateral breast cancer (controls) in a matched case-control study. Control women were of similar age and had a similar age of diagnosis of first breast cancer as the cases. For each woman who used tamoxifen, the starting and stopping dates were abstracted and the duration of tamoxifen use was calculated. Three hundred and thirty-one women had used tamoxifen (22 %); of these 84 (25 %) had completed four or more years of tamoxifen, the remainder stopped prematurely or were current users. For women with up to 1 year of tamoxifen use, the odds ratio for contralateral breast cancer was 0.37 (95 % CI 0.20-0.69; p = 0.001) compared to women with no tamoxifen use. Among women with 1-4 years of tamoxifen use the odds ratio was 0.53 (95 % CI 0.32-0.87; p = 0.01). Among women with four or more years of tamoxifen use the odds ratio was 0.83 (95 % CI 0.44-1.55; p = 0.55). Short-term use of tamoxifen for chemoprevention in BRCA1 and BRCA2 mutation carriers may be as effective as a conventional 5-year course of treatment.
Authors
Gronwald, J; Robidoux, A; Kim-Sing, C; Tung, N; Lynch, HT; Foulkes, WD; Manoukian, S; Ainsworth, P; Neuhausen, SL; Demsky, R; Eisen, A; Singer, CF; Saal, H; Senter, L; Eng, C; Weitzel, J; Moller, P; Gilchrist, DM; Olopade, O; Ginsburg, O; Sun, P; Huzarski, T; Lubinski, J; Narod, SA; Hereditary Breast Cancer Clinical Study Group,
MLA Citation
Gronwald, Jacek, et al. “Duration of tamoxifen use and the risk of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers..” Breast Cancer Res Treat, vol. 146, no. 2, July 2014, pp. 421–27. Pubmed, doi:10.1007/s10549-014-3026-3.
URI
https://scholars.duke.edu/individual/pub1327353
PMID
24951267
Source
pubmed
Published In
Breast Cancer Res Treat
Volume
146
Published Date
Start Page
421
End Page
427
DOI
10.1007/s10549-014-3026-3

Topotecan in patients with BRCA-associated and sporadic platinum-resistant ovarian, fallopian tube, and primary peritoneal cancers.

OBJECTIVE: To evaluate the efficacy of topoisomerase I inhibitor, topotecan, in patients with recurrent BRCA+ versus BRCA- ovarian, fallopian tube, and primary peritoneal carcinomas. METHODS: A single-institution retrospective analysis of platinum-resistant patients characterized for the presence or absence of known deleterious BRCA mutations. Patients received topotecan at a dose and schedule determined by their treating physician (five day or weekly). Response rate and progression-free survival (PFS) were assessed. RESULTS: A total of 50 patients (9 BRCA+, 41 BRCA-) were treated with topotecan. Both groups were well balanced in terms of age, stage, grade, and number of prior therapies. All patients had high-grade serous carcinoma. The clinical benefit rate in BRCA+ and BRCA- patients was 0% and 26.8% (6 PRs, 6 SDs), respectively (p=0.18). Median PFS in BRCA+ and BRCA- pts was 1.7 months (95% CI: 1.0-2.8 months) and 2.5 months (95%CI: 1.9-2.8 months), respectively (p=0.057). Median time to best response was 1.9 months, and median response duration 2.6 months. CONCLUSIONS: This analysis in a heavily pretreated cohort of patients fails to support the superiority of topotecan in BRCA+ platinum-resistant ovarian, fallopian tube, and primary peritoneal cancers. Further study of this class of agents, specifically in less heavily-pretreated patients, may still be warranted.
Authors
Hyman, DM; Zhou, Q; Arnold, AG; Grisham, RN; Iasonos, A; Kauff, ND; Spriggs, D
MLA Citation
Hyman, David M., et al. “Topotecan in patients with BRCA-associated and sporadic platinum-resistant ovarian, fallopian tube, and primary peritoneal cancers..” Gynecol Oncol, vol. 123, no. 2, Nov. 2011, pp. 196–99. Pubmed, doi:10.1016/j.ygyno.2011.07.019.
URI
https://scholars.duke.edu/individual/pub1327378
PMID
21855118
Source
pubmed
Published In
Gynecol Oncol
Volume
123
Published Date
Start Page
196
End Page
199
DOI
10.1016/j.ygyno.2011.07.019

A review of the challenges faced in the conservative treatment of young women with endometrial carcinoma and risk of ovarian cancer.

OBJECTIVE: The standard management for women diagnosed with endometrial carcinoma (EC) is hysterectomy with salpingo-oophorectomy. However, more conservative treatment approaches, including uterine and ovarian preservation, may be used for women who have a strong desire to maintain fertility in spite of potential oncologic risks. METHODS: We reviewed the literature regarding fertility-preserving treatment for EC. We also conducted medical chart reviews for two young patients diagnosed with EC whose treatment deviated from the standard approach in order to preserve fertility. These patients were subsequently diagnosed with ovarian cancer. Our review summarizes the literature regarding the clinical and emotional implications of fertility preservation in young women. CASES: Two young nulliparous women (29 and 23 years, respectively) with grade 1 endometrioid adenocarcinoma were initially treated with conservative fertility-sparing endocrine therapy. Upon failure of endocrine treatment both women underwent hysterectomy and staging with ovarian preservation. During surveillance, both women were subsequently diagnosed with ovarian carcinoma and underwent bilateral salpingo-oophorectomy (BSO) and comprehensive staging. CONCLUSION: The management of young women with endometrial cancer can be complex and challenging. Patients and physicians are confronted with the dilemma of following standard surgical guidelines versus the desire to maintain fertility and avoid surgical menopause. Careful oncologic, psychotherapeutic, genetic and reproductive counseling is advised before offering a non-standard treatment strategy to young endometrial cancer patients.
Authors
Zivanovic, O; Carter, J; Kauff, ND; Barakat, RR
MLA Citation
Zivanovic, O., et al. “A review of the challenges faced in the conservative treatment of young women with endometrial carcinoma and risk of ovarian cancer..” Gynecol Oncol, vol. 115, no. 3, Dec. 2009, pp. 504–09. Pubmed, doi:10.1016/j.ygyno.2009.08.011.
URI
https://scholars.duke.edu/individual/pub1327411
PMID
19758691
Source
pubmed
Published In
Gynecol Oncol
Volume
115
Published Date
Start Page
504
End Page
509
DOI
10.1016/j.ygyno.2009.08.011

Does a BRCA mutation plus tamoxifen equal hysterectomy?

Authors
Lu, KH; Kauff, ND
MLA Citation
Lu, Karen H., and Noah D. Kauff. “Does a BRCA mutation plus tamoxifen equal hysterectomy?.” Gynecol Oncol, vol. 104, no. 1, Jan. 2007, pp. 3–4. Pubmed, doi:10.1016/j.ygyno.2006.11.015.
URI
https://scholars.duke.edu/individual/pub1327398
PMID
17222708
Source
pubmed
Published In
Gynecologic Oncology
Volume
104
Published Date
Start Page
3
End Page
4
DOI
10.1016/j.ygyno.2006.11.015