Gita Suneja

Positions:

Associate Professor of Radiation Oncology

Radiation Oncology
School of Medicine

Associate Research Professor of Global Health

Duke Global Health Institute
Institutes and Provost's Academic Units

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2008

Brown University

Intern, Internal Medicine

University of Pennsylvania School of Medicine

Resident, Radiation Oncology

University of Pennsylvania School of Medicine

Chief Resident, Radiation Oncology

University of Pennsylvania School of Medicine

Clinical Instructor, Radiationoncology

University of Pennsylvania School of Medicine

Assistant Professor, Radiation Oncology

University of Utah School of Medicine

Grants:

Publications:

Trends and disparities in place of death for cancer patients in the United States, 1999-2015.

MLA Citation
Chino, Fumiko Ladd, et al. “Trends and disparities in place of death for cancer patients in the United States, 1999-2015.Journal of Clinical Oncology, vol. 36, no. 15_suppl, American Society of Clinical Oncology (ASCO), 2018, pp. 6522–6522. Crossref, doi:10.1200/jco.2018.36.15_suppl.6522.
URI
https://scholars.duke.edu/individual/pub1350410
Source
crossref
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
36
Published Date
Start Page
6522
End Page
6522
DOI
10.1200/jco.2018.36.15_suppl.6522

Cancer-specific mortality, cure fraction, and noncancer causes of death among diffuse large B-cell lymphoma patients in the immunochemotherapy era.

BACKGROUND: Survival after the diagnosis of diffuse large B-cell lymphoma (DLBCL) has been increasing since 2002 because of improved therapies; however, long-term outcomes for these patients in the modern treatment era are still unknown. METHODS: Using Surveillance, Epidemiology, and End Results data, this study first assessed factors associated with DLBCL-specific mortality during 2002-2012. An epidemiologic risk profile, based on clinical and demographic characteristics, was used to stratify DLBCL cases into low-, medium-, and high-risk groups. The proportions of DLBCL cases that might be considered cured in these 3 risk groups was estimated. Risks of death due to various noncancer causes among DLBCL cases versus the general population were also calculated with standardized mortality ratios (SMRs). RESULTS: Overall, 8274 deaths were recorded among 18,047 DLBCL cases; 76% of the total deaths were attributed to DLBCL, and 24% were attributed to noncancer causes. The 10-year survival rates for the low-, medium-, and high-risk groups were 80%, 60%, and 36%, respectively. The estimated cure proportions for the low-, medium-, and high-risk groups were 73%, 49%, and 27%, respectively; however, these cure estimates were uncertain because of the need to extrapolate the survival curves beyond the follow-up time. Mortality risks calculated with SMRs were elevated for conditions including vascular diseases (SMR, 1.3), infections (SMR, 3.1), gastrointestinal diseases (SMR, 2.5), and blood diseases (SMR, 4.6). These mortality risks were especially high within the initial 5 years after the diagnosis and declined after 5 years. CONCLUSIONS: Some DLBCL patients may be cured of their cancer, but they continue to experience excess mortality from lymphoma and other noncancer causes. Cancer 2017;123:3326-34. © 2017 American Cancer Society.
Authors
Howlader, N; Mariotto, AB; Besson, C; Suneja, G; Robien, K; Younes, N; Engels, EA
MLA Citation
Howlader, Nadia, et al. “Cancer-specific mortality, cure fraction, and noncancer causes of death among diffuse large B-cell lymphoma patients in the immunochemotherapy era..” Cancer, vol. 123, no. 17, Sept. 2017, pp. 3326–34. Pubmed, doi:10.1002/cncr.30739.
URI
https://scholars.duke.edu/individual/pub1252852
PMID
28464214
Source
pubmed
Published In
Cancer
Volume
123
Published Date
Start Page
3326
End Page
3334
DOI
10.1002/cncr.30739

Trends in primary central nervous system lymphoma incidence and survival in the U.S.

It is suspected that primary central nervous system lymphoma (PCNSL) rates are increasing among immunocompetent people. We estimated PCNSL trends in incidence and survival among immunocompetent persons by excluding cases among human immunodeficiency virus (HIV)-infected persons and transplant recipients. PCNSL data were derived from 10 Surveillance, Epidemiology and End Results (SEER) cancer registries (1992-2011). HIV-infected cases had reported HIV infection or death due to HIV. Transplant recipient cases were estimated from the Transplant Cancer Match Study. We estimated PCNSL trends overall and among immunocompetent individuals, and survival by HIV status. A total of 4158 PCNSLs were diagnosed (36% HIV-infected; 0·9% transplant recipients). HIV prevalence in PCNSL cases declined from 64·1% (1992-1996) to 12·7% (2007-2011), while the prevalence of transplant recipients remained low. General population PCNSL rates were strongly influenced by immunosuppressed cases, particularly in 20-39 year-old men. Among immunocompetent people, PCNSL rates in men and women aged 65+ years increased significantly (1·7% and 1·6%/year), but remained stable in other age groups. Five-year survival was poor, particularly among HIV-infected cases (9·0%). Among HIV-uninfected cases, 5-year survival increased from 19·1% (1992-1994) to 30·1% (2004-2006). In summary, PCNSL rates have increased among immunocompetent elderly adults, but not in younger individuals. Survival remains poor for both HIV-infected and HIV-uninfected PCNSL patients.
Authors
Shiels, MS; Pfeiffer, RM; Besson, C; Clarke, CA; Morton, LM; Nogueira, L; Pawlish, K; Yanik, EL; Suneja, G; Engels, EA
MLA Citation
Shiels, Meredith S., et al. “Trends in primary central nervous system lymphoma incidence and survival in the U.S..” Br J Haematol, vol. 174, no. 3, Aug. 2016, pp. 417–24. Pubmed, doi:10.1111/bjh.14073.
URI
https://scholars.duke.edu/individual/pub1144287
PMID
27018254
Source
pubmed
Published In
Br J Haematol
Volume
174
Published Date
Start Page
417
End Page
424
DOI
10.1111/bjh.14073

Elevated Cancer-Specific Mortality Among HIV-Infected Patients in the United States.

PURPOSE: Despite advances in the treatment of HIV, HIV-infected people remain at increased risk for many cancers, and the number of non-AIDS-defining cancers is increasing with the aging of the HIV-infected population. No prior study has comprehensively evaluated the effect of HIV on cancer-specific mortality. PATIENTS AND METHODS: We identified cases of 14 common cancers occurring from 1996 to 2010 in six US states participating in a linkage of cancer and HIV/AIDS registries. We used Cox regression to examine the association between patient HIV status and death resulting from the presenting cancer (ascertained from death certificates), adjusting for age, sex, race/ethnicity, year of cancer diagnosis, and cancer stage. We included 1,816,461 patients with cancer, 6,459 (0.36%) of whom were HIV infected. RESULTS: Cancer-specific mortality was significantly elevated in HIV-infected compared with HIV-uninfected patients for many cancers: colorectum (adjusted hazard ratio [HR], 1.49; 95% CI, 1.21 to 1.84), pancreas (HR, 1.71; 95% CI, 1.35 to 2.18), larynx (HR, 1.62; 95% CI, 1.06 to 2.47), lung (HR, 1.28; 95% CI, 1.17 to 1.39), melanoma (HR, 1.72; 95% CI, 1.09 to 2.70), breast (HR, 2.61; 95% CI, 2.06 to 3.31), and prostate (HR, 1.57; 95% CI, 1.02 to 2.41). HIV was not associated with increased cancer-specific mortality for anal cancer, Hodgkin lymphoma, or diffuse large B-cell lymphoma. After further adjustment for cancer treatment, HIV remained associated with elevated cancer-specific mortality for common non-AIDS-defining cancers: colorectum (HR, 1.40; 95% CI, 1.09 to 1.80), lung (HR, 1.28; 95% CI, 1.14 to 1.44), melanoma (HR, 1.93; 95% CI, 1.14 to 3.27), and breast (HR, 2.64; 95% CI, 1.86 to 3.73). CONCLUSION: HIV-infected patients with cancer experienced higher cancer-specific mortality than HIV-uninfected patients, independent of cancer stage or receipt of cancer treatment. The elevation in cancer-specific mortality among HIV-infected patients may be attributable to unmeasured stage or treatment differences as well as a direct relationship between immunosuppression and tumor progression.
Authors
Coghill, AE; Shiels, MS; Suneja, G; Engels, EA
MLA Citation
Coghill, Anna E., et al. “Elevated Cancer-Specific Mortality Among HIV-Infected Patients in the United States..” J Clin Oncol, vol. 33, no. 21, July 2015, pp. 2376–83. Pubmed, doi:10.1200/JCO.2014.59.5967.
URI
https://scholars.duke.edu/individual/pub1144293
PMID
26077242
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
33
Published Date
Start Page
2376
End Page
2383
DOI
10.1200/JCO.2014.59.5967

Effect of practice integration between urologists and radiation oncologists on prostate cancer treatment patterns.

PURPOSE: National attention has focused on whether urology-radiation oncology practice integration, known as integrated prostate cancer centers, contributes to the use of intensity modulated radiation therapy, a common and expensive prostate cancer treatment. MATERIALS AND METHODS: We examined prostate cancer treatment patterns before and after conversion of a urology practice to an integrated prostate cancer center in July 2006. Using the SEER (Statistics, Epidemiology and End Results)-Medicare database, we identified patients 65 years old or older in 1 statewide registry diagnosed with nonmetastatic prostate cancer between 2004 and 2007. We classified patients into 3 groups, including 1--those seen by integrated prostate cancer center physicians (exposure group), 2--those living in the same hospital referral region who were not seen by integrated prostate cancer center physicians (hospital referral region control group) and 3--those living elsewhere in the state (state control group). We compared changes in treatment among the 3 groups, adjusting for patient, clinical and socioeconomic factors. RESULTS: Compared with the 8.1 ppt increase in adjusted intensity modulated radiation therapy use in the state control group, the use of this therapy increased 20.3 ppts (95% CI 13.4, 27.1) in the integrated prostate cancer center group and 19.2 ppts (95% CI 9.6, 28.9) in the hospital referral region control group. Androgen deprivation therapy, for which Medicare reimbursement decreased sharply, similarly decreased in integrated prostate cancer center and hospital referral region controls. Prostatectomy decreased significantly in the integrated prostate cancer center group. CONCLUSIONS: Coincident with the conversion of a urology group practice to an integrated prostate cancer center, we observed an increase in intensity modulated radiation therapy and a decrease in androgen deprivation therapy in patients seen by integrated prostate cancer center physicians and those seen in the surrounding health care market that were not observed in the remainder of the state.
Authors
Bekelman, JE; Suneja, G; Guzzo, T; Pollack, CE; Armstrong, K; Epstein, AJ
MLA Citation
Bekelman, Justin E., et al. “Effect of practice integration between urologists and radiation oncologists on prostate cancer treatment patterns..” J Urol, vol. 190, no. 1, July 2013, pp. 97–101. Pubmed, doi:10.1016/j.juro.2013.01.103.
URI
https://scholars.duke.edu/individual/pub1144305
PMID
23399652
Source
pubmed
Published In
The Journal of Urology
Volume
190
Published Date
Start Page
97
End Page
101
DOI
10.1016/j.juro.2013.01.103