The Department of Cardiothoracic Surgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center is actively engaged in a robust program of basic science investigation and clinical trials with the potential to improve the management of patients with heart and lung diseases and disorders. Such investigations are made possible by the infrastructure of academic medical centers such as Weill Cornell, which not only provide high-quality patient care but explore new ways of advancing that care.
The research conducted in the department fall under the umbrella of three main sections: 1) Clinical Trials, 2) The Laragh Method, and 3) The Neuberger Berman Lung Cancer Research Center. Please feel free to explore each section and their corresponding projects by clicking on their sub-links.
Examples of projects under way include:
Minimally Invasive Treatments for Atrial Fibrillation
Nearly 10 percent of people over the age of 80 are affected by an abnormal heart rhythm called atrial fibrillation (AF). AF can lead to the formation of clots that can cause strokes. AF currently affects over two million Americans and is responsible for nearly 75,000 new cases of stroke each year. In extreme cases, AF may cause death. The surgical treatment for AF promises far greater chances for cure than medical or catheter-based treatments. However, current surgical treatments are complex and difficult.
We are currently developing and testing minimally invasive surgical approaches to treating AF. In our new approach, various probes are used to interrupt the electrical paths in the heart that cause the arrhythmia. This approach is associated with smaller incisions, less postoperative pain, and a shorter hospital stay after surgery.
Immunotherapy and COX-2 Inhibitors for Lung and Esophageal Cancers
Immunotherapy involves harnessing the power of the body's own immune system to fight cancer. We are currently conducting clinical trials investigating the use of cancer vaccines to reduce the risk of recurrence in patients with lung cancer. In addition, the enzyme cyclooxygenase 2 (COX-2) is believed to be involved in the development of many cancers, including those of the lung and esophagus. Specifically blocking the activity of COX-2 may reduce the growth of these cancers.
The results of a study conducted at Weill Cornell investigating the use of COX-2 inhibitors in combination with chemotherapy prior to surgical resection of the lung were published in the Journal of Clinical Oncology. To further assess the efficacy of these treatments, a randomized multicenter double blind study is in progress. A study of the use of COX-2 inhibitors in combination with chemotherapy to treat esophageal cancer is also under way.
Molecular mechanisms governing metastasis initiation and progression in the lung
The progression of human cancer to the metastatic disease is the major contributing factor to its lethality. Notably, metastasis is one of the leading causes of death in cancer patients, with a high mortality due to the invasive nature of the disease and resistance to current treatment modalities. Despite the clinical importance, the cellular and molecular mechanisms that govern the initiation, establishment, and progression of metastasis remain unclear.
We are carrying out a systematic genome-wide analysis to identify patterns of gene-expression, microRNA/piRNA expression, and epigenomic changes that dictate how malignant primary tumors metastasize to the lung. The role of epithelial to mesenchymal transition (EMT), and acquisition of stem cell properties in this process, is also an area of intense investigation in the laboratory. In addition, we are also actively examining the contribution of the microenvironment in sustaining both the initiation and progression of pulmonary metastatic lesions. From a clinical perspective, identification of metastatic-specific molecular determinants will not only have implications as potential prognostic markers of metastasis, but the therapeutic targeting of these candidate molecules could have tremendous promise in prolonging the life of many cancer patients.