Emese Zsiros, PhD

Cervical Endometrium Fallopian Tube Ovarian Uterine Endometrial Vaginal Vulvar
Specializing In:

Abnormal pap smear Cervical dysplasia Cervical lesions Cervix biopsy Colposcopy Cervical cancer Endometrial cancer Ovarian and Fallopian tube cancer Vulvar and vaginal cancer Trophoblastic disease Gynecologic cancer surgery Gynecological chemotherapy Laparotomy Complex laparoscopic surgery Robotic surgery Minimally invasive surgery Cancer prevention Cancer vaccine therapies and novel clinical trials
Research Interests:

Immunotherapy approaches for gynecological malignancies Early phase clinical trials Cancer immunotherapy Microbiome research Healthcare quality research
About Emese Zsiros
Biography:
Dr. Emese Zsiros is a clinician scientist and the Shashi Lele MD Endowed Chair in Gynecologic Oncology at Roswell Park Comprehensive Cancer Center in Buffalo, NY. Dr. Zsiros received her MD and Ph.D. from the University of Debrecen in Hungary, where she was ranked in the top 1% among medical students and received accolades for her research accomplishments, winning several university and national awards. She also conducted basic science research during her OB/GYN residency at Northwestern University in Chicago. In addition, she completed a gynecologic oncology fellowship at the University of Pennsylvania, where she was actively involved in designing and overseeing early-phase immunotherapy clinical trials for patients with ovarian cancer under the mentorship of George Coukos, MD, Ph.D., an international expert in ovarian cancer immunotherapy.

After completing her fellowship, Dr. Zsiros joined Roswell Park in 2014 as a gynecologic oncologist and clinician scientist. In addition to being the first female surgical chair appointed at Roswell Park, she was recently appointed a Co-Leader in the Tumor Immunology and Immunotherapy (TII) Cancer Center Support Grant (CCSG) program at Roswell Park, one of 53 NCI-designated Comprehensive Cancer Centers in the United States. As a Co-Leader for TII, she is responsible for developing a strategic plan for the overall research direction of TII, developing and coordinating new and ongoing scientific activities, recruiting and mentoring faculty, and translating efforts that lead to clinical trials.

Dr. Zsiros has several research interests. She is passionate about treating her patients with effective treatments that offer increased survival, reduced toxicities, and good quality of life. She has designed and successfully executed several interventional clinical trials, gained crucial experience in clinical trial design, management, and data analysis, and has been involved in more than fifty trials as a PI or Co-I. For example, she successfully conducted an investigator-initiated clinical trial (NCT02853318) sponsored by Merck & Co, published in JAMA Oncology, which recruited forty patients with recurrent OC who received pembrolizumab, an anti-PD1 immune checkpoint inhibitor, combined with bevacizumab, an anti-VEGF, and oral cyclophosphamide. This clinical trial in a very heavily pretreated patient population showed a remarkable objective response rate (47.5%) and disease control rate of 95%. Patients’ biospecimens are being analyzed using a variety of multi-omic means to determine the genomic, transcriptomic, immune, metabolomic, and microbiome signatures that may be indicative of patients who have exceptional responses. This immunotherapy regimen from our trial is now being used across the country.

Dr. Zsiros also has a translational lab that focuses on the ovarian cancer tumor microenvironment (TME) to identify ways to overcome immunosuppression so that different immunotherapeutic approaches may be more efficacious. Several approaches, including using various mouse models, involve identifying specific pathways to target, including metabolomic, microbiota, and humoral and cellular pathways, and collaborating with colleagues using adoptive cell therapy approaches.

Dr. Zsiros is committed to training the next generation of physicians/researchers. As Research Director and Associate Program Director, she actively participates in mentoring all Gyn Onc fellows with their research projects, includes them in activities related to her clinical trial research protocols, helps them prepare for national meetings, and assists them with writing research protocols, scientific reports, book chapters, and peer-reviewed manuscripts. In addition, she also mentors several junior faculties involved in translational ovarian cancer research projects.

That focus on her patients’ overall well-being has been a hallmark of Dr. Zsiros’ work in the operating room, in the clinic, and as a translational researcher. Dr. Zsiros is a dedicated clinician and has been named Buffalo Spree’s Top Doctor since 2019. As a visionary leader, she is committed to leading a top-tiered Gynecologic Oncology Department and driving innovative immunotherapy approaches to impact patient care and survival.

Positions
Roswell Park Comprehensive Cancer Center
Associate Professor of Oncology
Chair, Department of Gynecologic Oncology
Director of Research, Department of Gynecologic Oncology
Associate Program Director, Fellowships in Gynecologic Oncology
Department of Translational Immuno-Oncology
Shashi Lele, MD, Endowed Chair in Gynecologic Oncology
Co-Leader, Tumor Immunology and Immunotherapy CCSG Program
Jacobs School Of Medicine And Biomedical Sciences, State University of New York at Buffalo
Clinical Assistant Professor
Background
Education and Training:
2011 - PhD - Department of Biophysics and Cell Biology – University of Debrecen Medical and Health Science Center, Debrecen, Hungary in conjunction with the Universidad de Complutense, Madrid, Spain
2005 - MD/PhD - Membrane Physiology Program – University of Debrecen Medical and Health Science Center, Debrecen, Hungary and Universidad de Alcala de Henares, Spain
Residency:
2011 - OB/GYN – McGaw Medical Center, Northwestern University, Chicago, IL
Fellowship:
2014 - Gynecologic Oncology – University of Pennsylvania, Philadelphia, PA
Board Certification:
Obstetrics and Gynecology, American Board of Obstetrics and Gynecology
Gynecologic Oncology: American Board of Obstetrics and Gynecology
Professional Memberships:
Diplomate of the American Board of Obstetrics and Gynecology (ABOG)
Fellow of the American Congress of Obstetricians and Gynecologists (FACOG)
Full member of the Society of Gynecologic Oncology (SGO)
Full Member of the American Association for Cancer Research (AACR)
Full Member of the American Society of Clinical Oncology (ASCO)
Associate Active Member of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)
Full Member of Society for Immunotherapy of Cancer (SITC)
Professional Experience:
2020-present - Redesigning Oncology Care for the Future – Physician Champion, Member, Roswell Park
2020-present - COVID-19 Patient Safety Committee, Member, Roswell Park
2018-present - Physician Quality Officer, Roswell Park
2018-present - Data Safety Monitoring Board, Roswell Park
2018-present - Microbiome Interest Group, Physician Co-leader, Roswell Park
2017-present - Surgical Services Executive Committee, Roswell Park
Honors & Awards:
2019, 2020 Buffalo Spree’s Top Doctors
2011 - Ralph Reis Research Award, Department of Obstetrics and Gynecology, Northwestern University
2005 - Paul Harris Fellowship, Rotary International
2005 - Outstanding Research Award, Hungarian Society of Physiologists
2003, 2004 - Educational Scholarship, Republic of Hungary (awarded to the top 1% of medical students in Hungary)
Research
Research Overview:
I am a well-trained clinician scientist with a strong clinical and research background that extends across continents, who is involved in direct patient care for women with gynecological malignancies, who has a successful translational research laboratory, who is heavily involved in clinical trial conduct, infrastructure, development, negotiation and budgeting, who has established statewide, national, and international collaborations, who has spearheaded attempts to better manage narcotics during a rampant opioid epidemic, and who is committed to training the next generation of gynecological oncology physicians conducting clinical trial research.

I joined Roswell Park Comprehensive Cancer Center in 2014 as gynecologic oncologist and physician scientist. My current time contribution is 50% clinical and 50% research and I have my own laboratory and postdoctoral fellow focusing on ovarian cancer tumor microenvironment and microbiome research. I am also interested in developing novel therapeutic targets that offer better clinical outcomes and quality of life to our patients with gynecological cancers. I have designed and successfully executed several interventional clinical trials in which I gained a lot of experience on trial design, management, and data analysis.

I have recently led a successful investigator-initiated clinical trial (NCT02853318) sponsored by Merck &Co, where I designed and successfully enrolled 40 patients with recurrent ovarian cancer to receive pembrolizumab combined with bevacizumab and oral cyclophosphamide. This clinical trial showed a remarkable response rate in a heavily pretreated patient population with an overall response rate of 47.5% and a disease control rate of 95%. Interestingly, we saw 12 patients on this clinical trial who were outstanding responders with a very durable clinical response (>18 months). We have collected numerous biospecimens during this clinical trial and our major goal is to understand the factors that led to durable disease control in 30% of our patients by analyzing all of the collected translational specimens.

My ultimate goal is to develop new treatment approaches that optimize the tumor microenvironment and augment existing immunotherapy approaches, thus, to improve the quality of life of our patients and extend their survival. Currently, we have several new immunotherapy clinical trials in development for patients with recurrent ovarian and endometrial cancer.

Another portion of my research focuses on immunotherapy and quality of life interventions to improve the lives of our cancer patients. Our patients often live for years and sometimes decades with their cancer diagnosis, which frequently alters their level of activity and engagement in the society. I have designed and executed 2 clinical trials to understand the relationship between physical activity, microbiome, antitumor immune response, as well as the quality of life in our ovarian and endometrial cancer patients using state of the art wearable devices to monitor physical activity, sleep, and heart rate while collecting serial biospecimens. With these 2 trials, we have demonstrated the wearable activity tracking devices are feasible for research in both ovarian and endometrial cancer patients and the activity level of our patients is very low. We are actively working to develop new applications that could be further used to motivate our cancer patients to increase their activity level and also to maintain the lifestyle change for years or as long as physically possible with their diagnosis.

Besides my interest in basic and translational science, I am also interested in quality improvements projects, which improve the lives of our patients and our community. I have designed and implemented a restrictive opioid prescription policy in our institution, which led to significant decrease in perioperative opioid use across all surgical services without compromising patient recovery.  I serve as a Quality Officer at Roswell Park and my goal is to further extend opioid-sparing approaches to other medical centers across the country and continue to develop evidence-based guidelines for opioid prescribing.

As an associate program director, I actively participate mentoring all fellows with their research projects and help them prepare for national meetings, as well I assist them with writing research protocols, scientific reports, book chapters, and peer-reviewed manuscripts. I am passionate about training the next generation of gynecologic oncologists and physician scientist.

Lab Members:

Shanmuga Chilakapati, PhD, Postdoctoral researcher
Area of study: Role of human microbiome in antitumor immune responses; Role of SEMA4D on ovarian cancer progression

Aaron Varghese, MD, Clinical fellow
Research project: Understanding the role of opioids in cancer immunotherapy; Translational data analysis for phase II clinical trial of pembrolizumab with bevacizumab and oral cyclophosphamide
 

Clinical Trials
APL-2 and Pembrolizumab Versus APL-2, Pembrolizumab and Bevacizumab Versus Bevacizumab Alone for the Treatment of Recurrent Ovarian, Fallopian Tube, or Primary Peritoneal Cancer and Malignant Effusion
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Pembrolizumab/Placebo Plus Paclitaxel With or Without Bevacizumab for Platinum-resistant Recurrent Ovarian Cancer (MK-3475-B96/KEYNOTE-B96/ENGOT-ov65)
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A Safety and Tolerability Study of NC762 in Subjects With Advanced or Metastatic Solid Tumors
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Study of LN-145, Autologous Tumor Infiltrating Lymphocytes in the Treatment of Patients With Cervical Carcinoma