Publications

In order of most recent to oldest. See featured publication below utilizing ML.

  • Fidyk E, Kalesinskas L, Krismer K, Blarre A, Bouzit L, Ritten J, Gao J, Marinescu A, Kelly J, Harrison K, Cohen A. Real-world ctDNA testing patterns, associated biomarkers and sites of metastasis in early stage colorectal cancer. Journal of Clinical Oncology. 2024. JCO 42, 3610-3610(2024). doi:10.1200/JCO.2024.42.16_suppl.3610

  • Marinescu A, Chen J, Holmes HE, et al. Safety Assessment of High-Purity, Synthetic Nicotinamide Riboside (NR-E) in a 90-Day Repeated Dose Oral Toxicity Study, With a 28-Day Recovery Arm. International Journal of Toxicology. 2020;39(4):307-320. doi:10.1177/1091581820927406

  • Cody EA, Kraszewski AP, Marinescu A, et al. Measuring Joint Flexibility in Hallux Rigidus Using a Novel Flexibility Jig. Foot & Ankle International. 2017;38(8):885-892. doi:10.1177/1071100717709538

  • Cody EA, Mancuso CA, Burket JC, Marinescu A, MacMahon A, Ellis SJ, Patient Factors Associated With Higher Expectations From Foot and Ankle Surgery. Foot & Ankle International. 2017;38(5):472-478. doi:10.1177/1071100717690807

  • Cody EA, Mancuso CA, MacMahon A, Marinescu A, Burket JC, Drakos MC, Roberts MM, Ellis SJ. Development of an Expectations Survey for Patients Undergoing Foot and Ankle Surgery. Foot & Ankle International. 2016;37(12):1277-1284. doi:10.1177/1071100716666260

  • de Cesar Netto C, Kunas GC, Soukup D, Marinescu A, Ellis SJ. Correlation of Clinical Evaluation and Radiographic Hindfoot Alignment in Stage II Adult-Acquired Flatfoot Deformity. Foot & Ankle International. 2018;39(7):771-779. doi:10.1177/1071100718762113

  • Saunders SM, Ellis SJ, Demetracopoulos CA, Marinescu A, Burkett J, Deland JT. Comparative Outcomes Between Step-Cut Lengthening Calcaneal Osteotomy vs Traditional Evans Osteotomy for Stage IIB Adult-Acquired Flatfoot Deformity. Foot & Ankle International. 2018;39(1):18-27. doi:10.1177/1071100717732723

  • Oungoulian S, Hehir K, Zhu, K, Willis CE, Marinescu, A, Merali N, Ahmad C, Hung C, and Ateshian G. Effect of  glutaraldehyde fixation on the frictional response of immature bovine articular cartilage explants. Journal of Biomechanics, 2014. 47(3):  p. 694-701. doi:10.1016/j.jbiomech.2013.11.043

Featured Publication

Real-world ctDNA testing patterns, associated biomarkers and sites of metastasis in early stage colorectal cancer.

Authors: Erin Fidyk, Laurynas Kalesinskas, Konstantin Krismer, Auriane Blarre, Lilia Bouzit, John James Ritten, Jessica Gao, Anca Marinescu, Jonathan Kelly, Katherine Harrison, and Aaron B. Cohen

Publication: Journal of Clinical Oncology (May 2024) - Volume 42, Number 16_suppl - full abstract

Why it matters

Circulating tumor DNA (ctDNA) refers to fragments of DNA released by tumors into the bloodstream. It is increasingly important in clinical practice because it enables minimally invasive monitoring of cancer progression, treatment response, and early detection of relapse. This groundbreaking study leverages an NLP-driven deep learning model developed by my team to extract detailed ctDNA information from electronic medical records, achieving high recall, precision, and accuracy at scale. Representing the largest real-world analysis of circulating tumor DNA (ctDNA) testing in early-stage colorectal cancer (CRC), the research provides critical insights into clinical adoption patterns, the predictive value of ctDNA testing for metastasis, and its potential to guide risk stratification and personalized treatment. Without the innovative use of machine learning, analyzing ctDNA testing patterns across ~5 million patient records within Flatiron's network would have been infeasible.

Key Insights

  • Growing Adoption of ctDNA Testing

  • Among 78,046 early-stage CRC patients, over 5,000 underwent ctDNA testing, with an increasing adoption rate over time.

  • 11% of patients diagnosed in early 2021–2022 received ctDNA testing, increasing to 14% in 2022–2023.

  • ctDNA Positivity & Risk of Metastasis

    • 34.5% of tested patients had at least one positive ctDNA test.

    • Patients with ctDNA+ results were nearly 9x more likely to develop metastatic disease (21.1% vs. 2.8% in ctDNA- patients).

    • The median time to metastasis from first positive ctDNA test was 24.2 months.

  • Biomarkers & Metastasis Sites

    • ctDNA+ patients had a higher prevalence of TP53 and KRAS mutations.

    • Liver metastases were significantly more common in ctDNA+ patients (41% vs. 28% in ctDNA- patients).

    • Patients with higher minimal residual disease (MRD) levels had a greater risk of liver metastasis.

Impact & Applications

This study underscores the clinical value of ctDNA testing as a predictive biomarker in early-stage CRC, potentially transforming patient management through earlier identification of high-risk patients. The findings advocate for broader adoption of ctDNA testing to enhance proactive therapeutic interventions, improve patient outcomes, and inform targeted strategies for managing colorectal cancer progression.