Dr. Pike’s research interests are in the etiology and chemoprevention of breast, endometrial and ovarian cancers. He is the Principal Investigator of a large international multi-institutional study (MOCOG) of the determinants of long-term survival from high-grade advanced-stage ovarian cancer. This study investigates the molecular biology and immunology of tumors from 600 long-term, 600 medium-term and 600 short-term survivors. He also collaborates with the Ovarian Cancer Association Consortium to identify factors associated with ovarian cancer incidence. A woman’s risks of endometrial and ovarian cancers are significantly reduced by use of combined estrogen-progestin oral contraceptives (COCs). The protection increases with duration of COC use and lasts for more than 30 years after the last use of a COC. Why COC use protects against endometrial cancer is well-understood, but why COC use protects against ovarian cancer is not. ‘Traditionally’ almost all COC packs have contained 21 active and 7 placebo pills, but recently the ratio of active to placebo pills has been changed to 24:4 and 84:7. These 24:4 and 84:7 COCs are predicted to add significantly to the protection of COCs against endometrial cancer. The effect of these COCs on ovarian cancer risk is unclear. If ovarian cancer risk reduction is determined through ovulation inhibition these changes will have little or no effect on the extent of risk reduction. If, however, the protection is through increased exposure to the progestin component of the COC then these changes could make the protection much greater. Dr. Pike is working with gynecologic faculty at MSK on understanding the mechanism of protection against ovarian cancer from COCs by studying the biology of the fallopian tube and cortical inclusion cysts within the ovary, the two sites where current evidence suggests most of the most common ovarian cancers arise. Dr. Pike is working with Dr. Jonine Bernstein and radiology faculty at MSK to evaluate whether breast magnetic resonance imaging and contrast-enhanced mammography can be used through evaluation of background parenchymal enhancement (BPE). He is working with gynecology, radiology and pathology faculty at Columbia University Irving Medical Center on the use of an anti-progestin for the prevention of breast cancer – this study also compares the effect of the anti-progestin on proliferation in the breast and change in BPE.
Doctors and faculty members often work with pharmaceutical, device, biotechnology, and life sciences companies, and other organizations outside of MSK, to find safe and effective cancer treatments, to improve patient care, and to educate the health care community.
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Malcolm Pike discloses the following relationships and financial interests:
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