Photo of Larissa J. Lee,  MD

Larissa J. Lee, MD

Brigham And Women's Hospital

Brigham And Women's Hospital
Phone: (617) 732-6331
Fax: (617) 278-6988

Larissa J. Lee, MD

Brigham And Women's Hospital


  • Assistant Professor, Radiation Oncology, Harvard Medical School
  • Physician, Radiation Oncology, Brigham And Women's Hospital


Research Abstract

Endometrial cancer is the most common gynecologic cancer in the United States. Although the annual incidence rate is slightly lower in African Americans compared to Caucasians, the mortality rate is nearly twice as high. Although racial differences in health care access and delivery have been reported, socioeconomic inequalities only partially account for the poor survival rates. In cooperative group studies of advanced or recurrent endometrial cancer, African Americans have a 25% higher mortality rate, independent of performance status, disease stage, histology and chemotherapy regimen.

Biological differences may underlie the significant racial disparity in the survival of African American women with endometrial cancer. Population-based studies have shown that black women are more likely to be diagnosed with high-grade tumors and advanced stage disease. Non-endometrioid tumors, such as uterine papillary serous (UPSC) or clear cell carcinoma, account for a higher proportion of endometrial cancer deaths among African Americans. Although histologically similar to ovarian serous carcinoma, UPSC is not as sensitive to chemotherapy as first-line treatment or at the time of relapse. Nevertheless, the molecular underpinnings of UPSC may be similar to serous ovarian cancer given their shared Müllerian phenotype. The Cancer Genome Atlas demonstrated widespread copy alterations and p53 mutations in ovarian serous tumors, and others have shown low frequency somatic mutations in over 50% of serous tumors. The goal of our project is to perform high-throughput genomic analysis of UPSC in African American and Caucasian patients to develop a better molecular understanding of this disease, as well as identify potential differences that might explain the disparities in survival by race. We hope the identification of distinct molecular profiles may inform decisions regarding adjuvant therapy for UPSC, and lead to the identification of novel therapeutic targets.

Publications from Harvard Catalyst Profiles

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  • Xu Y, Harris T, O'Farrell D, Cormack R, Lee L, King M, Buzurovic I. Interfraction dose deviation and catheter position in cervical interstitial and intracavitary image guided HDR brachytherapy. Med Dosim 2021. PubMed
  • Yerramilli D, Chen YH, Venkatachalam V, Alban GM, Buscariollo DL, Cheng T, King MT, Pretz JL, Russo AL, Lee LJ. Adjuvant Radiation Field Extent and Sites of Failure in Node Positive Endometrioid Endometrial Cancer. 2021. PubMed
  • Alban G, Cheng T, Adleman J, Buzurovic I, Pretz J, Singer L, King M, Lee L. Definitive radiotherapy for vaginal recurrence of early-stage endometrial cancer: survival outcomes and effect of mismatch repair status. Int J Gynecol Cancer 2021. PubMed
  • Alimena S, Pachigolla SL, Feldman S, Yang D, Orio PF, Lee L, King M. Race- and Age-Related Disparities in Cervical Cancer Mortality. J Natl Compr Canc Netw 2021. PubMed
  • Hathout L, Wang Y, Wang Q, Vergalasova I, Elshaikh MA, Dimitrova I, Damast S, Li JY, Fields EC, Beriwal S, Keller A, Kidd EA, Usoz M, Jolly S, Jaworski E, Leung EW, Donovan E, Taunk NK, Chino J, Natesan D, Russo AL, Lea JS, Albuquerque KV, Lee LJ. A Multi-Institutional Analysis of Adjuvant Chemotherapy and Radiation Sequence in Women With Stage IIIC Endometrial Cancer. Int J Radiat Oncol Biol Phys 2021. PubMed
  • Leung SOA, Feldman S, Kalyanaraman R, Shanmugam V, Worley MJ, Berkowitz RS, Horowitz NS, Feltmate CM, Muto MG, Lee LJ, King MT, Einarsson JI, Ajao MO, Elias KM. Triaging abnormal cervical cancer screening tests using p16INK4a detection by ELISA on fresh cervical samples. Am J Reprod Immunol 2021. PubMed
  • Elshaikh MA, Modh A, Jhingran A, Biagioli MC, Coleman RL, Gaffney DK, Harkenrider MM, Heskett K, Jolly S, Kidd E, Lee LJ, Li L, Portelance L, Sherertz T, Venkatessan AM, Wahl AO, Yashar CM, Small W. Executive summary of the American Radium Society® Appropriate Use Criteria for management of uterine carcinosarcoma. Gynecol Oncol 2020. PubMed
  • Steiner A, Alban G, Cheng T, Kapur T, Bay C, McLaughlin PY, King M, Tempany C, Lee LJ. Vaginal recurrence of endometrial cancer: MRI characteristics and correlation with patient outcome after salvage radiation therapy. Abdom Radiol (NY) 2020. PubMed
  • Lee EK, Esselen KM, Kolin DL, Lee LJ, Matulonis UA, Konstantinopoulos PA. Combined CDK4/6 and PD-1 Inhibition in Refractory SMARCA4-Deficient Small-Cell Carcinoma of the Ovary, Hypercalcemic Type. JCO Precis Oncol 2020; 4:736-742. PubMed
  • Alimena S, Yang DD, Melamed A, Mahal BA, Worley MJ, Feldman S, Elias KM, Orio PF, Lee LJ, King M. Racial disparities in brachytherapy administration and survival in women with locally advanced cervical cancer. Gynecol Oncol 2019; 154:595-601. PubMed
  • Singer L, Damast S, Lin L, Taunk N, Lee LJ, Albuquerque K, Chino J, Petereit D, Joyner M, Fields E. Development of a Multi-Institutional Simulation-Based Gynecologic Brachytherapy Curriculum. Int J Radiat Oncol Biol Phys 2019; 104:1175-1176. PubMed
  • Jiang G, Balboni T, Taylor A, Liu J, Lee LJ. Palliative Radiation Therapy for Recurrent Ovarian Cancer: Efficacy and Predictors of Clinical Response. Int J Gynecol Cancer 2018; 28:43-50. PubMed
  • Markt SC, Tang T, Cronin AM, Katz IT, Howitt BE, Horowitz NS, Lee LJ, Wright AA. Insurance status and cancer treatment mediate the association between race/ethnicity and cervical cancer survival. PLoS ONE 2018; 13:e0193047. PubMed
  • Kamran SC, Manuel MM, Catalano P, Cho L, Damato AL, Lee LJ, Schmidt EJ, Viswanathan AN. MR- versus CT-based high-dose-rate interstitial brachytherapy for vaginal recurrence of endometrial cancer. Brachytherapy 2017. PubMed
  • Liu CY, Elias KM, Howitt BE, Lee LJ, Feltmate CM. Sentinel lymph node mapping reduces practice pattern variations in surgical staging for endometrial adenocarcinoma: A before and after study. Gynecol Oncol 2017. PubMed
  • Damato AL, Buzurovic I, Bhagwat MS, Cormack RA, Devlin PM, Friesen S, Hansen J, Lee LJ, Manuel MM, Cho LP, O'Farrell D, Viswanathan AN. The value of systematic contouring of the bowel for treatment plan optimization in image-guided cervical cancer high-dose-rate brachytherapy. Brachytherapy 2017. PubMed
  • Watkins JC, Howitt BE, Horowitz NS, Ritterhouse LL, Dong F, MacConaill LE, Garcia E, Lindeman NI, Lee LJ, Berkowitz RS, Nucci MR, Crum CP. Differentiated exophytic vulvar intraepithelial lesions are genetically distinct from keratinizing squamous cell carcinomas and contain mutations in PIK3CA. Mod Pathol 2016. PubMed
  • Elshaikh MA, Vance S, Gaffney DK, Biagioli M, Jhingran A, Jolly S, Kidd E, Lee LJ, Li L, Moore DH, Rao GG, Wahl AO, Williams NL, Yashar CM, Small W, . ACR Appropriateness Criteria® Management of Recurrent Endometrial Cancer. Am J Clin Oncol 2016; 39:507-15. PubMed
  • Lee LJ, Howitt B, Catalano P, Tanaka C, Murphy R, Cimbak N, DeMaria R, Bu P, Crum C, Horowitz N, Matulonis U, Viswanathan AN. Prognostic importance of human papillomavirus (HPV) and p16 positivity in squamous cell carcinoma of the vulva treated with radiotherapy. Gynecol Oncol 2016. PubMed
  • Howitt BE, Sun HH, Roemer MG, Kelley A, Chapuy B, Aviki E, Pak C, Connelly C, Gjini E, Shi Y, Lee L, Viswanathan A, Horowitz N, Neuberg D, Crum CP, Lindeman NL, Kuo F, Ligon AH, Freeman GJ, Hodi FS, Shipp MA, Rodig SJ. Genetic Basis for PD-L1 Expression in Squamous Cell Carcinomas of the Cervix and Vulva. JAMA Oncol 2016; 2:518-22. PubMed
  • Jolly S, Soni P, Gaffney DK, Biagioli M, Elshaikh MA, Jhingran A, Kidd E, Lee LJ, Li L, Moore DH, Rao GG, Wahl AO, Williams NL, Yashar CM, Small W. ACR Appropriateness Criteria® Adjuvant Therapy in Vulvar Cancer. Oncology (Huntingt) 2015; 29:867-72, 874-5. PubMed
  • Meyer LA, Bohlke K, Powell MA, Fader AN, Franklin GE, Lee LJ, Matei D, Coallier L, Wright AA. Postoperative Radiation Therapy for Endometrial Cancer: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the American Society for Radiation Oncology Evidence-Based Guideline. J Clin Oncol 2015. PubMed
  • Damato AL, Lee LJ, Bhagwat MS, Buzurovic I, Cormack RA, Finucane S, Hansen JL, O'Farrell DA, Offiong A, Randall U, Friesen S, Viswanathan AN. Redesign of process map to increase efficiency: Reducing procedure time in cervical cancer brachytherapy. Brachytherapy 2015. PubMed
  • Viswanathan AN, Lee LJ, Eswara JR, Horowitz NS, Konstantinopoulos PA, Mirabeau-Beale KL, Rose BS, von Keudell AG, Wo JY. Complications of pelvic radiation in patients treated for gynecologic malignancies. Cancer 2014. PubMed
  • Damato AL, Devlin PM, Bhagwat MS, Buzurovic I, Friesen S, Hansen JL, Lee LJ, Molodowitch C, Nguyen PL, O'Farrell DA, Viswanathan AN, Williams CL, Killoran JH, Cormack RA. Independent brachytherapy plan verification software: improving efficacy and efficiency. Radiother Oncol 2014; 113:420-4. PubMed
  • Lee LJ, Bu P, Feltmate C, Viswanathan AN. Adjuvant chemotherapy with external beamradiation therapy for high-grade, node-positive endometrial cancer. Int J Gynecol Cancer 2014; 24:1441-8. PubMed
  • Viswanathan AN, Erickson B, Gaffney DK, Beriwal S, Bhatia SK, Lee Burnett O, D'Souza DP, Patil N, Haddock MG, Jhingran A, Jones EL, Kunos CA, Lee LJ, Lin LL, Mayr NA, Petersen I, Petric P, Portelance L, Small W, Strauss JB, Townamchai K, Wolfson AH, Yashar CM, Bosch W. Comparison and consensus guidelines for delineation of clinical target volume for CT- and MR-based brachytherapy in locally advanced cervical cancer. Int J Radiat Oncol Biol Phys 2014; 90:320-8. PubMed
  • Myers A, Barry WT, Hirsch MS, Matulonis U, Lee L. β-Catenin mutations in recurrent FIGO IA grade I endometrioid endometrial cancers. Gynecol Oncol 2014; 134:426-7. PubMed
  • Elshaikh MA, Yashar CM, Wolfson AH, Cardenes HR, Erickson B, Jhingran A, Jolly S, Kidd E, Lee LJ, Mayr NA, Moore D, Rao GG, Small W, Varia MA, Wahl AO, Yuh W, Gaffney DK, . ACR appropriateness Criteria® advanced stage endometrial cancer. Am J Clin Oncol 2014; 37:391-6. PubMed
  • Tung N, Gaughan E, Hacker MR, Lee LJ, Alexander B, Poles E, Schnitt SJ, Garber JE. Outcome of triple negative breast cancer: comparison of sporadic and BRCA1-associated cancers. Breast Cancer Res Treat 2014. PubMed
  • Damato AL, Townamchai K, Albert M, Bair RJ, Cormack RA, Jang J, Kovacs A, Lee LJ, Mak KS, Mirabeau-Beale KL, Mouw KW, Phillips JG, Pretz JL, Russo AL, Lewis JH, Viswanathan AN. Dosimetric consequences of interobserver variability in delineating the organs at risk in gynecologic interstitial brachytherapy. Int J Radiat Oncol Biol Phys 2014; 89:674-81. PubMed
  • Lalwani N, Dubinsky T, Javitt MC, Gaffney DK, Glanc P, Elshaikh MA, Kim YB, Lee LJ, Pannu HK, Royal HD, Shipp TD, Siegel CL, Simpson L, Wahl AO, Wolfson AH, Zelop CM, . ACR Appropriateness Criteria® pretreatment evaluation and follow-up of endometrial cancer. Ultrasound Q 2014; 30:21-8. PubMed
  • Lee LJ, Demaria R, Berkowitz R, Matulonis U, Viswanathan AN. Clinical predictors of long-term survival for stage IVB uterine papillary serous carcinoma confined to the abdomen. Gynecol Oncol 2014; 132:65-9. PubMed
  • Lee LJ, Ratner E, Uduman M, Winter K, Boeke M, Greven KM, King S, Burke TW, Underhill K, Kim H, Boulware RJ, Yu H, Parkash V, Lu L, Gaffney D, Dicker AP, Weidhaas J. The KRAS-variant and miRNA expression in RTOG endometrial cancer clinical trials 9708 and 9905. PLoS ONE 2014; 9:e94167. PubMed
  • Lee LJ, Damato AL, Viswanathan AN. Clinical outcomes following 3D image-guided brachytherapy for vaginal recurrence of endometrial cancer. Gynecol Oncol 2013; 131:586-92. PubMed
  • Lee LJ, Jhingran A, Kidd E, Cardenes HR, Elshaikh MA, Erickson B, Mayr NA, Moore D, Puthawala AA, Rao GG, Small W, Varia MA, Wahl AO, Wolfson AH, Yashar CM, Yuh W, Gaffney DK. Acr appropriateness Criteria management of vaginal cancer. Oncology (Huntingt) 2013; 27:1166-73. PubMed
  • Singer L, McLaughlin PY, Alban G, Joyner M, King M, Lee L. Simulation-based graduate medical education in MR-guided brachytherapy for cervical cancer. Brachytherapy ; 19:725-731. PubMed
  • King MT, Yang DD, Muralidhar V, Mahal B, Butler S, Devlin PM, Lee LJ, Mouw KW, Martin NM, D'Amico AV, Nguyen PL, Orio PF. A comparative analysis of overall survival between high-dose-rate and low-dose-rate brachytherapy boosts for unfavorable-risk prostate cancer. Brachytherapy ; 18:186-191. PubMed
  • Brown LC, Petersen IA, Haddock MG, Bakkum-Gamez JN, Lee LJ, Cimbak NC, Berkowitz RS, Viswanathan AN. Vaginal brachytherapy for early-stage carcinosarcoma of the uterus. Brachytherapy ; 14:433-9. PubMed
  • Townamchai K, Poorvu PD, Damato AL, DeMaria R, Lee LJ, Berlin S, Feltmate C, Viswanathan AN. Radiation dose escalation using intensity modulated radiation therapy for gross unresected node-positive endometrial cancer. ; 4:90-8. PubMed
  • Lee LJ, Viswanathan AN. Predictors of toxicity after image-guided high-dose-rate interstitial brachytherapy for gynecologic cancer Int J Radiat Oncol Biol Phys 2000.