H. Lee Moffitt Cancer Center & Research Institute

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Tuya Pal, MD

Tuya Pal, MD

Faculty Rank:

Associate Member

Titles:

Department/Program Affiliations:

  • Breast  
  • Risk Assessment,Detection & Intervention  

Primary Address:

H. Lee Moffitt Cancer Center &
Research Institute
12902 Magnolia Drive
Tampa, FL 33612

Office:

(813) 745-6239

USF Affiliations/College Department:

  • Medicine / Oncologic Sciences
  • Medicine / Pediatrics

University Academic Rank:

Assistant Professor

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Tuya Pal, MD

Education & Training:

  • M.D., McGill University Fac Of Med, 1992
  • Internship, St. Louis Children's Hospital, 1993 - Pediatrics
  • Residency, St. Louis Children's Hospital, 1995 - Pediatrics
  • Fellowship, Hospital for Sick Children, 1998 - Clinical Genetics

General Board Certification / SubSpecialty:

  • Pediatrics
  • Medical Genetics

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Tuya Pal, MD

Research Interests:

Dr. Pal's epidemiology-based cancer genetics research has two foci: identification of individuals with genetic and environmental risk factors that place them at increased risk of developing cancer, and development of strategies to reduce this risk. Her currently active research includes studies on ovarian cancer and mismatch repair deficiency and on genetic and hormonal risk factors for breast cancer in African American women. 

One of the best defined molecular pathways involved in both inherited and sporadic cancer pathogenesis involves the mismatch repair (MMR) pathway, which leads to microsatellite instability (MSI).  MSI may result from both genetic (i.e.: germline mutations in the MMR genes, including MLH1, MSH2, and MSH6) and epigenetic (i.e.: MLH1 promoter hypermethylation) mechanisms.  The purpose of the ‘Ovarian Cancer and Mismatch Repair Deficiency’ study is to quantify the proportion of ovarian tumors due to the mismatch repair genes and to characterize the tumors in this group.   Our ability to classify ovarian cancers by their genetic basis offers promise for improvements in cancer prevention and screening of high risk women, in basing diagnosis and prognosis on molecular markers, and in development of individualized treatments.  This study will include 2200 population-based cases of incident epithelial ovarian cancers based at the Moffitt Cancer Center, Duke Comprehensive Cancer Center, and the University of Toronto. Paraffin-embedded tumor samples will be analyzed from all subjects with incident ovarian cancers to perform MSI testing and investigate MMR gene protein expression.  In those samples with MSI-H status or with loss of expression of MMR gene proteins, epigenetic (MLH1 promoter hypermethylation) and genetic (germline MMR mutations) will be investigated.

Although African American women have a lower overall incidence of breast cancer than Caucasian women, the incidence of early-onset breast cancer is actually higher in African Americans. There is strong evidence that breast cancer in premenopausal women has a significant genetic component. In some cases, the genetic component may be attributable to high-penetrance genes such as BRCA1 and BRCA2; in others, to lower penetrance genes. Most of the low-penetrance genes thus far implicated in increased breast cancer risk are involved in hormone metabolism. Dr. Pal is investigating the contribution of high-penetrance BRCA1/BRCA2 genes in young African American breast cancer patients with a personal or family history suggestive of hereditary predisposition. This study will improve our understanding of inherited breast cancer in young African American women.

 


Clinical Interests:

Genetic counseling and testing of individuals and families at high-risk for inherited cancer susceptibility.


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Tuya Pal, MD

Publications:

  1. Daly MB, Axilbund JE, Buys S, Crawford B, Farrell CD, Friedman S, Garber JE, Goorha S, Gruber SB, Hampel H, Kaklamani V, Kohlmann W, Kurian A, Litton J, Marcom PK, Nussbaum R, Offit K, Pal T, Pasche B, Pilarski R, Reiser G, Shannon KM, Smith JR, Swisher E, Weitzel JN. Genetic/familial high-risk assessment: breast and ovarian. J Natl Compr Canc Netw. 2010 May;8(5):562-594. Pubmedid: 20495085.   Pubmed ID: 20495085

  2. Pal T, Keefe D, Sun P, Narod SA. Fertility in women with BRCA mutations: a case-control study. Fertil Steril. 2010 Apr;93(6):1805-1808. Pubmedid: 19200971.   Pubmed ID: 19200971

  3. Permuth-Wey J, Vadaparampil S, Rumphs A, Kinney AY, Pal T. Development of a culturally tailored genetic counseling booklet about hereditary breast and ovarian cancer for Black women. Am J Med Genet A. 2010 Apr;152A(4):836-845. Pubmedid: 20358592.   Pubmed ID: 20358592

  4. Permuth-Wey J, Boulware D, Valkov N, Livingston S, Nicosia S, Lee JH, Sutphen R, Schildkraut J, Narod S, Parker A, Coppola D, Sellers T, Pal T. Sampling strategies for tissue microarrays to evaluate biomarkers in ovarian cancer. Cancer Epidemiol Biomarkers Prev. 2009 Jan;18(1):28-34. Pubmedid: 19124477.   Pubmed ID: 19124477

  5. Pal T, Permuth-Wey J, Kumar A, Sellers TA. Systematic review and meta-analysis of ovarian cancers: estimation of microsatellite-high frequency and characterization of mismatch repair deficient tumor histology. Clin Cancer Res. 2008 Nov;14(21):6847-6854. Pubmedid: 18980979.   Pubmed ID: 18980979

  6. Pal T, Permuth-Wey J, Sellers TA. A review of the clinical relevance of mismatch-repair deficiency in ovarian cancer. Cancer. 2008 Aug;113(4):733-742. Pubmedid: 18543306.   Pubmed ID: 18543306

  7. Pal T, Vadaparampil S, Betts J, Miree C, Li S, Narod SA. BRCA1/2 in high-risk African American women with breast cancer: providing genetic testing through various recruitment strategies. Genet Test. 2008 Sep;12(3):401-407. Pubmedid: 18752448.   Pubmed ID: 18752448

  8. Chu W, Fyles A, Sellers E, McCready D, Murphy J, Pal T, Narod S. Association between CYP3A4 genotype and risk of endometrial cancer following tamoxifen use. Carcinogenesis. 2007 Oct;28(10):2139-42. Pubmedid: 17434921.   Pubmed ID: 17434921

  9. Pal T, Napierala D, Becker T, Loscalzo M, Baldridge D, Lee B, Sutphen R. The presence of germ line mosaicism in cleidocranial dysplasia. Clin Genet. 2007 Jun;71(6):589-591. Pubmedid: 17539909.   Pubmed ID: 17539909

  10. Pal T, Permuth-Wey J, Kapoor R, Cantor A, Sutphen R. Improved survival in BRCA2 carriers with ovarian cancer. Fam Cancer. 2007 Jan;6(1):9-119. Pubmedid: 17160431.   Pubmed ID: 17160431

  11. Beiner M, Rosen B, Fyles A, Harley I, Pal T, Siminovitch K, Zhang S, Sun P, Narod S. Endometrial cancer risk is associated with variants of the mismatch repair genes MLH1 and MSH2. Cancer Epidemiol Biomarkers Prev. 2006 Aug;15(9):1636-1640. Pubmedid: 16985024.   Pubmed ID: 16985024

  12. Pal T, Permuth-Wey J, Betts JA, Krischer JP, Fiorica J, Arango H, LaPolla J, Hoffman M, Martino MA, Wakeley K, Wilbanks G, Nicosia S, Cantor A, Sutphen R. BRCA1 and BRCA2 mutations account for a large proportion of ovarian carcinoma cases. Cancer. 2005 Dec;104(12):2807-2816. Pubmedid: 16284991.   Pubmed ID: 16284991

  13. Sellers T, Schildkraut J, Pankratz V, Vierkant R, Fredericksen Z, Olson J, Cunningham J, Taylor W, Liebow M, McPherson C, Hartmann L, Pal T, Adjei A. Estrogen bioactivation, genetic polymorphisms, and ovarian cancer. Cancer Epidemiol Biomarkers Prev. 2005 Nov;14(11Pt1):2536-2543. Pubmedid: 16284375.   Pubmed ID: 16284375

  14. Pal T, Permuth-Wey J, Holtje T, Sutphen R. BRCA1 and BRCA2 mutations in a study of African American breast cancer patients. Cancer Epidemiol Biomarkers Prev. 2004 Nov;13(11 Pt 1):1794-1799. Pubmedid: 15533909.   Pubmed ID: 15533909

  15. Pal T, Sutphen R, Sellers T. Mismatch repair gene expression defects contribute to microsatellite instability in ovarian carcinoma. Cancer. 2004;100(11):2485-2486. Pubmedid: 15160358.   Pubmed ID: 15160358

  16. Thiffault I, Hamel N, Pal T, McVety S, Marcus V, Farber D, Cowie S, Deschenes J, Meschino W, Odefrey F, Goldgar D, Graham T, Narod S, Watters A, MacNamara E, Sart D, Chong G, Foulkes W. Germline truncating muations in both MSH2 and BRCA2 in a single kindred. Br J Cancer. 2004;90(2):483-491. Pubmedid: 14735197.   Pubmed ID: 14735197

  17. Elit L, Pal T, Goshen R, Jernstrom H, Ackerman I, Fyles A, Carey M, Mitchell M, Aube J, Narod S. Familial and hormonal risk factors for papillary serous uterine cancer. Eur J Gynaecol Oncol. 2002;23(3):187-190. Pubmedid: 12094951.   Pubmed ID: 12094951

  18. Elliot A, Graham J, Curry C, Pal T, Rimoin D, Lachman R. Spectrum of dolichospondylic dysplasia: two new patients with distinctive findings. Am J Med Genet. 2002;113(4):351-361. Pubmedid: 12457407.   Pubmed ID: 12457407

  19. Bevan S, Pal T, Greenberg C, Green H, Wixey J, Bignell G, Narod S, Foulkes W, Stratton M, Houlston R. A comprehensive analysis of MNG1, TCO1, fPTC, PTEN, TSHR, and TRKA in familial nonmedullary thyroid cancer: confirmation of linkage to TCO1. J Clin Endocrinol Metab. 2001;86(8):3701-3704. Pubmedid: 11502798.   Pubmed ID: 11502798

  20. Pal T, Hamel N, Vesprini D, Sanders K, Mitchell M, Quercia N, Ng C, Murray A, Foulkes W, Narod S. Double primary cancers of the breast and thyroid in women: molecular analysis and genetic implications. Familial Cancer. 2001;1(1):17-24. Pubmedid: 14574011.   Pubmed ID: 14574011

  21. Pal T, Liede A, Mitchell M, Calender A, Narod S. Intestinal carcinoid tumours in a father and daughter. Can J Gastroenterol. 2001;15(6):405-409. Pubmedid: 11429670.   Pubmed ID: 11429670

  22. Pal T, Vogl F, Chappuis P, Tsang R, Brierley J, Renard H, Sanders K, Kantemiroff T, Bagha S, Goldgar D, Narod S, Foulkes W. Increased risk for nonmedullary thyroid cancer in the first degree relatives of prevalent cases of nonmedullary thyroid cancer: a hospital-based study. J Clin Endocrinol Metab. 2001;86(11):5307-5312. Pubmedid: 11701697.   Pubmed ID: 11701697

  23. Charames G, Millar A, Pal T, Narod S, Bapat B. Do MSH6 mutations contribute to double primary cancers of the colorectum and endometrium?. Hum Genet. 2000;107(6):623-629. Pubmedid: 11153917.   Pubmed ID: 11153917

  24. Goshen R, Chu W, Elit L, Pal T, Hakimi J, Ackerman I, Fyles A, Mitchell M, Narod S. Is uterine papillary serous adenocarcinoma a manifestation of the hereditary breast-ovarian cancer syndrome?. Gynecol Oncol. 2000;79(3):477-481. Pubmedid: 11104623.   Pubmed ID: 11104623

  25. Liede A, Pal T, Mitchell M, Narod S. Delineation of a new syndrome: clustering of pyloric stenosis, endometriosis, and breast cancer in two families. J Med Genet. 2000;37(10):794-796. Pubmedid: 11183186.   Pubmed ID: 11183186

  26. Millar A, Pal T, Madlensky L, Sherman C, Temple L, Mitri A, Cheng H, Marcus V, Gallinger S, Bapat B, Narod S. Mismatch repair gene defects contribute to the genetic basis of double primary cancers of the colorectum and endometrium. Hum Mol Genet. 1999;8(5):823-829. Pubmedid: 10196371.   Pubmed ID: 10196371

  27. Pal T, Flanders T, Mitchell-Lehman M, MacMillan A, Brunet J, Narod S, Foulkes W. Genetic implications of double primary cancers of the colorectum and endometrium. J Med Genet. 1998;35(12):978-984. Pubmedid: 9863592.   Pubmed ID: 9863592

Tuya Pal, MD

Below is a list of active grants where the faculty member is the Principal Investigator. Grants are sorted by sponsor and then sorted by start date, with the more recent grant shown first.

Ovarian Cancer and Mismatch Repair Deficiency (NO COST EXTENSION)

5 R01 CA111914-05
Sponsor: Nat Institutes of Health / NCI
Project Dates: April 20, 2005 to February 28, 2011

Black Women: Etiology and Survival of Triple-Negative Breast Cancers (BEST) Study

1BG-10
Sponsor: State of Florida / Dept of Health
Project Dates: August 19, 2010 to June 30, 2015
Annual Direct Cost: $252,544
Annual Total Cost: $290,155
Project Total: $1,499,830

Inherited Cancer Registry (I CARE) Initiative

1BG-09
Sponsor: State of Florida / Dept of Health
Project Dates: August 2, 2010 to June 30, 2015
Annual Direct Cost: $219,336
Annual Total Cost: $252,236
Project Total: $1,069,292

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