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Christine  Walko

Christine Walko, PharmD

Program: Precision Medicine


  • Overview

    Dr. Walko’s research focus is optimizing drug therapy using pharmacogenomics and pharmacokinetics to personalize intravenous and oral anticancer therapy for patients with cancer.


    • Pathology

    Education & Training


    • Duquesne University, PharmD - Pharmacy


    • University of North Carolina - Pharmacy


    • University of North Carolina - Pharmacy
    • Virginia Commonwealth University - Pharmacy
  • Research Interest

    Dr. Walko’s research focus is optimizing drug therapy using pharmacogenomics and pharmacokinetics to personalize intravenous and oral anticancer therapy for patients with cancer.

  • Publications

    • Mehta R, Sinnamon A, Dam A, Walko C, Palm R, Barton L, Lauwers G, Pimiento JM. Locally advanced mismatch repair-deficient gastroesophageal junction cancer: Diagnosis, treatment modifications, and monitoring. CA-Cancer J Clin. 2023 Oct. Pubmedid: 37849051.
    • Baker SD, Bates SE, Brooks GA, Dahut WL, Diasio RB, El-Deiry WS, Evans WE, Figg WD, Hertz DL, Hicks JK, Kamath S, Kasi PM, Knepper TC, McLeod HL, O'Donnell PH, Relling MV, Rudek MA, Sissung TM, Smith DM, Sparreboom A, Swain SM, Walko CM. DPYD Testing: Time to Put Patient Safety First. J Clin Oncol. 2023 May.41(15):2701-2705. Pubmedid: 36821823.
    • Battisti NML, De Glas N, Soto-Perez-de-Celis E, Liposits G, Bringuier M, Walko C, Lichtman SM, Aapro M, Cheung KL, Biganzoli L, Ring A, Portielje J, Wildiers H, Brain E. Chemotherapy and gene expression profiling in older early luminal breast cancer patients: An International Society of Geriatric Oncology systematic review. Eur J Cancer. 2022 Sep.172:158-170. Pubmedid: 35777273.
    • Miao R, Bui MM, Walko C, Mullinax JE, Brohl AS. A Malignant Glomus Tumor of the Liver Harboring MIR143-NOTCH2 Rearrangement: From Diagnosis to Management. Cureus. 2022 Oct.14(10):e30718. Pubmedid: 36439569. Pmcid: PMC9696860.
    • Tan E, Whiting J, Xie H, Imanirad I, Carballido E, Felder S, Frakes J, Mo Q, Walko C, Permuth JB, Sommerer K, Kim R, Anaya DA, Fleming JB, Sahin IH. BRAF Mutations Are Associated with Poor Survival Outcomes in Advanced-stage Mismatch Repair-deficient/Microsatellite High Colorectal Cancer. Oncologist. 2022 Mar.27(3):191-197. Pubmedid: 35274712. Pmcid: PMC8914499.
    • Karan C, Tan E, Sarfraz H, Knepper TC, Walko CM, Felder S, Kim R, Sahin IH. Human Epidermal Growth Factor Receptor 2-Targeting Approaches for Colorectal Cancer: Clinical Implications of Novel Treatments and Future Therapeutic Avenues. JCO Oncol Pract. 2022 Aug.18(8):545-554. Pubmedid: 35613416.
    • Wood AC, Zhang Y, Mo Q, Cen L, Fontaine J, Hoffe SE, Frakes J, Dineen SP, Pimiento JM, Walko CM, Mehta R. Evaluation of Tumor DNA Sequencing Results in Patients with Gastric and Gastroesophageal Junction Adenocarcinoma Stratified by TP53 Mutation Status. Oncologist. 2022 Apr.27(4):307-313. Pubmedid: 35380714. Pmcid: PMC8982441.
    • Tan E, Whiting J, Knepper T, Xie H, Imanirad I, Carballido E, Felder S, Frakes J, Mo Q, Permuth JB, Somerer K, Kim R, Anaya DA, Fleming JB, Walko C, Sahin IH. Core Homologous Recombination Mutations and Improved Survival in Nonpancreatic GI Cancers. Am J Clin Oncol. 2022 Apr.45(4):137-141. Pubmedid: 35320814.
    • Fusco MJ, Piña Y, Macaulay RJ, Sahebjam S, Forsyth PA, Peguero E, Walko CM. Durable Progression-Free Survival With the Use of BRAF and MEK Inhibitors in Four Cases With BRAF V600E-Mutated Gliomas. Cancer Control. 2021 Jan.28. Pubmedid: 34620004. Pmcid: PMC8506147.
    • Fusco MJ, Saeed-Vafa D, Carballido EM, Boyle TA, Malafa M, Blue KL, Teer JK, Walko CM, McLeod HL, Hicks JK, Extermann M, Fleming JB, Knepper TC, Kim DW. Identification of Targetable Gene Fusions and Structural Rearrangements to Foster Precision Medicine in KRAS Wild-Type Pancreatic Cancer. JCO Precis Oncol. 2021 Jan.5. Pubmedid: 34250383. Pmcid: PMC8232071.
    • Seligson ND, Knepper TC, Ragg S, Walko CM. Developing Drugs for Tissue-Agnostic Indications: A Paradigm Shift in Leveraging Cancer Biology for Precision Medicine. Clin Pharmacol Ther. 2021 Feb.109(2):334-342. Pubmedid: 32535906. Pmcid: PMC7891377.
    • Fusco MJ, West HJ, Walko CM. Tumor Mutation Burden and Cancer Treatment. JAMA Oncol. 2021 Feb.7(2):316. Pubmedid: 33331847.
    • Sahebjam S, Forsyth PA, Tran ND, Arrington JA, Macaulay R, Etame AB, Walko CM, Boyle T, Peguero EN, Jaglal M, Mokhtari S, Enderling H, Raghunand N, Gatewood T, Long W, Dzierzeski JL, Evernden B, Robinson T, Wicklund MC, Kim S, Thompson ZJ, Chen DT, Chinnaiyan P, Yu HM. Hypofractionated stereotactic re-irradiation with pembrolizumab and bevacizumab in patients with recurrent high-grade gliomas: results from a phase I study. Neurooncol. 2021 Apr.23(4):677-686. Pubmedid: 33173935. Pmcid: PMC8041351.
    • Piña Y, Fusco MJ, Macaulay RJ, Walko CM, Peguero E, Evernden BR, Smalley KS, Forsyth P. Using personalized medicine in gliomas: a genomic approach to diagnosis and overcoming treatment resistance in a case with pleomorphic xanthoastrocytoma. J Neurol. 2020 Mar.267(3):783-790. Pubmedid: 31748891. Pmcid: PMC7035305.
    • Chahoud J, Skelton WP, Spiess PE, Walko C, Dhillon J, Gage KL, Johnstone PAS, Jain RK. Case Report: Two Cases of Chemotherapy Refractory Metastatic Penile Squamous Cell Carcinoma With Extreme Durable Response to Pembrolizumab. Front Oncol. 2020 Dec.10:615298. Pubmedid: 33425770. Pmcid: PMC7793656.
    • Nelson RS, Mehta RJ, McLeod HL, Walko CM. Prioritization of Therapy Options for a Patient With High Tumor Mutation Burden and Microsatellite Instability but No Clinical Benefit From Immunotherapy. JCO Precis Oncol. 2019 Oct.3. Pubmedid: 32923851. Pmcid: PMC7446362.
    • Bridge JA, Sumegi J, Druta M, Bui MM, Henderson-Jackson E, Linos K, Baker M, Walko CM, Millis S, Brohl AS. Clinical, pathological, and genomic features of EWSR1-PATZ1 fusion sarcoma. Mod Pathol. 2019 Nov.32(11):1593-1604. Pubmedid: 31189996.
    • Walko CM, West HJ. Antibody Drug Conjugates for Cancer Treatment. JAMA Oncol. 2019 Nov.5(11):1648. Pubmedid: 31556926.
    • Chon HS, Sehovic M, Marchion D, Walko C, Xiong Y, Extermann M. Biologic Mechanisms Linked to Prognosis in Ovarian Cancer that May Be Affected by Aging. J Cancer. 2019 Jun.10(12):2604-2618. Pubmedid: 31258768. Pmcid: PMC6584919.
    • Rizk VT, Walko CM, Brohl AS. Precision medicine approaches for the management of Ewing sarcoma: current perspectives. Pharmgenomics Pers Med. 2019 Jan.12:9-14. Pubmedid: 30697061. Pmcid: PMC6340366.
    • Fradley MG, Gliksman M, Emole J, Viganego F, Rhea I, Welter-Frost A, Armanious M, Lee DH, Walko C, Shah B, Chavez JC, McLeod H, Pinilla-Ibarz J, Schabath MB. Rates and Risk of Atrial Arrhythmias in Patients Treated With Ibrutinib Compared With Cytotoxic Chemotherapy. Am J Cardiol. 2019 Aug.124(4):539-544. Pubmedid: 31208701.
    • Boddu S, Walko CM, Bienasz S, Bui MM, Henderson-Jackson E, Naghavi AO, Mullinax JE, Joyce DM, Binitie O, Letson GD, Gonzalez RJ, Reed DR, Druta M, Brohl AS. Clinical Utility of Genomic Profiling in the Treatment of Advanced Sarcomas: A Single-Center Experience. JCO Precis Oncol. 2018 Nov.2:1-8. Pubmedid: 35135155.
    • Vela CM, Van den Bergh M, Gillis NK, Ball M, Hussaini MO, Walko CM, Hicks JK, Perez L, Padron E, Komrokji RS. Somatic Sequencing Identifies Trametinib-Responsive Myelodysplastic Syndrome and Finds Acquired Clonal Hematopoiesis of Indeterminate Potential. JCO Precis Oncol. 2018 Nov.2. Pubmedid: 35135101. Pmcid: PMC9797240.
    • Saller J, Walko CM, Millis SZ, Henderson-Jackson E, Makanji R, Brohl AS. Response to Checkpoint Inhibitor Therapy in Advanced Classic Kaposi Sarcoma: A Case Report and Immunogenomic Study. J Natl Compr Canc Ne. 2018 Jul.16(7):797-800. Pubmedid: 30006421.
    • Williams GR, Deal AM, Shachar SS, Walko CM, Patel JN, O'Neil B, McLeod HL, Weinberg MS, Choi SK, Muss HB, Sanoff HK. The impact of skeletal muscle on the pharmacokinetics and toxicity of 5-fluorouracil in colorectal cancer. Cancer Chemother Pharmacol. 2018 Feb.81(2):413-417. Pubmedid: 29159476. Pmcid: PMC5777882.
    • Coombs CC, Gillis NK, Tan X, Berg JS, Ball MC, Balasis ME, Montgomery ND, Bolton K, Parker JS, Mesa TE, Yoder SJ, Hayward MC, Patel NM, Richards KL, Walko CM, Knepper TC, Soper JT, Weiss J, Grilley-Olson JE, Kim WY, Earp S, Levine R, Papaemmanuil E, Zehir A, Hayes DN, Padron E. Identification of Clonal Hematopoiesis Mutations in Solid Tumor Patients Undergoing Unpaired Next-Generation Sequencing Assays. Clin Cancer Res. 2018 Dec.24(23):5918-5924. Pubmedid: 29866652. Pmcid: PMC6812550.
    • Vela CM, Knepper TC, Gillis NK, Walko CM, McLeod HL, Hicks JK. Quantitation of Targetable Somatic Mutations Among Patients Evaluated by a Personalized Medicine Clinical Service: Considerations for Off-Label Drug Use. Pharmacotherapy. 2017 Sep.37(9):1043-1051. Pubmedid: 28235141.
    • A Marcath L, Deal AM, Van Wieren E, Danko W, Walko CM, Ibrahim JG, Weck KE, Jones DR, Desta Z, McLeod HL, Carey LA, Irvin WJ, Hertz DL. Comprehensive assessment of cytochromes P450 and transporter genetics with endoxifen concentration during tamoxifen treatment. Pharmacogenet Genomics. 2017 Nov.27(11):402-409. Pubmedid: 28877533. Pmcid: PMC5659294.
    • Knepper TC, Bell GC, Hicks JK, Padron E, Teer JK, Vo TT, Gillis NK, Mason NT, McLeod HL, Walko CM. Key Lessons Learned from Moffitt's Molecular Tumor Board: The Clinical Genomics Action Committee Experience. Oncologist. 2017 Feb.22(2):144-151. Pubmedid: 28179575. Pmcid: PMC5330702.
    • Walko CM, Aubert RE, La-Beck NM, Clore G, Herrera V, Kourlas H, Epstein RS, McLeod HL. Pharmacoepidemiology of Clinically Relevant Hypothyroidism and Hypertension from Sunitinib and Sorafenib. Oncologist. 2017 Feb.22(2):208-212. Pubmedid: 28167571. Pmcid: PMC5330710.
    • Knepper TC, Saller J, Walko CM. Novel and Expanded Oncology Drug Approvals of 2016-PART 1: New Options in Solid Tumor Management. Oncology (Williston Park). 2017 Feb.31(2):110-121. Pubmedid: 28205191.
    • Gillis NK, Rotroff DM, Mesa TE, Yao J, Chen Z, Carulli MA, Yoder SJ, Walko CM, Teer JK, McLeod HL. Tumor exome sequencing and copy number alterations reveal potential predictors of intrinsic resistance to multi-targeted tyrosine kinase inhibitors. Oncotarget. 2017 Dec.8(70):115114-115127. Pubmedid: 29383146. Pmcid: PMC5777758.
    • Hertz DL, Deal A, Ibrahim JG, Walko CM, Weck KE, Anderson S, Magrinat G, Olajide O, Moore S, Raab R, Carrizosa DR, Corso S, Schwartz G, Graham M, Peppercorn JM, Jones DR, Desta Z, Flockhart DA, Evans JP, McLeod HL, Carey LA, Irvin WJ. Tamoxifen Dose Escalation in Patients With Diminished CYP2D6 Activity Normalizes Endoxifen Concentrations Without Increasing Toxicity. Oncologist. 2016 Jul.21(7):795-803. Pubmedid: 27226358. Pmcid: PMC4943390.
    • Walko C, Kiel PJ, Kolesar J. Precision medicine in oncology: New practice models and roles for oncology pharmacists. Am J Health Syst Pharm. 2016 Dec.73(23):1935-1942. Pubmedid: 27864201.
    • Calvo E, Walko C, Dees EC, Valenzuela B. Pharmacogenomics, Pharmacokinetics, and Pharmacodynamics in the Era of Targeted Therapies. Am Soc Clin Oncol Educ Book. 2016.35:e175-e184. Pubmedid: 27249721.
    • Hertz DL, Snavely AC, McLeod HL, Walko CM, Ibrahim JG, Anderson S, Weck KE, Magrinat G, Olajide O, Moore S, Raab R, Carrizosa DR, Corso S, Schwartz G, Peppercorn JM, Evans JP, Jones DR, Desta Z, Flockhart DA, Carey LA, Irvin WJ. In vivo assessment of the metabolic activity of CYP2D6 diplotypes and alleles. Br J Clin Pharmacol. 2015 Nov.80(5):1122-1130. Pubmedid: 25907378. Pmcid: PMC4631184.
    • Biganzoli L, Lichtman S, Michel JP, Papamichael D, Quoix E, Walko C, Aapro M. Oral single-agent chemotherapy in older patients with solid tumours: A position paper from the International Society of Geriatric Oncology (SIOG). Eur J Cancer. 2015 Nov.51(17):2491-2500. Pubmedid: 26340809.
    • Ward MA, Fang G, Richards KL, Walko CM, Earnshaw SR, Happe LE, Blalock SJ. Comparative evaluation of patients newly initiating first-generation versus second-generation tyrosine kinase inhibitors for chronic myeloid leukemia and medication adherence, health services utilization, and healthcare costs. Curr Med Res Opin. 2015 Feb.31(2):289-297. Pubmedid: 25420131.
    • Shea TC, Walko C, Chung Y, Ivanova A, Sheets J, Rao K, Gabriel D, Comeau T, Wood W, Coghill J, Armistead P, Sarantopoulos S, Serody J. Phase I/II Trial of Dose-Escalated Busulfan Delivered by Prolonged Continuous Infusion in Allogeneic Transplant Patients. Biol Blood Marrow Tr. 2015 Dec.21(12):2129-2135. Pubmedid: 26210442. Pmcid: PMC4639403.
    • Morgan KP, Snavely AC, Wind LS, Buie LW, Grilley-Olson J, Walko CM, Weiss J. Rates of Renal Toxicity in Cancer Patients Receiving Cisplatin With and Without Mannitol. Ann Pharmacother. 2014 Jul.48(7):863-869. Pubmedid: 24778426.
    • Walko CM, Grande C. Management of common adverse events in patients treated with sorafenib: nurse and pharmacist perspective. Semin Oncol. 2014 Feb.41 Suppl 2:S17-S28. Pubmedid: 24576655.
    • Walko CM, McLeod HL. Personalizing medicine in geriatric oncology. J Clin Oncol. 2014 Aug.32(24):2581-2586. Pubmedid: 25071134.
    • Walko CM, Combest AJ, Spasojevic I, Yu AY, Bhushan S, Hull JH, Hoskins J, Armstrong D, Carey L, Collicio F, Dees EC. The effect of aprepitant and race on the pharmacokinetics of cyclophosphamide in breast cancer patients. Cancer Chemother Pharmacol. 2012 May.69(5):1189-1196. Pubmedid: 22245954.
    • Patel JN, Walko CM. Sylatron: a pegylated interferon for use in melanoma. Ann Pharmacother. 2012 Jun.46(6):830-838. Pubmedid: 22619474.
    • Hertz DL, Walko CM, Bridges AS, Hull JH, Herendeen J, Rollins K, Watkins PB, Dees EC. Pilot study of rosiglitazone as an in vivo probe of paclitaxel exposure. Br J Clin Pharmacol. 2012 Jul.74(1):197-200. Pubmedid: 22680343. Pmcid: PMC3394145.
    • Raddin RS, Walko CM, Whang YE. Response to degarelix after resistance to luteinizing hormone-releasing hormone agonist therapy for metastatic prostate cancer. Anticancer Drugs. 2011 Mar.22(3):299-302. Pubmedid: 21360851.
    • Aapro MS, Walko CM. Aprepitant: drug-drug interactions in perspective. Ann Oncol. 2010 Dec.21(12):2316-2323. Pubmedid: 20488873.
  • Grants

    • Title: Randomized comparison of an educationally enhanced genomic tumor board (eGTB) intervention to usual practice of incorporating genomic test results into clinical care
      Sponsor: SWOG
      PI: Walko, C.

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