About

Dr. Julie Stein Deutsch, MD, is an Assistant Professor of Dermatology and Oncology at Johns Hopkins School of Medicine. She specializes in dermatopathology and is affiliated with The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center in Baltimore, MD. Dr. Deutsch completed her fellowship in Dermatopathology at Johns Hopkins University School of Medicine in 2023 and her residency in Pathology at the same institution in 2022. She earned her MD from The George Washington University School of Medicine in 2016. She is board certified in Dermatopathology by the American Board of Pathology as of 2023 and in Anatomic Pathology since 2022.

Research topics

• Internal medicine
• Medicine
• Oncology
• Pathology

Selected publications

• Eruptive Cutaneous Metastatic Leiomyosarcoma

  SKIN The Journal of Cutaneous Medicine · 2026-03-10

  articleOpen access

  Introduction: Leiomyosarcomas are malignant tumors of smooth muscle origin that infrequently involve the skin. Cutaneous metastases are rare and typically arise from retroperitoneal, uterine, or vascular primaries. We report a case of eruptive cutaneous leiomyosarcoma metastases occurring over two decades after excision of a primary subcutaneous leiomyosarcoma, representing an unusually long latency period and atypical metastatic pattern. Case Presentation: An 85-year-old Black man presented with several months of pruritic, painful, firm nodules on the scalp, right palm, and left shoulder. His history included a subcutaneous high-grade leiomyosarcoma of the right forearm excised with negative margins 26 years earlier and an incidentally discovered hepatic mass five years prior to presentation. Biopsies of the cutaneous nodules revealed atypical spindle cell proliferations positive for smooth muscle actin and desmin, consistent with leiomyosarcoma. PET imaging demonstrated an infiltrative hepatic mass invading the right kidney and numerous pulmonary and adrenal metastases. Histopathologic correlation confirmed metastatic leiomyosarcoma involving the liver and skin. The patient elected palliative gemcitabine monotherapy. Discussion: Cutaneous metastases from leiomyosarcoma are uncommon and typically signify advanced disease. The clinical and pathologic findings in this case suggest metastatic spread from the original subcutaneous tumor to the liver, which subsequently re-metastasized to the skin. Conclusion: This case underscores the potential for very late visceral and cutaneous metastases in leiomyosarcoma and highlights the need for ongoing clinical vigilance, even decades after initial treatment.

  PublisherOA PDFDOI

• PP01.93: Associations Between Percent Residual Viable Tumor (%RVT) and Efficacy with Perioperative Nivolumab for Resectable Non-Small Cell Lung Cancer (NSCLC) in CheckMate 77T

  Journal of Thoracic Oncology · 2026-05-01

  article1st authorCorresponding
  PublisherDOI

• Figure S6 from Divergent Clinical and Immunologic Outcomes Based on <i>STK11</i> Co-mutation Status in Resectable <i>KRAS-</i>Mutant Lung Cancers Following Neoadjuvant Immune Checkpoint Blockade

  2025-01-17

  preprintOpen access

  <p>Figure S6</p>

  PublisherDOI

• Data from Divergent Clinical and Immunologic Outcomes Based on <i>STK11</i> Co-mutation Status in Resectable <i>KRAS-</i>Mutant Lung Cancers Following Neoadjuvant Immune Checkpoint Blockade

  2025-01-17

  preprintOpen access

  <div>AbstractPurpose:<p>Co-mutations of the <i>Kirsten rat sarcoma virus</i> (<i>KRAS</i>) and <i>serine</i>/<i>threonine kinase 11</i> (<i>STK11</i>) genes in advanced non–small cell lung cancer (NSCLC) are associated with immune checkpoint blockade (ICB) resistance. Although neoadjuvant chemoimmunotherapy is now a standard-of-care treatment for resectable NSCLC, the clinical and immunologic impacts of <i>KRAS</i> and <i>STK11</i> co-mutations in this setting are unknown.</p>Experimental Design:<p>We evaluated and compared recurrence-free survival of resectable <i>KRAS</i>-mutated NSCLC tumors, with or without co-occurring <i>STK11</i> mutations, treated with neoadjuvant ICB. Single-cell transcriptomics was performed on tumor-infiltrating T cells from seven <i>KRAS</i><sup><i>mut</i></sup><i>/STK11</i><sup><i>wt</i></sup> tumors and six <i>KRAS</i> and <i>STK11</i> co-mutated (<i>KRAS</i><sup><i>mut</i></sup><i>/STK11</i><sup><i>mut</i></sup>) tumors.</p>Results:<p>Relative to <i>KRAS</i><sup><i>mut</i></sup><i>/STK11</i><sup><i>wt</i></sup> tumors, <i>KRAS</i><sup><i>mut</i></sup><i>/STK11</i><sup><i>mut</i></sup> exhibited significantly higher recurrence risk. Single-cell transcriptomics showed enhanced oxidative phosphorylation with evidence of decreased prostaglandin E2 signaling and increased IL-2 signaling in CD8<sup>+</sup> tumor-infiltrating lymphocytes (TIL) from <i>KRAS</i><sup><i>mut</i></sup><i>/STK11</i><sup><i>mut</i></sup> tumors, a finding that was mirrored in <i>KRAS</i><sup><i>wt</i></sup> tumors that relapsed. TILs from <i>KRAS</i><sup><i>mut</i></sup><i>/STK11</i><sup><i>mut</i></sup> tumors expressed high levels of molecules associated with tumor residence, including CD39 and ZNF683 (HOBIT).</p>Conclusions:<p>These divergent T-cell transcriptional fates suggest that T-cell maintenance and residence may be detrimental to antitumor immunity in the context of neoadjuvant ICB for resectable NSCLC, regardless of <i>KRAS</i> mutation status. Our work provides a basis for future investigations into the mechanisms underpinning prostaglandin E2 signaling and IL-2 signaling as they relate to T-cell immunity to cancer and to divergent clinical outcomes in <i>KRAS</i><sup><i>mut</i></sup><i>/STK11</i><sup><i>mut</i></sup> NSCLC treated with neoadjuvant ICB.</p></div>

  PublisherDOI

• Figure S3 from Divergent Clinical and Immunologic Outcomes Based on <i>STK11</i> Co-mutation Status in Resectable <i>KRAS-</i>Mutant Lung Cancers Following Neoadjuvant Immune Checkpoint Blockade

  2025-01-17

  preprintOpen access

  <p>Figure S3</p>

  PublisherDOI

• Society for Immunotherapy of Cancer (SITC) consensus statement on essential biomarkers for immunotherapy clinical protocols

  Journal for ImmunoTherapy of Cancer · 2025-03-01 · 35 citations

  articleOpen access

  Immunotherapy of cancer is now an essential pillar of treatment for patients with many individual tumor types. Novel immune targets and technical advances are driving a rapid exploration of new treatment strategies incorporating immune agents in cancer clinical practice. Immunotherapies perturb a complex system of interactions among genomically unstable tumor cells, diverse cells within the tumor microenvironment including the systemic adaptive and innate immune cells. The drive to develop increasingly effective immunotherapy regimens is tempered by the risk of immune-related adverse events. Evidence-based biomarkers that measure the potential for therapeutic response and/or toxicity are critical to guide optimal patient care and contextualize the results of immunotherapy clinical trials. Responding to the lack of guidance on biomarker testing in early-phase immunotherapy clinical trials, we propose a definition and listing of essential biomarkers recommended for inclusion in all such protocols. These recommendations are based on consensus provided by the Society for Immunotherapy of Cancer (SITC) Clinical Immuno-Oncology Network (SCION) faculty with input from the SITC Pathology and Biomarker Committees and the Journal for ImmunoTherapy of Cancer readership. A consensus-based selection of essential biomarkers was conducted using a Delphi survey of SCION faculty. Regular updates to these recommendations are planned. The inaugural list of essential biomarkers includes complete blood count with differential to generate a neutrophil-to-lymphocyte ratio or systemic immune-inflammation index, serum lactate dehydrogenase and albumin, programmed death-ligand 1 immunohistochemistry, microsatellite stability assessment, and tumor mutational burden. Inclusion of these biomarkers across early-phase immunotherapy clinical trials will capture variation among trials, provide deeper insight into the novel and established therapies, and support improved patient selection and stratification for later-phase clinical trials.

  PublisherOA PDFDOI

• AstroID resource: a scalable, relational database structure for longitudinal biomarker discovery

  Journal for ImmunoTherapy of Cancer · 2025-12-01

  articleOpen access

  BACKGROUND: The biological sciences are producing increasingly larger datasets for biomarker discovery. While common data models have been developed for medical terms as they relate to patient health outcomes, a data model that supports longitudinal tracking of biospecimens and relating them against an individual patient experience is a large, unmet need. METHOD: A structure and associated taxonomy were achieved through a six-tier build in Research Electronic Data CAPture (REDCap), which organizes the complexity of the therapeutic decisions, biospecimens, and outcomes that characterize a longitudinal patient experience. Modules were developed to support export of REDCap data into a Structured Query Language (SQL) format for merging with extended biomarker data, also housed in SQL. RESULTS: The resultant AstroID resource is a relational structure for clinical and biospecimen data that meets several desired goals: searchable, flexible, generic, Health Insurance Portability and Accountability Act-compliant, auditable, and easy-to-use. The essential elements forming the core of the six-tiered build are provided, so others can readily adopt this schema, as well as an example of an extended, customized build to support biomarker discovery for patients with melanoma. Two examples where this data structure was used to support biomarker discovery and development are described, and example queries of the database are also presented. To the extent possible, the data dictionary was aligned with large data models, such as those for the National Institutes of Health's Human Tumor Atlas Network. The structure can readily scale to accommodate thousands of patients, multimodality data, and spatial characterization of billions of cells. Radiologic imagery can also be included along with pathology imagery to support spatial studies, including artificial intelligence-driven analyses. CONCLUSIONS: This effort provides a database model for investigators conducting research on large volumes of biospecimens with clinical annotation. We have now deployed this structure in our laboratories and have over 1B cells spatially mapped, each effectively tagged with the clinical information from longitudinal patient experiences. While the description uses the example of cancer biomarkers, this data structure could be used to characterize longitudinal biospecimens from any disease process. In the near future, automatic synchronization between the electronic medical record and one or more AstroID databases is anticipated.

  PublisherOA PDFDOI

• OA12.03 Neoadjuvant Nivolumab or Nivolumab Plus Ipilimumab in Resectable Diffuse Pleural Mesothelioma

  Journal of Thoracic Oncology · 2025-10-01

  article
  PublisherDOI

• Baseline histopathologic biomarker for predicting frontline immunotherapy combination outcomes in metastatic clear cell renal cell carcinoma (mccRCC).

  Journal of Clinical Oncology · 2025-05-28

  articleSenior author

  e16539 Background: The treatment landscape of mccRCC has evolved in recent years, with immune checkpoint inhibitor (ICI) combinations currently serving as the frontline backbone therapy. However, there remains a lack of robust biomarkers to predict treatment outcomes with ICI combinations. Previously, we demonstrated favorable outcomes with nivolumab monotherapy in previously treated mccRCC patients using hematoxylin and eosin (H&E)-based scoring of tumor infiltrating immune cells (TIL plus ) and necrosis (Deutsch, Cell Rep Med , 2023). Herein, we investigated the utility of this biomarker in the context of first-line ICI combinations in mccRCC. Methods: We conducted a retrospective analysis of mccRCC patients treated at our institution (2013–2024). Eligibility criteria included: confirmed ccRCC histology, metastatic disease, treatment with first-line ICI combinations (dual ICI or ICI plus tyrosine kinase inhibitor [TKI]), and availability of H&E-stained slides from metastatic lesions (excluding brain) prior to treatment. Using previously published methodology, TIL plus scores were generated by assessing the mononuclear immune infiltrate, including tumor infiltrating lymphocytes, macrophages, plasma cells, and other associated immune cells. TIL plus was scored as ‘‘0’’ (no immune infiltrate identified interfacing with tumor) or ‘‘1’’ (immune infiltrate involving tumor was present). Necrosis was scored as “0” if necrosis involved ≤10% surface area and as a “1” if > 10%. Overall survival (OS) and progression-free survival (PFS) were calculated from ICI initiation using the Kaplan-Meier method. Associations between survival outcomes and the TIL plus and necrosis scores were assessed. Results: A total of 35 patients were included, receiving first-line ICI combinations: ICI+ICI (n = 12) and ICI+TKI (n = 23). Across all patients, OS and PFS were significantly improved in those with TIL plus 1 compared to TIL plus 0 (p = 0.04, log-rank test, and p = 0.01, Gehan-Breslow-Wilcoxon test, respectively) (Table). Necrosis scores did not associate with OS or PFS. Conclusions: Baseline assessment of TIL plus on H&E may serve as a novel biomarker for predicting outcomes to first-line ICI combinations in patients with mccRCC. Incorporation of this biomarker into a prospective clinical trial will be needed for validation. Group N Median OS (months) P-value Median PFS (months) P-value TIL plus group TIL plus 1 17 NR P=0.04 23.7 P=0.01 TIL plus 0 18 24.0 9.9 NR = not reached.

  PublisherDOI

• Supplementary Tables 1 from Divergent Clinical and Immunologic Outcomes Based on <i>STK11</i> Co-mutation Status in Resectable <i>KRAS-</i>Mutant Lung Cancers Following Neoadjuvant Immune Checkpoint Blockade

  2025-01-17

  supplementary-materialsOpen access

  <p>Tables S1-S4</p>

  PublisherDOI

Frequent coauthors

• Janis M. Taube

  Foundation Center

  102 shared

• Joel C. Sunshine

  Johns Hopkins University

  39 shared

• Evan J. Lipson

  Sidney Kimmel Cancer Center

  39 shared

• Daphne Wang

  Johns Hopkins University

  30 shared

• Robert A. Anders

  Johns Hopkins University

  30 shared

• Suzanne L. Topalian

  Bloomberg (United States)

  27 shared

• Ludmila Danilova

  25 shared

• Jaroslaw Jedrych

  Johns Hopkins Medicine

  25 shared