About

Kristen N Ganjoo is a Professor of Medicine (Oncology) at Stanford University with a focus on clinical research and therapies for sarcomas, including soft tissue sarcoma, gastrointestinal stromal tumors, Ewing's sarcoma, osteosarcoma, and uterine leiomyosarcoma. Her research involves the development and evaluation of new and targeted therapies, anti-angiogenesis agents, and novel treatment approaches for sarcoma patients. Ganjoo has contributed to multiple clinical trials investigating the safety and efficacy of various agents such as anti-CD20 monoclonal antibodies, unesbulin, cabozantinib combined with PD-1 and CTLA-4 inhibition, TRC105 with pazopanib, and other investigational drugs for advanced or metastatic sarcomas. She has held academic appointments at Indiana University and Stanford University, progressing from assistant to full professor, and is actively involved in professional organizations including the American Society of Clinical Oncology and the Connective Tissue Oncology Society. Her work emphasizes translating scientific advances into clinical applications to improve outcomes for patients with complex sarcomas.

Research topics

• Medicine
• Surgery
• Pathology
• Radiology
• Oncology
• Internal medicine
• Biology
• Cancer research

Selected publications

• Efficacy and Safety of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Recurrent Uterine Leiomyosarcoma: Results of a Phase 2 Study

  Annals of Surgical Oncology · 2026-05-08

  article
  PublisherDOI

• Data from Histologic and Immunologic Factors Associated with Response to Immune Checkpoint Inhibitors in Advanced Sarcoma

  2025-02-17

  preprintOpen access

  <div>AbstractPurpose:<p>To characterize factors associated with response to immune checkpoint inhibitors (ICI) in advanced sarcoma.</p>Experimental Design:<p>This is a retrospective study with a cohort of 216 patients with advanced sarcoma treated with ICI between 2016 and 2023 at Stanford Health Care. Overall survival, progression-free survival (PFS), objective response rates (ORR) per RECIST criteria, and reason for ICI discontinuation were analyzed across histologic subtypes, ICI regimens, tumor mutational burden, and PD-L1 expression.</p>Results:<p>The overall ORR in the cohort was 16.7%. The histologic subtypes with the highest ORR were Kaposi sarcoma (KS, 66.7%), alveolar soft part sarcoma (ASPS, 50%), angiosarcoma (33.3%), myxofibrosarcoma (MFS, 28.6%), and undifferentiated pleomorphic sarcoma (UPS, 27.8%). The subtypes with the lowest ORR were osteosarcoma (0%), synovial sarcoma (0%), and liposarcoma (3.7%). The subtypes with the highest median PFS were KS (median not reached), ASPS (median not reached), MFS (27.4 months), and UPS (11.3 months). The ORR for sarcomas with PD-L1 ≥ 1% was 27.8% (<i>P</i> = 0.02), whereas the ORR for sarcomas with tumor mutational burden ≥10 mutations per megabase of DNA was 28.6% (<i>P</i> = 0.20).</p>Conclusions:<p>ORR and PFS were highly variable across sarcoma histologic subtypes. In this large analysis, KS, ASPS, angiosarcoma, MFS, and UPS demonstrated the highest ORR and longest PFS while osteosarcoma, synovial sarcoma, and liposarcoma had the lowest ORR and shortest PFS. PD-L1 expression was also associated with increased ORR. Our findings provide further insight into understanding the sarcoma histologic and immunologic factors that correspond with response to ICI.</p></div>

  PublisherDOI

• A Multi-center Retrospective Outcomes Analysis of Patients with Localized Synovial Sarcoma

  Cancer Research Communications · 2025-05-28

  articleOpen access

  Abstract To identify clinicopathologic factors associated with outcomes in patients with localized synovial sarcoma (SS). We retrospectively reviewed 248 patients with localized SS treated across three US quaternary medical centers between 2000–2024. Demographics, tumor characteristics, and treatments, including perioperative chemotherapy and radiotherapy, were assessed. Disease-free survival (DFS) and overall survival (OS) were estimated via Kaplan–Meier, and Cox regression was used for univariable and multivariable analysis, including significant univariate factors and confounders such as age and tumor size. Median follow-up was 5.2 years; median age at diagnosis 35 years (IQR 26–46). Median DFS was 110.3 months. Perioperative chemotherapy was given to 150 (60%) patients, while perioperative radiotherapy (RT) was given to 173 (69.8%) patients. Multivariable analysis showed that tumor size correlated with worse DFS (P < 0.001) and OS (P < 0.001), while a location in the chest wall, trunk or extremities correlated with improved DFS (P = 0.006). Percent tumor necrosis was associated with worse OS (P = 0.04), while R0 (P = 0.002) resection margins correlated with improved OS. Perioperative RT or chemotherapy did not correlate with OS or DFS in the whole cohort, though patients with tumor size ≥ 10 cm (n = 47) showed worse OS when receiving perioperative chemotherapy only as opposed to combined perioperative chemotherapy and RT (P = 0.006). Tumor size, location, margin status, and tumor necrosis are independent prognostic factors in localized SS. Combined perioperative chemotherapy and radiotherapy correlated with improved OS in patients with tumors larger than 10 cm.

  PublisherDOI

• Abstract 3678: Liquid biopsy fragmentomics approach for the diagnosis of uterine tumors

  Cancer Research · 2025-04-21

  article

  Abstract Background: Leiomyomas (LM), also known as fibroids, are common benign tumors of the smooth muscle of the uterus that can cause pain, infertility, and abnormal menstrual bleeding. Diagnosing LM is challenging using clinical indications alone, as they share symptoms with leiomyosarcoma (LMS), a rare, aggressive uterine malignancy with a ∼50% disease-specific survival. Pre-operative distinction between LM and LMS is difficult because these tumors are rarely biopsied before surgery. We hypothesize that a non-invasive circulating tumor DNA (ctDNA) test based on LMS- and LM-specific molecular markers will provide accurate pre-operative diagnosis and guide appropriate surgical treatment. Methods: We previously analyzed point mutations and copy number alterations (CNAs) in ctDNA using deep targeted sequencing and shallow whole-genome sequencing (WGS) from plasma specimens of 7 LMS and 12 LM patients (PMIDs: 29463554, 32232185). To build on this, we performed a new analysis of the first 4 nucleotide sequences (4-mer motifs) on the 5’ end of the cell-free DNA fragments using shallow WGS data. The frequency of 256 possible 4-mer motifs was calculated using R programming and normalized to total reads in each specimen. Two-class differential analysis identified motifs enriched in LM and LMS (false discovery rate < 0.05). Results: Our previous studies demonstrated the feasibility of ctDNA detection in LMS and LM patients. In LMS patients, ctDNA was detected in 6 of 7, with >98% specificity; in LM patients, ctDNA was detected in 6 of 12, with 76% specificity. To increase ctDNA detection sensitivity, we incorporated fragmentomics as a new ctDNA marker. Our new analysis identified 66 significantly enriched and 21 significantly decreased motifs in cell-free DNA from LMS patients compared to LM patients. Motifs associated with DNASE1L3 nuclease activity (e.g., CCCA) were significantly decreased in LM compared to LMS patients. Conclusion: We identified new tumor-specific fragmentomic markers in cell-free DNA from LMS and LM patients. Combining detection of point mutations, CNAs, and fragmentomic patterns could enable a highly sensitive ctDNA assay for accurate pre-operative distinction between LM and LMS. Next, we will validate DNASE1L3 and other nucleases in tissue microarrays of 100+ LM and 200+ LMS specimens by immunohistochemistry, and validate distinct fragmentomic patterns using expanded plasma collections. This research addresses an unmet clinical need for accurate pre-operative diagnosis of uterine tumors. Citation Format: Meagan S. Cobb, Philippe Jolivet, Kristen N. Ganjoo, Deirdre A. Lum, Matt van de Rijn, Joanna Przybyl. Liquid biopsy fragmentomics approach for the diagnosis of uterine tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3678.

  PublisherDOI

• SCAN-ACT: Adoptive T Cell Therapy Target Discovery Through Single-Cell Transcriptomics

  bioRxiv (Cold Spring Harbor Laboratory) · 2025-01-22 · 1 citations

  preprintOpen access

  Summary The FDA approval of T cell receptor-engineered T cells (TCR-T) for synovial sarcoma demonstrates the potential for adoptive T cell therapies (ACTs) in solid tumors. However, the paucity of tumor-specific targets without expression in normal tissues remains a major bottleneck, especially in rare cancer subtypes. Here, we present a comprehensive computational pipeline called SCAN-ACT that leverages single cell RNA sequencing and multi-omics data from tumor and normal tissues to nominate and prioritize targets for both chimeric antigen receptor (CAR)- and TCR-T cells. For surface membrane targets, SCAN-ACT proposes target pairs for bispecific Boolean logic-gated CAR T cells. For peptide-MHC targets, SCAN-ACT proposes intracellular peptides bound to a diverse set of human leukocyte antigens. We applied the SCAN-ACT pipeline to soft tissue sarcoma (STS), analyzing 986,749 single cells to identify and prioritize 395 monospecific CAR-T targets, 14,192 bispecific CAR-T targets, and 5,020 peptide-MHC targets for TCR-T cells. Selected targets were validated experimentally by protein expression and for peptide-MHC binding. Proposed targets and target pairs reflected the mesenchymal, neuronal, and hematopoietic ontogeny of STS. This work provides a robust data repository along with a web-based and user-friendly set of analysis tools to accelerate ACT development for solid tumors.

  PublisherOA PDFDOI

• Gemcitabine Plus Docetaxel, Dacarbazine, Doxorubicin Combinations, or Doxorubicin Alone as First-Line Treatment for Advanced/Metastatic Leiomyosarcoma: A Retrospective Analysis at a Sarcoma Center

  Diseases · 2025-03-11 · 2 citations

  articleOpen access

  BACKGROUND/OBJECTIVES: Locally advanced and metastatic leiomyosarcoma (LMS) is an aggressive cancer with limited treatment options. This single-institution, retrospective study evaluated the efficacy of first-line chemotherapy regimens in patients with advanced or metastatic LMS treated at Stanford Medical Center. METHODS: Seventy-four patients with unresectable or metastatic LMS were deemed eligible and treated with first-line chemotherapy regimens, including gemcitabine plus docetaxel, dacarbazine, doxorubicin combinations (with evofosfamide or ifosfamide), and doxorubicin monotherapy. Progression-free survival (PFS), overall survival (OS), and disease control rate (DCR) were assessed using RECIST v1.1, with survival analyses performed using Kaplan-Meier and Cox proportional hazards methods. RESULTS: The cohort consisted of 56 females (75.7%) and 18 males (24.3%), with a median age of 55.5 years. The majority (93.2%) had metastatic disease. The median PFS for the entire cohort was 4.9 months (range: 0.6-28.1 mo), and the median OS was 27.3 months (range: 1.9-140.2 mo). The doxorubicin combination (DC) group had the highest median PFS of 7.9 months (range: 0.6-15.8 mo). Doxorubicin alone had the highest median OS of 33.8 months (4.2-100.2 mo). Doxorubicin combinations demonstrated superior PFS in both uterine and non-uterine LMS subgroups. CONCLUSIONS: These findings reaffirm the efficacy of doxorubicin-based combination regimens as a first-line treatment for locally advanced and metastatic LMS, particularly in non-uterine LMS.

  PublisherOA PDFDOI

• Supplementary Table 12 from Genomic, Epigenomic, and Transcriptomic Inter- and Intratumor Heterogeneity in Desmoid Tumors

  2025-01-06

  supplementary-materialsOpen access

  <p>Supplementary Table 12. Validation of clonal and subclonal variants detected in exome sequencing data of Patients 1 and 2 using RNA-seq data.</p>

  PublisherDOI

• Abstract 7346: Disparities in sarcoma care prior to initiation of treatment among patients with newly diagnosed sarcoma

  Cancer Research · 2025-04-21

  article

  Abstract Purpose: Disparities in the outcomes for patients with sarcoma have been reported, however, few studies have investigated the disparities in sarcoma care and the related etiologies. We investigated the care disparities and associated factors along the segments of the adult sarcoma care journey from the onset of symptoms to the establishment of diagnosis and sarcoma consult prior to the initiation of treatment. Patients and Methods: This cohort included patients with newly diagnosed soft tissue or bone sarcoma (including benign musculoskeletal neoplasms) who were referred to Stanford Medicine for establishing sarcoma care, from July 2020 to April 2024. We investigated the interval from the onset of symptoms (pain and/or palpable mass) to the first appointment with a primary care provider (PCP wait-time), the interval from first PCP appointment to obtaining the first imaging study for workup such as MRI, PET/CT or a Ct scan (imaging wait-time), the interval from the initial PCP appointment to obtaining the tissue biopsy for establishing the diagnosis (biopsy wait-time), and the interval from the referral date for sarcoma consult to obtaining the sarcoma consult (sarcoma consult wait-time. We also performed a survey among the physicians and non-physician staff within the Stanford sarcoma program to understand the perception of acceptability of wait-time more than 5 weeks. Results: Among 402 eligible patients, approximately one third had PCP wait-time longer than 5 weeks, young adults and Hispanic patients had the highest rate of such long wait-time. Approximately 20% of patients had imaging wait-time longer than 5 weeks, young adults had the highest rate of such long wait-time (30%). There were approximately 5% of patients with sarcoma consult wait-time longer than 5 weeks. However, nearly 80% of patients had biopsy wait-time longer than 5 weeks, African American and Hispanic patients had the highest rate of such long wait-time. In addition, compared to public insurance, there were more patients with private insurance that were associated with PCP wait-time, imaging wait-time, sarcoma consult wait-time and biopsy wait-time longer than 5 weeks. Our survey among the physicians and non-physician staff within the Stanford sarcoma program showed that wait-time longer than 5 weeks was considered unacceptable by a vast majority of responders. Conclusion: Substantial disparities in sarcoma care related to age group, ethnicity and insurance type appear to exist in the multiple segments of sarcoma care journey prior to the initiation of treatment. Biopsy wait-time appears to be the segment of sarcoma care with the highest rate of long wait-time and significant ethnicity disparities. Citation Format: Lauren Li, Nam Bui, Kristen Ganjoo, Minggui Pan. Disparities in sarcoma care prior to initiation of treatment among patients with newly diagnosed sarcoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7346.

  PublisherDOI

• Supplemental Figure 1 from Histologic and Immunologic Factors Associated with Response to Immune Checkpoint Inhibitors in Advanced Sarcoma

  2025-02-17

  preprintOpen access

  <p>Supplemental Figure 1</p>

  PublisherDOI

• Early assessment of response to chemotherapy via ctDNA in soft tissue sarcoma.

  Journal of Clinical Oncology · 2025-05-28

  articleSenior author

  11531 Background: Chemotherapy remains the cornerstone for treatment of soft tissue sarcomas (STS). Biomarkers are needed to enhance timely assessment of chemotherapy efficacy to limit toxicity and guide patient management including estimating prognosis and duration of chemotherapy. Methods: This retrospective study includes patients with STS who received chemotherapy in the neoadjuvant or unresectable/metastatic setting at Stanford Sarcoma Center between May 2021 and January 2025. ctDNA was tested with Natera’s CLIA lab using a personalized, tumor-informed ctDNA assay (Signatera, bespoke mPCR, NGS assay). Longitudinal changes in peripheral blood ctDNA were correlated with radiographic response and survival. ctDNA response was defined as > 50% decrease in MTM/mL from baseline, with a second confirmatory measurement. Radiographic response was defined as stable disease or partial response on first re-staging assessment after starting therapy. Overall survival (OS) was defined as time from initiation of chemotherapy to death or last clinical follow up. Progression-free survival (PFS) was defined as time from initiation of chemotherapy to radiographic disease progression, death, or last clinical follow up. Results: Twenty-six patients (median age at diagnosis = 63 years [range 26 – 78]) were included. Histological subtypes consisted of leiomyosarcoma (uterine [n = 10], extrauterine [n = 4]), malignant peripheral nerve sheath tumor (n = 2), undifferentiated pleomorphic sarcoma (n = 2), angiosarcoma (n = 2), and other (Ewing’s sarcoma, malignant phyllodes tumor, perivascular epithelioid cell tumor, low grade myoepithelial carcinoma, high grade uterine sarcoma not otherwise specified, and small round blue cell neoplasm with EWSR1 rearrangement, each n = 1). Chemotherapy consisted of doxorubicin-containing regimens (n = 9), gemcitabine/docetaxel (n = 9), temozolomide-containing regimens (n = 5), and other (cyclophosphamide/topotecan, paclitaxel, and trabectedin, each n = 1). Median follow-up time after initiation of chemotherapy was 12.9 months. 16 of 26 patients had radiographic response. Substantial agreement was observed between ctDNA response and radiographic response (Cohen’s kappa coefficient 0.752). Median OS was longer for ctDNA responders (n = 17) than non-responders (n = 9), at 43.8 months vs 20.6 months (p = 0.03). Median PFS was longer for ctDNA responders than non-responders, at 11.4 months vs 2.0 months (p < 0.001). In the metastatic cohort (n = 22), time on chemotherapy regimen was longer for ctDNA responders than non-responders, median 5.0 vs 2.6 months, p = 0.016 by Wilcoxon rank sum test. Conclusions: Early decline in ctDNA after initiation of chemotherapy correlates with radiographic response and survival in STS. Research is ongoing to evaluate these findings in a prospective study.

  PublisherDOI

Frequent coauthors

• Nam Q. Bui

  Stanford University

  220 shared

• Richard F. Riedel

  Duke Medical Center

  177 shared

• Lee D. Cranmer

  Fred Hutch Cancer Center

  128 shared

• Andrew J. Wagner

  122 shared

• Brian A. Van Tine

  Washington University in St. Louis

  121 shared

• Brian K. Link

  119 shared

• Sven de Vos

  University of California, Los Angeles

  115 shared

• Nam H. Dang

  112 shared

Education

• M.D.

  Stanford University

• B.A.

  University of California, Berkeley

Awards & honors

• MacArthur 'genius grant' (Neuroscientist Michelle Monje)