About

Maheswari Magi Senthil is a faculty member at the UC Irvine Chao Family Comprehensive Cancer Center, associated with the UC Irvine School of Medicine. She is based at 200 S. Manchester Drive, Orange, CA 92868-3217. Her work is integrated within the UCI Cancer Research Institute and the broader UCI Health system. The center emphasizes research in cancer control, clinical trials, and research programs related to biotechnology, imaging, drug development, and disease-oriented teams. Her role involves contributing to research initiatives, clinical trials, and educational programs aimed at advancing cancer research and treatment.

Research topics

• Medicine
• Internal medicine
• Surgery
• Oncology
• Cancer research

Selected publications

• Eosinophils: Effectors of Intraperitoneal Paclitaxel Antitumor Response

  Annals of Surgical Oncology · 2026-03-23

  article1st authorCorresponding
  PublisherDOI

• Validation of nomograms predicting survival in patients undergoing CRS-HIPEC for peritoneal dissemination of mucinous appendiceal cancer

  Surgical Oncology Insight · 2026-03-27

  articleOpen access

  BackgroundMucinous appendiceal neoplasms can develop peritoneal metastases, also known as pseudomyxoma peritonei (PMP), which is best treated with cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).Nomograms can be used to predict the outcomes of patients with PMP of appendiceal origin undergoing CRS-HIPEC.This study aimed to externally validate two (UK and Spanish) existing nomograms using patients from two large-volume centers in the United States. MethodsA prospectively maintained database of peritoneal surface malignancies was used for data collection with additional retrospective review of the electronic health record for missing data.Variables included those used in the nomograms.Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to analyze overall survival (OS) and diseasefree survival (DFS). ResultsThe study included 518 patients who underwent CRS-HIPEC from 2007-2024 with peritoneal histology of acellular mucin, low-grade mucinous carcinoma peritonei (LG), high-grade mucinous carcinoma peritonei, and high-grade mucinous carcinoma peritonei with signet ring cells (HG).The AUC ranged from 0.818-0.946for 1-5 year OS for the UK nomogram.For DFS, the AUC ranged from 0.807-0.948.For those with LG histology, the AUC for OS ranged from 0.610-0.696,and from 0.689-0.831for DFS.For HG histology, the AUC for OS ranged from J o u r n a l P r e -p r o o f 0.730-0.863and from 0.622-0.668.There were no significant differences between the UK and Spanish nomograms for DFS among all patients and among histological subgroups. ConclusionsExisting nomograms for OS and DFS after CRS-HIPEC for PMP are fairly accurate, highlighting their potential utility to predict outcomes in this population.

  PublisherOA PDFDOI

• BIO26-035: MTAP Deficiency in Thoracic Oncology: Bridging Genomic Loss, Survival Deficits, and Immunosuppressive Microenvironments

  Journal of the National Comprehensive Cancer Network · 2026-03-27

  article
  PublisherDOI

• Abstract 2497: A human pcVMT platform for personalizing chemotherapy route and regimen selection in peritoneal carcinomatosis

  Cancer Research · 2026-04-03

  articleSenior author

  Abstract Peritoneal carcinomatosis (PC) is a clinically aggressive metastatic disease state marked by diffuse peritoneal involvement and limited responsiveness to systemic chemotherapy due to poor penetration across the mesothelial barrier. Although intraperitoneal (IP) therapy offers a mechanistically rational alternative, clinicians currently lack human-relevant platforms to determine which patients will benefit most from systemic therapy, IP therapy, or a combination of both.To address this unmet need, we developed a dual-chamber peritoneal carcinomatosis vascularized micro-tumor (pcVMT) platform that recreates a human mesothelial-lined peritoneal cavity adjacent to a perfused vascular network, enabling patient-specific, route-specific chemotherapy testing. The pcVMT supports stable vascular perfusion, intact mesothelial barrier function, and tumor adhesion and invasion using both PC cell lines and patient-derived peritoneal metastases. High-resolution confocal imaging confirms robust tumor-stromal-vascular organization across multiple clinical samples.The platform facilitates testing of clinically relevant regimens, including vascular FOLFOX, IP paclitaxel, and bidirectional systemic+IP delivery, and permits real-time visualization of route-dependent tumor responses within each patient’s microenvironment. Early patient-derived experiments demonstrate feasibility of individualized assessment, including successful IP paclitaxel administration with observable changes in tumor architecture.By enabling controlled comparison of systemic, IP, and combined delivery strategies within a physiologic human peritoneal model, the pcVMT provides a precision-oncology tool designed to identify the most effective therapy and delivery route for each patient. Ongoing studies will expand patient-derived testing and explore correlations with clinical decision-making to guide personalized treatment selection and future systemic-IP combination strategies in PC. Citation Format: Aaqil M. Khan, Stephanie J. Hachey, Vinodh Kumar Radhakrishnan, Fatemeh Tajik, Melanie Roman, Christopher C. Hughes, Maheswari Senthil. A human pcVMT platform for personalizing chemotherapy route and regimen selection in peritoneal carcinomatosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 2497.

  PublisherDOI

• Response adapted neoadjuvant therapy in gastric cancer (RANT-GC): A phase Ib feasibility trial.

  Journal of Clinical Oncology · 2026-01-10

  article

  TPS465 Background: Current US based guidelines for locally advanced gastric/esophageal adenocarcinoma (GEA) (LAGEA) recommend peri-operative chemo-immunotherapy for all patients with at least cT2+ or any cN+ GEA. The specific regimen and duration of peri-operative systemic treatment is standardized, rather than personalized to biologic response. Given the availability of several different classes of active agents in the treatment of GEA, the unmet need in the treatment of LAGEA is a personalized approach with real-time adaptation of the treatment regimen based on biologic response. The Northstar Response (R) is a tissue-free treatment monitoring test that achieves a limit of detection down to 0.01% tumor fraction. We hypothesize that the Northstar Response(R) ctDNA assay can closely monitor response to treatment and guide neoadjuvant treatment (NAT) regimens based on response without negatively affecting curative intent surgery or surgical complications. Methods: Our prospective single center, single arm, open label Phase IB study in clinical stage IB-III GEA will measure ctDNA at baseline, and repeated every 8 weeks. Pts are treated with standard NAT (e.g. D-FLOT). Depending on ctDNA response the same regimen will either be maintained or switched to a different NAT backbone (e.g. irinotecan based regimen). Pts will proceed to surgery after a 4-6 mo of NAT. The primary and 2ndary objectives are feasibility, and safety/efficacy, respectively. Primary endpoint: % of pts completing per protocol NAT. 2ndary endpoints: % of pts completing resection, R0 rate, 30d post-op morbidity, % ctDNA clearance after NAT and resection, safety/AEs by CTCAE v5, RFS. Key eligibility inclusion criteria include adenocarcinoma by histology, cT2+ and/or N+, age ≥18, ECOG 0-2, life expectancy >6mo, adequate organ function, surgically resectable; Exclusion criteria include known metastases, other histologies, major comorbidities. The main objective is to describe feasibility, without formal hypothesis testing, including % of pts completing per protocol treatment (95% CI). Total enrollment will be 20 pts. Enrollment began in June 2025. 4 pts started NAT. Enrollment numbers will be updated at the meeting. Clinical trial information: NCT05733689 .

  PublisherDOI

• Computed tomography staging of colon cancer: improved patient selection for neoadjuvant therapy with combined radiologic tumor and nodal staging

  BMC Cancer · 2026-04-28

  articleOpen accessSenior authorCorresponding

  Patient selection for neoadjuvant therapy in colon cancer (CC) needs to be improved as utilizing computed tomography (CT) tumor (T) staging alone is associated with overstaging and overtreatment. Therefore, we sought to identify specific nodal imaging features that can be combined with radiologic T staging to improve patient selection. Pre-operative CTs of stage I-III CC patients treated with upfront resection (2018–2023) were assessed by an expert abdominal radiologist blinded to the histopathologic staging. Radiologic T and node (N) staging based on five imaging features (single lymph node (LN) > 1 cm, ≥ 3 prominent LNs, irregular borders, heterogenous enhancement, and extramural venous invasion) were compared to the pathologic staging, grouped by proficient or deficient mismatch repair status (pMMR vs. dMMR). Of the 177 patients, 147 and 30 had pMMR and dMMR CC, respectively. The overstaging rate for pathologic T staging was 6.1% pMMR vs. 6.7% dMMR CC (p = 0.91). The overstaging rate for pathologic N disease by any imaging feature was 17.0% pMMR vs. 33.3% dMMR (p = 0.04) but improved to 4.8% pMMR vs. 6.7% dMMR (p = 0.67) with irregular borders and/or heterogenous enhancement alone. Compared to radiologic T staging only, the addition of N staging (any feature) to T staging resulted in decreased overstaging rates of stage I/low-risk stage II to high-risk stage II/III CC from 25.2% to 15.6% for pMMR CC and 60.0% to 33.3% for dMMR CC. Overstaging rates further decreased to 4.8% for pMMR and 16.7% for dMMR CC with the combination of radiologic T and N staging by irregular borders and/or heterogenous enhancement specifically. Combining radiologic T and N stage based on any of the five imaging features resulted in lower overstaging rates than radiologic T staging alone, but overstaging rates continued to improve when only irregular borders and heterogenous enhancement were used to assess nodal disease. These results can be used as an initial framework for combining CT T and N staging for CC and improve patient selection for neoadjuvant treatment.

  PublisherDOI

• Abstract 3359: Distinct profile of peritoneal lavage fluid extracellular vesicles in gastrointestinal carcinomatosis

  Cancer Research · 2026-04-03

  articleSenior author

  Abstract Introduction: Gastrointestinal peritoneal carcinomatosis (GI PC) poses significant diagnostic and therapeutic challenges. The commonly used diagnostic tools such as circulating tumor DNA have poor sensitivity in PC. Recent evidence suggests that peritoneal cavity small extracellular vesicles (EV) play a critical role in peritoneal metastasis development and progression. We sought to compare the peritoneal lavage fluid (PL) EV profile (quantity and gene expression) to non-cancer PL to identify the potential of PL EV testing as a liquid biopsy in PC. Methods: PL samples were collected from GI PC patients and non-cancer patients. The inclusion criteria for the non-cancer cohort were BMI 18-30, no cancer/autoimmune history, and had a non-inflammatory indication for surgery (ex. hernia repair). EVs were isolated by precipitation and characterized via nanoparticle tracking analysis (NTA), cryo-electron microscopy (cryo-EM), and western blot. Size distribution (0.5-199.5nm, 200.5-500.5nm) and concentration were quantified by NTA. EV RNA was profiled using NanoString PanCancer Panel (770 genes). Differential expression used log2 fold change ≥1.5 or ≤-1.5 and p≤0.05. Results: A total of 66 PL samples were collected (35 cancer and 31 non-cancer). Of the 31 non-cancer PL, only 19 samples had EV pellets, indicating that in the rest of the samples there were too few EVs to result in an EV pellet. However, all cancer PL had an EV pellet. NTA of the samples that had adequate EV showed that the total quantity of EV (as ×105 particles/mL) was approximately two-fold higher in cancer samples compared to the non-cancer cohort (10.9 × 105 vs. 4.5 × 105; p=0.0005). The difference between the cancer and non-cancer PL EV quantity was retained even after systemic therapy (9.7 × 105 vs. 4.5 × 105; p=0.0002). Cryo-EM demonstrated distinct structural differences of EV between the groups, with cancer-derived EVs exhibiting multilayered, multicompartment, and cargo-dense structures, whereas non-cancer samples predominantly contained simple monolayer vesicles. Gene expression profiling demonstrated significant overexpression of genes involved in epithelial-mesenchymal transition, metastasis, cell-cycle regulation, angiogenesis, and extracellular matrix organization (STAB1, PRF1, CCDC80, SPARCL1, VHL, RHOA) in the cancer cohort compared to the non-cancer cohort. Conclusion: Our study represents one of the largest studies of PL comparison of GI PC to non-cancer. In GI PC the amount of EV and the biophysical and molecular signatures are distinctly different from the non-cancer group. PL EV can be developed into a liquid biopsy in GI PC to fill a critical clinical need. Citation Format: Fatemeh Tajik, Vinodh Kumar Radhakrishnan, Alex N. Dang, Aaqil M. Khan, Melanie Roman, Shaun Daly, Areg Grigorian, Cristobal Barrios, Sigrid Burruss, Maheswari Senthil. Distinct profile of peritoneal lavage fluid extracellular vesicles in gastrointestinal carcinomatosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 3359.

  PublisherDOI

• ASO Visual Abstract: Underutilization of Staging Laparoscopy Prior to Neoadjuvant Systemic Therapy in Gastric Cancer

  Annals of Surgical Oncology · 2025-11-13

  articleSenior author
  PublisherDOI

• The Intersection of Disability and Cancer

  Annals of Surgery · 2025-08-12

  articleCorresponding

  OBJECTIVE: To evaluate the barriers to timely health care access and health-related outcomes among patients with disabilities diagnosed with cancer. BACKGROUND: People with disabilities face unique challenges in navigating health care systems, including structural and socioeconomic barriers. These challenges may delay cancer diagnosis and treatment; however, they remain underexplored. METHODS: Patients diagnosed with breast, lung, colorectal, melanoma, pancreatic, and esophageal cancers were identified from the All of Us Research Program. The patients were stratified by disability status based on self-reported impairments in mobility, hearing, vision, communication, or cognition. Propensity score matching was performed to balance groups. Outcomes included health care access, financial burden, and physical and emotional health. RESULTS: Among 18,260 patients with cancer, 4546 (24.9%) reported a disability. Patients with disabilities were older (67 vs 65 y), Hispanic (10.2% vs 6.7%) or Black (17.3% vs 9.9%), had lower household incomes (<50k: 59% vs 25.8%), and were unemployed (76.5% vs 46.6%) (all P <0.001). After matching, patients with disabilities reported higher rates of out-of-pocket costs (15% vs 11.3%, P <0.001), lack of transportation (10.8% vs 3.8%, P <0.001), as well as greater difficulty accessing medications, mental health counseling, specialty care, and follow-up care (all P <0.001). Those with disabilities reported worse physical and mental health, higher pain scores, and lower quality of life (all P <0.001). CONCLUSIONS: Individuals with disabilities and cancer face significant disparities in access to timely and affordable care, which contributes to poorer health outcomes. Further research is needed to better understand and address these barriers, as well as identify potential interventions to close the gap in health care inequities for this vulnerable population.

  PublisherDOI

• ASO Author Reflections: Opportunity to Improve Outcomes in Patients with Gastric Cancer

  Annals of Surgical Oncology · 2025-11-11

  articleOpen accessSenior authorCorresponding

  Gastric cancer peritoneal metastasis is associated with extremely poor survival. 1Unfortunately, radiographically occult peritoneal metastasis is present in 30-40% of newly diagnosed gastric cancer cases. [2][3]3][4] Therefore, staging laparoscopy (SL) with peritoneal cytology is considered a critical component of the staging workup and the National Comprehensive Cancer Network strongly recommends SL with cytology for adequate staging of gastric cancer.

  PublisherOA PDFDOI

Frequent coauthors

• John H. Yim

  City of Hope

  58 shared

• Yasir Akmal

  East Cheshire NHS Trust

  56 shared

• Edwin A. Deitch

  56 shared

• Quanhua Xing

  54 shared

• Yujun Wang

  54 shared

• M.L. Richard Yip

  54 shared

• Claudia Kowolik

  54 shared

• David Lu

  54 shared

Education

• Complex general surgical oncology fellowship, Surgial oncology

  City of Hope National Medical Center

  2010

• General Surgery, Surgery

  Rutgers New Jersey Medical School

  2008

• M.B.B.S, Medical College

  Madurai Medical College

  1998