Last Updated: 4/28/2008

Marion Couch, MD PhD Associate Professor Clinical Research

Clinical Interests
Dr. Marion Couch is a surgical oncologist who specializes in head and neck surgery, and thyroid surgery. In addition, she cares for patients with salivary gland tumors, airway problems, hoarseness, and neck masses.

Many patients will require reconstruction after some of our major head and neck surgeries. Dr. Couch performs microvascular reconstructive surgery where tissue from one part of the body is transferred to the another region. This allows her team to rebuild jaws and recreate tongues, for instance.

Novel and innovative adjuvant therapies are needed that have different mechanisms of action from the standard modalities of therapy. Towards that end, Dr. Couch is interested in tumor vaccines for head and neck cancer patients. She also have some clinical trials related to the nutrition of head and neck cancer patients.

With her collaborators, they are actively studying cancer cachexia, a wasting syndrome that may affect patients. Metabolomics is being used to determine the metabolic changes seen in cancer cachexia. Anti-inflammatory medications have been used to combat this condition in a recent clinical trial.

Research Interests


Dr. Couch is an University of North Carolina Translational Research Fellow. She is the past receipient of a grant given by the American Academy of Otolaryngology - Head & Neck Surgery and GlaxoSmithKline entitled, "Allogeneic_Vaccine with Immunomodulators for Oral Cancer." This project will allow her to look at the efficacy of using an allogeneic whole cell GM-CSF secreting tumor vaccine. This would provide the preclinical data regarding the efficacy of this approach. Because it would not be necessary to harvest the patient's own tumor cells to generate the vaccines, this work would streamline the process of providing vaccines as adjuvant therapy. The goal would be to use this data to design rationale clinical trials using cell lines expressing common tumor antigens that could generate standardized batches of vaccine to stimulate anti tumor immunity. In addition, it is noted that chemotherapeutic agents can enhance the efficacy of allogeneic whole cell GMCSF- secreting tumor vaccines in the breast cancer model, and, therefore, this grant will allow her to look at the effect of various chemotherapeutic agents as immunomodulators for the allogeneic vaccine. Dr. Couch is fortunate to work with Dr. Jon Serody as her sponsor, as well as Dr. Elizabeth Jaffee at Johns Hopkins Hospital.

During her residency training at the Johns Hopkins Hospital, sheworked in Dr. David Sidransky's lab and looked at the immune response to p53 oncoproteins in head and neck cancer patients. They presented biochemical data that antigen presentation by Class II molecules was involved.

As a chief resident, she was awarded the Triological Society's Research Training Grant Award for the project entitled "Vaccination with Radiated,' Cytokine Gene Transduced Tumor Cells to Stimulate Antitumor Immunity in a Head and Neck Gancer Model." This resulted in two publications in the journal that the Triological Society hosts, The Laryngoscope. This work demonstrated that genetically modified tumor cells using the cytokine gene encoding granulocyte monocyte - colony stimulating factor (GM-CSF) were able to have significant protective effect when these mice were vaccinated then challenged with parental tumors.

One of her major areas of interest is with the severe wasting condition, cancer cachexia. With Dr. Albert Baldwin, novel NF-KB inhibitors are being used to treat this severe wasting condition. The cardiac dysfunction seen is being investigated with Dr. Monte Willis.

She is currently a member of the American College of Surgeons and a member of the American College of Surgeons Oncology Group. Dr. Couch serves on multiple committees including the research committee for the American Head and Neck Society and reviews grants as a long standing member of the grant review committee for the American Academy of Otolaryngology - Head & Neck Surgery Foundation.

Dr. Couch is currently a Director-At-Large for the American Head & Neck Society.

Recent Accomplishments and Honors
Honors:
. Alpha Omega Alpha Medical Honor Society, 1988 - present.
. George T. Nager Award for Excellence in Resident Teaching, Johns Hopkins OHNS, 1998.
. Grand Marshall at Johns Hopkins School of Medicine graduation, 2002.
. Co-chair, National Resident Curriculum Committee, American Academy of Otolaryngology - Head & Neck Surgery Foundation (AAO-HNSF), 2001 - present.
. Member, Continuing Education Advisory Committee, AAO-HNSF, 2001 - present.
. Member, Research Advisory Committee, AAO-HNSF, 2005 - present.
. Chair, Web Committee, American Head and Neck Society, 2001 - present.
. Research Committee member, American Head and Neck Society, 2000 - present.
. Committee on Research Grants and Prizes member, AAO-HNSF, 2000 - present.
. Co-chair, Committee on Research Grants and Prizes, AAO-HNSF, 2005 - present.
. Honors Award, AAO-HNSF, 2005.
Academy of Educators, University of North Carolina
2007

America’s Top Doctor for Cancer, American Registry
2005 - present

Training

1990 M.D. Rush Medical College

1988 Ph.D. Rush University

Postgraduate Training:

1991 - 1995 Resident in Otolaryngology - Head & Neck Surgery
Johns Hopkins Hospital, Baltimore, MD

1990 - 1991 General Surgery Internship
Johns Hopkins Hospital, Baltimore, MD

Publications

O’Connell T, Ardeshirpour F, Asher S, Winnike J, Yin X, George J, Guttridge D, He W, Wysong A, Willis M, Couch M. Metabolomic Detection of Lipid and Glucose Alterations in Cancer Cachexia. Metabolomics, In press, 2008.

Couch M, Ferris R, Brennan J, Koch W, Castro R, Erlich H, Jaffee E, Sidransky D. Association of Immune Response to Oncoprotein p53 with Specific HLA Class II Haplotypes. Clin Cancer Research, 1:13(23):7199-206, 2007.

Cannon TY, Couch ME, Yin X, Guttridge D, Lai V, Shores C. Comparison of animal models for head and neck cancer cachexia. Laryngoscope, 117(12):2152-2158, 2007.

Richey LM, George JR, Couch ME, Kanapkey BK, Yin X, Cannon T, Stewart PW, Weissler MC, Shores CG. Defining Cancer Cachexia in Head and Neck Squamous Cell Carcinoma. Clin Cancer Res, 13(22 Pt 1):6561-7, 2007.

Cannon TY, Shores C, Guttridge D, Lai V, George J, Couch M. An immunocompetent animal model of head and neck cancer cachexia. Head Neck, 30(3):320-326, 2007.

Cannon TY, Guttridge D, Dahlman J, Yin X, Shores C, Lai V, George J, Couch M. The effect of altered TLR4 signaling on cancer cachexia. Arch of Otolaryngology, 113(12):1263-9, 2007.

Lai V, George J, Richey L, Kim HJ, Cannon T, Shores C, Couch M. Results of a Pilot Study of the Effect of Celecoxib on Cancer Cachexia in Patients with Cancer of the Head, Neck, and Gastrointestinal Tract. Head Neck, 30(1):67-74, 2007.

George J, Cannon T, Lai V, Richey L, Zanation A, Hayes DN, Shores C, Guttridge D, Couch M. Cancer Cachexia Syndrome in Head and Neck Cancer Patients: Part II. Pathophysiology. Head & Neck, 29(5):497-507, 2007.

Richey LM, Shores CG, George J, Lee S, Couch ME, Weissler MC. The effectiveness of salvage surgery after the failure of concomitant chemoradiation in head and neck cancer. Otolaryngol 2007;136(1):98-103.

Newlon JL, Couch M, Brennan J. Castleman’s Disease: three case reports and a review of the literature. Ear Nose Throat 2007 86(7):414-8.

Rosenthal E, Couch M, Farwell G, Wax M. Update in microvascular reconstruction. Otolaryngol Head Neck Surg 136(4):519-24, 2007.

Couch M, Lai V, Cannon T, Guttridge D, Zanation A, George J, Hayes N, Zeisel S, Shores C. Cancer Cachexia Syndrome in Head and Neck Cancer Patients: Part I. Diagnosis, Impact on Quality of Life and Survival, and Treatment. Head & Neck 29(4):401-11, 2007.

Ho T, Couch M, Byrne P. Radial Forearm Free Flap Donor Site Outcomes Comparison by Closure Methods, Otolaryngol Head Neck Surg 2006;143(2):309-15.

Zanation AM, Sutton DK, Couch ME, Weissler MC, Shockley WW, Shores CG. Utilization, Accuracy, and Implications for Patient Management of [18F]-2-Fluorodeoxyglucose-Positron Emission/Computerized Tomography (PET/CT) for Head and Neck Tumors. Laryngoscope 2005;115(7):1186-90.

Ha PK, Couch ME, Tufano RP, Koch WM, Califano JA. Short hospital stay after neck dissection. Otolaryngol Head Neck Surg 2005;133(5):677-80.

Couch M. Update in Otolaryngology-Head and Neck Surgery, J Am Coll Surg 2005;201(1):101-109.

Couch M, Senior B. Non-surgical and surgical treatments for sleep apnea. Anesthesia Clinics of North America 2005;23(3):525-34.

Couch M, Saunders JK, O'Malley B, Pardoll D, Jaffee L. Spatial Distribution of Tumor Vaccines, Laryngoscope 2003;113(8):1401-1405.

Scartozzi R, Couch M, Sciubba J. Chondroid Chordoma of the Nasal Septum. Arch Otolaryngol Head Neck Surg 2003;129:244-246.

Couch M, Saunders JK, O'Malley BW, Jaffee E, Pardoll D. Genetically-Engineered Tumor Cell Vaccine in a Head and Neck Cancer Model. Laryngoscope 2003;113(3):552-556.

Couch M. Laryngopharyngectomy with Reconstruction. Otolaryngol Clin N Am 2002;35(5):1087-1100.

Couch M, Bhatti N. The current status of percutaneous tracheostomies. Advances in Surgery 2002;36:275-295.

Thompson AM, Couch M, Zahurak ML, Johnson C, Vogelsang G. Risk factors for post stem cell transplant sinusitis. BMT 2002;29:257-262.

O'Malley B, Couch M. Gene therapy principle and strategies for head and neck cancer. Adv Otorhinolaryngol 2000;56:279 - 288.

Brown M, Couch M, Huchton D. Assessment of Donor-Site Functional Morbidity From Radial Forearm Fasciocutaneous Free Flap Harvest. Arch Otolaryngol Head Neck Surg 1999;125:1371-1374.

Smith A, Couch M, Argani, P. Resident's Page: Pathology: papillary thyroid carcinoma, combined tall cell and columnar variants. Arch Otolaryngol Head Neck Surg 1998;124(10):1170, 1172.

Muehlberger T, Kunar D, Munster A, Couch M. Efficacy of fiberoptic laryngoscopy in diagnosis of inhalation injuries. Arch Otolaryngol Head Neck Surg 1998;124(9):1003-1007.


Brennan J, Boyle J, Koch W, Goodman S, Hruban R, Eby Y, Couch M, Forastiere A, Sidransky D. Association Between Cigarette Smoking and Mutation of the p53 Gene in Head and Neck Squamous Carcinoma. N Engl J Med 1995;332(11):712-717.

Couch MJ, Pauli BU, Weinstein RW, Coon JS. Induction of Reversible Changes in Cell Surface Glycoconjugates and Lung Colonization Potential by 13-cis Retinoic Acid. J Cell Biochem 1988;37:213-223.

Couch MJ, Pauli BU, Weinstein RW, Coon JS. Modulation of the metastatic phenotype by 13-cis retinoic acid. J Natl Cancer Inst 1987;78:971-977.

E-mail: marion_couch@med.unc.edu
Telephone: 919-843-3627
FAX: 919-843-3520
Address: G0412 Neurosciences Hospital Chapel Hill, NC 27599-7070

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