Carey Anders
Positions:
Professor of Medicine
Medicine, Medical Oncology
School of Medicine
Member of the Duke Cancer Institute
Duke Cancer Institute
School of Medicine
Education:
M.D. 2002
East Carolina University, Brody School of Medicine
Internal Medicine Residency, Medicine
Duke University School of Medicine
Hematololgy-Oncology Fellowship, Medicine
Duke University School of Medicine
Grants:
Immunotherapy to treat Triple Negative Breast Cancer Brain Metastases
Administered By
Medicine, Medical Oncology
Awarded By
University of North Carolina - Chapel Hill
Role
Principal Investigator
Start Date
End Date
Molecular Dissection and Immune Characterization of Breast Cancer Brain Metastases to Predict Outcomes and Reveal Novel Therapeutic Strategies
Administered By
Medicine, Medical Oncology
Awarded By
Conquer Cancer Foundation
Role
Principal Investigator
Start Date
End Date
A Randomized Open-Label, Multi-Center Pivotal Study of ANG1005 Compared with Physician's Best Choice in HER2-Negative Breast Cancer Patients with Newly Diagnosed Leptomeningeal Carcinomatosis and Previously Treated Brain Metastases (ANGLeD)
Administered By
Duke Cancer Institute
Awarded By
Angiochem Inc.
Role
Principal Investigator
Start Date
End Date
Immunotherapy to treat Triple Negative Breast Cancer Brain Metastases
Administered By
Medicine, Medical Oncology
Awarded By
University of North Carolina - Chapel Hill
Role
Principal Investigator
Start Date
End Date
In Vitro Fertilization Outcomes in Women Diagnosed with Cancer
Administered By
Medicine, Medical Oncology
Awarded By
University of North Carolina - Chapel Hill
Role
Principal Investigator
Start Date
End Date
Publications:
Examination and prognostic implications of the unique microenvironment of breast cancer brain metastases.
PURPOSE: Brain metastases (BM) are a complication of advanced breast cancer (BC). Histology of melanoma BM offers prognostic value; however, understanding the microenvironment of breast cancer brain metastases (BCBM) is less characterized. This study reports on four histological biomarkers, gliosis, immune infiltrate, hemorrhage, necrosis, and their prognostic significance in BCBM. METHODS: A biobank of 203 human tissues from patients who underwent craniotomy for BCBM was created across four academic institutions. Degree of gliosis, immune infiltrate, hemorrhage, and necrosis were identified and scored via representative H&E stain (0-3+). Overall survival (OS) was estimated using the Kaplan-Meier method. Cox proportional hazards regression evaluated prognostic value of the biomarkers in the context of standard clinical characteristics. RESULTS: BCBM subtype (available for n = 158) was 36% Her2+, 26% hormone receptor (HR)+/Her2- 38% HR-/Her2- (triple negative, TN). Gliosis was observed in 82% (116/141) of BCBM, with immune infiltrate 44% (90/201), hemorrhage 82% (166/141), and necrosis 87% (176/201). Necrosis was significantly higher in TNBC (p < 0.01). Presence of gliosis, immune infiltrate, and hemorrhage correlated with improved OS (p = 0.03, p = 0.03, p = 0.1), while necrosis correlated with inferior OS (p = 0.01). Improved OS was associated with gliosis in TN (p = 0.02), and immune infiltrate (p = 0.001) and hemorrhage (p = 0.07) in HER2+. In a multivariable model for OS, incorporating these biomarkers with traditional clinical variables improved the model fit (p < 0.001). CONCLUSION: Gliosis confers superior prognosis in TNBC BM; immune infiltrate and hemorrhage correlate with superior prognosis in HER2+ BCBM. Understanding the metastatic microenvironment of BCBM refines prognostic considerations and may unveil novel therapeutic strategies.
Authors
Sambade, MJ; Prince, G; Deal, AM; Trembath, D; McKee, M; Garrett, A; Keith, K; Ramirez, J; Midkiff, B; Blackwell, K; Sammons, S; Leone, JP; Brufsky, A; Morikawa, A; Brogi, E; Seidman, A; Ewend, M; Carey, LA; Moschos, SJ; Hamilton, RL; Vincent, B; Anders, C
MLA Citation
Sambade, Maria J., et al. “Examination and prognostic implications of the unique microenvironment of breast cancer brain metastases.” Breast Cancer Res Treat, vol. 176, no. 2, July 2019, pp. 321–28. Pubmed, doi:10.1007/s10549-019-05211-1.
URI
https://scholars.duke.edu/individual/pub1381998
PMID
31016641
Source
pubmed
Published In
Breast Cancer Res Treat
Volume
176
Published Date
Start Page
321
End Page
328
DOI
10.1007/s10549-019-05211-1

Professor of Medicine
Contact:
Box 3381, Seeley Mudd Building, Durham, NC 27710
Dept of Medicine, Durham, NC 27710