Carey Anders

Positions:

Instructor in the Department of Medicine

Medicine, Medical Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2002

The Brody School of Medicine at East Carolina University

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

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