Andrew Armstrong

Overview:

1. Predictors of sensitivity and clinical efficacy of therapies in advanced prostate cancer
2. Novel designs of clinical trials and pharmacodynamic/translational studies in prostate, kidney, bladder cancer
3. Pre-operative models for drug development of novel agents in human testing in prostate cancer
4. Novel therapies and drug development for prostate, renal, bladder, and testicular cancer
5. Design of rational combination therapies in men with metastatic hormone-refractory prostate cancer
6. PI3 kinase/mTOR inhibition in prostate cancer: mechanisms of sensitivity and resistance
7. Developing prognostic models for progression and survival in metastatic prostate cancer
8. Examining surrogate markers of mortality in metastatic prostate cancer
9. Clear cell and non-clear cell renal cell carcinoma: natural history, sensitivity to novel agents including mTOR and VEGF inhibition

Positions:

Professor of Medicine

Medicine, Medical Oncology
School of Medicine

Associate Professor in Pharmacology and Cancer Biology

Pharmacology & Cancer Biology
School of Medicine

Professor in Surgery

Surgery, Urology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S.E. 1996

Duke University

M.D. 2000

University of Virginia School of Medicine

M.Sc. 2008

Johns Hopkins University

Internship/Residency, General Internal Medicine

University of Pennsylvania, School of Medicine

Fellowship, Division Of Oncology/Hematology

Johns Hopkins University School of Medicine

Grants:

Study title: A Randomized, Double-blind, Placebo-controlled, Multicenter Phase III Study of Olaparib Plus Abiraterone Relative to Placebo Plus Abiraterone as First-line Therapy in Men with Metastatic Castration-resistant Prostate Cancer

Administered By
Duke Cancer Institute
Awarded By
AstraZeneca AB
Role
Principal Investigator
Start Date
End Date

ProSTAR: A Phase 1b/2 Study of CPI-1205, a Small Molecule Inhibitor of EZH2, Combined with Enzalutamide or Abiraterone/Prednisone in Patients with Metastatic Castration Resistant Prostate Cancer

Administered By
Duke Cancer Institute
Awarded By
Constellation Pharmaceuticals
Role
Principal Investigator
Start Date
End Date

VISION: An International, Prospective, Open-Label, Multicenter, Randomized Phase 3 Study of 177lu-Psma-617 in the Treatment of Patients with Progressive PSMA-Positive Metastatic Castration-Resistant Prostate Cancer (mCRPC)

Administered By
Duke Cancer Institute
Awarded By
Endocyte, Inc.
Role
Principal Investigator
Start Date
End Date

A Phase 2 Study of Nivolumab in combination with either Rucaparib, docetaxel, or enzalutamide in men with Castration-resistant metastaic prostate cancer (CheckMate 9KD: CHECKpoint pathway and nivoluMA

Administered By
Duke Cancer Institute
Awarded By
Bristol-Myers Squibb Company
Role
Principal Investigator
Start Date
End Date

A Phase II Study of Navarixin (MK-7123) in Combination with Pembrolizumab (MK-3475) in Participants with Selected Advanced/Metastatic Solid Tumors

Administered By
Duke Cancer Institute
Awarded By
Merck Sharp & Dohme
Role
Principal Investigator
Start Date
End Date

Publications:

Five-year Survival Prediction and Safety Outcomes with Enzalutamide in Men with Chemotherapy-naïve Metastatic Castration-resistant Prostate Cancer from the PREVAIL Trial.

BACKGROUND:In the PREVAIL study, enzalutamide significantly improved clinical outcomes versus placebo in patients with chemotherapy-naïve metastatic castration-resistant prostate cancer (mCRPC). OBJECTIVE:To evaluate long-term benefits and risks of enzalutamide in the final prespecified PREVAIL analysis. DESIGN, SETTING, AND PARTICIPANTS:We conducted a final 5-yr survival analysis of PREVAIL in men with chemotherapy-naïve mCRPC from the enzalutamide (n = 689) and placebo (n = 693) arms. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:Predictors of the primary outcome of overall survival were estimated using the Kaplan-Meier method. Long-term adverse events over time were analyzed. RESULTS AND LIMITATIONS:At the 5-yr data cutoff, 1382 of 1717 (80%) men had died. Enzalutamide reduced the hazard of death by 17% (hazard ratio 0.83; 95% confidence interval [CI] 0.75-0.93; p < 0.001), despite 65%, 54%, and 43% of placebo-treated patients receiving subsequent docetaxel, abiraterone, and enzalutamide, respectively. Median overall survival was 36 mo (95% CI 34-38) in the enzalutamide arm versus 31 mo (95% CI 29-34) in the placebo arm, with a median follow-up of 69 mo. Prognostic modeling showed 5-yr survival rates of 42%, 24%, and 5% for low-, intermediate-, and high-risk groups, respectively. Greater degrees of confirmed prostate-specific antigen declines (≤3 mo) were associated with greater 5-yr survival. A higher incidence of fatal treatment-emergent adverse events was observed with enzalutamide (6.9% vs 3.8%), with an increase in fatal cardiovascular events (1.6% vs 0.4%). CONCLUSIONS:With >5 yr of follow-up, enzalutamide continued to demonstrate improved survival in patients with mCRPC despite crossover and multiple subsequent effective therapies, balanced against a slightly higher rate of fatal cardiovascular events. PREVAIL is registered on ClinicalTrials.gov as NCT01212991. PATIENT SUMMARY:We report a maintained long-term survival benefit with enzalutamide and risks with >5 yr of enzalutamide treatment and follow-up in men with metastatic prostate cancer, and identify groups of men with widely different outcomes based on clinical factors.
Authors
Armstrong, AJ; Lin, P; Tombal, B; Saad, F; Higano, CS; Joshua, AM; Parli, T; Rosbrook, B; van Os, S; Beer, TM
MLA Citation
Armstrong, Andrew J., et al. “Five-year Survival Prediction and Safety Outcomes with Enzalutamide in Men with Chemotherapy-naïve Metastatic Castration-resistant Prostate Cancer from the PREVAIL Trial.European Urology, vol. 78, no. 3, Sept. 2020, pp. 347–57. Epmc, doi:10.1016/j.eururo.2020.04.061.
URI
https://scholars.duke.edu/individual/pub1448084
PMID
32527692
Source
epmc
Published In
European Urology
Volume
78
Published Date
Start Page
347
End Page
357
DOI
10.1016/j.eururo.2020.04.061

Cerebrovascular event (CVE) outcome and overall survival (OS) in patients (pts) treated with sipuleucel-T (sip-T) for metastatic castration-resistant prostate cancer (mCRPC): results from the PROCEED registry.

Authors
Higano, CS; Armstrong, AJ; Sartor, AO; Vogelzang, NJ; Kantoff, PW; McLeod, DG; Pieczonka, CM; Penson, DF; Shore, ND; Vacirca, JL; Concepcion, RS; Tutrone, RF; Nordquist, LT; Quinn, DI; Kassabian, V; Scholz, MC; Tyler, RC; Chang, NN; Brown, B; Cooperberg, MR
MLA Citation
Higano, Celestia S., et al. “Cerebrovascular event (CVE) outcome and overall survival (OS) in patients (pts) treated with sipuleucel-T (sip-T) for metastatic castration-resistant prostate cancer (mCRPC): results from the PROCEED registry.Journal of Clinical Oncology, vol. 36, no. 15_suppl, American Society of Clinical Oncology (ASCO), 2018, pp. e17018–e17018. Crossref, doi:10.1200/jco.2018.36.15_suppl.e17018.
URI
https://scholars.duke.edu/individual/pub1450820
Source
crossref
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
36
Published Date
Start Page
e17018
End Page
e17018
DOI
10.1200/jco.2018.36.15_suppl.e17018

Analysis of genomic alterations in matched circulating tumor cell DNA (CTC DNA) and plasma tumor DNA (ctDNA) in men with metastatic castration resistant prostate cancer (mCRPC).

Authors
Gupta, S; Hovelson, DH; Tomlins, SA; Kemeny, G; Liu, C-J; George, DJ; Rothwell, C; Anand, M; Nanus, DM; Giannakakou, P; Gregory, S; Armstrong, AJ
MLA Citation
Gupta, Santosh, et al. “Analysis of genomic alterations in matched circulating tumor cell DNA (CTC DNA) and plasma tumor DNA (ctDNA) in men with metastatic castration resistant prostate cancer (mCRPC).Journal of Clinical Oncology, vol. 36, no. 15_suppl, American Society of Clinical Oncology (ASCO), 2018, pp. 5065–5065. Crossref, doi:10.1200/jco.2018.36.15_suppl.5065.
URI
https://scholars.duke.edu/individual/pub1450821
Source
crossref
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
36
Published Date
Start Page
5065
End Page
5065
DOI
10.1200/jco.2018.36.15_suppl.5065

Multicenter retrospective analysis of patients with metastatic renal cell carcinoma (mRCC) and bone metastases treated with ipilimumab and nivolumab

Authors
Desai, K; Brown, LC; Wei, W; Allman, KD; Martin, A; Wood, LS; Gupta, S; Gilligan, TD; Garcia, JA; Kao, C; Kinsey, EN; Healy, P; Kephart, J; Harrison, MR; Ramalingam, S; Armstrong, AJ; George, DJ; Rini, BI; Zhang, T; Ornstein, MC
MLA Citation
Desai, Kunal, et al. “Multicenter retrospective analysis of patients with metastatic renal cell carcinoma (mRCC) and bone metastases treated with ipilimumab and nivolumab.” Journal of Clinical Oncology, vol. 38, no. 6, AMER SOC CLINICAL ONCOLOGY, 2020.
URI
https://scholars.duke.edu/individual/pub1441329
Source
wos
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
38
Published Date

Clinical activity of abiraterone acetate in patients with metastatic castration-resistant prostate cancer progressing after enzalutamide.

BACKGROUND: Abiraterone acetate and enzalutamide both improve outcomes in patients with metastatic castration-resistant prostate cancer (mCRPC). Optimal sequencing for these agents and whether cross-resistance occurs is unknown. METHODS: Multicentre review of patients with mCRPC treated with abiraterone acetate and prednisone after progressing on enzalutamide. Primary objective was to determine abiraterone acetate response. RESULTS: Thirty patients identified from four North American centres. At abiraterone initiation, median age was 70 years (56-84 years); 70% had ECOG performance status of 0-1; all had prior docetaxel. Median prior enzalutamide treatment duration was 41 weeks (6-95 weeks), with 70% (21 of 30) having a ≥30% prostate-specific antigen (PSA) decline. Median abiraterone acetate treatment duration was 13 weeks (1-52). No objective radiographic responses were observed. Median abiraterone time to progression (PSA, objective or symptomatic) was 15.4 weeks [95% confidence interval (CI) 10.7-20.2]. Median overall survival was 50.1 weeks (95% CI 28.3-72.0). Three patients had a ≥30% PSA decline with abiraterone. Two of these patients had PSA progression as best response with prior enzalutamide. CONCLUSIONS: In this study of patients progressing after enzalutamide, treatment with abiraterone was associated with a modest response rate and brief duration of effect. Primary progression on enzalutamide may not preclude a response to abiraterone.
Authors
Noonan, KL; North, S; Bitting, RL; Armstrong, AJ; Ellard, SL; Chi, KN
MLA Citation
Noonan, K. L., et al. “Clinical activity of abiraterone acetate in patients with metastatic castration-resistant prostate cancer progressing after enzalutamide.Ann Oncol, vol. 24, no. 7, July 2013, pp. 1802–07. Pubmed, doi:10.1093/annonc/mdt138.
URI
https://scholars.duke.edu/individual/pub1431474
PMID
32018616
Source
pubmed
Published In
Ann Oncol
Volume
24
Published Date
Start Page
1802
End Page
1807
DOI
10.1093/annonc/mdt138