Susan Dent

Overview:

Medical Oncologist with a focus on breast cancer
Associate Director of Breast Cancer Clinical Research
Co-Director Duke Cardio-Oncology Program

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. 1990

McMaster University (Canada)

Internal Medicine

Royal College of Physicians (United Kingdom)

Medical Oncology

Royal College of Physicians (United Kingdom)

Grants:

CardiovAscular Risk profile and Treatment patterns in ER+HER2 - Advanced Breast Cancer: A retrospective cohort study (CAREB)

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

A PHASEIB/III STUDY OF IPATASERTIB PLUS PALBOCICLIB AND FULVESTRANT VERSUS PLACEBO PLUS PALBOCICLIB AND FULVESTRANT IN HORMONE RECEPTOR POSITIVE AND HER2 NEGATIVE LOCALLY ADVANCED UNRESECTABLE OR METASTATIC BREAST CANCER

Administered By
Duke Cancer Institute
Awarded By
F. Hoffmann-La Roche Ltd
Role
Principal Investigator
Start Date
End Date

Translational Breast Cancer Research Consortium 2021 Infrastructure (BCRF)

Administered By
Duke Cancer Institute
Awarded By
Susan G. Komen Breast Cancer Foundation
Role
Principal Investigator
Start Date
End Date

Translational Breast Cancer Research Consortium 2021 Infrastructure - SGK

Administered By
Duke Cancer Institute
Awarded By
Susan G. Komen Breast Cancer Foundation
Role
Principal Investigator
Start Date
End Date

Publications:

The Role and Impact of Social Media in Cardio-oncology During the COVID-19 Pandemic.

PURPOSE OF REVIEW: To give an overview of the role of social media (SoMe) in cardio-oncology during the COVID-19 pandemic. RECENT FINDINGS: SoMe has been critical in fostering education, outreach, awareness, collaboration, dissemination of information, and advocacy in cardio-oncology. This has become increasingly evident during the COVID-19 pandemic, during which SoMe has helped share best practices, community, and research focused on the impact of COVID-19 in cardiology and hematology/oncology, with cardio-oncology at the interface of these two subspecialty fields. A strength of SoMe is the ability to amplify a message in real-time, globally, with minimal investment of resources. This has been particularly beneficial for the emerging field of cardio-hematology/cardio-oncology, a field focused on the interplay of cancer and cardiovascular disease. SoMe field especially during the COVID-19 pandemic. We illustrate how social media has supported innovation (including telemedicine), amplification of healthcare workers' voice, and illumination of pre-existing and continued health disparities within the field of cardio-oncology during the pandemic.
Authors
Kwan, JM; Henry, ML; Christophers, B; Tamirisa, K; Thamman, R; Sadler, D; Aggarwal, NR; Cheng, R; Parwani, P; Dent, S; Ismail-Khan, R; Fradley, MG; Brown, S-A
MLA Citation
Kwan, Jennifer M., et al. “The Role and Impact of Social Media in Cardio-oncology During the COVID-19 Pandemic.Curr Oncol Rep, vol. 23, no. 8, July 2021, p. 99. Pubmed, doi:10.1007/s11912-021-01081-3.
URI
https://scholars.duke.edu/individual/pub1507879
PMID
34259950
Source
pubmed
Published In
Current Oncology Reports
Volume
23
Published Date
Start Page
99
DOI
10.1007/s11912-021-01081-3

Anti-Yo antibody-mediated paraneoplastic cerebellar degeneration associated with cognitive affective syndrome in a patient with breast cancer: a case report and literature review.

Breast cancer is the most common cancer in women, with 15%-25% of those tumours overexpressing the human epidermal growth factor receptor 2 (her2), which is associated with more aggressive disease. On rare occasions, patients present with a paraneoplastic syndrome months to years before their cancer diagnosis. Paraneoplastic cerebellar degeneration (pcd) is associated with fewer than 1% of cancers and is strongly associated with breast and gynecologic malignancies. Anti-Yo antibody is the antibody most frequently identified with the syndrome, and it is associated with a very poor prognosis. Recent studies have implicated a relationship between overexpression of her2 and anti-Yo-mediated pcd. Current pcd treatments include tumour removal, chemotherapy, targeted therapy, and immune-suppressive treatments. Outcomes of pcd are typically poor, and no guidelines for treatment currently exist. Early recognition followed by rapid initiation of treatment remains the cornerstone of therapy. Here, we present a case of anti-Yo-antibody pcd secondary to estrogen and progesterone receptor-negative, her2-positive breast cancer. Despite treatment with mastectomy, chemotherapy, and her2-targeted therapy, no significant neurologic improvement was achieved, and cerebellar cognitive affective syndrome subsequently developed.
Authors
Le May, M; Dent, S
MLA Citation
URI
https://scholars.duke.edu/individual/pub1507896
PMID
30607127
Source
pubmed
Published In
Current Oncology (Toronto, Ont.)
Volume
25
Published Date
Start Page
e585
End Page
e591
DOI
10.3747/co.25.4106

Canadian Cardiovascular Society Guidelines for Evaluation and Management of Cardiovascular Complications of Cancer Therapy.

Modern treatment strategies have led to improvements in cancer survival, however, these gains might be offset by the potential negative effect of cancer therapy on cardiovascular health. Cardiotoxicity is now recognized as a leading cause of long-term morbidity and mortality among cancer survivors. This guideline, authored by a pan-Canadian expert group of health care providers and commissioned by the Canadian Cardiovascular Society, is intended to guide the care of cancer patients with established cardiovascular disease or those at risk of experiencing toxicities related to cancer treatment. It includes recommendations and important management considerations with a focus on 4 main areas: identification of the high-risk population for cardiotoxicity, detection and prevention of cardiotoxicity, treatment of cardiotoxicity, and a multidisciplinary approach to cardio-oncology. All recommendations align with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Key recommendations for which the panel provides a strong level of evidence include: (1) that routine evaluation of traditional cardiovascular risk factors and optimal treatment of preexisting cardiovascular disease be performed in all patients before, during, and after receiving cancer therapy; (2) that initiation, maintenance, and/or augmentation of antihypertensive therapy be instituted per the Canadian Hypertension Educational Program guidelines for patients with preexisting hypertension or for those who experience hypertension related to cancer therapy; and (3) that investigation and management follow current Canadian Cardiovascular Society heart failure guidelines for cancer patients who develop clinical heart failure or an asymptomatic decline in left ventricular ejection fraction during or after cancer treatment. This guideline provides guidance to clinicians on contemporary best practices for the cardiovascular care of cancer patients.
Authors
Virani, SA; Dent, S; Brezden-Masley, C; Clarke, B; Davis, MK; Jassal, DS; Johnson, C; Lemieux, J; Paterson, I; Sebag, IA; Simmons, C; Sulpher, J; Thain, K; Thavendiranathan, P; Wentzell, JR; Wurtele, N; Côté, MA; Fine, NM; Haddad, H; Hayley, BD; Hopkins, S; Joy, AA; Rayson, D; Stadnick, E; Straatman, L
MLA Citation
Virani, Sean A., et al. “Canadian Cardiovascular Society Guidelines for Evaluation and Management of Cardiovascular Complications of Cancer Therapy.Can J Cardiol, vol. 32, no. 7, July 2016, pp. 831–41. Pubmed, doi:10.1016/j.cjca.2016.02.078.
URI
https://scholars.duke.edu/individual/pub1238680
PMID
27343741
Source
pubmed
Published In
Can J Cardiol
Volume
32
Published Date
Start Page
831
End Page
841
DOI
10.1016/j.cjca.2016.02.078

Investigating the discernible and distinct effects of platinum-based chemotherapy regimens for metastatic triple-negative breast cancer on time to progression

Platinum-based chemotherapy regimens are frequently used in patients with triple-negative breast cancer (TNBC). The aim of the current study was to assess whether or not platinum-based chemotherapy is associated with an increased time to progression when compared with non-platinum-based regimens in TNBC and non-TNBC. A retrospective analysis was conducted within a cohort of patients with metastatic breast cancer who received platinum-based chemotherapy at a single institution. Data were collected for up to three lines of treatment for metastatic disease. Time to progression was determined for platinum-based chemotherapy and non-platinum-based regimens for each line of treatment. Adjusted hazard ratios (HRs), together with 95% confidence intervals (CIs) were estimated comparing the time to progression associated with the use of platinum-based chemotherapy versus non-platinum-based regimens. A total of 159 patients were included in the analysis, with 58 diagnosed with TNBC. Among the patients with TNBC, compared with non-platinum-based chemotherapy, no correlation was identified between platinum-based chemotherapy and an improved time to progression [first line: HR, 0.97 (95% CI, 0.40-2.35); second line: HR, 0.91 (95% CI,0.42-2.01); and third line: HR, 2.83 (95% CI, 0.73-11.03)]. By contrast, patients with non-TNBC appeared to improve with non-platinum-based chemotherapy [first line: HR, 2.57 (95% CI, 1.11-5.99); second line: HR, 1.91 (95% CI, 1.00-3.63); and third line: HR, 1.08 (95% CI, 0.53-2.18)]. Although the present study was limited by the sample size and its observational nature, the results indicated that platinum-based chemotherapy does not offer a discernible or distinct advantage compared with standard regimens in patients with TNBC, and is perhaps less efficacious in patients with non-TNBC.
Authors
Khalaf, D; Hilton, JF; Clemons, M; Azoulay, L; Yin, H; Vandermeer, L; Dent, S; Hopkins, S; Bouganim, N
MLA Citation
Khalaf, D., et al. “Investigating the discernible and distinct effects of platinum-based chemotherapy regimens for metastatic triple-negative breast cancer on time to progression.” Oncology Letters, vol. 7, no. 3, Jan. 2014, pp. 866–70. Scopus, doi:10.3892/ol.2014.1782.
URI
https://scholars.duke.edu/individual/pub1507992
Source
scopus
Published In
Oncology Letters
Volume
7
Published Date
Start Page
866
End Page
870
DOI
10.3892/ol.2014.1782

Real-world experience with adjuvant FEC-D chemotherapy in four Ontario regional cancer centres

Background: The efficacy of adjuvant chemotherapy with FEC-D (5-fluorouracil-epirubicin-cyclophosphamide followed by docetaxel) is superior to that with fec-100 alone in women with early-stage breast cancer. As the use of FEC-D increased in clinical practice, health care providers anecdotally noted higher-than-expected toxicity rates and frequent early treatment discontinuations because of toxicity. In the present study, we compared the rates of serious adverse events in patients who received adjuvant FEC-D chemotherapy in routine clinical practice with the rates reported in the pacs-01 trial. Methods: We retrospectively reviewed all patients prescribed adjuvant FEC-D for early-stage breast cancer at 4 regional cancer centres in Ontario. Information was collected from electronic and paper charts by a physician investigator from each centre. Data were analyzed using chi-square tests, independent samples t-tests, one-way analysis of variance, and univariate regression. Results: The 671 electronic and paper patient records reviewed showed a median patient age of 52.2 years, 229 patients (34.1%) with N0 disease, 508 patients (75.7%) with estrogen or progesterone receptor- positive disease (or both), and 113 patients (26%) with her2/neu-overexpressing breast cancer. Febrile neutropenia occurred in 152 patients (22.7%), most frequently at cycle 4, coincident with the initiation of docetaxel [78/152 (51.3%)]. Primary prophylaxis with hematopoietic growth factor support was used in 235 patients (35%), and the rate of febrile neutropenia was significantly lower in those who received prophylaxis than in those who did not [15/235 (6.4%) vs. 137/436 (31.4%); p < 0.001; risk ratio: 0.20]. Conclusions In routine clinical practice, treatment with FEC-D is associated with a higher-than-expected rate of febrile neutropenia, in light of which, primary prophylaxis with growth factor should be considered, per international guidelines. Adoption based on clinical trial reports of new therapies into mainstream practice must be done carefully and with scrutiny. © 2011 Multimed Inc.
Authors
Madarnas, Y; Dent, SF; Husain, SF; Robinson, A; Alkhayyat, S; Hopman, WM; Verreault, JL; Vandenberg, T
MLA Citation
Madarnas, Y., et al. “Real-world experience with adjuvant FEC-D chemotherapy in four Ontario regional cancer centres.” Current Oncology, vol. 18, no. 3, Jan. 2011, pp. 119–25. Scopus, doi:10.3747/co.v18i3.751.
URI
https://scholars.duke.edu/individual/pub1508028
Source
scopus
Published In
Current Oncology (Toronto, Ont.)
Volume
18
Published Date
Start Page
119
End Page
125
DOI
10.3747/co.v18i3.751