Peter Fecci

Overview:

As the Director of both the Brain Tumor Immunotherapy Program and the Center for Brain and Spine Metastasis at Duke University, I focus our programmatic interests on the design, optimization, and monitoring of immune-based treatment platforms for patients with intracranial tumors, whether primary or metastatic. Within this broad scope, however, my own group looks more specifically at limitations to immunotherapeutic success, with a particular focus on understanding and reversing T cell dysfunction in patients with glioblastoma (GBM) and brain metastases. We employ a systematic approach to categorizing T cell dysfunction (Woroniecka et al, Clin Cancer Res 2018 Aug 15;24(16):3792-3802), and whereas our earlier work addressed concerns for regulatory T cell-induced tolerance, we now heavily study T cell ignorance and exhaustion, as well. Regarding the former, we recently published the novel phenomenon of S1P1-mediated bone marrow T cell sequestration in patients with intracranial tumors (Chongsathidkiet et al, Nat Medicine 2018 Sep;24(9):1459-1468). Regarding the latter, we have likewise recently identified and characterized exhaustion as a significant limitation to T-cell function within GBM (Woroniecka et al, Clin Cancer Res 2018 Sep 1;24(17):4175-4186). I very much look to collaboratively integrate our approaches with others investigating innovative treatment options. I continue my focus on combining strategies for reversing T cell deficits with current and novel immune-based platforms as a means of deriving and improving rational and precise anti-tumor therapies. It is my sincerest desire to forge a career focused on co-operative, multi-disciplinary, organized brain tumor therapy. Ultimately, my goal is to help coordinate the efforts of a streamlined and effective center for brain tumor research and clinical care. I hope to play some role in ushering in a period where the science and treatment arms of brain tumor therapy suffer no disjoint, but instead represent the convergent efforts of researchers, neuro-oncologists, medical oncologists, radiation oncologists, biomedical engineers, and neurosurgeons alike. I hope to see such synergy become standard of care.

Positions:

Associate Professor of Neurosurgery

Neurosurgery
School of Medicine

Assistant Research Professor in Immunology

Immunology
School of Medicine

Associate Professor in Pathology

Pathology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2007

Duke University School of Medicine

Ph.D. 2007

Duke University

Internship, General Surgery

Massachusetts General Hospital

Residency, Neurosurgery

Massachusetts General Hospital

Postdoctoral Fellow

Dana Farber Cancer Institute

Instructor, Neurosurgery

Massachusetts General Hospital

Grants:

Laser Ablation using Robotic Neuroblate System (LAANTERN)

Administered By
Neurosurgery
Role
Principal Investigator
Start Date
End Date

NINDS Research Education Programs for Residents and Fellows in Neurosurgery

Administered By
Neurosurgery
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

LITT and Short Course Radiation for Patients with GBM Requiring Standard Treatment Alternatives (LASR)

Administered By
Duke Cancer Institute
Role
Principal Investigator
Start Date
End Date

Directed Chemotherapy Delivery for Leptomeningeal Metastases

Administered By
Neurosurgery
Role
Co Investigator
Start Date
End Date

Validation of Novel Therapeutic Approach for Leptomeningeal Metastases

Administered By
Neurosurgery
Role
Co Investigator
Start Date
End Date

Publications:

Creation of a non-contact, automated brain tumor detection device for use in brain tumor resection

© COPYRIGHT SPIE. Downloading of the abstract is permitted for personal use only. The ability to differentiate healthy and tumorous tissue is vital during the surgical removal of tumors. This ability is especially critical during neurosurgical tumor resection due to the risk associated with removing healthy brain tissue. In this paper, we present an epifluorescence spectroscopy guided device that is not only capable of autonomously classifying a region of tissue as tumorous or healthy in real-time-but is also able to differentiate between different tumor types. For this study, glioblastoma and melanoma were chosen as the two different tumor types. Six mice were utilized in each of the three classes (healthy, glioblastoma, melanoma) for a total of eighteen mice. A "one-vs-the-all" approach was used to create a multi-class classifier. The multi-class classifier was capable of classifying with 100% accuracy. Future work includes increasing the number of mice in each of the three tumor classes to create a more robust classifier and expanding the number of tumor types beyond glioblastoma and melanoma.
Authors
Tucker, MB; Joseph, S; Ross, W; Ma, G; Chongsathidkiet, P; Fecci, P; Codd, P
MLA Citation
Tucker, M. B., et al. “Creation of a non-contact, automated brain tumor detection device for use in brain tumor resection.” Progress in Biomedical Optics and Imaging  Proceedings of Spie, vol. 11225, 2019. Scopus, doi:10.1117/12.2546603.
URI
https://scholars.duke.edu/individual/pub1435965
Source
scopus
Published In
Progress in Biomedical Optics and Imaging Proceedings of Spie
Volume
11225
Published Date
DOI
10.1117/12.2546603

Expression of PDL-1 on Pituitary Adenomas: A Role for Immunotherapy

Authors
Elsamadicy, AA; Farber, H; Chongsathidkiet, P; Woroniecka, K; Cui, X; Dunn, I; Fecci, P
MLA Citation
Elsamadicy, Aladine Abdalla, et al. “Expression of PDL-1 on Pituitary Adenomas: A Role for Immunotherapy.” Journal of Neurosurgery, vol. 126, no. 4, AMER ASSOC NEUROLOGICAL SURGEONS, 2017, pp. A1401–A1401.
URI
https://scholars.duke.edu/individual/pub1250886
Source
wos
Published In
Journal of Neurosurgery
Volume
126
Published Date
Start Page
A1401
End Page
A1401

HEALTHCARE RESOURCE UTILIZATION OF LEPTOMENINGEAL CARCINOMATOSIS IN THE UNITED STATES

Authors
Hodges, SE; Yang, Z; Charalambous, L; Adil, SM; Kiyani, M; Musick, A; Edwards, RM; Parente, B; Lee, H-J; Peters, K; Fecci, P; Lad, S
MLA Citation
Hodges, Sarah E., et al. “HEALTHCARE RESOURCE UTILIZATION OF LEPTOMENINGEAL CARCINOMATOSIS IN THE UNITED STATES.” Neuro Oncology, vol. 21, OXFORD UNIV PRESS INC, 2019, pp. 117–18.
URI
https://scholars.duke.edu/individual/pub1433059
Source
wos
Published In
Neuro Oncology
Volume
21
Published Date
Start Page
117
End Page
118

ENHANCED DRUG DELIVERY AND CIRCULATION WITH THE NEURAPHERESIST SYSTEM FOR THE TREATMENT OF LEPTOMENINGEAL METASTASES

Authors
Marius, C; Ripple, K; de Castro, G; Chen, Y; Giamberadino, C; Verbick, L; McCabe, A; Fecci, P; Lad, S
MLA Citation
Marius, Choiselle, et al. “ENHANCED DRUG DELIVERY AND CIRCULATION WITH THE NEURAPHERESIST SYSTEM FOR THE TREATMENT OF LEPTOMENINGEAL METASTASES.” Neuro Oncology, vol. 21, OXFORD UNIV PRESS INC, 2019, pp. 86–87.
URI
https://scholars.duke.edu/individual/pub1433060
Source
wos
Published In
Neuro Oncology
Volume
21
Published Date
Start Page
86
End Page
87

CAR T cells and checkpoint inhibition for the treatment of glioblastoma.

Introduction: Glioblastoma (GBM) is a highly aggressive brain tumor and is one of the most lethal human cancers. Chimeric antigen receptor (CAR) T cell therapy has markedly improved survival in previously incurable disease; however, this vanguard treatment still faces challenges in GBM. Likewise, checkpoint blockade therapies have not enjoyed the same victories against GBM. As it becomes increasingly evident that a mono-therapeutic approach is unlikely to provide anti-tumor efficacy, there evolves a critical need for combined treatment strategies.Areas covered: This review highlights the clinical successes observed with CAR T cell therapy as well the current efforts to overcome its perceived limitations. The review also explores employed combinations of CAR T cell approaches with immune checkpoint blockade strategies, which aim to potentiate immunotherapeutic benefits while restricting the impact of tumor heterogeneity and T cell exhaustion.Expert opinion: Barriers such as tumor heterogeneity and T cell exhaustion have exposed the weaknesses of various mono-immunotherapeutic approaches to GBM, including CAR T cell and checkpoint blockade strategies. Combining these potentially complementary strategies, however, may proffer a rational means of mitigating these barriers and advancing therapeutic successes against GBM and other solid tumors.
Authors
Shen, SH; Woroniecka, K; Barbour, AB; Fecci, PE; Sanchez-Perez, L; Sampson, JH
MLA Citation
Shen, Steven H., et al. “CAR T cells and checkpoint inhibition for the treatment of glioblastoma.Expert Opin Biol Ther, vol. 20, no. 6, June 2020, pp. 579–91. Pubmed, doi:10.1080/14712598.2020.1727436.
URI
https://scholars.duke.edu/individual/pub1431231
PMID
32027536
Source
pubmed
Published In
Expert Opin Biol Ther
Volume
20
Published Date
Start Page
579
End Page
591
DOI
10.1080/14712598.2020.1727436

Research Areas:

Blood-Brain Barrier
Brain metastasis
Cancer
Glioma
Glioma, Subependymal
Immunotherapy
Immunotherapy, Active
T cells
T cells--Effect of drugs on
T cells--Receptors
Translational Medical Research