Daniel George

Positions:

Professor of Medicine

Medicine, Medical Oncology
School of Medicine

Professor in Surgery

Surgery
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1992

Duke University

Medical Resident, Medicine

Johns Hopkins University

Fellow in Medical Oncology, Medicine

Johns Hopkins University

Grants:

Plasma Angiome and Serum Androgens as Predictors of Overall Survival in Metastatic Prostate Cancer

Administered By
Medicine, Medical Oncology
Awarded By
Department of Defense
Role
Collaborator
Start Date
End Date

Disparities in the Use of Oral Anticancer Agents in Kidney Cancer

Administered By
Population Health Sciences
Awarded By
National Institutes of Health
Role
Investigator
Start Date
End Date

A Randomized, Double-Blind, Placebo-Controlled Phase 2 Study Comparing CB-839 in Combination with Cabozantinib (CB-Cabo) vs. Placebo with Cabozantinib (Pbo-Cabo) in Patients with Advanced or Metastatic Renal Cell Carcinoma (RCC)

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

A Phase II open-label, Multicenter study of Apalutamide, Abiraterone Acetate and Prednisone in African American and Caucasian men with metastatic castrate-resistant prostate cancer

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

BAYER PROTOTYPE PROSTATE PROGRAM - 3 DAY PROGRAMMING

Administered By
Medicine, Medical Oncology
Awarded By
Bayer Healthcare Pharmaceuticals Inc
Role
Principal Investigator
Start Date
End Date

Publications:

Phase II Study of Gemcitabine and Split-Dose Cisplatin Plus Pembrolizumab as Neoadjuvant Therapy Before Radical Cystectomy in Patients With Muscle-Invasive Bladder Cancer.

PURPOSE: To evaluate the safety and efficacy of gemcitabine and cisplatin in combination with the immune checkpoint inhibitor pembrolizumab as neoadjuvant therapy before radical cystectomy (RC) in muscle-invasive bladder cancer. METHODS: Patients with clinical T2-4aN0/XM0 muscle-invasive bladder cancer eligible for RC were enrolled. The initial six patients received lead-in pembrolizumab 200 mg once 2 weeks prior to pembrolizumab 200 mg once on day 1, cisplatin 70 mg/m2 once on day 1, and gemcitabine 1,000 mg/m2 once on days 1 and 8 every 21 days for four cycles. This schedule was discontinued for toxicity and subsequent patients received cisplatin 35 mg/m2 once on days 1 and 8 without lead-in pembrolizumab. The primary end point was pathologic downstaging (< pT2N0) with null and alternative hypothesis rates of 35% and 55%, respectively. Secondary end points were toxicity including patient-reported outcomes, complete pathologic response (pT0N0), event-free survival, and overall survival. Association of pathologic downstaging with programmed cell death ligand 1 staining was explored. RESULTS: Thirty-nine patients were enrolled between June 2016 and March 2020 (72% cT2, 23% cT3, and 5% cT4a). Patients received a median of four cycles of therapy. All patients underwent RC except one who declined. Twenty-two of 39 patients (56% [95% CI, 40 to 72]) achieved < pT2N0 and 14 of 39 (36% [95% CI, 21 to 53]) achieved pT0N0. Most common adverse events (AEs) of any grade were thrombocytopenia (74%), anemia (69%), neutropenia (67%), and hypomagnesemia (67%). One patient had new-onset type 1 diabetes mellitus with ketoacidosis related to pembrolizumab and no patients required steroids for immune-related AEs. Clinicians consistently under-reported AEs when compared with patients. CONCLUSION: Neoadjuvant gemcitabine and cisplatin plus pembrolizumab met its primary end point for improved pathologic downstaging and was generally safe. A global study of perioperative chemotherapy plus pembrolizumab or placebo is ongoing.
Authors
Rose, TL; Harrison, MR; Deal, AM; Ramalingam, S; Whang, YE; Brower, B; Dunn, M; Osterman, CK; Heiling, HM; Bjurlin, MA; Smith, AB; Nielsen, ME; Tan, H-J; Wallen, E; Woods, ME; George, D; Zhang, T; Drier, A; Kim, WY; Milowsky, MI
MLA Citation
Rose, Tracy L., et al. “Phase II Study of Gemcitabine and Split-Dose Cisplatin Plus Pembrolizumab as Neoadjuvant Therapy Before Radical Cystectomy in Patients With Muscle-Invasive Bladder Cancer.J Clin Oncol, vol. 39, no. 28, Oct. 2021, pp. 3140–48. Pubmed, doi:10.1200/JCO.21.01003.
URI
https://scholars.duke.edu/individual/pub1494307
PMID
34428076
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
39
Published Date
Start Page
3140
End Page
3148
DOI
10.1200/JCO.21.01003

What can we learn from cancer disparities?

Authors
MLA Citation
George, D. J. “What can we learn from cancer disparities?Gastroenterology and Hepatology, vol. 16, no. 3, Mar. 2020, p. 134.
URI
https://scholars.duke.edu/individual/pub1488764
Source
scopus
Published In
Gastroenterology & Hepatology
Volume
16
Published Date
Start Page
134

Provider- and patient-level predictors of oral anticancer agent initiation and adherence in patients with metastatic renal cell carcinoma.

BACKGROUND: Improving oral anticancer agent (OAA) initiation and adherence is the important quality-of-care issues, particularly since one fourth of anticancer agents being developed will be administered orally. Our objective was to identify provider- and patient-level characteristics associated with OAA initiation and adherence among individuals with metastatic renal cell carcinoma (mRCC). METHODS: We used state cancer registry data linked to multi-payer claims data to identify patients with mRCC diagnosed in 2004-2015. Provider data were obtained from North Carolina Health Professions Data System and the National Plan & Provider Enumeration System. We estimated risk ratios (RRs) and corresponding 95% confidence limits (CLs) using modified Poisson regression to evaluate factors associated with OAA initiation and adherence. RESULTS: Among the 207 (out of 687) patients who initiated an OAA following mRCC diagnosis and survived 90 days, median proportion of days covered was 0.91. Patients with a modal provider specializing in hematology/medical oncology were much more likely to initiate OAAs than those seen by other specialties. Additionally, patients with a female provider were more likely to initiate OAAs than those with a male provider. Compared to patients treated by providers practicing in both urban and rural areas, patients with providers practicing solely in urban areas were more likely to initiate OAAs, after controlling for patient-level factors (RR = 1.37; 95% CL: 1.09-1.73). Medicare patients were less likely to be adherent than those with private insurance (RR = 0.61; 95% CL: 0.42-0.87). CONCLUSIONS: Our results suggest that provider- and patient-level factors influence OAA initiation in patients with mRCC but only insurance type was associated with adherence.
Authors
Spees, LP; Wheeler, SB; Jackson, BE; Baggett, CD; Wilson, LE; Greiner, MA; Kaye, DR; Zhang, T; George, D; Scales, CD; Pritchard, JE; Leapman, M; Gross, CP; Dinan, MA
MLA Citation
Spees, Lisa P., et al. “Provider- and patient-level predictors of oral anticancer agent initiation and adherence in patients with metastatic renal cell carcinoma.Cancer Med, vol. 10, no. 19, Oct. 2021, pp. 6653–65. Pubmed, doi:10.1002/cam4.4201.
URI
https://scholars.duke.edu/individual/pub1496014
PMID
34480518
Source
pubmed
Published In
Cancer Medicine
Volume
10
Published Date
Start Page
6653
End Page
6665
DOI
10.1002/cam4.4201

Real-World Data from a Metastatic Renal Cell Carcinoma Community-Academic Registry: Comparative Outcomes of Progression Free Survival and Overall Survival

Background: No studies have looked at comparative outcomes in the treatment of metastatic renal cell carcinoma (mRCC) between academic and community practice settings. Methods: We created a joint academic (ACAD) and community (COMM) retrospective registry of patients treated for mRCC. This registry represents a collaboration of an academic research network (Duke Oncology Network; Durham, NC) and a community-based oncology network (ACORN Research; Memphis, TN) of multiple member practices. We compared progression free survival and overall survival between these centers. We included patients diagnosed with mRCC after January 1, 2007 and before February 7, 2011. Results: Four hundred and fifty-five patients were captured in the registry including N=255 COMM patients and N=200 ACAD patients. Initial analysis of COMM patients showed a median PFS of 6.24 months [95% CI, 5.4, 7.5], 3.88 months [95% CI, 3.0, 4.8], and 3.35 months [95% CI 2.9, 4.4] with first, second, and third line systemic therapy. ACAD patients had longer median PFS estimates of 11.3 months [95% CI, 7.5, 13.6], 4.4 months [95% CI, 2.7, 8.9], and 5.22 months [95% CI, 2.7, 6.3] respectively. Median OS was 12.06 months [95% CI 8.7, 15.4] among COMM patients and 36.73 months [95% CI 26.2 42.2) among ACAD patients. Differences persisted with inclusion of well-established prognostic models and predictive factors such as treatment exposures. Conclusions: There may be differences between outcomes for mRCC patients in community versus academic settings; however rselection most likely plays a role and we need further studies to determine reasons for these potential disparities. A prospective metastatic renal cell carcinoma (MaRCC) registry has been accrued encompassing sixty academic and community treatment sites across the United States rwith the goal of examining real-world treatment patterns and outcomes; MaRCC may shed further light on any potential outcomes differences.
Authors
Ramalingam, S; Walker, M; George, DJ; Harrison, MR
MLA Citation
Ramalingam, S., et al. “Real-World Data from a Metastatic Renal Cell Carcinoma Community-Academic Registry: Comparative Outcomes of Progression Free Survival and Overall Survival.” Kidney Cancer, vol. 3, no. 2, Jan. 2019, pp. 133–40. Scopus, doi:10.3233/KCA-190059.
URI
https://scholars.duke.edu/individual/pub1485735
Source
scopus
Published In
Kidney Cancer
Volume
3
Published Date
Start Page
133
End Page
140
DOI
10.3233/KCA-190059

Correction to: Outcomes based on plasma biomarkers in METEOR, a randomized phase 3 trial of cabozantinib vs everolimus in advanced renal cell carcinoma.

Authors
Powles, T; Choueiri, TK; Motzer, RJ; Jonasch, E; Pal, S; Tannir, NM; Signoretti, S; Kaldate, R; Scheffold, C; Wang, E; Aftab, DT; Escudier, B; George, DJ
MLA Citation
Powles, Thomas, et al. “Correction to: Outcomes based on plasma biomarkers in METEOR, a randomized phase 3 trial of cabozantinib vs everolimus in advanced renal cell carcinoma.Bmc Cancer, vol. 21, no. 1, Sept. 2021, p. 1023. Pubmed, doi:10.1186/s12885-021-08693-9.
URI
https://scholars.duke.edu/individual/pub1497326
PMID
34525968
Source
pubmed
Published In
Bmc Cancer
Volume
21
Published Date
Start Page
1023
DOI
10.1186/s12885-021-08693-9