Christopher Kelsey

Overview:

Clinical trials that are currently enrolling patients include a study investigating lower doses of radiation therapy for patients with diffuse large B-cell lymphoma, with the goal of maintaining excellent tumor control but decreasing the risk of long-term side effects of treatment.

I also have an interest in genetic determinants of radiation sensitivity, predictors of local recurrence after surgery for lung cancer, radiation-induced lung injury, and the role of radiation therapy in advanced (stage III-IV) diffuse large B-cell lymphoma and Hodgkin lymphoma.

Positions:

Associate Professor of Radiation Oncology

Radiation Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S. 1998

Brigham Young University

M.D. 2002

University of Colorado, Colorado Springs

Grants:

Early Detection of Changes in Pulmonary Gas Exchange by Hyperpolarized Xe MRI

Administered By
Radiology
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Early Detection of Changes in Pulmonary Gas Exchange by Hyperpolarized Xe MRI

Administered By
Radiology
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Publications:

Stage I-II nodular lymphocyte-predominant Hodgkin lymphoma: a multi-institutional study of adult patients by ILROG.

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is an uncommon histologic variant, and the optimal treatment of stage I-II NLPHL is undefined. We conducted a multicenter retrospective study including patients ≥16 years of age with stage I-II NLPHL diagnosed from 1995 through 2018 who underwent all forms of management, including radiotherapy (RT), combined modality therapy (CMT; RT+chemotherapy [CT]), CT, observation after excision, rituximab and RT, and single-agent rituximab. End points were progression-free survival (PFS), freedom from transformation, and overall survival (OS) without statistical comparison between management groups. We identified 559 patients with median age of 39 years: 72.3% were men, and 54.9% had stage I disease. Median follow-up was 5.5 years (interquartile range, 3.1-10.1). Five-year PFS and OS in the entire cohort were 87.1% and 98.3%, respectively. Primary management was RT alone (n = 257; 46.0%), CMT (n = 184; 32.9%), CT alone (n = 47; 8.4%), observation (n = 37; 6.6%), rituximab and RT (n = 19; 3.4%), and rituximab alone (n = 15; 2.7%). The 5-year PFS rates were 91.1% after RT, 90.5% after CMT, 77.8% after CT, 73.5% after observation, 80.8% after rituximab and RT, and 38.5% after rituximab alone. In the RT cohort, but not the CMT cohort, variant immunoarchitectural pattern and number of sites >2 were associated with worse PFS (P < .05). Overall, 21 patients (3.8%) developed large-cell transformation, with a significantly higher transformation rate in those with variant immunoarchitectural pattern (P = .049) and number of involved sites >2 (P = .0006). OS for patients with stage I-II NLPHL was excellent after all treatments.
Authors
Binkley, MS; Rauf, MS; Milgrom, SA; Pinnix, CC; Tsang, R; Dickinson, M; Ng, AK; Roberts, KB; Gao, S; Balogh, A; Ricardi, U; Levis, M; Casulo, C; Stolten, M; Specht, L; Plastaras, JP; Wright, C; Kelsey, CR; Brady, JL; Mikhaeel, NG; Hoppe, BS; Terezakis, SA; Picardi, M; Della Pepa, R; Kirova, Y; Akhtar, S; Maghfoor, I; Koenig, JL; Jackson, C; Song, E; Sehgal, S; Advani, RH; Natkunam, Y; Constine, LS; Eich, HT; Wirth, A; Hoppe, RT
MLA Citation
Binkley, Michael S., et al. “Stage I-II nodular lymphocyte-predominant Hodgkin lymphoma: a multi-institutional study of adult patients by ILROG.Blood, vol. 135, no. 26, June 2020, pp. 2365–74. Pubmed, doi:10.1182/blood.2019003877.
URI
https://scholars.duke.edu/individual/pub1435819
PMID
32211877
Source
pubmed
Published In
Blood
Volume
135
Published Date
Start Page
2365
End Page
2374
DOI
10.1182/blood.2019003877

Cutaneous T-cell lymphoma: Mycosis fungoides and sezary syndrome

Authors
Voorhees, TJ; Bowers, EV; Kelsey, CR; Park, Y; Beaven, AW
MLA Citation
Voorhees, T. J., et al. “Cutaneous T-cell lymphoma: Mycosis fungoides and sezary syndrome.” Novel Therapeutics for Rare Lymphomas, 2019, pp. 221–46. Scopus, doi:10.1007/978-3-030-25610-4_14.
URI
https://scholars.duke.edu/individual/pub1447134
Source
scopus
Published Date
Start Page
221
End Page
246
DOI
10.1007/978-3-030-25610-4_14

Definitive Radiotherapy for Inoperable Stage IIB Non-small-cell Lung Cancer: Patterns of Care and Comparative Effectiveness.

BACKGROUND: The purpose of this study was to analyze practice patterns and perform comparative effectiveness of definitive radiotherapy techniques for inoperable stage IIB (American Joint Committee on Cancer eighth edition) non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: Adults in the National Cancer Database diagnosed with T3N0M0 or T1-2N1M0 NCSLC between 2004 and 2015 who received definitive radiotherapy were identified. Cases were divided as stereotactic body radiotherapy (SBRT), hypofractionated radiotherapy (HFRT), or conventionally fractionated radiotherapy (CFRT) and stratified by systemic therapy (ST). Cox proportional hazards models evaluated the effect of covariates on overall survival (OS). Subgroup analysis by tumor size, chest wall invasion, multifocality, and ST use was performed with Kaplan-Meier estimates of OS. RESULTS: A total of 10,081 subjects met inclusion criteria: 4401 T3N0M0 (66.5% CFRT, 11.0% HFRT, and 22.5% SBRT) and 5680 T1-2N1M0 (92.5% CFRT and 7.5% HFRT). For T3N0M0 NSCLC, SBRT utilization increased from 3.7% in 2006% to 35.4% in 2015. Subjects treated with SBRT were more likely to have smaller tumors, multifocal tumors, or adenocarcinoma histology. SBRT resulted in similar or superior OS compared with CFRT for tumors > 5 cm, tumors invading the chest wall, or multifocal tumors. SBRT was significantly associated with improved OS on multivariate analysis (hazard ratio, 0.715; P < .001). For T1-2N1M0 NSCLC, patients treated with HFRT were significantly older and less likely to receive ST; nevertheless, there was no difference in OS between HFRT and CFRT on multivariate analysis. CONCLUSION: CFRT + ST is utilized most frequently to treat stage IIB NSCLC in the United States when surgery is not performed, though it is decreasing. SBRT utilization for T3N0M0 NSCLC is increasing and was associated with improved OS.
Authors
Jacobs, CD; Gao, J; Wang, X; Clarke, JM; Tong, B; Ready, NE; Suneja, G; Kelsey, CR; Torok, JA
MLA Citation
Jacobs, Corbin D., et al. “Definitive Radiotherapy for Inoperable Stage IIB Non-small-cell Lung Cancer: Patterns of Care and Comparative Effectiveness.Clin Lung Cancer, vol. 21, no. 3, May 2020, pp. 238–46. Pubmed, doi:10.1016/j.cllc.2019.10.005.
URI
https://scholars.duke.edu/individual/pub1422411
PMID
31757764
Source
pubmed
Published In
Clin Lung Cancer
Volume
21
Published Date
Start Page
238
End Page
246
DOI
10.1016/j.cllc.2019.10.005

Dynamic Changes in Circulating Tumor DNA During Chemoradiation for Locally Advanced Lung Cancer.

Purpose: Concurrent chemoradiation therapy (CRT) is the principal treatment modality for locally advanced lung cancer. Cell death due to CRT leads to the release of cell-free DNA (cfDNA) and circulating tumor DNA (ctDNA) into the bloodstream, but the kinetics and characteristics of this process are poorly understood. We hypothesized that there could be clinically meaningful changes in cfDNA and ctDNA during a course of CRT for lung cancer. Methods and materials: Multiple samples of plasma were obtained from 24 patients treated with CRT for locally advanced lung cancer to a mean dose of 66 Gy (range, 58-74 Gy) at the following intervals: before CRT, at weeks 2 and 5 during CRT, and 6 weeks after treatment. cfDNA was quantified, and a novel next generation sequencing (NGS) technique using enhanced tagged/targeted-amplicon sequencing was performed to analyze ctDNA. Results: Patients for whom specific mutations in ctDNA were undetectable at the baseline time point had improved survival, and potentially etiologic driver mutations could be tracked throughout the course of CRT via NGS in multiple patients. We quantified the levels of cfDNA from patients before CRT, at week 2, week 5, and at 6 weeks after treatment. No differences were observed at weeks 2 and 5 of therapy, but we noted a significant increase in cfDNA in the posttreatment follow-up samples compared with samples collected before CRT (P = .05). Conclusions: Dynamic changes in both cfDNA and ctDNA were observed throughout the course of CRT in patients with locally advanced lung cancer. Specific mutations with therapeutic implications can be identified and tracked using NGS methodologies. Further work is required to characterize the changes in cfDNA and ctDNA over time in patients treated with CRT and to assess the predictive and prognostic potential of this powerful technology.
Authors
Corradetti, MN; Torok, JA; Hatch, AJ; Xanthopoulos, EP; Lafata, K; Jacobs, C; Rushing, C; Calaway, J; Jones, G; Kelsey, CR; Nixon, AB
MLA Citation
Corradetti, Michael N., et al. “Dynamic Changes in Circulating Tumor DNA During Chemoradiation for Locally Advanced Lung Cancer.Adv Radiat Oncol, vol. 4, no. 4, Oct. 2019, pp. 748–52. Pubmed, doi:10.1016/j.adro.2019.05.004.
URI
https://scholars.duke.edu/individual/pub1395845
PMID
31673668
Source
pubmed
Published In
Advances in Radiation Oncology
Volume
4
Published Date
Start Page
748
End Page
752
DOI
10.1016/j.adro.2019.05.004

An Exploratory Radiomics Approach to Quantifying Pulmonary Function in CT Images.

Contemporary medical imaging is becoming increasingly more quantitative. The emerging field of radiomics is a leading example. By translating unstructured data (i.e., images) into structured data (i.e., imaging features), radiomics can potentially characterize clinically useful imaging phenotypes. In this paper, an exploratory radiomics approach is used to investigate the potential association between quantitative imaging features and pulmonary function in CT images. Thirty-nine radiomic features were extracted from the lungs of 64 patients as potential imaging biomarkers for pulmonary function. Collectively, these features capture the morphology of the lungs, as well as intensity variations, fine-texture, and coarse-texture of the pulmonary tissue. The extracted lung radiomics data was compared to conventional pulmonary function tests. In general, patients with larger lungs of homogeneous, low attenuating pulmonary tissue (as measured via radiomics) were found to be associated with poor spirometry performance and a lower diffusing capacity for carbon monoxide. Unsupervised dynamic data clustering revealed subsets of patients with similar lung radiomic patterns that were found to be associated with similar forced expiratory volume in one second (FEV1) measurements. This implies that patients with similar radiomic feature vectors also presented with comparable spirometry performance, and were separable by varying degrees of pulmonary function as measured by imaging.
Authors
Lafata, KJ; Zhou, Z; Liu, J-G; Hong, J; Kelsey, CR; Yin, F-F
MLA Citation
Lafata, Kyle J., et al. “An Exploratory Radiomics Approach to Quantifying Pulmonary Function in CT Images.Sci Rep, vol. 9, no. 1, Aug. 2019, p. 11509. Pubmed, doi:10.1038/s41598-019-48023-5.
URI
https://scholars.duke.edu/individual/pub1403969
PMID
31395937
Source
pubmed
Published In
Scientific Reports
Volume
9
Published Date
Start Page
11509
DOI
10.1038/s41598-019-48023-5