Yvonne Mowery

Positions:

Butler Harris Assistant Professor in Radiation Oncology

Radiation Oncology
School of Medicine

Assistant Professor of Radiation Oncology

Radiation Oncology
School of Medicine

Assistant Professor in Head and Neck Surgery & Communication Sciences

Head and Neck Surgery & Communication Sciences
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2012

Duke University

Ph.D. 2012

Duke University

Intern, Medicine

Duke University School of Medicine

Resident, Radiation Oncology

Duke University School of Medicine

Grants:

The Duke Preclinical Research Resources for Quantitative Imaging Biomarkers

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

Patient Reported Outcomes and Financial Toxicity in Head and Neck Cancer

Administered By
Radiation Oncology
Awarded By
Radiation Oncology Institute
Role
Principal Investigator
Start Date
End Date

SARC Spore - Bridge Funding

Administered By
Radiation Oncology
Awarded By
Sarcoma Alliance for Research Through Collaboration
Role
Co Investigator
Start Date
End Date

Mechanisms that Regulate Sarcoma Response to Immune Checkpoint Inhibition of PD-1

Administered By
Radiation Oncology
Awarded By
Sarcoma Alliance for Research Through Collaboration
Role
Investigator
Start Date
End Date

Dissecting the Interplay between Tumor Mutational Load and the Immune System in Response of Primary Sarcomas to Radiation Therapy

Administered By
Radiation Oncology
Awarded By
Conquer Cancer Foundation
Role
Principal Investigator
Start Date
End Date

Publications:

Corrigendum to 'Identification of proteins and cellular pathways targeted by 2-nitroimidazole hypoxic cytotoxins' [Redox Biol. 41 (2021) 101905].

Authors
Rashed, FB; Stoica, AC; MacDonald, D; El-Saidi, H; Ricardo, C; Bhatt, B; Moore, J; Diaz-Dussan, D; Ramamonjisoa, N; Mowery, Y; Damaraju, S; Fahlman, R; Kumar, P; Weinfeld, M
MLA Citation
Rashed, Faisal Bin, et al. “Corrigendum to 'Identification of proteins and cellular pathways targeted by 2-nitroimidazole hypoxic cytotoxins' [Redox Biol. 41 (2021) 101905].Redox Biol, Apr. 2021, p. 101986. Pubmed, doi:10.1016/j.redox.2021.101986.
URI
https://scholars.duke.edu/individual/pub1481182
PMID
33910780
Source
pubmed
Published In
Redox Biology
Published Date
Start Page
101986
DOI
10.1016/j.redox.2021.101986

Chlorhexidine Gluconate Bathing Reduces the Incidence of Bloodstream Infections in Adults Undergoing Inpatient Hematopoietic Cell Transplantation.

Bloodstream infections (BSIs) occur in 20% to 45% of inpatient autologous and allogeneic hematopoietic cell transplant (HCT) patients. Daily bathing with the antiseptic chlorhexidine gluconate (CHG) has been shown to reduce the incidence of BSIs in critically ill patients, although very few studies include HCT patients or have evaluated the impact of compliance on effectiveness. We conducted a prospective cohort study with historical controls to assess the impact of CHG bathing on the rate of BSIs and gut microbiota composition among adults undergoing inpatient HCT at the Duke University Medical Center. We present 1 year of data without CHG bathing (2016) and 2 years of data when CHG was used on the HCT unit (2017 and 2018). Because not all patients adhered to CHG, patients were grouped into four categories by rate of daily CHG usage: high (>75%), medium (50% to 75%), low (1% to 49%), and none (0%). Among 192 patients, univariate trend analysis demonstrated that increased CHG usage was associated with decreased incidence of clinically significant BSI, defined as any BSI requiring treatment by the medical team (high, 8% BSI; medium, 15.2%; low, 15.6%; no CHG, 30.3%; P = .003), laboratory-confirmed BSI (LCBI; P = .03), central line-associated BSI (P = .04), and mucosal barrier injury LCBI (MBI-LCBI; P = .002). Multivariate analysis confirmed a significant effect of CHG bathing on clinically significant BSI (P = .023) and MBI-LCBI (P = .007), without consistently impacting gut microbial diversity. Benefits of CHG bathing were most pronounced with >75% daily usage, and there were no adverse effects attributable to CHG. Adherence to daily CHG bathing significantly decreases the rate of bloodstream infection following HCT.
Authors
Giri, VK; Kegerreis, KG; Ren, Y; Bohannon, LM; Lobaugh-Jin, E; Messina, JA; Matthews, A; Mowery, YM; Sito, E; Lassiter, M; Saullo, JL; Jung, S-H; Ma, L; Greenberg, M; Andermann, TM; van den Brink, MRM; Peled, JU; Gomes, ALC; Choi, T; Gasparetto, CJ; Horwitz, ME; Long, GD; Lopez, RD; Rizzieri, DA; Sarantopoulos, S; Chao, NJ; Allen, DH; Sung, AD
MLA Citation
Giri, Vinay K., et al. “Chlorhexidine Gluconate Bathing Reduces the Incidence of Bloodstream Infections in Adults Undergoing Inpatient Hematopoietic Cell Transplantation.Transplant Cell Ther, vol. 27, no. 3, Mar. 2021, pp. 262.e1-262.e11. Pubmed, doi:10.1016/j.jtct.2021.01.004.
URI
https://scholars.duke.edu/individual/pub1475394
PMID
33781532
Source
pubmed
Published In
Transplant Cell Ther
Volume
27
Published Date
Start Page
262.e1
End Page
262.e11
DOI
10.1016/j.jtct.2021.01.004

Towards deep learning detection of lung nodules using micro-CT

We are developing imaging methods for the preclinical arm of a co-clinical trial investigating synergy between immunotherapy and radiotherapy. We perform in vivo micro-CT of mouse lungs to detect lung metastasis after treatment. This work explores deep learning (DL) as a fast and accurate approach to lung nodule segmentation. We examine the performance of DL lung tumor detection using realistically simulated nodules inserted into temporally-resolved real micro-CT datasets. Our simulations suggest that DL is a promising approach for fast, accurate segmentation of lung nodules in mice.
Authors
Holbrook, MD; Clark, DP; Patel, R; Qi, Y; Mowery, YM; Badea, CT
MLA Citation
Holbrook, M. D., et al. “Towards deep learning detection of lung nodules using micro-CT.” Progress in Biomedical Optics and Imaging  Proceedings of Spie, vol. 11600, 2021. Scopus, doi:10.1117/12.2581120.
URI
https://scholars.duke.edu/individual/pub1478202
Source
scopus
Published In
Progress in Biomedical Optics and Imaging Proceedings of Spie
Volume
11600
Published Date
DOI
10.1117/12.2581120

Daily Chlorhexidine Gluconate Bathing Reduces the Rate of Bloodstream Infections in Adults Undergoing Inpatient Hematopoietic Stem Cell Transplantation

<jats:p>Introduction: While hematopoietic stem cell transplantation (HSCT) has great therapeutic potential, intensive conditioning regimens and variability in time to stem cell engraftment result in a period of pancytopenia and immunosuppression in which patients are vulnerable to infection. Bloodstream infections (BSIs) occur in 20-45% of inpatient autologous and allogeneic transplant patients, leading to prolonged hospitalization and increased mortality. One method of infection prevention is daily application of the antiseptic chlorhexidine gluconate (CHG). Daily CHG bathing, either with a CHG wash or with application of CHG-impregnated cloths, has been shown to reduce the incidence of all-cause hospital-acquired BSIs in critically ill patients, such as those in the ICU, though very few studies include HSCT patients.</jats:p> <jats:p>Methods: We conducted an observational cohort study to assess the impact of daily CHG bathing on the rate of BSIs among adults undergoing inpatient HSCT at the Duke University Medical Center. Patients were included if they were admitted for pre-transplant conditioning and inpatient monitoring for allogeneic or autologous HSCT from January 2016 through December 2018. CHG bathing was instituted in January 2017 for all patients admitted to the inpatient HSCT unit using 2% CHG-impregnated cloths (SAGE™), providing one year of data with no CHG bathing and two years of data with bathing. Patients were tracked from admission until unit discharge, transfer, or first infection. Laboratory-confirmed bloodstream infections (LCBI), central-line associated bloodstream infections (CLABSI), and mucosal barrier injury laboratory-confirmed bloodstream infections (MBI-LCBI) were determined per CDC/NHSN definitions. An additional variable of "clinically-significant infection" was recorded; this included both laboratory-confirmed BSIs and infections deemed significant by the treatment team but that did not meet CDC/NHSN criteria. For example, patients that were febrile, hypotensive, and treated with antibiotics, but with only one positive culture of a common commensal were deemed to have a clinically-significant BSI. Because not all patients adhered to CHG, patients were grouped into four categories by rate of daily CHG usage: High (&gt;75%), Medium (50-75%), Low (1-49%), and None (0%). Baseline characteristics and clinical outcomes between groups were compared via ANOVA, Chi-squared test, or Cochran-Armitage two-sided trend test. Multivariate analysis using the Fine-Grey subdistribution hazard model was conducted to compare time to all infection variables, accounting for the effects of CHG usage, antibiotic prophylaxis regimen, and type of transplant.</jats:p> <jats:p>Results: We evaluated 192 patients hospitalized for HSCT, including 118 (62%) allogeneic transplants and 74 (38%) autologous transplants. Of these, 25 (13%) had high CHG usage, 33 (17%) medium, 45 (23%) low, and 89 (46%) none. Demographics and transplant characteristics were evenly matched between the CHG usage groups with the exception that high usage groups were more likely to receive levofloxacin for antibiotic prophylaxis (p=0.003). Increased CHG usage was significantly associated with decreased incidence of clinically-significant infection (p=0.006), CLABSI (p=0.04), and MBI-LCBI (p=0.002) (Table 1). Multivariate analysis did not demonstrate a significant contribution of antibiotic prophylaxis regimen. No significant difference was found between CHG usage groups in median days to stem cell engraftment, incidence of febrile neutropenia or C. difficile infection, or rashes requiring medical treatment. There were no rashes attributable to CHG usage. Among patients who were VRE rectal swab negative on admission, there was a significant trend toward lower rates of VRE acquisition with increasing CHG usage (High CHG 13.6% vs No CHG 25.3%, p=0.02).</jats:p> <jats:p>Discussion: Increased CHG usage is associated with a significant trend toward lower rates of clinically-significant infection, CLABSI, MBI-LCBI, and VRE colonization in adult inpatients undergoing HSCT. Effects are most strongly seen at &gt;75% daily CHG usage. There were no adverse effects due to CHG application. The significant decrease in MBI-LCBI with topical CHG suggests an interaction between the skin microbial environment and enteric organisms. Therefore, further research exploring the effects of CHG on the skin and gut microbiota is warranted.</jats:p> <jats:p /> <jats:sec> <jats:title>Disclosures</jats:title> <jats:p>Gasparetto: BMS: Consultancy, Honoraria, Other: Travel, accommodations, or other expenses paid or reimbursed ; Janssen: Consultancy, Honoraria, Other: Travel, accommodations, or other expenses paid or reimbursed ; Celgene: Consultancy, Honoraria, Other: Travel, accommodations, or other expenses paid or reimbursed . Horwitz:Abbvie Inc: Membership on an entity's Board of Directors or advisory committees. Rizzieri:Celgene, Gilead, Seattle Genetics, Stemline: Other: Speaker; AbbVie, Agios, AROG, Bayer, Celgene, Gilead, Jazz, Novartis, Pfizer, Sanofi, Seattle Genetics, Stemline, Teva: Other: Advisory Board; AROG, Bayer, Celgene, Celltron, Mustang, Pfizer, Seattle Genetics, Stemline: Consultancy; Stemline: Research Funding. Sung:Novartis: Research Funding; Merck: Research Funding; Seres: Research Funding.</jats:p> </jats:sec>
Authors
Giri, VK; Kegerreis, KG; Ren, Y; Bohannon, LM; Lobaugh-Jin, E; Messina, JA; Matthews, A; Allen, DH; Mowery, YM; Saullo, JL; Jung, S-H; Choi, T; Gasparetto, C; Horwitz, ME; Long, GD; Lopez, RD; Rizzieri, DA; Sarantopoulos, S; Chao, NJ; Sung, AD
MLA Citation
Giri, Vinay K., et al. “Daily Chlorhexidine Gluconate Bathing Reduces the Rate of Bloodstream Infections in Adults Undergoing Inpatient Hematopoietic Stem Cell Transplantation.” Blood, vol. 134, no. Supplement_1, American Society of Hematology, 2019, pp. 2210–2210. Crossref, doi:10.1182/blood-2019-122272.
URI
https://scholars.duke.edu/individual/pub1469906
Source
crossref
Published In
Blood
Volume
134
Published Date
Start Page
2210
End Page
2210
DOI
10.1182/blood-2019-122272

Postoperative radiotherapy is associated with improved overall survival for alveolar ridge squamous cell carcinoma with adverse pathologic features.

BACKGROUND: Alveolar ridge squamous cell carcinoma (ARSCC) is poorly represented in randomized trials. METHODS: Adults in the National Cancer Database diagnosed with ARSCC between 2010 and 2014 who should be considered for postoperative radiotherapy (PORT) based on National Comprehensive Cancer Network (NCCN)-defined risk factors were identified. RESULTS: Eight hundred forty-five (58%) of 1457 patients meeting the inclusion criteria received PORT. PORT was associated with improved overall survival (OS) on unadjusted (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.70-0.98, P = .02) and multivariable (HR 0.78, 95% CI 0.64-0.94, P = .002) analyses. PORT was associated with significantly improved 5-year OS for patients with 1 (68% vs 58%, P < .001), 2 (52% vs 31%, P < .001), and ≥3 (38% vs 24%, P < .001) NCCN-defined risk factors. Prognostic variables significantly associated with worse OS on multivariable analysis included advanced age, primary tumor size ≥3 cm, high grade, positive margin(s), stage N2-3, level IV/V nodal metastasis, and extranodal extension. CONCLUSION: PORT for resected ARSCC with adverse pathologic features is associated with significantly improved OS.
Authors
Jacobs, CD; Williamson, H; Barak, I; Rocke, DJ; Kahmke, RR; Suneja, G; Mowery, YM
MLA Citation
Jacobs, Corbin D., et al. “Postoperative radiotherapy is associated with improved overall survival for alveolar ridge squamous cell carcinoma with adverse pathologic features.Head Neck, vol. 43, no. 1, Jan. 2021, pp. 203–11. Pubmed, doi:10.1002/hed.26475.
URI
https://scholars.duke.edu/individual/pub1460955
PMID
32969107
Source
pubmed
Published In
Head Neck
Volume
43
Published Date
Start Page
203
End Page
211
DOI
10.1002/hed.26475

Research Areas:

Immunotherapy
Neck--Cancer--Radiotherapy
Radiation Oncology
Skin--Cancer--Radiotherapy