Lars Wagner

Overview:

I am a pediatric oncologist with a clinical and research focus on the care of adolescents and young adults with sarcoma. I have led multiple institutional and national clinical trials exploring new therapies for patients with recurrent sarcoma, and am interested in new drug development and identification of predictive biomarkers.

Positions:

Professor of Pediatrics

Pediatrics, Hematology-Oncology
School of Medicine

Chief, Division of Hematology/Oncology

Pediatrics, Hematology-Oncology
School of Medicine

Member of the Duke Cancer Institute of the

Duke Cancer Institute
School of Medicine

Education:

M.D. 1991

University of Kentucky, College of Medicine

Residency, Pediatrics

University of Tennessee Health Science Center

Hematology/Oncology Fellowship, St Jude Children's Hospital

University of Tennessee Health Science Center

Grants:

Per Case Reimbursement : NIH National Clinical Trials Network (NCTN)

Administered By
Pediatrics, Hematology-Oncology
Awarded By
Children's Hospital of Philadelphia
Role
Principal Investigator
Start Date
End Date

A Multi-Center Phase III, Randomized, Open-Label Trial of Vigil (bi-shRNAfurin and GMCSF Augmented Autologous Tumor Cell Immunotherapy) in combination with Irinotecan and Temozolomide as a Second-Line Regimen for Ewing's Sarcoma (CL-PTL-130)

Administered By
Pediatrics, Hematology-Oncology
Awarded By
Gradalis, Inc.
Role
Principal Investigator
Start Date
End Date

Workload Intensity NIH National Clinical Trials Network (NCTN)

Administered By
Pediatrics, Hematology-Oncology
Awarded By
Children's Hospital of Philadelphia
Role
Principal Investigator
Start Date
End Date

NCI Community Oncology Research Program (NCORP) Research Base Grant

Administered By
Pediatrics, Hematology-Oncology
Awarded By
Children's Hospital of Philadelphia
Role
Principal Investigator
Start Date
End Date

Project: One Time EOY, Integrated BIQSFP AAML1031- Echocardiogram Reports and Images

Administered By
Pediatrics, Hematology-Oncology
Awarded By
Children's Hospital of Philadelphia
Role
Principal Investigator
Start Date
End Date

Publications:

USE OF A RAPID HYDRATION PROTOCOL FOR PEDIATRIC ONCOLOGY PATIENTS RECEIVING NEPHROTOXIC CHEMOTHERAPY

Authors
Zachman, D; Graves, L; Sanborn, C; Sullivan, S; Kreissman, S; Rothman, J; Wagner, L
MLA Citation
Zachman, Derek, et al. “USE OF A RAPID HYDRATION PROTOCOL FOR PEDIATRIC ONCOLOGY PATIENTS RECEIVING NEPHROTOXIC CHEMOTHERAPY.” Pediatric Blood & Cancer, vol. 69, 2022.
URI
https://scholars.duke.edu/individual/pub1521701
Source
wos-lite
Published In
Pediatric Blood & Cancer
Volume
69
Published Date

Characteristics of patients ≥10 years of age with diffuse intrinsic pontine glioma: a report from the International DIPG/DMG Registry.

BACKGROUND: Diffuse intrinsic pontine gliomas (DIPG) generally occur in young school-age children, although can occur in adolescents and young adults. The purpose of this study was to describe clinical, radiological, pathologic, and molecular characteristics in patients ≥10 years of age with DIPG enrolled in the International DIPG Registry (IDIPGR). METHODS: Patients ≥10 years of age at diagnosis enrolled in the IDIPGR with imaging confirmed DIPG diagnosis were included. The primary outcome was overall survival (OS) categorized as long-term survivors (LTS) (≥24 months) or short-term survivors (STS) (<24 months). RESULTS: Among 1010 patients, 208 (21%) were ≥10 years of age at diagnosis; 152 were eligible with a median age of 12 years (range 10-26.8). Median OS was 13 (2-82) months. The 1-, 3-, and 5-year OS was 59.2%, 5.3%, and 3.3%, respectively. The 18/152 (11.8%) LTS were more likely to be older (P < .01) and present with longer symptom duration (P < .01). Biopsy and/or autopsy were performed in 50 (33%) patients; 77%, 61%, 33%, and 6% of patients tested had H3K27M (H3F3A or HIST1H3B), TP53, ATRX, and ACVR1 mutations/genome alterations, respectively. Two of 18 patients with IDH1 testing were IDH1-mutant and 1 was a LTS. The presence or absence of H3 alterations did not affect survival. CONCLUSION: Patients ≥10 years old with DIPG have a median survival of 13 months. LTS present with longer symptom duration and are likely to be older at presentation compared to STS. ATRX mutation rates were higher in this population than the general DIPG population.
Authors
Erker, C; Lane, A; Chaney, B; Leary, S; Minturn, JE; Bartels, U; Packer, RJ; Dorris, K; Gottardo, NG; Warren, KE; Broniscer, A; Kieran, MW; Zhu, X; White, P; Dexheimer, PJ; Black, K; Asher, A; DeWire, M; Hansford, JR; Gururangan, S; Nazarian, J; Ziegler, DS; Sandler, E; Bartlett, A; Goldman, S; Shih, C-S; Hassall, T; Dholaria, H; Bandopadhayay, P; Samson, Y; Monje, M; Fisher, PG; Dodgshun, A; Parkin, S; Chintagumpala, M; Tsui, K; Gass, D; Larouche, V; Broxson, E; Garcia Lombardi, M; Wang, SS; Ma, J; Hawkins, C; Hamideh, D; Wagner, L; Koschmann, C; Fuller, C; Drissi, R; Jones, BV; Leach, J; Fouladi, M
MLA Citation
Erker, Craig, et al. “Characteristics of patients ≥10 years of age with diffuse intrinsic pontine glioma: a report from the International DIPG/DMG Registry.Neuro Oncol, vol. 24, no. 1, Jan. 2022, pp. 141–52. Pubmed, doi:10.1093/neuonc/noab140.
URI
https://scholars.duke.edu/individual/pub1530364
PMID
34114629
Source
pubmed
Published In
Neuro Oncol
Volume
24
Published Date
Start Page
141
End Page
152
DOI
10.1093/neuonc/noab140

Addressing Barriers to Fertility Preservation for Cancer Patients: The Role of Oncofertility Patient Navigation.

BACKGROUND: Infertility is a common late effect for cancer survivors. Whereas assisted reproductive technology has made it possible for survivors to take steps to preserve fertility before starting treatment, only a minority of patients proceed with preservation. Patient-, provider-, health system-, and societal-level barriers to fertility preservation (FP) exist. Oncofertility patient navigation is a valuable resource for addressing FP barriers. OBJECTIVES: To highlight the critical role of oncofertility patient navigation in addressing barriers to FP within an academic oncofertility program. METHODS: The role of the oncofertility patient navigator in reducing FP barriers, promoting informed decision-making, and ensuring program sustainability is described. Program metrics illustrating the impact of oncofertility patient navigation on referrals for FP counseling and access to FP in the last year also are provided. DISCUSSION: The oncofertility program at our academic adult and pediatric medical centers aims to facilitate rapid referral to fertility counseling and preservation services for postpubertal cancer patients. The patient navigator is integral to the success of the program. The navigator ensures that patients are: (1) well-informed about the potential impact of cancer on fertility and FP options, (2) aware of available resources (eg, financial) for pursuing FP, (3) able to access FP services if desired, and (4) well supported in making an informed FP decision. The inclusion of the patient navigator has led to an almost 2-fold increase in referrals for FP counseling in the past year over the historic annual average. CONCLUSIONS: Our institution's oncofertility program, with patient navigation at the core, provides a potential model for increasing patient access to oncofertility care and promoting program sustainability. Oncofertility patient navigation is a valuable resource for providing patients and families with education and support regarding FP decision-making, as well as addressing the multilevel barriers to FP.
Authors
Dorfman, CS; Stalls, JM; Mills, C; Voelkel, S; Thompson, M; Acharya, KS; Baker, KC; Wagner, LM; Miller, N; Boswell, A; Corbett, C
MLA Citation
Dorfman, Caroline S., et al. “Addressing Barriers to Fertility Preservation for Cancer Patients: The Role of Oncofertility Patient Navigation.J Oncol Navig Surviv, vol. 12, no. 10, Oct. 2021, pp. 332–48.
URI
https://scholars.duke.edu/individual/pub1502976
PMID
34804640
Source
pubmed
Published In
J Oncol Navig Surviv
Volume
12
Published Date
Start Page
332
End Page
348

Immunotherapy for osteosarcoma: Where do we go from here?

Osteosarcoma is the most common bone tumor in children and young adults, with few advances in survival and treatment, especially for metastatic disease, in the last 30 years. Recently, immunotherapy has begun to show promise in various adult cancers, but the utility of this approach for osteosarcoma remains relatively unexplored. In this review, we outline the mechanisms and status of immunotherapies currently in clinical trials as well as future therapies on the horizon, and discuss their potential application for osteosarcoma.
Authors
Wedekind, MF; Wagner, LM; Cripe, TP
MLA Citation
Wedekind, Mary F., et al. “Immunotherapy for osteosarcoma: Where do we go from here?Pediatr Blood Cancer, vol. 65, no. 9, Sept. 2018, p. e27227. Pubmed, doi:10.1002/pbc.27227.
URI
https://scholars.duke.edu/individual/pub1530365
PMID
29923370
Source
pubmed
Published In
Pediatr Blood Cancer
Volume
65
Published Date
Start Page
e27227
DOI
10.1002/pbc.27227

Targeted therapy for infants with diencephalic syndrome: A case report and review of management strategies.

Young children with emaciation caused by a hypothalamic glioma are considered to have diencephalic syndrome (DS), which is often poorly controlled with conventional treatment. We describe an infant with DS whose tumor progressed following chemotherapy. Biopsy was performed for molecular testing and demonstrated a BRAF fusion. Treatment with the MEK inhibitor trametinib for 18 months resulted in reduction of tumor size, normalization of his weight curve, and marked neurodevelopmental improvement. Our results build on earlier reports of using targeted agents for low-grade glioma, and we review the evolving management strategy for such patients in the era of precision medicine.
Authors
Wagner, LM; Myseros, JS; Lukins, DE; Willen, CM; Packer, RJ
MLA Citation
Wagner, Lars M., et al. “Targeted therapy for infants with diencephalic syndrome: A case report and review of management strategies.Pediatr Blood Cancer, vol. 65, no. 5, May 2018, p. e26917. Pubmed, doi:10.1002/pbc.26917.
URI
https://scholars.duke.edu/individual/pub1530366
PMID
29369501
Source
pubmed
Published In
Pediatr Blood Cancer
Volume
65
Published Date
Start Page
e26917
DOI
10.1002/pbc.26917