Tammara Watts

Positions:

Associate Professor of 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:

B.A. 1995

University of Virginia

M.D. 2004

University of Maryland, Baltimore

Ph.D. 2005

University of Maryland, Baltimore

Otolaryngology Resident, Otolaryngology

Medical College of Georgia

Facial Plastics & Microvascular Reconstruction Fellow, Otolaryngology

Oregon Health and Science University, School of Medicine

Grants:

Overcoming Cisplatin Resistance in Head and Neck Cancer with Crenolanib, a PDGFR-¿ Small Molecule Inhibitor

Administered By
Head and Neck Surgery & Communication Sciences
Awarded By
Elsa U. Pardee Foundation
Role
Principal Investigator
Start Date
End Date

Targeting Mesenchymal Stem Cells in Head and Neck Cancer

Administered By
Head and Neck Surgery & Communication Sciences
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Targeting the Tumor Microenvironment in Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

Awarded By
Triological Society
Role
Principal Investigator
Start Date
End Date

Understanding How High Risk Human Papilloma Virus Serotypes Impacts Racial Disparities in Orophayrngeal Squamous Cell Carcinoma

Awarded By
NRG Oncology
Role
Principal Investigator
Start Date
End Date

Understanding How High Risk Human Papilloma Virus Serotypes Impacts Racial Disparities in Orophayrngeal Squamous Cell Carcinoma

Administered By
Head and Neck Surgery & Communication Sciences
Awarded By
NRG Oncology
Role
Principal Investigator
Start Date
End Date

Publications:

Human papillomavirus vaccine uptake among teens before and during the COVID-19 pandemic in the United States.

It is unclear how the COVID-19 pandemic impacted human papillomavirus (HPV) vaccine uptake and which sociodemographic groups may have been most impacted. We aimed to assess differences in HPV vaccine uptake (initiation and completion) before and during the pandemic in the United States. We conducted a cross-sectional study using data from the 2019 to 2020 National Immunization Surveys - Teen (NIS-Teen), comparing vaccine initiation and completion rates in 2019 vs. 2020, based on confirmed reports by a healthcare provider. Weighted logistic regression analysis estimated odds of vaccine initiation and completion for both adolescent and parental characteristics. There were 18,788 adolescents in 2019 and 20,162 in 2020. There was 3.6% increase in HPV vaccine initiation (71.5% vs. 75.1%) and a 4.4% in completion (54.2% vs. 58.6%) rates from 2019 to 2020. In 2020, Non-Hispanic White teens were significantly less likely to initiate (aOR = 0.62, 95% CI: 0.49, 0.79) and complete (aOR = 0.71, 95% CI: 0.58, 0.86) vaccine uptake compared with non-Hispanic Black teens. Additionally, teens who lived above the poverty line were also less likely to initiate HPV vaccination (aOR = 0.63, 95% CI: 0.49, 0.80) or complete them (aOR = 0.73, 95% CI: 0.60, 0.90), compared to those who lived below the poverty line. During the COVID-19 pandemic in 2020, some historically advantaged socioeconomic groups such as those living above the poverty line were less likely to receive HPV vaccine. The impact of the pandemic on HPV vaccine uptake may transcend traditional access to care factors.
Authors
Abouelella, DK; Canick, JE; Barnes, JM; Rohde, RL; Watts, TL; Adjei Boakye, E; Osazuwa-Peters, N
MLA Citation
Abouelella, Dina K., et al. “Human papillomavirus vaccine uptake among teens before and during the COVID-19 pandemic in the United States.Hum Vaccin Immunother, vol. 18, no. 7, Dec. 2022, p. 2148825. Pubmed, doi:10.1080/21645515.2022.2148825.
URI
https://scholars.duke.edu/individual/pub1558839
PMID
36484115
Source
pubmed
Published In
Hum Vaccin Immunother
Volume
18
Published Date
Start Page
2148825
DOI
10.1080/21645515.2022.2148825

Automated Nuclear Segmentation in Head and Neck Squamous Cell Carcinoma Pathology Reveals Relationships between Cytometric Features and ESTIMATE Stromal and Immune Scores.

The tumor microenvironment (TME) plays an important role in the progression of head and neck squamous cell carcinoma (HNSCC). Currently, pathologic assessment of TME is nonstandardized and subject to observer bias. Genome-wide transcriptomic approaches to understanding the TME, while less subject to bias, are expensive and not currently a part of the standard of care for HNSCC. To identify pathology-based biomarkers that correlate with genomic and transcriptomic signatures of TME in HNSCC, cytometric feature maps were generated in a publicly available data set from a cohort of patients with HNSCC, including whole-slide tissue images and genomic and transcriptomic phenotyping (N = 49). Cytometric feature maps were generated based on whole-slide nuclear detection, using a deep-learning algorithm trained for StarDist nuclear segmentation. Cytometric features in each patient were compared to transcriptomic measurements, including Estimation of Stromal and Immune Cells in Malignant Tumor Tissues Using Expression Data (ESTIMATE) scores and stemness scores. With correction for multiple comparisons, one feature (nuclear circularity) demonstrated a significant linear correlation with ESTIMATE stromal score. Two features (nuclear maximum and minimum diameter) correlated significantly with ESTIMATE immune score. Three features (nuclear solidity, nuclear minimum diameter, and nuclear circularity) correlated significantly with transcriptomic stemness score. This study provides preliminary evidence that observer-independent, automated tissue-slide analysis can provide insights into the HNSCC TME which correlate with genomic and transcriptomic assessments.
Authors
Blocker, SJ; Cook, J; Everitt, JI; Austin, WM; Watts, TL; Mowery, YM
MLA Citation
Blocker, Stephanie J., et al. “Automated Nuclear Segmentation in Head and Neck Squamous Cell Carcinoma Pathology Reveals Relationships between Cytometric Features and ESTIMATE Stromal and Immune Scores.Am J Pathol, vol. 192, no. 9, Sept. 2022, pp. 1305–20. Pubmed, doi:10.1016/j.ajpath.2022.06.003.
URI
https://scholars.duke.edu/individual/pub1524721
PMID
35718057
Source
pubmed
Published In
The American Journal of Pathology
Volume
192
Published Date
Start Page
1305
End Page
1320
DOI
10.1016/j.ajpath.2022.06.003

Differential Outcomes Among Survivors of Head and Neck Cancer Belonging to Racial and Ethnic Minority Groups.

IMPORTANCE: Approximately 1 in 5 new patients with head and neck cancer (HNC) in the US belong to racial and ethnic minority groups, but their survival rates are worse than White individuals. However, because most studies compare Black vs White patients, little is known about survival differences among members of racial and ethnic minority groups. OBJECTIVE: To describe differential survival and identify nonclinical factors associated with stage of presentation among patients with HNC belonging to racial and ethnic minority groups. DESIGN, SETTING, AND PARTICIPANTS: This population-based retrospective cohort study used data from the 2007 to 2016 Surveillance, Epidemiology, and End Results (SEER) database and included non-Hispanic Black, Asian Pacific Islander, American Indian/Alaska Native, and Hispanic patients with HNC. The data were analyzed from December 2020 to May 2021. MAIN OUTCOMES AND MEASURES: Outcomes were time to event measures: (HNC-specific and all-cause mortality) and stage of presentation. Covariates included nonclinical (age at diagnosis, sex, race and ethnicity, insurance status, marital status, and a composite socioeconomic status [SES]) and clinical factors (stage, cancer site, chemotherapy, radiation, and surgery). A Cox regression model was used to adjust associations of covariates with the hazard of all-cause death, and a Fine and Gray competing risks proportional hazards model was used to estimate associations of covariates with the hazard of HNC-specific death. A proportional log odds ordinal logistic regression identified which nonclinical factors were associated with stage of presentation. RESULTS: There were 21 966 patients with HNC included in the study (mean [SD] age, 56.02 [11.16] years; 6072 women [27.6%]; 9229 [42.0%] non-Hispanic Black, 6893 [31.4%] Hispanic, 5342 [24.3%] Asian/Pacific Islander, and 502 [2.3%] American Indian/Alaska Native individuals). Black patients had highest proportion with very low SES (3482 [37.7%]) and the lowest crude 5-year overall survival (46%). After adjusting for covariates, Hispanic individuals had an 11% lower subdistribution hazard ratio (sdHR) of HNC-specific mortality (sdHR, 0.89; 95% CI, 0.83-0.95), 15% lower risk for Asian/Pacific Islander individuals (sdHR, 0.85; 95% CI, 0.78-0.93), and a trending lower risk for American Indian/Alaska Native individuals (sdHR, 0.85; 95% CI, 0.71-1.01), compared with non-Hispanic Black individuals. Race, sex, insurance, marital status, and SES were consistently associated with all-cause mortality, HNC-specific mortality, and stage of presentation, with non-Hispanic Black individuals faring worse compared with individuals of other racial and ethnic minority groups. CONCLUSIONS AND RELEVANCE: In this cohort study that included only patients with HNC who were members of racial and ethnic minority groups, Black patients had significantly worse outcomes that were not completely explained by stage of presentation. There may be unexplored multilevel factors that are associated with social determinants of health and disparities in HNC outcomes.
Authors
Taylor, DB; Osazuwa-Peters, OL; Okafor, SI; Boakye, EA; Kuziez, D; Perera, C; Simpson, MC; Barnes, JM; Bulbul, MG; Cannon, TY; Watts, TL; Megwalu, UC; Varvares, MA; Osazuwa-Peters, N
MLA Citation
Taylor, Derian B., et al. “Differential Outcomes Among Survivors of Head and Neck Cancer Belonging to Racial and Ethnic Minority Groups.Jama Otolaryngol Head Neck Surg, vol. 148, no. 2, Feb. 2022, pp. 119–27. Pubmed, doi:10.1001/jamaoto.2021.3425.
URI
https://scholars.duke.edu/individual/pub1504757
PMID
34940784
Source
pubmed
Published In
Jama Otolaryngol Head Neck Surg
Volume
148
Published Date
Start Page
119
End Page
127
DOI
10.1001/jamaoto.2021.3425

Understanding the link between the oral microbiome and the development and progression of head and neck squamous cell carcinoma

In recent years, the human oral microbiome has emerged as a significant target of interest and research focus because of the role microbiota in oral cavity may play in the progression, diagnosis, and treatment of diseases. Home to an abundant and distinct network of microorganisms that include viruses, fungi, protozoa, and over 700 species of bacteria, only the human gastrointestinal tract harbors more microbiota than the oral microbiome. Although recent advances in genomic sequencing technologies have made it possible to study the involvement between oral bacterial communities and cancer, the role of the oral microbiome in head and neck squamous cell carcinoma remains poorly defined and understood. This review will highlight what is known to date about the connections between the oral microbiome and head and neck cancer.
Authors
Gonzalez, K; Watts, TL
MLA Citation
Gonzalez, K., and T. L. Watts. “Understanding the link between the oral microbiome and the development and progression of head and neck squamous cell carcinoma.” Current Opinion in Physiology, vol. 23, Oct. 2021. Scopus, doi:10.1016/j.cophys.2021.100471.
URI
https://scholars.duke.edu/individual/pub1507411
Source
scopus
Published In
Curr Opin Physiol
Volume
23
Published Date
DOI
10.1016/j.cophys.2021.100471

Impairment of Tissue-Resident Mesenchymal Stem Cells in Chronic Ulcerative Colitis and Crohn's Disease.

BACKGROUND AND AIMS: Little is known about the presence and function of tissue-resident mesenchymal stem cells [MtSCs] within the gastrointestinal mucosa in health and inflammatory bowel disease [IBD]. The contribution of MtSCs to the generation of inflammatory fibroblasts during IBD is also poorly understood. We hypothesized that IBD-MtSCs are impaired and contribute to the generation of the pathological myofibroblasts in IBD. METHODS: In a cohort of clinically and endoscopically active IBD patients and normal controls, we used quantitative RT-PCR and stem cell differentiation assays, as well as confocal microscopy, to characterize MtSCs. RESULTS: Expression of two stem cell markers, Oct4 and ALDH1A, was increased in the inflamed IBD colonic mucosa and correlated with an increase of the mesenchymal lineage marker Grem1 in ulcerative colitis [UC], but not Crohn's disease [CD]. Increased proliferation and aberrant differentiation of Oct4+Grem1+ MtSC-like cells was observed in UC, but not in CD colonic mucosa. In contrast to normal and UC-derived MtSCs, CD-MtSCs lose their clonogenic and most of their differentiation capacities. Our data also suggest that severe damage to these cells in CD may account for the pathological PD-L1low phenotype of CD myofibroblasts. In contrast, aberrant differentiation of MtSCs appears to be involved in the appearance of pathological partially differentiated PD-L1high myofibroblasts within the inflammed colonic mucosa in UC. CONCLUSION: Our data show, for the first time, that the progenitor functions of MtSCs are differentially impaired in CD vs UC, providing a scientific rationale for the use of allogeneic MSC therapy in IBD, and particularly in CD.
Authors
Grim, C; Noble, R; Uribe, G; Khanipov, K; Johnson, P; Koltun, WA; Watts, T; Fofanov, Y; Yochum, GS; Powell, DW; Beswick, EJ; Pinchuk, IV
MLA Citation
Grim, Carl, et al. “Impairment of Tissue-Resident Mesenchymal Stem Cells in Chronic Ulcerative Colitis and Crohn's Disease.J Crohns Colitis, vol. 15, no. 8, Aug. 2021, pp. 1362–75. Pubmed, doi:10.1093/ecco-jcc/jjab001.
URI
https://scholars.duke.edu/individual/pub1496091
PMID
33506258
Source
pubmed
Published In
J Crohns Colitis
Volume
15
Published Date
Start Page
1362
End Page
1375
DOI
10.1093/ecco-jcc/jjab001