Andrew Armstrong

Overview:

1. Predictors of sensitivity and clinical efficacy of therapies in advanced prostate cancer
2. Novel designs of clinical trials and pharmacodynamic/translational studies in prostate, kidney, bladder cancer
3. Pre-operative models for drug development of novel agents in human testing in prostate cancer
4. Novel therapies and drug development for prostate, renal, bladder, and testicular cancer
5. Design of rational combination therapies in men with metastatic hormone-refractory prostate cancer
6. PI3 kinase/mTOR inhibition in prostate cancer: mechanisms of sensitivity and resistance
7. Developing prognostic models for progression and survival in metastatic prostate cancer
8. Examining surrogate markers of mortality in metastatic prostate cancer
9. Clear cell and non-clear cell renal cell carcinoma: natural history, sensitivity to novel agents including mTOR and VEGF inhibition

Positions:

Professor of Medicine

Medicine, Medical Oncology
School of Medicine

Associate Professor in Pharmacology and Cancer Biology

Pharmacology & Cancer Biology
School of Medicine

Professor in Surgery

Surgery, Urology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S.E. 1996

Duke University

M.D. 2000

University of Virginia School of Medicine

M.Sc. 2008

Johns Hopkins University

Internship/Residency, General Internal Medicine

University of Pennsylvania, School of Medicine

Fellowship, Division Of Oncology/Hematology

Johns Hopkins University School of Medicine

Grants:

Study title: A Randomized, Double-blind, Placebo-controlled, Multicenter Phase III Study of Olaparib Plus Abiraterone Relative to Placebo Plus Abiraterone as First-line Therapy in Men with Metastatic Castration-resistant Prostate Cancer

Administered By
Duke Cancer Institute
Awarded By
AstraZeneca AB
Role
Principal Investigator
Start Date
End Date

ProSTAR: A Phase 1b/2 Study of CPI-1205, a Small Molecule Inhibitor of EZH2, Combined with Enzalutamide or Abiraterone/Prednisone in Patients with Metastatic Castration Resistant Prostate Cancer

Administered By
Duke Cancer Institute
Awarded By
Constellation Pharmaceuticals
Role
Principal Investigator
Start Date
End Date

VISION: An International, Prospective, Open-Label, Multicenter, Randomized Phase 3 Study of 177lu-Psma-617 in the Treatment of Patients with Progressive PSMA-Positive Metastatic Castration-Resistant Prostate Cancer (mCRPC)

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

A Phase 2 Study of Nivolumab in combination with either Rucaparib, docetaxel, or enzalutamide in men with Castration-resistant metastaic prostate cancer (CheckMate 9KD: CHECKpoint pathway and nivoluMA

Administered By
Duke Cancer Institute
Awarded By
Bristol-Myers Squibb Company
Role
Principal Investigator
Start Date
End Date

A Phase II Study of Navarixin (MK-7123) in Combination with Pembrolizumab (MK-3475) in Participants with Selected Advanced/Metastatic Solid Tumors

Administered By
Duke Cancer Institute
Awarded By
Merck Sharp & Dohme
Role
Principal Investigator
Start Date
End Date

Publications:

Cerebrovascular event (CVE) outcome and overall survival (OS) in patients (pts) treated with sipuleucel-T (sip-T) for metastatic castration-resistant prostate cancer (mCRPC): results from the PROCEED registry.

Authors
Higano, CS; Armstrong, AJ; Sartor, AO; Vogelzang, NJ; Kantoff, PW; McLeod, DG; Pieczonka, CM; Penson, DF; Shore, ND; Vacirca, JL; Concepcion, RS; Tutrone, RF; Nordquist, LT; Quinn, DI; Kassabian, V; Scholz, MC; Tyler, RC; Chang, NN; Brown, B; Cooperberg, MR
MLA Citation
Higano, Celestia S., et al. “Cerebrovascular event (CVE) outcome and overall survival (OS) in patients (pts) treated with sipuleucel-T (sip-T) for metastatic castration-resistant prostate cancer (mCRPC): results from the PROCEED registry.Journal of Clinical Oncology, vol. 36, no. 15_suppl, American Society of Clinical Oncology (ASCO), 2018, pp. e17018–e17018. Crossref, doi:10.1200/jco.2018.36.15_suppl.e17018.
URI
https://scholars.duke.edu/individual/pub1450820
Source
crossref
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
36
Published Date
Start Page
e17018
End Page
e17018
DOI
10.1200/jco.2018.36.15_suppl.e17018

Analysis of genomic alterations in matched circulating tumor cell DNA (CTC DNA) and plasma tumor DNA (ctDNA) in men with metastatic castration resistant prostate cancer (mCRPC).

Authors
Gupta, S; Hovelson, DH; Tomlins, SA; Kemeny, G; Liu, C-J; George, DJ; Rothwell, C; Anand, M; Nanus, DM; Giannakakou, P; Gregory, S; Armstrong, AJ
MLA Citation
Gupta, Santosh, et al. “Analysis of genomic alterations in matched circulating tumor cell DNA (CTC DNA) and plasma tumor DNA (ctDNA) in men with metastatic castration resistant prostate cancer (mCRPC).Journal of Clinical Oncology, vol. 36, no. 15_suppl, American Society of Clinical Oncology (ASCO), 2018, pp. 5065–5065. Crossref, doi:10.1200/jco.2018.36.15_suppl.5065.
URI
https://scholars.duke.edu/individual/pub1450821
Source
crossref
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
36
Published Date
Start Page
5065
End Page
5065
DOI
10.1200/jco.2018.36.15_suppl.5065

Five-year Survival Prediction and Safety Outcomes with Enzalutamide in Men with Chemotherapy-naïve Metastatic Castration-resistant Prostate Cancer from the PREVAIL Trial.

BACKGROUND:In the PREVAIL study, enzalutamide significantly improved clinical outcomes versus placebo in patients with chemotherapy-naïve metastatic castration-resistant prostate cancer (mCRPC). OBJECTIVE:To evaluate long-term benefits and risks of enzalutamide in the final prespecified PREVAIL analysis. DESIGN, SETTING, AND PARTICIPANTS:We conducted a final 5-yr survival analysis of PREVAIL in men with chemotherapy-naïve mCRPC from the enzalutamide (n = 689) and placebo (n = 693) arms. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:Predictors of the primary outcome of overall survival were estimated using the Kaplan-Meier method. Long-term adverse events over time were analyzed. RESULTS AND LIMITATIONS:At the 5-yr data cutoff, 1382 of 1717 (80%) men had died. Enzalutamide reduced the hazard of death by 17% (hazard ratio 0.83; 95% confidence interval [CI] 0.75-0.93; p < 0.001), despite 65%, 54%, and 43% of placebo-treated patients receiving subsequent docetaxel, abiraterone, and enzalutamide, respectively. Median overall survival was 36 mo (95% CI 34-38) in the enzalutamide arm versus 31 mo (95% CI 29-34) in the placebo arm, with a median follow-up of 69 mo. Prognostic modeling showed 5-yr survival rates of 42%, 24%, and 5% for low-, intermediate-, and high-risk groups, respectively. Greater degrees of confirmed prostate-specific antigen declines (≤3 mo) were associated with greater 5-yr survival. A higher incidence of fatal treatment-emergent adverse events was observed with enzalutamide (6.9% vs 3.8%), with an increase in fatal cardiovascular events (1.6% vs 0.4%). CONCLUSIONS:With >5 yr of follow-up, enzalutamide continued to demonstrate improved survival in patients with mCRPC despite crossover and multiple subsequent effective therapies, balanced against a slightly higher rate of fatal cardiovascular events. PREVAIL is registered on ClinicalTrials.gov as NCT01212991. PATIENT SUMMARY:We report a maintained long-term survival benefit with enzalutamide and risks with >5 yr of enzalutamide treatment and follow-up in men with metastatic prostate cancer, and identify groups of men with widely different outcomes based on clinical factors.
Authors
Armstrong, AJ; Lin, P; Tombal, B; Saad, F; Higano, CS; Joshua, AM; Parli, T; Rosbrook, B; van Os, S; Beer, TM
MLA Citation
Armstrong, Andrew J., et al. “Five-year Survival Prediction and Safety Outcomes with Enzalutamide in Men with Chemotherapy-naïve Metastatic Castration-resistant Prostate Cancer from the PREVAIL Trial.European Urology, vol. 78, no. 3, Sept. 2020, pp. 347–57. Epmc, doi:10.1016/j.eururo.2020.04.061.
URI
https://scholars.duke.edu/individual/pub1448084
PMID
32527692
Source
epmc
Published In
European Urology
Volume
78
Published Date
Start Page
347
End Page
357
DOI
10.1016/j.eururo.2020.04.061

Effect of Enzalutamide plus Androgen Deprivation Therapy on Health-related Quality of Life in Patients with Metastatic Hormone-sensitive Prostate Cancer: An Analysis of the ARCHES Randomised, Placebo-controlled, Phase 3 Study.

BACKGROUND: In the ARCHES study in metastatic hormone-sensitive prostate cancer (mHSPC), enzalutamide plus androgen deprivation therapy (ADT) improved radiographic progression-free survival (rPFS) versus ADT alone. OBJECTIVE: To evaluate patient-reported outcomes (PROs) to week 73. DESIGN, SETTING, AND PARTICIPANTS: ARCHES (NCT02677896) was a randomised, double-blind, placebo-controlled, phase 3 study in mHSPC patients. INTERVENTION: Enzalutamide (160 mg/day) plus ADT or placebo plus ADT. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: PROs were assessed at baseline, week 13, and every 12 wk until disease progression using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Prostate 25 (QLQ-PR25), Functional Assessment of Cancer Therapy-Prostate (FACT-P), Brief Pain Inventory Short Form, and EuroQoL 5-Dimensions, 5-Levels (EQ-5D-5 L) instruments. Endpoints included time to first (TTFD) and first confirmed (TTFCD) clinically meaningful deterioration (using predefined questionnaire thresholds) in health-related quality of life (HRQoL) and pain. RESULTS AND LIMITATIONS: A total of 1150 patients received ADT plus enzalutamide (n = 574) or placebo (n = 576). Baseline PRO scores indicated high HRQoL and low pain, which was generally maintained in both groups. There were no statistically significant (nominal p > 0.05) between-group differences that occurred in both TTFD and TTFCD together for QLQ-PR25 and FACT-P scores. Enzalutamide significantly delayed TTFD in worst pain (by ∼3 mo; nominal p = 0.032), pain severity (nominal p = 0.021), and EQ-5D-5 L visual analogue scale score (nominal p = 0.0070) versus placebo (not significant for confirmed deterioration for pain outcomes). Enzalutamide delays deterioration in several HRQoL subscales and pain severity in high-volume disease. CONCLUSIONS: Enzalutamide plus ADT enables men with mHSPC to maintain high-functioning HRQoL and low symptom burden. PATIENT SUMMARY: This study examined the effect on health-related quality of life and pain of adding enzalutamide or placebo to androgen deprivation therapy for patients with metastatic hormone-sensitive prostate cancer. Addition of enzalutamide allowed patients to maintain their health-related quality of life.
Authors
Stenzl, A; Dunshee, C; De Giorgi, U; Alekseev, B; Iguchi, T; Szmulewitz, RZ; Flaig, TW; Tombal, B; Morlock, R; Ivanescu, C; Ramaswamy, K; Saad, F; Armstrong, AJ
URI
https://scholars.duke.edu/individual/pub1439658
PMID
32336645
Source
pubmed
Published In
Eur Urol
Published Date
DOI
10.1016/j.eururo.2020.03.019

Expression of immune checkpoints (ICs) on circulating tumor cells (CTCs) in men with metastatic prostate cancer (mPC).

Authors
Zhang, T; Austin, RG; Park, SE; Runyambo, D; Boominathan, R; Rao, C; Bronson, E; Anand, M; Healy, P; George, DJ; McNamara, MA; Armstrong, AJ
MLA Citation
Zhang, Tian, et al. “Expression of immune checkpoints (ICs) on circulating tumor cells (CTCs) in men with metastatic prostate cancer (mPC).Journal of Clinical Oncology, vol. 36, no. 15_suppl, American Society of Clinical Oncology (ASCO), 2018, pp. 5059–5059. Crossref, doi:10.1200/jco.2018.36.15_suppl.5059.
URI
https://scholars.duke.edu/individual/pub1436782
Source
crossref
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
36
Published Date
Start Page
5059
End Page
5059
DOI
10.1200/jco.2018.36.15_suppl.5059