Thomas D'Amico

Overview:

Lung Cancer

1.Role of molecular markers in the prognosis and therapy of lung cancer
2.Genomic analysis lung cancer mutations


Esophageal Cancer

1.Role of molecular markers in the prognosis and therapy of esophageal cancer
2.Genomic analysis esophageal cancer mutations

Positions:

Gary Hock Distinguished Professor of Surgery

Surgery, Cardiovascular and Thoracic Surgery
School of Medicine

Professor of Surgery

Surgery, Cardiovascular and Thoracic Surgery
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1987

Columbia University

Grants:

Genetics, Inflammation & Post-op Cognitive Dysfunction

Administered By
Anesthesiology, Cardiothoracic
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Publications:

The immunotherapeutic landscape in non-small cell lung cancer and its surgical horizons.

Lung cancer continues to be a leading cause of cancer-related death worldwide. Despite tremendous advances in surgical technique, chemotherapy regimens, radiation, and targeted therapies, survival is <50% at 5 years. Immunotherapy, specifically immune checkpoint inhibitors (ICIs), demonstrates promise as a solution to this clinical problem. Several agents have been Food and Drug Administration-approved for locally advanced and metastatic non-small cell lung cancer (NSCLC). Further studies are now exploring the use of these agents in the neoadjuvant and adjuvant settings. Although ICIs have demonstrated meaningful efficacy in NSCLC and other advanced malignancies, they are not without adverse toxicities. Furthermore, there are minimal data on their use in the perioperative period. Here we discuss the current domain of ICIs and their surgical implications in NSCLC.
Authors
Rhodin, KE; Rucker, AJ; Ready, NE; D'Amico, TA; Antonia, SJ
MLA Citation
Rhodin, Kristen E., et al. “The immunotherapeutic landscape in non-small cell lung cancer and its surgical horizons..” J Thorac Cardiovasc Surg, Dec. 2019. Pubmed, doi:10.1016/j.jtcvs.2019.08.138.
URI
https://scholars.duke.edu/individual/pub1423626
PMID
31836182
Source
pubmed
Published In
The Journal of Thoracic and Cardiovascular Surgery
Published Date
DOI
10.1016/j.jtcvs.2019.08.138

Expression profiling of non-small cell lung carcinoma identifies metastatic genotypes based on lymph node tumor burden.

OBJECTIVE: This study hypothesized that non-small cell lung carcinoma cells from primary tumors isolated by laser capture microdissection would exhibit gene expression profiles associated with graded lymph node metastatic cell burden. METHODS: Non-small cell lung carcinoma tumors (n = 15) were classified on the basis of nodal metastatic cell burden by 2 methods, obtaining 3 groups: no metastasis, micrometastasis, and overt metastasis. We then performed microarray analysis on microdissected primary tumor cells and identified gene expression profiles associated with graded nodal tumor burden using a correlation-based selection algorithm coupled with cross-validation analysis. Hierarchical clustering showed the regrouping of tumor specimens; the classification inference was assessed with Fisher's exact test. We verified data for certain genes by using another independent assay. RESULTS: The 15 specimens clustered into 3 groups: cluster A predominated in specimens with overt nodal metastasis; cluster B had more specimens with nodal micrometastases; and cluster C included only specimens without nodal metastases. Cluster assignment was based on a validated 75-gene discriminatory subset. Notably, genes not previously associated with positive non-small cell lung carcinoma lymph node status were encountered in the profiling analysis. CONCLUSIONS: Microdissection, combined with microarray analysis, is a potentially powerful method to characterize the molecular profile of tumor cells. The 75-gene expression profiles representative of clusters A and B may define genotypes prone to metastasize. Overall, the 3 groups of tumor specimens clustered separately, suggesting that this approach may identify graded metastatic propensity. Further, genes singled out in clustering may yield insights into underlying metastatic mechanisms and may represent new therapeutic targets.
Authors
Hoang, CD; D'Cunha, J; Tawfic, SH; Gruessner, AC; Kratzke, RA; Maddaus, MA
MLA Citation
Hoang, Chuong D., et al. “Expression profiling of non-small cell lung carcinoma identifies metastatic genotypes based on lymph node tumor burden..” J Thorac Cardiovasc Surg, vol. 127, no. 5, May 2004, pp. 1332–41. Pubmed, doi:10.1016/j.jtcvs.2003.11.060.
URI
https://scholars.duke.edu/individual/pub767411
PMID
15115990
Source
pubmed
Published In
The Journal of Thoracic and Cardiovascular Surgery
Volume
127
Published Date
Start Page
1332
End Page
1341
DOI
10.1016/j.jtcvs.2003.11.060

Comment on "Can Minimally Invasive Esophagectomy Replace Open Esophagectomy for Esophageal Cancer? Latest Analysis of 24,233 Esophagectomies From the Japanese National Clinical Database".

Authors
Moris, D; Speicher, PJ; D'Amico, TA
MLA Citation
URI
https://scholars.duke.edu/individual/pub1422040
PMID
31726635
Source
pubmed
Published In
Ann Surg
Volume
270
Published Date
Start Page
e110
DOI
10.1097/SLA.0000000000003347

A Minimally Invasive Approach to Lobectomy After Induction Therapy Does Not Compromise Survival.

BACKGROUND: The objective of this study was to evaluate the impact of a VATS approach on outcomes in patients who underwent lobectomy after induction therapy. METHODS: Outcomes of patients with T2-T4, N0, M0 and T1-T4, N1-N2, M0 non-small-cell lung cancer (NSCLC) who received induction chemotherapy or chemoradiation followed by lobectomy in the National Cancer Data Base (NCDB) (2010-2014) were assessed using Kaplan-Meier, propensity score-matched, multivariable logistic regression and Cox proportional hazards analyses. RESULTS: In the NCDB, 2,887 lobectomy patients met inclusion criteria (VATS 676 [23%], Thoracotomy 2,211 [77%]). Of the VATS cases, patients who underwent induction chemoradiation were more likely to undergo conversion (aOR 1.70, p = 0.05). Compared to an open approach, VATS was associated with decreased length of stay (median: 5 days vs 6 days, P < 0.001) and no significant differences in 30-day mortality (VATS [1.5% (n=10)] vs open [2.6% (n=58)]; P=0.13) and 90-day mortality (VATS [3.7% (n=25)] vs open [5.6% (n=124)]; P=0.14). There were no significant differences in 5-year survival between the VATS and open groups in both the entire cohort (VATS [50.3%] vs open [52.3%]; P=0.83) and in a propensity score-matched analysis of 876 patients; furthermore, a VATS approach was also not associated with worse survival in multivariable analysis (HR = 1.02; 95% CI [0.86, 1.20]; P = 0.83). CONCLUSIONS: In this national analysis, a VATS approach for lobectomy in patients who received induction therapy for locally advanced NSCLC was not associated with worse short-term or long-term outcomes when compared to an open approach.
Authors
Jeffrey Yang, C-F; Nwosu, A; Mayne, NR; Wang, Y-Y; Raman, V; Meyerhoff, RR; D'Amico, TA; Berry, MF
MLA Citation
Jeffrey Yang, Chi-Fu, et al. “A Minimally Invasive Approach to Lobectomy After Induction Therapy Does Not Compromise Survival..” Ann Thorac Surg, Nov. 2019. Pubmed, doi:10.1016/j.athoracsur.2019.09.065.
URI
https://scholars.duke.edu/individual/pub1421840
PMID
31733187
Source
pubmed
Published In
The Annals of Thoracic Surgery
Published Date
DOI
10.1016/j.athoracsur.2019.09.065

The Oldest Old: A National Analysis of Outcomes for Patients 90 Years or Older With Lung Cancer.

BACKGROUND: Most clinicians will encounter patients 90 years or older with non-small cell lung cancer (NSCLC), but evidence that informs treatment decisions for this extremely elderly population is lacking. This study evaluated outcomes associated with treatment strategies for this nonagenarian population. METHODS: Treatment and overall survival for patients 90 years and older with NSCLC in the National Cancer Data Base (2004-2014) were evaluated using logistic regression, the Kaplan-Meier method, and multivariable Cox proportional hazard models. RESULTS: The majority (n = 4152, 57.6%) of the 7205 patients 90 years or older with stage I-IV NSCLC did not receive any therapy. For the entire cohort, receiving treatment was associated with significantly better survival when compared with no therapy (5-year survival, 9.3% [95% confidence interval [CI], 8.0%-10.7%] vs 1.7% [95% CI, 1.2%-2.2%]; multivariable adjusted hazard ratio, 0.53; P < .001). Stage I patients had the most pronounced survival benefit with treatment (median survival, 27.4 months vs 10.0 months with no treatment; P < .001). Among this subset of patients with stage I disease (n = 1430), only 12.7% (n = 182) had surgery and 33% (n = 471) had no therapy. In these stage I patients surgery was associated with significantly better 5-year survival (33.7% [95% CI, 25.4%-42.1%]) than nonoperative therapy (17.1% [95% CI, 13.7%-20.8%]) and no therapy (6.2% [95% CI, 3.8%-9.4%]). CONCLUSIONS: Therapy for nonagenarians with NSCLC is associated with a significant survival benefit but is not used in most patients. Treatment should not be withheld for these "oldest old" patients based on their age alone but should be considered based on stage and patient preferences in a multidisciplinary setting.
Authors
Yang, C-FJ; Brown, AB; Deng, JZ; Lui, NS; Backhus, LM; Shrager, JB; D'Amico, TA; Berry, MF
MLA Citation
Yang, Chi-Fu Jeffrey, et al. “The Oldest Old: A National Analysis of Outcomes for Patients 90 Years or Older With Lung Cancer..” Ann Thorac Surg, Nov. 2019. Pubmed, doi:10.1016/j.athoracsur.2019.09.027.
URI
https://scholars.duke.edu/individual/pub1422357
PMID
31757356
Source
pubmed
Published In
The Annals of Thoracic Surgery
Published Date
DOI
10.1016/j.athoracsur.2019.09.027