Annick Desjardins

Positions:

Associate Professor of Neurosurgery

Neurosurgery, Neuro-Oncology
School of Medicine

Associate Professor in Neurology

Neurology, General & Community Neurology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1998

University of Sherbrooke

Resident, Neurology

University of Sherbrooke

Fellow in Neuro-Oncology, Medicine

Duke University

Grants:

Phase 3 randomized, open-label study to evaluate Eflornithine with Lomustine compared to Lomustine (STELLAR) alone in patients with Anaplastic Astrocytoma

Administered By
Duke Cancer Institute
Role
Principal Investigator
Start Date
End Date

Ph1 Study of Marizomib and Bevacizumab-Naive Subjects with Grade IV Malignant Glioma

Administered By
Duke Cancer Institute
Role
Principal Investigator
Start Date
End Date

Establishing a Rationale for PVSRIPO Immunotherapy in Newly Diagnosed GBM

Administered By
Neurosurgery
Role
Investigator
Start Date
End Date

Phase 1b, Multicenter, Open-Label Study of Marizomib with Temozolomide and Radiotherapy in Patients with Newly Diagnosed WHO Grade IV Malignant Glioma

Administered By
Duke Cancer Institute
Role
Principal Investigator
Start Date
End Date

A Phase 1 Dose Escalation Study Evaluating the Safety and Tolerability of PF-06840003 in Patients with Malignant Glioma

Administered By
Duke Cancer Institute
Role
Principal Investigator
Start Date
End Date

Publications:

Second primary cancers in long-term survivors of glioblastoma.

Background: Overall survival (OS) in glioblastoma (GBM) is poor at an average of 14 to 18 months, and long-term survivors (LTS) of GBM are rare. LTS of GBM, defined as surviving >5 years postdiagnosis, represent only 2% to 10% of all GBM patients. LTS of cancer are at high risk of developing second primary neoplasms. This study looks at occurrences of second primary neoplasms in LTS of GBM. Methods: Records from adult patients newly diagnosed with GBM between January 1, 1998 and February 8, 2010, were retrospectively reviewed to identify LTS, defined as patients who survived ≥5 years. We focused on the identification of a new diagnosis of cancer occurring at least 2 years after the initial GBM diagnosis. Results: We identified 155 LTS of GBM, with a median OS of 11.0 years (95% CI: 9.0 to 13.1 years) and a median follow-up of 9.6 years (95% CI: 8.7 to 10.7 years). In this cohort of patients, 13 (8.4%) LTS of GBM developed 17 secondary cancers. Eight could potentially be attributed to previous radiation and chemotherapy (skin cancer in radiation field [n = 4], leukemia [n = 2], low-grade glioma [n = 1], and sarcoma of the scalp [n = 1]). The other 9 cases included melanoma (n = 2), prostate cancer (n = 2), bladder cancer (n = 1), endometrioid adenocarcinoma (n = 1), basal cell carcinoma (n = 1), and renal cell carcinoma (n = 1). Conclusions: Although second primary cancers are rare in GBM LTS, providers should continue close monitoring with appropriate oncologic care. Moreover, this highlights the need for survivorship care of patients with GBM.
Authors
Kim, J-Y; Jackman, JG; Woodring, S; McSherry, F; Herndon, JE; Desjardins, A; Friedman, HS; Peters, KB
MLA Citation
Kim, Jung-Young, et al. “Second primary cancers in long-term survivors of glioblastoma..” Neurooncol Pract, vol. 6, no. 5, Sept. 2019, pp. 386–91. Pubmed, doi:10.1093/nop/npz001.
URI
https://scholars.duke.edu/individual/pub1411790
PMID
31555453
Source
pubmed
Published In
Neuro Oncology Practice
Volume
6
Published Date
Start Page
386
End Page
391
DOI
10.1093/nop/npz001

Randomized open-label phase II trial of 5-day aprepitant plus ondansetron compared to ondansetron alone in the prevention of chemotherapy-induced nausea-vomiting (CINV) in glioma patients receiving adjuvant temozolomide.

PURPOSE: CINV remains a distressing side effect experienced by glioma patients receiving multi-day temozolomide therapy, in spite of guideline-based antiemetic therapy with selective serotonin-receptor-antagonists. Antiemetic research with aprepitant has routinely excluded glioma patients. In this randomized open-label phase II study, use of a nonstandard 5-day regimen of aprepitant for glioma patients was investigated. METHODS: One hundred thirty-six glioma patients receiving their first cycle of adjuvant temozolomide (150-200 mg/m2/day × 5 days every 28 days) were randomized to Arm-A (ondansetron 8 mg days 1-5 with aprepitant day 1: 125 mg, days 2-5: 80 mg) or Arm-B (ondansetron). Randomization was stratified by tumor grade and number of prior chemotherapy regimens. The primary endpoint was the percentage of patients achieving complete control (CC), defined as no emetic episode or antiemetic rescue medication over the 7-day study period. Secondary endpoints included CINV efficacy in the acute phase (≤ 24 h) and delayed phase (days 2-7), as well as safety and quality of life (QoL). RESULTS: Patients were 61% male, 97% white, 48% with KPS > 90%, 60% non-smokers, mean age 54, 92% with low alcohol use, and 46% with a CINV history. The CC was 58.6% (Arm-A) and 54.5% (Arm-B). Acute-complete response (CR) rates, defined as CC on day 1 in Arm-A and -B, were 97.1% and 87.9%, respectively (p = 0.056). Treatment-related toxicities were mild or moderate in severity. CONCLUSIONS: Aprepitant plus ondansetron may increase acute-CR, may have benefit regarding CINV's effect on QoL, and is safe for 5-day temozolomide compared to ondansetron. This study provides no evidence that aprepitant increases CC rate over ondansetron alone.
Authors
Patel, MP; Woodring, S; Randazzo, DM; Friedman, HS; Desjardins, A; Healy, P; Herndon, JE; McSherry, F; Lipp, ES; Miller, E; Peters, KB; Affronti, ML
URI
https://scholars.duke.edu/individual/pub1406357
PMID
31440823
Source
pubmed
Published In
Support Care Cancer
Published Date
DOI
10.1007/s00520-019-05039-x

A cross sectional analysis from a single institution's experience of psychosocial distress and health-related quality of life in the primary brain tumor population.

Primary brain tumor patients experience high levels of distress. The purpose of this cross-sectional, retrospective study is to evaluate the level and different sources of psychosocial distress and how these pertain to health-related quality of life (HRQoL). The Primary and Recurrent Glioma registry at Duke's The Preston Robert Tisch Brain Tumor Center was queried retrospectively for demographic and clinical information on patients seen between December 2013 and February 2014. Data also included the National Comprehensive Cancer Network's Distress Thermometer (NCCN-DT), Functional Assessment of Cancer Therapy-Brain Cancer (FACT-Br), and Functional Assessment of Chronic Illness Therapy- Fatigue (FACIT-F). 829 subjects completed questionnaires. 54% were male; 96% completed the NCCN-DT; 33.3% had a DT score ≥4 (moderate/severe distress). Women reported DT ≥ 4 more often than men (38.6 vs 29.0%; p = 0.005). Patients within 1 year of diagnosis reported DT ≥ 4 more often than those 1+ years after diagnosis (38.8 vs 30.9%; p = 0.034). 73.0% reported physical problems; the most frequent being fatigue (43.2%) and memory/concentration (40.9%). 42.0% complained of emotional problems with worry (29.4%) and nervousness (22.4%) being the most common. Patients who reported at least one practical, family, emotional or physical problem had significantly lower HRQoL scores (p < 0.001). Primary brain tumor patients experience memory dysfunction, fatigue, nervousness, worry, and financial concerns, which have a negative effect on the patient's HRQoL. By identifying and addressing these stressors, it may be possible to improve patient HRQoL.
Authors
Randazzo, DM; McSherry, F; Herndon, JE; Affronti, ML; Lipp, ES; Flahiff, C; Miller, E; Woodring, S; Freeman, M; Healy, P; Minchew, J; Boulton, S; Desjardins, A; Vlahovic, G; Friedman, HS; Keir, S; Peters, KB
MLA Citation
Randazzo, Dina M., et al. “A cross sectional analysis from a single institution's experience of psychosocial distress and health-related quality of life in the primary brain tumor population..” J Neurooncol, vol. 134, no. 2, Sept. 2017, pp. 363–69. Pubmed, doi:10.1007/s11060-017-2535-4.
URI
https://scholars.duke.edu/individual/pub1264108
PMID
28669010
Source
pubmed
Published In
J Neurooncol
Volume
134
Published Date
Start Page
363
End Page
369
DOI
10.1007/s11060-017-2535-4

AT-20 * SINGLE INSTITUTION RETROSPECTIVE REVIEW OF PERFORMANCE STATUS AND CORTICOSTEROID USE IN NEWLY DIAGNOSED GLIOBLASTOMA (GBM) PATIENTS (PTS) TREATED ON BEVACIZUMAB (BEV)

Authors
Desjardins, A; Herndon, J; McSherry, F; Ravelo, A; Lipp, E; Healy, P; Peters, K; Vlahovic, G; Sampson, J; Friedman, A; Friedman, H
MLA Citation
Desjardins, A., et al. “AT-20 * SINGLE INSTITUTION RETROSPECTIVE REVIEW OF PERFORMANCE STATUS AND CORTICOSTEROID USE IN NEWLY DIAGNOSED GLIOBLASTOMA (GBM) PATIENTS (PTS) TREATED ON BEVACIZUMAB (BEV).” Neuro Oncology, vol. 16, no. suppl 5, Oxford University Press (OUP), Nov. 2014, pp. v12–13. Crossref, doi:10.1093/neuonc/nou237.20.
URI
https://scholars.duke.edu/individual/pub1071013
Source
crossref
Published In
Neuro Oncology
Volume
16
Published Date
Start Page
v12
End Page
v13
DOI
10.1093/neuonc/nou237.20

O6-methylguanine-DNA methyltransferase (MGMT) immunohistochemistry as a predictor of resistance to temozolomide in primary CNS lymphoma.

Temozolomide, an alkylating agent, has shown promise in treating primary central nervous system lymphoma (PCNSL). The enzyme O(6)-methylguanine-DNA methyltransferase (MGMT) repairs alkylating damage, such as that induced by temozolomide. We hypothesized that MGMT immunohistochemistry would predict resistance to temozolomide in PCNSL. A retrospective study of newly-diagnosed and recurrent PCNSL patients treated at our institution was conducted to study the predictive value of MGMT immunohistochemistry for response to temozolomide. 20 patients who were treated with temozolomide as a single agent were identified during the study time period. 6/20 patients demonstrated a response, corresponding to an objective response rate of 30 % (95 % CI 8-52). Five patients with low MGMT level (<30 %) showed a response to temozolomide. Only one of 10 patients (10 %) with high MGMT level (≥30 %) exhibited a response to temozolomide. Small sample numbers precluded formal statistical comparisons. Two patients with complete response remain alive without progressive disease 6.7 and 7.2 years after temozolomide initiation. Immunohistochemistry can be performed on small biopsies to selectively assess MGMT status in tumor versus surrounding inflammation. MGMT analysis by immunohistochemistry may predict response to temozolomide in PCNSL and should be prospectively investigated.
Authors
Jiang, X; Reardon, DA; Desjardins, A; Vredenburgh, JJ; Quinn, JA; Austin, AD; Herndon, JE; McLendon, RE; Friedman, HS
MLA Citation
Jiang, Xiaoyin, et al. “O6-methylguanine-DNA methyltransferase (MGMT) immunohistochemistry as a predictor of resistance to temozolomide in primary CNS lymphoma..” J Neurooncol, vol. 114, no. 1, Aug. 2013, pp. 135–40. Pubmed, doi:10.1007/s11060-013-1162-y.
URI
https://scholars.duke.edu/individual/pub962053
PMID
23686298
Source
pubmed
Published In
J Neurooncol
Volume
114
Published Date
Start Page
135
End Page
140
DOI
10.1007/s11060-013-1162-y