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

Recurrent Glioblastoma Treated with Recombinant Poliovirus.

BACKGROUND: The prognosis of patients with recurrent World Health Organization (WHO) grade IV malignant glioma is dismal, and there is currently no effective therapy. We conducted a dose-finding and toxicity study in this population of patients, evaluating convection-enhanced, intratumoral delivery of the recombinant nonpathogenic polio-rhinovirus chimera (PVSRIPO). PVSRIPO recognizes the poliovirus receptor CD155, which is widely expressed in neoplastic cells of solid tumors and in major components of the tumor microenvironment. METHODS: We enrolled consecutive adult patients who had recurrent supratentorial WHO grade IV malignant glioma, confirmed on histopathological testing, with measurable disease (contrast-enhancing tumor of ≥1 cm and ≤5.5 cm in the greatest dimension). The study evaluated seven doses, ranging between 107 and 1010 50% tissue-culture infectious doses (TCID50), first in a dose-escalation phase and then in a dose-expansion phase. RESULTS: From May 2012 through May 2017, a total of 61 patients were enrolled and received a dose of PVSRIPO. Dose level -1 (5.0×107 TCID50) was identified as the phase 2 dose. One dose-limiting toxic effect was observed; a patient in whom dose level 5 (1010 TCID50) was administered had a grade 4 intracranial hemorrhage immediately after the catheter was removed. To mitigate locoregional inflammation of the infused tumor with prolonged glucocorticoid use, dose level 5 was deescalated to reach the phase 2 dose. In the dose-expansion phase, 19% of the patients had a PVSRIPO-related adverse event of grade 3 or higher. Overall survival among the patients who received PVSRIPO reached a plateau of 21% (95% confidence interval, 11 to 33) at 24 months that was sustained at 36 months. CONCLUSIONS: Intratumoral infusion of PVSRIPO in patients with recurrent WHO grade IV malignant glioma confirmed the absence of neurovirulent potential. The survival rate among patients who received PVSRIPO immunotherapy was higher at 24 and 36 months than the rate among historical controls. (Funded by the Brain Tumor Research Charity and others; ClinicalTrials.gov number, NCT01491893 .).
Authors
Desjardins, A; Gromeier, M; Herndon, JE; Beaubier, N; Bolognesi, DP; Friedman, AH; Friedman, HS; McSherry, F; Muscat, AM; Nair, S; Peters, KB; Randazzo, D; Sampson, JH; Vlahovic, G; Harrison, WT; McLendon, RE; Ashley, D; Bigner, DD
MLA Citation
Desjardins, Annick, et al. “Recurrent Glioblastoma Treated with Recombinant Poliovirus..” N Engl J Med, vol. 379, no. 2, July 2018, pp. 150–61. Pubmed, doi:10.1056/NEJMoa1716435.
URI
https://scholars.duke.edu/individual/pub1326086
PMID
29943666
Source
pubmed
Published In
The New England Journal of Medicine
Volume
379
Published Date
Start Page
150
End Page
161
DOI
10.1056/NEJMoa1716435

Phase 1 dose escalation trial of the safety and pharmacokinetics of cabozantinib concurrent with temozolomide and radiotherapy or temozolomide after radiotherapy in newly diagnosed patients with high-grade gliomas.

BACKGROUND: Cabozantinib inhibits mesenchymal-epithelial transition factor (MET) and vascular endothelial growth factor receptor 2 (VEGFR2) and has demonstrated activity in patients with recurrent glioblastoma, warranting evaluation of the addition of cabozantinib to radiotherapy (RT) and temozolomide (TMZ) for patients with newly diagnosed high-grade glioma. METHODS: Cabozantinib doses of 40 mg and 60 mg were explored. Patients on the concurrent treatment arm received cabozantinib daily with standard TMZ and after RT continued cabozantinib daily with adjuvant TMZ. In the maintenance arm, patients who completed RT and ≥1 adjuvant cycle of TMZ continued adjuvant TMZ with added cabozantinib (3 schedules: days 1-28, days 1-14, or days 8-21). RESULTS: A total of 26 patients (25 with recurrent glioblastoma and 1 patient with anaplastic astrocytoma) aged 30 to 72 years were enrolled (10 to the concurrent arm and 16 to the maintenance arm). The median number of post-RT TMZ cycles was 4.5 (range, 0-14 cycles) in the concurrent arm and 5.5 (range, 1-12 cycles) in the maintenance arm. Cabozantinib at a dose of 60 mg daily was the maximum administered dose and a dose of 40 mg daily was determined to be the maximum tolerated dose for both treatment arms (schedule of days 1-28). The most frequent grade 3/4 adverse events were thrombocytopenia (31% of patients), leukopenia (27% of patients, including 5 patients with neutropenia), and deep vein thrombosis and/or pulmonary embolism (23% of patients) (adverse events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events [version 3.0]). CONCLUSIONS: Cabozantinib at a dose of 40 mg daily with RT plus TMZ and post-RT TMZ for patients with newly diagnosed high-grade glioma was generally well tolerated, and demonstrated no pharmacokinetic interactions with concurrent TMZ. Given the strong theoretical rationale for combining anti-VEGF and anti-MET activity with standard therapy, cabozantinib at a dose of 40 mg daily warrants evaluation in combination with standard therapy for patients with newly diagnosed glioblastoma.
Authors
Schiff, D; Desjardins, A; Cloughesy, T; Mikkelsen, T; Glantz, M; Chamberlain, MC; Reardon, DA; Wen, PY
URI
https://scholars.duke.edu/individual/pub1104803
PMID
26588662
Source
pubmed
Published In
Cancer
Volume
122
Published Date
Start Page
582
End Page
587
DOI
10.1002/cncr.29798

SM-02 * LEVETIRACETAM USAGE IN POST-OPERATIVE SEIZURE MANAGEMENT IN MALIGNANT GLIOMA

Authors
Kang, J; Desjardins, A; Healy, P; Herndon, J; Lipp, E; Peters, K; Vlahovic, G; Sampson, J; Friedman, H; Friedman, A; Adamson, C
MLA Citation
Kang, J., et al. “SM-02 * LEVETIRACETAM USAGE IN POST-OPERATIVE SEIZURE MANAGEMENT IN MALIGNANT GLIOMA.” Neuro Oncology, vol. 16, no. suppl 5, Oxford University Press (OUP), Nov. 2014, pp. v206–v206. Crossref, doi:10.1093/neuonc/nou277.2.
URI
https://scholars.duke.edu/individual/pub1071019
Source
crossref
Published In
Neuro Oncology
Volume
16
Published Date
Start Page
v206
End Page
v206
DOI
10.1093/neuonc/nou277.2