Annick Desjardins

Positions:

Professor of Neurosurgery

Neurosurgery, Neuro-Oncology
School of Medicine

Professor in Neurology

Neurology, General & Community Neurology
School of Medicine

Associate Professor in Neurology

Neurology, General & Community Neurology
School of Medicine

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 (Canada)

Resident, Neurology

University of Sherbrooke (Canada)

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

Phase 1 Multicenter, Open-Label, Dose-Escalation, Combination Study of Marizomib and Bevacizumab-Naive Subjects with Grade IV Malignant Glioma

Administered By
Duke Cancer Institute
Role
Principal 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. MRZ112

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

Phase 2 study of SYM004 for adult patients with recurrent glioblastoma

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

Publications:

Primary brain tumor patients admitted to a US intensive care unit: a descriptive analysis.

Purpose: To describe our population of primary brain tumor (PBT) patients, a subgroup of cancer patients whose intensive care unit (ICU) outcomes are understudied. Methods: Retrospective analysis of PBT patients admitted to an ICU between 2013 to 2018 for an unplanned need. Using descriptive analyses, we characterized our population and their outcomes. Results: Fifty-nine PBT patients were analyzed. ICU mortality was 19% (11/59). The most common indication for admission was seizures (n = 16, 27%). Conclusion: Our ICU mortality of PBT patients was comparable to other solid tumor patients and the general ICU population and better than patients with hematological malignancies. Further study of a larger population would inform guidelines for triaging PBT patients who would most benefit from ICU-level care.
Authors
Kang, JH; Swisher, CB; Buckley, ED; Herndon, JE; Lipp, ES; Kirkpatrick, JP; Desjardins, A; Friedman, HS; Johnson, MO; Randazzo, DM; Ashley, DM; Peters, KB
MLA Citation
Kang, Jennifer H., et al. “Primary brain tumor patients admitted to a US intensive care unit: a descriptive analysis.Cns Oncol, vol. 10, no. 3, Sept. 2021, p. CNS77. Pubmed, doi:10.2217/cns-2021-0009.
URI
https://scholars.duke.edu/individual/pub1497219
PMID
34545753
Source
pubmed
Published In
Cns Oncology
Volume
10
Published Date
Start Page
CNS77
DOI
10.2217/cns-2021-0009

Repeatability of Automated Image Segmentation with BraTumIA in Patients with Recurrent Glioblastoma.

BACKGROUND AND PURPOSE: Despite high interest in machine-learning algorithms for automated segmentation of MRIs of patients with brain tumors, there are few reports on the variability of segmentation results. The purpose of this study was to obtain benchmark measures of repeatability for a widely accessible software program, BraTumIA (Versions 1.2 and 2.0), which uses a machine-learning algorithm to segment tumor features on contrast-enhanced brain MR imaging. MATERIALS AND METHODS: Automatic segmentation of enhancing tumor, tumor edema, nonenhancing tumor, and necrosis was performed on repeat MR imaging scans obtained approximately 2 days apart in 20 patients with recurrent glioblastoma. Measures of repeatability and spatial overlap, including repeatability and Dice coefficients, are reported. RESULTS: Larger volumes of enhancing tumor were obtained on later compared with earlier scans (mean, 26.3 versus 24.2 mL for BraTumIA 1.2; P < .05; and 24.9 versus 22.9 mL for BraTumIA 2.0, P < .01). In terms of percentage change, repeatability coefficients ranged from 31% to 46% for enhancing tumor and edema components and from 87% to 116% for nonenhancing tumor and necrosis. Dice coefficients were highest (>0.7) for enhancing tumor and edema components, intermediate for necrosis, and lowest for nonenhancing tumor and did not differ between software versions. Enhancing tumor and tumor edema were smaller, and necrotic tumor larger using BraTumIA 2.0 rather than 1.2. CONCLUSIONS: Repeatability and overlap metrics varied by segmentation type, with better performance for segmentations of enhancing tumor and tumor edema compared with other components. Incomplete washout of gadolinium contrast agents could account for increasing enhancing tumor volumes on later scans.
Authors
Abu Khalaf, N; Desjardins, A; Vredenburgh, JJ; Barboriak, DP
MLA Citation
Abu Khalaf, N., et al. “Repeatability of Automated Image Segmentation with BraTumIA in Patients with Recurrent Glioblastoma.Ajnr Am J Neuroradiol, vol. 42, no. 6, June 2021, pp. 1080–86. Pubmed, doi:10.3174/ajnr.A7071.
URI
https://scholars.duke.edu/individual/pub1476557
PMID
33737270
Source
pubmed
Published In
Ajnr Am J Neuroradiol
Volume
42
Published Date
Start Page
1080
End Page
1086
DOI
10.3174/ajnr.A7071

Spiritual well-being and its association with health-related quality of life in primary brain tumor patients.

Background: Spirituality can impact patients' attitudes and decisions about treatment and end-of-life care when coping with cancer. Previous studies documented health-related quality of life (HRQoL) and spiritual well-being (SWB) as positively correlated within a general cancer patient population, but little is known about their association in the primary brain tumor population. We sought to measure SWB in primary brain tumor patients and evaluate whether it was associated with HRQoL. Methods: Six-hundred and six patients treated at The Preston Robert Tisch Brain Tumor Center at Duke between December 16, 2013 and February 28, 2014 with data in the PRoGREss registry are included in this retrospective analysis. Each patient completed the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 (FACIT-Sp-12) and -Fatigue (FACIT-F), and the Functional Assessment of Cancer Therapy-General and -Brain (FACT-G and FACT-Br). Results: Mean age was 49.1 years (SD = 13.5 years), male (N = 328, 54.1%), married (N = 404, 66.7%), at least college-educated (N = 381, 62.9%), and diagnosed with a high-grade glioma (N = 412, 68.0%). Multiple regression analyses were performed on both the FACT-G and the FACT-Br using the FACIT-Sp-12 sub-scales of Meaning/Peace and Faith, FACIT-F, belief in God or a higher power, prayer, gender, tumor grade, and Karnofsky Performance Status (KPS) as predictors. We found that greater SWB (measured by FACIT-Sp-12) was associated with better HRQoL (measured by FACT-G and FACT-Br; p < .0001). Conclusion: The association between reported SWB and reported improved HRQoL emphasizes the importance of spirituality in primary brain tumor patients, suggesting SWB must be considered in strategies to improve HRQoL.
Authors
Randazzo, DM; McSherry, F; Herndon, JE; Affronti, ML; Lipp, ES; Miller, ES; Woodring, S; Healy, P; Jackman, J; Crouch, B; Desjardins, A; Ashley, DM; Friedman, HS; Peters, KB
MLA Citation
Randazzo, Dina M., et al. “Spiritual well-being and its association with health-related quality of life in primary brain tumor patients.Neurooncol Pract, vol. 8, no. 3, June 2021, pp. 299–309. Pubmed, doi:10.1093/nop/npaa084.
URI
https://scholars.duke.edu/individual/pub1484423
PMID
34055377
Source
pubmed
Published In
Neuro Oncology Practice
Volume
8
Published Date
Start Page
299
End Page
309
DOI
10.1093/nop/npaa084

Very low mutation burden is a feature of inflamed recurrent glioblastomas responsive to cancer immunotherapy.

Several immunotherapy clinical trials in recurrent glioblastoma have reported long-term survival benefits in 10-20% of patients. Here we perform genomic analysis of tumor tissue from recurrent WHO grade IV glioblastoma patients acquired prior to immunotherapy intervention. We report that very low tumor mutation burden is associated with longer survival after recombinant polio virotherapy or after immune checkpoint blockade in recurrent glioblastoma patients. A relationship between tumor mutation burden and survival is not observed in cohorts of immunotherapy naïve newly diagnosed or recurrent glioblastoma patients. Transcriptomic analyses reveal an inverse relationship between tumor mutation burden and enrichment of inflammatory gene signatures in cohorts of recurrent, but not newly diagnosed glioblastoma tumors, implying that a relationship between tumor mutation burden and tumor-intrinsic inflammation evolves upon recurrence.
Authors
Gromeier, M; Brown, MC; Zhang, G; Lin, X; Chen, Y; Wei, Z; Beaubier, N; Yan, H; He, Y; Desjardins, A; Herndon, JE; Varn, FS; Verhaak, RG; Zhao, J; Bolognesi, DP; Friedman, AH; Friedman, HS; McSherry, F; Muscat, AM; Lipp, ES; Nair, SK; Khasraw, M; Peters, KB; Randazzo, D; Sampson, JH; McLendon, RE; Bigner, DD; Ashley, DM
MLA Citation
Gromeier, Matthias, et al. “Very low mutation burden is a feature of inflamed recurrent glioblastomas responsive to cancer immunotherapy.Nat Commun, vol. 12, no. 1, Jan. 2021, p. 352. Pubmed, doi:10.1038/s41467-020-20469-6.
URI
https://scholars.duke.edu/individual/pub1471754
PMID
33441554
Source
pubmed
Published In
Nature Communications
Volume
12
Published Date
Start Page
352
DOI
10.1038/s41467-020-20469-6

Adjuvant Radiation in Older Patients With Glioblastoma: A Retrospective Single Institution Analysis.

Objectives: Standard 6-week and hypofractionated 3-week courses of adjuvant radiation therapy (RT) are both options for older patients with glioblastoma (GBM), but deciding the optimal regimen can be challenging. This analysis explores clinical factors associated with selection of RT course, completion of RT, and outcomes following RT. Materials and Methods: This IRB-approved retrospective analysis identified patients ≥70 years old with GBM who initiated adjuvant RT at our institution between 2004 and 2016. We identified factors associated with standard or hypofractionated RT using the Cochran-Armitage trend test, estimated time-to-event endpoints using the Kaplan-Meier method, and found predictors of overall survival (OS) using Cox proportional hazards models. Results: Sixty-two patients with a median age of 74 (range 70-90) initiated adjuvant RT, with 43 (69%) receiving standard RT and 19 (31%) receiving hypofractionated RT. Selection of short-course RT was associated with older age (p = 0.04) and poor KPS (p = 0.03). Eight (13%) patients did not complete RT, primarily for hospice care due to worsening symptoms. After a median follow-up of 37 months, median OS was 12.3 months (95% CI 9.0-15.1). Increased age (p < 0.05), poor KPS (p < 0.0001), lack of MGMT methylation (p < 0.05), and lack of RT completion (p < 0.0001) were associated with worse OS on multivariate analysis. In this small cohort, GTV size and receipt of standard or hypofractionated RT were not associated with OS. Conclusions: In this cohort of older patients with GBM, age and KPS was associated with selection of short-course or standard RT. These regimens had similar OS, though a subset of patients experienced worsening symptoms during RT and discontinued treatment. Further investigation into predictors of RT completion and survival may help guide adjuvant therapies and supportive care for older patients.
Authors
Lee, JW; Kirkpatrick, JP; McSherry, F; Herndon, JE; Lipp, ES; Desjardins, A; Randazzo, DM; Friedman, HS; Ashley, DM; Peters, KB; Johnson, MO
MLA Citation
Lee, Jessica W., et al. “Adjuvant Radiation in Older Patients With Glioblastoma: A Retrospective Single Institution Analysis.Front Oncol, vol. 11, 2021, p. 631618. Pubmed, doi:10.3389/fonc.2021.631618.
URI
https://scholars.duke.edu/individual/pub1476558
PMID
33732649
Source
pubmed
Published In
Frontiers in Oncology
Volume
11
Published Date
Start Page
631618
DOI
10.3389/fonc.2021.631618