Harry Erba

Overview:

I am a clinical investigator in the Division of Hematologic Malignancies and Cellular Therapy in the Department of Medicine.  I serve as Director of the Leukemia Program and Director of Phase I Development in Hematologic Malignancies.  I am also the Chair of the SWOG Leukemia Committee.  I am interested in the clinical development of novel therapies for acute myeloid leukemia, myelodysplastic syndromes, myeloproliferative neoplasms (such as chronic myeloid leukemia, polycythemia vera, essential thrombocythemia and myelofibrosis), and acute lymphoblastic leukemia.  Specifically, I have been the Principal Investigator for small molecular inhibitors, antibody-drug conjugates and cytotoxic chemotherapy.  

Positions:

Instructor in the Department of Medicine

Medicine, Hematologic Malignancies and Cellular Therapy
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1988

Stanford University, School of Medicine

Ph.D. 1988

Stanford University

Residency Physician, Medicine

Brigham and Women's Hospital

Clinical Fellow in Medicine, Medicine

Harvard Medical School

Research/Clinical Fellowship in Medicine, Medicine

Brigham and Women's Hospital

Research Fellowship in Medicine, Medicine

Harvard Medical School

Grants:

A PHASE 1 STUDY OF DS-3032B IN COMBINATION WITH QUIZARTINIB IN SUBJECTS WITH FLT3-ITD MUTANT ACUTE MYELOID LEUKEMIA THAT ARE RELAPSED/REFRACTORY, OR NEWLY DIAGNOSED AND UNFIT FOR INTENSIVE CHEMOTHERAPY

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

A Phase I Study of DS-3201B in Subjects With Acute Myelogenous Leukemia (AML) Or Acute Lymphocytic Leukemia (ALL)

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

A Phase III Randomized, Double-Blind Trial to Evaluate the Efficacy of Uproleselan Administered with Chemotherapy versus Chemotherapy Alone in Patients with Relapsed/Refractory Acute Myeloid Leukemia

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

A phase 1, Multi-center, open-label study of IMGN632 administered intravenously in patients with relapsed/refractory CD123-positive acute myeloid leukemia and other CD123-positive hematologic mali

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

NCTN Network Group Operations Center

Administered By
Medicine, Hematologic Malignancies and Cellular Therapy
Role
Principal Investigator
Start Date
End Date

Publications:

Adverse event burden in older patients with CLL receiving bendamustine plus rituximab or ibrutinib regimens: Alliance A041202.

Ibrutinib has superior progression-free survival compared with bendamustine plus rituximab (BR) in older CLL patients, however, differences in treatment duration, six monthly BR cycles versus continuous ibrutinib, complicate adverse event (AE) comparisons. We introduce the AE burden score (AEsc) to compare AEs, calculated for each patient by summing over products of reporting period length and grade for each all-cause grade 1-4 AE and dividing by the length of time over which AEs are assessed. A total of 176 patients received BR and 361 ibrutinib alone or with six cycles of rituximab. At 38 months median follow-up, 64% remained on ibrutinib. Median AEsc was higher with BR versus ibrutinib in the first six cycles (7.2 versus 4.9, p < 0.0001). Within ibrutinib arms, median AEsc decreased significantly to 3.7 after six cycles (p < 0.0001). 10% and 14% of BR and ibrutinib patients discontinued treatment for AEs. In ibrutinib arms, cumulative incidence of grade 3 or higher atrial fibrillation, hypertension, and infection (AEs of clinical interest) at 12 months was 4.5%, 17.5%, and 12.8%, respectively, and increased more slowly thereafter to 7.7%, 25.4%, and 20.5% at 36 months. Analytical tools including the AEsc and cumulative incidence of AEs can help to better characterize AE burden over time. ClinicalTrials.gov identifier: NCT01886872.
Authors
Ruppert, AS; Booth, AM; Ding, W; Bartlett, NL; Brander, DM; Coutre, S; Brown, JR; Nattam, S; Larson, RA; Erba, H; Litzow, M; Owen, C; Kuzma, CS; Abramson, JS; Little, RF; Smith, SE; Stone, RM; Byrd, JC; Mandrekar, SJ; Woyach, JA
MLA Citation
Ruppert, Amy S., et al. “Adverse event burden in older patients with CLL receiving bendamustine plus rituximab or ibrutinib regimens: Alliance A041202.Leukemia, vol. 35, no. 10, Oct. 2021, pp. 2854–61. Pubmed, doi:10.1038/s41375-021-01342-x.
URI
https://scholars.duke.edu/individual/pub1488902
PMID
34274940
Source
pubmed
Published In
Leukemia
Volume
35
Published Date
Start Page
2854
End Page
2861
DOI
10.1038/s41375-021-01342-x

Measurable Residual Disease Does Not Preclude Prolonged Progression-free Survival in CLL Treated with Ibrutinib.

E1912 was a randomized phase 3 trial comparing indefinite ibrutinib plus six cycles of rituximab (IR) to six cycles of fludarabine, cyclophosphamide and rituximab (FCR) in untreated younger patients with CLL. We describe measurable residual disease (MRD) levels in E1912 over time and correlate them with clinical outcome. Undetectable MRD rates (< 1 CLL cell per 104 leukocytes) were 29.1%, 30.3%, 23.4% and 8.6% at 3, 12, 24 and 36 months for FCR, and significantly lower at 7.9%, 4.2% and 3.7% at 12, 24 and 36 months for IR, respectively. Undetectable MRD at 3, 12, 24 and 36 months was associated with longer progression-free survival (PFS) for the FCR arm with hazard ratios (MRD detectable / MRD undetectable) of 4.29 (95% CI 1.89 - 9.71), 3.91 (95% CI 1.39 - 11.03), 14.12 (95% CI 1.78 - 111.73), and not estimable (no events among those with undetectable MRD), respectively. For the IR arm, patients with detectable MRD did not have significantly worse PFS compared to those in whom MRD was undetectable; however, PFS was longer for those with MRD levels of less than 10-1 compared to those with MRD levels above this threshold. Our observations provide additional support for the use of MRD as a surrogate endpoint for PFS in patients receiving FCR. For patients on indefinite ibrutinib-based therapy, PFS did not differ significantly by undetectable MRD status, while those with MRD less than 10-1 tend to have longer PFS, although continuation of ibrutinib is very likely required to maintain treatment efficacy.
Authors
Wang, V; Hanson, CA; Tschumper, R; Lesnick, C; Braggio, E; Paietta, E; O'Brien, SM; Barrientos, J; Leis, JF; Zhang, CC; Coutre, SE; Barr, PM; Cashen, AF; Mato, AR; Singh, AK; Mullane, MP; Erba, HP; Stone, RM; Litzow, MR; Tallman, MS; Shanafelt, TD; Kay, NE
MLA Citation
Wang, Victoria, et al. “Measurable Residual Disease Does Not Preclude Prolonged Progression-free Survival in CLL Treated with Ibrutinib.Blood, Aug. 2021. Pubmed, doi:10.1182/blood.2020010146.
URI
https://scholars.duke.edu/individual/pub1494209
PMID
34407545
Source
pubmed
Published In
Blood
Published Date
DOI
10.1182/blood.2020010146

Morphologic leukemia-free state in acute myeloid leukemia is sufficient for successful allogeneic hematopoietic stem cell transplant.

Authors
Pabon, CM; Li, Z; Hennig, T; de Castro, C; Neff, JL; Horwitz, ME; LeBlanc, TW; Long, GD; Lopez, RD; Sung, AD; Chao, N; Gasparetto, C; Sarantopoulos, S; Adams, DB; Erba, H; Rizzieri, DA
MLA Citation
Pabon, Cindy M., et al. “Morphologic leukemia-free state in acute myeloid leukemia is sufficient for successful allogeneic hematopoietic stem cell transplant.Blood Cancer J, vol. 11, no. 5, May 2021, p. 92. Pubmed, doi:10.1038/s41408-021-00481-9.
URI
https://scholars.duke.edu/individual/pub1482850
PMID
33994546
Source
pubmed
Published In
Blood Cancer Journal
Volume
11
Published Date
Start Page
92
DOI
10.1038/s41408-021-00481-9

Personalized Prediction Model to Risk Stratify Patients With Myelodysplastic Syndromes.

PURPOSE: Patients with myelodysplastic syndromes (MDS) have a survival that can range from months to decades. Prognostic systems that incorporate advanced analytics of clinical, pathologic, and molecular data have the potential to more accurately and dynamically predict survival in patients receiving various therapies. METHODS: A total of 1,471 MDS patients with comprehensively annotated clinical and molecular data were included in a training cohort and analyzed using machine learning techniques. A random survival algorithm was used to build a prognostic model, which was then validated in external cohorts. The accuracy of the proposed model, compared with other established models, was assessed using a concordance (c)index. RESULTS: The median age for the training cohort was 71 years. Commonly mutated genes included SF3B1, TET2, and ASXL1. The algorithm identified chromosomal karyotype, platelet, hemoglobin levels, bone marrow blast percentage, age, other clinical variables, seven discrete gene mutations, and mutation number as having prognostic impact on overall and leukemia-free survivals. The model was validated in an independent external cohort of 465 patients, a cohort of patients with MDS treated in a prospective clinical trial, a cohort of patients with paired samples at different time points during the disease course, and a cohort of patients who underwent hematopoietic stem-cell transplantation. CONCLUSION: A personalized prediction model on the basis of clinical and genomic data outperformed established prognostic models in MDS. The new model was dynamic, predicting survival and leukemia transformation probabilities at different time points that are unique for a given patient, and can upstage and downstage patients into more appropriate risk categories.
Authors
Nazha, A; Komrokji, R; Meggendorfer, M; Jia, X; Radakovich, N; Shreve, J; Hilton, CB; Nagata, Y; Hamilton, BK; Mukherjee, S; Al Ali, N; Walter, W; Hutter, S; Padron, E; Sallman, D; Kuzmanovic, T; Kerr, C; Adema, V; Steensma, DP; Dezern, A; Roboz, G; Garcia-Manero, G; Erba, H; Haferlach, C; Maciejewski, JP; Haferlach, T; Sekeres, MA
MLA Citation
Nazha, Aziz, et al. “Personalized Prediction Model to Risk Stratify Patients With Myelodysplastic Syndromes.J Clin Oncol, vol. 39, no. 33, Nov. 2021, pp. 3737–46. Pubmed, doi:10.1200/JCO.20.02810.
URI
https://scholars.duke.edu/individual/pub1494210
PMID
34406850
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
39
Published Date
Start Page
3737
End Page
3746
DOI
10.1200/JCO.20.02810

Associations between complete remission and 2- to 3-year survival following 7 + 3 induction for acute myeloid leukemia.

Among acute myeloid leukemia (AML) patients treated with 7 + 3 induction, we evaluate the association between complete morphologic remission (CR) and long-term overall survival (OS) over four decades. We analyzed 1247 patients age ≤65 randomized to 7 + 3 arms from five SWOG studies. OS has improved over the four decades. Hazards for death in the two most recent studies fell after year 2. In multivariable models, decade of therapy was the most important variable with respect to long-term survival and CR by day 100 the second most important variable. Protocol/decade, which captures many factors not included in our multivariable model, was the most important predictor of being alive at year 2 or 3. The next most important factor was achievement of first CR by day 100.
Authors
Othus, M; Garcia-Manero, G; Godwin, J; Weick, J; Stirewalt, D; Appelbaum, F; Erba, H; Estey, E
MLA Citation
Othus, Megan, et al. “Associations between complete remission and 2- to 3-year survival following 7 + 3 induction for acute myeloid leukemia.Leuk Lymphoma, vol. 62, no. 8, Aug. 2021, pp. 1967–72. Pubmed, doi:10.1080/10428194.2021.1885663.
URI
https://scholars.duke.edu/individual/pub1477140
PMID
33719833
Source
pubmed
Published In
Leuk Lymphoma
Volume
62
Published Date
Start Page
1967
End Page
1972
DOI
10.1080/10428194.2021.1885663

Research Areas:

Leukemia
Lymphoblastic leukemia
Lymphocytic leukemia
Myelodysplastic Syndromes
Myelodysplastic-Myeloproliferative Diseases
Nonlymphoid leukemia