Angeles Secord

Overview:

My primary research interest has focused on on novel therapeutics, biomarkers and clinical trial development for ovarian and endometrial cancer. My fundamental goal is to develop a strong translational research program at Duke University in the Gynecologic Oncology Division, where knowledge we glean from our basic science research can be incorporated into our clinical trial program. Specifically, my focus is on biologic therapy and molecular biomarkers to direct therapy in patients with ovarian and endometrial cancers to determine if a strategy that incorporates both clinical and genomic information can improve clinical outcome, minimize unnecessary toxicity, and impact positively on quality of life.

In addition I am interested in robotic-assisted laparoscopic surgery for women with endometrial, ovarian and cervical cancers, as well as for benign gynecologic conditions.

Positions:

Professor of Obstetrics and Gynecology

Obstetrics and Gynecology, Gynecologic Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1994

University of Washington

Resident, Obstetrics & Gynecology

Duke University

Gynecologic Oncology Fellowship, Obstetrics & Gynecology

Duke University School of Medicine

Grants:

NCI National Clinical Trials Network U10 (Year 5)

Administered By
Duke Cancer Institute
Awarded By
National Institutes of Health
Role
Co-Principal Investigator
Start Date
End Date

Women with BRCA-mutated Advanced Stage Ovarian Cancer

Administered By
Duke Clinical Research Institute
Awarded By
AstraZeneca LP
Role
Co Investigator
Start Date
End Date

Assessing the relevance of weighted values in the ASCO value framework in ovarian cancer patients

Administered By
Obstetrics and Gynecology, Gynecologic Oncology
Awarded By
Gynecologic Oncology Group
Role
Investigator
Start Date
End Date

Predictive value of the IL6 pathway to direct anti-angiogenic therapy in advanced ovarian cancer

Administered By
Obstetrics and Gynecology, Gynecologic Oncology
Awarded By
American Association of Obstetricians and Gynecologists Foundation
Role
Principal Investigator
Start Date
End Date

Biomarker Discovery to Direct Bevacizumab Therapy in Ovarian Cancer - Blood-based Angiome Profiling

Administered By
Obstetrics and Gynecology, Gynecologic Oncology
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Publications:

What proportion of patients with stage 3 ovarian cancer are potentially cured following intraperitoneal chemotherapy? Analysis of the long term (≥10 years) survivors in NRG/GOG randomized clinical trials of intraperitoneal and intravenous chemotherapy i

OBJECTIVE: Patients with advanced epithelial ovarian cancer (EOC) alive without progression at a landmark time-point of 10 years from diagnosis are likely cured. We report the proportion of patients with Stage III EOC who were long-term disease-free survivors (LTDFS≥10 years) following either intraperitoneal (IP) or intravenous (IV) chemotherapy as well as the predictors of LTDFS. METHODS: Data from 3 mature NRG/GOG trials (104, 114, 172) were analyzed and included demographics, clinicopathologic details, route of administration, and survival outcomes of patients living ≥10 years assessed according to the Kaplan-Meier method. Cox regression survival analysis was performed to evaluate independent prognostic predictors of LTDFS. RESULTS: Of 1174 patients randomized, 10-year overall survival (OS) was 26% (95% CI, 23-28%) and LTDFS ≥10 years was 18% (95% CI, 16-20%). Patients with LTDFS ≥10 years had a median age of 54.6 years (p < 0.001). Younger age (p < 0.001) was the only independent prognostic factor for LTDFS≥10 years on multivariate Cox analysis. CONCLUSIONS: Approximately 18% of patients were LTDFS ≥10 years. They form the tail end of the survival curve and are likely cured. Our results provide a comparative benchmark to evaluate the impact of PARP inhibitors in 1st line maintenance trials on survival outcomes.
Authors
Pitiyarachchi, O; Friedlander, M; Java, JJ; Chan, JK; Armstrong, DK; Markman, M; Herzog, TJ; Monk, BJ; Backes, F; Secord, AA; Bonebrake, A; Rose, PG; Tewari, KS; Lentz, SS; Geller, MA; Copeland, LJ; Mannel, RS
URI
https://scholars.duke.edu/individual/pub1529894
PMID
35835612
Source
pubmed
Published In
Gynecol Oncol
Published Date
DOI
10.1016/j.ygyno.2022.07.004

Olaparib With or Without Cediranib Versus Platinum-Based Chemotherapy in Recurrent Platinum-Sensitive Ovarian Cancer (NRG-GY004): A Randomized, Open-Label, Phase III Trial.

PURPOSE: Platinum-based chemotherapy is the standard of care for platinum-sensitive ovarian cancer, but complications from repeated platinum therapy occur. We assessed the activity of two all-oral nonplatinum alternatives, olaparib or olaparib/cediranib, versus platinum-based chemotherapy. PATIENTS AND METHODS: NRG-GY004 is an open-label, randomized, phase III trial conducted in the United States and Canada. Eligible patients had high-grade serous or endometrioid platinum-sensitive ovarian cancer. Patients were randomly assigned 1:1:1 to platinum-based chemotherapy, olaparib, or olaparib/cediranib. The primary end point was progression-free survival (PFS) in the intention-to-treat population. Secondary end points included activity within germline BRCA-mutated or wild-type subgroups and patient-reported outcomes (PROs). RESULTS: Between February 04, 2016, and November 13, 2017, 565 eligible patients were randomly assigned. Median PFS was 10.3 (95% CI, 8.7 to 11.2), 8.2 (95% CI, 6.6 to 8.7), and 10.4 (95% CI, 8.5 to 12.5) months with chemotherapy, olaparib, and olaparib/cediranib, respectively. Olaparib/cediranib did not improve PFS versus chemotherapy (hazard ratio [HR] 0.86; 95% CI, 0.66 to 1.10; P = .077). In women with germline BRCA mutation, the PFS HR versus chemotherapy was 0.55 (95% CI, 0.32 to 0.94) for olaparib/cediranib and 0.63 (95% CI, 0.37 to 1.07) for olaparib. In women without a germline BRCA mutation, the PFS HR versus chemotherapy was 0.97 (95% CI, 0.73 to 1.30) for olaparib/cediranib and 1.41 (95% CI, 1.07 to 1.86) for olaparib. Hematologic adverse events occurred more commonly with chemotherapy; however, nonhematologic adverse events were higher with olaparib/cediranib. In 489 patients evaluable for PROs, patients receiving olaparib/cediranib scored on average 1.1 points worse on the NFOSI-DRS-P subscale (97.5% CI, -2.0 to -0.2, P = .0063) versus chemotherapy; no difference between olaparib and chemotherapy was observed. CONCLUSION: Combination olaparib/cediranib did not improve PFS compared with chemotherapy and resulted in reduced PROs. Notably, in patients with a germline BRCA mutation, both olaparib and olaparib/cediranib had significant clinical activity.
Authors
Liu, JF; Brady, MF; Matulonis, UA; Miller, A; Kohn, EC; Swisher, EM; Cella, D; Tew, WP; Cloven, NG; Muller, CY; Bender, DP; Moore, RG; Michelin, DP; Waggoner, SE; Geller, MA; Fujiwara, K; D'Andre, SD; Carney, M; Alvarez Secord, A; Moxley, KM; Bookman, MA
MLA Citation
Liu, Joyce F., et al. “Olaparib With or Without Cediranib Versus Platinum-Based Chemotherapy in Recurrent Platinum-Sensitive Ovarian Cancer (NRG-GY004): A Randomized, Open-Label, Phase III Trial.J Clin Oncol, vol. 40, no. 19, July 2022, pp. 2138–47. Pubmed, doi:10.1200/JCO.21.02011.
URI
https://scholars.duke.edu/individual/pub1526827
PMID
35290101
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
40
Published Date
Start Page
2138
End Page
2147
DOI
10.1200/JCO.21.02011

The ProMisE of uniform care for endometrial cancer patients.

Authors
Maxwell, GL; Secord, AA; Powell, MA
MLA Citation
Maxwell, G. Larry, et al. “The ProMisE of uniform care for endometrial cancer patients.Gynecol Oncol, vol. 165, no. 2, May 2022, pp. 199–200. Pubmed, doi:10.1016/j.ygyno.2022.04.006.
URI
https://scholars.duke.edu/individual/pub1520495
PMID
35504672
Source
pubmed
Published In
Gynecol Oncol
Volume
165
Published Date
Start Page
199
End Page
200
DOI
10.1016/j.ygyno.2022.04.006

Novel Therapies in Gynecologic Cancer.

During the past decade, considerable strides have been made in the understanding and treatment of gynecologic cancers. The advent of PARP inhibitors, antiangiogenic therapies, immunotherapy combinations, and targeted agents have altered the standard of care in ovarian, endometrial, and cervical cancers. However, continued advancement in the treatment of gynecologic cancers is critical. Fortunately, exciting work defining new therapeutic targets and novel treatment strategies is on the horizon. Here, we discuss emerging treatments for gynecologic cancers, including endometrial, cervical, ovarian, and rare gynecologic cancers. We highlight research that has deepened our understanding of the unique biology and molecular underpinnings of these cancers and is being translated into powerful new treatment approaches. We particularly highlight the advent of immunotherapy in endometrial cancer; radiosensitizers in cervical, vaginal, and vulvar cancers; targeted therapies in ovarian cancer; and molecularly driven approaches to treat rare gynecologic cancers. Continued basic, translational, and clinical research holds the promise to change the landscape of gynecologic cancer and improve the lives of all women impacted by these diseases.
Authors
Bejar, FG; Oaknin, A; Williamson, C; Mayadev, J; Peters, PN; Secord, AA; Wield, AM; Coffman, LG
MLA Citation
Bejar, Francisco Grau, et al. “Novel Therapies in Gynecologic Cancer.Am Soc Clin Oncol Educ Book, vol. 42, Apr. 2022, pp. 1–17. Pubmed, doi:10.1200/EDBK_351294.
URI
https://scholars.duke.edu/individual/pub1521755
PMID
35594502
Source
pubmed
Published In
Am Soc Clin Oncol Educ Book
Volume
42
Published Date
Start Page
1
End Page
17
DOI
10.1200/EDBK_351294

Randomized Phase III Trial of Paclitaxel and Carboplatin Versus Paclitaxel and Ifosfamide in Patients With Carcinosarcoma of the Uterus or Ovary: An NRG Oncology Trial.

PURPOSE: This phase III randomized trial (NCT00954174) tested the null hypothesis that paclitaxel and carboplatin (PC) is inferior to paclitaxel and ifosfamide (PI) for treating uterine carcinosarcoma (UCS). PATIENTS AND METHODS: Adults with chemotherapy-naïve UCS or ovarian carcinosarcoma (OCS) were randomly assigned to PC or PI with 3-week cycles for 6-10 cycles. With 264 events in patients with UCS, the power for an overall survival (OS) hybrid noninferiority design was 80% for a null hazard ratio (HR) of 1.2 against a 13% greater death rate on PI with a type I error of 5% for a one-tailed test. RESULTS: The study enrolled 536 patients with UCS and 101 patients with OCS, with 449 and 90 eligible, respectively. Primary analysis was on patients with UCS, distributed as follows: 40% stage I, 6% stage II, 31% stage III, 15% stage IV, and 8% recurrent. Among eligible patients with UCS, PC was assigned to 228 and PI to 221. PC was not inferior to PI. The median OS was 37 versus 29 months (HR = 0.87; 90% CI, 0.70 to 1.075; P < .01 for noninferiority, P > .1 for superiority). The median progression-free survival was 16 versus 12 months (HR = 0.73; P = < 0.01 for noninferiority, P < .01 for superiority). Toxicities were similar, except that more patients in the PC arm had hematologic toxicity and more patients in the PI arm had confusion and genitourinary hemorrhage. Among 90 eligible patients with OCS, those in the PC arm had longer OS (30 v 25 months) and progression-free survival (15 v 10 months) than those in the PI arm, but with limited precision, these differences were not statistically significant. CONCLUSION: PC was not inferior to the active regimen PI and should be standard treatment for UCS.
Authors
Powell, MA; Filiaci, VL; Hensley, ML; Huang, HQ; Moore, KN; Tewari, KS; Copeland, LJ; Secord, AA; Mutch, DG; Santin, A; Warshal, DP; Spirtos, NM; DiSilvestro, PA; Ioffe, OB; Miller, DS
MLA Citation
Powell, Matthew A., et al. “Randomized Phase III Trial of Paclitaxel and Carboplatin Versus Paclitaxel and Ifosfamide in Patients With Carcinosarcoma of the Uterus or Ovary: An NRG Oncology Trial.J Clin Oncol, vol. 40, no. 9, Mar. 2022, pp. 968–77. Pubmed, doi:10.1200/JCO.21.02050.
URI
https://scholars.duke.edu/individual/pub1506010
PMID
35007153
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
40
Published Date
Start Page
968
End Page
977
DOI
10.1200/JCO.21.02050