Thomas Sporn

Overview:

Mesothelioma, lung cancer, occupational and asbestos-related diseases

Positions:

Adjunct Associate Professor in the Department of Pathology

Pathology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.A. 1982

University of Vermont

M.D. 1986

Georgetown University

Resident, Pulmonary Diseases And Critical Care Medicine

Georgetown University

Resident, Pathology

Duke University

Forensic Pathologist/Assistant Chief Medical Examiner, Pathology

University of North Carolina - Chapel Hill

Resident, Pathology

Duke University

Pulmonary Fellow, Pathology

Duke University

Grants:

Phase I/II Trial of ZD1839 and Celecoxib in Ex-Smokers

Administered By
Medicine, Medical Oncology
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Publications:

Mesothelioma Pathology

Authors
Pavlisko, E; Carney, J; Sporn, T; Roggli, V
MLA Citation
Pavlisko, Elizabeth, et al. “Mesothelioma Pathology.” Current Cancer Research: Asbestos and Mesothelioma, edited by J. Testa, Springer International Publishing, 2017, pp. 131–60.
URI
https://scholars.duke.edu/individual/pub1471817
Source
manual
Published Date
Start Page
131
End Page
160

Perioperative outcomes of pulmonary resection after neoadjuvant pembrolizumab in patients with non-small cell lung cancer.

OBJECTIVES: Pembrolizumab is a programmed death receptor-1 masking antibody approved for metastatic non-small cell lung cancer. This Phase 2 study (NCT02818920) of neoadjuvant pembrolizumab in non-small cell lung cancer had a primary end point of safety and secondary end points of efficacy and correlative science. METHODS: Patients with untreated clinical stage IB to IIIA non-small cell lung cancer were enrolled. Two cycles of pembrolizumab (200 mg) were administered before surgery. Standard adjuvant chemotherapy and radiation were encouraged but not required. Four cycles of adjuvant pembrolizumab were provided. RESULTS: Of 35 patients enrolled, 30 received neoadjuvant pembrolizumab and 25 underwent lung resection. Only 1 patient had a delay before surgery attributed to pembrolizumab; this was due to thyroiditis. All patients underwent anatomic resection and mediastinal lymph node dissection; the majority (18/25%, 72%) of patients underwent lobectomy. Of the 25 patients, 23 had an initial minimally invasive approach (92%); 5 of these were converted to thoracotomy (21.7%). R0 resection was achieved in 22 patients (88%), and major pathologic response was observed in 7 of 25 patients (28%). The most common postoperative adverse event was atrial fibrillation, affecting 6 of 25 patients (24%). Median chest tube duration and length of stay were 3 and 4 days, respectively. One patient required readmission to the hospital within 30 days. There was no mortality within 90 days of surgery. CONCLUSIONS: In this study, pembrolizumab was safe and well tolerated in the neoadjuvant setting, and its use was not associated with excess surgical morbidity or mortality. Minimally invasive approaches are feasible in this patient population, but may be more challenging than in cases without neoadjuvant immunotherapy. Pathologic response was higher than typically observed with standard neoadjuvant chemotherapy.
Authors
Tong, BC; Gu, L; Wang, X; Wigle, DA; Phillips, JD; Harpole, DH; Klapper, JA; Sporn, T; Ready, NE; D'Amico, TA
MLA Citation
Tong, Betty C., et al. “Perioperative outcomes of pulmonary resection after neoadjuvant pembrolizumab in patients with non-small cell lung cancer.J Thorac Cardiovasc Surg, Apr. 2021. Pubmed, doi:10.1016/j.jtcvs.2021.02.099.
URI
https://scholars.duke.edu/individual/pub1482178
PMID
33985811
Source
pubmed
Published In
The Journal of Thoracic and Cardiovascular Surgery
Published Date
DOI
10.1016/j.jtcvs.2021.02.099

Response to letter regarding "Talc and mesothelioma: mineral fiber analysis of 65 cases with clinicopathological correlation".

Authors
Roggli, VL; Carney, JM; Sporn, TA; Pavlisko, EN
MLA Citation
Roggli, Victor L., et al. “Response to letter regarding "Talc and mesothelioma: mineral fiber analysis of 65 cases with clinicopathological correlation".Ultrastruct Pathol, vol. 44, no. 4–6, Nov. 2020, pp. 524–25. Pubmed, doi:10.1080/01913123.2020.1795019.
URI
https://scholars.duke.edu/individual/pub1452442
PMID
32700637
Source
pubmed
Published In
Ultrastruct Pathol
Volume
44
Published Date
Start Page
524
End Page
525
DOI
10.1080/01913123.2020.1795019

Multi-Institutional Prospective Validation of Prognostic mRNA Signatures in Early Stage Squamous Lung Cancer (Alliance).

INTRODUCTION: Surgical resection is curative for some patients with early lung squamous cell carcinoma. Staging and clinical factors do not adequately predict recurrence risk. We sought to validate the discriminative performance of proposed prognostic gene expression signatures at a level of rigor sufficient to support clinical use. METHODS: The two-stage validation used independent core laboratories, objective quality control standards, locked test parameters, and large multi-institutional specimen and data sets. The first stage validation confirmed a signature's ability to stratify patient survival. The second-stage validation determined which signature(s) optimally improved risk discrimination when added to baseline clinical predictors. Participants were prospectively enrolled in institutional (cohort I) or cooperative group (cohort II) biospecimen and data collection protocols. All cases underwent a central review of clinical, pathologic, and biospecimen parameters using objective criteria to determine final inclusion (cohort I: n = 249; cohort II: n = 234). Primary selection required that a signature significantly predict a 3-year survival after surgical resection in cohort I. Signatures meeting this criterion were further tested in cohort II, comparing risk prediction using baseline risk factors alone versus in combination with the signature. RESULTS: Male sex, advanced age, and higher stage were associated with shorter survival in cohort I and established a baseline clinical model. Of the three signatures validated in cohort I, one signature was validated in cohort II and statistically significantly enhanced the prognosis relative to the baseline model (C-index difference 0.122; p < 0.05). CONCLUSIONS: These results represent the first rigorous validation of a test appropriate to direct adjuvant treatment or clinical trials for patients with lung squamous cell carcinoma.
Authors
Bueno, R; Richards, WG; Harpole, DH; Ballman, KV; Tsao, M-S; Chen, Z; Wang, X; Chen, G; Chirieac, LR; Chui, MH; Franklin, WA; Giordano, TJ; Govindan, R; Joshi, M-B; Merrick, DT; Rivard, CJ; Sporn, T; van Bokhoven, A; Yu, H; Shepherd, FA; Watson, MA; Beer, DG; Hirsch, FR
MLA Citation
Bueno, Raphael, et al. “Multi-Institutional Prospective Validation of Prognostic mRNA Signatures in Early Stage Squamous Lung Cancer (Alliance).J Thorac Oncol, vol. 15, no. 11, Nov. 2020, pp. 1748–57. Pubmed, doi:10.1016/j.jtho.2020.07.005.
URI
https://scholars.duke.edu/individual/pub1453144
PMID
32717408
Source
pubmed
Published In
J Thorac Oncol
Volume
15
Published Date
Start Page
1748
End Page
1757
DOI
10.1016/j.jtho.2020.07.005

Talc and mesothelioma: mineral fiber analysis of 65 cases with clinicopathological correlation.

Malignant mesothelioma is strongly associated with prior asbestos exposure. Recently there has been interest in the role of talc exposure in the pathogenesis of mesothelioma. We have analyzed lung tissue samples from a large series of malignant mesothelioma patients. Asbestos bodies were counted by light microscopy and mineral fiber concentrations for fibers 5 µm or greater in length were determined by scanning electron microscopy equipped with an energy dispersive spectrometer. The values were compared with 20 previously published controls. Among 609 patients with mesothelioma, talc fibers were detected in 375 (62%) and exceeded our control values in 65 (11%). Elevated talc levels were found in 48/524 men (9.2%) and 17/85 women (20%). Parietal pleural plaques were identified in 30/51 informative cases (59%) and asbestosis in 5/62 informative cases (8%). Commercial amphiboles (amosite and/or crocidolite) were elevated in 52/65 (80%) and noncommercial amphiboles (tremolite, actinolite or anthophyllite) in 41/65 (63%). Both were elevated in 34/65 (52%). Asbestos body counts by light microscopy were elevated in 53/64 informative cases (83%). A history of working in industries associated with asbestos exposure and increased mesothelioma risk was identified in 36/48 cases in men, and a history of exposure as household contacts of an occupationally exposed individual was identified in 12/17 cases in women. We conclude that among patients with mesothelioma, the vast majority have talc levels indistinguishable from background. Of the remaining 11% with elevated talc levels, the vast majority (80%) have elevated levels of commercial amphibole fibers.
Authors
Roggli, VL; Carney, JM; Sporn, TA; Pavlisko, EN
MLA Citation
Roggli, Victor L., et al. “Talc and mesothelioma: mineral fiber analysis of 65 cases with clinicopathological correlation.Ultrastruct Pathol, vol. 44, no. 2, Mar. 2020, pp. 211–18. Pubmed, doi:10.1080/01913123.2020.1737286.
URI
https://scholars.duke.edu/individual/pub1434817
PMID
32183579
Source
pubmed
Published In
Ultrastruct Pathol
Volume
44
Published Date
Start Page
211
End Page
218
DOI
10.1080/01913123.2020.1737286