Linda Sutton

Overview:

Clinical

Positions:

Associate Professor of Medicine

Medicine, Medical Oncology
School of Medicine

Medical Director, Duke Oncology Consortium

Medicine
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1987

U Mass Memorial Medical Center

Resident, Internal Medicine

Montefiore Medical Center

Fellowship, Hematology/ Oncology

Duke University School of Medicine

Grants:

NCI National Clinical Trials Network (UG1)

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

Improving Adherence to Adjuvant Endocrine Therapy in Breast Cancer Patients

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

A Self-Management Intervention for Women with Breast Cancer and Diabetes

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Role
Co Investigator
Start Date
End Date

Caregiver-Assisting Coping Skills Training for Lung Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Spouse Guided Pain Management Training for Cancer Pain

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Publications:

Coping Skills Training and Acceptance and Commitment Therapy for Symptom Management: Feasibility and Acceptability of a Brief Telephone-Delivered Protocol for Patients With Advanced Cancer.

CONTEXT: Patients with advanced cancer face a life-limiting condition that brings a high symptom burden that often includes pain, fatigue, and psychological distress. Psychosocial interventions have promise for managing symptoms but need additional tailoring for these patients' specific needs. Patients with advanced cancer in the community also face persistent barriers-availability of interventions in community clinics as well as financial and illness-related factors-to accessing psychosocial interventions. OBJECTIVES: The aim of the present study was to assess the feasibility and acceptability of telephone implementation of Engage, a novel brief combined Coping Skills Training and Acceptance and Commitment Therapy protocol, for reducing symptoms and increasing quality of life in community patients with advanced cancer. METHODS: Adult patients with advanced cancer receiving care in the community received Engage, four 60-minute manualized telephone sessions delivered by a trained psychotherapist and completed pretreatment and post-treatment assessments. RESULTS: Engage was feasible, achieving 100% accrual (N = 24) of a heterogeneous sample of patients with advanced cancer, with good retention (88% completed). Acceptability was demonstrated via satisfaction (mean 29 of 32; SD 2), engagement (95% attendance), and use of skills. Secondary analyses pointed to reductions in pain interference, fatigue, psychological distress, and improvements in psychological acceptance and engagement in value-guided activity after treatment. CONCLUSION: Engage, our brief novel combined Coping Skills and Acceptance and Commitment Therapy intervention, demonstrated initial feasibility and acceptability when delivered over the telephone and increased access for community clinic patients with advanced cancer. Future research will assess the comparative efficacy of Engage in larger randomized trials.
Authors
Plumb Vilardaga, JC; Winger, JG; Teo, I; Owen, L; Sutton, LM; Keefe, FJ; Somers, TJ
MLA Citation
Plumb Vilardaga, Jennifer C., et al. “Coping Skills Training and Acceptance and Commitment Therapy for Symptom Management: Feasibility and Acceptability of a Brief Telephone-Delivered Protocol for Patients With Advanced Cancer..” J Pain Symptom Manage, Sept. 2019. Pubmed, doi:10.1016/j.jpainsymman.2019.09.005.
URI
https://scholars.duke.edu/individual/pub1411901
PMID
31539599
Source
pubmed
Published In
J Pain Symptom Manage
Published Date
DOI
10.1016/j.jpainsymman.2019.09.005

Randomized Trial of Standard Adjuvant Chemotherapy Regimens Versus Capecitabine in Older Women With Early Breast Cancer: 10-Year Update of the CALGB 49907 Trial.

PURPOSE: Older women with breast cancer remain under-represented in clinical trials. The Cancer and Leukemia Group B 49907 trial focused on women age 65 years and older. We previously reported the primary analysis after a median follow-up of 2.4 years. Standard adjuvant chemotherapy showed significant improvements in recurrence-free survival (RFS) and overall survival compared with capecitabine. We now update results at a median follow-up of 11.4 years. PATIENTS AND METHODS: Patients age 65 years or older with early breast cancer were randomly assigned to either standard adjuvant chemotherapy (physician's choice of either cyclophosphamide, methotrexate, and fluorouracil or cyclophosphamide and doxorubicin) or capecitabine. An adaptive Bayesian design was used to determine sample size and test noninferiority of capecitabine. The primary end point was RFS. RESULTS: The design stopped accrual with 633 patients at its first sample size assessment. RFS remains significantly longer for patients treated with standard chemotherapy. At 10 years, in patients treated with standard chemotherapy versus capecitabine, the RFS rates were 56% and 50%, respectively (hazard ratio [HR], 0.80; P = .03); breast cancer-specific survival rates were 88% and 82%, respectively (HR, 0.62; P = .03); and overall survival rates were 62% and 56%, respectively (HR, 0.84; P = .16). With longer follow-up, standard chemotherapy remains superior to capecitabine among hormone receptor-negative patients (HR, 0.66; P = .02), but not among hormone receptor-positive patients (HR, 0.89; P = .43). Overall, 43.9% of patients have died (13.1% from breast cancer, 16.4% from causes other than breast cancer, and 14.1% from unknown causes). Second nonbreast cancers occurred in 14.1% of patients. CONCLUSION: With longer follow-up, RFS remains superior for standard adjuvant chemotherapy versus capecitabine, especially in patients with hormone receptor-negative disease. Competing risks in this older population dilute overall survival benefits.
Authors
Muss, HB; Polley, M-YC; Berry, DA; Liu, H; Cirrincione, CT; Theodoulou, M; Mauer, AM; Kornblith, AB; Partridge, AH; Dressler, LG; Cohen, HJ; Kartcheske, PA; Perez, EA; Wolff, AC; Gralow, JR; Burstein, HJ; Mahmood, AA; Sutton, LM; Magrinat, G; Parker, BA; Hart, RD; Grenier, D; Hurria, A; Jatoi, A; Norton, L; Hudis, CA; Winer, EP; Carey, L
MLA Citation
Muss, Hyman B., et al. “Randomized Trial of Standard Adjuvant Chemotherapy Regimens Versus Capecitabine in Older Women With Early Breast Cancer: 10-Year Update of the CALGB 49907 Trial..” J Clin Oncol, vol. 37, no. 26, Sept. 2019, pp. 2338–48. Pubmed, doi:10.1200/JCO.19.00647.
URI
https://scholars.duke.edu/individual/pub1402479
PMID
31339827
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
37
Published Date
Start Page
2338
End Page
2348
DOI
10.1200/JCO.19.00647

Palliative care, Version 1.2014. Featured updates to the NCCN Guidelines.

The NCCN Guidelines for Palliative Care provide interdisciplinary recommendations on palliative care for patients with cancer. These NCCN Guidelines Insights summarize the NCCN panel's discussions and guideline updates from 2013 and 2014. These include modifications/additions to palliative care screening and assessment protocols, new considerations for discussing the benefits and risks of anticancer therapy, and approaches to advance care planning. Recent updates focus on enhanced patient-centered care and seek to promote earlier integration of palliative care and advance care planning in oncology.
Authors
Levy, MH; Smith, T; Alvarez-Perez, A; Back, A; Baker, JN; Block, S; Codada, SN; Dalal, S; Dans, M; Kutner, JS; Kvale, E; Misra, S; Mitchell, W; Sauer, TM; Spiegel, D; Sutton, L; Taylor, RM; Temel, J; Tickoo, R; Urba, SG; Van Zyl, C; Weinstein, SM; Bergman, MA; Scavone, JL; National Comprehensive Cancer Network,
MLA Citation
Levy, Michael H., et al. “Palliative care, Version 1.2014. Featured updates to the NCCN Guidelines..” J Natl Compr Canc Netw, vol. 12, no. 10, Oct. 2014, pp. 1379–88. Pubmed, doi:10.6004/jnccn.2014.0136.
URI
https://scholars.duke.edu/individual/pub1050704
PMID
25313178
Source
pubmed
Published In
J Natl Compr Canc Netw
Volume
12
Published Date
Start Page
1379
End Page
1388
DOI
10.6004/jnccn.2014.0136

Pharmacokinetics and clinical impact of all-trans retinoic acid in metastatic breast cancer: a phase II trial.

PURPOSE: The purpose of this trial was to evaluate tumor cytoreduction by all-trans retinoic acid (ATRA) in patients with metastatic breast cancer and to characterize the initial pharmacokinetics of this agent. METHODS: The study was a single institution, phase II study. The treatment regimen consisted of ATRA administered orally at a dose of 50 mg/m2 three times a day for 14 consecutive day of a 21-day cycle. Cycles were repeated until disease progression, unacceptable toxicity or patient withdrawal. Plasma samples were obtained following the first dose of ATRA for pharmacokinetic analysis. RESULTS: A total of 17 patients with metastatic breast cancer were enrolled in the study, and 14 completed at least one cycle of therapy and were evaluable for response. One patient achieved a partial response in soft tissue of 4 months duration. Three patients had stable disease for 4, 2, and 2 months duration. The remainder had progressive disease. ATRA was reasonably well tolerated. Pharmacokinetic analysis revealed a high degree of interpatient variability in systemic exposure following the initial dose of ATRA. CONCLUSIONS: We conclude, that in the dose and schedule tested, ATRA does not have significant activity in patients with hormone-refractory, metastatic breast cancer. Future studies should focus on more intensive investigation of those individuals with very high or low ATRA initial systemic exposure in the hope of expanding our understanding of ATRA's clinical pharmacology, ultimately leading to improved efficacy.
Authors
Sutton, LM; Warmuth, MA; Petros, WP; Winer, EP
MLA Citation
Sutton, L. M., et al. “Pharmacokinetics and clinical impact of all-trans retinoic acid in metastatic breast cancer: a phase II trial..” Cancer Chemother Pharmacol, vol. 40, no. 4, 1997, pp. 335–41. Pubmed, doi:10.1007/s002800050666.
URI
https://scholars.duke.edu/individual/pub801321
PMID
9225952
Source
pubmed
Published In
Cancer Chemotherapy and Pharmacology
Volume
40
Published Date
Start Page
335
End Page
341
DOI
10.1007/s002800050666

Development of a virtual multidisciplinary lung cancer tumor board in a community setting.

PURPOSE: Creating an effective platform for multidisciplinary tumor conferences can be challenging in the rural community setting. The Duke Cancer Network created an Internet-based platform for a multidisciplinary conference to enhance the care of patients with lung cancer. This conference incorporates providers from different physical locations within a rural community and affiliated providers from a university-based cancer center 2 hours away. An electronic Web conferencing tool connects providers aurally and visually. METHODS: Conferences were set up using a commercially available Web conferencing platform. The video platform provides a secure Web site coupled with a secure teleconference platform to ensure patient confidentiality. Multiple disciplines are invited to participate, including radiology, radiation oncology, thoracic surgery, pathology, and medical oncology. Participants only need telephone access and Internet connection to participate. RESULTS: Patient histories and physicals are presented, and the Web conferencing platform allows radiologic and histologic images to be reviewed. Treatment plans for patients are discussed, allowing providers to coordinate care among the different subspecialties. Patients who need referral to the affiliated university-based cancer center for specialized services are identified. Pertinent treatment guidelines and journal articles are reviewed. On average, there are 10 participants with one to two cases presented per session. CONCLUSION: The use of a Web conferencing platform allows subspecialty providers throughout the community and hours away to discuss lung cancer patient cases. This platform increases convenience for providers, eliminating travel to a central location. Coordination of care for patients requiring multidisciplinary care is facilitated, shortening evaluation time before definitive treatment plan.
Authors
Stevenson, MM; Irwin, T; Lowry, T; Ahmed, MZ; Walden, TL; Watson, M; Sutton, L
MLA Citation
Stevenson, Marvaretta M., et al. “Development of a virtual multidisciplinary lung cancer tumor board in a community setting..” J Oncol Pract, vol. 9, no. 3, May 2013, pp. e77–80. Pubmed, doi:10.1200/JOP.2013.000882.
URI
https://scholars.duke.edu/individual/pub960946
PMID
23942505
Source
pubmed
Published In
J Oncol Pract
Volume
9
Published Date
Start Page
e77
End Page
e80
DOI
10.1200/JOP.2013.000882