David Ashley

Overview:

Dr. Ashley's primary research focus is laboratory based, investigating the role of immunotherapy as a novel approach to the treatment of tumors of the central nervous system (CNS). Since beginning his appointment at the faculty level at Duke in August of 1995 his activities have centered on two main areas of investigation. The first involves both in vivo and in vitro studies of the use of molecular therapeutics to target a CNS tumor associated antigen. The second area of interest comprises a detailed analysis of the role of TGF beta, a protein messenger produced by tumors of the CNS, both in the pathogenesis of disease and as a possible target for immunotherapy.

In addition to his laboratory role Dr. Ashley is involved in the design and application of a variety of clinical research protocols in the treatment of children with malignant brain tumors.

Positions:

Rory David Deutsch Distinguished Professor of Neuro-Oncology

Neurosurgery
School of Medicine

Professor of Neurosurgery

Neurosurgery
School of Medicine

Professor of Medicine

Medicine, Medical Oncology
School of Medicine

Professor in Pathology

Pathology
School of Medicine

Professor in Pediatrics

Pediatrics, Hematology-Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

F.R.A.C.P. 1993

Royal Australasian College of Physicians (Australia)

M.B.B.S. 1994

University of Melbourne (Australia)

Ph.D. 1998

University of Melbourne (Australia)

Grants:

LGG-14C03: A Phase III study comparing two carboplatin containing regimens for children and young adults with previously untreated low grade glioma

Administered By
Duke Cancer Institute
Awarded By
Ann & Robert H Lurie Children's Hospital of Chicago
Role
Principal Investigator
Start Date
End Date

SJMB12: A Clinical and Molecular Risk-Directed Therapy for Newly Diagnosed Medulloblastoma

Administered By
Pediatrics, Hematology-Oncology
Awarded By
St. Jude Children's Research Hospital
Role
Principal Investigator
Start Date
End Date

NEWLY DIAGNOSED CHILDREN (LESS THAN 10 YEARS OLD) WITH MEDULLOBLASTOMA AND OTHER CENTRAL NERVOUS SYSTEMPRIMITIVE NEURO-ECTODERMAL TUMORS:CLINICAL AND MOLECULAR RISK-TAILORED INTENSIVE AND COMPRESSED INDUCTION CHEMOTHERAPY FOLLOWED BY CONSOLIDATION WI

Administered By
Duke Cancer Institute
Awarded By
Research Institute at Nationwide Children's Hospital
Role
Principal Investigator
Start Date
End Date

Collaborative Network for Neuroooncology Clinical Trials (CONNECT)

Administered By
Duke Cancer Institute
Awarded By
Cincinnati Children's Hospital Medical Center
Role
Principal Investigator
Start Date
End Date

A Phase II study of Panobinostat in Paediatric, Adolescent and Young Adult Patients with Solid Tumours (ATRT)

Administered By
Duke Cancer Institute
Awarded By
Australian and New Zealand Children's Haematology/Oncology Group
Role
Principal Investigator
Start Date
End Date

Publications:

QOLP-28. COMPARING KNOWLEDGE OF AND BELIEFS ABOUT PALLIATIVE CARE AMONG NEURO-ONCOLOGY PATIENTS, CAREGIVERS, PROVIDERS AND A NATIONALLY-REPRESENTATIVE U.S. SAMPLE

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>INTRODUCTION</jats:title> <jats:p>There is increasing recognition that palliative care (PC) can benefit patients with advanced cancers. However, early referral to PC is not yet a reality for patients diagnosed with a primary brain tumor. We hypothesize that lack of knowledge and/or misperceptions regarding PC by patients, caregivers, or their providers remain barriers.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>This is an IRB-exempt, one-time QR-accessible REDcap questionnaire administered to patients, caregivers, and providers at the Preston Robert Tisch Brain Tumor Center between September 2020 and May 2021. We administered 9 questions regarding knowledge and beliefs about PC from the Health Information National Trends Survey 5, Cycle 2: results of this nationally representative U.S. sample are publicly available and used for comparison.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>We had 141 survey respondents: 25 providers, 59 patients, and 57 caregivers. The median patient and caregiver ages were 49 (21-74) and 50 years (24-73), respectively. Caregivers were more likely female (55.2 %) and identified as a spouse or domestic partner (58.2%). Providers, were equally distributed by years of experience. Compared to patients and caregivers, providers reported more baseline knowledge of PC (p&amp;lt; 0.0001, p&amp;lt; 0.0001) and better understood the role of PC in pain/symptom management (p=0.0038, p=0.0087) and social/emotional support (p=0.0044, p=0.0279). Interestingly, most providers (76.0%) disagreed with the statement “the goal of palliative care is to give patients more time at the end of life.” Compared to a general U.S. sample (n=1,162) our patients (n=39) were better informed in only 2 of 9 questions. Whereas, caregivers (n=48) were better informed in 6 of 9 questions.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSION</jats:title> <jats:p>Neuro-oncology providers were knowledgeable, but a minor gap in understanding the goal of PC was identified. Caregivers were overall more knowledgeable than patients. However, Neuro-oncology patients, had similar knowledge and beliefs compared to a nationally representative sample. PC interventions should prioritize filling knowledge gaps for Neuro-oncology patients.</jats:p> </jats:sec>
Authors
Johnson, M; Khasraw, M; Kim, J-Y; Cort, N; Herndon, J; Ramirez, L; Lipp, E; Landi, D; Desjardins, A; Friedman, H; Ashley, DM; Affronti, M; Casarett, DJ; Peters, KB
MLA Citation
Johnson, Margaret, et al. “QOLP-28. COMPARING KNOWLEDGE OF AND BELIEFS ABOUT PALLIATIVE CARE AMONG NEURO-ONCOLOGY PATIENTS, CAREGIVERS, PROVIDERS AND A NATIONALLY-REPRESENTATIVE U.S. SAMPLE.” Neuro Oncology, vol. 23, no. Supplement_6, Oxford University Press (OUP), 2021, pp. vi189–vi189. Manual, doi:10.1093/neuonc/noab196.748.
URI
https://scholars.duke.edu/individual/pub1502887
Source
manual
Published In
Neuro Oncology
Volume
23
Published Date
Start Page
vi189
End Page
vi189
DOI
10.1093/neuonc/noab196.748

INNV-20. RADIOGRAPHIC RESPONSE AND SEIZURE CONTROL IN IDH1 MUTANT GLIOMA PATIENTS USING IVOSIDENIB

<jats:title>Abstract</jats:title> <jats:p>Isocitrate dehydrogenase 1 (IDH1) is commonly mutated in grade II-III gliomas, and the mutant enzyme leads to the production of the oncometabolite 2-hydroxyglutarate (2-HG). 2-HG is responsible for the gliomagenesis associated with these tumors and the promotion of seizures via glutamate receptors. Ivosidenib, a small molecule oral mIDH1 inhibitor, has shown promise in clinical trials to treat IDH1 mutant gliomas, and providers can utilize this agent in IDH1 mutant glioma patients. We evaluated our IDH1 mutant glioma patients treated off-label with ivosidenib and described the radiographic response and seizure control in this cohort when ivosidenib was initiated between October 2020 to February 2021. Radiographic response was determined using RANO criteria, and seizure control was determined by comparing seizures per month before and after initiation of ivosidenib. All patients represented received single-agent ivosidenib dosed at 500 mg orally once a day. One patient required a dose reduction to 250 mg orally once a day because of drug-induced diarrhea. In our cohort of six patients, patient age range was 31 to 74 years with four female patients and two male patients. Diagnoses represented were astrocytoma, IDH1 mutant (n=3) oligodendroglioma (WHO), IDH1 mutant, 1p19q co-deleted (n=2), and anaplastic astrocytoma IDH1 mutant (n=1). Three patients experienced a reduction of seizure frequency, two patients did not have seizures before or after therapy, and one patient remained with the same level of seizures (1 seizure/month). Radiographic responses recorded included three patients with stable disease, two patients with minor responses, and one patient with a partial response. Treatment with ivosidenib is ongoing for this cohort of mIDH1 glioma patients. Updated information on prolonged disease control and seizure control in this cohort of IDH1 mutant glioma patients will be presented. Therapeutics, such as ivosidenib, can lead to improved seizure control and radiographic outcomes in IDH1 mutant glioma patients.</jats:p>
Authors
Peters, K; Patel, M; Alford, C; Chavez, G; Kim, J-Y; Durling, J; Novack, T; Batich, K; Shoaf, M; Hanzlik, E; Affronti, M; Johnson, M; Landi, D; Khasraw, M; Desjardins, A; Friedman, H; Ashley, DM
MLA Citation
Peters, Katherine, et al. “INNV-20. RADIOGRAPHIC RESPONSE AND SEIZURE CONTROL IN IDH1 MUTANT GLIOMA PATIENTS USING IVOSIDENIB.” Neuro Oncology, vol. 23, no. Supplement_6, Oxford University Press (OUP), 2021, pp. vi109–vi109. Manual, doi:10.1093/neuonc/noab196.431.
URI
https://scholars.duke.edu/individual/pub1502898
Source
manual
Published In
Neuro Oncology
Volume
23
Published Date
Start Page
vi109
End Page
vi109
DOI
10.1093/neuonc/noab196.431

CHEMOTHERAPY STRATEGIES FOR YOUNG CHILDREN NEWLY DIAGNOSED WITH DESMOPLASTIC/EXTENSIVE NODULAR MEDULLOBLASTOMA UP TO THE ERA OF MOLECULAR PROFILING - A COMPARATIVE OUTCOMES ANALYSIS OF PROSPECTIVE MULTI-CENTER EUROPEAN AND NORTH AMERICAN TRIALS

Authors
Finlay, J; Mynarek, M; Dhall, G; Lafay-Cousin, L; Mazewski, C; Ashley, D; Leary, S; Cohen, BH; Robinson, G; Geyer, R; Tait, D; Stanek, J; Gajjar, A; Rutkowski, S
URI
https://scholars.duke.edu/individual/pub1501992
Source
wos-lite
Published In
Neuro Oncology
Volume
23
Published Date
Start Page
6
End Page
6

QOLP-10. A LONGITUDINAL OBSERVATIONAL STUDY OF EXERCISE BEHAVIOR IN GLIOBLASTOMA PATIENTS TREATED WITH TUMOR-TREATING FIELDS

<jats:title>Abstract</jats:title> <jats:p>Glioblastoma (GBM) patients can use tumor-treating fields (TTFs) with adjuvant temozolomide (TMZ) to treat their disease. TTFs involve wearing transfixed transducers to the shaved scalp, and the transducers are wired to a battery pack that is either fixed or carried (weighing 2.7 pounds). EF-14 clinical trial did evaluate health-related quality of life with standardized patient-report outcome measures but did not measure exercise behavior. We sought to evaluate the exercise behavior of GBM patients using TTFs. We consented GBM patients who intended to use TTFs with adjuvant TMZ after completion of chemoradiation. After informed consent and before starting TTFs, patients completed a self-administered questionnaire, Godin Leisure-Time Exercise Questionnaire, to assess exercise behavior/physical function. To calculate our primary outcome of total exercise behavior, the frequency of exercise sessions per week within each intensity category was multiplied by the average reported duration, weighted by an estimate of the MET, summed across all intensities, and expressed as average MET-hr/wk. Prior work has defined that physical function can be compared as &amp;lt; 9 MET-h/wk vs. ≥ 9 MET-h/wk. We evaluated at baseline and up to 24-week exercise behavior in patients with TTFs vs. historical controls not using TTFs. We enrolled 19 total GBM patients, with 14 proceeding to use TTFs. Of the 14 patients on TTFs, seven patients (50%) completed ≥ 9 MET-h/wk of exercise, and this level was maintained 8, 16, and 24 weeks after starting TTFs. Six months after the completion of chemoradiation, mean MET-h/wk was decreased in the TTFs group (n=6) (10.71 sd=7.06) vs. historical controls (n=38) (27.35 sd=46.94). TTFs did not interfere with exercise behavior in our GBM cohort, but when compared to GBM patients not utilizing TTFs, there could be a long-term impact on exercise behavior. More research is needed to evaluate exercise behavior in GBM patients using TTFs.</jats:p>
Authors
Peters, K; Affronti, M; Kim, J-Y; Patel, M; Johnson, M; Bartlett, D; Cort, N; Lipp, E; Iden, D; Broadwater, G; Herndon, J; Landi, D; Khasraw, M; Desjardins, A; Friedman, H; Ashley, DM
MLA Citation
Peters, Katherine, et al. “QOLP-10. A LONGITUDINAL OBSERVATIONAL STUDY OF EXERCISE BEHAVIOR IN GLIOBLASTOMA PATIENTS TREATED WITH TUMOR-TREATING FIELDS.” Neuro Oncology, vol. 23, no. Supplement_6, Oxford University Press (OUP), 2021, pp. vi184–85. Manual, doi:10.1093/neuonc/noab196.731.
URI
https://scholars.duke.edu/individual/pub1502899
Source
manual
Published In
Neuro Oncology
Volume
23
Published Date
Start Page
vi184
End Page
vi185
DOI
10.1093/neuonc/noab196.731

INNV-31. NEURO-ONCOLOGY OUTPATIENT SATISFACTION IS MAINTAINED IN THE ERA OF COVID-19 TELEMEDICINE

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>INTRODUCTION</jats:title> <jats:p>The use of telemedicine increased during the COVID-19 pandemic. However, the impact on patient satisfaction in the Neuro-oncology population is unknown. This quality improvement project compares outpatient satisfaction before and during the COVID-19 pandemic as well as in-person versus telemedicine platforms during the pandemic.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>We performed an IRB-exempt retrospective analysis of aggregate de-identified outpatient satisfaction scores among Neuro-oncology patients seen at The Preston Robert Tisch Brain Tumor Center (PRTBTC) at Duke University. The Clinician &amp; Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) is a survey developed and distributed by Press Ganey Associates, and is the most widely used outpatient satisfaction survey in the United States. We compared pre-COVID-19 CG-CAHPS scores from patients who received in-person care at the PRBTC between April 2019 and March 2020 to COVID-19 pandemic CG-CAHPS scores (i.e. those who received either telemedicine or in-person care at the PRTBTC) from April 2020 to March 2021.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Approximately 1448 surveys were completed for both in-person and telemedicine visits. During the pandemic, 48.6% of surveys represented telemedicine, with monthly variations from 84.6% (April 2020) to 21.4% (March 2021). Patient satisfaction scores pre-COVID-19 were similar to those during the pandemic: overall provider rating from 0-10 (9.28 v 9.36), knowledge of medical history (96.9% v 95.4%), listens carefully (96.6% v 96.9%), shows respect (97.2% v 98.1%), and time spent (93.2% v 95.5%). During the COVID-19 pandemic, in-person and telemedicine demonstrate similar levels of satisfaction: overall provider rating from 0-10 (9.29 v 9.48), knowledge of medical history (94.9% v 96.1%), listens carefully (95.4% v 99.0%), shows respect (97.5% v 99.0%), and time spent (94.7% v 96.7%).</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSION</jats:title> <jats:p>Outpatient satisfaction prior to and during the COVID-19 pandemic was similar. Patients reported similar satisfaction between in-person and telemedicine platforms. We support the ongoing use of telemedicine for outpatient Neuro-oncology.</jats:p> </jats:sec>
Authors
Petitt, Z; Herndon, J; Gottfried, O; Cone, C; Landi, D; Khasraw, M; Friedman, H; Ashley, DM; Desjardins, A; Peters, K; Johnson, M
MLA Citation
Petitt, Zoey, et al. “INNV-31. NEURO-ONCOLOGY OUTPATIENT SATISFACTION IS MAINTAINED IN THE ERA OF COVID-19 TELEMEDICINE.” Neuro Oncology, vol. 23, no. Supplement_6, Oxford University Press (OUP), 2021, pp. vi112–vi112. Manual, doi:10.1093/neuonc/noab196.442.
URI
https://scholars.duke.edu/individual/pub1502905
Source
manual
Published In
Neuro Oncology
Volume
23
Published Date
Start Page
vi112
End Page
vi112
DOI
10.1093/neuonc/noab196.442