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Sammons, Sarah

Positions:

Assistant Professor of Medicine

Medicine, Medical Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2012

M.D. — Jefferson Medical College of Thomas Jefferson University

Internal Medicine Residency

University of Maryland School of Medicine

Hematology-Oncology Fellowship

Duke University School of Medicine

Grants:

Targeting tumor-specific apoptosis regulation in advanced ER+ breast cancer

Administered By
Pharmacology & Cancer Biology
AwardedBy
Department of Defense
Role
Collaborator
Start Date
August 15, 2019
End Date
August 14, 2022

Cancer cell intrinsic and extrinsic actions of steroid hormones in breast tumors

Administered By
Pharmacology & Cancer Biology
AwardedBy
Department of Defense
Role
Clinical Investigator
Start Date
June 15, 2018
End Date
June 14, 2022

Phase II Multicenter Study of Durvalumab (MEDI4736) and Olaparib in PlatinumTreated Advanced Triple Negative Breast Cancer ¿ DORA

Administered By
Duke Cancer Institute
AwardedBy
Duke University
Role
Principal Investigator
Start Date
September 18, 2018
End Date
October 01, 2020

Determining the clinical efficacy and predictive biomarkers of mirvetuximab soravtansine (IMGN853) in folate receptor alpha (FRA) expressing, chemotherapy refractory triple negative breast cance

Administered By
Medicine, Medical Oncology
Role
Principal Investigator
Start Date
December 01, 2016
End Date
March 05, 2019

TNBC Study

Administered By
Duke Clinical Research Institute
Role
Principal Investigator
Start Date
April 28, 2017
End Date
November 01, 2018
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Publications:

Examination and prognostic implications of the unique microenvironment of breast cancer brain metastases.

PURPOSE: Brain metastases (BM) are a complication of advanced breast cancer (BC). Histology of melanoma BM offers prognostic value; however, understanding the microenvironment of breast cancer brain metastases (BCBM) is less characterized. This study reports on four histological biomarkers, gliosis, immune infiltrate, hemorrhage, necrosis, and their prognostic significance in BCBM. METHODS: A biobank of 203 human tissues from patients who underwent craniotomy for BCBM was created across four academic institutions. Degree of gliosis, immune infiltrate, hemorrhage, and necrosis were identified and scored via representative H&E stain (0-3+). Overall survival (OS) was estimated using the Kaplan-Meier method. Cox proportional hazards regression evaluated prognostic value of the biomarkers in the context of standard clinical characteristics. RESULTS: BCBM subtype (available for n = 158) was 36% Her2+, 26% hormone receptor (HR)+/Her2- 38% HR-/Her2- (triple negative, TN). Gliosis was observed in 82% (116/141) of BCBM, with immune infiltrate 44% (90/201), hemorrhage 82% (166/141), and necrosis 87% (176/201). Necrosis was significantly higher in TNBC (p < 0.01). Presence of gliosis, immune infiltrate, and hemorrhage correlated with improved OS (p = 0.03, p = 0.03, p = 0.1), while necrosis correlated with inferior OS (p = 0.01). Improved OS was associated with gliosis in TN (p = 0.02), and immune infiltrate (p = 0.001) and hemorrhage (p = 0.07) in HER2+. In a multivariable model for OS, incorporating these biomarkers with traditional clinical variables improved the model fit (p < 0.001). CONCLUSION: Gliosis confers superior prognosis in TNBC BM; immune infiltrate and hemorrhage correlate with superior prognosis in HER2+ BCBM. Understanding the metastatic microenvironment of BCBM refines prognostic considerations and may unveil novel therapeutic strategies.

Authors
Sambade, MJ; Prince, G; Deal, AM; Trembath, D; McKee, M; Garrett, A; Keith, K; Ramirez, J; Midkiff, B; Blackwell, K; Sammons, S; Leone, JP; Brufsky, A; Morikawa, A; Brogi, E; Seidman, A; Ewend, M; Carey, LA; Moschos, SJ; Hamilton, RL; Vincent, B; Anders, C
MLA Citation
Sambade, Maria J., et al. “Examination and prognostic implications of the unique microenvironment of breast cancer brain metastases..” Breast Cancer Res Treat, vol. 176, no. 2, July 2019, pp. 321–28. Pubmed, doi:10.1007/s10549-019-05211-1.
PMID
31016641
Source
pubmed
Published In
Breast Cancer Res Treat
Volume
176
Issue
2
Publish Date
2019
Start Page
321
End Page
328
DOI
10.1007/s10549-019-05211-1

Cardiotoxicities of Modern Treatments in Breast Cancer.

PURPOSE OF REVIEW: This paper will focus on novel breast cancer therapies used in clinical practice today, as well as review our understanding of standard therapies and their potential impact on cardiovascular health. RECENT FINDINGS: Established and novel treatments such as anthracyclines, HER2-targeted agents, and immunotherapy have contributed to improvements in breast cancer outcomes; however, these treatments may be associated with an increased risk of cardiovascular injury. The number of available breast cancer treatments continues to expand, as does the need for health care providers to understand the potential impact of these treatments on cardiovascular health. Collaborative approaches in the development of risk stratification, prevention, and surveillance strategies for patients exposed to established and novel breast cancer treatments will facilitate improvements in patient outcomes without compromising their cardiovascular health.

Authors
Dent, S; Melloni, C; Ivars, J; Sammons, S; Kimmick, G
MLA Citation
Dent, Susan, et al. “Cardiotoxicities of Modern Treatments in Breast Cancer..” Curr Treat Options Cardiovasc Med, vol. 21, no. 7, June 2019. Pubmed, doi:10.1007/s11936-019-0738-z.
PMID
31203459
Source
pubmed
Published In
Current Treatment Options in Cardiovascular Medicine
Volume
21
Issue
7
Publish Date
2019
Start Page
34
DOI
10.1007/s11936-019-0738-z

Fulvestrant-Based Combination Therapy for Second-Line Treatment of Hormone Receptor-Positive Advanced Breast Cancer.

Fulvestrant is recommended for patients with hormone receptor-positive (HR+) advanced breast cancer (ABC) who progress after aromatase inhibitor therapy. As most patients in this setting have already developed mechanisms of resistance to endocrine therapy, targeting biological pathways associated with endocrine resistance in combination with fulvestrant may improve outcomes. Therefore, evidence supporting a combinatorial treatment approach in the second-line setting was investigated based on a search of PubMed and ClinicalTrials.gov . Twenty-eight studies of targeted therapies plus fulvestrant as second-line treatment for HR+ ABC were identified, including three and six key randomized trials exploring cyclin-dependent kinase 4/6 (CDK4/6) inhibitors and phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) inhibitors plus fulvestrant respectively. Additional combinations with fulvestrant included inhibitors of epidermal growth factor receptors, androgen receptor, and the bromodomain and extra-terminal family of proteins. Across the studies reviewed with available data, the addition of targeted therapies to fulvestrant resulted in clinically meaningful improvements in progression-free survival compared with fulvestrant alone. While some challenging toxicities were observed, most adverse events could be effectively managed. Selection of second-line targeted therapy for use with fulvestrant should consider prior treatment as well as the mutation status of the tumor. In conclusion, available data indicate that fulvestrant combined with agents targeting mechanisms of endocrine resistance is a promising approach. The ongoing trials identified in this review will help further inform the selection of combination treatments with fulvestrant for HR+ ABC.

Authors
Sammons, S; Kornblum, NS; Blackwell, KL
MLA Citation
Sammons, Sarah, et al. “Fulvestrant-Based Combination Therapy for Second-Line Treatment of Hormone Receptor-Positive Advanced Breast Cancer..” Target Oncol, vol. 14, no. 1, Feb. 2019, pp. 1–12. Pubmed, doi:10.1007/s11523-018-0587-9.
PMID
30136059
Source
pubmed
Published In
Target Oncol
Volume
14
Issue
1
Publish Date
2019
Start Page
1
End Page
12
DOI
10.1007/s11523-018-0587-9

Correction to: Fulvestrant-Based Combination Therapy for Second-Line Treatment of Hormone Receptor-Positive Advanced Breast Cancer.

The article Fulvestrant-Based Combination Therapy for Second-Line Treatment of Hormone Receptor-Positive Advanced Breast Cancer, written by Sarah Sammons, Noah S. Kornblum and Kimberly L. Blackwell, was originally published electronically on the publisher's internet portal (currently SpringerLink).

Authors
Sammons, S; Kornblum, NS; Blackwell, KL
MLA Citation
Sammons, Sarah, et al. “Correction to: Fulvestrant-Based Combination Therapy for Second-Line Treatment of Hormone Receptor-Positive Advanced Breast Cancer..” Target Oncol, vol. 14, no. 1, Feb. 2019. Pubmed, doi:10.1007/s11523-018-0614-x.
PMID
30535552
Source
pubmed
Published In
Target Oncol
Volume
14
Issue
1
Publish Date
2019
Start Page
13
DOI
10.1007/s11523-018-0614-x

Early Stage HER2-Positive Breast Cancers Not Achieving a pCR From Neoadjuvant Trastuzumab- or Pertuzumab-Based Regimens Have an Immunosuppressive Phenotype.

BACKGROUND: Stromal tumor-infiltrating lymphocytes (TILs) might predict pathologic complete response (pCR) in patients with HER2-positive (HER2+) breast cancer treated with trastuzumab (H). Docetaxel (T), carboplatin (C), H, and pertuzumab (P) have immune-modulating effects. Pre- and post-treatment immune biomarkers in cancers treated with neoadjuvant TCH with or without P are lacking. In this study we quantified baseline and changes in TILs, cluster of differentiation (CD) 4+, CD8+, FoxP3+, and PD-L1+ cells using immunohistochemistry (IHC) and quantified productive T-cell receptor β (TCRβ) rearrangements and TCRβ clonality using next-generation sequencing (NGS) in 30 HER2+ breast cancer tissues treated with neoadjuvant H with or without P regimens. MATERIALS AND METHODS: Thirty pre- and post-neoadjuvant TCH (n = 4) or TCHP (n = 26) breast cancer tissues were identified. TILs were quantified manually using hematoxylin and eosin. CD4, CD8, FoxP3, and PD-L1 were stained using IHC. TCRβ was evaluated using NGS. Immune infiltrates were compared between pCR and non-pCR groups using the Wilcoxon rank sum test. RESULTS: A pCR occurred in 15 (n = 15; 50%) cancers (TCH n = 2; TCHP, n = 13). Pretreatment TILs, CD4+, CD8+, FoxP3+, and PD-L1+ cells were not associated with response (P = .42, P = .55, P = .19, P = .66, P = .87, respectively. Pretreatment productive TCRβ and TCRβ clonality did not predict response, P = .84 and P = .40, respectively). However, post-treatment CD4+ and FoxP3+ cells (T-regulatory cells) were elevated in the non-pCR cohort (P = .042 and P = .082, respectively). CONCLUSION: An increase in regulatory T cells in non-pCR tissues suggests the development of an immunosuppressive phenotype. Further investigation in a larger cohort of samples is warranted to validate these findings.

Authors
Force, J; Howie, LJ; Abbott, SE; Bentley, R; Marcom, PK; Kimmick, G; Westbrook, K; Sammons, SL; Parks, M; Topping, DL; Emerson, R; Broadwater, G; Hyslop, T; Blackwell, KL; Nair, SK
MLA Citation
Force, Jeremy, et al. “Early Stage HER2-Positive Breast Cancers Not Achieving a pCR From Neoadjuvant Trastuzumab- or Pertuzumab-Based Regimens Have an Immunosuppressive Phenotype..” Clin Breast Cancer, vol. 18, no. 5, Oct. 2018, pp. 410–17. Pubmed, doi:10.1016/j.clbc.2018.02.010.
PMID
29615305
Source
pubmed
Published In
Clin Breast Cancer
Volume
18
Issue
5
Publish Date
2018
Start Page
410
End Page
417
DOI
10.1016/j.clbc.2018.02.010

Immune checkpoint inhibition

© Springer International Publishing AG, part of Springer Nature 2018. All rights reserved. Immune checkpoint inhibitors (ICI) represent a class of immuno-oncology drugs consisting of monoclonal antibodies occurring against inhibitory receptors or ligands within the immune system including CTLA-4, PD-1, and PD-L1. ICI has transformed oncology in the last decade leading to increased response rates and improved overall survival across several advanced malignancies. ICI is associated with a unique array of toxicities termed immune-related adverse events (IrAEs) which are T-cell-mediated autoimmune toxicities reported in nearly every organ system; most commonly affecting the skin, liver, gastrointestinal tract, and endocrine system. Most IrAEs are manageable with prompt recognition and initiation of appropriate management. General treatment of IrAEs is based on immunosuppression using varying strengths of glucocorticoids. Severe steroid-refractory IrAEs have required nonsteroidal immunosuppressive agents. In this chapter, we describe IrAEs observed with CTLA-4 and PD-1/PDL-1 inhibition by system describing clinical presentation, grading, incidence, time of onset, management, and time to resolution.

Authors
Sammons, S; McNamara, M; Salama, AKS; Crawford, J
MLA Citation
Sammons, S., et al. “Immune checkpoint inhibition.” Side Effects of Medical Cancer Therapy: Prevention and Treatment: Second Edition, 2018, pp. 315–53. Scopus, doi:10.1007/978-3-319-70253-7_12.
Source
scopus
Publish Date
2018
Start Page
315
End Page
353
DOI
10.1007/978-3-319-70253-7_12

Biopsy of enlarging lesions after stereotactic radiosurgery for brain metastases frequently reveals radiation necrosis.

Background: Stereotactic radiosurgery (SRS) offers excellent local control for brain metastases (BM) with low rates of toxicity. Radiation necrosis (RN) may occur after treatment and is challenging to distinguish from local recurrence (LR). We evaluated enlarging brain lesions following SRS that were subsequently biopsied to differentiate RN versus LR. Methods: This study reviewed patients receiving SRS for BM between 2008 and 2012 who underwent a biopsy for suspicion of RN versus LR on MRI. Data collection included demographics, radiation parameters, imaging findings, and post-biopsy pathology. Kaplan-Meier methods determined overall survival. Fisher's exact test assessed for association between lesion biopsy result and variables of interest. Results: Thirty-four patients with 35 biopsied BM were included. Lesions were biopsied a median of 8.8 months after SRS. Most patients had primary lung cancer (11; 31.4%). Eleven (31.4%) biopsies were positive for LR and 24 (68.6%) showed RN only. Median overall survival was longer for patients with RN (31.0 mo) than for patients with LR (14.5 mo; P = 0.135). Time from SRS to biopsy was significantly different between RN and LR groups; 10 lesions (52.5%) biopsied ≤9 months after SRS showed LR, whereas 1 lesion (6.3%) biopsied >9 months after SRS showed LR (P = 0.004). For 16 (65.7%) lesions, management was changed or directed by the biopsy results. Conclusions: Stereotactic biopsy for accessible enlarging lesions after SRS appears diagnostically valuable in patients with few lesions and changes clinical management. RN should be suspected in patients with an enlarging lesion more than 9 months post-SRS.

Authors
Narloch, JL; Farber, SH; Sammons, S; McSherry, F; Herndon, JE; Hoang, JK; Yin, F-F; Sampson, JH; Fecci, PE; Blackwell, KL; Kirkpatrick, JP; Kim, GJ
MLA Citation
Narloch, Jessica L., et al. “Biopsy of enlarging lesions after stereotactic radiosurgery for brain metastases frequently reveals radiation necrosis..” Neuro Oncol, vol. 19, no. 10, Oct. 2017, pp. 1391–97. Pubmed, doi:10.1093/neuonc/nox090.
PMID
28472527
Source
pubmed
Published In
Neuro Oncol
Volume
19
Issue
10
Publish Date
2017
Start Page
1391
End Page
1397
DOI
10.1093/neuonc/nox090

HR+, HER2- Advanced Breast Cancer and CDK4/6 Inhibitors: Mode of Action, Clinical Activity, and Safety Profiles.

BACKGROUND: Cyclin-dependent kinase (CDK) 4/6 inhibitor-based therapies have shown great promise in improving clinical outcomes for patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer. OBJECTIVES: 1. Discuss the mode of action of the three CDK4/6 inhibitors in late clinical development: palbociclib (PD-0332991; Pfizer), ribociclib (LEE011; Novartis), and abemaciclib (LY2835219; Lilly). 2. Describe the efficacy and safety data relating to their use in HR+, HER2- advanced breast cancer. 3. Discuss the key side effects associated with CDK4/6 inhibitors along with considerations for adverse event management and patient monitoring. METHOD: Relevant information and data were assimilated from manuscripts, congress publications, and online sources. RESULTS: CDK4/6 inhibitors have demonstrated improved progression-free survival in combination with endocrine therapy compared with endocrine therapy alone. The side-effect profile of each agent is described, along with implications for patient monitoring, and considerations for patient care providers and pharmacists. CONCLUSION: Addition of a CDK4/6 inhibitor to endocrine therapy increases efficacy and delays disease progression. Insight into the unique side-effect profiles of this class of agents and effective patient monitoring will facilitate the successful use of CDK4/6 inhibitor-based therapies in the clinic.

Authors
Sammons, SL; Topping, DL; Blackwell, KL
MLA Citation
Sammons, Sarah L., et al. “HR+, HER2- Advanced Breast Cancer and CDK4/6 Inhibitors: Mode of Action, Clinical Activity, and Safety Profiles..” Curr Cancer Drug Targets, vol. 17, no. 7, 2017, pp. 637–49. Pubmed, doi:10.2174/1568009617666170330120452.
PMID
28359238
Source
pubmed
Published In
Curr Cancer Drug Targets
Volume
17
Issue
7
Publish Date
2017
Start Page
637
End Page
649
DOI
10.2174/1568009617666170330120452
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