Katherine Peters

Overview:

Dr. Katy Peters, MD Ph.D. FAAN is an associate professor of neurology and neurosurgery at the Preston Robert Tisch Brain Tumor Center (PRTBTC) at Duke.   Her academic medical career started at Stanford University School of Medicine, receiving an MD and Ph.D. in Cancer Biology.  After completing a neurology residency at Johns Hopkins University and a fellowship in cognitive neurosciences, Katy joined the PRTBTC as a neuro-oncology fellow.  In 2009, she became a faculty member at PRTBTC.  With a fantastic team of nursing and advanced practice providers, she actively sees and cares for patients with primary brain tumors.  Her research interests include supportive care for brain cancer patients, cognitive dysfunction in cancer patients, and physical function and activity of brain cancer patients.   While she runs clinical trials to treat primary brain tumors, her key interest is on clinical trials that focus on improving brain tumor patients' quality of life and cognition.   In 2019, the PRTBTC designated her as the Director of Supportive Care, thus furthering the PRTBTC and her committee to better the quality of life for brain tumor patients.   She is active in teaching medical school students, residents, fellows, and advanced practice providers and is the Program Director of the PRTBRC neuro-oncology fellowship.     She is board certified by the American Board of Psychiatry and Neurology and the United Council of Neurologic Subspecialties for neuro-oncology.

Positions:

Associate Professor of Neurosurgery

Neurosurgery, Neuro-Oncology
School of Medicine

Vice Chair for Education in the Department of Neurology

Neurology
School of Medicine

Associate Professor in Neurology

Neurology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2003

Stanford University

Ph.D. 2003

Stanford University

Intern, Medicine

Johns Hopkins University

Resident and Fellow in Neurology, Neurology

Johns Hopkins University

Fellow in Neuro-Oncology, Surgery

Duke University

Grants:

Ph 1/2 Trial for Patients with Newly Diagnosed High Grade Glioma Treated with Concurrent Radiation Therapy, Temozolomide, and BMX-001

Administered By
Neurosurgery, Neuro-Oncology
Awarded By
BioMimetix JV LLC
Role
Principal Investigator
Start Date
End Date

A Phase 1, Multicenter, Randomized, Controlled, Open-label, Perioperative Study of AG-120 and AG-881 in Subjects with Recurrent, Non-enhancing, IDH1 Mutant, Low-grade Glioma. (AG120-881-C-001)

Administered By
Duke Cancer Institute
Awarded By
Agios Pharmaceuticals, Inc.
Role
Principal Investigator
Start Date
End Date

Functional Capacity and Physical Function in Glioblastoma Patients Treated with or without Tumor-Treating Fields

Administered By
Duke Cancer Institute
Awarded By
Novocure
Role
Principal Investigator
Start Date
End Date

A Study for Management of Ocular Side Effects in Subjects with EGFR-Amplified Glioblastoma receiving Depatuxizumab Mafodotin

Administered By
Duke Cancer Institute
Awarded By
AbbVie Inc.
Role
Principal Investigator
Start Date
End Date

A randomized phase 2 single blind study of temozolomide plus radiation therapy combined with nivolumab or placebo in newly diagnosed adult subjects with MGMT-methylated glioblastoma (BMS CA209-548)

Administered By
Duke Cancer Institute
Awarded By
Bristol-Myers Squibb Company
Role
Principal Investigator
Start Date
End Date

Publications:

Comparison of differing dose levels of methotrexate for patients with primary central nervous system lymphoma.

INTRODUCTION: It has long been established that high-dose methotrexate is an essential part of therapy for primary central nervous system lymphoma. When regimens utilizing high-dose methotrexate were first studied, a dose of 8 g/m2 was used. More recently, reduced dosing strategies have been studied and adopted in attempts to reduce rates of adverse events. Studies utilizing 3.5 g/m2 of methotrexate have shown promising outcomes and improved rates of adverse events but there have never been any randomized head-to-head studies of differing dose levels of high-dose methotrexate. The purpose of this study was to compare efficacy and safety of different dosing strategies of high-dose methotrexate (HD-MTX) for primary central nervous system lymphoma (PCNSL). METHODS: This single center retrospective review was conducted between 07/01/2013 to 6/3/2020. The patient population was separated into two arms based upon dose of methotrexate. The high intensity (HiHD) arm was defined as patients who received doses > 3.5 g/m2, while the low intensity (LiHD) arm received ≤ 3.5 g/m2. The primary endpoint was overall response rate (ORR) and secondary endpoints include efficacy via 2-year overall survival (OS), progression to transplant, and utilization of consolidation or salvage therapy. Safety was assessed through monitoring of relevant laboratory studies. RESULTS: A total of 92 patients were included in this analysis. Baseline demographics were similar between groups, with the LiHD group trending toward older age. There were 78 patients eligible for assessment for ORR; there was no significant difference between the two groups (42.0% LiHD vs. 44.4% HiHD; p = 1.0). Rates of OS, progression to transplant and progression to consolidation chemotherapy were not different between groups. There were statistically significantly higher rates of renal and/or hepatic dysfunction with the first dose in the HiHD group compared with the LiHD group (11.5% LiHD vs. 64.3% HiHD; p ≤ 0.01). CONCLUSIONS: In this PCNSL patient cohort, there is no difference in terms of efficacy between HiHD LiHD methotrexate, but patients in the HiHD group had higher rates of renal and hepatic dysfunction. Limitations include small sample size and disparity between group sizes.
Authors
Schrum, DP; Moorman, MT; Li, Z; Dillon, M; Peters, KB; McKinney, M; Patel, MP
MLA Citation
Schrum, Daniel P., et al. “Comparison of differing dose levels of methotrexate for patients with primary central nervous system lymphoma.J Oncol Pharm Pract, May 2023, p. 10781552231176754. Pubmed, doi:10.1177/10781552231176754.
URI
https://scholars.duke.edu/individual/pub1578407
PMID
37198894
Source
pubmed
Published In
J Oncol Pharm Pract
Published Date
Start Page
10781552231176754
DOI
10.1177/10781552231176754

Clinical management of seizures in patients with meningiomas: Efficacy of surgical resection for seizure control and patient-tailored postoperative anti-epileptic drug management.

Meningiomas are the most common primary intracranial tumor. They are slow growing and often incidentally found tumors that arise from the arachnoid villi. As they grow, they have a greater likelihood of becoming symptomatic with seizures being one of the most clinically significant symptoms. Seizures are more likely to present as a symptom of larger meningiomas and meningiomas that compress cortical areas particularly those in non-skull base locations. These seizures are often managed medically, utilizing the same anti-seizure medications that are used to treat other causes of epilepsy. We discuss common anti-seizure medications used including valproate, phenobarbital, carbamazepine, phenytoin, lacosamide, lamotrigine, levetiracetam and topiramate and their common adverse effects. The goal of pharmacotherapy for seizure control is to maximize seizure control while minimizing the adverse effects of the medication. The decision to provide medical management is dependent on individual seizure history and plans for surgical treatment. Patients who did not require seizure prophylaxis before surgery are commonly prescribed seizure prophylaxis postoperatively. Symptomatic meningiomas not controlled by medical management alone are commonly evaluated for surgical resection. The efficacy of surgical resection in providing seizure freedom is dependent on several features of the tumor including tumor size, the extent of the peritumoral edema, the number of tumors, sinus infiltration and the degree of resection.
Authors
Peart, R; Melnick, K; Cibula, J; Walbert, T; Gerstner, ER; Rahman, M; Peters, KB; Mrugala, M; Ghiaseddin, A
MLA Citation
Peart, Rodeania, et al. “Clinical management of seizures in patients with meningiomas: Efficacy of surgical resection for seizure control and patient-tailored postoperative anti-epileptic drug management.Neurooncol Adv, vol. 5, no. Suppl 1, May 2023, pp. i58–66. Pubmed, doi:10.1093/noajnl/vdac136.
URI
https://scholars.duke.edu/individual/pub1584014
PMID
37287578
Source
pubmed
Published In
Neuro Oncology Advances
Volume
5
Published Date
Start Page
i58
End Page
i66
DOI
10.1093/noajnl/vdac136

Novel Mechanisms and Future Opportunities for the Management of Radiation Necrosis in Patients Treated for Brain Metastases in the Era of Immunotherapy.

Radiation necrosis, also known as treatment-induced necrosis, has emerged as an important adverse effect following stereotactic radiotherapy (SRS) for brain metastases. The improved survival of patients with brain metastases and increased use of combined systemic therapy and SRS have contributed to a growing incidence of necrosis. The cyclic GMP-AMP (cGAMP) synthase (cGAS) and stimulator of interferon genes (STING) pathway (cGAS-STING) represents a key biological mechanism linking radiation-induced DNA damage to pro-inflammatory effects and innate immunity. By recognizing cytosolic double-stranded DNA, cGAS induces a signaling cascade that results in the upregulation of type 1 interferons and dendritic cell activation. This pathway could play a key role in the pathogenesis of necrosis and provides attractive targets for therapeutic development. Immunotherapy and other novel systemic agents may potentiate activation of cGAS-STING signaling following radiotherapy and increase necrosis risk. Advancements in dosimetric strategies, novel imaging modalities, artificial intelligence, and circulating biomarkers could improve the management of necrosis. This review provides new insights into the pathophysiology of necrosis and synthesizes our current understanding regarding the diagnosis, risk factors, and management options of necrosis while highlighting novel avenues for discovery.
Authors
Vaios, EJ; Winter, SF; Shih, HA; Dietrich, J; Peters, KB; Floyd, SR; Kirkpatrick, JP; Reitman, ZJ
MLA Citation
Vaios, Eugene J., et al. “Novel Mechanisms and Future Opportunities for the Management of Radiation Necrosis in Patients Treated for Brain Metastases in the Era of Immunotherapy.Cancers (Basel), vol. 15, no. 9, Apr. 2023. Pubmed, doi:10.3390/cancers15092432.
URI
https://scholars.duke.edu/individual/pub1578387
PMID
37173897
Source
pubmed
Published In
Cancers
Volume
15
Published Date
DOI
10.3390/cancers15092432

Ibrutinib in primary central nervous system diffuse large B-cell lymphoma.

The standard regimen for the treatment of newly diagnosed primary CNS lymphoma (PCNSL) remains regimens that contain high-dose methotrexate (MTX). While these regimens can provide control for some patients, there is a dearth of options for the treatment of patients with PCNSL who cannot tolerate MTX-containing regimens, or whose cancers are refractory to MTX. In this article, we review a promising new option; ibrutinib, a Bruton tyrosine kinase inhibitor, for patients with relapsed and refractory PCNSL.
Authors
T Low, J; B Peters, K
MLA Citation
T Low, Justin, and Katherine B Peters. “Ibrutinib in primary central nervous system diffuse large B-cell lymphoma.Cns Oncol, vol. 9, no. 1, Mar. 2020, p. CNS51. Pubmed, doi:10.2217/cns-2019-0022.
URI
https://scholars.duke.edu/individual/pub1570175
PMID
32141313
Source
pubmed
Published In
Cns Oncology
Volume
9
Published Date
Start Page
CNS51
DOI
10.2217/cns-2019-0022

Use of Trametinib in Children and Young Adults With Progressive Low-grade Glioma and Glioneuronal Tumors.

Low-grade gliomas/glioneuronal tumors comprise one-third of all pediatric-type CNS tumors. These tumors are generally caused by activating mutations in the mitogen-activated protein kinase (MAPK) pathway. Targeted drugs, such as trametinib, have shown promise in other cancers and are being utilized in low-grade gliomas. A retrospective chart review was conducted to evaluate radiographic response, visual outcomes, tolerability, and durability of response in progressive circumscribed low-grade gliomas treated with trametinib. Eleven patients were treated with trametinib. The best radiographic response was 2/11 partial response, 3/11 minor response, 3/11 stable disease, and 3/13 progressive disease. In the patients with partial or minor response, the best response was seen after longer durations of therapy; 4 of 5 best responses occurred after at least 9 months of therapy with a median of 21 months. Patients with optic pathway tumors showed at least stable vision throughout treatment, with 3 having improved vision on treatment. Trametinib is effective and well-tolerated in patients with progressive low-grade glioma. Best responses were seen after a longer duration of therapy in those with a positive response. Patients with optic pathway lesions showed stable to improved vision while on treatment.
Authors
Hanzlik, E; Archambault, B; El-Dairi, M; Schroeder, K; Patel, MP; Lipp, ES; Peters, KB; Ashley, DM; Landi, D
MLA Citation
Hanzlik, Emily, et al. “Use of Trametinib in Children and Young Adults With Progressive Low-grade Glioma and Glioneuronal Tumors.J Pediatr Hematol Oncol, vol. 45, no. 4, May 2023, pp. e464–70. Pubmed, doi:10.1097/MPH.0000000000002598.
URI
https://scholars.duke.edu/individual/pub1565314
PMID
36730221
Source
pubmed
Published In
Journal of Pediatric Hematology/Oncology
Volume
45
Published Date
Start Page
e464
End Page
e470
DOI
10.1097/MPH.0000000000002598

Research Areas:

Brain--Tumors
Cancer
Cognition
Quality of Life
Supratentorial brain tumors