Research Summary
The overall global research focus of Dr. Armstrong is on the development of new approaches to prevention, early detection and treatment of breast cancer and gynecologic malignancies. Her clinical focus covers three broad categories: treatment of gynecologic cancers, treatment of breast cancer, and genetic risk factors for breast and ovarian cancer with a particular emphasis on early detection and prevention for high risk women.
Much of Dr. Armstrong's work in treatment of gynecologic malignancies has been done through the Gynecologic Oncology Group. She has served as a member of the Ovarian Cancer, Developmental Therapeutics, Phase I Committee and Medical Oncology Committees for the GOG. Completed studies through the GOG for which Dr. Armstrong has been a Principal Investigator include a phase I study of taxol, cisplatin and topotecan in newly diagnosed ovarian cancer, a phase I study if intraperitoneal paclimer microspheres in ovarian cancer, a randomized phase III study of IV cisplatin and paclitaxel vs. an intensive intraperitoneal approach using these drugs in newly diagnosed ovarian cancer, phase II studies of Bryostatin-1 in ovarian cancer and cervical cancer and a trial of carboplatin and cetuximab in recurrent ovarian cancer. GOG studies ongoing or in development for which Dr. Armstrong is an investigator include a phase III trial of paclitaxel and carboplatin with or without bevacizumab in recurrent platinum sensitive ovarian cancer, a randomized phase II trial of temozolomide with or without the PARP inhibitor ABT-888 in uterine leiomyosarcoma, and a phase I trial of pegylated liposomal doxorubicin and carboplatin with the PARP inhibitor ABD-888 and bevacizumab.
In addition to work with GOG, Dr. Armstrong has worked at the institutional level on the development of new treatments for gynecologic malignancies. Current clinical trial directions include evaluation of the folate receptor alpha antagonist Farletuzumab in the treatment of both platinum resistant and platinum sensitive ovarian cancer, the use of sequential blockade of the VEGF pathway with the combination of bevacizumab and enzastaurin in gynecologic malignancies and targeting surface lectins with AGS8M4 in ovarian cancer. Ongoing areas of potential translational laboratory research include targeting Notch in ovarian cancer and identification and characterization of ovarian cancer stem cells.
Dr. Armstrong's work with breast and ovarian cancer patients has led to an increasing interest in identifying patients at increased risk of these diseases. Dr. Armstrong serves as director of the Breast and Ovarian Surveillance Service. This service provides genetic counseling and risk assessment for patients at an increased risk of developing these diseases. Ongoing trials through the high risk clinic evaluate screening, early detection and prevention. These studies include an ovarian cancer screening study (ROCA study), characterization of benign breast disease in women at increased risk for breast cancer and an evaluation of BRCA polymorphisms and clinical outcome in ovarian cancer.
Clinical Trial Keywords
Phase I, II and III clinical trials; Cancer Genetics; Breast Cancer; Ovarian Cancer; Gynecologic Malignancies
Selected Publications
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Messersmith, W.A.; Baker, S.D.; Lassiter, L.; Sullivan, R.A.; Dinh, K.; Almuete, V.I.; Wright, J.J.; Donehower, R.C.; Carducci, M.A.; Armstrong, D.K. Phase I trial of bortezomib in combination with docetaxel in patients with advanced solid tumors. Clin Cancer Res. 2006 Feb 15;12(4):1270-1275.
Visvanathan, K.; Santor, D.; Ali, S.Z.; Brewster, A.; Arnold, A.; Armstrong, D.K.; Davidson, N.E.; Helzlsouer, K.J. The reliability of nipple aspirate and ductal lavage in women at increased risk for breast cancer-a potential tool for breast cancer risk assessment and biomarker evaluation. Cancer Epidemiol Biomarkers Prev. 2007 May;16(5):950-955.
Rudin, C.M.; Liu, W.; Desai, A.; Karrison, T.; Jiang, X.; Janisch, L.; Das, S.; Ramirez, J.; Poonkuzhali, B.; Schuetz, E.; Fackenthal, D.L.; Chen, P.; Armstrong, D.K.; Brahmer, J.R.; Fleming, G.F.; Vokes, E.E.; Carducci, M.A.; Ratain, M.J. Pharmacogenomic and pharmacokinetic determinants of erlotinib toxicity. J Clin Oncol. 2008 Mar 1;26(7):1119-1127.
Balmanoukian, A.; Zhang, Z.; Jeter, S.; Slater, S.; Armstrong, D.K.; Emens, L.A.; Fetting, J.H.; Wolff, A.C.; Davidson, N.E.; Jacobs, L.; Lange, J.; Tsangaris, T.N.; Zellars, R.; Gabrielson, E.; Stearns, V. African American women who receive primary anthracycline- and taxane-based chemotherapy for triple-negative breast cancer suffer worse outcomes compared with white women. J Clin Oncol. 2009 Aug 1;27(22):e35-37; author reply e38-39.
Zellars, R.C.; Stearns, V.; Frassica, D.; Asrari, F.; Tsangaris, T.; Myers, L.; DiPasquale, S.; Lange, J.R.; Jacobs, L.K.; Emens, L.A.; Armstrong, D.K.; Fetting, J.H.; Garrett-Mayer, E.; Davidson, N.E.; Wolff, A.C. Feasibility trial of partial breast irradiation with concurrent dose-dense doxorubicin and cyclophosphamide in early-stage breast cancer. J Clin Oncol. 2009 Jun 10;27(17):2816-2822.
Chumsri, S.; Jeter, S.; Jacobs, L.K.; Nassar, H.; Armstrong, D.K.; Emens, L.A.; Fetting, J.H.; Lange, J.R.; Riley, C.; Tsangaris, T.N.; Wolff, A.C.; Zellars, R.; Zhang, Z.; Stearns, V. Pathologic complete response to preoperative sequential doxorubicin/cyclophosphamide and single-agent taxane with or without trastuzumab in stage II/III HER2-positive breast cancer. Clin Breast Cancer. 2010 Feb;10(1):40-45.
Sharrow, A.C.; Ronnett, B.M.; Thoburn, C.J.; Barber, J.P.; Giuntoli, R.L., 2nd; Armstrong, D.K.; Jones, R.J.; Hess, A.D. Identification and characterization of a spontaneous ovarian carcinoma in Lewis rats. J Ovarian Res. 2010;3:9.
