Brief Bio

Dr. Mary Lou Affronti joined the Duke University School of Nursing faculty in February 2014. She earned both her DNP and her MSN at DUSON, and also earned a Master’s degree in Health Science in Clinical Research from the Duke University School of Medicine. She holds a Clinical Associate faculty appointment in the Duke University Medical Center Department of Surgery /Neurosurgery. She is also Senior Investigator and Adult Nurse Practitioner at the Preston Robert Tisch Brain Tumor Center in the Duke Cancer Institute.

Dr. Affronti has been a part of Duke’s oncology clinical and research community for almost three decades, and has been associated with DUSON since 1989 in a variety of roles, including clinical associate, guest lecturer, preceptor, and clinical instructor. She was instrumental in developing the oncology curriculum for DUSON nurse practitioner students. In 2005, she was honored by the Friends of Nursing at Duke with the Evelyn Morgan Award for Excellence in Oncology Nursing. Dr. Affronti’s DNP capstone on adherence to antiemetic guidelines in patients with malignant glioma, which received the Outstanding Capstone Doctoral Project Award in 2013, has just been published in Supportive Care in Cancer.

Dr. Affronti has been developing and leading therapeutic and supportive care research while continuing to see patients as a nurse practitioner, and is continuing both her clinical and research activities at the Brain Tumor Center. She has a strong interest in the development and testing of therapies for primary brain tumors, and is currently a co-principal or principal investigator on four Phase II clinical trials at the Brain Tumor Center.

Academic Program Affiliations

Education

Professional Certifications

Research Interests

Awards and Honors

• 2013 Graduation Marshal, Duke University School of Nursing Doctor of Nursing Practice

• 2013 Outstanding Capstone Doctoral Project Award, Duke University School of Nursing DNP Program

• 2005 Received Evelyn Morgan Award for Excellence in Oncology Nursing Practice, Friends of Nursing

• 2002 Nominee, Evelyn Morgan Award for Excellence in Oncology Nursing Practice, Friends of Nursing

• 2000 Who’s Who in Medicine and Healthcare

• 1995 Nominee, Evelyn Morgan Award for Excellence in Oncology Nursing Practice, Friends of Nursing

• 1993 William Randolph Hearst Nursing Merit Scholarship, Duke University School of Nursing

• 1990 Nominee, Oncology Nursing Society (ONS) / Schering Excellence in Cancer Nursing Research Award, Oncology Nursing Society

• 1986 Anna Hoyns Memorial Merit Scholarship, Duke University School of Nursing

• 1986 Inducted, National Dean’s List

• 1986 Outstanding Thesis Award (MSN), Duke University School of Nursing

• 1986 Who’s Who Among Students in American Universities & Colleges

• 1985 Betsy Keaton Fonville Gant Nursing Education Scholarship, Duke University School of Nursing

• 1982 Anna R. Overdeer Award – Merit Scholarship, University of Delaware

• 1982 Inducted, Sigma Theta Tau International

Areas of Expertise

• Oncology
• Translational Research

Areas of Interest

• clinical trials
• glioma
• brain tumors

Representative Publications

• 2014 -- Pubmed # 25228819 Affronti, M. L., Bubalo, J. Palonosetron in the management of chemotherapy-induced nausea and vomiting in patients receiving multiple-day chemotherapy. Cancer Manag Res. September 5, 2014; 6 329-37

• 2014 -- Pubmed # 24570103 Affronti, M. L., Schneider, S. M., Herndon 2nd, J. E., Schlundt, S., Friedman, H. S. Adherence to antiemetic guidelines in patients with malignant glioma: a quality improvement project to translate evidence into practice. Support Care Cancer. July, 2014; 22(7); 1897-905

• 2009 -- Pubmed # 19514083 Affronti, M. L., Heery, C. R., Herndon 2nd, J. E., Rich, J. N., Reardon, D. A., Desjardins, A., Vredenburgh, J. J., Friedman, A. H., Bigner, D. D., Friedman, H. S. Overall survival of newly diagnosed glioblastoma patients receiving carmustine wafers followed by radiation and concurrent temozolomide plus rotational multiagent chemotherapy. Cancer. August 1, 2009; 115(15); 3501-11

• 2007 -- Pubmed # 18472995 Bota, D. A., Desjardins, A., Quinn, J. A., Affronti, M. L., Friedman, H. S. Interstitial chemotherapy with biodegradable BCNU (Gliadel) wafers in the treatment of malignant gliomas. Ther Clin Risk Manag. October 1, 2007; 3(5); 707-15

• 2006 -- Pubmed # 16633363 Vredenburgh, J. J., Madan, B., Coniglio, D., Ross, M., Broadwater, G., Niedzwiecki, D., Edwards, J., Marks, L., Vandemark, R., McDonald, C., Affronti, M. L., Peters, W. P. A randomized phase III comparative trial of immediate consolidation with high-dose chemotherapy and autologous peripheral blood progenitor cell support compared to observation with delayed consolidation in women with metastatic breast cancer and only bone metastases following intensive induction chemotherapy. Bone Marrow Transplant. June 1, 2006; 37(11); 1009-15

• 2006 -- Pubmed # 16443517 Vredenburgh, J. J., Coniglio, D., Broadwater, G., Jones, R. B., Ross, M., Shpall, E. J., Hussein, A., Rizzieri, D., Marks, L. B., Gilbert, C., Affronti, M. L., Moore, S., McDonald, C., Petros, W. P., Peters, W. P. Consolidation with high-dose combination alkylating agents with bone marrow transplantation significantly improves disease-free survival in hormone-insensitive metastatic breast cancer in complete remission compared with intensive standard-dose chemotherapy alone. Biol Blood Marrow Transplant. February 1, 2006; 12(2); 195-203

• 2004 -- Pubmed # 15134629 Quinn, J. A., Reardon, D. A., Friedman, A. H., Rich, J. N., Sampson, J. H., Vredenburgh, J., Gururangan, S., Provenzale, J. M., Walker, A., Schweitzer, H., Bigner, D. D., Tourt-Uhlig, S., Herndon 2nd, J. E., Affronti, M. L., Jackson, S., Allen, D., Ziegler, K., Bohlin, C., Lentz, C., Friedman, H. S. Phase 1 trial of irinotecan plus BCNU in patients with progressive or recurrent malignant glioma. Neuro Oncol. April 1, 2004; 6(2); 145-53

• 2004 -- Pubmed # 15134628 Reardon, D. A., Quinn, J. A., Rich, J. N., Gururangan, S., Vredenburgh, J., Sampson, J. H., Provenzale, J. M., Walker, A., Badruddoja, M., Tourt-Uhlig, S., Herndon 2nd, J. E., Dowell, J. M., Affronti, M. L., Jackson, S., Allen, D., Ziegler, K., Silverman, S., Bohlin, C., Friedman, A. H., Bigner, D. D., Friedman, H. S. Phase 2 trial of BCNU plus irinotecan in adults with malignant glioma. Neuro Oncol. April 1, 2004; 6(2); 134-44

• 2003 -- Pubmed # 12586801 Quinn, J. A., Reardon, D. A., Friedman, A. H., Rich, J. N., Sampson, J. H., Provenzale, J. M., McLendon, R. E., Gururangan, S., Bigner, D. D., Herndon 2nd, J. E., Avgeropoulos, N., Finlay, J., Tourt-Uhlig, S., Affronti, M. L., Evans, B., Stafford-Fox, V., Zaknoen, S., Friedman, H. S. Phase II trial of temozolomide in patients with progressive low-grade glioma. J Clin Oncol. February 15, 2003; 21(4); 646-51

• 2001 -- Pubmed # 11584894 Gururangan, S., Cokgor, L., Rich, J. N., Edwards, S., Affronti, M. L., Quinn, J. A., Herndon 2nd, J. E., Provenzale, J. M., McLendon, R. E., Tourt-Uhlig, S., Sampson, J. H., Stafford-Fox, V., Zaknoen, S., Early, M., Friedman, A. H., Friedman, H. S. Phase I study of Gliadel wafers plus temozolomide in adults with recurrent supratentorial high-grade gliomas. Neuro Oncol. October 1, 2001; 3(4); 246-50

• 1999 -- Pubmed # 10506601 Rizzieri, D. A., Vredenburgh, J. J., Jones, R., Ross, M., Shpall, E. J., Hussein, A., Broadwater, G., Berry, D., Petros, W. P., Gilbert, C., Affronti, M. L., Coniglio, D., Rubin, P., Elkordy, M., Long, G. D., Chao, N. J., Peters, W. P. Prognostic and predictive factors for patients with metastatic breast cancer undergoing aggressive induction therapy followed by high-dose chemotherapy with autologous stem-cell support. J Clin Oncol. October 1, 1999; 17(10); 3064-74

• 1996 -- Pubmed # 8612310 Hussein, A. M., Petros, W. P., Ross, M., Vredenburgh, J. J., Affrontil, M. L., Jones, R. B., Shpall, E. J., Rubin, P., Elkordy, M., Gilbert, C., Gupton, C., Egorin, M. J., Soper, J., Berchuck, A., Clarke-Person, D., Berry, D. A., Peters, W. P. A phase I/II study of high-dose cyclophosphamide, cisplatin, and thioTEPA followed by autologous bone marrow and granulocyte colony-stimulating factor-primed peripheral-blood progenitor cells in patients with advanced malignancies. Cancer Chemother Pharmacol. 1996; 37(6); 561-8

• 1995 -- Pubmed # 7578986 Cartee, L., Petros, W. P., Rosner, G. L., Gilbert, C., Moore, S., Affronti, M. L., Hoke, J. A., Hussein, A. M., Ross, M., Rubin, P. Evaluation of GM-CSF mouthwash for prevention of chemotherapy-induced mucositis: a randomized, double-blind, dose-ranging study. Cytokine. July 1, 1995; 7(5); 471-7

• 1994 -- Shpall, E. J., Jones, R. B., Bast, R., Shogan, J., Ross, M., Edwards, S., Eggleston, S., Johnston, C., Affronti, M., Coniglio, D., Peters, W.P. Mobilization and collection of peripheral blood progenitor cells for support of high-dose cancer therapy. In Bone Marrow Transplantation, edited by Forman, S. J. and Blume, K. G., andThomas, E. D. 1994; pp. 913-918. Boston, MA: Blackwell Scientific Publications.

• 1992 -- Pubmed # 1629422 Vandemark, R. M., Shpall, E. J., Affronti, M. L. Bone metastases from breast cancer: value of CT bone windows. J Comput Assist Tomogr. August 20, 1992; 16(4); 608-14

• 1991 -- Pubmed # 1985173 Shpall, E. J., Jones, R. B., Bast Jr, R. C., Rosner, G. L., Vandermark, R., Ross, M., Affronti, M. L., Johnston, C., Eggleston, S., Tepperburg, M. 4-Hydroperoxycyclophosphamide purging of breast cancer from the mononuclear cell fraction of bone marrow in patients receiving high-dose chemotherapy and autologous marrow support: a phase I trial. J Clin Oncol. January 1, 1991; 9(1); 85-93

• 1991 -- Affronti, M. L., Vanacek, K., Peters, W. P. High-dose chemotherapy followed by autologous bone marrow transplant for the treatment of advanced breast cancer. Innovations in Oncology Nursing. 1991; 6(4); 2-21

• 1991 -- Abernathy, E., Affronti, M. L. Clinical guidelines for patient management: Prokine Sargramostim. 1991;

• 1990 -- Pubmed # 2364358 Jones, R. B., Shpall, E. J., Shogan, J., Affronti, M. L., Coniglio, D., Hart, L., Halperin, E., Iglehart, J. D., Moore, J., Gockerman, J. The Duke AFM Program. Intensive induction chemotherapy for metastatic breast cancer. Cancer. August 1, 1990; 66(3); 431-6

• 1990 -- Pubmed # 2189592 Jones, R. B., Shpall, E. J., Ross, M., Coniglio, D., Affronti, M. L., Peters, W. P. High-dose carboplatin, cyclophosphamide, and BCNU with autologous bone marrow support: excessive hepatic toxicity. Cancer Chemother Pharmacol. 1990; 26(2); 155-6

• 1990 -- Pubmed # 2308989 Shpall, E. J., Anderson, I. C., Bast Jr, R. C., Joines, W. T., Jones, R. B., Ross, M., Edwards, S., Eggleston, S., Johnston, C., Tepperberg, M., Affronti, M. L., Coniglio, D., Mathias, B., Peters, W. P. Immunopharmacologic purging of breast cancer from bone marrow for autologous bone marrow transplantation. Prog Clin Biol Res. 1990; 333 321-35; discussion 336

• 1990 -- Affronti, M. L., Coniglio, D. Going for the cure [book review] Journal of the National Cancer Institute. 1990; 82(5); 425-426

• 1989 -- Peters, W. P., Atwater, S., Kurtzberg, J., Borowitz, M., Brandt, S. J., Coleman, R. E., Kim, C. S., Gilbert, C., Shpall, E. J., Jones, R. B., Shogan, J., Bast, R. C., Oette, D., Stuart, A., Coniglio, D., Affronti, M. L., Evans, S. The use of recombinant human granulocyte-macrophage colony-stimulating factor in autologous bone marrow transplantation. Autologous Bone Marrow Transplantation. 1989; 4 657-667

• 1989 -- Peters, W. P., Atwater, S., Kurtzberg, J., Borowitz, M., Brandt, S. J., Coleman, R. E., Kim, C.S., Gilbert, C., Shpall, E. J., Jones, R. B., Shogan, J., Oette, D., Stuart, A., Coniglio, D., Affronti, M. L., Evans, S. The use of recombinant human granulocyte-macrophage colony-stimulating factor in autologous bone marrow transplantation. In Bone Marrow Transplantation: Current Controversies. Proceedings of a Sandoz-UCLA Symposium, held at Tamarron, Colorado, March 6-12, 1988, edited by Gale, R. P. and Champlin, R. 1989; pp. 595-606. New York: Alan R. Liss.

• 1988 -- Pubmed # 3048440 Peters, W. P., Stuart, A., Affronti, M. L., Kim, C. S., Coleman, R. E. Neutrophil migration is defective during recombinant human granulocyte-macrophage colony-stimulating factor infusion after autologous bone marrow transplantation in humans. Blood. October 1, 1988; 72(4); 1310-5

Grant Funding (selected)

• Phase II Randomized Cross-over Study to Evaluate Patient Satisfaction, Efficacy and Compliance of Granisetron Patch vs. Ondansetron in Malignant Glioma Patients Receiving Standard Radiotherapy (RT ) and Concomitant Temozolomide (TMZ)  
  Prostrakan Pharmaceuticals
  NCT01952886
  04/2014-06/2016
  Role: PI
  1. To assess whether malignant glioma patients receiving RT and concomitant TMZ (Stupp regimen) prefer (e.g. are more satisfied with) ondansetron or the granisetron transdermal patch (GTP) for the prevention of nausea and vomiting. 2. To compare the efficacy of granisetron transdermal patch and ondansetron in the prevention of nausea and vomiting, as measured by the overall complete response (CR) rate, among malignant glioma patients during the first 2 weeks of RT and concomitant TMZ.

• Phase II study to evaluate the efficacy and safety of AMG102 and Avastin in subjects with recurrent malignant glioma  
  Amgen
  07/2010-06/2015
  Role: Co-PI
  Project Goal: The primary purpose of the study is to assess the response rate of AMG 102 and Avastin treatment in subjects with advanced malignant glioma. The primary study endpoint is radiographic response, as defined by the modified McDonald (RANO) criteria, with progression-free survival, overall survival and toxicity as secondary endpoints.

• A Phase II Study to Evaluate the Efficacy and Safety of Intravenous Palonosetron in Primary Glioma Patients Receiving Standard Radiotherapy and Concomitant Temozolomide  
  Eisai, Inc.
  NCT00900757
  10/2007-10/2014
  Role: Co-PI
  Project Goal: To determine the efficacy and tolerability of intravenous palonosetron in preventing acute and delayed CINV in glioma patients receiving temozolomide and concurrent radiation.

• A Phase II trial of Aprepitant (Emend) Compared to Standard 5HT3 Serotonin Antagonist (Ondansetron) in the Prevention of Acute and Delayed Chemotherapy Induced Nausea and Vomiting (CINV) in Malignant Glioma Patients Receiving a Temozolomide Based Regimen.  
  Merck
  MISP 37322896
  07/2013-06/2014
  Role: Co-PI
  Project Goals: 1. To assess the CINV efficacy and toxicity of aprepitant in combination Ondansetron versus Ondansetron alone in preventing acute CINV in brain tumor patients during the acute period (first 23-hours) of receiving five day temozolomide therapy. 2. To assess the efficacy of aprepitant in combination with Ondansetron versus Ondansetron in preventing delayed CINV (day 2–5).

• A Phase II Trial of Zoledronic Acid to Prevent Osteoporosis in Patients with Brain Tumors  
  Novartis
  07/2006-06/2010
  Role: Co-PI
  Project Goal: To determine BMD changes in glioma patients over 12 month period while receiving zoledronic acid (Zometa)

• Phase II Trial for Patients with Glioblastoma Multiforme (GBM) Treated with Gliadel® Followed by Avastin Plus Irinotecan  
  MGI Pharma
  07/2008-06/2009
  Role: Co-PI
  Project Goal: To use 24 week survival to assess the efficacy of the combination of Gliadel® followed by Avastin and irinotecan in the treatment of grade IV malignant glioma patients following surgical resection.

• A Patient Survey to Determine the Use of Ondansetron and Palonosetron (PALO) in the Prevention of Acute and Delayed Nausea and Vomiting (CINV) in Forty Malignant Glioma Patients Receiving Irinotecan in Combination with Bevacizumab  
  MGI Pharma
  07/2007-06/2009
  Role: Co-PI
  Project Goal: To evaluate Palonosetron in combination with dexamethasone in preventing both acute and delayed chemotherapy induced nausea and vomiting (CINV) in malignant glioma patients receiving Irinotecan in combination with Bevacizumab. Pilot to Phase I PALO trial.

• Overall Survival of Primary GBM Patients receiving (BCNU Wafers Followed by) RT and Concurrent Temozolomide (TMZ) Plus Rotational Multi-agent Chemotherapy  
  OncoMethylome Sciences
  01/2008-12/2008
  Role: Co-PI
  Project Goal: Retrospective study - To determine the overall survival of primary GBM patients receiving (BCNU wafers followed by) radiation and concurrent TMZ plus rotational multi-agent chemotherapy.