The Duke Endocrine Neoplasia Research Group is committed to providing high-quality research and training in the field of Endocrine Neoplasia. The group comprises surgeons, endocrinologists, medical and radiation oncologists, residents, fellows, health services researchers, epidemiologists, pathologists, biostatisticians, surgical scientists, pharmacologists, and environmental health scientists at Duke, as well as surgery and biomedical engineering faculty from UNC-Chapel Hill and NC State. The multidisciplinary nature of this group makes it ideal to tackle the pressing issues of endocrine neoplasms and work toward bridging gaps in patient care at the individual and population levels.
Our research is focused on benign and malignant diseases of the thyroid, parathyroid, pancreas, and adrenal glands. Although our primary focus is health services research and health outcomes, we are also interested in examining different issues along the continuum of patient care, including translational research, the psychological and economic impact on patients of endocrine diseases and their subsequent treatment, and patients’ decisions regarding the different diagnostic and treatment strategies available to them.
Key Projects Underway
- Rethinking the current AJCC staging systems for medullary and papillary thyroid cancer
- Examination of national complication and readmission rates after endocrine surgery
- Environmental exposures as risk factors for development of thyroid cancer
- Development of genetic signature that predicts progression of thyroid cancer and clonal evolution of metastatic disease
- Examination of the underlying mechanisms of disrupted calcium sensing in parathyroid tumors
The research we have undertaken has had an impact on the way patients with endocrine diseases, specifically thyroid cancer, are cared for in the United States. Some of our most impactful recent projects have included:
- Optimal extent of surgical resection for differentiated thyroid cancer (featured as a landmark study in the 2015 edition of the practice guidelines for thyroid nodules and differentiated thyroid cancer of the American Thyroid Association)
- Role of age in disease severity and selection for treatment of differentiated thyroid cancer
- Prognostic role of lymph node metastases in differentiated thyroid cancer
- Utilization and oncologic safety of alternative surgical approaches, such as robotic and endoscopic thyroidectomy
- Establishing minimum annual surgeon volume thresholds for thyroidectomy for optimal patient outcomes (featured in the New York Times, The Washington Post, and included in the 2016 edition of the practice guidelines for hyperthyroidism and thyrotoxicosis of the American Thyroid Association)
We also conduct correlative and therapeutic clinical trials to develop novel diagnostics and treatments for patients with advanced, unresectable endocrine malignancies. Active trials include:
Role of NGS-Based ThyroSeq Panel in Cancer Diagnosis in Thyroid Nodules
Targeted next generation sequencing (NGS) platforms allow testing for tens and hundreds mutational hotspots, identifying markers associated with tumor prognosis. By participating in this multi-institutional study, we hope to assist in the validation of these markers.
Funding: University of Pittsburgh
Thyroid Cancer and Polybrominated Diphenyl Ether (PBDE) Exposure
Clinical-translational mechanisms are used to explore the association between PBDE exposure, serum PBDE levels, and thyroid cancer.
Funding: Cancer in the Environment Award from the DCI and Nicholas School of the Environment
Randomized Double-Blind Phase II Study of Radioactive Iodine (RAI) in Combination with Placebo or Selumetinib for the Treatment of RAI-Avid Recurrent/Metastatic Thyroid Cancers
The study examines the response of tumors following treatment with radioactive iodine in combination with placebo or selumetinib for RAIA recurrent and/or metastatic thyroid cancer.
Funding: Academic and Community Cancer Research United and the International Thyroid Oncology Group
RIFTOS MKI – Radioactive Iodine reFractory Asymptomatic Patients in Differentiated Thyroid Cancer – An Observational Study to Assess the Use of MultiKinase Inhibitors
An international prospective, open-label, multi-center, non-interventional study designed to compare treatment options in DTC, and practice patterns of care of patients with RAI-refractory DTC.
Funding: Bayer Healthcare
Eisai – An Open-Label, Single-Arm, Multicenter, Phase 2 Trial of Lenvatinib for the Treatment of Anaplastic Thyroid Cancer (ATC)
This study evaluates objective response in subjects with ATC treated with lenvatinib.
Funding: Eisai, Inc.
Postdoctoral Research Training: For fellows who have completed a clinical Endocrine Surgery Fellowship or other qualified surgeons who are interested in pursuing endocrine neoplasia research training or mentorship in clinical or health services research, we offer a one-year post-doctoral research fellowship.
Julie Ann Sosa, MD, MA
Sanziana Roman, MD