Mary L. Affronti, DNP, MHSc, RN, ANP

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
  • Master of Science in Nursing Program
  • Doctor of Nursing Practice Program
Education
  • MHSc - Duke University School of Medicine
  • DNP - Duke University School of Nursing
  • MSN - Duke University
  • BS - University of Delaware
Research Interests
Research interests include:
1. Primary Brain Tumors
2. Therapeutic Management
3. Symptomatic Management
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 Interest
clinical trials
glioma
brain tumors
Representative Publications
  • 2009 -- PubMed # : 19514083 -- Affronti, M. L. and Heery, C. R. and Herndon 2nd, J. E. and Rich, J. N. and Reardon, D. A. and Desjardins, A. and Vredenburgh, J. J. and Friedman, A. H. and Bigner, D. D. and Friedman, H. S. Overall survival of newly diagnosed glioblastoma patients receiving carmustine wafers followed by radiation and concurrent temozolomide plus rotational multiagent chemotherapy. Cancer. 115(15); 3501-11.
  • 2007 -- PubMed # : 18472995 -- Bota, D. A. and Desjardins, A. and Quinn, J. A. and Affronti, M. L. and Friedman, H. S. Interstitial chemotherapy with biodegradable BCNU (Gliadel) wafers in the treatment of malignant gliomas. Ther Clin Risk Manag. 3(5); 707-15.
  • 2006 -- PubMed # : 16633363 -- Vredenburgh, J. J. and Madan, B. and Coniglio, D. and Ross, M. and Broadwater, G. and Niedzwiecki, D. and Edwards, J. and Marks, L. and Vandemark, R. and McDonald, C. and Affronti, M. L. and 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 Marrow Transplant. 37(11); 1009-15.
  • 2006 -- PubMed # : 16443517 -- Vredenburgh, J. J. and Coniglio, D. and Broadwater, G. and Jones, R. B. and Ross, M. and Shpall, E. J. and Hussein, A. and Rizzieri, D. and Marks, L. B. and Gilbert, C. and Affronti, M. L. and Moore, S. and McDonald, C. and Petros, W. P. and 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 chemo Biol Blood Marrow Transplant. 12(2); 195-203.
  • 2004 -- PubMed # : 15134629 -- Quinn, J. A. and Reardon, D. A. and Friedman, A. H. and Rich, J. N. and Sampson, J. H. and Vredenburgh, J. and Gururangan, S. and Provenzale, J. M. and Walker, A. and Schweitzer, H. and Bigner, D. D. and Tourt-Uhlig, S. and Herndon 2nd, J. E. and Affronti, M. L. and Jackson, S. and Allen, D. and Ziegler, K. and Bohlin, C. and Lentz, C. and Friedman, H. S. Phase 1 trial of irinotecan plus BCNU in patients with progressive or recurrent malignant glioma. Neuro Oncol. 6(2); 145-53.
  • 2004 -- PubMed # : 15134628 -- Reardon, D. A. and Quinn, J. A. and Rich, J. N. and Gururangan, S. and Vredenburgh, J. and Sampson, J. H. and Provenzale, J. M. and Walker, A. and Badruddoja, M. and Tourt-Uhlig, S. and Herndon 2nd, J. E. and Dowell, J. M. and Affronti, M. L. and Jackson, S. and Allen, D. and Ziegler, K. and Silverman, S. and Bohlin, C. and Friedman, A. H. and Bigner, D. D. and Friedman, H. S. Phase 2 trial of BCNU plus irinotecan in adults with malignant glioma. Neuro Oncol. 6(2); 134-44.
  • 2003 -- PubMed # : 12586801 -- Quinn, J. A. and Reardon, D. A. and Friedman, A. H. and Rich, J. N. and Sampson, J. H. and Provenzale, J. M. and McLendon, R. E. and Gururangan, S. and Bigner, D. D. and Herndon 2nd, J. E. and Avgeropoulos, N. and Finlay, J. and Tourt-Uhlig, S. and Affronti, M. L. and Evans, B. and Stafford-Fox, V. and Zaknoen, S. and Friedman, H. S. Phase II trial of temozolomide in patients with progressive low-grade glioma. J Clin Oncol. 21(4); 646-51.
  • 2001 -- PubMed # : 11584894 -- Gururangan, S. and Cokgor, L. and Rich, J. N. and Edwards, S. and Affronti, M. L. and Quinn, J. A. and Herndon 2nd, J. E. and Provenzale, J. M. and McLendon, R. E. and Tourt-Uhlig, S. and Sampson, J. H. and Stafford-Fox, V. and Zaknoen, S. and Early, M. and Friedman, A. H. and Friedman, H. S. Phase I study of Gliadel wafers plus temozolomide in adults with recurrent supratentorial high-grade gliomas. Neuro Oncol. 3(4); 246-50.
  • 1999 -- PubMed # : 10506601 -- Rizzieri, D. A. and Vredenburgh, J. J. and Jones, R. and Ross, M. and Shpall, E. J. and Hussein, A. and Broadwater, G. and Berry, D. and Petros, W. P. and Gilbert, C. and Affronti, M. L. and Coniglio, D. and Rubin, P. and Elkordy, M. and Long, G. D. and Chao, N. J. and 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. 17(10); 3064-74.
  • 1995 -- PubMed # : 7578986 -- Cartee, L. and Petros, W. P. and Rosner, G. L. and Gilbert, C. and Moore, S. and Affronti, M. L. and Hoke, J. A. and Hussein, A. M. and Ross, M. and Rubin, P. Evaluation of GM-CSF mouthwash for prevention of chemotherapy-induced mucositis: a randomized, double-blind, dose-ranging study. Cytokine. 7(5); 471-7.
  • 1992 -- PubMed # : 1629422 -- Vandemark, R. M. and Shpall, E. J. and Affronti, M. L. Bone metastases from breast cancer: value of CT bone windows. J Comput Assist Tomogr. 16(4); 608-14.
  • 1991 -- PubMed # : 1985173 -- Shpall, E. J. and Jones, R. B. and Bast Jr, R. C. and Rosner, G. L. and Vandermark, R. and Ross, M. and Affronti, M. L. and Johnston, C. and Eggleston, S. and 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. 9(1); 85-93.
  • 1990 -- PubMed # : 2364358 -- Jones, R. B. and Shpall, E. J. and Shogan, J. and Affronti, M. L. and Coniglio, D. and Hart, L. and Halperin, E. and Iglehart, J. D. and Moore, J. and Gockerman, J. The Duke AFM Program. Intensive induction chemotherapy for metastatic breast cancer. Cancer. 66(3); 431-6.
  • 1990 -- PubMed # : 2189592 -- Jones, R. B. and Shpall, E. J. and Ross, M. and Coniglio, D. and Affronti, M. L. and 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.
  • 1988 -- PubMed # : 3048440 -- Peters, W. P. and Stuart, A. and Affronti, M. L. and Kim, C. S. and Coleman, R. E. Neutrophil migration is defective during recombinant human granulocyte-macrophage colony-stimulating factor infusion after autologous bone marrow transplantation in humans. Blood. 72(4); 1310-5.
  • 2014 -- PubMed # : 24570103 -- Affronti, M. L. and Schneider, S. M. and Herndon 2nd, J. E. and Schlundt, S. and 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.
  • 1989 -- Peters, W. P. and Atwater, S. and Kurtzberg, J. and Borowitz, M. and Brandt, S. J. and Coleman, R. E. and Kim, C. S. and Gilbert, C. and Shpall, E. J. and Jones, R. B. and Shogan, J. and Bast, R. C. and Oette, D. and Stuart, A. and Coniglio, D. and Affronti, M. L. and 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.
  • 1990 -- PubMed # : 2308989 -- Shpall, E. J. and Anderson, I. C. and Bast Jr, R. C. and Joines, W. T. and Jones, R. B. and Ross, M. and Edwards, S. and Eggleston, S. and Johnston, C. and Tepperberg, M. and Affronti, M. L. and Coniglio, D. and Mathias, B. and 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.
  • 1991 -- Affronti, M. L. and Vanacek, K. and 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.
  • 1996 -- PubMed # : 8612310 -- Hussein, A. M. and Petros, W. P. and Ross, M. and Vredenburgh, J. J. and Affrontil, M. L. and Jones, R. B. and Shpall, E. J. and Rubin, P. and Elkordy, M. and Gilbert, C. and Gupton, C. and Egorin, M. J. and Soper, J. and Berchuck, A. and Clarke-Person, D. and Berry, D. A. and 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.
  • 1990 -- Affronti, M. L. and Coniglio, D. Going for the cure [book review] Journal of the National Cancer Institute. 1990 82(5); 425-426.
  • 1991 -- Abernathy, E. and Affronti, M. L. Clinical guidelines for patient management: Prokine Sargramostim. 1991 .
  • 1989 -- Peters, W. P. and Atwater, S. and Kurtzberg, J. and Borowitz, M. and Brandt, S. J. and Coleman, R. E. and Kim, C.S. and Gilbert, C. and Shpall, E. J. and Jones, R. B. and Shogan, J. and Oette, D. and Stuart, A. and Coniglio, D. and Affronti, M. L. and Evans, S. The use of recombinant human granulocyte-macrophage colony-stimulating factor in autologous bone marrow transplantation. 1989 595-606.
  • 1994 -- Shpall, E. J. and Jones, R. B. and Bast, R. and Shogan, J. and Ross, M. and Edwards, S. and Eggleston, S. and Johnston, C. and Affronti, M. and Coniglio, D. and Peters, W.P. Mobilization and collection of peripheral blood progenitor cells for support of high-dose cancer therapy. 1994 913-918.
  • 2014 -- PubMed # : 25228819 -- Affronti, M. L. and 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.
Grant Funding (Selected)
  • Phase II study to evaluate the efficacy and safety of AMG102 and Avastin in subjects with recurrent malignant glioma
    Amgen
    07/2010 to 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.
  • 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 to 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.
  • 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 to 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 to 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 to 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 to 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 to 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 to 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.
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