Terri S. Armstrong, Ph.D., ANP-BC, FAAN, FAANP
Dr. Armstrong, being a trained clinician and scientist, strives to understand the natural history of brain tumors to better predict the clinical trajectory of patients, especially those participating in clinical trials. Driven by her experience as a care provider for patients with central nervous system tumors for nearly 30 years, her research program primarily encompasses the investigation of interventions that reduce symptom burden on brain tumor patients. Additionally, Dr. Armstrong’s Cancer Moonshot-funded NCI-CONNECT program specifically seeks to study rare CNS tumors.
The goal of this research is to better understand not only what therapeutics interventions designed in other parts of NOB are beneficial to patient outcomes, but how these therapies affect the patient themselves. There are several modules within Dr. Armstrong’s research study that seek to delve deeper into technologies and methods that can enhance patients’ lives while undergoing treatment and also collect data to eventually gain a better understanding of CNS tumors and their development.
Areas of expertise: 1) symptom science, 2) clinical trials, 3) neuro-oncology, 4) natural history, 5) patient outcomes
Dr. Armstrong’s research group, comprised of post-doctoral fellows, post-baccalaureate fellows, and research associates, brings various aspects of patient outcomes research to the Neuro-Oncology Branch through both observational and interventional studies. Previous studies have shed light on the heavy symptom burden on patients with CNS tumors often rated as moderate-severe, which can then lead to functional limitations with significant societal, social, emotional and financial impacts on their lives. The first set of studies within Dr. Armstrong’s program focuses on improving understanding of the natural history and outcomes by enrolling every patient that consults with the branch into a Natural History Study (NHS). Results from this study allow the tracking of each patient’s disease trajectory along with obtaining longitudinal self-reported data on treatment, symptoms, functional status, and quality of life. These patient-reported outcomes are also included in every clinical trial within NOB, ensuring that the benefit of all therapeutic trials can be measured. Finally, this project also includes the integration of strategic interventions in the form of wearable technologies to combat issues such as scan anxiety or sleep distress and aid self-management of symptoms.
The second broad project within Dr. Armstrong’s research program explores the identification of clinical and genomic predictors of toxicity. Her previous studies have shown that single-nucleotide polymorphisms can be associated with risk of certain therapeutic-related toxicities occurring with temozolomide use or hypersomnia caused by radiation therapy. Development of mouse models to recapitulate radiation-induced hypersomnia (RIH) to elucidate their biologic correlates and study circadian rhythms is an additional aim of this work that may eventually improve outcome in patients. To further this second project, Dr. Armstrong co-leads the NCI-CONNECT program with Dr. Gilbert, the mission of which is to advance the understanding of twelve rare adult CNS cancers by establishing and fostering patient-advocacy-provider partnerships and networks to improve approaches to care and treatment. The primary objective of NCI-CONNECT is also to identify clinical and genomic factors associated with the risk of developing the respective toxicities in patients.
Dr. Armstrong’s research program seeks to gain a better understanding of how a patient feels and functions through their disease trajectory and can have a significant impact on patients with CNS tumors and their caregivers, how a clinician may better time therapeutic intervention for maximal benefit, and finally, how this will improve long-term care for this subset of patients.
FIGURE LEGEND: An overview of the patient outcomes research project led by Dr. Armstrong illustrates how collecting patient data and investigation of the genetic and biological basis of disease can lead to better predictions in a patient’s clinical trajectory through treatment, as well as the development of more effective, biologically-based therapeutic interventions that result in maximal benefit.
Selected Key Publications
Glioma patient reported outcome assessment in clinical care and research: a RANO collaborative report..Lancet Oncology. Submitted: [ Journal Article ]
Identifying symptom recurrences in primary brain tumor patients using the MDASI-BT and qualitative interviews..Patient Reported Outcomes. 3:58: Epub ahead of print., 2019. [ Journal Article ]
- Nature. 561 (7724): Epub ahead of print., 2018. [ Journal Article ]
The impact and incidence of altered body image in patients with head and neck tumors: a systematic review. .Neuro-Oncology Practice. 5(4): 204-213, 2018. [ Journal Article ]
- Neuro-Oncology Practice. 5(10): 122-128, 2018. [ Journal Article ]
Dr. Armstrong obtained her Bachelor of Science in Nursing from the University of Akron in Ohio, and, following a few years of clinical practice as a staff nurse, pursued a Master of Science in Oncology from Ohio State University. She also completed a Postmaster’s Nurse Practitioner Certificate and was soon after introduced to the field of Neuro-Oncology. Realizing that her passion lay in understanding disease burden for patients and their caregivers, she became an instructor and adjunct faculty member at Emory University, where her experience drove her to later pursue a Ph.D. in order to eventually lead an independent research program. Dr. Armstrong remained an advanced practice nurse and adjunct faculty member at the University of Texas MD Anderson Cancer Center while working on her advanced degree and later joined the staff as an Associate Professor. She was awarded the John S. Dunn Distinguished Professorship in Oncology Nursing in 2012 and joined the NIH Neuro-Oncology Branch in 2016 as a Senior Investigator and later became Deputy Branch Chief of NOB in 2018.
In addition to her Deputy Chief role at NOB, Dr. Armstrong has served on several committees and the Board of Directors for the Society for Neuro-Oncology. She is also Associate Editor for several journals such as Neuro-Oncology Practice and Neuro-Oncology and is licensed to practice as a clinician in Maryland. Her work is highlighted by an impressive track records of awarded grants, the most prestigious of which are received from the CERN foundation and the National institute of Nursing Research, in addition to a Beau Biden Cancer Moonshot Grant received in 2017 that provided the funding for the NCI- CONNECT (Comprehensive Oncology Networks Evaluation Rare CNS Tumors) program.
Honors, Awards and Leadership
- Distinguished Alumni, University of Texas Health Science Center - 2018
- Dean’s Mentoring Award, University of Texas Health School of Nursing - 2015
- Inducted Fellow, American Academy of Nursing - 2013
- John S. Dunn Distinguished Professorship in Oncology Nursing, University of Texas Health School of Nursing - 2012
- Inducted Fellow, American Academy of Nurse Practitioners - 2009
- Outstanding Researcher of the Year, Sigma Theta Tau - 2008
- Doctoral Student Writing Award, University of Texas Health School of Nursing - 2006
- Patient Educator of the Year, MD Anderson Cancer Center - 2005
- Educator of the Month, MD Anderson Cancer Center -March 2005
- Leadership Award in Education, MD Anderson Cancer Center - 2001
- Quality of Life Lectureship, Oncology Nursing Society - 1998
- Phi Kappa Phi Scholastic Honor, Ohio State University – 1991
Select Societies and Initiatives
- Women Scientist Advisory Committee, NCI, NIH (2018 - present)
- Society for Neuro-Oncology: Annual Awards Committee (2007 - 2015), Board of Directors (2008 - 2011), Vice President (2015 - 2017), Health Policy Committee Chair (2015 - 2018), Guidelines Committee (2016 - present), Wellness Committee Co-Chair (2018 - present)
- Patient Reported Outcomes Committee, NRG, NCI (2014-present),
- Head for the Cure Board of Directors (2012-2016)
- Collaborative Ependymoma Research (CERN) Foundation Board Member (2015 - present)
- American Society of Clinical Oncology (ASCO), PLWC Advisory Panel (2006 - 2017)
- Alliance Oncology Research Group: Health Disparities (2013 - present), Neuro-Oncology Working Group (2013 - present), CCDR Representative for Neuro-Oncology (2013 - present)
|Alvina Acquaye M.S.||Senior Research Associate (Contr.)|
|Nicole Briceno||Lab Technician (Contr.)|
|Alexa Christ||Clinical Research Coordinator (Contr.)|
|Varna Jammula||Postbaccalaureate Fellow (CRTA)|
|Amanda King Ph.D.||Postdoctoral Fellow (iCure)|
|Nicole M. Leggiero||Special Volunteer|
|James Rogers||Special Volunteer|
|Dorela Shuboni-Mulligan Ph.D.||Postdoctoral Fellow (CRTA)|
|Michael Timmer||Special Volunteer|
|Elizabeth Vera M.S.||Senior Research Associate (Contr.)|
|Demarrius Young||Special Volunteer|