Terri S. Armstrong, Ph.D., ANP-BC, FAAN, FAANP
- Center for Cancer Research
- National Cancer Institute
- Building 82, Room 201
- Bethesda, MD 20892
Dr. Armstrong is a trained clinician and scientist, who leads the Patient Outcomes Research Program at the Neuro-Oncology Branch (NOB). She strives to understand the impact of both the disease and treatment on how a person with a central nervous system (CNS) tumor feels and functions. Driven by her experience as a care provider for patients with CNS tumors for over 30 years, she oversees a research program that primarily investigates this impact through natural history studies, use of patient reported outcomes in clinical research and therapeutic trials, and evaluation of interventions that reduce the symptom burden on brain tumor patients. Her translational program also includes developing preclinical models specifically focused on the importance of circadian dysregulation and alterations in sleep on symptomatic toxicities. Additionally, Dr. Armstrong’s Cancer Moonshot-funded NCI-CONNECT (Comprehensive Oncology Network Evaluating Rare CNS Tumors) program specifically seeks to study rare CNS tumors.
The goal of the Patient Outcomes Research Program is to better understand not only which therapeutic interventions designed in other parts of the NOB are beneficial to patient outcomes, but also how these therapies affect the patient themselves. There are several components within Dr. Armstrong’s research that delve deeper into the underlying biology, use technologies and methods that can enhance patients’ lives while undergoing treatment, and collect data to eventually gain a better understanding of CNS tumors and their development.
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Dr. Armstrong’s Patient Outcomes Research Program is comprised of trans-disciplinary research staff and trainees, including research fellows, post-doctoral fellows, post-baccalaureate fellows, and research associates. Her team brings a translational research approach representing various aspects of patient outcomes research to the Neuro-Oncology Branch (NOB) through preclinical, observational, and interventional studies. Previous studies have shed light on the heavy symptom burden on patients with central nervous system (CNS) tumors, which can 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, and record longitudinal clinician-assessed and self-reported data on symptoms and functions. A standardized collection of patient-reported outcomes is also included in every clinical trial within the NOB, ensuring that the patient-perceived clinical benefit of all therapeutic trials can be measured. Finally, this project also includes the integration of strategic interventions in the form of wearable technologies, mobile application development, and the use of technology to deliver interventions 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 outcomes in patients. To further this second project, Dr. Armstrong co-leads the NCI-CONNECT (Comprehensive Oncology Network Evaluating Rare CNS Tumors) program with Dr. Mark Gilbert, which aims to advance the understanding of 12 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. This work can have a significant impact on patients with CNS tumors and their caregivers, how a clinician times therapeutic intervention for maximal benefit, and finally, has the potential to improve long-term care for this subset of patients.
Neurocognitive, symptom, and health-related quality of life outcomes of a randomized trial of bevacizumab for newly diagnosed glioblastoma (NRG/RTOG 0825).
A phase II study of dose-dense temozolomide and lapatinib for recurrent low-grade and anaplastic supratentorial, infratentorial, and spinal cord ependymoma.
Association of circadian clock gene expression with glioma tumor microenvironment and patient survival.
Glioma patient reported outcome assessment in clinical care and research: a RANO collaborative report.
See brain cancer as more than just the sum of biology.
Terri S. Armstrong, Ph.D., ANP-BC, FAAN, FAANP
Dr. Armstrong obtained a Bachelor of Science in nursing from the University of Akron in Ohio, a Master of Science in oncology from Ohio State University, 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. and 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 (MDACC) while working on her advanced degree. Upon completion, she joined the faculty at The University of Texas Health Science Center while maintaining an adjunct position at MDACC as an associated professor. She was awarded the John S. Dunn Distinguished Professorship in Oncology Nursing in 2012, followed by tenure. In 2016, she joined the Neuro-Oncology Branch (NOB) as a tenured senior investigator and head of the Patient Outcomes Program, and later became the NOB’s deputy branch chief in 2018. She is also licensed to practice as a clinician in Maryland.
In addition to her deputy chief role at the NOB, Dr. Armstrong has served on several NIH and professional committees, including the past vice president of the Society for Neuro-Oncology (SNO). She has also held multiple positions on SNO’s board of directors, in addition to being an elected member and chair of the NCI’s Center for Cancer Research Women Scientist Advisors. She is currently the executive editor for Neuro-Oncology Practice and former associate editor for several other journals, such as Neuro-Oncology. Her work is highlighted by an impressive track record of awarded grants—including grants from the CERN (Collaborative Ependymoma Research Network) Foundation, the National Institute of Nursing Research R01-funded grant, and 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)
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Dr. Terri Armstrong shares why she chose to study rare brain and spine tumors and how her research is advancing patient quality of life. Read more >