Peter Edward Fecci

Professor of Neurosurgery

As the Director of both the Brain Tumor Immunotherapy Program and the Center for Brain and Spine Metastasis at Duke University, I focus our programmatic interests on the design, optimization, and monitoring of immune-based treatment platforms for patients with intracranial tumors, whether primary or metastatic. Within this broad scope, however, my own group looks more specifically at limitations to immunotherapeutic success, with a particular focus on understanding and reversing T cell dysfunction in patients with glioblastoma (GBM) and brain metastases. We employ a systematic approach to categorizing T cell dysfunction (Woroniecka et al, Clin Cancer Res 2018 Aug 15;24(16):3792-3802), and whereas our earlier work addressed concerns for regulatory T cell-induced tolerance, we now heavily study T cell ignorance and exhaustion, as well. Regarding the former, we recently published the novel phenomenon of S1P1-mediated bone marrow T cell sequestration in patients with intracranial tumors (Chongsathidkiet et al, Nat Medicine 2018 Sep;24(9):1459-1468). Regarding the latter, we have likewise recently identified and characterized exhaustion as a significant limitation to T-cell function within GBM (Woroniecka et al, Clin Cancer Res 2018 Sep 1;24(17):4175-4186). I very much look to collaboratively integrate our approaches with others investigating innovative treatment options. I continue my focus on combining strategies for reversing T cell deficits with current and novel immune-based platforms as a means of deriving and improving rational and precise anti-tumor therapies. It is my sincerest desire to forge a career focused on co-operative, multi-disciplinary, organized brain tumor therapy. Ultimately, my goal is to help coordinate the efforts of a streamlined and effective center for brain tumor research and clinical care. I hope to play some role in ushering in a period where the science and treatment arms of brain tumor therapy suffer no disjoint, but instead represent the convergent efforts of researchers, neuro-oncologists, medical oncologists, radiation oncologists, biomedical engineers, and neurosurgeons alike. I hope to see such synergy become standard of care.

Appointments and Affiliations

  • Professor of Neurosurgery
  • Professor in Pathology
  • Associate Professor of Biomedical Engineering
  • Associate Professor in Integrative Immunobiology
  • Member of the Duke Cancer Institute

Contact Information

  • Office Location: 201 Sands Bldg., Box 3050, Durham, NC 27710
  • Office Phone: +1 919 681 1010
  • Email Address:


  • M.D. Duke University, School of Medicine, 2007
  • Ph.D. Duke University, 2007
  • Massachusetts General Hospital, 2008
  • Massachusetts General Hospital, 2013
  • Dana Farber Cancer Institute, 2012

Research Interests

Brain Tumor Immunotherapy
Cancer-Induced Immune Dysfunction
Brain Metastasis

Courses Taught

  • PATHOL 793: Research Independent Study
  • PATHOL 293: Research Independent Study
  • NEUROSCI 494: Research Independent Study 2
  • NEUROSCI 493: Research Independent Study 1
  • MOLMED 301B: Research in MOLMED - Oncological Sciences

In the News

Representative Publications

  • Shen, Steven H., Karolina Woroniecka, Andrew B. Barbour, Peter E. Fecci, Luis Sanchez-Perez, and John H. Sampson. “CAR T cells and checkpoint inhibition for the treatment of glioblastoma.” Expert Opin Biol Ther 20, no. 6 (June 2020): 579–91.
  • Moravan, Michael J., Peter E. Fecci, Carey K. Anders, Jeffrey M. Clarke, April K. S. Salama, Justus D. Adamson, Scott R. Floyd, et al. “Current multidisciplinary management of brain metastases.” Cancer 126, no. 7 (April 1, 2020): 1390–1406.
  • Kemeny, Hanna R., Aladine A. Elsamadicy, S Harrison Farber, Cosette D. Champion, Selena J. Lorrey, Pakawat Chongsathidkiet, Karolina I. Woroniecka, et al. “Targeting PD-L1 Initiates Effective Antitumor Immunity in a Murine Model of Cushing Disease.” Clin Cancer Res 26, no. 5 (March 1, 2020): 1141–51.
  • Huang, Min-Nung, Lowell T. Nicholson, Kristen A. Batich, Adam M. Swartz, David Kopin, Sebastian Wellford, Vijay K. Prabhakar, et al. “Antigen-loaded monocyte administration induces potent therapeutic antitumor T cell responses.” J Clin Invest 130, no. 2 (February 3, 2020): 774–88.
  • Mohammadi, Alireza M., Mayur Sharma, Thomas L. Beaumont, Kevin O. Juarez, Hanna Kemeny, Cosette Dechant, Andreas Seas, et al. “Upfront Magnetic Resonance Imaging-Guided Stereotactic Laser-Ablation in Newly Diagnosed Glioblastoma: A Multicenter Review of Survival Outcomes Compared to a Matched Cohort of Biopsy-Only Patients.” Neurosurgery 85, no. 6 (December 1, 2019): 762–72.
  • Kirkpatrick, John P., and Peter E. Fecci. “Offer Hypofractionated SRS… If Her Performance Status Is Good.” Int J Radiat Oncol Biol Phys 105, no. 5 (December 1, 2019): 940–41.
  • Fecci, Peter E., Cosette D. Champion, Jacob Hoj, Courtney M. McKernan, C Rory Goodwin, John P. Kirkpatrick, Carey K. Anders, Ann Marie Pendergast, and John H. Sampson. “The Evolving Modern Management of Brain Metastasis.” Clin Cancer Res 25, no. 22 (November 15, 2019): 6570–80.
  • Sankey, Eric W., Vadim Tsvankin, Matthew M. Grabowski, Gautam Nayar, Kristen A. Batich, Aida Risman, Cosette D. Champion, April K. S. Salama, C Rory Goodwin, and Peter E. Fecci. “Operative and peri-operative considerations in the management of brain metastasis.” Cancer Med 8, no. 16 (November 2019): 6809–31.
  • Liu, Yang, Pakawat Chongsathidkiet, Bridget M. Crawford, Ren Odion, Cosette A. Dechant, Hanna R. Kemeny, Xiuyu Cui, et al. “Plasmonic gold nanostar-mediated photothermal immunotherapy for brain tumor ablation and immunologic memory.” Immunotherapy 11, no. 15 (October 2019): 1293–1302.
  • Lorrey, Selena J., Luis Sanchez-Perez, and Peter E. Fecci. “Rescuing imperfect antigens for immuno-oncology.” Nat Biotechnol 37, no. 9 (September 2019): 1002–3.
  • Fecci, Peter E., and John H. Sampson. “The current state of immunotherapy for gliomas: an eye toward the future.” J Neurosurg 131, no. 3 (September 1, 2019): 657–66.
  • Choi, Kevin J., Feras Y. Ackall, Tracy Truong, Tracy Z. Cheng, Maragatha Kuchibhatla, Ali R. Zomorodi, Patrick J. Codd, Peter E. Fecci, Ralph Abi Hachem, and David W. Jang. “Sinonasal Quality of Life Outcomes After Extended Endonasal Approaches to the Skull Base.” J Neurol Surg B Skull Base 80, no. 4 (August 2019): 416–23.
  • Chongsathidkiet, Pakawat, Christina Jackson, Shohei Koyama, Franziska Loebel, Xiuyu Cui, S Harrison Farber, Karolina Woroniecka, et al. “Author Correction: Sequestration of T cells in bone marrow in the setting of glioblastoma and other intracranial tumors.” Nat Med 25, no. 3 (March 2019): 529.
  • Suryadevara, Carter M., Rupen Desai, S Harrison Farber, Bryan D. Choi, Adam M. Swartz, Steven H. Shen, Patrick C. Gedeon, et al. “Preventing Lck Activation in CAR T Cells Confers Treg Resistance but Requires 4-1BB Signaling for Them to Persist and Treat Solid Tumors in Nonlymphodepleted Hosts.” Clin Cancer Res 25, no. 1 (January 1, 2019): 358–68.
  • Natarajan, Brahma D., Christel N. Rushing, Michael A. Cummings, Jessica Ms Jutzy, Kingshuk R. Choudhury, Michael J. Moravan, Peter E. Fecci, et al. “Predicting intracranial progression following stereotactic radiosurgery for brain metastases: Implications for post SRS imaging.” J Radiosurg SBRT 6, no. 3 (2019): 179–87.
  • Woroniecka, Karolina, and Peter E. Fecci. “T-cell exhaustion in glioblastoma.” Oncotarget 9, no. 82 (October 19, 2018): 35287–88.
  • Atik, Ahmet F., Carter M. Suryadevara, Ryan M. Schweller, Jennifer L. West, Patrick Healy, James E. Herndon Ii, Kendra L. Congdon, et al. “Hyaluronic acid based low viscosity hydrogel as a novel carrier for Convection Enhanced Delivery of CAR T cells.” J Clin Neurosci 56 (October 2018): 163–68.
  • Chongsathidkiet, Pakawat, Christina Jackson, Shohei Koyama, Franziska Loebel, Xiuyu Cui, S Harrison Farber, Karolina Woroniecka, et al. “Sequestration of T cells in bone marrow in the setting of glioblastoma and other intracranial tumors.” Nat Med 24, no. 9 (September 2018): 1459–68.
  • Woroniecka, Karolina, Pakawat Chongsathidkiet, Kristen Rhodin, Hanna Kemeny, Cosette Dechant, S Harrison Farber, Aladine A. Elsamadicy, et al. “T-Cell Exhaustion Signatures Vary with Tumor Type and Are Severe in Glioblastoma.” Clin Cancer Res 24, no. 17 (September 1, 2018): 4175–86.
  • Woroniecka, Karolina I., Kristen E. Rhodin, Pakawat Chongsathidkiet, Kristin A. Keith, and Peter E. Fecci. “T-cell Dysfunction in Glioblastoma: Applying a New Framework.” Clin Cancer Res 24, no. 16 (August 15, 2018): 3792–3802.
  • Rennert, Robert C., Usman Khan, Stephen B. Tatter, Melvin Field, Brian Toyota, Peter E. Fecci, Kevin Judy, et al. “Patterns of Clinical Use of Stereotactic Laser Ablation: Analysis of a Multicenter Prospective Registry.” World Neurosurg 116 (August 2018): e566–70.
  • Giles, Amber J., Marsha-Kay N. D. Hutchinson, Heather M. Sonnemann, Jinkyu Jung, Peter E. Fecci, Nivedita M. Ratnam, Wei Zhang, et al. “Dexamethasone-induced immunosuppression: mechanisms and implications for immunotherapy.” J Immunother Cancer 6, no. 1 (June 11, 2018): 51.
  • Oldham, Mark, Suk W. Yoon, Justus Adamson, Xiaofeng Zhang, Peter Fecci, and Mark Dewhirst. “In Reply to Pratx and Kapp.” Int J Radiat Oncol Biol Phys 101, no. 2 (June 1, 2018): 495–96.
  • Babi, Marc-Alain, Peter Fecci, Matthew Luedke, Olinda Pineda, and Yasmin Ali O’Keefe. “Atypical teratoid rhabdoid tumor in a 65-year-old man presenting with disseminated leptomeningeal disease: A case report and review of the literature.” SAGE Open Med Case Rep 6 (2018): 2050313X18775298.
  • Woroniecka, Karolina, Pakawat Chongsathidkiet, Aladine Elsamadicy, Harrison Farber, Xiuyu Cui, and Peter E. Fecci. “Flow Cytometric Identification of Tumor-Infiltrating Lymphocytes from Glioblastoma.” Methods Mol Biol 1741 (2018): 221–26.
  • Suryadevara, Carter M., Rupen Desai, Melissa L. Abel, Katherine A. Riccione, Kristen A. Batich, Steven H. Shen, Pakawat Chongsathidkiet, et al. “Temozolomide lymphodepletion enhances CAR abundance and correlates with antitumor efficacy against established glioblastoma.” Oncoimmunology 7, no. 6 (2018): e1434464.
  • Riccione, Katherine A., Li-Zhen He, Peter E. Fecci, Pamela K. Norberg, Carter M. Suryadevara, Adam Swartz, Patrick Healy, et al. “CD27 stimulation unveils the efficacy of linked class I/II peptide vaccines in poorly immunogenic tumors by orchestrating a coordinated CD4/CD8 T cell response.” Oncoimmunology 7, no. 12 (2018): e1502904.
  • Reap, Elizabeth A., Carter M. Suryadevara, Kristen A. Batich, Luis Sanchez-Perez, Gary E. Archer, Robert J. Schmittling, Pamela K. Norberg, et al. “Dendritic Cells Enhance Polyfunctionality of Adoptively Transferred T Cells That Target Cytomegalovirus in Glioblastoma.” Cancer Res 78, no. 1 (January 1, 2018): 256–64.
  • Narloch, Jessica L., S Harrison Farber, Sarah Sammons, Frances McSherry, James E. Herndon, Jenny K. Hoang, Fang-Fang Yin, et al. “Biopsy of enlarging lesions after stereotactic radiosurgery for brain metastases frequently reveals radiation necrosis.” Neuro Oncol 19, no. 10 (October 1, 2017): 1391–97.
  • Nayar, Gautam, Tiffany Ejikeme, Pakawat Chongsathidkiet, Aladine A. Elsamadicy, Kimberly L. Blackwell, Jeffrey M. Clarke, Shivanand P. Lad, and Peter E. Fecci. “Leptomeningeal disease: current diagnostic and therapeutic strategies.” Oncotarget 8, no. 42 (September 22, 2017): 73312–28.
  • Elsamadicy, Aladine A., Pakawat Chongsathidkiet, Rupen Desai, Karolina Woroniecka, S Harrison Farber, Peter E. Fecci, and John H. Sampson. “Prospect of rindopepimut in the treatment of glioblastoma.” Expert Opin Biol Ther 17, no. 4 (April 2017): 507–13.
  • Farber, S Harrison, Aladine A. Elsamadicy, Ahmet Fatih Atik, Carter M. Suryadevara, Pakawat Chongsathidkiet, Peter E. Fecci, and John H. Sampson. “The Safety of available immunotherapy for the treatment of glioblastoma.” Expert Opin Drug Saf 16, no. 3 (March 2017): 277–87.
  • Mei, Yu, Wenya Linda Bi, Noah F. Greenwald, Ziming Du, Nathalie Y. R. Agar, Ursula B. Kaiser, Whitney W. Woodmansee, et al. “Increased expression of programmed death ligand 1 (PD-L1) in human pituitary tumors.” Oncotarget 7, no. 47 (November 22, 2016): 76565–76.
  • Limon, D., G. J. Kim, F. McSherry, J. Herndon, P. E. Fecci, J. Adamson, J. H. Sampson, et al. “Single-Fraction Radiosurgery for 4 or More Brain Metastases.” Int J Radiat Oncol Biol Phys 96, no. 2S (October 1, 2016): E84–85.
  • Suryadevara, Carter M., Rupen Desai, Samuel Harrison Farber, Patrick C. Gedeon, Adam Swartz, David Snyder, James Herndon, et al. “369 Chimeric Antigen Receptors Deficient in Lck Signaling Require 4-1BB Costimulation to Expand in Vivo, Resist Regulatory T-Cell Suppression, and Treat Solid Tumors in Immune-Intact Hosts.” Neurosurgery 63 Suppl 1 (August 2016): 209–10.
  • Suryadevara, C. M., R. Desai, S. H. Farber, P. C. Gedeon, A. Swartz, D. Snyder, J. Herndon, et al. “369 Chimeric Antigen Receptors Deficient in Lck Signaling Require 4-1BB Costimulation to Expand in Vivo, Resist Regulatory T-Cell Suppression, and Treat Solid Tumors in Immune-Intact Hosts.” Neurosurgery 63, no. CN_suppl_1 (August 1, 2016): 209–10.
  • Farber, S Harrison, Vadim Tsvankin, Jessica L. Narloch, Grace J. Kim, April K. S. Salama, Gordana Vlahovic, Kimberly L. Blackwell, John P. Kirkpatrick, and Peter E. Fecci. “Embracing rejection: Immunologic trends in brain metastasis.” Oncoimmunology 5, no. 7 (July 2016): e1172153.
  • Koyama, Shohei, Esra A. Akbay, Yvonne Y. Li, Amir R. Aref, Ferdinandos Skoulidis, Grit S. Herter-Sprie, Kevin A. Buczkowski, et al. “STK11/LKB1 Deficiency Promotes Neutrophil Recruitment and Proinflammatory Cytokine Production to Suppress T-cell Activity in the Lung Tumor Microenvironment.” Cancer Res 76, no. 5 (March 1, 2016): 999–1008.
  • Koyama, Shohei, Esra A. Akbay, Yvonne Y. Li, Grit S. Herter-Sprie, Kevin A. Buczkowski, William G. Richards, Leena Gandhi, et al. “Adaptive resistance to therapeutic PD-1 blockade is associated with upregulation of alternative immune checkpoints.” Nat Commun 7 (February 17, 2016): 10501.
  • Choi, Bryan D., Peter E. Fecci, and John H. Sampson. “Editorial: Not everything that matters can be measured and not everything that can be measured matters.” J Neurosurg 123, no. 3 (September 2015): 543–44.
  • Vlahovic, Gordana, Peter E. Fecci, David Reardon, and John H. Sampson. “Programmed death ligand 1 (PD-L1) as an immunotherapy target in patients with glioblastoma.” Neuro Oncol 17, no. 8 (August 2015): 1043–45.
  • Swartz, Adam M., Kristen A. Batich, Peter E. Fecci, and John H. Sampson. “Peptide vaccines for the treatment of glioblastoma.” J Neurooncol 123, no. 3 (July 2015): 433–40.
  • Fecci, Peter E., Ranjith Babu, D Cory Adamson, and John H. Sampson. “Editorial: Turning fluorescence into black and white.” J Neurosurg 122, no. 6 (June 2015): 1356–58.
  • Suryadevara, Carter M., Patrick C. Gedeon, Luis Sanchez-Perez, Terence Verla, Christopher Alvarez-Breckenridge, Bryan D. Choi, Peter E. Fecci, and John H. Sampson. “Are BiTEs the "missing link" in cancer therapy?” Oncoimmunology 4, no. 6 (June 2015): e1008339.
  • Suryadevara, Carter M., Terence Verla, Luis Sanchez-Perez, Elizabeth A. Reap, Bryan D. Choi, Peter E. Fecci, and John H. Sampson. “Immunotherapy for malignant glioma.” Surg Neurol Int 6, no. Suppl 1 (2015): S68–77.
  • Fecci, Peter E., Amy B. Heimberger, and John H. Sampson. “Immunotherapy for primary brain tumors: no longer a matter of privilege.” Clin Cancer Res 20, no. 22 (November 15, 2014): 5620–29.
  • Yanamadala, Vijay, Brian P. Walcott, Peter E. Fecci, Peter Rozman, Jay I. Kumar, Brian V. Nahed, and Brooke Swearingen. “Reversal of warfarin associated coagulopathy with 4-factor prothrombin complex concentrate in traumatic brain injury and intracranial hemorrhage.” J Clin Neurosci 21, no. 11 (November 2014): 1881–84.
  • Gedeon, Patrick C., Katherine A. Riccione, Peter E. Fecci, and John H. Sampson. “Antibody-based immunotherapy for malignant glioma.” Semin Oncol 41, no. 4 (August 2014): 496–510.
  • Cheema, Tooba A., Peter E. Fecci, Jianfang Ning, and Samuel D. Rabkin. “Immunovirotherapy for the treatment of glioblastoma.” Oncoimmunology 3, no. 1 (January 1, 2014): e27218.
  • Akbay, Esra A., Shohei Koyama, Julian Carretero, Abigail Altabef, Jeremy H. Tchaicha, Camilla L. Christensen, Oliver R. Mikse, et al. “Activation of the PD-1 pathway contributes to immune escape in EGFR-driven lung tumors.” Cancer Discov 3, no. 12 (December 2013): 1355–63.
  • Cheema, Tooba A., Hiroaki Wakimoto, Peter E. Fecci, Jianfang Ning, Toshihiko Kuroda, Deva S. Jeyaretna, Robert L. Martuza, and Samuel D. Rabkin. “Multifaceted oncolytic virus therapy for glioblastoma in an immunocompetent cancer stem cell model.” Proc Natl Acad Sci U S A 110, no. 29 (July 16, 2013): 12006–11.
  • Reardon, David A., Kai W. Wucherpfennig, Gordon Freeman, Catherine J. Wu, E Antonio Chiocca, Patrick Y. Wen, William T. Curry, et al. “An update on vaccine therapy and other immunotherapeutic approaches for glioblastoma.” Expert Rev Vaccines 12, no. 6 (June 2013): 597–615.
  • Choi, Bryan D., Peter E. Fecci, and John H. Sampson. “Regulatory T cells move in when gliomas say "I Do".” Clin Cancer Res 18, no. 22 (November 15, 2012): 6086–88.
  • Dunn, Gavin P., Peter E. Fecci, and William T. Curry. “Cancer immunoediting in malignant glioma.” Neurosurgery 71, no. 2 (August 2012): 201–22.
  • Agarwalla, Pankaj, Zachary Barnard, Peter Fecci, Glenn Dranoff, and William T. Curry. “Sequential immunotherapy by vaccination with GM-CSF-expressing glioma cells and CTLA-4 blockade effectively treats established murine intracranial tumors.” J Immunother 35, no. 5 (June 2012): 385–89.
  • Chatterjee, N., K. Domoto-Reilly, P. E. Fecci, L. H. Schwamm, and A. B. Singhal. “Licorice-associated reversible cerebral vasoconstriction with PRES.” Neurology 75, no. 21 (November 23, 2010): 1939–41.
  • Fecci, Peter E., Hidenobu Ochiai, Duane A. Mitchell, Peter M. Grossi, Alison E. Sweeney, Gary E. Archer, Thomas Cummings, James P. Allison, Darell D. Bigner, and John H. Sampson. “Systemic CTLA-4 blockade ameliorates glioma-induced changes to the CD4+ T cell compartment without affecting regulatory T-cell function.” Clin Cancer Res 13, no. 7 (April 1, 2007): 2158–67.
  • Fecci, Peter E., Alison E. Sweeney, Peter M. Grossi, Smita K. Nair, Christopher A. Learn, Duane A. Mitchell, Xiuyu Cui, et al. “Systemic anti-CD25 monoclonal antibody administration safely enhances immunity in murine glioma without eliminating regulatory T cells.” Clin Cancer Res 12, no. 14 Pt 1 (July 15, 2006): 4294–4305.
  • Fecci, Peter E., Duane A. Mitchell, John F. Whitesides, Weihua Xie, Allan H. Friedman, Gary E. Archer, James E. Herndon, Darell D. Bigner, Glenn Dranoff, and John H. Sampson. “Increased regulatory T-cell fraction amidst a diminished CD4 compartment explains cellular immune defects in patients with malignant glioma.” Cancer Res 66, no. 6 (March 15, 2006): 3294–3302.