Carol Bruggers, MD
Disclosures: Nothing to disclose

BIOGRAPHICAL SKETCH

Provide the following information for the Senior/key personnel and other significant contributors.

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NAME: Bruggers, Carol S.

eRA COMMONS USER NAME: CAROLBRUGGERS

POSITION TITLE: Professor of Pediatrics with Tenure, Pediatric Hematology-Oncology

EDUCATION/TRAINING

 

INSTITUTION AND LOCATION

DEGREE

YEAR

FIELD OF STUDY

Denison University, Granville, OH

BA

1975

Biology

Stanford University, Stanford, CA

MA

1977

Physical Therapy

Michigan State University, East Lansing, MI

MD

1984

Medicine

 

A.  PERSONAL STATEMENT

 

I have the necessary clinical expertise in pediatric oncology; experience in creating a prototype mobile pediatric cancer-specific, activity and empowerment promoting video game; experience in clinical trial design, conduct, administration, and IRB procedural compliance; and collaborative multidisciplinary team administration skills needed to successfully carry out the proposed project Empower! Interactive Mobile Video Game to Improve Health Outcomes in Children with Cancer. Prior to medical school, I worked as an integral Pediatric Rehabilitation team member in my role as a Pediatric Physical Therapist. After medical school and pediatric residency, I sub-specialized in Pediatric Hematology- Oncology. I have been a Pediatric Hematologist-Oncologist for more than 27 years at the University of Utah.  My major role has been that of clinician, including the sole Pediatric Neuro-oncologist for 24 years, and educator and mentor for medical students, residents, and pediatric hematology-oncology fellows. My prior research experience has centered on translational and clinical investigation. I also served as our institutional Site Lead for the National Childhood Cancer Foundation Grant U10 CA13539 Children’s Oncology Group for Pediatric Oncology, University of Utah for several years, which involved managing an estimated 40-50 trials simultaneously; a member of the University of Utah Institutional Review Board for several years; Institutional Co-PI for PNOC neurooncological pediatric consortium, and have mentored many Pediatric Hematology-Oncology Fellows in their respective clinical and translational endeavors.

 

I have been very fortunate to have been part of the remarkable progress in improving survival and cure in childhood cancer. This has also gone hand-in-hand with being part of the cost” of improved survival and cure with respect to impact on the quality of life during and following cancer treatment including long-term survivorship. As an integral member of our comprehensive pediatric oncology team, I have experienced vast clinical lessons and insights from children with cancer and their families-many who are thriving long-term survivors; some who are survivors struggling with significant adverse late effects; and some who succumbed to cancer. Importantly, all have taught me amazing lessons of courage, resilience and personal empowerment.

 

My current research focuses on exercise and empowerment-centered video game therapy for Pediatric Oncology patients. This integrates my extensive clinical experience with my insights in courage, resilience and empowerment of children with cancer. I had the major role in conceiving, designing and creating a novel exercise-empowerment activity promoting video game prototype that address pediatric cancer and related comorbidities of fatigue, depression, and generalized deconditioning, The Patient Empowerment Exercise Video Game, for which a U.S. Intellectual Patent was granted. This disease-specific prototype video game therapy, created on PlayStation platform, has been presented nationally and internationally. I also had the major role in creating the early prototype EmpowerStars!, a mobile empowerment-centered prototype video game for children, adding emotional and education empowerment themes to our prior experience and that leverages digital and mobile health advances. We have successfully completed and published a multi-level feasibility, usability and engagement IRB-approved clinical study that yielded very informative results for continued game development.  We are now in the ideal position to build upon this early prototype game in preparation for a future pivotal clinical investigation evaluating efficacy as add-on therapy in children with cancer. The overarching goal is to improve pediatric cancer care during and after therapy by integrating the concepts of exercise and empowerment over disease, emotional and educational including, treatment adherence, and disease self-management to positively influence long-term health care behavior


My commitment to improving quality of life in children with cancer, my clinical trials experience, and commitment to multidisciplinary teamwork is strong and clear. The unique team of extremely talented collaborators across diverse schools and programs within the University of Utah strategically aligns us to successfully bringing this innovative proposal to fruition.

 

  1. Bruggers CS, Baranowski S, Beseris M, Leonard R, Long D, Schulte E, Shorter A, Stigner R, Mason CC, Bedrov A, Pascual I, Bulaj G.  A prototype exercise-empowerment mobile video game for children with cancer and its usability assessment: developing digital empowerment interventions for pediatric diseases. Front. Pediatr.2018; 6:69. PMCID: PMC5900044
  2. Govender M, Bowen RC, German ML, Bulaj G, Bruggers CS. Clinical and Neurobiological Perspectives of Empowering Pediatric Cancer Patients Using Videogames. Games Health J. 2015 Oct;4(5):362-374. PMCID: PMC4545566
  3. Bruggers CS, Altizer RA, Kessler RR, Caldwell CB, Coppersmith K, Warner L, Davies B, Paterson W, Wilcken J, D'Ambrosio TA, German ML, Hanson GR, Gershan LA, Korenberg JR, Bulaj G. Patient- empowerment interactive technologies. Sci Transl Med. 2012 Sep 19;4(152):152ps116.
  4. Moyer-Mileur LJ, Ransdell L, Bruggers CS. Fitness of children with standard-risk acute lymphoblastic leukemia during maintenance therapy: response to a home-based exercise and nutrition program. J Pediatr Hematol Oncol. 2009 Apr;31(4):259-266.

 

B.  POSITIONS AND HONORS

Positions and employment and Other Experiences

1984-1987              Resident in Pediatrics, University of Colorado, Denver, CO

1987-1988              Staff Physician, Denver Children’s Hospital, Denver, CO

1988-1991              Fellow, Pediatric Hematology/Oncology, Duke University, Durham, NC

1991-1992              Associate in Pediatrics, Duke University, Durham, NC

1992-1998              Assistant Professor of Pediatrics, University of Utah, Salt Lake City, UT

1998-1999              Associate Professor of Pediatrics, University of Utah, Salt Lake City, UT

1999-2005              Tenured Associate Professor of Pediatrics, University of Utah, Salt Lake City, UT 2005-present              Tenured Professor of Pediatrics, University of Utah, Salt Lake City, UT

 

Other Experience

1993-2004              Member: Clinical Cancer Investigation Committee, an IRB Sub-committee, Huntsman Cancer Institute, University of Utah School of Medicine

1993-present              Intern Selection Committee, Department of Pediatrics, University of Utah

1998-2006              Institutional Principle Investigator for Children’s Cancer Group for Phase I, II Trials 2000-present              Member, Pediatric Retention, Promotion, Tenure Committee, University of Utah 2001-2007              Member, University of Utah Institutional Review Board

2002-2006              Institutional Principle Investigator for The Children’s Oncology Group

2013-present              Institutional Co-Principle Investigator for PNOC:  Pediatric Neuro-Oncology Clinical Consortium

 

Honors

1972              PHI Honorary Society, Denison University

1975              AED Premedical Honorary Society, Denison University

1975              Phi Beta Kappa, Denison University

1982              Glasgow Memorial Achievement Citation, Michigan State University School of Medicine 1984              Samuel Oates Award, Michigan State University School of Medicine

 

Professional Memberships

American Academy of Pediatrics American Society for Clinical Oncology

American Society for Pediatric Hematology/Oncology

Huntsman Cancer Institute Investigators, University of Utah School of Medicine


C.  CONTRIBUTION TO SCIENCE

 

1.      Progressive Low Grade Gliomas (LGG) in Young Children

When I joined the faculty at this institution, standard of care for treating children with progressive symptomatic low grade gliomas [LGG] was radiation, even in infants and young children. Given the immature brain development in very young children, marked global intellectual and psychomotor arrest was a frequent and permanent late effect. I initiated our institution’s collaboration with Duke Univesity in one of the very early oligo-institutional trials evaluating chemotherapy to defer or abrogate the need for radiation, obtained IRB approval, and then enrolled, treated and performed all data recording and its transfer for our institution, which enrolled the second highest patient number on this trial. I then designed and conducted an institutional trial evaluating sequential dose intense chemotherapy for children with progressive LGG which was presented nationally and published. I have also designed and collaborated in LGG translational research projects. I served as our institutional Co-Site Lead on a national NF1 consortium LGG trial. In summary, I was very instrumental in bringing upfront chemotherapy, now standard of care treatment approach to the University of Utah and the intermountain west. This approach has resulted in marked decrease in neuro-cognitive and developmental impairment, and significant improvement in overall and neurologic quality of life. As institutional Co-PI for PNOC, I am involved in defining optimal chemotherapies for identified targetable molecular abnormalities in LGG and other brain tumors, and am actively enrolling eligible children onto these novel clinical investigations.

a.      Bruggers CS, Fults D, Perkins SL, Coffin CM, Carroll WL. Co-expression of genes involved in apoptosis in central nervous system neoplasms. J Pediatr Hematol Oncol. 1999 Jan-Feb;21(1):19-25.

b.      Gururangan S, Cavazos CM, Ashley D, Herndon JE, 2nd, Bruggers CS, Moghrabi A, Scarcella DL, Watral M, Tourt-Uhlig S, Reardon D, Friedman HS. Phase II study of carboplatin in children with progressive low-grade gliomas. J Clin Oncol. 2002 Jul 1;20(13):2951-2958.

c.      Bruggers CS, Greene D. A phase 2 feasibility study of sequential, dose intensive chemotherapy to treat progressive low-grade gliomas in children. J Pediatr Hematol Oncol. 2007 Sep;29(9):602-607.

d.      Verma A, Zhou H, Chin S, Bruggers C, Kestle J, Khatua S. EGFR as a predictor of relapse in myxopapillary ependymoma. Pediatr Blood Cancer. 2012 Oct;59(4):746-748.

 

2.      Quality of Life and Pediatric Cancer

I conceived of the idea to design and prospectively study a customized exercise and nutrition intervention   in children with Acute Lymphoblastic Leukemia during the Maintenance Phase of Chemotherapy at the University of Utah and Primary Children’s Hospital. I established collaboration with pediatric nutrition and exercise physiology experts in separate University of Utah graduate programs, wrote the protocol, submitted all related material to the IRB for approval, and served as the Principle Investigator for this study. The results of this trial were presented nationally and internationally at conferences and subsequently published. I also designed a clinical trial to study long-term hearing loss in children treated for posterior fossa medulloblastoma with multi-agent chemotherapy and neuraxis radiation. I established a multi-disciplinary collaborative team comprised of medical students, audiologists, and radiation oncologist. I was responsible for all IRB-related procedures, trial conduction, team coordination and mentoring the medical student. This study involved detailed analysis of serial audiology evaluations and was presented nationally. I also conceived of and designed a clinical trial studying the impact osteonecrosis on quality of life of leukemia survivors. I was responsible for IRB-related procedures, and data collection, analysis and interpretation for this study, which was presented nationally.

 

a.      Bruggers CS, Moyer-Milleur L Ransdale L, Quick J. Body composition, bone mineralization and cardiovascular fitness in children with standard risk acute lymphoblastic leukemia: response to a home- based exercise and nutrition education program [ASPHO/PAS Abstract 3505]. Pediatr Blood Cancer. 2006;46(Suppl 6):691.

b.      Moyer-Milleur L, Slater H, Bruggers CS. Bone mineral content in children with acute lymphoblastic leukemia [ASPHO/PAS Abstract 600]. Pediatr Blood Cancer. 2006;46 Supp 6):705.

c.      Bruggers CS, Norby J, Thomson J, Hazard L. Sensorineural hearing loss following treatment in children with medulloblastoma: a longitudinal study [ASPHO/PAS Abstract 3506]. Pediatr Blood Cancer. 2006;46(Suppl 6):691.

d.             Levin J, Afify Z, Bruggers CS. Impact of osteonecrosis on quality of life in survivors of childhood acute lymphoblastic leukemia. In: Proceedings of ASPHO; May 2012; New Orleans, Louisiana.

 

3.      Familial Atypical Teratoid Rhabdoid Tumor (ATRT) of the Central Nervous System

Through personal patient experience, I was the first in the intermountain west, and among the early investigators nationally to recognize the familial nature of ATRT. I established early collaboration with a basic scientist expert in the field at Children’s Hospital of Philadelphia who was pioneering the molecular analysis for ATRT. This resulted in publication of our single institution experience describing and comparing the clinical-pathologic features of 20 patients with ATRT, 12 who had confirmed germline mutations, and 8 who had sporadic disease. We showed that very aggressive chemotherapy and involved-field radiation resulted in cure in about half of these young children. No other publication exists comparing familial versus sporadic ATRT in this manner. I contributed substantially to a larger manuscript describing Rhabdoid tumor predisposition syndrome. We identified asymptomatic parent and sibling carriers of SMARCB1 gene abnormality,