Novel Immunotherapy Combination Shows Promise in Some with Resistant Metastatic Colon Cancer

MedicalResearch.com Interview with:

Dr James Kuo, MBBS Medical oncologist and Deputy Medical Director Scientia Clinical Research Sydney, Australia 

Dr. Kuo

Dr James Kuo, MBBS
Medical oncologist and Deputy Medical Director
Scientia Clinical Research
Sydney, Australia

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Immune checkpoint inhibitors (ICI) that have seen success in the treatment of patients with various tumour types have not been as effective in patients with metastatic pancreatic cancer and therefore immune-therapeutic agents of novel mechanism of action, in particular in combination with existing ICI, need to be investigated.

This study set out to test the safety and efficacy of pixatimod, a novel immunomodulatory agent, in combination with nivolumab, firstly in the dose escalation cohorts in patients with any solid tumour for the maximal tolerable dose, and then using this dose to further treat an expansion cohort of patients with pancreatic cancer. Altogether 16 patients had received the combination and in 10 patients in whom treatment response was evaluable, 4 patients experienced a clinical benefit and continued treatment in the trial, with 1 patient having a significant partial response now treated for 48 weeks. Interestingly, all these 4 patients had metastatic colorectal cancer. Side effect profile has been consistent with other immunotherapeutic agent combination and in the patients who had clinical benefit, no treatment related side effects were observed.  Continue reading

Advanced Prostate Cancer: Androgen-Receptor Testing May Guide Selection of Treatment

MedicalResearch.com Interview with:

Diagram_showing_prostate_cancer_that_has_spread_to_the_bones_CRUK_183.svg.png

Prostate cancer that has metastasized to the bone: Wikipedia Image

Vincenza Conteduca, MD, PhD
Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Srl – IRCCS
Meldola , Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In our previous publications, we showed that the study of plasma cell-free DNA holds promise for improving treatment choice in metastatic castration-resistant prostate cancer (mCRPC). Specifically, we demonstrated that the detection in plasma of aberrations (copy number alterations and/or point somatic mutations) of androgen receptor (AR), using an easy and robust multiplex droplet digital PCR method, predicted an adverse outcome in mCRPC patients treated with second-generation AR-directed therapies (abiraterone or enzalutamide) in both settings: chemotherapy-naïve and post-docetaxel.

This current multi-institution work builds on our previous discoveries. We investigated the association of androgen receptor status and survival in men treated with docetaxel. Moreover, we performed an exploratory analysis in patients treated with docetaxel or AR-directed therapies as first-line therapy.

Interestingly, we observed that plasma AR-gained patients do not have a worse outcome compared to AR-normal patients when treated with docetaxel as first-line therapy. This introduces the opportunity to use plasma to select for docetaxel in preference to androgen receptor-directed therapies in AR gained mCRPC patients.

Continue reading

Brain Metastases: Stereotactic Radiation vs Surgery Compared

MedicalResearch.com Interview with:

Dr. Stephanie E. Weiss MD FASTRO Chief, Division of Neurologic Oncology Associate Professor, Department of Radiation Oncology Director, Radiation Oncology Residency and Fellowship Training Program Fox Chase Cancer Center Philadelphia, Pennsylvania

Dr. Weiss

Dr. Stephanie E. Weiss MD FASTRO
Chief, Division of Neurologic Oncology
Associate Professor, Department of Radiation Oncology
Director, Radiation Oncology Residency and Fellowship Training Program
Fox Chase Cancer Center
Philadelphia, Pennsylvania

MedicalResearch.com: What is the background for this study?

Response: Brain metastasis are the most common form of brain tumor.

Historically all patients received whole brain radiation as the primary therapy. Patients required neurosurgery to remove lesions if there was a question of diagnosis, what the diagnosis is and if there was a mass effect not relieved with steroids. Surgery was also indicated for patients with a single brain lesion because this offers a survival benefit over just receiving whole brain radiotherapy.

In 2003 a randomized trial proved that radiosurgery offers a similar benefit. So the question taxing patients and doctors at tumor boards since has been: which is better? If neurosurgery is superior, we are under-treating a lot of patients with radiosurgery. If radiosurgery is superior, we are subjecting a lot of patients to unnecessary brain surgery. Attempts to study this in a head-to-head randomized trial have failed. Patient and physician preference for one treatment or the other has proven to be a barrier to randomization and accrual. The EORTC 22952-2600 trial was originally designed to compare outcomes with and without whole brain radiation for patients receiving surgery or radiosurgery for brain metastasis.

We used this as the highest-quality source data available to compare local control of brain metastasis after surgery or radiosurgery, adjusted for by receipt or not of whole brain radiation.   Continue reading

Estrogen Receptors More Versatile and Widespread Than Previously Recognized

MedicalResearch.com Interview with:
"Mammogram" by slgckgc is licensed under CC BY 2.0Prof. Cathrin Brisken MD, PhD

ISREC, School of Life Sciences
Ecole Polytechnique Fédérale (EPFL)
CH-1015 Lausanne, Switzerland 

MedicalResearch.com: What is the background for this study?

Response: Estrogen receptor signaling has been well characterized in various in vitro models, like breast cancer cell lines.  Understanding estrogen receptor action in complex in vivo context is much more challenging.

We obtained elegant mouse models in which either all estrogen receptor function or specifically either the hormone dependent (AF-2) or the hormone independent (AF-1) function were ablated. Using the mammary glands from these mice we performed tissue recombination studies to discern the role of the different aspects of estrogen receptor signaling in the mouse mammary epithelium and its different cell populations.

Continue reading

About 20% of Women With Earlier Stage Breast Cancer Progress to Metastatic Disease Within 20 Years

MedicalResearch.com Interview with:

Angela Mariotto PhD Chief of the Data Analytics Branch  Surveillance Research Program (SRP) Division of Cancer Control and Population Sciences National Cancer Institute 

Dr. Mariotto

Angela Mariotto PhD
Chief of the Data Analytics Branch
Surveillance Research Program (SRP)
Division of Cancer Control and Population Sciences
National Cancer Institute (NCI

MedicalResearch.com: What is the background for this study?

Response: Progressing to metastatic breast cancer (MBC) is one of the major concerns for women diagnosed with early-stage breast cancer. Before our study there were no reliable numbers on risk of metastatic breast cancer recurrence after a (non-metastatic) breast cancer diagnosis, as registries do not routinely collect this data.

Continue reading

Treatment Delays Linked To High Mortality for Head and Neck Cancer

MedicalResearch.com Interview with:

Dr. Evan M. Graboyes is a otolaryngologist-head and neck surgeon with the Medical University of South Carolina. CREDIT Emma Vought, Medical University of South Carolina

Dr. Graboyes

Dr. Evan M. Graboyes MD
Otolaryngologist: Head and Neck Surgeon
Medical University of South Carolina

MedicalResearch.com: What is the background for this study?

Response: Unfortunately, there is no screening test for head and neck cancer like there is for colorectal, prostate, breast, lung, or cervical cancers. As a result, two-thirds of patients with head and neck cancer (HNC) present with loco-regionally advanced disease, making other aspects of timely treatment that much more critically important. We therefore sought to understand the association between treatment delay at different points along the cancer care continuum and oncologic outcomes for patients with head and neck cancer.

Continue reading

Computer Algorithm Can Distinguish Dangerous From Manageable Prostate Cancer

MedicalResearch.com Interview with:

Davide Pellacani Ph.D. Postdoctoral Fellow, Eaves' Lab Terry Fox Laboratory, BC Cancer Research Centre Vancouver, BC

Dr. Pellacani

Davide Pellacani Ph.D.
Postdoctoral Fellow, Eaves’ Lab
Terry Fox Laboratory,
BC Cancer Research Centre
Vancouver, BC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Prostate cancer is characterized by frequent DNA methylation changes compared to normal tissue. Nevertheless, understanding which of those changes lead to the acquisition of malignant proprieties is complicated by the predominance of cells with luminal features in prostate cancers.

In this study we generated DNA methylation maps of two distinct cell populations found within prostate cancer samples (called basal and luminal) and their normal counterparts. These datasets clearly showed that many of the common DNA methylation changes found in prostate cancer are present in luminal cells from both cancer and normal tissues. These changes are not necessarily cancer-specific, and are likely due to the bias associated with analyzing tissues in bulk, where most cancer cells have luminal-like features.

We used these datasets to derive two cancer-specific and phenotype-independent DNA methylation signatures: one specific to prostate cancer luminal cells, and one composed of changes measured in both luminal and basal cancer cells.

We then validated the potential clinical utility of these signatures by testing their ability to distinguish prostate cancer from normal samples, and tumours that have already escaped the prostate from those that have not, using the publicly available dataset from The Cancer Genome Atlas.

Continue reading

Can an Organic Diet Reduce Cancer Risk?

MedicalResearch.com Interview with:

"Sunday market in Paris: all organic food" by Richard Smith is licensed under CC BY 2.0Julia Baudry &
Emmanuelle Kesse-Guyot PhD
Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité, Institut National de la Santé et de la Recherche Médicale (INSERM) U1153, Institut National de la Recherche

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Among the environmental risk factors for cancer, there are concerns about exposure to different classes of pesticides, notably through occupational exposure. Organic foods are less likely to contain pesticide residues than conventional foods, and studies have showed that an organic diet reduces exposure to certain pesticides (Baudry et al 2018, Oates et al 2014, Curl et al 2015). In the general population, the primary route of exposure is diet, especially intake of conventionally grown fruits and vegetables. However, few studies have examined the association of organic food consumption with cancer risk.

In a population of 68 946 French adults from the NutriNet-Santé study, we found a reduction of 25% of cancer risk among consumers with a high frequency of organic foods compared to consumers with a low frequency, after accounting for many factors (such as lifestyle, diet and sociodemographic factors). Specifically a 34% and 76% decrease in risk was observed for post-menopausal breast cancer and all lymphomas, respectively, among frequent organic food consumers compared to consumers with a low organic food consumption frequency.

Continue reading

Improved Progression-Free Survival in Early Mutated NSC Lung Cancer with Erlotinib

MedicalResearch.com Interview with:

Prof. Yi-Long Wu, PI of CTONG1103 Tenured Professor of Guangdong Lung Cancer Institue, South China University of Technology (SCUT) Chair of Chinese Thoracic Oncolgy Group (CTONG)

Prof. Yi-Long Wu

Prof. Yi-Long Wu, PI of CTONG1103
Tenured Professor of Guangdong Lung Cancer Institue,
South China University of Technology (SCUT)
Chair of Chinese Thoracic Oncolgy Group (CTONG)

MedicalResearch.com: What is the background for this study?

Response: Patients with stage IIIA-N2 non-small-cell lung cancer (NSCLC) are considerable heterogeneity with variable ipsilateral mediastinal lymph node involvement. Current treatment options for this group of NSCLC patients include surgery followed by adjuvant chemotherapy, neoadjuvant therapy followed by surgical resection or definitive chemoradiation. The optimal strategy is controversial and neoadjuvant chemotherapy only give patients more 5% 5-year survival.

Continue reading

TumorScan May Become a Universal Screening Blood Test For Cancer

MedicalResearch.com Interview with:

Professor Diana Anderson Established Chair in Biomedical Sciences The University of Bradford Richmond Road Bradford West Yorkshire

Prof Anderson

Prof. Diana Anderson
Established Chair in Biomedical Sciences
The University of Bradford Richmond Road Bradford West Yorkshire

MedicalResearch.com: What is the background for this study?

Response: I have worked in this field for over 40 years both as a research scientist in industry and as a university-based researcher. It has always been my ambition to develop a relatively simple and affordable test to predict if a person is sensitive to cancer. In fact, in 1974, I was appointed as Head of Mutagenesis Studies at ICI’s Central Toxicology Laboratory in Manchester, UK, and I was looking at developing a short-term test to predict cancer even back then.

Our ‘universal’ cancer test is different from other ‘universal’ tests being developed, because ours is not looking for a specific biomarker or mutation. Ours is a generic test for cancer in an individual, regardless of any underlying mechanism that’s causing their cancer.

It is known that levels of damage to the DNA in the cellular genome can correlate with cancer and this is what we set out to investigate with the Comet assay.

Of the available tests to detect damage to the genome the Comet assay is very straightforward. This assay was primarily developed as a method to measure DNA damage. Briefly, cells are embedded in agarose on a microscope slide and lysed to remove membranes leaving supercoiled DNA loops, breaks in which after alkaline treatment and alkaline electrophoresis move towards a positive charge. The DNA is stained with a fluorescent dye and visualised by fluorescent microscopy. The image is like Haley‘s comet and the greater number of breaks the greater is the migration to the anode and the greater the damage.  Continue reading

Higher BMI Linked to Increased Risk of Younger Colon Cancer

MedicalResearch.com Interview with:

Stuart Po-Hong Liu, MD, MPH

Dr. Po-Hong Liu

Stuart Po-Hong Liu, MD, MPH
Clinical and Translational Epidemiology Unit Massachusetts General Hospital and
Harvard Medical School
Boston

MedicalResearch.com: What is the background for this study?

Response: Although there were global decreases in overall colorectal cancer (CRC) incidence, CRC rates have increased dramatically in those aged 20 to 49 years in the United States, parts of Europe, and Asia. The etiology and early detection of young-onset becomes an emerging research and clinical priority. Another important fact that is that this emerging public health concern has resulted in updated guidelines from the American Cancer Society advising average-risk screening begin at age 45, rather than 50.

However, up to this point, the etiology of young onset CRC remains largely unknown. Elucidating the role of traditional CRC risk factors in the etiopathogenesis of young-onset CRC is one of the first research agenda. Continue reading

Dysplastic Moles Not Necessarily Precursor to Melanoma But Indicate Increased Risk

MedicalResearch.com Interview with:

Caroline C. Kim, M.D. Associate Professor, Department of Dermatology Harvard Medical School Director, Pigmented Lesion Clinic Associate Director, Cutaneous Oncology Program Beth Israel Deaconess Medical Center Boston, MA 02215

Dr. Kim

Caroline C. Kim, M.D.
Associate Professor, Department of Dermatology
Harvard Medical School
Director, Pigmented Lesion Clinic
Associate Director, Cutaneous Oncology Program
Beth Israel Deaconess Medical Center
Boston, MA 02215

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: Atypical/dysplastic nevi have been identified as risk factors for melanoma, however the majority of melanomas arise as new lesions on the skin.

Unlike other models of dysplasia having a clear trajectory towards cancer as seen in cervical dysplasia, dysplastic nevi are not proven to be obligate precursors for melanoma.  However, there is little evidence to guide the management of biopsied dysplastic nevi with positive margins, with much clinical variation in the management of moderately dysplastic nevi in particular.

In this multi-center national study of 9 U.S. academic centers, we examined outcomes of 467 moderately dysplastic nevi excisionally biopsied without residual clinical pigmentation but with positive histologic margins with at least 3 years of clinical follow-up.  We found that no cases developed into a same-site melanoma with a mean follow-up time of 6.9 years. However, 22.8% of our patients went on to develop a future separate site melanoma.

Continue reading

MidLife PSA Can Risk-Stratify Prostate Cancer in African American Men

MedicalResearch.com Interview with:

Mark Preston, MD, MPH Associate Surgeon, Brigham and Women's Hospital Assistant Professor of Surgery, Harvard Medical School Brigham and Women's Hospital Department of Surgery, Urology Boston, MA

Dr. Preston

Mark Preston, MD, MPH
Associate Surgeon, Brigham and Women’s Hospital
Assistant Professor of Surgery, Harvard Medical School
Brigham and Women’s Hospital
Department of Surgery, Urology
Boston, MA
MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Black men are at significantly increased risk of developing and dying from prostate cancer. Unfortunately, there is limited research on screening strategies in this high-risk population. In this original investigation, we studied how baseline PSA levels measured in midlife predict later risk of aggressive prostate cancer in a population of black men. This study used stored blood samples and over a decade of follow-up in the Southern Community Cohort Study, an on-going cohort study with the highest representation of black men in the U.S.

We demonstrated that PSA levels in midlife very strongly predict future aggressive prostate cancer. Our data identify subgroups of black men who have widely divergent long-term risk of aggressive prostate cancer based on baseline PSA during midlife. We suggest that these groups could benefit from screening intervals tailored to their actual magnitude of disease risk.

These important findings build on our previous work on baseline PSA and subsequent risk of lethal prostate cancer in mainly white men, which was published in the Journal of Clinical Oncology in August 2016. 

MedicalResearch.com: What should readers take away from your report? 

Response: One strategy for improving PSA screening is to do an earlier measurement of PSA during midlife (aged 40-55). PSA levels during midlife have been shown by our group and others to strongly predict long-term risk of prostate cancer, particularly risk of aggressive disease, in now both black and white men.

This baseline PSA level during midlife can be used to risk-stratify PSA screening, targeting higher risk men for screening in order to diagnosis and treat them early while an opportunity exists for cure.  In addition, men at low risk could safely be screened less frequently. As a result, much of the benefit of PSA screening on prostate cancer mortality could be maintained, while overdiagnosis and overtreatment would be reduced.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Prospective studies of a risk stratified screening program should be conducted.  We are also studying ways to further improve risk prediction and to explore biologic mechanisms why a midlife PSA is so predictive.

Disclosures. I have no disclosures. Disclosures for other authors are listed in the manuscript.

Citation:

Eur Urol. 2018 Sep 17. pii: S0302-2838(18)30627-4. doi: 10.1016/j.eururo.2018.08.032. [Epub ahead of print]

Baseline Prostate-specific Antigen Level in Midlife and Aggressive Prostate Cancer in Black Men.

Preston MA1, Gerke T2, Carlsson SV3, Signorello L4, Sjoberg DD5, Markt SC6, Kibel AS7, Trinh QD7, Steinwandel M8, Blot W9, Vickers AJ5, Lilja H10, Mucci LA6, Wilson KM11.

Oct 14, 2018 @ 12:36 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Text Messages Improved Colonoscopy Adherence

MedicalResearch.com Interview with:

Nadim Mahmud, MD, MS, MPH Hospital of the University of Pennsylvania

Dr. Mahmud

Nadim Mahmud, MD, MS, MPH
Hospital of the University of Pennsylvania

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Colonoscopy is an effective screening technique for colorectal cancer (CRC) prevention, but many patients either do not show up or have poor bowel preparation for the procedure. There are many contributors to this issue, including challenges with colonoscopy bowel preparations and communication barriers between healthcare systems and their patients. To address this, we performed a pilot of 21 patients using automated text messages sent over the course of one week prior to scheduled colonoscopy. These messages included instructional, educational, and reminder messages regarding aspects of the colonoscopy preparation process.

We found significantly improved colonoscopy adherence among patients who received the text message program as compared to routine care controls (90% versus 62%). Furthermore, patient satisfaction and likelihood to recommend the text messaging program was high. Similar texting programs are simple to create and manage, and should be considered to improve outpatient colonoscopy adherence. 

Continue reading

Dual Stain More Accurate & Efficient for Detecting Cervical Precancers in HPV-Positive Women

MedicalResearch.com Interview with:

Megan Clarke, PhD, MHS Cancer Prevention Fellow Clinical Genetics Branch Division of Cancer Epidemiology & Genetics National Cancer Institute Rockville, MD 20892

Dr. Clarke

Megan Clarke, PhD, MHS
Cancer Prevention Fellow
Clinical Genetics Branch
Division of Cancer Epidemiology & Genetics
National Cancer Institute
Rockville, MD 20892 

MedicalResearch.com: What is the background for this study?

  • Infection with high-risk human papillomavirus (hrHPV) is the primary cause of cervical cancer. While hrHPV infection is common, most infections are benign and clear on their own without causing cervical cancer. However, some women develop persistent hrHPV infections and are at risk for cervical cancer and its precursors (i.e., precancer).
  • The United States Preventative Services Task Force recommends screening every 3 years with cervical cytology (i.e. Pap) alone, every 5 years with hrHPV testing alone, or with a combination of hrHPV testing and cytology (co-testing) for women aged 30 to 65 years.
  • Screening with hrHPV testing is highly sensitive for detecting cervical precancer but requires additional triage tests to identify HPV-positive women at high-risk of developing cancer who should undergo colposcopy (visualization of the cervix) and biopsy from those at low-risk who can be safely monitored.
  • Currently, Pap cytology is recommended as a triage test for women testing HPV-positive, but this approach requires frequent re-testing at short intervals because the risk of cervical precancer is not low enough in HPV-positive women who test cytology negative to provide long-term reassurance against future risk. In most settings, women who test HPV-positive, cytology-negative are referred to repeat screening within one year.
  • The p16/Ki-67 dual stain assay is a molecular test that measures two specific proteins, p16 that is strongly linked with hrHPV infection, and Ki-67, a marker of cell proliferation that is common in precancers and cancers.
  • Studies have shown that the dual stain test has greater accuracy for detecting cervical precancers in HPV-positive women compared with cytology.
  • In order to determine the optimal screening intervals for the dual stain test, long-term prospective studies are needed to determine how long HPV-positive women who test dual stain negative can be safely reassured of a low precancer risk.

Continue reading

Education Using VR Can Encourage Patients To Get Colon Cancer Screening

MedicalResearch.com Interview with:

Nathaniel Ernstoff, MD University of Miami

Dr. Ernstoff

Nathaniel Ernstoff, MD
University of Miami

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Despite the best efforts of all healthcare providers, colon cancer screening is underutilized with screening rates ranging anywhere from 58-76% based on the state (American Cancer Society 2017). At best we are still failing to screen 25% of the population.  Patients have serious concerns about colorectal cancer (CRC) screening with the most common barriers to screening being fear of colonoscopy and of the bowel preparation, amongst others. These barriers coupled with the lack of understanding of the risks, benefits, and the efficacy of screening contribute to our inadequate screening.

This study aims to prove that through education, and most importantly comprehension, patients will choose one of the 6 recommended colorectal cancer screening tests that best fits their preferences. In this study we had 24 patients who previously refused colonoscopy on 3 separate occasions, and had no other CRC screening, undergo a virtual reality (VR) demonstration, created by TheBodyVR, to see if education would improve the uptake of screening. Prior to the virtual reality demonstration, the patients completed a 5-item questionnaire which evaluated their baseline knowledge of CRC risk, polyps and screening as well as determining barriers to prior screening. The patient then viewed the VR demonstration which starts with an overview of colorectal cancer, followed by a tour through a virtual colon explaining and showing the viewer polyps and cancer.

Finally, the demonstration reviews and compares the strengths and weaknesses of all USPSTF-recommended CRC screening tests.  After the study, the patients complete the same questionnaire, and in this study there was a statistically significant improvement in knowledge in all questions.  Ultimately, 23 of 24 patients who previously refused colorectal cancer screening on 3 separate occasions chose to undergo screening after the VR demonstration, and about 50% have performed the screening 60 days out from the study’s completion.

Continue reading

Who Might Benefit From Early Screening for Colorectal Cancer?

MedicalResearch.com Interview with:

Mohammad Bilal, MD University of Texas Medical Branc

Dr. Bilal

Mohammad Bilal, MD
University of Texas Medical Branch

MedicalResearch.com: What is the background for this study?

Response: Colorectal cancer (CRC) is the fourth most commonly diagnosed cancer among adults in the United States and the second leading cause of cancer related deaths. Recent studies have shown an increasing incidence of CRC in younger patients. This has led to increasing interests in identifying patient populations who might be at increased risk of developing CRC.

The U.S. Multi-Society Task Force of Colorectal Cancer (MSTF) recommends that CRC screening should begin at age 50 in average-risk persons. However, recently the American Cancer Society (ACS) have published recommendations to begin CRC screening at age 45 years in average risk patient population.

These recommendations were primarily based of modeling studies since there is little outcomes data in younger age groups in regards to prevention and detection of CRC. Despite these new recommendations from the ACS, there is limited direct evidence to support CRC screening at a younger age. In our study, we have evaluated the predictors of increased prevalence of adenomas in the 40 to 49-year-old individuals undergoing colonoscopy.  Continue reading

Breast Cancer: Gene Expression of Receptors on a Chip Can Enhance Precision Diagnosis

MedicalResearch.com Interview with:
"JFK Plaza/ Breast Cancer Awareness" by nakashi is licensed under CC BY 2.0Univ.- Prof. Dr. Wolfgang Schreiner
Section Biosimulation and Bioinformatics
Center for Medical Statistics, Informatics, and Intelligent Systems
Medical University of Vienna
General Hospital
WIEN / AUSTRIA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The choice of correct individualized therapy for breast cancer depends on correct diagnosis: receptors for estrogen, progesterone and HER2 are determined routinely. However 5-10% of these routine diagnostics are inaccurate and may entail suboptimal therapy.

We have paved the way for additional diagnostics from gene expression data so as to increase precision of diagnostics. Continue reading

Exercise May Benefit Some Cancer Patients More Than Others

MedicalResearch.com Interview with:

Laurien Buffart, PhD  Chair Amsterdam eXercise in Oncology (AXiON) research Departments of Epidemiology & Biostatistics and Medical Oncology VUmc  Amsterdam | The Netherlands

Dr. Buffart

Laurien Buffart, PhD
Chair Amsterdam eXercise in Oncology (AXiON) research
Departments of Epidemiology & Biostatistics and Medical Oncology
VUmc  Amsterdam | The Netherlands

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: There is evidence from randomized controlled trials that exercise has beneficial effects on physical fitness, fatigue, quality of life and self-reported physical function during and following cancer treatment. The magnitude of the effects, however, often appear modest, possibly because interventions rarely target patients with worse symptoms and quality of life.

Based on individual patient data from 34 randomized controlled trials, we found that exercise interventions during cancer treatment are effective in maintaining muscle strength and quality of life, regardless of their baseline values.

Offering exercise interventions post cancer treatment to patients with a relatively high muscle strength and quality of life does not appear to further improve these outcomes. For aerobic fitness, exercise interventions during treatment had larger effects in patients with higher baseline aerobic fitness, whereas all patients were able to improve aerobic fitness post treatment. Greater effects on fatigue and self-reported physical function were found for patients with worse baseline fatigue and physical function, both during and post-treatment. 

Continue reading

Obesity Linked to Alarming Risk in Gastric and Colon Cancers in Young Adults

MedicalResearch.com Interview with:

Hisham Hussan, M.D. Assistant Professor of Clinical Medicine Director, Obesity and Bariatric Endoscopy Section Division of Gastroenterology, Hepatology, and Nutrition Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus, OH 43210

Dr. Hussan

Hisham Hussan, M.D.
Assistant Professor of Clinical Medicine
Director, Obesity and Bariatric Endoscopy Section
Division of Gastroenterology, Hepatology, and Nutrition
Department of Internal Medicine
The Ohio State University Wexner Medical Center
Columbus, OH 43210

MedicalResearch.com: What is the background for this study?

Response: Obesity, a major healthcare burden, is an established risk factor for many gastrointestinal cancers. With obesity being on the rise, we inspected whether obesity related gastrointestinal cancers are increasing in different age groups, and relation to obesity.

MedicalResearch.com: What are the main findings? 

Response: We identify an alarming increase in incidence of gastric and colorectal cancers in young adults (less than 50 years of age) between 2002-2013.

This was paralleled by an uptrend in obese patients undergoing surgeries for these cancers during the same period. 

MedicalResearch.com: What should readers take away from your report?

Response: Our results suggest, for the first time, a contributing role of obesity in the etiology as well as the increasing incidence of gastric and colorectal cancers in young adults. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: More studies are needed to investigate the interplay of epigenetics factors such as young-onset obesity and western diet in relation to risk of adults developing colorectal and gastric cancers at an earlier age. Also public policies are needed to counter obesity and the rising incidence of gastric and colorectal cancer in this young high risk group.

MedicalResearch.com: Is there anything else you would like to add?

Response: My main career focus is translational and clinical research at the interface of energy balance, the microbiome and gastrointestinal cancer.

We have no financial disclosers or conflict of interest.

Citation:

 ACG18 abstract:

Rising, Age‐Specific, Trends of Obesity‐Related Gastrointestinal Cancers Correspond With Increasing Cancer Resections in Obese Patients: A 2002‐2013 National Analysis Using the SEER and NIS Databases

Oct 9, 2018 @ 11:58 am

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Cutting Out Bacon, Sausage and Hot Dogs May Reduce Risk of Breast Cancer

MedicalResearch.com Interview with:
"bacon&eggs" by ilaria is licensed under CC BY 2.0
Maryam Farvid, Ph.D., Research Scientist  

Department of Nutrition
Harvard T.H. Chan School of Public Health
Boston, MA 02115

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Prior prospective studies on red and processed meat consumption with risk of breast cancer have produced inconsistent results.

Current meta-analysis of 15 prospective studies shows that women who eat a high amount of processed meat each day may have a higher risk of breast cancer than those who don’t eat or have a low intake in their diet.  Continue reading

Combination Oral Contraceptives Associated With Reduced Ovarian Cancer Risk

MedicalResearch.com Interview with:

Dr Lisa Iversen PhD; MSc Epidemiology Research Fellow Academic Primary Care Institute of Applied Health Sciences University of Aberdeen

Dr. Iversen

Dr Lisa Iversen PhD; MSc Epidemiology
Research Fellow
Academic Primary Care
Institute of Applied Health Sciences
University of Aberdeen

MedicalResearch.com: What is the background for this study?

Response: Everyday at least 100 million women worldwide use hormonal contraception. Previous research has found a reduced risk of ovarian cancer in women using combined oral contraceptives but this evidence related to older products. It is important for users of contemporary combined oral contraceptives to know whether they are likely to experience the same patterns of reduction in risk of ovarian cancer and whether the benefit is specific to a particular formulation. Users of other hormonal contraceptives such as those with non-oral routes of administration and progestogen-only products should also know whether they have a reduced risk of ovarian cancer.

We investigated the influence of all contemporary hormonal contraceptives on ovarian cancer risk in over 1.8 million women in Denmark aged 15-49 years, over a 20 year period from 1995-2014.

MedicalResearch.com: What are the main findings? 

Response: Compared to never users, current or recent users of hormonal contraceptives and former users had a reduced risk of ovarian cancer. The reduced risk became stronger the longer time period hormonal contraceptives were used and the protection remained several years after stopping. We found most of the hormonal contraceptive use was of combined oral contraceptives. There was little evidence of important differences between products containing different progestogens. The reduced risk of ovarian cancer for combined products was seen for most ovarian cancer types. There was no firm evidence to suggest any protective effect among women who had used progestogen-only products but few women exclusively used these contraceptives so their limited data might not be powerful enough. We estimate that hormonal contraception prevented 21% of ovarian cancers in our study

MedicalResearch.com: What should readers take away from your report?

Response: Our findings are reassuring to women of reproductive age, contemporary combined oral contraceptives (which generally contain lower doses of oestrogen and newer progestogens) are still associated with a reduced risk of ovarian cancer. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: It is still to be established how long the protective effects associated with contemporary combined oral contraceptives persist. We were unable to investigate this as our study examined contemporary products and did not include older women. 

MedicalResearch.com: Is there anything else you would like to add?

Response: Although our observational study is unable to draw conclusions about cause and effect, it is noteworthy that our findings are consistent with studies of older products.

All authors have completed the ICMJE uniform disclosure form and declare Professor Lidegaard reports grants from Novo Nordisk Foundation, during the conduct of the study; and has been an expert witness in two legal cases in the US on hormonal contraception and venous thrombosis for the plaintiff in 2011 and 2012. Dr Mørch reports grants from Novo Nordisk Foundation, during the conduct of the study. Professor Hannaford and Drs Iversen, Fielding and Skovlund have nothing to disclose.

Citation:

Association between contemporary hormonal contraception and ovarian cancer in women of reproductive age in Denmark: prospective, nationwide cohort study

BMJ 2018362 doi: https://doi.org/10.1136/bmj.k3609 (Published 26 September 2018)Cite this as: BMJ 2018;362:k3609

Oct 1, 2018 @ 2:44 pm 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Trial Demonstrates Efficacy of Injecting Bacterial Spores Into Resistant Cancerous Tumors

MedicalResearch.com Interview with:

Filip Janku, MD, PhD Associate Professor, Investigational Cancer Therapeutics (Phase I Clinical Trials Program) Center Medical Director, Clinical and Translational Research Center The University of Texas MD Anderson Cancer Center Houston, TX 77030

Dr. Janku

Filip Janku, MD, PhD
Associate Professor, Investigational Cancer Therapeutics
(Phase I Clinical Trials Program)
Center Medical Director, Clinical and Translational Research Center
The University of Texas MD Anderson Cancer Center
Houston, TX 77030

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Clostridium novyi-NT is an attenuated strain of bacteria Clostridium, which induced a microscopically precise, tumor-localized response in a rat brain tumor model and in companion dogs bearing spontaneous cancers. Clostridium novyi-NT can only grow in hypoxic (low-oxygen) tumor environment and destroys cancer cells by secreting lipases, proteases, and other hydrolytic enzymes; recruiting inflammatory cells to tumors eliciting anti-tumor immune responses in animals. Furthermore, intratumoral injection can plausibly induce an immune mediated abscopal effect in non-injected tumor sites.

Therefore, we designed a phase I dose-finding study to test for safety and tolerability of the single intratumoral injection of Clostridium novyi-NT in 24 patients with advanced cancers with no available standard therapies. We also designed experiments to study activation of antitumor immune response in blood and tumor samples from patients undergoing the therapy.

We demonstrated that single dose of intratumoral injection of Clostridium novyi-NT is feasible and has led to significant destruction of injected tumor masses. Adverse events, which were often related to the tumor destruction at the infected site, could have been significant but mostly manageable. Correlative studies of pre-treatment and post-treatment tumor and blood samples suggested immune response to therapy.

Continue reading

Mammograms: Minorities and Poor Less Likely To Report Barriers to Care

MedicalResearch.com Interview with:

Mammogram showing small lesion - Wikipedia

Mammogram showing small lesion
– Wikipedia

Sage J. Kim, PhD
Division of Health Policy and Administration,
School of Public Health,
University of Illinois at Chicago,
Chicago, IL 60612 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our study examined the rates at which women who received patient navigation in a randomized clinical trial reported barriers to obtaining a screening mammogram. The trial, called the Patient Navigation in Medically Underserved Areas (PNMUA) study, randomly assigned patients to one of two groups: one received a patient navigation support intervention and the other served as a control. Of the 3,754 women who received the patient navigation intervention, only 14 percent identified one or more barriers to care, which led to additional interactions with navigators who helped overcome barriers.

Black women, women living in poverty, and women who reported high levels of distrust of the health care system were the least likely to report barriers. Women who reported barriers were more likely to have additional contact with navigators and obtain a subsequent screening mammogram. The extra support could help with early diagnosis and better survival and mortality outcomes. Continue reading

Study Identifies Viral Protein That Allows HPV-Associated Head/Neck Cancers to Spread

MedicalResearch.com Interview with:

Manon Eckhardt, PhD Gladstone Institutes Quantitative BioSciences Institute University of California San Francisco 

Dr. Manon Eckhardt

Manon Eckhardt, PhD
Gladstone Institutes
The Quantitative Biosciences Institute
University of California San Francisco 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Infection with Human Papillomavirus (HPV) causes 5% of all cancers worldwide, including cervical cancer and an increasing number of head and neck cancers. Most cancers are caused by mutations in genes, leading to the production of malfunctioning proteins that result in unconstrained cell division. However, certain viruses like HPV can cause cancer without introducing mutations.

In this study, we compared cancers of the same type (i.e. head and neck) that are caused by either mutation or virus infection to identify important processes that are dysregulated in both subsets. We hypothesized that identifying which proteins the virus binds can lead the way to prioritize which of the proteins and cellular processes (pathways) that are affected in cancer cells are most important. To do this, we identified the complete set of human proteins that interact with HPV. We next determined genes that were more frequently mutated in non-viral cancers, and combined both data sets. The proteins we find to be both binding to HPV and mutated in non-viral cancers will be potential targets for new, more specific drug development, and help better understand the development of head and neck cancer.

From the many pathways we identified in this study, we highlighted two pathways with further mechanistic studies: the oxidative stress response, which helps cancer cells survive, as well as a pathway that allows the cancer to spread to other parts of the body. Continue reading