Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Stem Cells / 05.03.2021

MedicalResearch.com Interview with: [caption id="attachment_56841" align="alignleft" width="163"]Khalid Shah, MS, PhD Vice Chair of Research, Department of Neurosurgery Director, Center for Stem Cell Therapeutics and Imaging Director, Center for Excellence in Biomedicine Brigham and Women's Hospital Associate Professor, Harvard Medical School Principal Faculty, Harvard Stem Cell Institute Dr. Shah[/caption] Khalid Shah, MS, PhD Vice Chair of Research, Department of Neurosurgery Director, Center for Stem Cell Therapeutics and Imaging Director, Center for Excellence in Biomedicine Brigham and Women's Hospital Associate Professor, Harvard Medical School Principal Faculty, Harvard Stem Cell Institute  MedicalResearch.com: What is the background for this study? Response: Approximately 15-to-30 percent of patients with metastatic breast cancer have brain metastasis (BM), with basal-like breast cancer (BLBC) metastasizing to the brain most frequently. The prognosis for BLBC-BM patients is poor, as the blood-brain barrier prevents most therapeutics from reaching the brain. Testing candidate therapies in clinical trials is also challenging because animal models that mimic BM are limited. In this study we engineered a bimodal tumor-suppressing and killing molecule that can be delivered to the brain by stem cells and tested them in mouse models of brain metastases that mimic clinical setting.
Author Interviews, Breast Cancer, Genetic Research, JAMA, Race/Ethnic Diversity / 22.01.2021

MedicalResearch.com Interview with: [caption id="attachment_56433" align="alignleft" width="150"]Kent Hoskins, MD Eileen Lindsay Heidrick Professor in Oncology Division of Hematology/Oncology University of Illinois at Chicago Director of Cancer Genetics Co-Leader, Breast Cancer Research Group University of Illinois Cancer Center Dr. Hoskins[/caption] Kent Hoskins, MD Eileen Lindsay Heidrick Professor in Oncology Division of Hematology/Oncology University of Illinois at Chicago Director of Cancer Genetics Co-Leader, Breast Cancer Research Group University of Illinois Cancer Center MedicalResearch.com: What is the background for this study? Response: The racial disparity in breast cancer mortality emerged in the US in the late 1980s in the wake of widespread implementation of mammography screening and the development of successful systemic adjuvant therapies for early breast cancer. Unfortunately, more than three decades later, Black women in the US still have a 40% higher mortality rate from breast cancer compared with non-Hispanic White women despite similar disease incidence. Health disparities research has primarily focused on the fact that Black women have a higher incidence of the aggressive triple-negative subtype, and that they are more likely to present with more advanced stages of disease. As important as those factors are, in recent years our group and others reported that Black women with hormone receptor-positive breast cancer have worse survival than non-Hispanic white women even after adjustment for stage at diagnosis and treatment. Since nearly 2/3 of breast cancers in Black women are hormone receptor-positive, this is a significant contributor to the overall mortality disparity. Importantly, these studies also suggested that Black women disproportionately develop biologically aggressive forms of hormone-dependent breast cancer, which is typically considered a more favorable disease subtype. Using data on more than 70,000 patients from the SEER registry that is linked to data from Genomic Health Laboratory, which provides the Oncotype DX recurrence score (the most commonly ordered prognostic/predictive multi-gene expression assay for early breast cancer), we set out to address three questions: 1) is there evidence of disproportionately aggressive tumor biology among Black women with hormone receptor (HR)-positive breast cancer, as reflected in the Oncotype DX recurrence score? 2) Is there a racial survival disparity even among patients with early stage, axillary node-negative tumors with comparable recurrence scores on the Oncotype assay? and 3) Is there is a difference in the prognostic accuracy of the Oncotype assay between Black and non-Hispanic white patients, since there was limited representation of Black women in the development and validation of the Oncotype assay and other prognostic/predictive assays? 
Author Interviews, Breast Cancer, Cancer Research, COVID -19 Coronavirus / 10.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56183" align="alignleft" width="200"]Joanne L. Blum, MD, PhD, FACP Texas Oncology and Director Hereditary Cancer Risk Program Baylor University Medical Center Dr. Blum[/caption] Joanne L. Blum, MD, PhD, FACP Texas Oncology and Director Hereditary Cancer Risk Program Baylor University Medical Center MedicalResearch.com: What is the background for this study? Would you briefly describe the POLARIS study? Response: POLARIS is an ongoing prospective, real-world, non-interventional study in patients with HR+/HER2-ABC receiving palboiclib plus endocrine therapy with a targeted enrollment of 1500 patients at 110 sites in the United States and Canada.  MedicalResearch.com: What are the main findings?
  • Because of the COVID-19 pandemic, approximately one third of the study sites experienced an impact on their responsiveness to correspondence, timely data entry, and subject management.
  • The geographic location or type (e.g., academic or community) of study site appears associated with whether the site was impacted by COVID-19.
  • Other study site characteristics were generally similar between sites that reported an impact of COVID-19 and those that were not impacted.
  • Because of inherent limitations of survey studies, these findings must be interpreted with caution.
Author Interviews, BMC, Breast Cancer, Brigham & Women's - Harvard, Cancer Research, Diabetes, Nutrition / 10.12.2020

MedicalResearch.com Interview with: Tengteng Wang, PhD, MSPH, MBBS Postdoctoral Research Fellow Department of Epidemiology Harvard T.H. Chan School of Public Health Channing Division of Network Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Type 2 diabetes (T2D) has been associated with poor progression of breast cancer. Moreover, having a breast cancer diagnosis may also increase the risk of developing T2D. Therefore, identifying strategies for T2D prevention among breast cancer survivors may play a key role in improving their survival outcomes. One approach may be through a diabetes risk reduction diet (DRRD), a dietary pattern comprised of 9 components that has been associated with 40% lower T2D risk in a previous Nurses’ Health Study publication.1 However, no studies to date have evaluated the association between adherence to the DRRD (as measured by the DRRD score) and survival outcomes following breast cancer. In this prospective cohort study among 8,320 breast cancer survivors, we found that greater adherence to the diabetes risk reduction diet after diagnosis was associated with a statistically significant 31% lower risk of overall mortality. Reduced breast cancer-specific mortality was also observed, which was more pronounced (20% lower risk) among those who improved adherence after diagnosis compared to women with consistently low DRRD adherence before and after diagnosis.
Author Interviews, Breast Cancer, Cancer Research, Chemotherapy, JAMA, Yale / 26.11.2020

MedicalResearch.com Interview with: [caption id="attachment_56014" align="alignleft" width="191"]Lajos Pusztai, M.D, D.Phil. Professor of Medicine Director, Breast Cancer Translational Research Co-Director, Yale Cancer Center Genetics and Genomics Program Yale Cancer Center Yale School of Medicine Dr. Pusztai[/caption] Lajos Pusztai, M.D, D.Phil. Professor of Medicine Director, Breast Cancer Translational Research Co-Director, Yale Cancer Center Genetics and Genomics Program Yale Cancer Center Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In HER2-positive early stage (stage I-II) breast cancer, several different preoperative (also called neoadjuvant) chemotherapy options exist, each of these is associated with a different rate of complete eradication of cancer from the breast and lymph nodes (called pathologic complete response or pCR). Patients who experience pCR have excellent long term survival. The complete response rates range from 20% to 80%, the rates are higher with regimens that include several different chemotherapy drugs and dual HER2 blockade. Unfortunately, these highly effective multi-drug treatment regimens are also more toxic and more expensive.  We also learned that patients who do not achieve pCR after preoperative therapy, have high rates of recurrence, but the recurrence rate can be improved by administering postoperative adjuvant therapy. These two observations together, (1) different regimens with different toxicities and costs resulting in different pCR rates, and (2) existence of effective postoperative therapies for patients with residual cancer after preoperative therapy, sets the stage for combining various pre- and post-operative treatment strategies. Starting with a shorter, less toxic and less expensive neoadjuvant regimen would allow a substantial minority (20-45%) of patients who archive pCR to be spared of longer and more toxic regimens, whereas those with residual disease could receive the remaining part of the currently most effective regimens post-operatively as adjuvant therapy. In this study we examined the cost effectiveness of different neoadjuvant followed by adjuvant treatment strategies from a healthcare payer perspective.
Author Interviews, BMJ, Breast Cancer, Cancer Research, Radiation Therapy / 10.11.2020

MedicalResearch.com Interview with: Professor Jayant S Vaidya MBBS MS DNB FRCS PhD Professor of Surgery and Oncology University College London MedicalResearch.com: What is the background for this study? What type of single dose radiation is used?  [caption id="attachment_55895" align="alignleft" width="500"]Prof Jeffrey S Tobias, Prof Jayant S Vaidya, Prof Max Bulsara and Prof Michael Baum Prof Jeffrey S Tobias, Prof Jayant S Vaidya, Prof Max Bulsara.                             and Prof Michael Baum[/caption] Response: The findings of the large international randomised trial (TARGIT-A trial), published in the British Medical Journal (BMJ 2020;370:m2836), confirm the long-term effectiveness of Targeted Intraoperative Radiotherapy (TARGIT-IORT): a breast cancer treatment which is increasingly available throughout the world. For most women with early breast cancer, a single dose of targeted radiotherapy during surgery is just as effective as conventional radiotherapy, which requires several visits to hospital after surgery. Conventional external beam radiotherapy (EBRT) is delivered from outside the body via a radiotherapy machine (linear accelerator), and consists of a daily treatment session (known as fractions) to the whole breast, over a period between three to six weeks. Each of these treatments is given over a few minutes, but requires 15 to 30 hospital visits, which could be a significant distance from where the patient lives. TARGIT-IORT is delivered immediately after lumpectomy (tumour removal), via a small ball-shaped device placed inside the breast, directly where the cancer had been. The single-dose treatment lasts for around 20 to 30 minutes and replaces the need for extra hospital visits, benefiting both patient safety and well-being. The device used is called INTRABEAM. More details are described on the BMJ and UCL webpages: https://www.bmj.com/company/newsroom/single-dose-radiotherapy-as-good-as-conventional-radiotherapy-for-most-women-with-early-breast-cancer/ https://www.ucl.ac.uk/news/2020/aug/single-dose-radiotherapy-effective-treating-breast-cancer https://blogs.bmj.com/bmj/2020/08/20/targeted-intraoperative-radiotherapy-for-early-breast-cancer-new-evidence/
Author Interviews, Breast Cancer, Cancer Research, Genetic Research, Ovarian Cancer / 22.07.2020

MedicalResearch.com Interview with: [caption id="attachment_54909" align="alignleft" width="200"]Prof Ranjit Manchanda MD, MRCOG, PhD Professor of Gynaecological Oncology & Consultant Gynaecological Oncologist Prof. Manchanda[/caption] Prof Ranjit Manchanda MD, MRCOG, PhD Professor of Gynaecological Oncology & Consultant Gynaecological Oncologist NHS Innovation Accelerator (NIA) Fellow Integrated Academic Training Programme Director London Specialty School of Obstetrics & Gynaecology, Health Education England Specialty Research Lead for Gynaecological Cancer, NIHR, North Thames Clinical Research Network Cancer Research UK, Barts Centre | Queen Mary University of London Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine | Charterhouse Square | London Department of Gynaecological Oncology | Barts Health NHS Trust, Royal London Hospital MedicalResearch.com: What is the background for this study? Response: Around 10–20% of ovarian cancers and 6% breast cancers overall are caused by inheritable BRCA1/BRCA2 mutations. Women carrying BRCA1/BRCA2 mutations have a 17–44% risk of ovarian cancer and 69–72% risk of breast cancer until age 80 years. Most of these cancers can be prevented in unaffected BRCA1/BRCA2 women carriers. Women can opt for a range of options including screening, preventive, and reproductive choices to minimise their risk. The current approach uses established clinical-criteria/family-history (FH) based a priori BRCA probability thresholds to identify high-risk individuals eligible for BRCA testing. However, this requires individuals and health practitioners to recognise and act on a significant FH. BRCA carriers, who are unaware of their FH, unappreciative of its risk/significance, not proactive in seeking advice, or lack a strong FH (small families/paternal inheritance/chance) get excluded. Over 50% BRCA carriers do not fulfil clinical criteria and are missed. Despite >25 years of BRCA testing and effective mechanisms for prevention, current guidelines and access to testing pathways remain complex and associated with a massive under-utilisation of genetic testing. Only 20% of eligible women have accessed/undergone genetic testing and our earlier analysis showed that 97% of BRCA carriers in the population remain unidentified. Current detection rates are inadequate to identify all BRCA carriers and even doubling detection rates will not work. Why should we wait for decades for people to develop cancer before identifying BRCA carriers and unaffected at-risk family members to offer prevention?. This highlights substantial missed opportunities for early detection and prevention. A new population testing approach can change this. Jewish population studies show this is feasible, acceptable, has high satisfaction (91–95%), significantly reduces anxiety, doesn’t harm psychological well-being or quality of life, and is extremely cost-effective. However, this has not been evaluated in the general population and in particular across different  countries or health systems. The potential applicability and scope for this approach transcends continents and countries. Additionally, for interventions to be sustainable, they need to be cost-effective and affordable. We have undertaken a cost-effectiveness analysis of population based BRCA testing compared with current standard clinical testing of women designated as high risk, across high income countries (UK/USA/Netherlands), upper-middle income countries (China/Brazil), and low-middle income country (India).
Author Interviews, Breast Cancer, Mammograms / 30.06.2020

MedicalResearch.com Interview with: Rachel Farber, MPH School of Public Health Faculty of Medicine and Health University of Sydney New South Wales, Australia MedicalResearch.com: What is the background for this study? Response: Most breast screening programs worldwide have replaced the use of film mammography with digital mammography. While digital mammography provides significant technical and practical advantages over film mammography in the provision of population screening programs, the effect of this move on health outcomes remained unclear. An increase in screen detected cancer rates is only beneficial if the additional cancers detected would have otherwise presented at a later stage and caused morbidity and premature mortality. An indirect measure of this is an observed decrease in interval cancer rates. Interval cancers are cancers that are diagnosed after a woman has a negative screening result and before her subsequent scheduled screening.
ASCO, AstraZeneca, Author Interviews, Breast Cancer, Cancer Research / 02.06.2020

MedicalResearch.com Interview with: [caption id="attachment_54437" align="alignleft" width="200"]Josefa Briceno, MD Medical Head, DDR/ADC Franchise AstraZenca Dr. Briceno[/caption] Josefa Briceno, MD Medical Head, DDR/ADC Franchise AstraZenca  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In January 2018, the US FDA expanded the approved use of LYNPARZA to treat patients with HER2- negative metastatic breast cancer with germline BRCA mutations based on positive results from the Phase III OlympiAD trial, which demonstrated the benefit of LYNPARZA over standard of care in physician’s choice chemotherapy in this patient population. LUCY is a Phase IIIb interim analysis aimed to evaluate the clinical effectiveness and safety of LYNPARZA in a real-world setting and has been expanded to include a group of patients with somatic BRCA mutations. A total of 252 patients with HER2-negative metastatic breast cancer with germline BRCA mutations were enrolled in the open-label, single-arm, Phase IIIb study. Patients received a taxane and/or anthracycline in the (neo)adjuvant/metastatic setting, and ≤2 lines of chemotherapy. The primary end point of the study was investigator-defined progression-free survival (PFS), and secondary end points included overall survival, time to first subsequent therapy or death, and investigator-assessed clinical response rate. The interim analysis was planned to take place after 160 progression-free survival events. Overall, treatment lasted for a median of 7.9 months, and the median progression-free survival was 8.1 months (95% confidence interval of 6.9-8.7; 166 progression-free survival events). In addition, the median time to first subsequent therapy or death was 9.7 months (95% confidence interval of 8.7-11.1) and the investigator-assessed clinical response rate was 48.6% (95% confidence interval of 42.2-55.0). Adverse events of all grades were reported in >20% of patients were nausea, anemia, asthenia, vomiting, and fatigue. Grade ≥3 adverse events were reported in 24.6% of patients, and 4.4% of patients had an adverse event that led to treatment discontinuation.
ASCO, Author Interviews, Biomarkers, Breast Cancer / 30.05.2020

MedicalResearch.com Interview with: [caption id="attachment_54388" align="alignleft" width="200"]Francois-Clement Bidard, MD PhD Head of Breast Cancer Group, Institut Curie Professor of Med. Oncology, UVSQ/Paris  Dr. Clement Bidard[/caption] Francois-Clement Bidard, MD PhD Head of Breast Cancer Group, Institut Curie Professor of Med. Oncology, UVSQ/Paris MedicalResearch.com: What is the background for this study? Response: A timely question is how to optimize the endocrine therapy of ER+ HER2- metastatic breast cancers? Aromatase inhibitors (AI) are currently the standard of care in first line, in combination with CDK4/6 inhibitors. Mutations in the estrogen receptor gene (ESR1) can be detected in up to 40% of AI-resistant metastatic breast cancers, but no data was available in the current first line setting (AI combined to CDK4/6 inhibitor). This exploratory study of the first line PADA-1 study reports on the detection rate of ESR1 mutations in cell-free DNA from an “AI-sensitive” population (with no metastatic relapse during adjuvant AI therapy), before the start of therapy (at inclusion). As expected, we found a low prevalence of 3.2% in the general population (N=1,017 patients included). The prevalence of ESR1 mutations among subgroups appeared primarily driven by the type of adjuvant endocrine therapy: patients with prior exposure to adjuvant therapy with AI displayed the highest prevalence of ESR1 mutations (7.1%), followed by patients with no prior adjuvant endocrine therapy (mostly de novo stage IV; ESR1 mutation prevalence: 2.4%). Patients who received adjuvant endocrine therapy with no AI (e.g. tamoxifen only) had the lowest ESR1 mutation prevalence (1.2%).
Author Interviews, Breast Cancer, Cancer Research, Genetic Research, JAMA / 08.05.2020

MedicalResearch.com Interview with: [caption id="attachment_54074" align="alignleft" width="225"]Anurag K. Singh MD Professor of Oncology Director of Radiation Research Leader, Cell Stress and Biophysical Therapy Program Associate Dean Graduate Medical Education, Research Roswell Park Comprehensive Cancer Center Buffalo NY  Dr. Singh[/caption] Anurag K. Singh MD Professor of Oncology Director of Radiation Research Leader, Cell Stress and Biophysical Therapy Program Associate Dean Graduate Medical Education, Research Roswell Park Comprehensive Cancer Center Buffalo NY MedicalResearch.com: What is the background for this study? Response: More than 40% of women with hormone receptor-positive, HER2-negative early stage breast cancer with high recurrence scores (RS) have RS of 26-30. Optimal adjuvant systemic therapy in this subgroup remains unclear, and national guideline currently recommends either chemoendocrine therapy or endocrine therapy alone. In addition, the difference in overall survival of a patient with a RS 26-30 versus RS >30 is unclear.  
Author Interviews, Breast Cancer, Genetic Research, JAMA, Stanford / 12.03.2020

MedicalResearch.com Interview with: [caption id="attachment_41598" align="alignleft" width="200"]Dr-Allison W. Kurian Dr. Kurian[/caption] Allison W. Kurian, M.D., M.Sc. Associate Professor of Medicine (Oncology) and of Epidemiology and Population Health Director, Women’s Clinical Cancer Genetics Program Stanford University School of Medicine Stanford, CA 94305-5405 MedicalResearch.com: What is the background for this study? Response: Genetic testing is increasingly relevant for the care of cancer patients. However, little was known about the prevalence of inherited mutations in cancer susceptibility genes among the most common group of women with breast cancer: those diagnosed after menopause and without a strong family history of cancer. 
Author Interviews, BMC, Breast Cancer, Cancer Research, Weight Research / 27.02.2020

MedicalResearch.com Interview with: [caption id="attachment_53328" align="alignleft" width="120"]Carolyn Ee PhD NICM Health Research Institute Western Sydney University Australia Dr. Ee[/caption] Carolyn Ee PhD NICM Health Research Institute Western Sydney University Australia MedicalResearch.com: What is the background for this study? Response: Worldwide and in Australia, breast cancer is the most common cancer in women. Weight gain is common after diagnosis of breast cancer and may increase tumour recurrence risk, mortality rate, and worsen quality of life. As there was no national data on the prevalence of weight gain after breast cancer in Australia, we undertook a national survey which was open to any woman living in Australia who had breast cancer.
Author Interviews, Breast Cancer, Radiation Therapy / 25.02.2020

MedicalResearch.com Interview with: [caption id="attachment_53297" align="alignleft" width="133"]Jennifer Sims-Mourtada, Ph.D. Senior Rsearch Scientist Director of Translational Breast Cancer Research Center for Translational Cancer Research ChristianaCare Dr. Sims-Mourtada[/caption] Jennifer Sims-Mourtada, Ph.D. Senior Rsearch Scientist Director of Translational Breast Cancer Research Center for Translational Cancer Research ChristianaCare MedicalResearch.com: What is the background for this study? Response: Cancer stem cells are resistant cancer cells that are able to continuously grow and are very resistant to radiation and chemotherapy. Cancer stem cells can also escape to the blood stream and travel to another site causing metastasis.
Annals Internal Medicine, Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Cancer Research, Mammograms / 25.02.2020

MedicalResearch.com Interview with: [caption id="attachment_53229" align="alignleft" width="124"]Xabier Garcia-De-Albeniz MD PhD Research Associate Department of Epidemiology Harvard T.H. Chan School of Public Health Mongan Institute for Health Policy Massachusetts General Hospital Dr. Garcia-De-Albeniz[/caption] Xabier Garcia-De-Albeniz MD PhD Research Associate Department of Epidemiology Harvard T.H. Chan School of Public Health Mongan Institute for Health Policy Massachusetts General Hospital  MedicalResearch.com: What is the background for this study? Response: The goal of breast cancer screening is to reduce deaths from breast cancer by finding breast cancer at early, more treatable stages. The main way to screen for breast cancer is periodic mammography, which is an x-ray of the breast that can show tumors before they are large enough to feel. High-quality studies called clinical trials have shown that screening women in their 50s and 60s decreases breast cancer deaths. However, the point at which women can safely stop screening because it no longer decreases breast cancer deaths has not been studied. More than half of women in the United States continue screening mammography after age 75 years. 
Author Interviews, Breast Cancer, Cancer Research, Cognitive Issues / 20.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52873" align="alignleft" width="200"]Annelise Madison Lead author of the study Graduate Student in Clinical Psychology Ohio State Annelise Madison[/caption] Annelise Madison Lead author of the study Graduate Student in Clinical Psychology Ohio State MedicalResearch.com: What is the background for this study? Response: Recently, there have been some reports of cognitive problems among those using proton pump inhibitors (PPIs). Some breast cancer survivors use PPIs during and after treatment to manage gastrointestinal side effects of cancer treatment or to prevent damage to the gut lining. We were interested in whether PPI use among breast cancer survivors related to cognitive problems. We conducted secondary analyses on data from three studies with breast cancer survivors. We found that breast cancer survivors taking PPIs reported cognitive problems that were between 20-29% worse than those reported by non-users.
Author Interviews, Breast Cancer, Cost of Health Care, JAMA, Race/Ethnic Diversity / 09.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52714" align="alignleft" width="184"]Naomi Y Ko, MD Director, Inpatient Medical Operations Assistant Professor of Medicine, Department of Medicine Boston University School of Medicine Dr. Ko[/caption] Naomi Y Ko, MD Director, Inpatient Medical Operations Assistant Professor of Medicine, Department of Medicine Boston University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is to help understand the association between risk of more advanced cancer in racial minorities and insurance.  
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, JAMA, Surgical Research / 08.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52688" align="alignleft" width="200"]Mehra Golshan, MD, MBA Dr. Abdul Mohsen & Sultana Al-Tuwaijri Distinguished Chair Surgical OncologyDirector of Breast Surgical Oncology Fellowship Associate Professor, Harvard Medical School Dr. Golshan[/caption] Mehra Golshan, MD, MBA Dr. Abdul Mohsen & Sultana Al-Tuwaijri Distinguished Chair Surgical OncologyDirector of Breast Surgical Oncology Fellowship Associate Professor, Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Triple negative breast cancer is an aggressive form of breast cancer that often requires chemotherapy. In this study we provided neoadjuvant chemotherapy with or without a PARP inhibitor and showed that many women who were originally ineligible for breast conservation (lumpectomy) became eligible after treatment. If lumpectomy was tried it was usually successful.  Many more women in the US compared to Europe and Asia chose mastectomy when lumpectomy was an option even when genetics is negative.
Author Interviews, Breast Cancer, Weight Research / 19.12.2019

MedicalResearch.com Interview with: [caption id="attachment_52536" align="alignleft" width="136"]Lauren Teras, PHD Scientific Director, Epidemiology Research American Cancer Society Dr. Teras[/caption] Lauren Teras, PHD Scientific Director, Epidemiology Research American Cancer Society MedicalResearch.com: What is the background for this study? Response: Excess body weight is a known cause of postmenopausal breast cancer, but an important question is: can you reverse it? Believe it or not, this not something we knew for certain. We had hoped it was true, but the scientific evidence was not there. This research question is, of course, particularly important for the more than two-thirds of U.S. women who are overweight or obese, and therefore at higher risk for breast cancer. To try to answer this question, we used a very large pooled study of 180,000 women aged ≥50 years from 10 different prospective studies. 
Author Interviews, Breast Cancer, Mammograms / 19.12.2019

MedicalResearch.com Interview with: [caption id="attachment_52515" align="alignleft" width="60"]Nancy R. Kressin, PhD VA Medical Center, Jamaica Plain Campus Boston, MA  Dr. Kressin[/caption] Nancy R. Kressin, PhD VA Medical Center, Jamaica Plain Campus Boston, MA   MedicalResearch.com: What is the background for this study? Response: State-level legislation requires informing women about breast density (BD) with mammogram results, to increase awareness of BD’s tendency to mask cancers on mammography, its association with increased breast cancer risk, and to encourage women to discuss personal risk and supplemental screening with physicians. The Food and Drug Administration is currently developing dense breast notification (DBN) language for use nationwide; information about effects of state DBNs could be informative for FDA’s language.
Author Interviews, Breast Cancer, Exercise - Fitness / 16.12.2019

MedicalResearch.com Interview with: [caption id="attachment_52481" align="alignleft" width="200"]Tiffany Won-Shau Chen MD Internal Medicine Residency Mount Sinai Beth Israel Dr. Chen[/caption] Tiffany Won-Shau Chen MD Internal Medicine Residency Mount Sinai Beth Israel MedicalResearch.com: What is the background for this study? Response: The research I presented on details a randomized, prospective study done to evaluate whether it would be feasible and effective to implement a yoga program for breast cancer patients receiving chemotherapy that could reduce patients' chemotherapy-related symptoms and improve their quality of life. 50 patients were recruited, half of whom underwent a 12-week long yoga program with weekly courses, while the other half did not participate in the program. Surveys were completed at baseline, 6 weeks, and 12 weeks assessing patients' functional wellbeing, sleep quality, and anxiety/depression levels.
Author Interviews, Breast Cancer, Genetic Research / 15.12.2019

MedicalResearch.com Interview with: [caption id="attachment_52448" align="alignleft" width="200"]Dr. Julia Blanter, MD MS Icahn School of Medicine at Mount Sinai First author of the study Dr. Blanter[/caption] Dr. Julia Blanter, MD MS Icahn School of Medicine at Mount Sinai First author of the study MedicalResearch.com: What is the background for this study? Response: The Oncotype DX Breast Cancer Assay was developed to genetically profile patients with early stage, hormone positive breast cancer and predict their 10-year risk of distant recurrence. A high-risk recurrence score is associated with a benefit from adjuvant chemotherapy whereas a low risk recurrence score is associated with little to no benefit. BRCA mutated tumors have been associated with higher risk recurrence scores as compared to BRCA negative breast cancer patients. However, there have been minimal studies relating discordance to BRCA mutations. Discordance refers to a poorly differentiated or high-grade tumor with a low risk recurrence score. Prior studies demonstrated 7-19% discordance, or difference between recurrence score and tumor grade in breast cancer patients regardless of BRCA mutation status. It has been concluded that patients who exhibit discordance may benefit from additional therapy in conjunction with endocrine therapy.
Author Interviews, Breast Cancer, Cancer Research / 10.12.2019

MedicalResearch.com Interview with: [caption id="attachment_52426" align="alignleft" width="130"]Jian Jin, Ph.D. Mount Sinai Endowed Professor in Therapeutics Discovery Professor, Department of Pharmacological Sciences Professor, Department of Oncological Sciences Director, Mount Sinai Center for Therapeutics Discovery Co-leader, Cancer Clinical Investigation Program, Tisch Cancer Institute Icahn School of Medicine at Mount Sinai  Dr. Jian Jin[/caption] Jian Jin, Ph.D. Mount Sinai Endowed Professor in Therapeutics Discovery Professor, Department of Pharmacological Sciences Professor, Department of Oncological Sciences Director, Mount Sinai Center for Therapeutics Discovery Co-leader, Cancer Clinical Investigation Program, Tisch Cancer Institute Icahn School of Medicine at Mount Sinai  MedicalResearch.com: What is the background for this study? Response: Triple-negative breast cancer (TNBC), a subtype of breast cancer that lacks estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2), represents 12-20% of all breast cancers. TNBC has poor prognosis, high recurrence, a low survival rate, and has higher incidence in African-American and Hispanic women. Currently, there are no effective therapies for treating a substantial portion of TNBC patients. Enhancer of zeste homolog 2 (EZH2) is the main enzymatic subunit of the polycomb repressive complex 2 (PRC2) which catalyzes trimethylation of histone H3 lysine 27 (H3K27me3) to promote transcriptional silencing. EZH2 is overexpressed in multiple types of cancer including triple negative breast cancer (TNBC) and high expression levels correlate with poor prognosis. Several EZH2 inhibitors which inhibit the enzymatic activity of EZH2 have shown promise in treating sarcoma and follicular lymphoma in clinics. However, current EZH2 inhibitors are ineffective at blocking proliferation of TNBC cells even though they effectively inhibit the enzymatic activity of EZH2. While the proteolysis targeting chimera (PROTAC) technology for selective degradation of the target protein has been rapidly gaining momentum in the drug discovery field, the hydrophobic tagging approach for selective protein degradation has received considerately less attention from the scientific community. 
Author Interviews, Breast Cancer, Mammograms / 06.12.2019

MedicalResearch.com Interview with: [caption id="attachment_52282" align="alignleft" width="144"]Sarah Moorman, MD  Department of Radiology  Michigan Medicine   Dr. Moorman[/caption] Sarah Moorman, MD Department of Radiology Michigan Medicine   MedicalResearch.com: What is the background for this study? Response: Professional societies and government agencies have variable recommendations regarding how often women should get a screening mammogram. Breast cancer screening may be recommended annually or biennially. These differing recommendations lead to confusion for both referring physicians and patients. The goal of our study was to better understand differences between annual and biennial screening. We reviewed clinical outcomes of women undergoing annual or biennial mammographic screening to determine if there is an advantage to annual screening.
Author Interviews, Breast Cancer, JAMA, Mammograms / 15.11.2019

MedicalResearch.com Interview with: [caption id="attachment_52174" align="alignleft" width="300"]Mammograms showing a normal breast (left) and a breast with cancer (right, white arrows). Wikipedia Image Mammograms showing a normal breast (left) and a breast with cancer (right, white arrows). Wikipedia Image[/caption] Dr. Elham Kharazmi, MD, PhD Co-Leader, Risk Adapted Prevention (RAD) Group Division of Preventive Oncology National Center for Tumor Diseases (NCT) German Cancer Research Center (DKFZ) Germany MedicalResearch.com: What is the background for this study? Response: Breast cancer is the most common cancer in women worldwide and the second leading cause of cancer death in American women, exceeded only by lung cancer. Available evidence suggests that implementation of a screening program can decrease breast cancer mortality. Reductions in breast cancer mortality in Europe over the past two decades have been associated at least in part with the implementation of screening programs. Screening enables the detection of tumors at an early stage, when more treatment options are feasible and most effective. However, screening is associated with substantial risks, such as over-diagnosis, false-positive results, and physical and psychological harms, particularly when large numbers of women with low risk are frequently screened.
Author Interviews, Breast Cancer, JAMA, USPSTF / 12.09.2019

MedicalResearch.com Interview with: [caption id="attachment_46135" align="alignleft" width="200"]Dr. Carol Mangione M.D., M.S.P.H., F.A.C.P Ronald Reagan UCLA Medical Center Division Chief of General Internal Medicine and Health Services Research Professor of Medicine. Barbara A. Levey, MD, and Gerald S. Levey, MD Endowed chair in medicine David Geffen School of Medicine University of California Dr. Mangione[/caption] Dr. Carol Mangione, M.D., M.S.P.H., F.A.C.P. Division Chief of General Internal Medicine and Health Services Research Professor of Medicine Barbara A. Levey, MD, and Gerald S. Levey, MD, endowed chair in Medicine David Geffen School of Medicine University of California Los Angeles Professor of public health at the UCLA Fielding School of Public Health.  MedicalResearch.com: What is the background for this study? Response: We all want to find better ways to help prevent breast cancer, a disease that impacts the lives of too many women in the United States each year. Fortunately, the Task Force found there are steps that women at increased risk can take to reduce their chances of developing breast cancer.
Author Interviews, Breast Cancer, Cancer Research, Genetic Research, JAMA, Ovarian Cancer, USPSTF / 28.08.2019

MedicalResearch.com Interview with: [caption id="attachment_46135" align="alignleft" width="200"]Dr. Carol Mangione M.D., M.S.P.H., F.A.C.P Ronald Reagan UCLA Medical Center Division Chief of General Internal Medicine and Health Services Research Professor of Medicine. Barbara A. Levey, MD, and Gerald S. Levey, MD Endowed chair in medicine David Geffen School of Medicine University of California Dr. Mangione[/caption] Dr. Carol Mangione, M.D., M.S.P.H., F.A.C.P. Division Chief of General Internal Medicine and Health Services Research Professor of Medicine Barbara A. Levey, MD, and Gerald S. Levey, MD, endowed chair in Medicine David Geffen School of Medicine University of California, Los Angeles (UCLA) Professor of public health at the UCLA Fielding School of Public Health.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Every year, too many American women are faced with the challenge of dealing with a cancer diagnosis related to potentially harmful mutations of the BRCA1 and BRCA2 genes.  However, the Task Force found that there are several steps women can take to determine if they’re potentially at increased risk for BRCA gene mutations – and if genetic counseling and BRCA testing are needed. It is important to note that while some women can benefit from risk assessment, counseling, and testing, these services are not for everyone.
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Genetic Research / 19.08.2019

MedicalResearch.com Interview with: Tengteng Wang, PhD, MSPH, MBBS Postdoctoral Research Fellow Department of Epidemiology Harvard T.H. Chan School of Public Health Channing Division of Network Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Chronic inflammation is a key player in the development of multiple cancer types, including breast cancer. Aspirin is one of the major non-steroidal anti-inflammatory drugs (NSAIDs) which clearly has anti-inflammatory properties. Given this, substantial evidence from laboratory and population studies suggests that taking aspirin may reduce the risk of developing breast cancer. However, the association of aspirin use with death outcomes following breast cancer diagnosis remains inconclusive and inconsistent across studies. Therefore, we choose to focus on mortality outcomes in this paper and we hypothesized that the inconsistent results for aspirin in relation to mortality could be due to differences in the association by patients’ biological profiles, specifically DNA methylation profiles here. 
Author Interviews, Breast Cancer, JAMA, UCLA / 12.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50709" align="alignleft" width="200"]Joann G. Elmore, MD, MPH Professor of Medicine, Director of the UCLA National Clinician Scholars Program David Geffen School of Medicine at UCLA Dr. Elmore[/caption] Joann G. Elmore, MD, MPH Professor of Medicine, Director of the UCLA National Clinician Scholars Program David Geffen School of Medicine at UCLA  MedicalResearch.com: What is the background for this study? What are the main findings?
  • A pathologist makes the diagnosis of breast cancer versus non-cancer after reviewing the biopsy specimen. Breast biopsies are performed on millions of women each year and It is critical to get a correct diagnosis so that we can guide patients to the most effective treatments.
  • Our prior work (Elmore et al. 2015 JAMA) found significant levels of disagreement among pathologists when they interpreted the same breast biopsy specimen. We also found that pathologists would disagree with their own interpretations of breast biopsies when they where shown the same biopsy specimen a year later.
  • In this study, 240 breast biopsy images were fed into a computer, training it to recognize patterns associated with several types of breast lesions, ranging from benign (noncancerous) to invasive breast cancer. We compared the computer readings to independent diagnoses made by 87 practicing U.S. pathologists and found that while our artificial intelligence program came close to performing as well as human doctors in differentiating cancer from non-cancer, the AI program outperformed doctors when differentiating ductal carcinoma in situ (DCIS) from atypia, which is considered the greatest diagnostic challenge.
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