Author Interviews, Cancer Research, JAMA, Lung Cancer, NIH, Race/Ethnic Diversity, Stanford / 01.11.2023

MedicalResearch.com Interview with: Summer S Han, PhD Associate Professor Quantitative Sciences Unit Stanford Center for Biomedical Informatics Research (BMIR) Department of Neurosurgery and Department of Medicine Department of Epidemiology & Population Health (by Courtesy) Stanford University School of Medicine Dr. Eunji Choi PhD Instructor, Neurosurgery Department: Adult Neurosurgery Stanford University School of Medicine   MedicalResearch.com: What is the background for this study?
  • Lung cancer is the leading cause of cancer death in the United States, killing about 127,000 people annually, but it can be treatable if detected early.
  • Low-dose computed tomography, or CT scan, has been shown to significantly reduce the number of lung cancer deaths. But because the radiation delivered by the scans can be harmful (they use on average about 10 times the radiation of standard X-rays), only those people at relatively high risk for lung cancer should be screened. The two biggest risk factors for lung cancer are exposure to tobacco smoke and age. Current national guidelines that rely on age and smoking exposure to recommend people for lung cancer screening are disproportionally failing minority populations including African Americans, according to a new study led by researchers at Stanford Medicine.
  • In 2021, the national guidelines by the U.S. Preventive Services Task Force (USPSTF) issued revised recommendation guidelines on lung cancer screening, lowering the start age from 55-year to 50-year and the smoking pack-year criterion from 30 to 20, compared to the 2013 USPSTF criteria. In comparison to the 2013 criteria, the new modifications have been shown to lessen racial disparities in screening eligibility between African Americans and Whites. However, potential disparities across other major racial groups in the U.S., such as Latinos, remains poorly examined.
  • Meanwhile, risk prediction model assesses a person’s risk score of developing an illness, such as lung cancer.
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ASCO, Author Interviews, Cancer Research, Lung Cancer, University of Pennsylvania / 05.06.2023

MedicalResearch.com Interview with: Lova L. Sun, MD, MSCE Medical Oncology Assistant Professor of Medicine Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: An common clinical question for patients with metastatic non-small cell lung cancer with long-term response to immunotherapy-based treatment is how long to continue treatment. The major clinical trials stopped immunotherapy at a maximum of 2 years, but in clinical practice many patients and clinicians continue treatment beyond this time point. We conducted a retrospective study of lung cancer patients across the US with long-term response to immunotherapy, to compare survival between those who stopped treatment at 2 years vs those who continued beyond 2 years. We found that there was no statistically significant difference in survival between the two groups. (more…)
Lung Cancer, Race/Ethnic Diversity / 02.05.2023

MedicalResearch.com Interview with: Andres Kohan MD MHSc. in Translational Research Joint Department of Medical Imaging University Health Network Mount Sinai Hospital and Women's College Hospital University of Toronto Toronto, Canada   MedicalResearch.com: What is the background for this study? Response: Inequalities in access to healthcare for oncologic patients and its impact on quality of life and survival have been previously described. However, there also exists reports pointing out that when factors contributing to socioeconomic inequality are accounted for differences in outcome between races remain identifiable. In this context, we sought to evaluate the presence of disparities in imaging in a selected population of patients with non-small cell lung cancer (NSCLC) within AACRs Project GENIE Biopharma Consortium (BPC) dataset v 1.1. This database is the largest in existence that has not only the patients’ imaging and clinical staging/follow-up, but also the genetic profile of the patients’ tumors. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, JAMA, Lancet, Lung Cancer, Medical Imaging, Technology / 07.09.2022

MedicalResearch.com Interview with: Raymond H. Mak, MD Radiation Oncology Disease Center Leader for Thoracic Oncology Director of Patient Safety and QualityDirector of Clinical Innovation Associate Professor, Harvard Medical School Cancer - Radiation Oncology, Radiation Oncology Department of Radiation Oncology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What is the algorithm detecting? Response: Lung cancer, the most common cancer worldwide is highly lethal, but can be treated and cured in some cases with radiation therapy.  Nearly half of lung cancer patients will eventually require some form of radiation therapy, but the planning for a course of radiation therapy currently entails manual, time-consuming, and resource-intensive work by highly trained physicians to segment (target) the cancerous tumors in the lungs and adjacent lymph nodes on three-dimensional images (CT scans). Prior studies have shown substantial variation in how expert clinicians delineate these targets, which can negatively impact outcomes and there is a projected shortage of skilled medical staff to perform these tasks worldwide as cancer rates increase. To address this critical gap, our team developed deep learning algorithms that can automatically target lung cancer in the lungs and adjacent lymph nodes from CT scans that are used for radiation therapy planning, and can be deployed in seconds. We trained these artificial intelligence (AI) algorithms using expert-segmented targets from over 700 cases and validated the performance in over 1300 patients in external datasets (including publicly available data from a national trial), benchmarked its performance against expert clinicians, and then further validated the clinical usefulness of the algorithm in human-AI collaboration experiments that measured accuracy, task speed, and end-user satisfaction. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lung Cancer, Supplements, USPSTF / 30.06.2022

MedicalResearch.com Interview with: Michael J. Barry, M.D Director of the Informed Medical Decisions Program Health Decision Sciences Center Massachusetts General Hospital. Professor of medicine at Harvard Medical School Dr. Barry was appointed as Vice Chair of USPSTF in March 2021. He previously served as a member from January 2017 through December 2020.   MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: The Task Force looked at the use of vitamin and mineral supplementation specifically for the prevention of heart disease, stroke, and cancer. We found that there is not enough evidence to recommend for or against taking multivitamin supplements, nor the use of single or paired nutrient supplements, to prevent these conditions. However, we do know that you should not take vitamin E or beta-carotene for this purpose. (more…)
Author Interviews, Cancer Research, COVID -19 Coronavirus, Lung Cancer, Surgical Research / 21.06.2022

MedicalResearch.com Interview with: Emanuela Taioli, MD, PhD Director, Institute for Translational Epidemiology Professor, Population Health Science and Policy Professor, Thoracic Surgery Icahn School of Medicine at Mount Sinai New York, NY MedicalResearch.com:  What is the background for this study?  Response: NYC experienced a halt on all elective care from March 22 to June 8, 2020, provoking reduced cancer screening rates, and delayed cancer care and treatment. We wanted to quantify the effect of the “pause” on cancer stage at diagnosis using lung cancer as an example of a condition where early diagnosis can dramatically modify survival. (more…)
Author Interviews, Cost of Health Care, JAMA, Lung Cancer, Stanford, USPSTF / 24.10.2021

MedicalResearch.com Interview with: Summer S Han, PhD Assistant Professor Quantitative Sciences Unit Stanford Center for Biomedical Informatics Research (BMIR) Neurosurgery and Medicine Stanford University School of Medicine Stanford, CA 94304  MedicalResearch.com: What is the background for this study? Response: The US Preventive Services Task Force (USPSTF) issued their 2021 recommendation on lung cancer screening lowering the start age from 55 to 50 years and the minimum pack-year criterion from 30 to 20, relative to the 2013 recommendations. Although costs are expected to increase with the expanded screening eligibility, it is unknown if the new guidelines for lung cancer screening are cost-effective. (more…)
Author Interviews, Cancer Research, JAMA, Lung Cancer, Smoking, USPSTF / 16.03.2021

MedicalResearch.com Interview with: John B. Wong, M.D. Chief Scientific Officer, Vice Chair for Clinical Affairs Chief of the Division of Clinical Decision Making Primary Care Clinician Department of Medicine Tufts Medical Center  MedicalResearch.com: What is the background for this study? Response: Lung cancer is the leading cause of cancer death for both men and women in the United States. More than 200,000 people are diagnosed with this devastating disease each year. Smoking is the leading cause of lung cancer, resulting in the vast majority of lung cancers in the United States. (more…)
Author Interviews, Cancer Research, COVID -19 Coronavirus, Lung Cancer / 17.12.2020

MedicalResearch.com Interview with: Robert Van Haren, MD, MSPH College of Medicine University of Cincinnati  MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has impacted all areas of society including the field of oncology. This study evaluated the impact of COVID-19 on lung cancer screening.  Screening with low-dose computed tomography (LDCT) scans are important because they reduce lung cancer mortality by at least 20%.  Our lung cancer screening program was closed in March 2020 due to COVID 19 and reopened again in June 2020.  We cancelled over 800 LDCTs during that time period.  (more…)
Author Interviews, Cancer Research, CDC, JAMA, Lung Cancer / 10.12.2020

MedicalResearch.com Interview with: David A. Siegel, MD, MPH Division of Cancer Prevention and Control US Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: Why is it important to better understand the smoking histories (both current/former and never smokers) among lung cancer patients? Response: Knowledge of smoking status of patients diagnosed with lung cancer can help us understand how to best prevent, detect, and treat lung cancer in the future. More than 84% of women and 90% of men newly diagnosed with lung cancer had ever smoked cigarettes, and half of patients aged 20 to 64 years newly diagnosed with lung cancer were current cigarette smokers. These findings reinforce the importance of cigarette cessation and lung cancer screening. 1 out of every 8 people diagnosed with lung cancer had never smoked cigarettes, which reiterates the importance of learning more about their risk factors for lung cancer, which could impact prevention and treatment.  (more…)
AstraZeneca, Author Interviews, Cancer Research, ESMO, Lung Cancer, NEJM, Yale / 08.10.2020

MedicalResearch.com Interview with: Roy S. Herbst, M.D., Ph.D. Ensign Professor of Medicine (Medical Oncology) and Professor of Pharmacology Chief of Medical Oncology Yale Cancer Center and Smilow Cancer Hospital Associate Cancer Center Director for Translational Research Yale Cancer Center  MedicalResearch.com: What is the background for this study? How does osimertinib differ from prior versions of EGFR-TKI Inhibitors? o   ADAURA is a randomized, double-blinded, global and placebo-controlled Phase III trial in the adjuvant treatment of 682 patients with Stage IB, II, and IIIA EGFRm NSCLC following complete tumor resection and adjuvant chemotherapy as indicated. Patients were treated with osimertinib 80 mg once-daily oral tablets or placebo for three years or until disease recurrence. The primary endpoint is disease free survival (DFS) in Stage II and IIIA patients, and a key secondary endpoint is DFS in Stage IB, II and IIIA patients. Osimertinib is not currently approved in the adjuvant setting in any country. o   Osimertinib is a third-generation, irreversible EGFR-TKI with clinical activity against central nervous system metastases. The results of the Phase III ADAURA trial of osimertinib demonstrate for the first time in a global trial that an EGFR inhibitor can change the course of early-stage EGFR-mutated lung cancer for patients. o   ADAURA results were first presented in May during the American Society of Clinical Oncology ASCO20 Virtual Scientific Program. (more…)
ASCO, AstraZeneca, Author Interviews, Cancer Research, Lung Cancer, Yale / 13.06.2020

MedicalResearch.com Interview with: Roy S. Herbst, MD, PhD Ensign Professor of Medicine (Medical Oncology) Professor of Pharmacology Chief of Medical Oncology, Yale Cancer Center and Smilow Cancer Hospital; Associate Cancer Center Director for Translational Research Yale Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings?
  • ADAURA is the first global trial for an EGFR tyrosine kinase inhibitor to show statistically significant and clinically meaningful benefit in adjuvant treatment of Stage IB, II, and IIIA EGFRm NSCLC. The results demonstrated unprecedented disease free survival (DFS) in the adjuvant treatment of these patients after complete tumor resection with curative intent. Osimertinib was assessed against placebo for a treatment duration of up to three years and then unblinded two years earlier than expected at the recommendation of the Independent Data Monitoring Committee (IDMC), based on its determination of overwhelming efficacy during a planned safety analysis.
  • In the primary endpoint of DFS in patients with Stage II and IIIA disease, adjuvant (after surgery) treatment with osimertinib reduced the risk of disease recurrence or death by 83% (based on a hazard ratio [HR] of 0.17; 95% confidence interval [CI] 0.12, 0.23; p<0.0001).
  • DFS results in the overall trial population, Stage IB through IIIA, a key secondary endpoint, demonstrated a reduction in the risk of disease recurrence or death of 79% (based on a HR of 0.21; 95% CI 0.16, 0.28; p<0.0001).
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Author Interviews, COVID -19 Coronavirus, Lung Cancer / 27.03.2020

MedicalResearch.com Interview with: Dr. Amy C. Moore PhD Director of Science and Research GO2 Foundation for Lung Cancer MedicalResearch.com: What is the mission of the GO2 Foundation for Lung Cancer? Response: GO2 Foundation for Lung Cancer’s mission is to transform survivorship by  saving, extending, and improving the lives of those vulnerable, at risk, and diagnosed with lung cancer. (more…)
Author Interviews, Cancer Research, Environmental Risks, Lung Cancer, Occupational Health / 18.03.2020

MedicalResearch.com Interview with: Theresa S. Emory MD Department of Pathology, Peninsula Pathology Associates Newport News, VA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cosmetic talc products can contain asbestos, which is the primary cause of malignant mesothelioma. We investigated 75 individuals with malignant mesothelioma, whose only known exposure to asbestos was repeated exposures to cosmetic talcum powder. 83% of the individuals were female and several occurred in barbers/cosmetologists. 16% occurred in individuals younger than 45 years old, and on average the subjects were 11 years younger than predicted, based on SEER data. The asbestos fibers in tissue samples that were examined in 11 cases were identical (anthophyllite and tremolite) to those identified in cosmetic talc. (more…)
Author Interviews, Biomarkers, Lung Cancer, Stanford / 09.03.2020

MedicalResearch.com Interview with: Professor Dr. Andreas Keller Stanford University School of Medicine Office Department of Neurology and Neurological Sciences Chair for Clinical Bioinformatics Saarbrücken, Germany MedicalResearch.com: What is the background for this study? Response: Lung cancer is among the three most common cancers and the leading cause of cancer-related deaths worldwide. The overall low survival rate of patients with lung cancer calls for improved detection tools to enable better treatment options and improved patients’ outcomes. To detect lung tumors, liquid biopsy-based strategies are increasingly explored, that are biomarkers, which are identifiable in body fluids such as human blood. The clinical application of biomarkers is, however, largely hampered by the relatively small numbers of cases that have been analyzed in the majority of the preclinical studies including the studies on lung cancer.  (more…)
Author Interviews, Cancer Research, CT Scanning, Lung Cancer / 04.02.2020

MedicalResearch.com Interview with: Carlijn M. van der Aalst, Ph.D. MPH Department of Public Health Erasmus MC MedicalResearch.com: What is the background for this study? Response: Lung cancer is the leading cause of cancer-related mortality among both men and women. About 70% of patients with lung cancer are diagnosed with advanced disease, which results in only 15% surviving five years. About 70% of patients with lung cancer are diagnosed with advanced disease, a stage in which cure is problematic. This results in only 15% surviving five years. Although quit smoking is most effective in preventing lung cancer, about half of all lung cancers are currently diagnosed in former smokers, who remain at high risk for decades after quitting smoking. The National Lung Screening Trial (NLST; U.S.) reported a 20% lung cancer-related mortality reduction and a 6.7% reduction in all-cause mortality for CT screening compared with chest radiography screening for lung cancer in 53,454 enrolled subjects at high risk for lung cancer.1 As a consequence, the United States Preventive Services Task Force (USPSTF) requested an independent review and a modelling study. Based on these NLST data, an efficient strategy with a reasonable harm-benefit ratio could be established, resulting in the recommendation to annually screen persons aged 55-80 with ≥30 pack-years of smoking history, who currently smoke or quit smoking <15 years ago. However, data of only one trial provides limited evidence and more trial data are needed. NELSON is the second largest lung cancer screening trial that is adequately designed to provide the evidence that is needed to conclude whether CT screening can reduce lung cancer mortality. (more…)
Author Interviews, Cancer Research, Lung Cancer / 23.10.2019

MedicalResearch.com Interview with: Li C. Cheung, PhD Staff Scientist, Biostatistics Branch Division of Cancer Epidemiology & Genetics NCI National Cancer Institute MedicalResearch.com: What is the background for this study? Response: Using individualized risk prediction models to select individuals for lung-cancer screening will prevent more lung cancer deaths than current USPSTF guidelines (ages 55-80y; 30+ pack-years; smoke in past 15y). However, risk-based screening would lead to screening even more older smokers with comorbidities, for whom the harms of screening may outweigh the benefits. (more…)
Author Interviews, JAMA, Lung Cancer, Vaccine Studies / 28.09.2019

MedicalResearch.com Interview with: Naomi E Aronson, MD, FIDA, FACP Professor and Director, Infectious Diseases Division Uniformed Services University of the Health Sciences Bethesda, MD  MedicalResearch.com: What is the background for this study? Response: BCG is a live attenuated mycobacteria vaccine used to prevent tuberculosis which has been reported to have associated nonspecific effects such as treatment of diabetes, bladder cancer, prevention of severe respiratory infections in children, and suppressed autoimmune responses. In earlier reports in the 1970s, results of epidemiologic studies were divided as to whether BCG vaccine was associated with subsequent rates of malignancy, specifically leukemia (protective) and non Hodgkins lymphoma (higher rates). To further evaluate these observations we studied cancer data collected in the 60 year follow up of a controlled trial of BCG in American Indian/ Alaska Native schoolchildren. (more…)
Author Interviews, CT Scanning, JAMA, Lung Cancer, UCSF / 23.09.2019

MedicalResearch.com Interview with: Joshua Demb, PhD, MPH Postdoctoral Scholar, Moores Cancer Center University of California, San Diego Health Science Research Specialist Veterans Affairs San Diego Healthcare System MedicalResearch.com: What is the background for this study? Response: Our study leveraged radiation dose data from 72 facilities performing CT scans around the United States to learn more about the radiation dose used for lung cancer screening scans, as well as possible institutional predictors that might be associated with higher dose.  Currently, the American College of Radiology has recommendations for how these low-dose lung cancer screening scans should be performed. However, it is unclear how much adherence there currently is to these guidelines. Our findings indicated that there is wide variation in the distribution of radiation doses for low-dose lung cancer screening scans both within- and between facilities in our sample—in some cases this variation led to doses higher than the ACR recommendations.   (more…)
AACR, Author Interviews, CT Scanning, Lung Cancer / 28.06.2019

MedicalResearch.com Interview with: Barbara Nemesure, PhD Professor, Department of Family, Population and Preventive Medicine Division Head, Epidemiology and Biostatistics Director, Cancer Prevention and Control Program Director, Lung Cancer Program, Stony Brook Cancer Center Renaissance School of Medicine Stony Brook University    MedicalResearch.com: What is the background for this study? What are the main findings? Response: Lung cancer is the most common cause of cancer death, claiming the lives of more than 150,000 people in the United States each year. While lung nodules are not uncommon, it has remained a challenge to differentiate those that will progress to cancer and those that will remain benign. Although numerous risk prediction models for lung cancer have been developed over the past 2 decades, the majority have been based on retrospective analyses or high risk groups with a strong history of tobacco use. To date, there have been a limited number of large-scale, prospective studies evaluating risk that a nodule will convert to cancer in the general population. This investigation aimed to construct a population-based risk prediction model of incident lung cancer for patients found to have a lung nodule on initial CT scan. The derived model was determined to have high accuracy for predicting nodule progression to cancer and identified a combination of clinical and radiologic predictors including age, smoking history (pack-years), a personal history of cancer, the presence of chronic obstructive pulmonary disease (COPD), and nodule features such as size, presence of spiculation and ground glass opacity type. When compared to patients in the low risk category, those defined as high risk had more than 14 times the risk of developing lung cancer. Quantification of reliable risk scores has high clinical utility, enabling physicians to better stratify treatment plans for their patients.      (more…)
Author Interviews, Cancer Research, Lung Cancer / 19.06.2019

MedicalResearch.com Interview with: Thomas A. Quinn, DO, FAOCOPM Clinical Professor Lake Erie College of Osteopathic Medicine Bradenton  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Canine scent detection of lung cancer is showing evidence of being an effective, safe and cost effective method of early detection of lung as well as other types of cancer. Lung cancer is the leading cause of cancer deaths and early detection has proven to be one of the most effective ways to reduce the mortality and morbidity of this deadly disease.  In a collaborative study conducted by the Lake Erie College of Osteopathic Medicine (LECOM) and BioScentDX, a canine training and research facility, we were able to show that highly trained dogs can detect non-small cell cancer of the lung by scent alone.  For this study we chose to use Beagles because of their superior scent capability as well as their temperament, sociability and easy trainability.  The dogs proved to be able, in this double blind study, to detect lung cancer in blood serum with a 96.7% sensitivity and a 97.5% specificity. The dogs underwent an eight-week training program using the clicker/treat training method.  We trained four Beagles for this study but one of the dogs did not respond well to the training methods and had to be removed from the program. That dog was retrained as a service dog for a handicapped child. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Lung Cancer, Radiation Therapy / 10.06.2019

MedicalResearch.com Interview with:   Raymond H Mak, MD Assistant Professor of Radiation Oncology Harvard Medical School Radiation Oncology Brigham and Women's Hospital       Katelyn M. Atkins MD PhD Harvard Radiation Oncology Program Dana-Farber Cancer Institute Brigham and Women’s Hospital Boston, Massachusetts     MedicalResearch.com: What is the background for this study? What are the main findings? 
  • Lung cancer remains the leading cause of cancer-related death worldwide and nearly half of patients will require radiation therapy as part of their care.
  • Cardiac toxicity following radiotherapy has been well-studied in breast cancer and lymphomas, however the impact of cardiac toxicity following lung cancer radiotherapy has historically been under-appreciated due to the high risk of lung cancer death.
  • Recent studies highlighting cardiac toxicity following lung cancer radiotherapy have been limited by small numbers of patients and, to our best knowledge, have not included validated cardiac event endpoints defined by the American Heart Association (AHA)/American College of Cardiology (ACC).
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Author Interviews, BMJ, CT Scanning, Lung Cancer, University of Pittsburgh / 14.03.2019

MedicalResearch.com Interview with: Panayiotis (Takis) Benos, Ph.D. Professor and Vice Chair for Academic Affairs Department of Computational and Systems Biology Associate Director, Integrative Systems Biology Program Department of Computational and Systems Biology, SOM and Departments of Biomedical Informatics and Computer Science University of Pittsburgh    MedicalResearch.com: What is the background for this study? What are the main findings? Response: Low-dose computed tomography (LDCT) scans is the main method used for early lung cancer diagnosis.  Early lung cancer diagnosis significantly reduces mortality.  LDCT scans identify nodules in the lungs of 24% of the people in the high-risk population, but 96% of these nodules are benign.  Currently there is no accurate way to discriminate benign from malignant nodules and hence all people with identified nodules are subjected to follow up screens or biopsies.  This increases healthcare costs and creates more anxiety for these individuals.  By analyzing a compendium of low-dose computed tomography scan data together with demographics and other clinical variables we were able to develop a predictor that offers a promising solution to this problem.  (more…)
Author Interviews, Lung Cancer, Nature, Technology / 05.03.2019

MedicalResearch.com Interview with: Saeed Hassanpour, PhD Assistant Professor Departments of Biomedical Data Science, Computer Science, and Epidemiology Geisel School of Medicine at Dartmouth Lebanon, NH 03756 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Lung cancer is the deadliest cancer for both men and women in the western world. The most common form, lung adenocarcinoma, requires pathologist’s visual examination of resection slides to determine grade and treatment. However, this is a hard and tedious task. Using new technologies in artificial intelligence and deep learning, we trained a deep neural network to classify lung adenocarcinoma subtypes on histopathology slides and found that it performed on par with three practicing pathologists. (more…)
Author Interviews, Biomarkers, CT Scanning, JAMA, Lung Cancer, Medical Imaging / 01.03.2019

MedicalResearch.com Interview with: Martin C. Tammemägi PhD Senior Scientist Cancer Care Ontario | Prevention & Cancer Control Scientific Lead Lung Cancer Screening Pilot for People at High Risk Professor (Epidemiology) | Brock University Department of Health Sciences Ontario, Canada MedicalResearch.com: What is the background for this study? Response: Some prediction models can accurately predict lung cancer risk (probability of developing lung cancer during a specified time). Good model predictors include sociodemographic, medical and exposure variables. In recent years, low dose computed tomography (LDCT) lung cancer screening has become widespread in trials, pilots, demonstration studies, and public health practice. It appears that screening results provides added valuable, independent predictive information regarding future lung cancer risk, aside from the lung cancers directly detected from the diagnostic investigations resulting from positive screens. (more…)
Author Interviews, Compliance, Electronic Records, Lung Cancer, Race/Ethnic Diversity / 07.02.2019

MedicalResearch.com Interview with: Samuel Cykert, MD Professor of Medicine and Director of the Program on Health and Clinical Informatics UNC School of Medicine, and Associate Director for Medical Education, NC AHEC Program Chapel Hill, NC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Reports going as far back as the early 1990’s through reports published very recently show that Black patients with early stage, curable lung cancer are not treated with aggressive, curative treatments as often as White patients. These type of results have been shown in other cancers also. It’s particularly important for lung cancer because over 90% of these patients are  dead within 4 years if left untreated. In 2010, our group published a study in the Journal of the American Medical Association that showed that Black patients who had poor perceptions of communication (with their provider), who did not understand their prognosis with vs. without treatment, and who did not have a regular source of care ( a primary care doctor) were much less likely to get curative surgery. Also our results suggested that physicians who treated lung cancer seemed less willing to take the risk of aggressive treatments in treating Black patients (who they did not identify with as well) who had other significant illnesses. Because of the persisting disparities and our 2010 findings, we worked with a community group, the Greensboro Health Disparities Collaborative to consider potential solutions.  As these omissions were not overt or intentional because of race on the part of the patients or doctors, we came up with the idea that we needed transparency to shine light on treatment that wasn’t progressing and better communication to ensure that patients were deciding on good information and not acting on mistrust or false beliefs.  We also felt the need for accountability – the care teams needed to know how things were going with patients and they needed to know this according to race. To meet these specifications, we designed a system that received data from electronic health records about patients’ scheduled appointments and procedures. If a patient missed an appointment this umbrella system triggered a warning. When a warning was triggered, a nurse navigator trained specially on communication issues, re-engaged the patient to bring him/her back into care. In the system, we also programmed the timing of expected milestones in care, and if these treatment milestones were not reached in the designated time frame, a physician leader would re-engage the clinical team to consider the care options. Using this system that combined transparency through technology, essentially our real time warning registry, and humans who were accountable for the triggered warnings, care improved for both Black and White patients and the treatment disparity for Black patients was dramatically reduced. In terms of the numbers, at baseline, before the intervention, 79% of White patients completed treatment compared to 69% of Black patients. For the group who received the intervention, the rate of completed treatment for White patients was 95% and for Black patients 96.5%.  (more…)
Author Interviews, Lung Cancer / 21.10.2018

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) 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. (more…)
Author Interviews, Lung Cancer, Nature, NYU, Technology / 17.09.2018

MedicalResearch.com Interview with: Aristotelis Tsirigos, Ph.D. Associate Professor of Pathology Director, Applied Bioinformatics Laboratories New York University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pathologists routinely examine slides made from tumor samples to diagnose cancer types. We studied whether an AI algorithm can achieve the same task with high accuracy. Indeed, we show that such an algorithm can achieve an accuracy of ~97%, slightly better than individual pathologists. In addition, we demonstrated that AI can be used to predict genes that are mutated in these tumors, a task that pathologists cannot do. Although the accuracy for some genes is as high as 86%, there is still room for improvement. This will come from collecting more training data and also from improvement in the annotations of the slides by expert pathologists.   (more…)