Author Interviews, Cancer Research, Genetic Research, JAMA, Yale / 22.09.2018

MedicalResearch.com Interview with: Michael F. Murray, MD, FACMG, FACP Director for Clinical Operations in the Center for Genomic Health Yale School of Medicine MedicalResearch.com: What is the background for this study? Response: Population screening for the cancer risk associated with the BRCA1 and BRCA2 genes has been suggested by some.  We screened a cohort of about 50,000 adult patient volunteers at Geisinger Health System in Pennsylvania for this risk.  (more…)
Author Interviews, Endocrinology, JAMA, Prostate Cancer, UCLA / 22.09.2018

MedicalResearch.com Interview with: Amar U. Kishan, MD Assistant Professor Department of Radiation Oncology University of California, Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings? Response: Three large randomized trials demonstrated an overall survival (OS) benefit when androgen deprivation therapy (ADT) is combined with radiotherapy (RT) for high-risk prostate cancer (PCa). The duration of ADT in these seminal studies ranged from six months to lifelong. Because ADT has multiple attendant adverse effects--including bone loss, altered metabolism, diminished muscle mass, gynecomastia, hot flashes, and possibly increased cardiovascular events--shortening the duration of ADT without compromising oncologic effectiveness has been an area of active study. Five trials have compared various durations of ADT, reaching conflicting conclusions with respect to overall survival outcomes, with some suggesting an improvement with longer durations of ADT and others failing to show a uniform survival benefit. Most of these trials have amalgamated Gleason grade group 4 (Gleason score 8) PCa with Gleason grade group (GG) 5 (Gleason score 9-10) PCa. Emerging data indicate that GS 9-10 PCa constitutes a distinct subset of high-risk PCa with inferior outcomes and earlier progression than GS 8 disease. With the knowledge that GS 9-10 PCas constitute a distinct, more aggressive form of PCa, one might hypothesize that longer durations of ADT may be more advantageous in both augmenting local control and controlling potential micrometastatic disease. Alternatively, as GS 9-10 lesions by definition contain highly de-differentiated Gleason pattern 5 disease foci and may proceed to a castrate-resistant state more rapidly, one may also hypothesize that GS 9-10 lesions are less responsive to ADT, and longer durations may be counter-productive. In order to identify differences in the impact of ADT duration on clinical outcomes of patients with GG 4 and GG 5 PCa, we performed an individual patient-level meta-analysis of six randomized trials. Our working hypothesis was that longer durations of ADT would offer significant survival benefits in both groups. (more…)
Author Interviews, Cancer Research, Cost of Health Care, Dermatology, Emory, JAMA, Medicare / 21.09.2018

MedicalResearch.com Interview with: “Actinic Keratosis” by Ed Uthman is licensed under CC BY 2.0Howa Yeung, MD Assistant Professor of Dermatology Emory University School of Medicine Atlanta, GA 30322  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by actinic keratoses? Response: Actinic keratoses are common precancerous skin lesions caused by sun exposure. Because actinic keratoses may develop into skin cancers such as squamous cell carcinoma and basal cell carcinoma, they are often treated by various destructive methods. We used Medicare Part B billing claims to estimate the number and cost of treated actinic keratoses from 2007 to 2015. MedicalResearch.com: What are the main findings?  Response: While the number of Medicare Part B beneficiaries increased only moderately, the number of actinic keratoses treated by destruction rose from 29.7 million in 2007 to 35.6 million in 2015. Medicare paid an average annual amount of $413.1 million for actinic keratosis destruction from 2007 to 2015. Independently billing non-physician clinicians, including advanced practice registered nurses and physician assistants, are treating an increasing proportion of actinic keratosis, peaking at 13.5% in 2015. MedicalResearch.com: What should readers take away from your report? Response: Readers should understand that the burden of actinic keratosis treatment is increasing in the Medicare population. There is also an increasing proportion of actinic keratoses being treated by advanced practice registered nurses and physician assistants.  (more…)
Author Interviews, Cancer Research, Cost of Health Care, ENT, HPV, JAMA, Surgical Research / 18.09.2018

MedicalResearch.com Interview with: Richard B. Cannon, MD Division of Otolaryngology–Head and Neck Surgery School of Medicine University of Utah, Salt Lake City  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The Patient Protection and Affordable Care Act (ACA) is a nationwide effort to reduce the number of uninsured individuals in the United States and increase access to health care. This legislation is commonly debated and objective data is needed to evaluate its impact.  As a head and neck cancer surgeon, I sought to evaluate how the ACA had specifically influenced my patients.  Main findings below:     MedicalResearch.com: What should readers take away from your report? Response: This population-based study found an increase in the percentage of patients enrolled in Medicaid and private insurance and a large decrease in the rates of uninsured patients after implementation of the Patient Protection and Affordable Care Act (ACA).  This change was only seen in states that adopted the Medicaid expansion in 2014. The decrease in the rate of uninsured patients was significant, 6.2% before versus 3.0% after. Patients who were uninsured prior to the Patient Protection and Affordable Care Act had poorer survival outcomes. (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…)
Author Interviews, Breast Cancer, Surgical Research / 17.09.2018

MedicalResearch.com Interview with: Dr. Emily Albright, MD Surgical Oncology Missouri University Health Care MedicalResearch.com: What is the background for this study? What are the main findings? Response: Traditional medicine had a paternalistic approach but more recent changes have transitioned into shared decision making and a patient centered approach. However, current research has not addressed the mode of communicating bad news to patients. This study was designed to look at trends in modes of communication of a breast cancer diagnosis. This study identified a trend for patients to receive a diagnosis of breast cancer over the telephone in more recent years. Also noted was that of those receiving the diagnosis in person 40% were alone. (more…)
Author Interviews, Dermatology, Environmental Risks, JAMA, Melanoma / 15.09.2018

MedicalResearch.com Interview with: Lori A. Crane, PhD Department of Community and Behavioral Health Colorado School of Public Health University of Colorado Anschutz Medical Campus, Aurora CO  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nevi, which are commonly called “moles”, are brown or black spots on the skin that are usually raised.  Moles are the number one risk factor for malignant melanoma, the most dangerous kind of skin cancer.  About 9,000 people die of melanoma each year in the U.S. The more moles a person has, the higher their risk for melanoma.  Sun exposure is a major factor in the development of moles, and in order to prevent melanoma, it is important to better understand how moles are formed on the skin. Most moles are formed during childhood and adolescence.  We studied non-Hispanic and Hispanic white children age 3-16 and found that non-Hispanic children developed many more moles than Hispanic children.  Overall, boys developed more moles than girls, but there were some important differences.  For parts of the skin that are often covered by clothing but sometimes exposed to the sun, such as the chest and back, upper arms and upper legs, girls developed more moles than boys, especially among Hispanic children.  In contrast, for parts of the skin that are usually exposed to the sun, such as the face, boys developed many more moles than girls.  The development of moles leveled off by age 16 for parts of the skin usually exposed to the sun, while for the less often exposed skin, children continued to develop moles to age 16. (more…)
Author Interviews, Breast Cancer, Cancer Research, JAMA, MD Anderson / 15.09.2018

MedicalResearch.com Interview with: Kelly K. Hunt, MD Department of Breast Surgical Oncology The University of Texas MD Anderson Cancer Center Houston MedicalResearch.com: What is the background for this study? What are the main findings? Response: We completed a neoadjuvant trial at MD Anderson Cancer Center and published the results in 2005 demonstrating that trastuzumab delivered in combination with anthracycline and taxane based chemotherapy resulted in pathologic complete response rates of up to 60% in patients with HER-2 positive breast cancer. This was a single institutions study and there was concern about cardiac toxicity when using anthracyclines and trastuzumab concurrently. We therefore worked with the NCI cooperative groups, the American College of surgeons oncology group (ACOSOG), to design the ACOSOG Z1041 trial. This trial compared to different regimens in the neoadjuvant setting, one regimen utilizing concurrent anthracycline and taxanes based chemotherapy with trastuzumab and the other regimen utilizing concurrent taxanes with trastuzumab but the anthracycline was delivered in a sequential fashion. The primary end point of the trial was pathologic complete response rates in the breast. The results from this primary end point were published in the Lancet Oncology in 2013 and showed that the pathologic complete response rates were the same with the 2 different regimens. This was important since patients could be assured of similar efficacy without the potential added toxicity of delivering anthracyclines and trastuzumab together. The current publication is a report of the disease-free and overall survival rates from the Z1041 trial. Several studies have shown an association between pathologic complete response rates and survival. The current study shows that there is no difference in survival rates between the 2 different regimens. So once again there is an association between pathologic complete response and survival and it is not important that the anthracycline and trastuzumab are given concurrently in order to achieve these high pathologic complete response rates and improve survival rates. (more…)
Author Interviews, Cancer Research, Gastrointestinal Disease, Infections / 14.09.2018

MedicalResearch.com Interview with: Nina R. Salama. PhD Member Human Biology Division Member Public Health Sciences Division Affiliate Member Basic Sciences Division Dr. Penny E. Petersen Memorial Chair for Lymphoma Research Director of Molecular and Cellular Biology (MCB) Graduate Program Fred Hutchinson Cancer Research Center  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to better understand why certain patients infected with H. pylori developed stomach cancer and how we could better identify them. H. pylori is one of the strongest risk factors for stomach cancer, but how much it predisposes individuals to gastric cancer varies around the world. Working closely with colleagues from Zhengzhou University, we ran tests on 49 samples from China and found that 91 percent of patients infected with the EPIYA D gene variant of H. pylori also had stomach cancer. (more…)
Author Interviews, Cancer Research, Immunotherapy, JAMA, Vanderbilt / 13.09.2018

MedicalResearch.com Interview with: Douglas B. Johnson, M.D. Assistant Professor of Medicine Clinical Director, Melanoma Research Program Melanoma, clinical and translational studies Vanderbilt University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Immune checkpoint inhibitors produce long-lasting responses in patients with many different types of cancer. However, they may cause serious autoimmune-like side effects that may affect any organ. We used several large databases to determine how often these side effects were fatal, when they occurred, and which types of side effects were responsible. We found that overall, fatal side effects were uncommon, ranging from 0.3 – 1.3%. However, they tended to occur early on treatment (on average within the first 6 weeks), and affected a variety of organs, including the heart, lungs, colon, liver, and brain. There was a dramatic increase in reporting of fatal toxicities since 2017, likely reflecting the increased use of immune checkpoint inhibitors.  (more…)
Author Interviews, Biomarkers, Cancer Research, Immunotherapy, Melanoma, Nature / 11.09.2018

MedicalResearch.com Interview with: Dr. Noam Auslander PhD National Cancer institute and the Center for Bioinformatics and Computational Biology University of Maryland, College Park MedicalResearch.com: What is the background for this study? Response: Immunotherapy – specifically immune checkpoint blockage (ICB) therapy – has been shown to be very effective in treating melanoma. However, only some patients with advanced tumors currently benefit from ICB therapies, while others are completely resistant and hence can be spared from the associated side effects and costs. Hence, predicting which patients are most likely to respond is an important challenge that can have great clinical benefits.   (more…)
Author Interviews, Leukemia / 11.09.2018

MedicalResearch.com Interview with: Hans van Eenennaam, Ph.D. Executive vice president antibody research and site head Aduro Biotech Europe MedicalResearch.com: What is the background for this study? Response: A PRoliferation Inducing Ligand (APRIL) is a member of the tumor necrosis factor superfamily and has been shown to stimulate the proliferation and survival of healthy B-lymphocytes. Malignant B-lymphocytes, such as multiple myeloma, use APRIL primarily in the bone marrow to support its proliferation and survival. Studies have shown that APRIL is overproduced in patients with multiple myeloma and mediates primarily via binding to B-cell maturation antigen (BCMA) to stimulate a wide variety of responses that promote multiple myeloma growth and survival, as well as suppressing the immune system so that the tumor cells are protected and sustained in the bone marrow and can escape current available treatments. (more…)
Author Interviews, Cancer Research, Dermatology, Heart Disease, JAMA, Vaccine Studies / 10.09.2018

MedicalResearch.com Interview with: Dr. Jeffrey Rapaport MD, PA Emeritus head of Dermatology Teaneck's Holy Name Hospital. Dr. Rapaport discusess a case recently reported in JAMA: In 2016: A 97-year-old female patient was suffering from multiple squamous cell carcinomas varying from small to incredibly large in size on both of her legs. She was injected with the HPV vaccine commonly known as Gardasil, which is also used to treat warts and oral papilloma. She was first injected in her arm, and then after a period of six weeks, the vaccine was directly injected into her tumors. It was observed that this treatment eventually killed off almost all the tumors on her legs. According to recent press coverage, she is now looking forward to celebrating her 100th birthday in fall 2018. MedicalResearch.com: What is the background for this study?Is HPV thought be a trigger for some cutaneous squamous cell carcinomas? Response: The link between skin cancers and HPV vaccinations has normally been investigated in patients who have received organ transplants. Due to the immune-suppressant drugs these patients must take, it is incredibly common to find cases of skin cancer in patients who have undergone transplants. The relaxed immune system, which would normally eliminate cancers caused by the HPV virus, would open the floodgates for multiple skin tumors to emerge. In this case of the 97 year old, I would assume her immune system was healthy. There is, however, growing evidence that receiving multiple vaccines for the HPV virus is necessary even in patients with healthy immune systems. So, regardless of immune health, I believe we need to expand the frequency of the HPV vaccine, even beyond the current three-tiered system for women below 26 and men below 21. (more…)
AACR, Author Interviews, Biomarkers, Colon Cancer / 05.09.2018

MedicalResearch.com Interview with: Dr. Andrea Sottoriva, PhD Centre for Evolution and Cancer, The Institute of Cancer Research, London, United Kingdom MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by a liquid biopsy? Response: Cetuximab is a targeted treatment available for metastatic colorectal cancer patients. Unfortunately, although many patients benefit from Cetuximab, after an initial response to the treatment many patients relapse and become resistant to the drug. We know that this resistance is due to the tumour evolving and adapting to therapy. Liquid biopsies allow to look for residual cancer DNA in the blood of a patient and hence monitor the emergence of resistance over time. We used blood samples take every 4 weeks (quite frequently for this type of study) to monitor the evolution of the cancers under treatment and see if there were some measurements that would predict if and when patients will relapse. (more…)
Author Interviews, Cancer Research, Dermatology, Science / 01.09.2018

MedicalResearch.com Interview with: Dr Andrew South, PhD, Associate Professor in the department of Dermatology and Cutaneous Biology at Jefferson (Philadelphia University + Thomas Jefferson University)  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Butterfly Syndrome or recessive dystrophic epidermolysis bullosa? Response: Epidermolysis Bullosa, or EB, is a group of genetic diseases caused by mutations in genes which play a role in maintaining skin integrity. An EB patients’ skin can be very fragile which has been likened to butterfly wings, which are also very fragile. Skin blisters are common in EB patients and in some cases large wounds can result from the slightest mechanical trauma, hence the term Butterfly Syndrome. Skin cancer is a major complication of patients with the recessive dystrophic subtype of EB, known as recessive dystrophic epidermolysis bullosa or RDEB, and these cancers, called squamous cell carcinoma (SCC), are very aggressive. SCC is the leading cause of death in patients with RDEB. SCC also arise very early, affecting RDEB patients in their 20’s and 30’s. Our study used genetic analysis of cancers collected from patients to try and determine what causes the cancer at such an early age and what causes these cancers to be so fatal. Skin SCC arising in the general population as a result of sun exposure are generally benign and occur much later in life, regular skin SCC patients are predominantly over the age of 60, therefore something must be different about RDEB SCC.  (more…)
Author Interviews, Cancer Research, JAMA, OBGYNE, UCLA / 29.08.2018

MedicalResearch.com Interview with: 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: Screening for cervical cancer saves lives by identifying cervical cancer early when it is treatable. Most cases of cervical cancer occur in women who have not been regularly screened or treated, which is why it’s important for women to get screened regularly throughout their lifetime with one of several effective options. Women ages 21 to 29 should get a Pap test every three years. Women ages 30-65 can choose between three approaches, depending on their preferences: a Pap test every three years, an HPV test every five years, or a combination of a Pap test and an HPV test every five years. There are some women who don’t need to be screened for cervical cancer including women younger than 21, women older than 65 who have been adequately screened in the past and are not at high risk, and women who have had a hysterectomy.  (more…)
Author Interviews, Breast Cancer, Cancer Research, JAMA, Mammograms / 25.08.2018

MedicalResearch.com Interview with: Lisa A Newman, MD Director of the Breast Oncology Program for the multi-hospital Henry Ford  Health System MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In 2009 the United States Preventive Services Task Force published a guideline recommending that American women at average risk for breast cancer defer undergoing screening mammography until they reach the age of 50 years. Prior to this publication, women were widely-encouraged to initiate annual mammography at age 40 years. Women that have a history of breast cancer are automatically considered to be at increased risk for developing a new breast cancer, and so routine screening mammography guidelines do not apply to them. These women require annual mammography regardless of age, unless they have undergone a bilateral mastectomy. We utilized data from Michigan Blue Cross/Blue Shield to evaluate patterns of mammography utilization among women age 40-49 years, comparing rates before versus after 2009, when the USPSTF guideline was published. We analyzed women that had a prior history of breast cancer separately from those that had no history of breast cancer, and we excluded women that underwent bilateral mastectomy. Disturbingly, we found that mammography utilization rates declined among women with a history of breast cancer as well as among those with no history of breast cancer in the post-2009 timeline. This suggested to us that changes in screening recommendations may have had the unintended consequence of generating confusion and misunderstandings regarding the value of mammography among women that undeniably benefit from this imaging, such as those with a history of breast cancer.  (more…)
Alcohol, Author Interviews, Prostate Cancer / 23.08.2018

MedicalResearch.com Interview with: Emma H. Allott, PhD Research Assistant Professor of Nutrition UNC GILLINGS SCHOOL OF GLOBAL PUBLIC HEALTH University of North Carolina, Chapel Hill  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prostate cancer development may span decades. In addition, the prostate grows rapidly during puberty and therefore may be particularly susceptible to dietary or lifestyle factors during this time. Our study found that heavier alcohol intake earlier in life, as well as higher cumulative alcohol intake across the lifespan, was associated with an increased odds of being diagnosed with an aggressive (clinically significant) prostate cancer in later life. However, current alcohol intake at the time of prostate cancer diagnosis was unrelated to tumor aggressiveness. (more…)
Author Interviews, Biomarkers, Cancer Research, Journal Clinical Oncology, Lymphoma, Stanford / 23.08.2018

MedicalResearch.com Interview with: Dr. David Kurtz, MD/PhD, Instructor and Dr. Ash Alizadeh MD/PhD, Associate Professor Division of Oncology, Department of Medicine Stanford University Medical Center  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This work investigates the utility of circulating tumor DNA - a type of liquid biopsy - in diffuse large B-cell lymphoma, the most common blood cancer in adults. Liquid biopsies are an emerging technology to track cancers from a simple blood draw. Here, using a cohort of over 200 patients from 6 centers across North America and Europe, we asked if circulating tumor DNA could be used to detect lymphoma in patients, and more importantly, could it be used to identify responders and non-responders.  (more…)
Author Interviews, Breast Cancer, Cancer Research, Chemotherapy, Radiation Therapy / 22.08.2018

MedicalResearch.com Interview with: Kathleen Horst, MD Associate Professor of Radiation Oncology (Radiation Therapy) Stanford University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: We were interested in focusing on young women with breast cancer as this is a high-risk patient population that is not studied on its own in clinical trials. Furthermore, the available data on treating breast cancer with neoadjuvant chemotherapy (NAC) does not include detailed outcomes for women under the age of 40 years. Because most women who are diagnosed with breast cancer in this age group will have aggressive disease, most of them will be treated with NAC followed by surgery. From prospective randomized trials we know that women with breast cancer who attain a pathologic complete response (PCR) to neoadjuvant chemotherapy fare significantly better than those who do not. In addition, existing data suggest that a complete response in the lymph nodes also portends a better prognosis. This is the foundation for the currently ongoing NSABP B-51/RTOG 1304 trial, which is evaluating the role of nodal irradiation in those women who attain a pathologic complete response in the lymph nodes after NAC. We wanted to know whether differences in pathologic response in the breast versus lymph nodes led to different clinical outcomes in this patient group. We evaluated outcomes following neoadjuvant chemotherapy for breast cancer in 155 women age 40 and younger. We focused on pathologic response in the breast and lymph nodes as predictors of disease recurrence and survival. We found that any residual disease in either the breast or lymph nodes lessened the chance of cure significantly. Importantly, women who attained a complete response in the lymph nodes but continued to have residual disease in the breast fared just as poorly as those who remained lymph node positive following neoadjuvant chemotherapy.  (more…)
Author Interviews, Cost of Health Care, JAMA, Medicare, NYU, Prostate Cancer / 22.08.2018

MedicalResearch.com Interview with: Danil V. Makarov, MD, MHS Department of Urology and Department of Population Health New York University Langone School of Medicine VA New York Harbor Healthcare System, Robert F. Wagner Graduate School of Public Service Cancer Institute, New York University School of Medicine, New York MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Reducing prostate cancer staging imaging for men with low-risk disease is an important national priority to improve widespread guideline-concordant practice, as determined by the National Comprehensive Cancer Network guidelines. It appears that prostate cancer imaging rates vary by several factors, including health care setting. Within Veterans Health Administration (VHA), physicians receive no financial incentive to provide more services. Outside VHA, the fee-for-service model used in Medicare may encourage provision of more healthcare services due to direct physician reimbursement. In our study, we compared these health systems by investigating the association between prostate cancer imaging rates and a VA vs fee-for-service health care setting. We used novel methods to directly compare Veterans, Medicare Recipients, and Veterans that chose to receive care from both the VA at private facilities using Medicare insurance through the Choice Act with regard to rates of guideline-discordant imaging for prostate cancer. We found that Medicare beneficiaries were significantly more likely to receive guideline-discordant prostate cancer imaging than men treated only in VA. Moreover, we found that men with low-risk prostate cancer patients in the VA-only group had the lowest likelihood of guideline-discordant imaging, those in the VA and Medicare group had the next highest likelihood of guideline-discordant imaging (in the middle), and those in the Medicare-only group had the highest likelihood of guideline-discordant imaging.  (more…)
Author Interviews, Breast Cancer, Cancer Research, Genetic Research, JAMA, Ovarian Cancer / 21.08.2018

MedicalResearch.com Interview with: Ambry GeneticsShuwei Li, PhD Principal Statistical Geneticist Ambry Genetics MedicalResearch.com: What is the background for this study? What are the main findings? Response: Breast cancer is the most commonly diagnosed cancer, while ovarian cancer is the fifth leading cause of death due to cancer, in US women. Since the discovery of BRCA1 and BRCA2, multiple genes have been reported as risk factors; however, it is still unclear whether the known findings represent the complete genetic landscape of breast and ovarian cancers. Our team performed exome sequencing on more than 10,000 breast and/or ovarian cancer patients and nearly 4,000 controls. We observed increased risk of breast cancer associated with PALB2, ATM, CHEK2 and MSH6 genes, and increased risk of ovarian cancer associated with MSH6, RAD51C, TP53 and ATM genes.   (more…)
Author Interviews, Cancer Research, JAMA, Pediatrics / 20.08.2018

MedicalResearch.com Interview with: Rebecca D. Kehm, PhD Division of Epidemiology and Community Health University of Minnesota School of Public Health Minneapolis, MN   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Racial and ethnic differences in childhood cancer survival have long been known, and there has been some research indicating that SES could explain disparities. However, our study is the first to use statistical methods that put numbers to the relative contribution of SES to survival disparities for different types of childhood cancer. We set out to investigate whether racial and ethnic disparities in childhood cancer survival are attributed to underlying differences in socioeconomic status, defined as one’s social and economic position in relation to others based on income, education, and occupation, which scientists abbreviate as SES. Our findings provide evidence that SES does in fact contribute to racial and ethnic disparities in survival for some types of childhood cancer. Specifically, we found that SES accounted for 28-73% of the racial and ethnic survival disparity for acute lymphoblastic leukemia, acute myeloid leukemia, neuroblastoma, and non-Hodgkin lymphoma. However, SES did not significantly contribute to racial and ethnic disparities in survival for other types of childhood cancer including central nervous system tumors, soft tissue sarcomas, Hodgkin lymphoma, Wilms tumor, and germ cell tumors. These tumor-specific results help inform where to place resources to best reduce racial and ethnic survival disparities for each of the major types of childhood cancer. (more…)
Author Interviews, Cancer Research, Pharmaceutical Companies / 20.08.2018

MedicalResearch.com Interview with: Jeffrey S. Humphrey, MD President of Kyowa Kirin Pharmaceutical Development, Inc MedicalResearch.com: What is the background for this announcement? Would you briefly explain what is meant by Mycosis Fungoides and Sézary Syndrome? Response: Kyowya Kirin has received FDA approval for Poteligeo (mogamulizumab), based on findings from the MAVORIC trial. Mogamulizumab is a humanized immunoglobulin G1 (IgG1) monoclonal antibody (mAb) that targets CC chemokine receptor 4 (CCR4), for the treatment of the most common subtypes of cutaneous T-cell lymphoma (CTCL), mycosis fungoides (MF) and Sézary syndrome (SS). MF and SS may have a profound and severe impact on quality of life, including a patient’s functional, emotional and social well-being, as symptoms may include a scaly red rash or light or dark patches in areas of the body that are not usually exposed to the sun; thin, reddened, eczema-like rash; thickened scaly, red skin (or plaques) or psoriasis-like rash; more advanced disease can include tumors (with significant thickness) on the skin, which may develop ulcers and become infected. Because CTCL manifests in skin lesions, it is often mistaken for other skin conditions (early stage MF and SS can be diagnosed as other skin conditions), which can delay conclusive diagnosis and treatment options. MF is the most common subtype of CTCL, affecting 50-70% of individuals. In most patients diagnosed with early stage MF, the skin involvement does not progress, but in some patients, it will slowly progress. SS accounts for approximately 3% of CTCL cases and is a more aggressive, leukemic form of CTCL, affecting the blood, skin, lymph nodes and visceral organs (more…)
AACR, Author Interviews, Cancer Research, Imperial College, Kidney Disease / 20.08.2018

MedicalResearch.com Interview with: Dr. David C. Muller PhD Faculty of Medicine, School of Public Health Research Fellow in Epidemiology and Biostatistics Imperial College, London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our colleagues in the U.S. have been working on KIM-1 for years, particularly in the context of chronic kidney disease. Recently they found that KIM-1 is also elevated at the time of diagnosis of kidney cancer. We wanted to see if KIM-1 concentrations could predict the chances of a future diagnosis of kidney cancer. We found that KIM-1 was a strong predictor of being diagnosis with kidney cancer in the next 5 years. We also found that higher pre-diagnostic KIM-1 was associated with worse survival after diagnosis.  (more…)
Author Interviews, Cancer Research, CT Scanning, JAMA, Lung Cancer / 16.08.2018

MedicalResearch.com Interview with: “CT Scan” by frankieleon is licensed under CC BY 2.0Dr. Bruno Heleno MD PhD Assistant Professor | Professor Auxiliar NOVA Medical School | Faculdade de Ciências Médicas Universidade Nova da Lisboa  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Danish Lung Cancer Screening Trial (DLCST) is a randomized controlled trial which enrolled 4104 participants (aged 50-70 years; current or former smokers; ≥20 pack years; former smokers must have quit <10 years before enrollment) to either 5 rounds of screening for lung cancer with low-dose CT-scans or to no screening. After 10 years of follow-up, there was a 2.10 percentage points lung cancer absolute risk increase with low-dose CT-screening. Overdiagnosis, i.e. the detection of cancer that would not progress to symptoms or death, was estimated at 67.2% of the screen-detected cancers. (more…)
Abuse and Neglect, Dermatology, Leukemia, Lymphoma, Melanoma / 15.08.2018

MedicalResearch.com Interview with: Clive S. Zent MD Professor of Medicine Director of Lymphoma/CLL Program Wilmot Cancer Institute University of Rochester Medical Center Rochester NY MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) have an increased risk of all skin cancers including malignant melanoma. This study in a stable population of CLL patients managed by a regional referral center confirmed that melanoma was over 6 times more common in than in an age and sexed matched general population. Because of the proactive skin screening program at the University of Rochester Medical Center’s Wilmot Cancer Center, most melanomas (77%) were detected at earlier stages and were treated surgically with curative intent. One patient with CLL and metastatic melanoma had a sustained remission of both diseases on treatment with ibrutinib and pembrolizumab. (more…)
Author Interviews, Breast Cancer, JAMA, Radiation Therapy / 14.08.2018

MedicalResearch.com Interview with: Steven Narod, MD, FRCPC, FRSC Senior Scientist, Women’s College Research Institute Director, Familial Breast Cancer Research Unit, Women's College Research Institute Professor, Dalla Lana School of Public Health, University of Toronto Professor, Department of Medicine Tier 1 Canada Research Chair in Breast Cancer University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In the past we have shown that about 3 percent of women with ductal carcinoma in situ (DCIS) will die of breast cancer within 20  years of diagnosis.   In the current study, we took a very close look at how the different treatments impact on the risk of dying of breast cancer. Women with DCIS are at risk for  both a new cancer within the breast and dying of breast cancer from cells that spread beyond the breast (lung, liver, brain and bone).   About 20% of DCIS patients will get a new breast cancer within the breast at 20 years.
  • We show here that it is not necessary to develop a new cancer within the breast to die of breast cancer,  in some cases the DCIS spreads directly in the absence of local recurrence.
  • We show that radiotherapy can prevent 25% of the deaths from breast cancer after DCIS. And this has nothing to do with local recurrence.
  • We show that mastectomy reduces the chance of a getting a new cancer (local recurrence) but  doesn’t reduce the chance of dying of breast cancer.
So, if the goal is to prevent new cancers in the breast -   then mastectomy is the best treatment If the goal is to prevent the woman from dying of breast cancer - then radiotherapy is the best treatment.  (more…)