Author Interviews, Breast Cancer, Nature / 10.11.2018

MedicalResearch.com Interview with: "Mammogram" by slgckgc is licensed under CC BY 2.0Prof. Cathrin Brisken MD, PhD ISREC, School of Life Sciences Ecole Polytechnique Fédérale (EPFL) CH-1015 Lausanne, Switzerland  MedicalResearch.com: What is the background for this study? Response: Estrogen receptor signaling has been well characterized in various in vitro models, like breast cancer cell lines.  Understanding estrogen receptor action in complex in vivo context is much more challenging. We obtained elegant mouse models in which either all estrogen receptor function or specifically either the hormone dependent (AF-2) or the hormone independent (AF-1) function were ablated. Using the mammary glands from these mice we performed tissue recombination studies to discern the role of the different aspects of estrogen receptor signaling in the mouse mammary epithelium and its different cell populations. (more…)
Author Interviews, Breast Cancer, Cancer Research, JNCI / 09.11.2018

MedicalResearch.com Interview with: Angela Mariotto PhD Chief of the Data Analytics Branch Surveillance Research Program (SRP) Division of Cancer Control and Population Sciences National Cancer Institute (NCI MedicalResearch.com: What is the background for this study? Response: Progressing to metastatic breast cancer (MBC) is one of the major concerns for women diagnosed with early-stage breast cancer. Before our study there were no reliable numbers on risk of metastatic breast cancer recurrence after a (non-metastatic) breast cancer diagnosis, as registries do not routinely collect this data. (more…)
Author Interviews, Cancer Research, ENT, JAMA, Surgical Research / 06.11.2018

MedicalResearch.com Interview with: Dr. Evan M. Graboyes MD Otolaryngologist: Head and Neck Surgeon Medical University of South Carolina MedicalResearch.com: What is the background for this study? Response: Unfortunately, there is no screening test for head and neck cancer like there is for colorectal, prostate, breast, lung, or cervical cancers. As a result, two-thirds of patients with head and neck cancer (HNC) present with loco-regionally advanced disease, making other aspects of timely treatment that much more critically important. We therefore sought to understand the association between treatment delay at different points along the cancer care continuum and oncologic outcomes for patients with head and neck cancer. (more…)
Author Interviews, Biomarkers, Cancer Research, Prostate Cancer / 28.10.2018

MedicalResearch.com Interview with: Davide Pellacani Ph.D. Postdoctoral Fellow, Eaves' Lab Terry Fox Laboratory, BC Cancer Research Centre Vancouver, BC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prostate cancer is characterized by frequent DNA methylation changes compared to normal tissue. Nevertheless, understanding which of those changes lead to the acquisition of malignant proprieties is complicated by the predominance of cells with luminal features in prostate cancers. In this study we generated DNA methylation maps of two distinct cell populations found within prostate cancer samples (called basal and luminal) and their normal counterparts. These datasets clearly showed that many of the common DNA methylation changes found in prostate cancer are present in luminal cells from both cancer and normal tissues. These changes are not necessarily cancer-specific, and are likely due to the bias associated with analyzing tissues in bulk, where most cancer cells have luminal-like features. We used these datasets to derive two cancer-specific and phenotype-independent DNA methylation signatures: one specific to prostate cancer luminal cells, and one composed of changes measured in both luminal and basal cancer cells. We then validated the potential clinical utility of these signatures by testing their ability to distinguish prostate cancer from normal samples, and tumours that have already escaped the prostate from those that have not, using the publicly available dataset from The Cancer Genome Atlas. (more…)
Author Interviews, Cancer Research, JAMA, Nutrition / 23.10.2018

MedicalResearch.com Interview with: "Sunday market in Paris: all organic food" by Richard Smith is licensed under CC BY 2.0Julia Baudry & Emmanuelle Kesse-Guyot PhD Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité, Institut National de la Santé et de la Recherche Médicale (INSERM) U1153, Institut National de la Recherche MedicalResearch.com: What is the background for this study? What are the main findings? Response: Among the environmental risk factors for cancer, there are concerns about exposure to different classes of pesticides, notably through occupational exposure. Organic foods are less likely to contain pesticide residues than conventional foods, and studies have showed that an organic diet reduces exposure to certain pesticides (Baudry et al 2018, Oates et al 2014, Curl et al 2015). In the general population, the primary route of exposure is diet, especially intake of conventionally grown fruits and vegetables. However, few studies have examined the association of organic food consumption with cancer risk. In a population of 68 946 French adults from the NutriNet-Santé study, we found a reduction of 25% of cancer risk among consumers with a high frequency of organic foods compared to consumers with a low frequency, after accounting for many factors (such as lifestyle, diet and sociodemographic factors). Specifically a 34% and 76% decrease in risk was observed for post-menopausal breast cancer and all lymphomas, respectively, among frequent organic food consumers compared to consumers with a low organic food consumption frequency. (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, Biomarkers, Cancer Research, FASEB / 21.10.2018

MedicalResearch.com Interview with: Prof. Diana Anderson Established Chair in Biomedical Sciences The University of Bradford Richmond Road Bradford West Yorkshire MedicalResearch.com: What is the background for this study? Response: I have worked in this field for over 40 years both as a research scientist in industry and as a university-based researcher. It has always been my ambition to develop a relatively simple and affordable test to predict if a person is sensitive to cancer. In fact, in 1974, I was appointed as Head of Mutagenesis Studies at ICI’s Central Toxicology Laboratory in Manchester, UK, and I was looking at developing a short-term test to predict cancer even back then. Our ‘universal’ cancer test is different from other ‘universal’ tests being developed, because ours is not looking for a specific biomarker or mutation. Ours is a generic test for cancer in an individual, regardless of any underlying mechanism that’s causing their cancer. It is known that levels of damage to the DNA in the cellular genome can correlate with cancer and this is what we set out to investigate with the Comet assay. Of the available tests to detect damage to the genome the Comet assay is very straightforward. This assay was primarily developed as a method to measure DNA damage. Briefly, cells are embedded in agarose on a microscope slide and lysed to remove membranes leaving supercoiled DNA loops, breaks in which after alkaline treatment and alkaline electrophoresis move towards a positive charge. The DNA is stained with a fluorescent dye and visualised by fluorescent microscopy. The image is like Haley‘s comet and the greater number of breaks the greater is the migration to the anode and the greater the damage.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Colon Cancer, JAMA, Weight Research / 15.10.2018

MedicalResearch.com Interview with: Stuart Po-Hong Liu, MD, MPH Clinical and Translational Epidemiology Unit Massachusetts General Hospital and Harvard Medical School Boston MedicalResearch.com: What is the background for this study? Response: Although there were global decreases in overall colorectal cancer (CRC) incidence, CRC rates have increased dramatically in those aged 20 to 49 years in the United States, parts of Europe, and Asia. The etiology and early detection of young-onset becomes an emerging research and clinical priority. Another important fact that is that this emerging public health concern has resulted in updated guidelines from the American Cancer Society advising average-risk screening begin at age 45, rather than 50. However, up to this point, the etiology of young onset CRC remains largely unknown. Elucidating the role of traditional CRC risk factors in the etiopathogenesis of young-onset CRC is one of the first research agenda. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Melanoma / 14.10.2018

MedicalResearch.com Interview with: Caroline C. Kim, M.D. Associate Professor, Department of Dermatology Harvard Medical School Director, Pigmented Lesion Clinic Associate Director, Cutaneous Oncology Program Beth Israel Deaconess Medical Center Boston, MA 02215 MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Atypical/dysplastic nevi have been identified as risk factors for melanoma, however the majority of melanomas arise as new lesions on the skin. Unlike other models of dysplasia having a clear trajectory towards cancer as seen in cervical dysplasia, dysplastic nevi are not proven to be obligate precursors for melanoma.  However, there is little evidence to guide the management of biopsied dysplastic nevi with positive margins, with much clinical variation in the management of moderately dysplastic nevi in particular. In this multi-center national study of 9 U.S. academic centers, we examined outcomes of 467 moderately dysplastic nevi excisionally biopsied without residual clinical pigmentation but with positive histologic margins with at least 3 years of clinical follow-up.  We found that no cases developed into a same-site melanoma with a mean follow-up time of 6.9 years. However, 22.8% of our patients went on to develop a future separate site melanoma. (more…)
Author Interviews, Colon Cancer, Gastrointestinal Disease, Technology / 14.10.2018

MedicalResearch.com Interview with: Nadim Mahmud, MD, MS, MPH Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colonoscopy is an effective screening technique for colorectal cancer (CRC) prevention, but many patients either do not show up or have poor bowel preparation for the procedure. There are many contributors to this issue, including challenges with colonoscopy bowel preparations and communication barriers between healthcare systems and their patients. To address this, we performed a pilot of 21 patients using automated text messages sent over the course of one week prior to scheduled colonoscopy. These messages included instructional, educational, and reminder messages regarding aspects of the colonoscopy preparation process. We found significantly improved colonoscopy adherence among patients who received the text message program as compared to routine care controls (90% versus 62%). Furthermore, patient satisfaction and likelihood to recommend the text messaging program was high. Similar texting programs are simple to create and manage, and should be considered to improve outpatient colonoscopy adherence.  (more…)
Author Interviews, Cancer Research, HPV, JAMA, OBGYNE / 13.10.2018

MedicalResearch.com Interview with: Megan Clarke, PhD, MHS Cancer Prevention Fellow Clinical Genetics Branch Division of Cancer Epidemiology & Genetics National Cancer Institute Rockville, MD 20892  MedicalResearch.com: What is the background for this study?
  • Infection with high-risk human papillomavirus (hrHPV) is the primary cause of cervical cancer. While hrHPV infection is common, most infections are benign and clear on their own without causing cervical cancer. However, some women develop persistent hrHPV infections and are at risk for cervical cancer and its precursors (i.e., precancer).
  • The United States Preventative Services Task Force recommends screening every 3 years with cervical cytology (i.e. Pap) alone, every 5 years with hrHPV testing alone, or with a combination of hrHPV testing and cytology (co-testing) for women aged 30 to 65 years.
  • Screening with hrHPV testing is highly sensitive for detecting cervical precancer but requires additional triage tests to identify HPV-positive women at high-risk of developing cancer who should undergo colposcopy (visualization of the cervix) and biopsy from those at low-risk who can be safely monitored.
  • Currently, Pap cytology is recommended as a triage test for women testing HPV-positive, but this approach requires frequent re-testing at short intervals because the risk of cervical precancer is not low enough in HPV-positive women who test cytology negative to provide long-term reassurance against future risk. In most settings, women who test HPV-positive, cytology-negative are referred to repeat screening within one year.
  • The p16/Ki-67 dual stain assay is a molecular test that measures two specific proteins, p16 that is strongly linked with hrHPV infection, and Ki-67, a marker of cell proliferation that is common in precancers and cancers.
  • Studies have shown that the dual stain test has greater accuracy for detecting cervical precancers in HPV-positive women compared with cytology.
  • In order to determine the optimal screening intervals for the dual stain test, long-term prospective studies are needed to determine how long HPV-positive women who test dual stain negative can be safely reassured of a low precancer risk.
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Author Interviews, Colon Cancer, Gastrointestinal Disease, Technology / 11.10.2018

MedicalResearch.com Interview with: Nathaniel Ernstoff, MD University of Miami MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite the best efforts of all healthcare providers, colon cancer screening is underutilized with screening rates ranging anywhere from 58-76% based on the state (American Cancer Society 2017). At best we are still failing to screen 25% of the population.  Patients have serious concerns about colorectal cancer (CRC) screening with the most common barriers to screening being fear of colonoscopy and of the bowel preparation, amongst others. These barriers coupled with the lack of understanding of the risks, benefits, and the efficacy of screening contribute to our inadequate screening. This study aims to prove that through education, and most importantly comprehension, patients will choose one of the 6 recommended colorectal cancer screening tests that best fits their preferences. In this study we had 24 patients who previously refused colonoscopy on 3 separate occasions, and had no other CRC screening, undergo a virtual reality (VR) demonstration, created by TheBodyVR, to see if education would improve the uptake of screening. Prior to the virtual reality demonstration, the patients completed a 5-item questionnaire which evaluated their baseline knowledge of CRC risk, polyps and screening as well as determining barriers to prior screening. The patient then viewed the VR demonstration which starts with an overview of colorectal cancer, followed by a tour through a virtual colon explaining and showing the viewer polyps and cancer. Finally, the demonstration reviews and compares the strengths and weaknesses of all USPSTF-recommended CRC screening tests.  After the study, the patients complete the same questionnaire, and in this study there was a statistically significant improvement in knowledge in all questions.  Ultimately, 23 of 24 patients who previously refused colorectal cancer screening on 3 separate occasions chose to undergo screening after the VR demonstration, and about 50% have performed the screening 60 days out from the study's completion. (more…)
Author Interviews, Cancer Research, Colon Cancer, Genetic Research, University Texas / 10.10.2018

MedicalResearch.com Interview with: Mohammad Bilal, MD University of Texas Medical Branch MedicalResearch.com: What is the background for this study? Response: Colorectal cancer (CRC) is the fourth most commonly diagnosed cancer among adults in the United States and the second leading cause of cancer related deaths. Recent studies have shown an increasing incidence of CRC in younger patients. This has led to increasing interests in identifying patient populations who might be at increased risk of developing CRC. The U.S. Multi-Society Task Force of Colorectal Cancer (MSTF) recommends that CRC screening should begin at age 50 in average-risk persons. However, recently the American Cancer Society (ACS) have published recommendations to begin CRC screening at age 45 years in average risk patient population. These recommendations were primarily based of modeling studies since there is little outcomes data in younger age groups in regards to prevention and detection of CRC. Despite these new recommendations from the ACS, there is limited direct evidence to support CRC screening at a younger age. In our study, we have evaluated the predictors of increased prevalence of adenomas in the 40 to 49-year-old individuals undergoing colonoscopy.  (more…)
Author Interviews, Breast Cancer, Genetic Research / 10.10.2018

MedicalResearch.com Interview with: "JFK Plaza/ Breast Cancer Awareness" by nakashi is licensed under CC BY 2.0Univ.- Prof. Dr. Wolfgang Schreiner Section Biosimulation and Bioinformatics Center for Medical Statistics, Informatics, and Intelligent Systems Medical University of Vienna General Hospital WIEN / AUSTRIA MedicalResearch.com: What is the background for this study? What are the main findings? Response: The choice of correct individualized therapy for breast cancer depends on correct diagnosis: receptors for estrogen, progesterone and HER2 are determined routinely. However 5-10% of these routine diagnostics are inaccurate and may entail suboptimal therapy. We have paved the way for additional diagnostics from gene expression data so as to increase precision of diagnostics. (more…)
Author Interviews, Cancer Research, Exercise - Fitness / 10.10.2018

MedicalResearch.com Interview with: Laurien Buffart, PhD Chair Amsterdam eXercise in Oncology (AXiON) research Departments of Epidemiology & Biostatistics and Medical Oncology VUmc  Amsterdam | The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is evidence from randomized controlled trials that exercise has beneficial effects on physical fitness, fatigue, quality of life and self-reported physical function during and following cancer treatment. The magnitude of the effects, however, often appear modest, possibly because interventions rarely target patients with worse symptoms and quality of life. Based on individual patient data from 34 randomized controlled trials, we found that exercise interventions during cancer treatment are effective in maintaining muscle strength and quality of life, regardless of their baseline values. Offering exercise interventions post cancer treatment to patients with a relatively high muscle strength and quality of life does not appear to further improve these outcomes. For aerobic fitness, exercise interventions during treatment had larger effects in patients with higher baseline aerobic fitness, whereas all patients were able to improve aerobic fitness post treatment. Greater effects on fatigue and self-reported physical function were found for patients with worse baseline fatigue and physical function, both during and post-treatment.  (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Cancer Research, Red Meat / 05.10.2018

MedicalResearch.com Interview with: "bacon&eggs" by ilaria is licensed under CC BY 2.0 Maryam Farvid, Ph.D., Research Scientist   Department of Nutrition Harvard T.H. Chan School of Public Health Boston, MA 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior prospective studies on red and processed meat consumption with risk of breast cancer have produced inconsistent results. Current meta-analysis of 15 prospective studies shows that women who eat a high amount of processed meat each day may have a higher risk of breast cancer than those who don't eat or have a low intake in their diet.  (more…)
AACR, Author Interviews, Cancer Research, MD Anderson, University Texas / 01.10.2018

MedicalResearch.com Interview with: Filip Janku, MD, PhD Associate Professor, Investigational Cancer Therapeutics (Phase I Clinical Trials Program) Center Medical Director, Clinical and Translational Research Center The University of Texas MD Anderson Cancer Center Houston, TX 77030 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clostridium novyi-NT is an attenuated strain of bacteria Clostridium, which induced a microscopically precise, tumor-localized response in a rat brain tumor model and in companion dogs bearing spontaneous cancers. Clostridium novyi-NT can only grow in hypoxic (low-oxygen) tumor environment and destroys cancer cells by secreting lipases, proteases, and other hydrolytic enzymes; recruiting inflammatory cells to tumors eliciting anti-tumor immune responses in animals. Furthermore, intratumoral injection can plausibly induce an immune mediated abscopal effect in non-injected tumor sites. Therefore, we designed a phase I dose-finding study to test for safety and tolerability of the single intratumoral injection of Clostridium novyi-NT in 24 patients with advanced cancers with no available standard therapies. We also designed experiments to study activation of antitumor immune response in blood and tumor samples from patients undergoing the therapy. We demonstrated that single dose of intratumoral injection of Clostridium novyi-NT is feasible and has led to significant destruction of injected tumor masses. Adverse events, which were often related to the tumor destruction at the infected site, could have been significant but mostly manageable. Correlative studies of pre-treatment and post-treatment tumor and blood samples suggested immune response to therapy. (more…)
Author Interviews, Breast Cancer, Race/Ethnic Diversity, Social Issues / 30.09.2018

MedicalResearch.com Interview with: Sage J. Kim, PhD Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL 60612  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study examined the rates at which women who received patient navigation in a randomized clinical trial reported barriers to obtaining a screening mammogram. The trial, called the Patient Navigation in Medically Underserved Areas (PNMUA) study, randomly assigned patients to one of two groups: one received a patient navigation support intervention and the other served as a control. Of the 3,754 women who received the patient navigation intervention, only 14 percent identified one or more barriers to care, which led to additional interactions with navigators who helped overcome barriers. Black women, women living in poverty, and women who reported high levels of distrust of the health care system were the least likely to report barriers. Women who reported barriers were more likely to have additional contact with navigators and obtain a subsequent screening mammogram. The extra support could help with early diagnosis and better survival and mortality outcomes. (more…)
Author Interviews, Cancer Research, HPV, UCLA / 28.09.2018

MedicalResearch.com Interview with: Manon Eckhardt, PhD Gladstone Institutes The Quantitative Biosciences Institute University of California San Francisco  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infection with Human Papillomavirus (HPV) causes 5% of all cancers worldwide, including cervical cancer and an increasing number of head and neck cancers. Most cancers are caused by mutations in genes, leading to the production of malfunctioning proteins that result in unconstrained cell division. However, certain viruses like HPV can cause cancer without introducing mutations. In this study, we compared cancers of the same type (i.e. head and neck) that are caused by either mutation or virus infection to identify important processes that are dysregulated in both subsets. We hypothesized that identifying which proteins the virus binds can lead the way to prioritize which of the proteins and cellular processes (pathways) that are affected in cancer cells are most important. To do this, we identified the complete set of human proteins that interact with HPV. We next determined genes that were more frequently mutated in non-viral cancers, and combined both data sets. The proteins we find to be both binding to HPV and mutated in non-viral cancers will be potential targets for new, more specific drug development, and help better understand the development of head and neck cancer. From the many pathways we identified in this study, we highlighted two pathways with further mechanistic studies: the oxidative stress response, which helps cancer cells survive, as well as a pathway that allows the cancer to spread to other parts of the body. (more…)
Author Interviews, Cancer Research, Gastrointestinal Disease, Microbiome, Science / 27.09.2018

MedicalResearch.com Interview with: Joao Xavier PhD Associate Faculty Member | Computational & Systems Biology Memorial Sloan Kettering Cancer Center New York, NY 10065  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our team at Memorial Sloan Kettering has been investigating the intestinal microbiota of patients receiving bone marrow transplantations for more than eight years now. We have found through several studies that these patients lose important healthy bacteria from their microbiota, and that these losses are mostly caused by the antibiotics given as prophylaxis or to treat infections. We also found that the drastic changes in the microbiota composition, especially the intestinal dominations by bacteria such as Enterococcus, increase the risk of transplant-related complications and lowered patient survival. We aimed to determine the feasibility of autologous microbiota transplant (auto-FMT) as a way to reconstitute lost bacteria. This randomized study found that indeed auto-FMT could reconstitute important microbial groups to patients.  (more…)
Author Interviews, Biomarkers, Ovarian Cancer / 25.09.2018

MedicalResearch.com Interview with: Fabian Coscia PhD Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Martinsried, German and Ernst Lengyel MD PhD Department of Obstetrics and Gynecology Section of Gynecologic Oncology University of Chicago, Chicago, IL  MedicalResearch.com: What is the background for this study? Response: Ovarian cancer is a very aggressive disease. Only one in six patients survives more than 10 years after the first diagnosis. This high mortality is primarily because the disease is usually detected late in its course, when the tumor has already spread from the ovaries to the surrounding organs in the abdomen. In an interdisciplinary collaboration between the Max Planck Institute of Biochemistry in Martinsried, Munich, the University of Chicago and the University of Copenhagen, we performed deep tissue proteomics on archived biobank material to identify drivers of long-term patient survival.  (more…)
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…)