Author Interviews, Cancer Research, Esophageal, Gastrointestinal Disease, JAMA / 21.12.2017

MedicalResearch.com Interview with: [caption id="attachment_39050" align="alignleft" width="184"]Dr. Edward D. McCoul, MD, MPH Ochsner Medical Center Dr. McCoul[/caption] Dr. Edward D. McCoul, MD, MPH Ochsner Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Population-level data suggests a link between gastroesophageal reflux disease and cancer of the throat and sinuses in adults over 65 years of age.  T he strength of association between reflux and cancer is strongest for anatomic sites closest to the esophagus, where acid and other stomach contents may have the greatest exposure.
Author Interviews, Cancer Research, Hematology / 21.12.2017

MedicalResearch.com Interview with: janseen-oncologyMaria-Victoria Mateos, MD, PhD University Hospital of Salamanca/IBSAL Salamanca, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Phase 3 ALCYONE study data showed DARZALEX (daratumumab) in combination with bortezomib, melphalan, and prednisone (VMP) significantly improved clinical outcomes, including reducing the risk of disease progression or death by 50 percent, in newly diagnosed patients with multiple myeloma who are ineligible for autologous stem cell transplantation (ASCT) at a median follow-up of 16.5 months (Hazard Ratio [HR] = 0.50; 95 percent CI [0.38-0.65], p<0.0001). The median progression-free survival (PFS) for DARZALEX-VMP had not yet been reached, compared to an estimated median PFS of 18.1 months for patients who received VMP alone. In addition to reducing the risk of disease progression or death, DARZALEX significantly improved the overall response rate (ORR) as compared to VMP alone, including more than doubling rates of stringent complete response, significantly improved rates of very good partial response or better and complete response or better (CR). The most common (≥10 percent) Grade 3/4 treatment-emergent adverse events (TEAEs) for DARZALEX-VMP vs. VMP were neutropenia (40 percent vs. 39 percent), thrombocytopenia (34 percent vs. 38 percent), anemia (16 percent vs. 20 percent) and pneumonia (11 percent vs. 4 percent). One patient in each arm discontinued treatment due to pneumonia, and 0.9 percent of patients discontinued DARZALEX due to an infection. Twenty-eight percent of patients experienced infusion reactions (IRs) due to DARZALEX.. In the DARZALEX-VMP arm, 42 percent of patients experienced a serious adverse event (SAE), compared to 33 percent in the VMP arm. The study findings were as a late-breaking abstract (Abstract #LBA-4) at the 59th American Society of Hematology (ASH) Annual Meeting in Atlanta, and simultaneously published in the New England Journal of Medicine (NEJM).
Author Interviews, Cancer Research, JAMA, Johns Hopkins / 16.12.2017

MedicalResearch.com Interview with: Gonzalo Torga, MD Urology Department Johns Hopkins Hospital Baltimore, MD 21287 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Liquid biopsy is a new and noninvasive alternative to tumor tissue sequencing, and it is intended to specifically detect and sequence tumor DNA circulating in patients’ blood. The results are used to help guide oncologists to tailor the best treatment for patients at each point of their disease. Our research was initially aimed at finding the best commercial lab to test samples from metastatic prostate cancer patients. We wanted to make the best choice for our patients, so we started submitting the samples to both places at the same time to compare results. However, we found significant disparities in the results from identical patient samples submitted to two different commercial liquid biopsy providers, and we believed it would be important to share them with the oncology community. The two liquid biopsy panels compared were the Guardant360, from Guardant Health, Inc., which sequenced at least part of the coding sequences of 73 genes; and the PlasmaSELECT panel from Personal Genome Diagnostics, which sequenced coding segments of 64 genes.  Both laboratories were licensed by Clinical Laboratory Improvement Amendments (CLIA) and accredited by the College of American Pathologists (CAP), and report having high sensitivity (in this case, the ability to correctly identify mutations when they occur) and high specificity (the ability to correctly report as negative when those mutations are not present). The two companies differ in which genes, and regions within each gene, are covered. Just 25 of the 40 patients in the study had at least one genetic mutation reported within the overlapping genetic sequences covered by both companies. Even when the companies were analyzing DNA from the same blood drawn, their results rarely matched each other. When comparing results within the overlapping genetic sequences, the results from both companies completely matched for all the mutations reported in only 7.5 percent (3 of 40 patients) of cases. In 15 percent of the patients (6 of 40), both companies’ results matched for at least one of the reported mutations. In 40 percent (16 of 40) of the patients, no mutations reported that were potentially covered by both panels were detected by both companies.
Author Interviews, Cancer Research, Hematology, NEJM / 15.12.2017

MedicalResearch.com Interview with: [caption id="attachment_38970" align="alignleft" width="200"]Dr. Meletios A. Dimopoulos MD Professor and Chairman Department of Clinical Therapeutics University Athens School of Medicine Athens, Greece Dr. Dimopoulos[/caption] Dr. Meletios A. Dimopoulos MD Professor and Chairman Department of Clinical Therapeutics University Athens School of Medicine Athens, Greece MedicalResearch.com: What is the background for this study? What are the main findings? Response: Updated data from the Phase 3 POLLUX trials showed DARZALEX, in combination with lenalidomide and dexamethasone, reduced the risk of disease progression or death by 56 percent, compared to lenalidomide and dexamethasone alone (Hazard Ratio [HR]=0.44; 95 percent CI [0.34-0.55], p<0.0001). After a median follow-up of 32.9 months, the median progression-free survival (PFS) in the DARZALEX arm has not been reached, compared with a median PFS of 17.5 months for patients who received lenalidomide and dexamethasone alone. DARZALEX in combination with lenalidomide and dexamethasone also significantly increased the overall response rate (ORR) compared to lenalidomide and dexamethasone alone (93 percent vs. 76 percent, p<0.0001), including rates of complete response (CR) or better (55 percent vs. 23 percent, p<0.0001). DARZALEX also showed significantly higher (>3-fold) MRD-negative rates compared to lenalidomide and dexamethasone alone. These data were featured as an oral presentation (Abstract #739) at the 59th American Society of Hematology (ASH) Annual Meeting in early December.
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Genetic Research, JAMA / 15.12.2017

MedicalResearch.com Interview with: [caption id="attachment_38960" align="alignleft" width="200"]Annette S. Kim, MD, PhD Associate Professor, Harvard Medical School Brigham & Women's Hospital Boston MA 02115 Dr. Kim[/caption] Annette S. Kim, MD, PhD Associate Professor, Harvard Medical School Brigham & Women's Hospital Boston MA 02115  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The recent debate on laboratory developed tests (LDTs) and FDA-approved companion diagnostics (FDA-CDs) has centered upon both the regulatory and performance aspects of LDTs and we, at the College of American Pathologists (CAP), had the data through our proficiency testing (PT) programs to address the latter point, performance that we wanted to share with the community.  We analyzed almost 7000 PT responses on three molecular oncology tests, those for BRAF, EGFR, and KRAS mutations, and found that both LDTs and FDA-CDs demonstrated excellent performance, with both test types exceeding 97% accuracy overall. The second key finding of the study was that more than 60% of all laboratories in our study that were using an FDA-CD kit report using it with modifications from the FDA-approved protocol.  These modifications in fact render these test LDTs.  These modifications appear to be driven by the exigencies of real day-to-day clinical practice that requires adapting the assays to meet the needs of a variety of clinical situations that may not be accommodated by the FDA-approved protocol.  These modifications include, for example, the testing of other tumor types that may carry targetable variants, different types of input specimen preparations available in pathology such as cytology smears or other fresh specimens rather than paraffin blocks, and availability of different methods of DNA quantification that those mandated by the FDA approval based upon pre-existing technologies in the laboratories.  In the clinical laboratory, we are always acutely aware that there is a patient awaiting this result. Therefore, we validate our assays to ensure that we can provide reliable and accurate results from our laboratory under as many varied clinical situations as possible. These data support that practice.
Author Interviews, Genetic Research, Melanoma / 14.12.2017

MedicalResearch.com Interview with: [caption id="attachment_38934" align="alignleft" width="246"]Hildur Helgadottir, M.D., Ph.D. Department of Oncology Karolinska University Hospit Dr. Helgadottir[/caption] Hildur Helgadottir, M.D., Ph.D. Department of Oncology Karolinska University Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Malignant melanoma of the skin is one of the fastest increasing cancer types in the West. The main risk factors for melanoma are UV light exposure and hereditary factors. It is therefore relatively common for the afflicted to have family members with the disease. Inherited mutations of the tumour suppressor gene CDKN2A are the strongest known risk factors for familial melanoma and mutations in this gene also increase the risk of other cancers. Children, siblings or parents of mutation carriers have a 50-50 chance of also having the mutation, which can be identified with a gene test. The present study included Swedish and American families with inherited CDKN2A mutations. The researchers studied whether family members who have not inherited the mutation have any higher than normal risk of developing melanoma or other cancers. Melanoma, but no other cancers, was more common in the non-carriers in these families compared to the normal population. The phenomenon whereby non-carriers of a specific mutation copy the phenotype (in this case melanoma) from their mutation-carrying relatives is known as phenocopy. Phenocopy can be caused by other risk-modifying genes or exposure patterns that increase the probability of the specific phenotype manifesting itself. Previous studies have shown that people with the mutation who also have certain pigmentation variants run an even higher risk of melanoma. Even though the CDKN2A mutation should be present in all populations, it has almost exclusively been identified in families with a Caucasian heritage.This suggests that dark-skinned people with this mutation probably don’t develop melanoma as often and are therefore not tested for this specific mutation, presumably because they lack the risk-modifying pigmentation variants that increase the risk of melanoma. The researchers believe that such pigmentation variants also contribute to a higher melanoma risk in the family members who do not carry the mutation.
Author Interviews, Breast Cancer, Cancer Research, JAMA, Technology / 13.12.2017

MedicalResearch.com Interview with: Babak Ehteshami Bejnordi Department of Radiology and Nuclear Medicine Radboud University medical center, NijmegenBabak Ehteshami Bejnordi Department of Radiology and Nuclear Medicine Radboud University medical center, Nijmegen MedicalResearch.com: What is the background for this study? Response: Artificial intelligence (AI) will play a crucial role in health care. Advances in a family of AI popularly known as deep learning have ignited a new wave of algorithms and tools that read medical images for diagnosis. Analysis of digital pathology images is an important application of deep learning but requires evaluation for diagnostic performance. Accurate breast cancer staging is an essential task performed by the pathologists worldwide to inform clinical management. Assessing the extent of cancer spread by histopathological analysis of sentinel lymph nodes (SLN) is an important part of breast cancer staging. Traditionally, pathologists endure time and labor-intensive processes to assess tissues by reviewing thousands to millions of cells under a microscope. Using computer algorithms to analyze digital pathology images could potentially improve the accuracy and efficiency of pathologists. In our study, we evaluated the performance of deep learning algorithms at detecting metastases in lymph nodes of patients with breast cancer and compared it to pathologist’s diagnoses in a diagnostic setting.
Author Interviews, Brigham & Women's - Harvard, Infections, Leukemia, Merck, Transplantation / 12.12.2017

MedicalResearch.com Interview with: [caption id="attachment_38873" align="alignleft" width="120"]Francisco M. Marty, M.D Associate Professor, Harvard Medical School Dana–Farber Cancer Institute and Brigham and Women’s Hospital Dr. Marty[/caption] Francisco M. Marty, M.D Associate Professor, Harvard Medical School Dana–Farber Cancer Institute and Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cytomegalovirus (CMV) is the most common infection in patients who undergo allogeneic hematopoietic-cell transplantation (bone marrow transplantation with cells from donors different than the patient). Up until now, we had no antiviral agent that could be used for prophylaxis (prevention) of CMV post-transplant because of the side effects of drugs available to date (ganciclovir, valganciclovir, foscarnet, cidofovir). This trial confirmed that letermovir was highly effective in preventing CMV infection when used in the first 100 days after allogeneic HCT, was associated with minimal side effects of concern and was also associated with lower all-cause mortality by Week 24 post-HCT.
Author Interviews, Cancer Research, Chemotherapy, Diabetes, PLoS / 08.12.2017

MedicalResearch.com Interview with: [caption id="attachment_38714" align="alignleft" width="200"]Terra G Arnason, MD PhD, Associate Professor, Division of Endocrinology, Department of Medicine University of Saskatchewan Saskatoon, SK, Canada  Dr. Arnason[/caption] Terra G Arnason, MD PhD, Associate Professor, Division of Endocrinology, Department of Medicine University of Saskatchewan Saskatoon, SK, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Response: Metformin has been used worldwide for decades to treat Type diabetes. Metformin is a cheap non-toxic compound that was originally plant derived. In the past decade a number of meta-analyses have demonstrated that Type 2 individuals taking metformin have a reduced risk of developing many different cancers and do better longterm. The molecular events facilitating metformin’s activity remain obscure and it is unknown whether metformin can help cancer patients avoid the development of drug resistant cancers years after successful treatment. In our study we asked whether metformin can not only restore sensitivity of multiple drug resistant tumors to chemotherapy once again, but whether metformin can prevent the development of multiple drug resistance in the "rst place. We demonstrate that metformin can sensitize drug resistant cells to chemotherapy once again, which supports recent studies, but we also show for the "first time that Metformin can prevent the progression of cancer cells towards drug resistance using cell culture experiments.
Author Interviews, Breast Cancer, Cancer, CDC, Race/Ethnic Diversity / 07.12.2017

MedicalResearch.com Interview with: “Family Weekend 2014-Breast Cancer Walk” by Nazareth College is licensed under CC BY 2.0Dr. Jacqueline Miller, MD Division of Cancer Prevention and Control CDC  MedicalResearch.com: What efforts have proven successful in reducing racial disparities like these? Response: While some racial disparities will exist due to differences in tumor types, improving early diagnosis and providing specific treatment based on tumor characteristics in a timely fashion would result in reducing breast cancer disparities.
Author Interviews, Breast Cancer, NEJM, OBGYNE / 06.12.2017

MedicalResearch.com Interview with: “Birth control pills” by lookcatalog is licensed under CC BY 2.0Lina Mørch PhD, MSc Senior Researcher Rigshospitalet MedicalResearch.com: What is the background for this study? What are the main findings? Response: There was a lack of evidence on contemporary hormonal contraception and risk of breast cancer. In particular the knowledge of risk with newer progestins was sparse.
Author Interviews, Cancer Research / 06.12.2017

MedicalResearch.com Interview with: Dr. Cheng Liu PhD President and Chief Executive Officer of Eureka Therapeutics. MedicalResearch.com: What is the background for this study? What are the main findings?  
    • Eureka Therapeutics, Inc. is a clinical stage biotechnology company focused on improving the safety profile of T cell therapies and developing novel T cell therapies for the treatment of solid tumors.
    • ET190L1-ARTEMISTM utilizes Eureka’s proprietary ARTEMISTM T cell receptor platform and proprietary human anti- CD19 binder to target CD19-positive malignancies. In preclinical studies, ET190L1-ARTEMISTM matched the cancer killing potency of current CAR-T therapies but with a dramatic reduction in the levels of inflammatory cytokines released, a main cause of cytokine release syndrome. In addition, these studies have shown that ET190L1-ARTEMISTM T cells are less exhausted and more naive and therefore, expected to have improved persistence in vivo. If confirmed in the clinic, this could result in a longer term therapeutic benefit to patients with an improved safety profile.
    • Eureka is also focused on developing the next evolution of T cell therapies against solid tumors which represent 90% of all cancers. While CAR-T therapies have been successful with liquid tumors such as leukemia and lymphoma, they have not been successful in solid tumors because of a lack of specific cell surface antigens. Eureka has pioneered the use of TCR mimic antibodies to target intracellular antigens in solid tumors that were once considered undruggable. Using its proprietary human E-ALPHA® phage display library, Eureka has discovered highly-specific, high affinity TCR mimic antibodies that can target intracellular antigens in solid tumors when processed into peptides and presented onto the cell surface by the MHCI complex. Pre-clinical studies have shown that when these TCR mimic antibodies were engineered onto the ARTEMISTM or CAR-T cell receptor platform against hepatocellular carcinoma (liver cancer) cells, the T cells launched a potent anti-tumor response.
Author Interviews, Cancer, CDC, Ovarian Cancer, Race/Ethnic Diversity / 06.12.2017

MedicalResearch.com Interview with: [caption id="attachment_38743" align="alignleft" width="300"]The Centers for Disease Control and Prevention CDC image Site of Ovarian Cancer CDC image[/caption] Dr. Sherri Stewart, PhD Division of Cancer Prevention and Control CDC MedicalResearch.com: What do women most need to know about ovarian cancer detection and treatment? Response: There is no effective test to detect ovarian cancer at an early stage where treatment is most likely to be effective.  Many women mistakenly believe that the Pap test can detect ovarian cancer, but it does not. The Pap test is recommended only for the detection of cervical cancer.  Recognizing early symptoms of ovarian cancer and seeking timely care may help lead to detection of the cancer at an earlier stage, where treatment is likely to be more effective.  Symptoms – such  as abdominal and back pain, feeling full quickly after eating, and frequent urination – are often present among women with ovarian cancer.  Women should talk with their doctors if they experience any of these symptoms for 2 weeks or longer and the symptoms persist or worsen. If a woman is diagnosed with ovarian cancer, she should seek treatment from a gynecologic oncologist, a physician specially trained to treat ovarian cancer.  Ovarian cancer patients who have been treated by gynecologic oncologists have been shown to survive longer than those treated by other physicians.          
Author Interviews, Cancer Research, CDC, Colon Cancer, Race/Ethnic Diversity / 06.12.2017

MedicalResearch.com Interview with: [caption id="attachment_38738" align="alignleft" width="222"]“Large Colon Cancer Arising in Adenoma” by Ed Uthman is licensed under CC BY 2.0 “Large Colon Cancer Arising in Adenoma” by Ed Uthman[/caption] Dr. Arica White PhD MPH Division of Cancer Prevention and Control CDC MedicalResearch.com: What is the likelihood of reaching the 80% CRC screening rate goal by next year? Response: As of 2016, 67% of adults age 50-75 years reported being up-to-date with colorectal cancer screening. The 80% by 2018 initiative represented an aspirational goal that public health, non-profit, and community-based organizations will continue to strive for regardless of the outcome in 2018.
Author Interviews, Blood Pressure - Hypertension, Cancer Research / 21.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38454" align="alignleft" width="191"]Anton Wellstein, MD PhD Professor Oncology & Pharmacology Georgetown University Medical School Associate Director for Basic and Translational Science Lombardi Comprehensive Cancer Center Washington DC Dr. Wellstein[/caption] Anton Wellstein, MD PhD Professor Oncology & Pharmacology Georgetown University Medical School Associate Director for Basic and Translational Science Lombardi Comprehensive Cancer Center Washington DC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Tumor angiogenesis and signaling by growth factors such as Fibroblast growth factors (FGFs) are targets for the treatment of cancer. Targeting some of these factors will alter blood pressure. We show that FGF activation in an animal model can cause hypertension. We show that the hypertension is driven by sensitization of resistance vessels to the vasoconstrictor angiotensin II. We propose that drugs used to target FGF pathway signaling in cancer could be useful to treat hypertension.
Author Interviews, Cancer Research, Pharmaceutical Companies / 20.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38378" align="alignleft" width="168"]Dr. Koustubh Ranade, Vice President of Research & Development Translational Medicine MedImmune Dr. Ranade[/caption] Dr. Koustubh Ranade, PhD Vice President of Research & Development Translational Medicine MedImmune MedicalResearch.com: What is the background for this study? What are the main findings? Response: In a healthy person, abnormal cells including cancer cells are typically detected and destroyed by the immune system in response to danger signals activated by the abnormal cells. However, some solid tumors avoid triggering danger signals, and thus the immune system cannot recognize and destroy cancer cells, permitting tumor growth. To help activate the patient’s immune system to fight these “hidden” cancer cells, MedImmune scientists have developed MEDI9197, a TLR 7/8 agonist, to trigger the needed danger signals. Our latest data from the Phase 1 study of MEDI9197 demonstrated that through intratumor injection, the therapy binds to TLR7 and TLR8 receptors and activates dendritic cells, which call in other immune cells to fight the tumor.
Author Interviews, Breast Cancer / 20.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38345" align="alignleft" width="130"]Hanna Irie MD PhD Assistant Professor Oncology Mount Sinai Health System  Dr. Irie[/caption] Hanna Irie MD PhD, senior author Assistant Professor of Medicine (Hematology and Medical Oncology) and Oncological Sciences at The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study identified PTK6 as a critical gene regulating survival of ER+ breast cancer cells. PTK6 inhibition also suppresses growth and survival of ER+ breast cancer cells that are resistant to the effects of therapies commonly used to treat patient ER+ breast cancers, making PTK6 an attractive candidate therapeutic target for these resistant cancers.
Author Interviews, Cancer Research, Stem Cells / 17.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38353" align="alignleft" width="378"] Credit: Tim Pierpont, Cornell University A low magnification image of a germ cell tumor, called a teratocarcinoma, from a new mouse model developed to study testicular cancer. A cluster of cancer stem cells, termed embryonal carcinoma, is shown at higher magnification at the bottom.[/caption]   Amy M. Lyndaker, Ph.D. Assistant Professor of Biology Division of Mathematics and Natural Sciences Elmira College This work was completed when I was a Research Associate in the laboratory of Dr. Robert S. Weiss at: Department of Biomedical Sciences College of Veterinary Medicine Cornell University Ithaca, NY     MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been this puzzle in the field of cancer biology that testicular cancers, even after they have spread to the brain or the lungs, are often able to be cured with radiation and chemotherapy (think of Lance Armstrong, for instance), whereas the majority of cancers are not curable with similar treatments. We thought that this could be due to the unique properties of the cells from which the cancers are derived; testicular cancers arise from germ cells (which later go on to make sperm), whereas most cancers arise from somatic cells (body cells). We proposed that maybe the germ cells and somatic cells were hard-wired to respond differently to DNA damage, and that because of this, cancers derived from these two distinct types of cells might then respond differently to chemotherapies (which typically kill cancer cells by creating DNA damage). To test this, we generated a novel genetic mouse model that develops cancers similar to the malignant testicular cancers seen in young men. We then used standard chemotherapies (cisplatin alone, or combined bleomycin/etoposide/cisplatin), and found that treatment with DNA-damaging chemotherapies specifically killed the cancer stem cells within the tumors. Thus, we were able to show that testicular cancers are curable with standard DNA-damaging chemotherapies because their stem cells are highly sensitive to DNA damage. This is in contrast to most cancers, where the cancer stem cells are refractory to treatment and are responsible for tumor recurrence and metastasis.
Author Interviews, Colon Cancer, Race/Ethnic Diversity / 15.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38283" align="alignleft" width="180"]Helmneh M. Sineshaw, MD, MPH American Cancer Society Atlanta, GA 30303 Dr. Sineshaw[/caption] Helmneh M. Sineshaw, MD, MPH American Cancer Society Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? Response: Colorectal cancer (CRC) is the third most commonly diagnosed cancer in both men and women in the United Sates. Although overall CRC incidence and mortality rates are decreasing in the United States, rates are increasing in the younger population. Notwithstanding these patterns, CRC incidence and mortality rates continue to be higher in blacks than in whites. Although black-white survival disparity among patients with colorectal cancer is well documented in the literature and multiple factors have been proposed as potential contributors, the contributions of differences in demographic characteristics, insurance type, comorbidity, tumor presentation, and treatment receipt to the racial disparity in survival among nonelderly CRC patients are unknown.
Author Interviews, Cancer Research, Orthopedics, Pharmacology / 13.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38207" align="alignleft" width="130"]Dr-Charles L Shapiro.jpg Dr. Shapiro[/caption] Charles L.Shapiro MD Professor of Medicine Director of Translational Breast Cancer Research Director of Cancer Survivorship Division of Hematology/Oncology Tisch Cancer Institute New York, NY MedicalResearch.com: What is the background for this study? What are the main findings? Response: The new 2017 ASCO guidelines for the use bone-modifying in individuals with bone metastases recently endorsed every 3-month zoledronic, because of high level evidence from three randomized trials, including our trial (published in Jama in Jan 2017, first author Himelstein et al) that giving zoledronic acid every 3-months was non-inferior to the standard of monthly zoledronic. The guidelines also concluded that there was not one preferred bone modifying agent of the other, despite the fact the comparing monthly zoledronic to monthly denosumab in women with bone metastases, denosumab delayed the time to first skeletal-related event (pathological fractures, necessity for radiation or surgery, and spinal cord compression) and subsequent events by 23% (or in absolute terms about 3 months) . Zoledronic acid became generic in 2013, whereas monthly denosumab is still patented until 2022-25.
Author Interviews, JAMA, Lung Cancer, Medical Imaging, Surgical Research, Vanderbilt / 10.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38163" align="alignleft" width="300"]PET Scan Vanderbilt Health PET Scan Vanderbilt Health[/caption] Amelia W. Maiga, MD MPH Vanderbilt General Surgery Resident VA Quality Scholar, TVHS MedicalResearch.com: What is the background for this study? What are the main findings? Response: Positron emission tomography (PET) combined with fludeoxyglucose F18 (FDG) is currently recommended for the noninvasive diagnosis of lung nodules suspicious for lung cancer. Our investigation adds to growing evidence that FDG-PET scans should be interpreted with caution in the diagnosis of lung cancer. Misdiagnosis of lung lesions driven by FDG-PET avidity can lead to unnecessary tests and surgeries for patients, along with potentially additional complications and mortality. To estimate FDG-PET diagnostic accuracy, we conducted a multi-center retrospective cohort study. The seven cohorts originating from Tennessee, Arizona, Massachusetts and Virginia together comprised 1188 nodules, 81 percent of which were malignant. Smaller nodules were missed by FDG-PET imaging. Surprisingly, negative PET scans were also not reliable indicators of the absence of disease, especially in patients with smaller nodules or who are known to have a high probability of lung cancer prior to the FDG-PET test. Our study supports a previous meta-analyses that found FDG-PET to be less reliable in regions of the country where fungal lung diseases are endemic. The most common fungal lung diseases in the United States are histoplasmosis, coccidioidomycosis and blastomycosis. All three fungi reside in soils. Histoplasmosis and blastomycosis are common across much of the Mississippi, Ohio and Missouri river valleys and coccidioidomycosis is prevalent in the southwestern U.S. These infections generate inflamed nodules in the lungs (granulomas), which can be mistaken for cancerous lesions by imaging.
Abuse and Neglect, Author Interviews, Cancer Research, ENT, JAMA, Smoking, Social Issues / 10.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38154" align="alignleft" width="150"]Nosayaba Osazuwa-Peters, BDS, MPH, CHES Instructor, Department of Otolaryngology-Head and Neck Surgery Saint Louis University School of Medicine Member, Saint Louis University Cancer Center St Louis, Missouri Nosayaba Osazuwa-Peters[/caption] Nosayaba Osazuwa-Peters, BDS, MPH, CHES Instructor, Department of Otolaryngology-Head and Neck Surgery Saint Louis University School of Medicine Member, Saint Louis University Cancer Center St Louis, Missouri  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several studies have shown that there is an adverse effect of smoking on head and neck cancer survival; however, there are studies that show no effect between smoking and head and neck cancer. We wanted to investigate this problem using a single institution’s cancer dataset. Additionally, we wanted to understand the role of marital status in the smoking behavior of head and neck cancer patients, and to understand if smoking played any role in head and neck cancer survival. Our study confirmed that head and neck cancer patients who were smokers at the time of diagnosis had lower survival rates than nonsmokers. We also found that married head and neck cancer patients were less likely to be smokers and more likely to survive longer than those unmarried.
Author Interviews, Breast Cancer / 08.11.2017

MedicalResearch.com Interview with: [caption id="attachment_37960" align="alignleft" width="112"]Dr Hongchao Pan PhD Medical Research Council Population Health Research Unit Clinical Trial Service Unit & Epidemiological Studies Unit Nuffield Department of Population Health Oxford  Dr Hongchao Pan[/caption] Dr Hongchao Pan PhD Medical Research Council Population Health Research Unit Clinical Trial Service Unit & Epidemiological Studies Unit Nuffield Department of Population Health Oxford MedicalResearch.com: What is the background for this study? What are the main findings? Response: We’ve known for a long time that recurrences can occur late in women with oestrogen receptor positive breast cancers. Our study aimed to assess how big the risk was for women who had taken endocrine treatment (tamoxifen or an aromatase inhibitor) for 5 years, which greatly reduces the risk of recurrence (by about a half during treatment and one third for the 5 years after stopping). We also wanted to find out what factors influenced the risk of recurrence, and whether some women had such a low risk that they could safely stop hormonal treatment after 5 years or, conversely, whether other women had a particularly high risk so it would make sense for them to keep on taking hormonal treatment. What we found by following the progress of over 60,000 women who had stopped hormonal treatment at 5 years is that the risk of the cancer spreading stays about the same for the next 15 years. This risk is much higher for women whose breast cancer had spread to the nodes when first diagnosed but even for those with the best outlook (no spread to the lymph nodes and small tumours), there was a 10% chance of cancer spread over 15 years.
Author Interviews, Gastrointestinal Disease, JAMA, Lymphoma / 08.11.2017

MedicalResearch.com Interview with: ANSMRosemary Dray-Spira, MD, PhD Department of Epidemiology French National Agency for Medicines and Health Products Safety (ANSM) Saint-Denis, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: Anti-tumor necrosis factor (anti-TNF) agents are increasingly used for the management of inflammatory bowel diseases (IBD), either alone or in combination with thiopurines. Their clinical benefits have been largely assessed, however they may expose to potentially serious adverse effects. While an increased risk of lymphoma has been established with thiopurines, up to now such a risk of lymphoma remained uncertain with anti-TNF agents. In this study based upon a large, nationwide cohort of 189,289 patients with IBD, the use of anti-TNF agents alone was found associated with a 2 to 3 fold increase in the risk of lymphoma, similarly to thiopurines alone. In addition, the combination of these two treatments was associated with a 6 fold increase in the risk of lymphoma, ie a higher risk than with each treatment used alone. Although these differences are statistically significant, the risk of lymphoma among patients exposed to anti-TNF agents is less than 1 case per 1000 person-years.
Author Interviews, BMJ, Cancer Research / 07.11.2017

MedicalResearch.com Interview with: Dr. Wai Keung Leung Professor, Division of Gastroenterology & Hepatology Department of Medicine Assistant Dean, LKS Faculty of Medicine University of Hong Kong Hong Kong MedicalResearch.com: What is the background for this study? What are the main findings? Response: It remains controversial whether proton pump inhibitors will increase the risk of gastric cancer. Although previous studies have shown a possible increase in risk in patients taking long-term proton pump inhibitors (PPI), these studies are confounded by the presence of H. pylori infection. In this population-based study from Hong Kong, we have determined the risk of gastric cancer development in more than 63,000 H. pylori-infected subjects who had the bacterium eradicated by a course of  clarithromycin-based triple therapy and continued to take PPI or H2-receptor antagonist (H2RA). After adjusting for various baseline differences among those PPI and non-PPI users, we found that the risk of gastric cancer was increased by 2.4-fold in those who used long-term PPI. The risk was in tandem with the frequency and duration of PPIs treatment. The risk increased from 5-fold to 8-fold for more than 1-year and 3-year use of PPI, respectively. Similar increase in risk was not observed among those who took H2RA, a weaker acid suppressive agent.
Author Interviews, Cancer Research, Weight Research / 06.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38011" align="alignleft" width="142"]Daniel P. Schauer, MD, MSc Associate Professor, Internal Medicine University of Cincinnati College of Medicine Division of General Internal Medicine Cincinnati OH 45267-0535 Dr. Schauer[/caption] Daniel P. Schauer, MD, MSc Associate Professor, Internal Medicine University of Cincinnati College of Medicine Division of General Internal Medicine Cincinnati OH 45267-0535 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obesity is associated with many types of cancer and bariatric surgery is the most effective treatment for severe obesity.  We conducted a retrospective cohort study of patients undergoing bariatric surgery between 2005 and 2012 with follow-up through 2014 using data from Kaiser Permanente using 5 study sites. The study included 22,198 patients who had bariatric surgery matched to 66,427 nonsurgical patients with severe obesity. We found that bariatric surgery was associated with a reduced risk of cancer.  The risk reduction was greatest for the cancers that are associated with obesity including postmenopausal breast, endometrial, colon, and pancreatic cancers, as well as esophageal adenocarcinoma.
Author Interviews, Cancer Research, JAMA / 06.11.2017

MedicalResearch.com Interview with: Gry Haaland, MD James Lorens PhD, Professor The Department of Biomedicine University of Bergen  MedicalResearch.com: What is the background for this study? Response: Antitumor activity of the common blood thinner warfarin has been reported in several experimental cancer model systems. We therefore considered whether warfarin is cancer protective. Using the comprehensive national health registries in Norway, we examined cancer incidence among a large number of people taking warfarin (92,942) and compared to those not taking warfarin (more than 1.1 million).
Author Interviews, Cancer Research, Opiods, Pain Research / 06.11.2017

MedicalResearch.com Interview with: [caption id="attachment_37962" align="alignleft" width="104"]Sebastiano Mercadante, MD Anesthesia and Intensive Care Unit and Pain Relief and Palliative Care Unit La Maddalena Cancer Center Department of Anesthesia, Intensive Care & Emergencies University of Palermo Palermo, Italy Dr. Mercadante[/caption] Sebastiano Mercadante, MD Anesthesia and Intensive Care Unit and Pain Relief and Palliative Care Unit La Maddalena Cancer Center Department of Anesthesia, Intensive Care & Emergencies University of Palermo Palermo, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many clinical experiences suggesting that methadone, when optimally used by skilled physicians, has invaluable properties in the management of cancer pain. Methadone used as first opioid may provide interesting advantages due to the low tendency to induce tolerance, while providing a clinical profile similar to that of other opioids. Moreover, methadone possesses other extra-opioid effects that can be of interest.
Author Interviews, Cancer Research, Lancet / 30.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37758" align="alignleft" width="110"]Dr Miranda M Fidler, PhD Section of Cancer Surveillance International Agency for Research on Cancer Lyon, France  Dr. Fidler[/caption] Dr Miranda M Fidler, PhD Section of Cancer Surveillance International Agency for Research on Cancer Lyon, France  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The burden of cancer among young adults has been rarely studied in depth. To our knowledge, we describe for the first time the scale and profile of cancer incidence and mortality worldwide among 20-39 year-olds, highlighting major patterns by age, sex, development level, and geographic region. Although cancer is less frequent than that observed at older ages, its impact remains considerable because these individuals have a large proportion of their expected lifespans remaining, contribute substantially to the economy, and play a major role in caring for their families. Worldwide, almost 1 million new cases of cancer and 400 000 cancer-related deaths occurred among young adults aged 20–39 years in 2012. Overall, the most common cancer types in terms of new cases were female breast cancer, cervical cancer, thyroid cancer, leukemia, and colorectal cancer, and the most common types of cancer-related deaths were those due to female breast cancer, liver cancer, leukemia, and cervical cancer. The burden was disproportionately greater among women, with an estimated 633 000 new cancer cases (65% of all new cancer cases in that age group) and 194 000 cancer-related deaths (54% of all cancer-related deaths in that age group) in 2012.