Author Interviews, Journal Clinical Oncology, Lung Cancer / 23.08.2017

MedicalResearch.com Interview with: Theodore M. Brasky, PhD Research Assistant Professor The Ohio State University – James Comprehensive Cancer Center Columbus, OH 43201 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior literature has been suggestive of both a protective and harmful effect of certain B vitamins on lung cancer risk. We wanted to examine the association of intakes of vitamins B6, folic acid (B9), and B12 from supplements –which are typically taken at very high doses– and lung cancer risk in a large, prospective study of 77,000 men and women living in Washington State. The study is unique as it was designed specifically to examine associations of dietary supplements with cancer occurrence. We found that men who took high doses of vitamin B6 and B12 from individual supplements over a long period of time (meaning, doses much higher than the US RDA and much greater than what one would receive from taking a multivitamin over the long term) were at nearly 2-fold increased risk of lung cancer compared to men who did not have B6 or B12 intake from any supplemental source. This finding of increased risk appeared to be specific to men who were current smokers. Among them, long term high-dose supplementation was associated with 3-4 fold increases in lung cancer risk. We observed no increased risk for any of the supplements – B6, B12, or folic acid – with lung cancer risk in women or women who smoked. (more…)
Author Interviews, Cancer Research, Gastrointestinal Disease, Infections, Nature, Stem Cells / 20.08.2017

MedicalResearch.com Interview with: Michael Sigal PhD Clinical scientist of the Charité -- Universitätsmedizin Berlin Investigator at the Max Planck Institute for Infection Biology  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have previously found that H. pylori can colonize gastric glands and that in colonized glands the epithelial turnover was increased. We wanted to characterize the mechanisms that control the gland turnover in the stomach. We found that Axin2, a classic Wnt target gene, marks two different subpopulations of cells with stem cell properties, one of which is Lgr5-positive and the other one Lgr5-negative. Both populations are affected by Rspondin 3, that is produced in myofibroblasts right beneath the stem cell compartment. Rspondin is crucial for stem cell signaling and knockout of Rspondin 3 in myofibroblasts results in loss of Lgr5 and Axin2 expression. Once we increased the bioavailability of Rspondin, that now could also interact with cells outside of the stem cell compartment, we noticed that the number of Axin2 positive stem cells dramatically increased. Of interest, only Lgr5-negative cells expanded in number and proliferate more, while the Lgr5-positive cells remained silenced. Infection with Helicobacter pylori leads to an expansion of Axin2-positive cells which is driven by increased expression of Rspondin3. Expansion of the long lived stem cell pool could be an explanation for how H. pylori infection increases the risk for gastric cancer. (more…)
Author Interviews, Cancer Research, Dermatology / 17.08.2017

MedicalResearch.com Interview with: Prof. Gary M. Halliday Discipline of Dermatology, Bosch Institute Central Clinical School University of Sydney Sydney, NSW, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: The recently published article is a review paper- we reviewed previous laboratory studies of the effects of nicotinamide on normal pigment cells and on melanoma, and also the previous studies showing that nicotinamide can reduce rates of non-melanoma skin cancer (basal cell and squamous cell carcinoma) in high risk patients. We have not done any clinical investigations of nicotinamide as a preventive agent for melanoma. (more…)
Author Interviews, Cancer Research, CDC / 15.08.2017

MedicalResearch.com Interview with: Mary C. White, ScD MPH Epidemiology and Applied Research Branch Division of Cancer Prevention and Control CDC Atlanta GA 30341 MedicalResearch.com: What is the background for this study? Response: Most cancers are caused not by just one thing, but instead by a combination of different factors over many years. Early adulthood is a time of many life changes and stresses, and exposure to harmful products and unhealthy habits during early adulthood can set the stage for developing cancer at older ages. We analyzed responses from a national sample of young adults to questions about diet, physical activity, tobacco products, alcohol, indoor tanning, sleep, the HPV vaccine, and obesity. These factors have been linked to higher risks of different types of cancer. (more…)
Author Interviews, Cancer Research, CMAJ, HPV, Vaccine Studies / 14.08.2017

MedicalResearch.com Interview with: Steven Habbous MSc, PhD candidate Ontario Cancer Institute Scarborough, Ontario, Canada MedicalResearch.com: What is the background for this study? Response: Human papillomavirus (HPV) is a strong risk factor for oropharyngeal cancers (a subset of head and neck cancers). Because HPV-related oropharyngeal cancers generally respond well to treatment and may be prevented through HPV vaccination, it is critical to be able to accurately estimate the incidence and prevalence of this disease. Only recently, however, has testing for HPV become routine at most cancer centres across Canada.  As a result, attempts to estimate the growth of HPV-related oropharyngeal cancer over time may be inaccurate. (more…)
Author Interviews, Cancer Research, Cost of Health Care, Duke, JAMA / 11.08.2017

MedicalResearch.com Interview with: Dr. Fumiko Chino, MD Duke Radiation Oncology Duke School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The financial burden of cancer treatment is a growing concern. Out-of-pocket expenses are higher for patients with cancer than for those who have other chronic illnesses. Fifty percent of elderly cancer patients spend at least 10% of their income on treatment-related out-of-pocket expenses. Additionally, high financial burden is associated with both increased risk of poor psychological well-being and worse health-related quality of life. A cancer diagnosis has been shown to be an independent risk factor for declaring personal bankruptcy, and cancer patients who declare personal bankruptcy are at greater risk for mortality. These potentially harmful outcomes resulting from financial burden have been recognized as the financial toxicity of cancer therapy, analogous to the more commonly considered physical toxicity. We conducted an IRB approved study of financial distress and cost expectations among patients with cancer presenting for anti-cancer therapy. In this cross-sectional, survey based study of 300 patients, over one third of patients reported higher than expected financial burden. Cancer patients with highest financial distress are underinsured, paying nearly 1/3 of income in cancer-related costs. In adjusted analysis, experiencing higher than expected financial burden was associated with high/overwhelming financial distress (OR 4.78; 95% CI 2.02-11.32; p<0.01) and with decreased willingness to pay for cancer care (OR 0.48, 95% CI 0.25-0.95, p=0.03). Sambla, a Scandinavian lender, has been working with many patients to prevent any financial distress resulting from unexpected medical bills. As a result of customer feedback, it has modified the terms of all loans it issues to allow for jumbo loan sizes and reduced interest rates, combined with longer repayment times to help its borrowers. (more…)
Author Interviews, Cancer Research, OBGYNE, PLoS / 11.08.2017

MedicalResearch.com Interview with: Jane McElroy, Ph.D. Associate professor Department of Family and Community Medicine MU School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: More than 31,000 new cases of endometrial cancer are expected to be diagnosed in 2017. Through a five-year observational study, we found that women with increased levels of cadmium had an increased risk of endometrial cancer. Cadmium is a metal commonly found in foods such as kidneys, liver and shellfish as well as tobacco It’s a finding we hope could lead to new treatments or interventions to prevent the fourth most common cancer in women. (more…)
Author Interviews, Cancer, Cancer Research, Opiods / 09.08.2017

MedicalResearch.com Interview with: Rinku Sutradhar, Ph.D. Senior Scientist, Institute for Clinical Evaluative Sciences Associate Professor, Dalla Lana School of Public Health University of Toronto, Canada MedicalResearch.com: What is the background for this study? What are the main findings?
  • We suspected that pain was prevalent among survivors of cancer, but there were no comprehensive estimates on the magnitude of this prevalence. For example, recent work had reported pain prevalence among cancer survivors to be anywhere from 5% to 56%, which is quite a wide range.
  • To our knowledge, there has been no prior research conducted at the individual-level that specifically examines opioid prescribing rates for cancer survivors, compared to matched control groups who have no prior cancer diagnosis.
  • We also know that socio-economically disadvantaged populations are more at risk for opioid dependency, but previous studies have not examined cancer survivors who a part of this disadvantaged group, so this is an important knowledge gap to fill.
  • We found that cancer survivors have significantly higher rates of opioid prescriptions compared with their matched controls (who had no prior cancer diagnosis). In fact, after adjusting for other study factors, we found that the rate of opioid prescriptions was 22% higher among survivors.
  • MOST SURPRISING: This higher rate of opioid prescriptions persisted even among survivors who were 10 or more years past their cancer diagnosis (compared to matched control individuals who had no prior cancer diagnosis).
  • When we broke the cohort down based on the type of cancer, we didn’t see a significant spike in opioid prescriptions for breast cancer survivors compared to their non-cancer controls, but we did see higher opioid prescriptions for survivors of lung, gastrointestinal, genitourinary, or gynaecological cancers, compared to their controls.
(more…)
Author Interviews, Cancer Research, Colon Cancer, Race/Ethnic Diversity / 08.08.2017

MedicalResearch.com Interview with: Rebecca Siegel, MPH Strategic Director, Surveillance Information Services American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colorectal cancer (CRC) incidence rates have been increasing in people under 55 since at least the mid-1990s, despite rapid declines in older age groups. We analyzed mortality data covering over 99% of the US population and found that death rates for CRC in adults under 55 have been increasing over the past decade of data (2004-2014) by 1% per year, in contrast to rapid declines in previous years. This indicates that the increase in incidence is not solely increased detection due to more colonoscopy use, but a true increase in disease occurrence that is of sufficient magnitude to outweigh improvements in survival because of better treatment for colorectal cancer. The second major finding was that the rise in death rates was confined to whites, among whom death rates rose by 1.4% per year, for an overall increase of 14%. In blacks, the colorectal cancer death rate declined slowly during the entire study period (1970-2014). This racial disparity is consistent with incidence, but in contrast to trends for major risk factors for CRC, like obesity, which has increased across all racial and ethnic groups. This means that the obesity epidemic is probably not wholly responsible for the increase in disease. Third major finding was that CRC death rates are increasing in people in their early 50s, for whom screening has been recommended for decades. This was particularly surprising since CRC screening has a two-fold impact on death rates by both preventing cancer and detecting it early when treatment is more effective. Rising death rates in this age group likely reflects lower screening rates in ages 50-54 than 55+ -- 46% vs 67% in 2015, probably because of delayed initiation of screening. (more…)
Author Interviews, BMC, Breast Cancer, Radiation Therapy / 02.08.2017

MedicalResearch.com Interview with: Heiko Enderling, Ph.D. Associate Member & Director for Education and Outreach Dept. of Integrated Mathematical Oncology Dept. of Radiation Oncology H. Lee Moffitt Cancer Center & Research Institute Tampa, FL 33612 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although radiation therapy after breast-conserving surgery for early-stage breast cancer has significantly improved patient prognosis, many patients will face a second cancer diagnosis within 20 years of primary treatment. Experimental and clinical studies have shown that local radiation therapy can activate an immune response that can propagate systemically to attack distant untreated metastases. However, current radiotherapy practice has not specifically focused on enhancing immune responses. We asked the question if pre-operative irradiation, when applied to the bulk of disease, could have potentially higher immune stimulatory effects. To study this, we analyzed historic outcomes of breast cancer patients treated with either adjuvant (radiation after surgery) or neoadjuvant (radiation before surgery) radiotherapies. Our analysis showed that the risk of developing a second tumor after neoadjuvant compared with adjuvant RT was significantly lower, especially for estrogen receptor-positive women who underwent breast conserving surgery or mastectomy. Historic data revealed an increase in disease-free survival of 12% over 20 years after treatment of the original tumor. (more…)
Author Interviews, Breast Cancer, JAMA, Surgical Research / 02.08.2017

MedicalResearch.com Interview with: Dr. Lisa K. Jacobs MD Johns Hopkins School of Medicine Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Breast preservation is the preferred treatment for many women diagnosed with breast cancer.  The most common question that a patient will ask after the surgery is, “Did you get it all?” In the ideal case, this is accomplished in a single outpatient surgery with very good cosmetic results.  In our study, Beyond the Margins-Economic Costs and Complications Associated with Repeated Breast-Conserving Surgeries we evaluated the detrimental effects of an unsuccessful initial surgery due to positive surgical margins. Using private insurance claims data, we found that 16% of patients planning breast preservation required a second breast-conserving surgery and an additional 7% converted to mastectomy.  Of those patients that required additional surgery there was a 56% ($16,072) increase in cost and a 48% increase in complications.  Those complications include infection, hematoma, seroma, and fat necrosis.  This study demonstrates that repeated surgery has not only cosmetic consequences, but also has financial implications and increased risk. (more…)
Author Interviews, Cancer Research, JAMA / 02.08.2017

MedicalResearch.com Interview with: Benjamin Weixler, MD Department of Surgery University Hospital Basel, Basel, Switzerland and Leiden University Medical Center, Leiden, the Netherlands  MedicalResearch.com: What is the background for this study? What are the main findings? Response: For most patients with lymph node negative colon cancer (stage I and II) surgery is regarded to be the curative treatment. Despite the curative attempt up to thirty percent of these patients will develop disease recurrence, most likely due to missed micro-metastatic disease at initial tumor staging. Pathological standard processing with hematoxylin and eosin (H&E) entails a considerable risk of missing micro-metastatic deposits in the lymph nodes. Mounting evidence indicates that micro-metastatic tumor deposits in the lymph nodes as well as in the bone marrow might be associated with an increased risk of disease recurrence and death in node negative patients. With our study we wanted to examine the correlation between the occurrence of micro-metastatic deposits in the lymph nodes and the bone marrow as well as their prognostic significance. As a main finding, the study provides compelling evidence that tumor cell dissemination to the lymph nodes and to the bone marrow are independent events in patients with colon cancer. Most importantly did the study demonstrate that micro-metastatic deposits in the lymph nodes as well as in the bone marrow are independent negative prognostic factors regarding  disease-free and overall survival. The combined occurrence is associated with significantly worse prognosis compared to either one of them. (more…)
AACR, Author Interviews, Cancer Research, Dental Research, Menopause / 02.08.2017

MedicalResearch.com Interview with: Jean Wactawski-Wende, PhD Dean, SUNY Distinguished Professor Professor, Department of Epidemiology and Environmental Health School of Public Health and Health Professions University of Buffalo MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a growing interest in the role of periodontal disease in system chronic diseases, including cancer. We explored the association of periodontal disease history and incident cancer in the women's health initiative study of postmenopausal women. We found that women reporting periodontal disease history were at increased risk of developing cancer overall. In addition they were found to have significant increased risk of specific cancers including cancers of the lung, breast, esophagus, gallbladder and melanoma. The risk persisted after control for many other factors. In addition, the risk was seen in women regardless of their smoking history. Both ever smokers and never smokers were found to have increased risk of cancer associated with periodontal disease history. (more…)
Author Interviews, Cancer Research, Dermatology, Ophthalmology / 24.07.2017

MedicalResearch.com Interview with: Dr.med.univ. Christoph Schwab Departement of Ophthalmology Medical University of Graz Graz, Austria  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Knowledge about risk factors and/or pathways involved in pathogenesis is from special importance in order of preventing diseases. The role of sunlight in several eye diseases is unclear. In our study we found a close relation between sun light exposure - evaluated by a full body skin examination and a personal questionnaire - and iris freckles. Therefore we suggest the presence of iris freckles as a novel biomarker indicating high ocular sun exposure. (more…)
Author Interviews, Chemotherapy, Lung Cancer, Science / 24.07.2017

MedicalResearch.com Interview with: Prof. Gerhard Hamilton Department of Obstetrics and Gynecology Medical University of Vienna MedicalResearch.com: What is the background for this study? What are the main findings? Response: Small cell lung cancer (SCLC) is a highly aggressive tumor (15 % of all lung cancers) mainly of patients with high tobacco consumption which shows an extremely poor survival (< 5% 2-year survival rate). Unfortunately the low survival rates of advanced SCLC cases has not improved significantly during the last decades, with platinum drugs/etoposide and topotecan employed for first- and second-line chemotherapy, respectively. All kinds of new chemotherapeutics, targeted drugs and immunotherapies either failed or resulted in prolongation of survival of several months at best. SCLC responds well to first-line therapy but relapses within a short time as chemoradioresistant tumor. The failure of hundreds of registered studies seem to be linked to the lack of knowledge of the mechanism of resistance of SCLCs and proper ways to reverse the refractoriness. Small cell lung cancer is distinguished by excessive numbers of circulating tumor cells (CTCs) in advanced stages. CTCs contain the founder of metastasis and seem to constitute a highly chemoresistant cell population. Thus, we ware able to establish a panel of permanent CTC lines in vitro for the first time (8 SCLC lines so far from blood samples). Although CTCs were considered to be chemoresistant we detected that they are chemosensitive in vitro in form of single cell suspensions. However, all CTC lines developed spontaneously into large multicellular aggregates, termed tumorospheres, which grow up to 1-2 mm in size and exhibit high chemoradioresistance due to limited drug perfusion as well as content of quiescent and hypoxic cells. Resistance to irradiation seems to be caused by lack of oxygen, such limiting the generation of oxygen radicals. High resistance mediated by the occurrence of tumorospheres easily explains the failure of a large number of drugs - if one is not able to achieve a sufficient concentration of a drug in cancer cells and the cells are quiescent, the respective compounds will not be able to destroy the target cells, regardless of their chemical nature. (more…)
Author Interviews, Baylor College of Medicine Houston, Biomarkers, Brain Cancer - Brain Tumors, Cancer Research, PNAS / 19.07.2017

MedicalResearch.com Interview with: Chonghui Cheng, M.D., Ph.D. Associate Professor Department of Molecular & Human Genetics Lester & Sue Smith Breast Center Baylor College of Medicine Houston, TX77030 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Understanding the mechanisms that give cancer cells the ability to survive and grow opens the possibility of developing improved treatments to control or cure disease. In the case of glioblastoma multiforme, the deadliest type of brain cancer, abnormal EGFR signaling is frequently observed. Treatment with the EGFR inhibitor erlotinib attempts to kill cancer cells. However, the clinical benefit of treatment with this and other EGFR inhibitors has been limited by the development of drug resistance. Scientists at Baylor College of Medicine discovered that the molecule CD44s seems to give cancer cells a survival advantage. Eliminating this advantage by reducing the amount of CD44s resulted in cancer cells being more sensitive to the deadly effects of the drug erlotinib. (more…)
Author Interviews, Dermatology, Immunotherapy, JAMA, Lung Cancer / 14.07.2017

MedicalResearch.com Interview with: Dr. Noelia Rivera MD Dermatologist Hospital Universitari Germans Trias i Pujol, Badalona Universitat Autònoma de Barcelona MedicalResearch.com: What is the background for this study? Response: In the last few years some new therapies targeting immune checkpoints have been developed. The programmed death receptor-1 (PD-1) are immune checkpoints that prevent the immune system to act against own tissues. By blocking these mediators it is possible to prevent tumors to escape from the immune system. About half of the patients receiving these therapies will develop mild to moderate cutaneous adverse events. In the pre-authorization studies for malignant melanoma these include rash, vitiligo, and pruritus. "Rash" has commonly been reported as an adverse event in many oncologic trials evaluating the drugs, without providing further information about the clinical or histological details. Lately, lichenoid eruptions associated to these therapies have been reported and it suggests that an important percentage of these reactions present lichenoid histological features. (more…)
Author Interviews, Dermatology, Melanoma / 14.07.2017

MedicalResearch.com Interview with: Maryam M. Asgari, MD, MPH Department of Dermatology Massachusetts General Hospital, Department of Population Medicine Harvard Medical School, Boston, Massachusetts Division of Research, Kaiser Permanente Northern California, Oakland  MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Laboratory studies show lithium, an activator of  the Wnt/ß-catenin signaling pathway, slows melanoma progression, but no published epidemiologic studies have explored this association. We conducted a retrospective cohort study of adult white Kaiser Permanente Northern California members (n=2,213,848) from 1997-2012 to examine the association between lithium use and melanoma risk. Our main finding is that lithium-exposed individuals had a reduced incidence of melanoma, did not develop very thick tumors (> 4 mm Breslow depth) or extensive disease at presentation, and had decreased melanoma-specific mortality compared to unexposed individuals suggesting a possible role for lithium in altering melanoma risk. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Dermatology, HIV, JAMA, Kaiser Permanente, Merck / 13.07.2017

MedicalResearch.com Interview with: Maryam M. Asgari, MD, MPH Department of Dermatology Massachusetts General Hospital, Department of Population Medicine Harvard Medical School, Boston, Massachusetts Division of Research, Kaiser Permanente Northern California, Oakland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nonmelanoma skin cancer – defined as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) – is a common malignant condition, affecting more than 2 million Americans every year. BCCs are more common than SCCs among individuals with healthy immune systems, while SCCs are more predominate than BCCs among people who are immunocompromised. We examined how laboratory markers used to evaluate HIV disease progression may be associated with subsequent nonmelanoma skin cancer risk in white patients previously diagnosed with at least one such cancer from 1996 to 2008.  We measured CD4 count, viral load and subsequent nonmelanoma skin cancer. The study included 455 participants with HIV and 1,952 without HIV. All were members of the Kaiser Permanente Northern California health care plan. (more…)
Author Interviews, Colon Cancer / 13.07.2017

MedicalResearch.com Interview with: Dr.Yi Xu PhD Center for Infectious and Inflammatory Diseases Institute of Biosciences and Technology Department of Microbiology and Microbial Genetics, University of Texas Health Science Center Texas A&M Health Science Center College Station, Texas MedicalResearch.com: What is the background for this study? Response: Colorectal cancer is fairly treatable when caught early with regular screenings, but it is still the second-leading cause of cancer-related deaths in American men and the third-leading cause in women. Researchers at Texas A&M have found that a subspecies of the bacterium Streptococcus gallolyticus appears to actively promote the development of colorectal cancer, which could lead to potential treatment strategies. Their findings are published in the journal PLOS Pathogens. Scientists have known for some time that people infected with S. gallolyticus are more likely to have colorectal cancer. “This association was well established in the clinical literature,” said Yi Xu, PhD, associate professor at the Texas A&M Institute of Biosciences and Technology and principal investigator of the study. However, it was unclear if that relationship was cause or effect—that the bacteria promote cancer development—or if S. gallolyticus simply grows easily in the environment that the tumor cells provide.  (more…)
Author Interviews, NEJM, Prostate Cancer / 13.07.2017

MedicalResearch.com Interview with: Dr. Timothy Wilt, MD MPH Core Investigator: Minneapolis VA Center for Chronic Disease Outcomes Research Staff Physician: Section of General Internal Medicine, Minneapolis VA Health Care System Professor: Medicine, University of Minnesota School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prostate cancer is common and potentially serious. However, the comparative benefits and harms of surgery versus observation in men with localized prostate cancer are not known. After nearly 20 years, surgery did not significantly reduce all-cause or prostate cancer mortality compared to observation, particularly in men with low risk disease. Surgery was associated with more harms than observation, causing complications within 30 days in about 20% of men and large long term increases in urinary incontinence, sexual dysfunction and dissatisfaction, as well as treatment related bother and reductions in daily functioning. (more…)
AACR, Abuse and Neglect, Boehringer Ingelheim, Cancer Research / 11.07.2017

MedicalResearch.com Interview with: Dr. Jordi Bruix, MD Professor of Medicine University of Barcelona Director of the Barcelona Clinic Liver Cancer (BCLC) Group Liver Unit Hospital Clinic of Barcelona MedicalResearch.com: What is the background for this study? What are the main findings? Response: The RESORCE Phase III pivotal trial is an international, multicenter, placebo-controlled trial which investigated the efficacy of Stivarga (regorafenib) in adults with Child-Pugh A and Barcelona Clinic Liver Cancer Stage Category B or C hepatocellular carcinoma (HCC) who had documented disease progression following first-line treatment with Nexavar (sorafenib). Trial participants were administered a daily oral 160mg dose (three weeks on/ one week off) of regorafenib plus best supportive care (BSC), or placebo plus BSC. Results from the trial demonstrated that participants treated with regorafenib experienced a statistically significant and clinically meaningful improvement in the study’s primary endpoint—overall survival (OS). Participants treated with regorafenib demonstrated a median overall survival of 10.6 months vs. 7.8 months with placebo. At ASCO 2017, an exploratory analysis evaluated the impact of baseline alpha-fetoprotein (AFP) and c-Met as predictors of poor prognosis in patients enrolled in the RESORCE trial (Abstract #4078). (more…)
Author Interviews, BMC, Prostate Cancer, Race/Ethnic Diversity, Weight Research / 11.07.2017

MedicalResearch.com Interview with: Aurora Perez-Cornago, PhD Cancer Epidemiology Unit Nuffield Department of Population Health University of Oxford MedicalResearch.com: What is the background for this study? What are the main findings? Response: Greater height and adiposity have been suggested as possible prostate cancer risk factors, but these associations are not clear, probably because most previous studies have not looked separately at different tumour subtypes. For this reason, we wanted to look at these associations splitting tumours into subtypes according to tumour stage and histological grade, looking as well at death from prostate cancer. We found a marked difference in risks looking at low and high risk tumours. Taller men and men with greater adiposity had an elevated of high-grade prostate cancer and prostate cancer death. (more…)
Author Interviews, Cancer Research, CDC / 07.07.2017

MedicalResearch.com Interview with: Lisa C. Richardson, MD, MPH, Oncologist Director,Division of Cancer Prevention and Control CDC MedicalResearch.com: What is the background for this study? Response: This MMWR report is the first complete description of cancer incidence and mortality comparing rural and urban America.  From previous reports we know that rural residents are more likely to be older, have more comorbid conditions and participate in high risk behaviors that can lead to cancer. CDC researchers were interested in how these factors were related to new cancers and cancer deaths in rural counties compared to metropolitan counties. Researchers found that rates of new cases for lung cancer, colorectal cancer, and cervical cancer were higher in rural America. In contrast, rural areas were found to have lower rates of new cancers of the female breast, and prostate. Rural counties had higher death rates from lung, colorectal, prostate, and cervical cancers. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Dermatology, JAMA / 07.07.2017

MedicalResearch.com Interview with: Dr. Chrysalyne D. Schmults, MD, MSCE Associate Professor of Dermatology, Harvard Medical School Director, Mohs and Dermatologic Surgery Center and Mr. Pritesh S. Karia, MPH Department of Epidemiology Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland Department of Dermatology Brigham and Women's Faulkner Hospital Harvard Medical School, Boston, Massachusetts Jamaica Plain, MA 02130-3446  MedicalResearch.com: What is the background for this study? Response: Perineural nerve invasion (PNI) is a well-recognized risk factor for poor prognosis in patients with cutaneous squamous cell carcinoma (CSCC). Most cases of CSCC with PNI are identified on histologic examination at the time of surgery and the patient has no clinical symptoms or radiologic evidence of PNI. These cases are classified as incidental PNI (IPNI). However, some patients with PNI present with clinical symptoms and/or radiologic evidence of PNI. These cases are classified as clinical PNI (CPNI). A few studies have shown differences in disease-related outcomes between CSCC patients with IPNI and CPNI but consensus regarding adjuvant treatment and detailed guidelines on follow-up schedules have not yet materialized. (more…)
Author Interviews, Cancer Research, Dermatology, JAMA, University of Pennsylvania / 06.07.2017

MedicalResearch.com Interview with: Mackenzie R. Wehner, MD, MPhil Department of Dermatology University of Pennsylvania Philadelphia, PA MedicalResearch.com: What is the background for this study? Response: For some diseases, we have national registries, in which information about every person with that disease is entered for research purposes. For other diseases, unfortunately, we do not have such registries. There are growing opportunities to use information like internet searches to better understand behaviors and diseases, however. Our study was a proof-of-concept: we aimed to find out whether internet searches for diseases correlated with known incidence (how many people are diagnosed with the disease) and mortality (how many people die of the disease) rates. E.g. does the number of people who searched 'lung cancer' online correlate with the number of people who we know were diagnosed with or who died of lung cancer during that same time period? This is important to know if researchers in the future want to use internet search data for diseases where we lack registry information. (more…)
Author Interviews, Prostate Cancer, Race/Ethnic Diversity / 06.07.2017

MedicalResearch.com Interview with: Dr. Norman Lee PhD Professor of Pharmacology and Physiology School of Medicine and Health Sciences George Washington University MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are health disparities when it comes to prostate cancer. The African American population, in general, has a higher prostate cancer incidence and mortality rate compared to other racial groups such as European Americans. A major reason for this disparity is due to socioeconomic factors such as access to health care. There are also biological influences for the disparities, such as specific gene mutations and genetic polymorphisms that are found at a higher incidence in the African American population. My lab has been studying other potential contributing biological factors in prostate cancer disparities; namely, RNA splicing. RNA splicing is a cellular program that increases the diversity of expressed proteins by regulating which exons are included in an mRNA transcript, leading to mRNA variants encoding slightly different proteins (or isoforms) in different cells, organs, and individuals. One can think of RNA splicing as a form of genetic diversity. What we have found is that the repertoire of mRNA variants can differ in prostate cancer between African and European Americans. We also find that the mRNA variants in African American prostate cancer encode signal transduction proteins that are more oncogenic and resistant to targeted therapies, compared to the variants found in European American prostate cancer. (more…)
Author Interviews, Cancer Research, Melatonin, Occupational Health / 28.06.2017

MedicalResearch.com Interview with: Parveen Bhatti, PhD Associate Member Fred Hutchinson Cancer Research Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Evidence in humans for an association between shift work and cancer has been mixed. This may be due to difficulties in accurately assessing long-term exposures to shift work in studies of cancer risk. We took a different approach that circumvented these difficulties. Rather than look at cancer risk directly, we measured, among actively employed shift workers, a marker of DNA damage that has been linked to cancer. When repaired by cellular machinery, this particular marker is excreted in urine where it can be measured. We found that, compared to sleeping at night during their night off, shift workers had lower urinary levels of the DNA damage marker during their night work. This effect appears to be driven by reductions in circulating melatonin levels among shift workers during night work relative to night sleep. Given that melatonin has been shown to enhance repair of DNA damage, our results suggest that, during night work, shift workers have reduced ability to repair DNA damage resulting in lower levels being excreted in their urine. Because of this, shift workers likely have higher levels of DNA damage remaining in their cells, which can lead to mutations and cause cancer. (more…)
Author Interviews, Cancer Research / 24.06.2017

MedicalResearch.com Interview with: Dr. Ajai Chari, MD Associate Professor of Medicine Multiple Myeloma Program and Associate Director of Clinical Research Mount Sinai Hospital, New York MedicalResearch.com: What is the background for this study? Would you briefly explain multiple myeloma (How common is it, whom does it chiefly affect, etc.)? Response: Multiple myeloma is a rare form of blood cancer that occurs when plasma cells grow uncontrollably in the bone marrow. It is estimated that approximately 30,280 people will be diagnosed and 12,590 will die from the disease in the United States in 2017. While some patients with multiple myeloma have no symptoms at all, symptoms can include bone fracture or pain, low red blood counts, fatigue, calcium elevation, kidney problems or infections. Despite tremendous progress, most patients with multiple myeloma continually relapse or become resistant to available therapies, such as proteasome inhibitors (PIs) and immunomodulatory agents. Therefore, these patients continue to need new options. The MMY1001 (EQUULEUS) study is a Phase 1b, open-label study assessing daratumumab in combination with multiple backbone regimens for multiple myeloma. In one arm of the study, supporting the recent approval of DARZALEX (daratumumab), the treatment was assessed in combination with pomalidomide and dexamethasone in patients with multiple myeloma who had received a prior PI and an immunomodulatory agent. Data from the study showed that the addition of daratumumab resulted in an overall response rate (ORR) of 59.2 percent (95 percent CI: 49.1 percent, 68.8 percent), with very good partial response (VGPR) achieved in 28.2 percent of patients. Complete response (CR) was achieved in 5.8 percent of patients and stringent CR (sCR) was achieved in 7.8 percent of patients. (more…)
Author Interviews, Cancer Research, Genetic Research / 22.06.2017

MedicalResearch.com Interview with: Antonis Antoniou PhD Reader in Cancer Risk Prediction Academic Course Director MPhil in Epidemiology Centre for Cancer Genetic Epidemiology Department of Public Health and Primary Care Strangeways Research Laboratory Cambridge University of Cambridge MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several studies demonstrated that women with genetic faults in the BRCA1 and BRCA2 genes are at increased risk of developing breast and ovarian cancer. Having accurate age-specific cancer risk estimates for women with mutations is essential for their optimal clinical management. Most studies to date that estimated cancer risks for BRCA1 and BRCA2 mutation carriers have been "retrospective", in other words they look at what happened in the past. Estimates from such studies are prone to biases because they rely on the experience of women who have already developed cancer and on self-reported cancer family history information on relatives - which may have inaccuracies. The ideal epidemiological study design for estimating cancer risks are prospective studies.  In prospective studies, healthy women with genetic faults are followed over time and overcome these potential biases. However, to date, published  prospective studies have been very small. In the present study we used data from a prospective cohort of women with BRCA1 and BRCA2 mutations who were recruited from 1997 to 2011 and were followed over time. The study included almost 10,000 women who were included in the analyses, and was made possible through collaborations between scientists from Europe, North America and Australia.  The prospective study design explains why it has taken 20 years of hard work to get these results. Most importantly, it took an enormous long-term contribution and commitment from the women themselves to allow the scientists to be able to assemble this dataset. Here, we were able to estimate more precisely the breast and ovarian cancer risks for women with faults in BRCA1 and BRCA2.  These risk estimates will provide more confidence in the counseling and clinical management of women with faults in the BRCA1 and BRCA2  genes. A novel finding in this study is that breast cancer risk for women with faults in BRCA1 and BRCA2  increases rapidly at a young age then remains at a constant high level for the rest of their lives. It peaks in the 40’s for BRCA1 mutation carriers and in the 50’s for BRCA2 carriers, but  carriers of mutations in both genes  are at about the same high risk in later life. This is important information to inform the clinical management of older mutation carriers. This study also shows clearly that for women with a mutation, there are other factors that are important in modifying the breast cancer risk. The study has demonstrated that the extent of the woman’ family history of cancer and the exact place on the gene where her mutation is located are very important in determining the actual risk. (more…)