Author Interviews, Cancer Research, Lung Cancer / 03.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37310" align="alignleft" width="180"]Dr. Sunitha Nagrath, PhD Associate Professor, Chemical Engineering University of Michigan Dr. Nagrath[/caption] Dr. Sunitha Nagrath, PhD Associate Professor, Chemical Engineering University of Michigan  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Lung cancer is leading cause of cancer-related mortality, and detecting it in earlier stages is crucial to improving outcomes for patients. The motivation for this study lies in understanding the phenotypic and genetic make-up of lung cancer during its early stages, using a blood sample (blood biopsy). We have done this by employing a microfluidic device to capture cancer cells circulating in the blood that is obtained from the peripheral veins and the pulmonary vein (a vein next to the tumor itself) from patients with early stage lung cancers. The idea behind using blood from the pulmonary vein was to obtain a richer yield of these circulating tumor cells, which are rare in the blood. Through this study, we found that the pulmonary vein does yield a much higher quantity of circulating tumor cells, and also often harbors these cells in large clusters. We further went on to study the significance of these clusters, and found that these clusters indicated aggressive traits such as resistance to treatment, and could also potentially suggest poorer patient outcomes at long term.
Author Interviews, JAMA, Lung Cancer / 03.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37287" align="alignleft" width="120"]Raymond U. Osarogiagbon, MBBS, FACP Translational Lung Cancer Research Multidisciplinary Thoracic Oncology Program Baptist Centers for Cancer Care Memphis, TN Dr. Osarogiagbon[/caption] Raymond U. Osarogiagbon, MBBS, FACP Translational Lung Cancer Research Multidisciplinary Thoracic Oncology Program Baptist Centers for Cancer Care Memphis, TN  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Most long-term survivors of lung cancer are among the patients who were fortunate enough to be identified early enough to undergo curative-intent surgery. In the US, 60,000 individuals undergo curative-intent surgery for lung cancer every year. This number is likely to increase over the next few years as lung cancer screening becomes more widely adopted. Unfortunately, fewer than 50% of patients who undergo curative-intent surgery actually survive up to 5 years. We show that the quality of surgery, especially the quality of pathologic nodal staging is a powerful driver of survival differences between groups of patients. In general, pathologic nodal staging (important as it is stratifying patients into risk groups so those at high risk can be offered additional treatments to increase the chances of cure while those at truly low risk can be left alone without exposure to cost and side-effects of additional treatments) is very poorly done. We show how the percentage of patients whose pathologic staging met sequentially more stringently-define thoroughness of staging metrics falls off sharply, while the survival sequentially increases.
Author Interviews, Cancer Research, JAMA, Lung Cancer, Radiation Therapy / 02.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37256" align="alignleft" width="97"]Florence K Keane MD Resident, Radiation Oncology Harvard Radiation Oncology Program Boston, Massachusetts Dr. Keane[/caption] Florence K Keane MD Resident, Radiation Oncology Harvard Radiation Oncology Program Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: Checkpoint inhibitors (CPIs) have recently transformed the management of patients with metastatic lung cancer, demonstrating significant improvements in overall and progression-free survival in both the first-line setting in patients with increased expression of PD-L1 (≥50%) and in patients with previously treated NSCLC who have progressed on chemotherapy. CPIs are also moving into the treatment of patients with localized lung cancer, with the recently published PACIFIC trial demonstrating a significant improvement in progression-free survival in patients with inoperable stage III NSCLC treated with adjuvant durvalumab after definitive chemoradiotherapy. However, CPIs are associated with unique toxicities as compared to cytotoxic chemotherapy, including pulmonary, endocrine, neurologic, gastrointestinal, and dermatologic adverse events, which may be fatal in some cases. The risk of autoimmune pneumonitis with checkpoint inhibitors is estimated to be on the order of 5%. Many patients with lung cancer will require radiotherapy for palliation of symptoms. Thoracic radiotherapy (TRT) is also a risk factor for pneumonitis, with a dose- and volume-dependent impact on risk. However, it is unknown whether treatment with CPIs and TRT is associated with increased risk of toxicity.
Author Interviews, Cancer Research, Cannabis / 27.09.2017

MedicalResearch.com Interview with: [caption id="attachment_18486" align="alignleft" width="200"]Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC Marijuana plant (Cannabis sativa)[/caption] Jiries Meehan-Atrash Department of Chemistry, Portland State University Portland, Oregon MedicalResearch.com: What is the background for this study? What are the main findings? Response: The need for this study stems from the rising popularity of cannabis, and specifically the fact that many consumers are under the belief that vaporizing extracts thereof is safer than smoking. While this may in fact have some truth to it, it is clear that we must assess the safety of vaporization a route of administration. The main findings are that vaporizing terpenes under dabbing conditions generates some levels of methacrolein (a noxious irritant) at all temperatures that are hot enough to vaporize cannabinoids, but significant levels arise at higher temperatures that are more commonly used. To do this, you'll need to make sure your dab rig is in excellent condition. At the highest temperature used by consumers, significant levels of benzene arise, a compound that is a potent carcinogen and should be avoided at all costs.
Author Interviews, Prostate Cancer, Radiation Therapy / 26.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37181" align="alignleft" width="108"]Dr. Shuang George Zhao, MD House Officer, Radiation Oncology University Hospital Ann Arbor, MI 48109-5010 Dr. Zhao[/caption] Dr. Shuang George Zhao, MD House Officer, Radiation Oncology University Hospital Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? Response: Targeting cancer through the immune system has been a longstanding goal of cancer research, and with recent advances in immunotherapy, it is now a reality. However, the role of immunotherapy in prostate cancer is still being defined. Sipuleucel-T was the first FDA approved immunotherapy in prostate cancer, and is a personalized cellular therapy that has been shown to prolong survival in patients with metastatic prostate cancer. On the other hand, two recent phase III randomized trials looking at ipilimumab, a CTLA-4 checkpoint inhibitor in metastatic prostate cancer have both been negative for their primary endpoint of OS. Interestingly, there was a PSA response, suggesting that there may be some therapeutic effect in a subset of patients. Therefore, understanding the immune infiltrate is likely critical to selecting patients and therapeutic strategies utilizing the immune system. Unfortunately, it is difficult and laborious to histologically assess immune infiltrate directly. Therefore, we used existing high throughput transcriptomic data with new computational methods in order to more fully characterize the immune landscape of localized prostate cancer.
Author Interviews, Breast Cancer / 23.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37125" align="alignleft" width="125"]Rebekah Nagler PhD Assistant professor Hubbard School of Journalism and Mass Communication University of Minnesota Dr. Nagler[/caption] Rebekah Nagler PhD Assistant professor Hubbard School of Journalism and Mass Communication University of Minnesota  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Both the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF) have stated that women in their 40s--or, in the case of ACS, women ages 40-44--should have the choice to decide when they want to start screening for breast cancer. These organizations recommend that women in this age group weigh the benefits and risks of mammography screening, with the goal of making an informed decision about when to start screening. Yet recent research has shown that women are more aware of the benefits of mammography screening than the harms, including overdiagnosis and overtreatment (doi:10.1001/jamainternmed.2017.2247). We therefore wondered whether women actually have the information they need to make informed screening decisions. In a population-based sample of 429 U.S. women ages 35-55, we found that awareness of breast cancer overdiagnosis (16.5%) and overtreatment (18.0%) was low. Moreover, we found that most women did not find statements about these harms to be believable and persuasive.
Author Interviews, JAMA, Leukemia, Transplantation / 19.09.2017

MedicalResearch.com Interview with: Huisheng Ai, MD, Director Department of Hematology and Transplantation, Affiliated Hospital of the Academy  of Military Medical Sciences, Beijing, China  MedicalResearch.com: Which of these results did you find most interesting or surprising? Response: First, we must stress that microtransplant dramatically improved the outcome of older patients with AML. As we know, older AML patients often possess unfavorable prognostic factors, organ dysfunction, and slow post-chemotherapy hematopoietic recovery. Therefore, the general treatment outcome is unsatisfactory even though the incidence is increasing by age with low complete remission (CR) rates (34% to 65%) and poor short-term survival (Two years overall survival was about 11% to 25%). This study involved cases from multiple centers of China, USA and Spain, and found that microtransplant could not only significantly improve complete remission rate in older AML patients among all age groups from 60 to 85, but also improve 1-year and 2-year overall survival and disease free survival especially in patients aged 60 to 75. Second, microtransplant completely overcomes the restriction of HLA typing. The donor could be the patient’s haploidentical family member, or unrelated and fully mismatched one. The incidence of graft-versus-host disease (GVHD) was only 1.1%, even if no any GVHD prevention was given. Other treatment related complications and mortality were also decreased. These results are much better than those of traditional chemotherapy, myeloablative and non-myeloablative transplant, which provides a more safe and effective treatment choice. We are looking forward to seeing the revision of NCCN guideline for older AML to make microtransplant benefit more older patients.
Author Interviews, Cancer Research, Stroke / 15.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37007" align="alignleft" width="116"]Jacobo Rogado Dr. Rogado[/caption] Dr Jacobo Rogado Medical oncology fellow Hospital de La Princesa Madrid, Spain MedicalResearch.com: What is the background for this study? Response: Some publications have suggested that there is an association between stroke and the subsequent diagnosis of cancer, although others have not confirmed this. We have addressed this issue with a study conducted at our hospital during two years. We studied a population of about 1000 patients with stroke. We evaluated the incidence of cancer in this population during the follow-up of 18 months, as well as whether there were factors associated with its occurrence.
Author Interviews, Cancer Research / 14.09.2017

MedicalResearch.com Interview with: [caption id="attachment_36969" align="alignleft" width="120"]Ezra Cohen, MD Associate Director, Moores Cancer Center Professor of Medicine Moores Cancer Center UC San Diego Health - La Jolla Moores Cancer Center La Jolla, CA  92093 Dr. Cohen[/caption] Ezra Cohen, MD Associate Director, Moores Cancer Center Professor of Medicine Moores Cancer Center UC San Diego Health - La Jolla Moores Cancer Center La Jolla, CA  92093 MedicalResearch.com: What is the background for this study? Response: We have known for a couple of years that anti-PD1 therapy, and specifically pembrolizumab, is active in  head and neck squamous cell carcinoma (HNSCC). The KN40 trial now tested pembrolizuamb against standard of care in patients whose cancers progressed on platinum containing regimens. MedicalResearch.com: What are the main findings? Response: The main findings really supported what we know about pembrolizumab in this disease - it is active and effective with a favorable side effect profile. Pembrolizumab reduced the risk of death by 19% and was associated with a 14% response rate. The effect was even greater in tumors that expressed PDL1 and, in the highest expressing group, the benefit in reduction of risk of death was 46% with a 27% response rate.
Author Interviews, Melanoma, NEJM / 14.09.2017

MedicalResearch.com Interview with: [caption id="attachment_36963" align="alignleft" width="116"]Dr Alexander Menzies BSc(Med) MBBS (Hons) FRACP PhD Medical Oncologist and Senior Research Fellow at Melanoma Institute Australia The University of Sydney and Royal North Shore and Mater Hospital  Dr. Menzies[/caption] Dr Alexander Menzies BSc(Med) MBBS (Hons) FRACP PhD Medical Oncologist and Senior Research Fellow at Melanoma Institute Australia The University of Sydney and Royal North Shore and Mater Hospital  MedicalResearch.com: What is the background for this study? Response: For early-stage melanoma, surgical resection is the standard treatment and is associated with an excellent long-term prognosis. However until now, Stage III melanoma patients (where the disease has spread to the lymph nodes) who have had their tumours surgically removed have simply had to play the waiting game to see if their melanoma would metastasise, with many ultimately dying of the disease. Checkpoint inhibitor immunotherapies and drugs that target the mitogen-activated protein kinase (MAPK) pathway have improved the outcome of patients with metastatic melanoma, but their role as adjuvant therapy is still being actively investigated. Prior Phase III trials (COMBI-D and COMBI-V) have shown improved overall survival in patients with unresectable or metastatic melanoma with BRAF V600E or V600K mutations. At Melanoma Institute Australia, we were keen to see if this improvement would be seen in the adjuvant setting also. This clinical trial was the first in the world to give targeted therapy to melanoma patients at an earlier stage of the disease to prevent spread and recurrence.
Author Interviews, Melanoma, NYU / 13.09.2017

MedicalResearch.com Interview with: [caption id="attachment_36922" align="alignleft" width="108"]Jeffrey Weber, M.D., Ph.D Laura and Isaac Perlmutter Cancer Center New York University Langone Medical Center New York, NY 10016 Dr. Weber[/caption] Jeffrey Weber, M.D., Ph.D Laura and Isaac Perlmutter Cancer Center New York University Langone Medical Center New York, NY 10016  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a major unmet need for well tolerated and effective adjuvant therapy for high risk melanoma, that is, melanoma that has been removed but the patients have a 50%+ risk of relapse over 5 years, and a 50%+ risk of death over 10 years from melanoma. Since nivolumab is an active and well tolerated drug in metastatic disease, it seemed reasonable to test it after surgery to prevent recurrence. Since ipilimumab is approved for resected stage III melanoma in the US as adjuvant therapy, that was the control arm for comparison, and that is an active control, which prolongs relapse free and overall survival comared to placebo.
Author Interviews, Cancer Research, Dermatology, JAMA, Surgical Research / 11.09.2017

MedicalResearch.com Interview with: Matthew Q. Miller, MD Department of Otolaryngology–Head and Neck Surgery University of Virginia Health System, Charlottesville  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Skin cancer is the most common type of cancer worldwide. In the United States, 3.3 million people are diagnosed with a new skin cancer annually and many of these individuals will have more than one cancer. The face is the most common place for skin cancers to develop. Mohs micrographic surgery (often referred to as Mohs surgery) is the standard of care for some skin cancers on the face. Once the cancer is removed, the skin defect is usually repaired by the Mohs surgeon but many require referral to a reconstructive surgeon. We were intrigued by a recent publication that noted an increased risk in complications when repair of Mohs defects is delayed beyond 2 days. While most patients that will require referral for reconstruction can be predicted and scheduled accordingly in concert with the Mohs surgery, it is not infrequent that a Mohs procedure requires multiple, unexpected passes to excise the entire cancer and the patient is then left with an unexpectedly large defect requiring reconstruction. These large defects often require more OR time and planning and, therefore, reconstruction cannot be easily completed within 2 days of the Mohs procedure.
Author Interviews, Genetic Research, Melanoma / 08.09.2017

MedicalResearch.com Interview with: [caption id="attachment_36856" align="alignleft" width="120"]Rutao Cui, MD/PhD Professor  Vice Chair for Laboratory Administration  Director, Laboratory of Melanoma Biology Department of Pharmacology and Experimental Therapeutics Professor of Dermatology Boston University Boston, Mass 02118 Dr. Cui[/caption] Rutao Cui, MD/PhD Professor Vice Chair for Laboratory Administration Director, Laboratory of Melanoma Biology Department of Pharmacology and Experimental Therapeutics Professor of Dermatology Boston University Boston, Mass 02118 MedicalResearch.com: What is the background for this study? Response: Red-headed people are making up to 1~2% of the world’s population. They carry “red hair color” variants of MC1R (MC1R-RHC) which are responsible for their characteristic features, including red hair, pale skin, freckles and poor tanning ability. MC1R-RHC also increases risk of melanoma, the deadliest form of skin cancer. People without red hair but with a single copy of MC1R-RHC also have an increased melanoma risk, who may make more than 50% of the northern European population. It is unknown why redheads are more prone to melanoma, and whether the activity of red hair color variants could be restored for therapeutic benefits.
Author Interviews, Breast Cancer / 08.09.2017

MedicalResearch.com Interview with: [caption id="attachment_36844" align="alignleft" width="80"]Wolfgang Janni, MD, PhD University of Ulm MONALEESA-2 investigator Dr. Janni[/caption] Wolfgang Janni, MD, PhD University of Ulm MONALEESA-2 investigator MedicalResearch.com: What is the background for the MONALEESA-2 trial? What are the main findings? Response: The Phase III MONALEESA-2 trial was the primary study that supported the recent European approval of Kisqali (ribociclib). Findings from the study showed superior efficacy and demonstrated safety of Kisqali plus letrozole compared to letrozole alone in postmenopausal women with hormone receptor positive, human epidermal growth factor receptor-2 negative (HR+/HER2-) locally advanced or metastatic breast cancer who received no prior therapy for their advanced breast cancer. The trial showed Kisqali plus letrozole reduced the risk of progression or death by 43% versus letrozole alone. At a pre-planned analysis, Kisqali plus letrozole demonstrated a median progression-free survival (PFS) of 25.3 months compared to 16.0 months for letrozole alone (HR=0.568 (95% CI: 0.457-0.704; p<0.0001)). More than half of patients (55%) with measurable disease taking Kisqali plus letrozole experienced a tumor reduction of at least 30%. Finally, Kisqali plus letrozole demonstrated rapid clinical improvement in patients with measurable disease, with 76% seeing a reduction in tumor size after only eight weeks versus 67% with letrozole alone. Most side effects in the MONALEESA-2 trial were mild to moderate in severity, identified early through routine monitoring, and generally managed through dose interruption and/or reduction. The most common grade 3/4 adverse events (reported at a frequency ≥5%) for Kisqali plus letrozole compared to letrozole alone were neutropenia (60% vs 1%, respectively), leukopenia (21% vs 1%), hypertension (10% vs. 11%), increased alanine aminotransferase level (9% vs. 1%), lymphopenia (7% vs. 1%) and increased aspartate aminotransferase level (6% vs. 1%).
Author Interviews, Brain Cancer - Brain Tumors, Zika / 07.09.2017

MedicalResearch.com Interview with: [caption id="attachment_36827" align="alignleft" width="156"]Milan G. Chheda, MD Assistant Professor  Department of Medicine  Oncology Division  Molecular Oncology  Department of Neurology Washington University School of Medicine in St. Louis Dr. Chheda[/caption] Milan G. Chheda, MD Assistant Professor Department of Medicine Oncology Division Molecular Oncology Department of Neurology Washington University School of Medicine in St. Louis MedicalResearch.com: What is the background for this study? What are the main findings? Response: Glioblastoma is an extremely aggressive brain tumor. Most patients die in less than two years. A longstanding challenge has been killing tumor cells that are inherently resistant to our current therapies (radiation and chemotherapy). These cells, called cancer stem cells, are extremely hardy. A longstanding dream of oncologists has been to devise a way to find them and kill them. The public health epidemic in 2015 made Zhe Zhu, post-doctoral fellow in Jeremy Rich’s lab, wonder whether Zika virus could work on cancer stem cells, that share properties with stem cells in fetal brain. Zika virus doesn’t cause significant problems in adults. We took a lesson from nature and tested Zika virus.
Author Interviews, Cancer Research, JAMA / 07.09.2017

MedicalResearch.com Interview with: [caption id="attachment_36799" align="alignleft" width="140"]Elias Jabbour, MD Associate Professor Leukemia Department MD Anderson Cancer Center Dr. Jabbour[/caption] Elias Jabbour, MD Associate Professor Leukemia Department MD Anderson Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Inotuzumab is active in relapsed or refractory (R/R) acute lymphoblastic leukemia  (R/R ALL). The addition of low intensity chemotherapy may further improve outcome. ORR around 80%. Median survival 11 months. Better results obtained in Savage 1. Superior outcome when compared to historical cohort treated with inotuzumab monotherapy
Author Interviews, Dermatology, Melanoma / 06.09.2017

MedicalResearch.com Interview with: [caption id="attachment_36780" align="alignleft" width="200"]Riccardo Pampena MD and Caterina Longo, MD, PhD Dermatology Unit University of Modena and Reggio Emilia Arcispedale Santa Maria Nuova-IRCCS Reggio Emilia Italy Mole or Nevus
Wikipedia[/caption] Riccardo Pampena MD and Caterina Longo, MD, PhD Dermatology Unit University of Modena and Reggio Emilia Arcispedale Santa Maria Nuova-IRCCS Reggio Emilia Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: High heterogeneity has been reported in previous studies on the ratio of melanoma associated with moles (nevus-associated melanomas). Despite this heterogeneity, researchers agree that some melanomas may develop in conjunction with a pre-existing mole. We know that nevus-associated melanomas are usually located on the trunk and more frequently occur in younger patients than de novo melanomas (not nevus-associated). Defining the risk for a melanoma to arise in association with a pre-existing mole is important in order to define the best strategies for early melanoma diagnosis. The main finding of our study is that only one third of melanomas arose from a pre-existing mole, in fact the majority were de novo. We also found that nevus-associated melanomas were less aggressive than de novo.
Author Interviews, Cancer Research, HIV, JAMA / 29.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36694" align="alignleft" width="133"]Fahad Mukhtar MD MPH Department of Epidemiology and Biostatistics College of Public Health University of South Florida, Tampa Dr. Mukhtar[/caption] Fahad Mukhtar MD MPH Department of Epidemiology and Biostatistics College of Public Health University of South Florida, Tampa MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies done in the 80s and 90s showed that patients with Kaposi sarcoma may be at risk of having secondary tumors. As a result of changes that have taken place in the demographics of patients affected with HIV/AIDS as well as Kaposi’s sarcoma, we hypothesized that tumors that follow Kaposi sarcoma might have also changed. We analyzed the incidence of second tumors developing after Kaposi sarcoma using the Surveillance Epidemiology and End Result (SEER) data. Our result indicated that the incidence of secondary tumors following Kaposi sarcoma have decreased after the emergence of antiretroviral therapy. However, we observed a significantly higher than expected number of cancer of the anus, liver, tongue, penis lymphomas, and acute lymphocytic leukemia developing in patients with Kaposi sarcoma in the era of antiretroviral therapy.
Author Interviews, Cancer Research, Cost of Health Care, HPV, University Texas / 25.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36569" align="alignleft" width="153"]David R. Lairson, PhD Professor of Health Economics Division of Management Policy and Community Health Co-Director, Center for Health Services Research School of Public Health The University of Texas Health Science Center at Houston (UTHealth) Dr. Lairson[/caption] David R. Lairson, PhD Professor of health economics Department of Management, Policy, and Community Health The University of Texas Health Science Center at Houston (UTHealth) School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study of oropharyngeal cancer treatment cost was initiated by the Head and Neck Cancer Surgery Department at the University of Texas MD Anderson Cancer Center as part of a larger study of the economic and health consequences of human papillomavirus (HPV) related conditions in Texas.  State specific information is required for policy-makers to consider future investments in cancer prevention based on HPV immunization and cancer screening.  The cost estimates at $140,000 per case for the first two years of treatment are substantially higher than previous estimates.  They indicate the potential savings associated with cancer prevention and partially justify increased investment in immunization efforts.
Author Interviews, Genetic Research, JAMA, Pancreatic, Surgical Research / 25.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36633" align="alignleft" width="105"]Nancy You, MD, MHSc, FACS Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Dr. You[/caption] Nancy You, MD, MHSc, FACS Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston  MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was motivated by the emerging promise of precision medicine and the emerging evidence that immunotherapy may have phenomenal efficacy in particular molecular subtypes of cancers.  This specific molecular subtype shows deficiency in DNA mismatch repair mechanisms and therefore is thought to be more immunogenic.  DNA mismatch repair deficiency can arise from germline defects such as in the case of patients with Lynch Syndrome, an inherited cancer syndrome, or from epigenetic inactivation DNA mismatch repair genes. Overall, pancreas cancer has seen limited success with conventional chemotherapy.  In our study, we demonstrated that there is a particular molecular subtype of pancreas cancer that is characterized by defect in DNA mismatch repair genes and by microsatelie instability that has a different prognosis than other pancreas cancers.  This subtype of pancreas cancer is suspected to also respond to immunotherapy.
Author Interviews, Journal Clinical Oncology, Lung Cancer / 23.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36611" align="alignleft" width="100"]Theodore M. Brasky, PhD Research Assistant Professor The Ohio State University – James Comprehensive Cancer Center Columbus, OH 43201 Dr. Brasky[/caption] 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.
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.
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.
Author Interviews, Cancer Research, CDC / 15.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36464" align="alignleft" width="163"]Mary C. White, ScD MPH Epidemiology and Applied Research Branch Division of Cancer Prevention and Control CDC Atlanta GA 30341 Dr. White[/caption] 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.
Author Interviews, Cancer Research, CMAJ, HPV, Vaccine Studies / 14.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36432" align="alignleft" width="200"]Steven Habbous MSc, PhD candidate Ontario Cancer Institute Scarborough, Ontario, Canada Steven Habbous[/caption] 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.
Author Interviews, Cancer Research, Cost of Health Care, Duke, JAMA / 11.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36369" align="alignleft" width="150"]Dr. Fumiko Chino, MD Duke Radiation Oncology Duke School of Medicine Dr. Chino[/caption] 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.
Author Interviews, Cancer Research, OBGYNE, PLoS / 11.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36421" align="alignleft" width="150"]Jane McElroy, Ph.D. Associate professor Department of Family and Community Medicine MU School of Medicine Dr. McElroy[/caption] 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.
Author Interviews, Cancer, Cancer Research, Opiods / 09.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36364" align="alignleft" width="160"]Rinku Sutradhar, Ph.D. Senior Scientist, Institute for Clinical Evaluative Sciences Associate Professor, Dalla Lana School of Public Health University of Toronto, Canada Dr. Sutradhar[/caption] 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.
Author Interviews, Cancer Research, Colon Cancer, Race/Ethnic Diversity / 08.08.2017

MedicalResearch.com Interview with: [caption id="attachment_31023" align="alignleft" width="175"]Rebecca Siegel, MPH Strategic Director, Surveillance Information Services American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 Rebecca Siegel[/caption] 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.
Author Interviews, BMC, Breast Cancer, Radiation Therapy / 02.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36286" align="alignleft" width="150"]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 Dr.Enderling[/caption] 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.