Author Interviews, Cancer Research, CT Scanning, JAMA, Lung Cancer / 30.01.2017

MedicalResearch.com Interview with: Linda Kinsinger, MD, MPH National Center for Health Promotion and Disease Prevention U.S. Department of Veterans Affairs NW Washington DC 20420 MedicalResearch.com: What is the background for this study?  Response: The U.S. Preventive Services Task Force recommends annual lung cancer screening with low-dose computed tomography (LDCT) for current and former heavy smokers ages 55 to 80. However, clinicians have questioned the practical aspects of implementing lung cancer screening. VA provides care for 6.7 million Veterans each year, mostly older men – many of whom are current or former smokers – thus the implementation of a lung cancer screening program for VA patients would require substantial resources. In order to understand the feasibility and implications of this for patients and clinical staff, VA implemented a three-year Lung Cancer Screening Demonstration Project (LCSDP) in eight geographically-diverse VA hospitals. Investigators identified 93,033 primary care patients at eight sites who were assessed on screening criteria, of whom 2,106 patients were screened between July 2013 and June 2015. (more…)
Author Interviews, Cancer Research, Colon Cancer / 27.01.2017

MedicalResearch.com Interview with: Dr. Mark Prince MD USMD Health System Arlington, TX 76017 MedicalResearch.com: What is the background for this study? Response: This 12-month retrospective study conducted to determine the screening compliance rates for a noninvasive multitarget stool DNA (mt-sDNA) screening test (Cologuard) for colon cancer among a cohort of nearly 400 average-risk Medicare patients who had previously not complied with recommended screening. These were patients who had never had a colonoscopy, had been more than ten years since last colonoscopy, or had been more than one year since last stool testing for occult blood. (more…)
Author Interviews, Electronic Records, Endocrinology, Thyroid, Thyroid Disease / 25.01.2017

MedicalResearch.com Interview with: Ilya Likhterov, MD Assistant Professor, Otolaryngology Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: As our understanding of thyroid cancer improves, the way these patients are diagnosed and treated is changing. It is difficult for clinicians to incorporate every individual scientific study into their practice. These studies are numerous and the results can be conflicting. To address this difficulty, organizations such as the American Thyroid Association (ATA) create summary recommendations that account for the latest research and translate it into a format that is easily usable for physicians. Such clinical practice guidelines are available not just for thyroid cancer care, but in many other fields. The difficulty however, is how to ensure that clinicians have access to the guidelines and incorporate the recommendations into their practice. There are a number of barriers to actually using the guidelines in practice, and we attempt to identify strategies on how to overcome these. (more…)
Author Interviews, Cancer Research, Colon Cancer, JAMA, Surgical Research / 25.01.2017

MedicalResearch.com Interview with: Kangmin Zhu, PhD, MD John P. Murtha Cancer Center, Walter Reed National Military Medical Center Professor at the Uniformed Services University of the Health Sciences in the Department of Preventive Medicine and Biostatistics Bethesda, Maryland MedicalResearch.com: What is the background for this study? Response: An article published on JAMA Surgery in 2015 showed more utilization of chemotherapy among young colon cancer patients.  To demonstrate the study findings, we analyzed the data from the Department of Defense healthcare system, in which all members have the same level of access to medical care and therefore the potential effects of insurance status and types on research results can be reduced. MedicalResearch.com: What are the main findings? Response: The main findings were that young and middle-aged colon cancer patients were 2 to 8 times more likely to receive postoperative chemotherapy and 2.5 times more likely to receive multiagent regimens, compared with their counterparts aged 65 to 75 years.  However, no matched survival benefits were observed for the young and middle-aged among patients who received surgery and postoperative chemotherapy. (more…)
Author Interviews, Cancer Research, Nature / 24.01.2017

MedicalResearch.com Interview with: Dr. Hua Lu MS PhD Department of Biochemistry & Molecular Biology Reynolds and Ryan Families Chair in Translation Cancer Tulane Cancer Center Tulane University School of Medicine New Orleans, Louisiana 70112 MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been well appreciated and acknowledged that p53 is the most important tumor suppressor in human body. However, approximately 50% of human cancers still sustain the wild type form of its gene, and also oddly, some cancers, such as breast cancer, which contain wild type p53, are often less sensitive to chemotherapy than those harbor mutated p53. Although a number of oncoproteins, including MDM2 and MDMX (MDM4), have been shown to be highly expressed and to inactivate p53 in those wild type p53-containing cancers, more molecules need to be discovered to keep p53 in control in order to let cancer cells to proliferate and growth. Our study as described in our recent publication in Nature Communications unveils a new p53 target gene that encodes pleckstrin homology domain-containing protein (PHLDB3) as another p53 inhibitor in a negative feedback fashion. Interestingly and mechanistically, PHLDB3 can work with MDM2 by boosting its E3 ubiquitin ligase activity, consequently leading to degradation of p53. Biologically, PHLDB3 can promote cancer cell proliferation and growth in culture and in xenograft tumor models by in part inactivating p53 activity. More interestingly, PHLDB3 is highly amplified and expressed in a number of human cancers, such as pancreatic, prostate, colon and breast cancers. High expression of PHLDB3 is well correlated with the wild type status of p53 in certain portion of breast cancer. These findings uncover PHLDB3 as another oncoprotein that can promote cancer growth by partially inactivate p53, and thus might serve as a potential target for future development of anti-cancer therapy. Our study also suggests that PHLDB3 has a p53-independent function important for cancer growth. (more…)
Author Interviews, Colon Cancer, Cost of Health Care, Medicare / 23.01.2017

MedicalResearch.com Interview with: Nengliang “Aaron” Yao PhD Assistant professor Department of Public Health Sciences University of Virginia MedicalResearch.com: What is the background for this study? What are the main findings? Response: The ACA made several changes in Medicare that could increase the use of cancer screening and thus lead to more early cancer diagnoses. This includes waiving patient cost-sharing for screening, waiving patient cost-sharing for one wellness visit per year, and paying bonuses to physicians for doing more work in a primary care setting. We studied how effective those changes were in facilitating more early diagnoses of breast and colorectal cancers. We found that the changes had no effect on early breast cancer diagnoses (likely because costs and other access barriers for mammograms were already low), but increased the number of early colorectal cancer diagnoses by 8 percent. (more…)
ASCO, Author Interviews, Brigham & Women's - Harvard, Colon Cancer, Exercise - Fitness / 21.01.2017

MedicalResearch.com Interview with: Brendan John Guercio, M.D. Clinical Fellow in Medicine (EXT) Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sedentary lifestyle is a known risk factor for the development of colon cancer and has been associated with increased disease recurrence and mortality in patients with early stage colorectal cancer. This is the first study to our knowledge to show an association between increased physical activity (i.e. non-sedentary lifestyle) and improved survival and progression-free survival in patients with metastatic colorectal cancer. (more…)
Author Interviews, Lancet, Prostate Cancer / 20.01.2017

MedicalResearch.com Interview with: Dr. Nina Klemann MD, PhD-student Copenhagen Prostate Cancer Center Copenhagen MedicalResearch.com: What is the background for this study? Response: For 30 years, ultrasound-guided biopsies of the prostate have been used in the evaluation of men suspected for prostate cancer. The biopsy needles are employed systematically into the prostate at different sites where prostate cancer is typically present. However, it has been recognized for years, that there is a risk of not hitting the cancer areas, simply by chance. Although cancer diagnosis may be missed in the initial biopsy set by sampling error, it has been a continuous debate whether lethal prostate cancer is missed. Today, we know that prostate cancer is a common finding in men age 50-80, but that the life-time risk of prostate cancer death in this age-group is low. Consequently, we know that there is a considerable risk of diagnosing, and ultimately treating, a disease that will never result in symptoms or death. (more…)
Author Interviews, Cancer Research, Immunotherapy, NEJM, Transplantation / 19.01.2017

MedicalResearch.com Interview with: Kenar D. Jhaveri, MD Professor of Medicine Division of Kidney Diseases and Hypertension Hofstra Northwell School of Medicine, 100 Community Drive, Great Neck, NY 11021 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The immune check point inhibitors are novel anti cancer agents being used rapidly in various cancers. Many cancers don’t allow our natural immune system to attack the cancer. These immunotherapy agents “activate” the immune system to attack the cancer. These agents have been reported to cause multiple end organ side effects as noted by this recent NYT article. We also recently reported the known renal effects of immunotherapy. In the kidney transplant patient who is on immunosuppressive agents, the physicians need to keep the immune system suppressed to preserve the kidney. When one of these agents are used for a cancer in a kidney transplant patient, prior reports have suggested severe rejection episodes and loss of the transplanted kidney. Our case in the NEJM is the first report of a preventive strategy used to allow for simultaneous treatment of cancer and preventive rejection of the kidney. We used a regimen of steroids and sirolimus( an anti-proliferative agent that is used to treat cancer and also is an immunosuppresant) along with the immunotherapy. The cancer started regressing and the kidney did not reject. (more…)
Author Interviews, Biomarkers, Breast Cancer, Cancer Research / 14.01.2017

MedicalResearch.com Interview with: Ulrich Pfeffer, PhD Head of the Functional Genomics lab IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro Genova, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: In recent years our knowledge on genetic variants that are associated with the risk to develop breast cancer has grown substantially. In addition to the two breast cancer genes, BRCA1 and BRCA2 we know approximately 100 other genes that are present in the population in two variants. In the presence of a single of these variants the breast cancer risk is slightly increased and several variants together determine a significant increase in risk. We also know that certain variants are associated with specific subtypes of breast cancer such as the estrogen receptor positive breast cancer. We show in our work for the first time that some of these variants are more frequent in breast cancers that carry a specific somatic, non-inherited, mutation. In particular, we show this for the most frequent somatic mutation in breast cancer, PIK3CA, a gene involved in the control of tumor metabolism and many other aspects, a fundamental gene. The knowledge of this association tells us a lot on cancer biology. But most important, it might help to design specific prevention strategies. Since when you carry a germline allele that is associated with a specific somatic mutation you know your risk of a specific molecular type of breast cancer and eventually you can do something specific to prevent it. (more…)
Author Interviews, Biomarkers, Cancer Research, ENT / 13.01.2017

MedicalResearch.com Interview with: Jacek Majewski PhD Associate Professor Department of Human Genetics McGill University and Genome Quebec Innovation Centre Montreal, Canada  MedicalResearch.com: What is the background for this study? Response: Our lab, in collaboration with Dr. Nada Jabado, has been investigating the molecular genetics of pediatric glioblastoma – a deadly brain cancer. Several years ago, in the majority of our patients’ tumors we discovered mutations in genes that encode histone proteins. Those mutations disrupt the epigenome - that is the way the DNA is modified, silenced, or activated in the cancer cells. It appears that epigenome-modifying mutations are particularly important in pediatric cancers, and our hypothesis is that they act by diverting the normal developmental pathways into unrestrained proliferation. Many other studies have highlighted the significance of epigenome disruption in a number of cancers. (more…)
Author Interviews, Biomarkers, JAMA, Prostate Cancer, Radiation Therapy / 13.01.2017

MedicalResearch.com Interview with: Trevor Royce MD MS Resident, Harvard Radiation Oncology Program MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clinical trials in early prostate cancer take more than a decade to report on. Multiple early reporting endpoints have been proposed, but which one is best, remains unknown, until now. Of all the possible early endpoints examined, to date, how low a PSA blood test falls to, after treatment with radiation and hormonal therapy, appears to be the best, specifically, if the PSA doesn’t get below half a point, that patient is very likely to die of prostate cancer if given standard treatment for recurrence. Those men deserve prompt enrollment on clinical trials in order to properly save their life. (more…)
Annals Internal Medicine, Author Interviews, Breast Cancer, Cancer Research, Prostate Cancer / 13.01.2017

MedicalResearch.com Interview with: Karsten Juhl Jørgensen, MD, Dr. MedSci The Nordic Cochrane Centre Rigshospitalet, Copenhagen  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our systematic Cochrane review of the original randomised breast screening trials showed substantial conflict between their estimates of the benefit. Some trials showed a large benefit, others none or a small benefit. This difference was related to the design of the trials. The most optimistic trials were those with suboptimal randomisation. The main findings of our current study support those of the most rigorously performed randomised trials: breast screening does not fulfill its fundamental premise, which is to reduce the occurrence of late stage disease. This means a mortality reduction is unlikely and that use of less invasive surgery due to breast screening is also unlikely. However, we did find very substantial increases in early stage breast cancer, which persisted over our 17 year observation period. This means that breast screening likely leads to substantial overdiagnosis of breast cancers that would otherwise not have caused health problems during a woman’s lifetime. We estimate that 1 in 3 breast cancers detected in a screened population is likely overdiagnosed. (more…)
Author Interviews, Dermatology, Environmental Risks, Melanoma / 10.01.2017

MedicalResearch.com Interview with: Sophie Seite, Ph. D La Roche-Posay Dermatological Laboratories Asnières, France. MedicalResearch.com: What is the background for this study? What are the main findings? Response: The survey included nearly 20,000 men and women in 23 countries, ages 16-65, and was primarily conducted online. The questionnaire collected data regarding demographics, sun exposure, behaviors regarding prevention and tanning, risk knowledge, self-examination, medical advice seeking, and social attitude. This unprecedented international survey on sun exposure behaviors and skin cancer detection found that there are many imperfections and geographical inequalities in primary and secondary prevention of skin cancer. The study was published in the Journal of the European Academy of Dermatology & Venereology by researchers from La Roche-Posay and the George Washington University (GW) Department of Dermatology. Survey results indicate that 88 percent of those questioned were aware of the risks of developing skin cancer when exposed without protection to the sun. However, just 1 in 2 respondents has ever consulted a dermatologist for a mole screening and 4 in 10 people don’t think to protect themselves from the sun outside of vacation. (more…)
Author Interviews, Cost of Health Care, Prostate Cancer / 10.01.2017

MedicalResearch.com Interview with: Tudor Borza, MD, MS Urologic Oncology and Health Service Research Fellow Department of Urology, University of Michigan MedicalResearch.com: What is the background for this study? Response: Starting in the late 2000’s studies began to identify overdiagnosis and overtreatment in men with prostate cancer. Because of the indolent nature of some prostate cancers many men who ended up diagnosed and treated would have never had any consequences from their prostate cancer. This led national organizations (like the American Urological Association and the National Comprehensive Cancer Network) to call for decreased prostate cancer screening (using the serum PSA test) and eventually led to the US Preventive Services Task Force to recommend against routine PSA screening, citing that the harms from diagnosis and treatment outweighed the harms from the disease. Over the same specialists treating the disease began to report on the safety of surveillance strategies in select men with prostate cancer. Watchful waiting (delaying any treatment until men become symptomatic from their cancer and then offering palliative treatment) was found to be comparable to initial treatment in men with a limited life expectance, either from advanced age or multiple comorbidities. Similarly, active surveillance (a technique employing intense monitoring with PSA testing, digital rectal exams, repeat biopsies and possible use of MRI or other biomarkers) was introduced with the goal of delaying treatment in some men with low risk cancer until the cancer becomes more aggressive and was shown to have similar outcomes to initial treatment in carefully selected men. We wanted to study the trends in initial prostate cancer treatment in this context of recommendations for decreased screening and recognition of the feasibility of surveillance in certain patients with prostate cancer. (more…)
Author Interviews, Breast Cancer, Cancer Research, Colon Cancer, Cost of Health Care, Mammograms, Medical Imaging, Race/Ethnic Diversity, Radiology / 09.01.2017

MedicalResearch.com Interview with: Dr. Gregory Cooper, MD Program Director, Gastroenterology UH Cleveland Medical Center Co-Program Leader for Cancer Prevention and Control, UH Cleveland Medical Center Professor, Medicine, CWRU School of Medicine Co-Program Leader for Cancer Prevention and Control UH Seidman Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Affordable Care Act, among other features, removed out of pocket expenses for approved preventive services, and this may have served as a barrier to cancer screening in socioeconomically disadvantaged individuals. If so, then the gap in screening between socioeconomic groups should narrow following the ACA. The main findings of the study were that although in the pre-ACA era, there were disparities in screening, they narrowed only for mammography and not colonoscopy. (more…)
Author Interviews, Cancer Research / 06.01.2017

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 bottom line for incidence and mortality trends? Response: The bottom line for cancer mortality is that in contrast to many other major causes of death, cancer death rates continue to decline, dropping by 25% from 1991 to 2014. This translates to about 2 million fewer cancer deaths over this time period than would be expected if cancer death rates had remained at their peak. Death rates are the best measure of progress against disease. Cancer incidence rates also dropped in men over the past decade of data, whereas in women they are flat. The drop in men is because of large declines for the top 3 cancers (prostate, lung, and colorectum), which account for more than 40% of cancers diagnosed in men. The stable trend in women is largely because declines in lung and colorectal cancers are offset by a flat trend for both breast and uterine corpus (i.e., endometrial) cancers, which combined account for almost 40% of cases in women, as well as rapid increases for thyroid cancer over the past decade -- increasing by almost 5% annually. Importantly, thyroid incidence rates have stabilized in the past few data years because of modifications in diagnostic criteria. (more…)
Author Interviews, Cancer Research, JAMA, Orthopedics / 06.01.2017

MedicalResearch.com Interview with: Charles L. Shapiro, MD Professor of Medicine Co-Director of Dubin Breast Center Director of Translational Breast Cancer Research Director of Cancer Survivorship, Tisch Cancer Institute Mount Sinai Health System Division of Hematology / Medical Oncology: Tisch Cancer Institute New York, NY 10029 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Metastases to bone are frequent in many cancers and cause pain, pathological fractures, necessitate surgical and/or radiation treatments, cause spinal chord compression that can lead to paralysis, and significantly increase health care costs. Zoledronic acid, a bisphosphonate that inhibits bone resorption, is used in standard practice because it reduces the risks skeletal-related events including cancer-related pathological fractures, the need for surgery and/or radiation to bone metastases, and spinal chord compression in patients with breast cancer, prostate cancer and multiple myeloma. However, the optimal dosing interval for zoledronic acid is unknown and based on prior studies and empiricism it is administered monthly along with anti-cancer treatments. In this trial, over 1800 breast cancer, prostate cancer and multiple myeloma patients with bone metastases were randomized to the standard dosing interval of monthly zoledronic acid versus every 3-months zoledronic acid for a duration of two years. The results overall, and in each specific disease site, show that giving zoledronic acid once every 3-months as opposed to monthly did not result in any increase in skeletal-related events. (more…)
Author Interviews, Cancer Research, Diabetes, Pharmacology, Science / 05.01.2017

MedicalResearch.com Interview with: Dr. Don Gary Benjamin Biozentrum, University of Basel Basel, Switzerland. MedicalResearch.com: What is the background for this study? What are the main findings? Response: We initiated the study to find a co-drug that would increase the anti-cancer effect of the commonly prescribed anti-diabetic drug metformin. Metformin is a very well tolerated medication, however the dosage required to show anti-cancer activity is higher than that usually prescribed, hence the aim of the study. We found that metformin in combination with a second drug, syrosingopine (an anti-hypertensive), potently kills cancer cells in a variety of pre-clinical models. Quite nicely, both these drugs combine to kill the cells at a concentration where they have no impact on cell growth when applied singly. (more…)
Author Interviews, Cancer Research, JAMA, Prostate Cancer / 03.01.2017

MedicalResearch.com Interview with: Dr. Jim C. Hu MD MPH Professor of Urology Weill Cornell Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The most significant finding from our population based study is that after years of decline following the introduction of PSA screening, we see a rise in the incidence of metastatic prostate cancer at diagnosis among men aged 75 years and older. This is concerning in light of recent criticisms and guidelines against PSA testing. For instance, in 2008, the US Preventative Services Task Force recommended against PSA testing in this age group, and in our study, we see the incidence of metastasis at diagnosis rising in 2012 and 2013. This is significant because there is no cure for men with metastatic prostate cancer of their disease. The traditional argument against PSA screening is that it leads to over-diagnosis and over-treatment of prostate cancer. However, we currently do not have a better test for diagnosing prostate cancers before it has spread beyond the prostate and metastasized. Remarkably, when Ben Stiller shared his personal use of PSA testing in his mid to late 40's and how this led to a detection of intermediate risk prostate cancer that led him to surgery and cure, others criticized him for sharing his story. (more…)
Author Interviews, Dermatology, JAMA, Melanoma / 02.01.2017

MedicalResearch.com Interview with: Jessica S. Mounessa, BS Robert P. Dellavalle, MD, PhD, MSPH Dermatology Service, Denver Veterans Affairs Medical Center, Denver, Colorado Department of Dermatology, University of Colorado School of Medicine, Aurora MedicalResearch.com: What is the background for this study? What are the main findings? Response: Skin cancer remains the most common cancer in the U.S., despite ongoing efforts to address this major public health problem. Over 9,000 deaths occur annually, and mortality rates continue to increase faster than those associated with any other preventable cancer. Malignant melanoma, the deadliest type of skin cancer, accounts for the overwhelming majority of these deaths. Our study identified regional and state differences in the incidence and mortality rates of melanoma in the United States. We found that the Northeast, specifically New England, represents the only U.S. region in which the majority of states experienced a reduction in both incidence and death rates over the ten-year period between 2003 and 2013. (more…)
Author Interviews, Biomarkers, Cancer Research, JAMA / 29.12.2016

MedicalResearch.com Interview with David A Mankoff, MD, PhD Gerd Muehllehner Professor of Radiology Attending Physician University of Pennsylvania Health System PET Center Director Vice-Chair of Research, Department of Radiology University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: This review was designed to describe the current status of molecular imaging, especially positron emission tomography (PET) as a clinical tool for helping to direct precision oncology. We found that while there had been a number of promising methods tested in small, single research studies, the number of new molecular imaging tests translated to the clinic was small. In addition, the application of molecular methods as tools for therapeutic decision making (versus use for disease detections and staging) was even smaller. We noted that some recently published studies, including a few large multi-center trials, indicated the considerable potential of new molecular imaging tests to identify therapeutic targets for cancer treatment, to evaluate early response to targeted cancer therapy, and to predict downstream outcomes such as progression free survival. We made some observations and recommendations in the review for directing these potentially powerful imaging tools towards use as biomarkers for precision oncology. (more…)
Author Interviews, Cost of Health Care, Dermatology, Melanoma / 28.12.2016

MedicalResearch.com Interview with: Isabelle Hoorens, MD, PhD Department of Dermatology Ghent University Hospital Ghent, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this study we questioned whether a population-based screening for skin cancer is cost-effective. In addition we compared the cost-effectiveness of two specific screening techniques. The first technique, a lesion-directed screening being a free-of-charge skin cancer check of a specific lesion meeting 1 or more of the following criteria: ABCD rule (asymmetry, border irregularity, color variation, and diameter >6 mm), “ugly duckling” sign, new lesion lasting longer than 4 weeks, or red nonhealing lesions. The second screening technique consisted of a systematic total body examination in asymptomatic patients. A clinical screening study was performed in Belgium in 2014. (more…)
Author Interviews, Cancer Research, Immunotherapy, Nature, Technology, University of Michigan / 27.12.2016

MedicalResearch.com Interview with: James Moon, PhD John Gideon Searle Assistant Professor University of Michigan Dept. of Pharmaceutical Sciences and Biomedical Engineering Biointerfaces Institute Ann Arbor, MI, 48109 MedicalResearch.com: What is the background for this study? Response: The field of cancer immunotherapy has recently made a breakthrough with the clinical success of immune checkpoint inhibitors, which work by removing the brakes on immunosuppressed T-cells. However, these approaches generally work by augmenting pre-existing T-cell immunity and benefit only a subset of patients. In addition, because the majority of somatic mutations in cancer cells are unique to each patient, cancer immunotherapy may benefit from a personalized approach. (more…)
Author Interviews, Cancer Research / 27.12.2016

MedicalResearch.com Interview with: Dr. Richard Quek MBBS, MRCP, FAMS Senior Consultant, Medical Oncology Parkway Cancer Centre Singapore MedicalResearch.com: What is the background for this study? Response: Angiosarcoma is an uncommon form of aggressive soft tissue sarcoma (STS). It comprises of 2 distinct subgroups of patients: one originating from the skin - typically scalp, seen predominantly in elderly patients while the second subgroup affects younger patients and tends to originate from visceral organs including the liver and breasts. Angiosarcoma may also develop as a complication of prior radiation treatment. Prognosis in patient is poor, with survival generally less than 1 year in those with advanced or unresectable disease. Optimal treatment remains unclear; most published series on angiosarcoma tends to be small singlecenter studies. In our previous Asian STAR study evaluating epidemiology, treatment patterns and outcomes in Asian patients diagnosed with STS [J Clin Oncol 33, 2015 (suppl; abstract 10549)], we found that angiosarcoma represented 7% of the cohort, a proportion higher than what we would have expected from published series coming out of the west and hence our interest in this subject. (more…)
AACR, Author Interviews, Biomarkers, Breast Cancer, Chemotherapy / 26.12.2016

MedicalResearch.com Interview with: Helena Jernström, PhD Associate Professor in Experimental Oncology Study Coordinator for Graduate studies Division of Oncology and Pathology Coordinator of the programmes in statistics and epidemiology for doctoral students at the Medical Faculty, Lund University Division of Oncology and Pathology, Department of Clinical Sciences, Lund Lund University Cancer Center/Kamprad Lund, Sweden MedicalResearch.com: What is the background for this study? Response: There is a need for better predictive markers to guide selection of therapy in breast cancer patients. Estrogen receptor beta (ER-beta) may confer prognostic information beyond what is currently obtained by the established clinical markers, including ER-alpha, which is routinely evaluated. (more…)
Author Interviews, Cancer Research, Columbia, Genetic Research, Personalized Medicine / 23.12.2016

MedicalResearch.com Interview with: Dr. Kai Wang Zilkha Neurogenetic Institute, University of Southern California Institute for Genomic Medicine, Columbia University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cancer is a genetic disease caused by a small number of “driver mutations” in the cancer genome that drive disease initiation and progression. To understand such mechanism, there are increasing community efforts in interrogating cancer genomes, transcriptomes and proteomes by high-throughput technologies, generating huge amounts of data. For example, The Cancer Genome Atlas (TCGA) project has already made public 2.5 petabytes of data describing tumor and normal tissues from more than 11,000 patients. We were interested in using such publicly available genomics data to predict cancer driver genes/variants for individual patients, and design an "electronic brain” called iCAGES that learns from such information to provide personalized cancer diagnosis and treatment. iCAGES is composed of three consecutive layers, to infer driver variants, driver genes and drug treatment, respectively. Unlike most other existing tools that infer driver genes from a cohort of patients with similar cancer, iCAGES attempts to predict drivers for individual patient based on his/her genomic profile. What we have found is that iCAGES outperforms other tools in identifying driver variants and driver genes for individual patients. More importantly, a retrospective analysis on TCGA data shows that iCAGES predicts whether patients respond to drug treatment and predicts long-term survival. For example, we analyzed two groups of patients and found that using iCAGES recommend drugs can increase patients’ survival probability by 66%. These results suggest that whole-genome information, together with transcriptome and proteome information, may benefit patients in getting optimal and precise treatment. (more…)
Author Interviews, Cancer Research, End of Life Care / 23.12.2016

MedicalResearch.com Interview with: Yu Uneno, M.D. Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University Kyoto city, Kyoto Japan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prognosis prediction is one of the most important issues to make an optimal treatment decision for both cancer patients and health care professionals. Previous prognosis prediction models were developed using data from single time point (at the baseline, for example), limiting the use of the models at the similar situation. Recently, we have developed the Six Adaptable Prognostic (SAP) models which can be repeatedly used at any time point after the initiation of treatment for patients with cancer receiving chemotherapy. Those models use only three laboratory items (albumin, neutrophil, lactate dehydrogenase) which are routinely monitored in daily clinical practice. (more…)
Author Interviews, Immunotherapy, Lancet, Lung Cancer / 23.12.2016

MedicalResearch.com Interview with: Dr Kiyotaka Yoh Department of Thoracic Oncology National Cancer Center Hospital East Kashiwa, Japan MedicalResearch.com: What is the background for this study? What are the main findings? Response: LURET is multicenter, single-arm, phase II study to evaluate the efficacy and safety of vandetanib as RET inhibitor in patients with advanced RET-rearranged non-small-cell lung cancer (NSCLC). In 2012, RET rearrangements were identified as rare oncogenic alterations for NSCLC. Among 17 eligible patients included in primary analysis, the objective response rate was 53% (95% CI 28–77), which met the primary endpoint. At the data cutoff, median progression-free survival was 4.7 months (95% CI 2.8–8.5). Overall, vandetanib was tolerated, with an adverse event profile similar to those seen in previous large population studies of vandetanib in patients with unselected NSCLC. (more…)
Author Interviews, Breast Cancer, Immunotherapy / 22.12.2016

MedicalResearch.com Interview with: Joyce O'Shaughnessy, MD Co-Chair, Breast Cancer Research Texas Oncology-Baylor Charles A. Sammons Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The MONALEESA-2 trial is a Phase III, randomized, double-blind, international study of LEE011 in combination with letrozole vs. letrozole alone, in postmenopausal women with HR+/HER2- advanced breast cancer who had received no prior systemic therapy for advanced disease. Because de novo disease has not been previously treated with systemic treatment for early-stage breast cancer, tumors may exhibit a different disease biology, which could result in varied responses compared to patients who experience recurrence of their initial breast cancer. We analyzed a pre-defined subgroup of women with de novo HR+/HER2- advanced breast cancer to better understand the response of LEE011 plus letrozole in this patient population. In the de novo advanced breast cancer patient sub-group, progression free survival was significantly prolonged; LEE011 plus letrozole reduced the risk of disease progression or death by 55% over letrozole alone (HR=0.448 [95% CI: 0.267–0.750]). The 12-month PFS rate was 82% in the LEE011 plus letrozole arm compared to 66% with letrozole alone. Most adverse events were mild to moderate in severity, identified early through routine monitoring, and generally managed through dose interruption and reduction. The most common all-grade adverse events (≥30% of patients with de novo advanced breast cancer) in the LEE011 plus letrozole arm were neutropenia (70.2%), nausea (48.2%), fatigue (42.1%), alopecia (39.5%), and leukopenia (31.6%). (more…)