Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Stem Cells / 05.03.2021

MedicalResearch.com Interview with: Khalid Shah, MS, PhD Vice Chair of Research, Department of Neurosurgery Director, Center for Stem Cell Therapeutics and Imaging Director, Center for Excellence in Biomedicine Brigham and Women's Hospital Associate Professor, Harvard Medical School Principal Faculty, Harvard Stem Cell Institute  MedicalResearch.com: What is the background for this study? Response: Approximately 15-to-30 percent of patients with metastatic breast cancer have brain metastasis (BM), with basal-like breast cancer (BLBC) metastasizing to the brain most frequently. The prognosis for BLBC-BM patients is poor, as the blood-brain barrier prevents most therapeutics from reaching the brain. Testing candidate therapies in clinical trials is also challenging because animal models that mimic BM are limited. In this study we engineered a bimodal tumor-suppressing and killing molecule that can be delivered to the brain by stem cells and tested them in mouse models of brain metastases that mimic clinical setting. (more…)
Cancer Research / 01.03.2021

liver-metastases-cancer-chemoebolization.jpegOne of the main dangers of cancer is metastasizing. This process can affect any organ in the human body. The most frequent causes of liver metastases are tumors of the gastrointestinal tract, mammary glands, lungs, and pancreas. One of the modern methods of liver metastases treatment today is chemoembolization procedure. Its use allows doctors to fight cancer liver metastases with minimal harm to the patient. Statistics shows that this method is 30% more effective than traditional treatment of metastases with systemic chemotherapy. Symptoms As a rule, secondary liver cancer has no symptoms for a long time. This makes it difficult to diagnose this type of oncology. However, with regular medical check-ups, you can avoid this. To know when you should see a doctor, you need to know the symptoms of liver metastases that are most commonly seen:
  • Abdominal bloating
  • Nausea and vomiting
  • Constipation or diarrhea
  • Decreased appetite
  • Severe weight loss
  • Persistent low-grade increase in body temperature
  • General weakness and fatigue
If you have one or more of these symptoms, it is better to see your doctor. This will allow the tumor to be diagnosed at an early stage, so you can improve your prognosis for treatment and also make it less harmful to your health. (more…)
Author Interviews, Cancer Research / 25.02.2021

MedicalResearch.com Interview with: group-picture Catharina Svanborg M.D., Ph.D. Professor at Lund University Department of Laboratory Medicine, Division of Microbiology, Immunology and Glycobiology Founder/Chairman of the Board at HAMLET Pharma MedicalResearch.com: What is the background for this study? HAMLET PharmaResponse: Like many unexpected scientific developments, this finding was serendipitous. In our search for the molecular basis of host susceptibility to infection, we discovered that infection directly affects MYC levels. Gene expression analysis revealed that MYC itself was inhibited and that genes regulated by MYC were affected in children with acute kidney infection. Rapid reductions in MYC levels was further confirmed by infecting human kidney cells with the pathogenic E. coli bacteria isolated from patients with acute pyelonephritis, allowing us to formulate the hypothesis that bacteria regulate host MYC levels during acute infection and to investigate the mechanism leading to this inhibition. This work was conducted by the Laboratory Medicine group at Lund University in Sweden led by Professor Catharina Svanborg. (more…)
Author Interviews, Cancer Research, Hepatitis - Liver Disease, Race/Ethnic Diversity / 25.02.2021

MedicalResearch.com Interview with: Andrea D. Branch PhD Professor of Medicine Division of Liver Diseases Associate Professor of Surgery Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Liver cancer is a deadly condition with a high mortality rate. About 90% of people who develop liver cancer have cirrhosis (advanced liver scarring) due to a chronic underlying liver disease. Patients with cirrhosis are advised to undergo liver cancer surveillance. Early detection improves survival, but diagnosis requires more than a blood test, which makes surveillance complex and expensive. Black individuals are more likely to develop liver cancer than white individuals and are more likely to die from it. Black patients also have more advanced liver cancer at the time of diagnosis than Whites. We aimed to identify additional factors that distinguish liver cancer in African Americans, focusing on patients with hepatitis C virus infection, the most common chronic liver disease in people who die from liver cancer in the United States. (more…)
Author Interviews, Brain Cancer - Brain Tumors, Cancer Research, Immunotherapy, Pharmaceutical Companies / 22.02.2021

MedicalResearch.com Interview with: https://www.inovio.com/Jeffrey Skolnik, MD Senior Vice President, Clinical Development INOVIO MedicalResearch.com: What is the background for this technology? Would you tell us a little about the brain tumor, Glioblastoma Multiforme? How common is it, whom does it primarily affect?  Response: Glioblastoma (GBM) is the most common malignant brain tumor, affecting more than 10 thousand people each year in the United States. Most people diagnosed with GBM are above the age of 60 years, although GBM can be diagnosed at any age, including in children and young adults. Despite decades of research, GBM remains almost universally fatal. GBM is a tumor of the glial cells of the brain, and current therapies are directed at removing tumor with surgery and killing residual tumor cells with radiation and chemotherapy. More recently, with the introduction of immunotherapies such as immune checkpoint inhibitors (ICI) for the treatment of cancer, clinical studies have tried to add this promising technology to the treatment of GBM. Unfortunately, despite success in other types of cancer, ICIs have not demonstrated any clinical benefit in treating GBM. Newer clinical studies aim at introducing a combination of newer therapies together to try to tackle this terrible disease, and INOVIO’s GBM-001 study is one such example of an innovative approach to treating GBM.    (more…)
Author Interviews, Biomarkers, Cancer Research, Science / 18.02.2021

MedicalResearch.com Interview with: Muhammed Murtaza M.B.B.S. (M.D.), Ph.D. Translational Genomics Research Institute Phoenix, AZ MedicalResearch.com: What is the background for this study? Response: Liquid biopsies and cell-free DNA analysis using blood samples have transformed cancer diagnostics in recent years. We started this project wondering whether cell-free DNA in urine is a viable alternative to blood, since urine could be collected completed non-invasively. Our very first experiment showed the lengths of DNA fragments in urine very similar across healthy individuals, leading us to wonder whether urine was actually as randomly degraded as we had previously thought. (more…)
Author Interviews, Colon Cancer, Heart Disease, JAMA, Nutrition / 18.02.2021

MedicalResearch.com Interview with: Nathorn (Nui) Chaiyakunapruk PharmD, PhD Professor, Department of Pharmacotherapy University of Utah College of Pharmacy  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colorectal cancer is one of the cancers for which we found that the risk can be significantly reduced by modifying diet. Individual components of your diet can contribute to an overall healthy diet pattern to lower the risk of colorectal cancer or increase it. Strong scientific evidence shows that limiting red meat and alcohol consumption, eating foods containing fiber and calcium, consumption of dairy products especially yogurt can help prevent colorectal cancer.  (more…)
Author Interviews, Leukemia, Stem Cells, Technology / 11.02.2021

MedicalResearch.com Interview with: Eirini Papapetrou, MD, PhD Associate Professor Department of Oncological Sciences Icahn School of Medicine at Mount Sinai New York, NY 10029 MedicalResearch.com: What is the background for this study? Would you tell us a little about acute myeloid leukemia? Response: Acute myeloid leukemia is a form of cancer of the blood. It is typically very aggressive and lethal without treatment. The main treatment is high-dose chemotherapy and it has not changed very much in decades. Some more recent "targeted" therapies that are less toxic help somewhat but still do not result in cures. We believe a reason for this might be that both chemotherapy and newer "targeted" therapies target the cells at the later stages of the disease and spare the earlier ones, which can then give rise to disease resistance and relapse.  (more…)
Author Interviews, Cancer Research, Dermatology, NEJM / 11.02.2021

MedicalResearch.com Interview with: Jane Fang, MD Clinical Athenex, Inc.  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by actinic keratoses? How common are they and who is primarily affected? Response: Actinic keratosis is a very common precancerous skin condition that affects about 58 millions people in the US. Most commonly affected people are older (over 40 years old) men with fair skin type. Actinic keratosis lesions are red scaly bumps on sun-damaged skin mostly on the face, scalp, back of hands, forearms and legs. As there is a risk of 0.025-16% per year for each actinic keratosis to progress to skin cancer and it is not possible to predict which actinic keratosis will become cancerous, early treatment of actinic keratosis is generally recommended. Currently approved topical treatments require weeks or months of application and may lead to intolerable side effects that undermine compliance and reduce efficacy of treatment. Tirbanibulin ointment is a novel anti-proliferative agent that inhibits tubulin polymerization and disrupts Src kinase signaling, and has the potential to inhibit growth of abnormal skin cells in actinic keratosis. The current report described two Phase 3 randomized vehicle or placebo-controlled clinical studies that demonstrated that a 5-day course of tirbanibulin ointment applied once daily by patients was safe, well-tolerated, and effective in clearing actinic keratosis on the face or scalp compared to vehicle control. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, COVID -19 Coronavirus, Prostate, Prostate Cancer, Surgical Research, Urology / 01.02.2021

MedicalResearch.com Interview with: David-Dan Nguyen Research Fellow | Center for Surgery and Public Health, Brigham and Women's Hospital MPH (Health Policy) Student | Harvard T.H. Chan School of Public Health Medical Student | McGill University MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has forced hospitals to delay the definitive treatment of cancers via surgery or radiation therapy. While previous evidence has shown that delaying the treatment of low-risk prostate cancer is not associated with worse outcomes, treatment delays for intermediate-risk and high-risk prostate cancer are more controversial. As such, we sought to determine if delays for these disease states negatively impacted oncological outcomes. (more…)
Cancer Research / 29.01.2021

Cancer occurs when cancerous cells in one area of the body reproduce rapidly and invade surrounding cells, tissue, and organs. Occasionally, these cells can spread to other parts of the body. Symptoms, treatments and the prognosis will depend on the type and stage of the cancer.

Give them emotional support

Your parent is probably as confused and overwhelmed as you are, if not more. Offer them a comforting ear and allow them to talk through how it is affecting them, their concerns, their treatment options, and their wishes. Offer assistance, but don’t force it. Being too helpful could end up with your parent feeling a loss of control or independence. Organize what type and level of support you can offer, sustainable to their wellbeing, and yours. Offer spontaneous and scheduled companionship to help them to feel a sense of normalcy and provide opportunities to spend time together. If you both decide you should accompany them to their physician’s appointments and treatments, take notes, and don’t be scared to speak up if you have a question.

cancer-chemotherapy-cancer-treatment.jpegTry to understand what they’re going through

Take the time to understand the individual symptoms that they are experiencing and suggest proven solutions to relieve and manage. For example, the symptoms of mouth or esophageal cancer will be very different from that of any other part of the body. Namely, these cancers can cause loss of the ability to chew and swallow (medically referred to as dysphagia), which are alleviated using a thickener in food and beverages. In contrast, individuals suffering from cancer of the spine are more likely to have trouble mobilizing, which would be improved by a walking aid. Managing conditions like cancer begin with a full understanding. Read about the origin of SimplyThick Easy Mix and see the value in understanding health conditions from a patient perspective. (more…)
Author Interviews, Breast Cancer, Genetic Research, JAMA, Race/Ethnic Diversity / 22.01.2021

MedicalResearch.com Interview with: Kent Hoskins, MD Eileen Lindsay Heidrick Professor in Oncology Division of Hematology/Oncology University of Illinois at Chicago Director of Cancer Genetics Co-Leader, Breast Cancer Research Group University of Illinois Cancer Center MedicalResearch.com: What is the background for this study? Response: The racial disparity in breast cancer mortality emerged in the US in the late 1980s in the wake of widespread implementation of mammography screening and the development of successful systemic adjuvant therapies for early breast cancer. Unfortunately, more than three decades later, Black women in the US still have a 40% higher mortality rate from breast cancer compared with non-Hispanic White women despite similar disease incidence. Health disparities research has primarily focused on the fact that Black women have a higher incidence of the aggressive triple-negative subtype, and that they are more likely to present with more advanced stages of disease. As important as those factors are, in recent years our group and others reported that Black women with hormone receptor-positive breast cancer have worse survival than non-Hispanic white women even after adjustment for stage at diagnosis and treatment. Since nearly 2/3 of breast cancers in Black women are hormone receptor-positive, this is a significant contributor to the overall mortality disparity. Importantly, these studies also suggested that Black women disproportionately develop biologically aggressive forms of hormone-dependent breast cancer, which is typically considered a more favorable disease subtype. Using data on more than 70,000 patients from the SEER registry that is linked to data from Genomic Health Laboratory, which provides the Oncotype DX recurrence score (the most commonly ordered prognostic/predictive multi-gene expression assay for early breast cancer), we set out to address three questions: 1) is there evidence of disproportionately aggressive tumor biology among Black women with hormone receptor (HR)-positive breast cancer, as reflected in the Oncotype DX recurrence score? 2) Is there a racial survival disparity even among patients with early stage, axillary node-negative tumors with comparable recurrence scores on the Oncotype assay? and 3) Is there is a difference in the prognostic accuracy of the Oncotype assay between Black and non-Hispanic white patients, since there was limited representation of Black women in the development and validation of the Oncotype assay and other prognostic/predictive assays?  (more…)
Author Interviews, Opiods, Pancreatic, PLoS / 08.01.2021

MedicalResearch.com Interview with: Faraz Bishehsari, MD, PhD Associate Professor of Medicine and Graduate College Director of the Translational Gastroenterology Unit Division of Digestive Diseases Rush University Medical Center MedicalResearch.com: What is the background for this study? Response: This study builds on recent population based studies where opium use was found to be possible risk factor for pancreatic cancer. Although opium use is not a common recreational habit in the United States, opioid use has been rising remarkably over the past decade. In fact, opioid misuse and overdose have evolved into a public health crisis here with increasing opioid prescription use and abuse over the past decade. (more…)
Author Interviews, Cancer Research, Microbiome / 04.01.2021

MedicalResearch.com Interview with: Ben Boursi MD Senior Physician in the Gastrointestinal Cancer Department at Sheba Medical Center School of Medicine, Sackler Faculty of Medicine Tel Aviv University Tel Aviv, Israel MedicalResearch.com:  What is the background for this study? What conditions have fecal matter transplants been previously studied in (ie c. diff)? Response: “Many melanoma patients do not respond to immunotherapy and even among responders, many eventually progress. Extensive research has been conducted in order to overcome resistance to immunotherapy and modulation of the gut microbiota, is one of the promising leads. The gut microbiome has been shown to influence response to immunotherapy in preclinical mouse models and observational patient cohorts. Currently FMT is being used for the treatment of C. Difficile that is resistant to antibiotics, but it is also being evaluated as a treatment option for other disease states such as inflammatory bowel disease and obesity.” (more…)
Author Interviews, Cancer Research, JAMA / 31.12.2020

MedicalResearch.com Interview with: Deborah C. Marshall, MD New York University School of Medicine New York, New York  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Tarras ES, Marshall DC, Rosenzweig K, Korenstein D, Chimonas S. Trends in Industry Payments to Medical Oncologists in the United States Since the Inception of the Open Payments Program, 2014 to 2019. JAMA Oncol. Published online December 30, 2020. doi:10.1001/jamaoncol.2020.6591  MedicalResearch.com: What should readers take away from your report? Response: Overall, though, there has not been a dramatic shift in these interactions after the inception of Open Payments. (more…)
Author Interviews, Cancer Research, COVID -19 Coronavirus, Lung Cancer / 17.12.2020

MedicalResearch.com Interview with: Robert Van Haren, MD, MSPH College of Medicine University of Cincinnati  MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has impacted all areas of society including the field of oncology. This study evaluated the impact of COVID-19 on lung cancer screening.  Screening with low-dose computed tomography (LDCT) scans are important because they reduce lung cancer mortality by at least 20%.  Our lung cancer screening program was closed in March 2020 due to COVID 19 and reopened again in June 2020.  We cancelled over 800 LDCTs during that time period.  (more…)
Author Interviews, Cancer Research, Immunotherapy / 17.12.2020

MedicalResearch.com Interview with: Joshua Brody MD Director, Lymphoma Immunotherapy Program Icahn School of Medicine at Mount Sinai Hess Center for Science and Medicine New York, New York 10029 MedicalResearch.com: What is the background for this study?   Response: Cancer Immunotherapies target "antigens" on the surface of cells. -CAR-T cells targets antigens e.g. CD19 -Bispecific antibodies target antigens e.g. CD20 -Anti-PD1 antibodies awaken T cells that target antigens on e.g. MHC-I Cancer Immunotherapies frequently fail because a small percent of tumor cells simply lack the antigen and cause cancer relapse ('Antigen Escape') (more…)
Author Interviews, Breast Cancer, Cancer Research, COVID -19 Coronavirus / 10.12.2020

MedicalResearch.com Interview with: Joanne L. Blum, MD, PhD, FACP Texas Oncology and Director Hereditary Cancer Risk Program Baylor University Medical Center MedicalResearch.com: What is the background for this study? Would you briefly describe the POLARIS study? Response: POLARIS is an ongoing prospective, real-world, non-interventional study in patients with HR+/HER2-ABC receiving palboiclib plus endocrine therapy with a targeted enrollment of 1500 patients at 110 sites in the United States and Canada.  MedicalResearch.com: What are the main findings?
  • Because of the COVID-19 pandemic, approximately one third of the study sites experienced an impact on their responsiveness to correspondence, timely data entry, and subject management.
  • The geographic location or type (e.g., academic or community) of study site appears associated with whether the site was impacted by COVID-19.
  • Other study site characteristics were generally similar between sites that reported an impact of COVID-19 and those that were not impacted.
  • Because of inherent limitations of survey studies, these findings must be interpreted with caution.
(more…)
Author Interviews, Cancer Research, CDC, JAMA, Lung Cancer / 10.12.2020

MedicalResearch.com Interview with: David A. Siegel, MD, MPH Division of Cancer Prevention and Control US Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: Why is it important to better understand the smoking histories (both current/former and never smokers) among lung cancer patients? Response: Knowledge of smoking status of patients diagnosed with lung cancer can help us understand how to best prevent, detect, and treat lung cancer in the future. More than 84% of women and 90% of men newly diagnosed with lung cancer had ever smoked cigarettes, and half of patients aged 20 to 64 years newly diagnosed with lung cancer were current cigarette smokers. These findings reinforce the importance of cigarette cessation and lung cancer screening. 1 out of every 8 people diagnosed with lung cancer had never smoked cigarettes, which reiterates the importance of learning more about their risk factors for lung cancer, which could impact prevention and treatment.  (more…)
Author Interviews, BMC, Breast Cancer, Brigham & Women's - Harvard, Cancer Research, Diabetes, Nutrition / 10.12.2020

MedicalResearch.com Interview with: Tengteng Wang, PhD, MSPH, MBBS Postdoctoral Research Fellow Department of Epidemiology Harvard T.H. Chan School of Public Health Channing Division of Network Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Type 2 diabetes (T2D) has been associated with poor progression of breast cancer. Moreover, having a breast cancer diagnosis may also increase the risk of developing T2D. Therefore, identifying strategies for T2D prevention among breast cancer survivors may play a key role in improving their survival outcomes. One approach may be through a diabetes risk reduction diet (DRRD), a dietary pattern comprised of 9 components that has been associated with 40% lower T2D risk in a previous Nurses’ Health Study publication.1 However, no studies to date have evaluated the association between adherence to the DRRD (as measured by the DRRD score) and survival outcomes following breast cancer. In this prospective cohort study among 8,320 breast cancer survivors, we found that greater adherence to the diabetes risk reduction diet after diagnosis was associated with a statistically significant 31% lower risk of overall mortality. Reduced breast cancer-specific mortality was also observed, which was more pronounced (20% lower risk) among those who improved adherence after diagnosis compared to women with consistently low DRRD adherence before and after diagnosis. (more…)
Author Interviews, Cancer Research, COVID -19 Coronavirus, Leukemia / 06.12.2020

MedicalResearch.com Interview with: William Wood, MD Associate Professor of Medicine, Division of Hematology UNC School of MedicineWilliam Wood, MD Associate Professor of Medicine, Division of Hematology UNC School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the earliest days of the COVID-19 pandemic, there were concerns that individuals with cancer, and especially those with hematologic malignancies, could be at higher risk for adverse outcomes following COVID-19 infection than the general population. For this reason the ASH Research Collaborative developed a voluntary data collection registry in which providers or sites caring for patients with hematologic malignancies and COVID-19 infection provided de-identified data via an online data collection platform. We believe that our findings – that 20% of patients with blood cancers who had COVID-19 infection died, including 33% of those who required hospital or ICU level-care – indicate that patients with blood cancers are a medically vulnerable group when it comes to COVID-19. The risk of dying was highest in patients who were older, had more severe infection, opted to forego more intensive treatment, and/or had poorer prognosis before their COVID-19 infection, as determined by their treating clinicians (more…)
Author Interviews, Cancer Research, Immunotherapy / 05.12.2020

MedicalResearch.com Interview with: Dr. Corina Dutcus MD Vice President of Clinical Research Oncology Business Group Eisai MedicalResearch.com: What is the background for this study? Would you briefly explain how lenvatinib works? Is it used for any other malignancies, ex. thyroid cancer? Dr. Corina Dutcus Response: LENVIMA (lenvatinib), discovered and developed by Eisai, is an orally available multiple receptor tyrosine kinase inhibitor that inhibits the kinase activities of vascular endothelial growth factor (VEGF) receptors VEGFR1 (FLT1), VEGFR2 (KDR), and VEGFR3 (FLT4). LENVIMA inhibits other kinases that have been implicated in pathogenic angiogenesis, tumor growth, and cancer progression in addition to their normal cellular functions, including fibroblast growth factor (FGF) receptors FGFR1-4, the platelet derived growth factor receptor alpha (PDGFRα), KIT, and RET. LENVIMA is approved in combination with everolimus for the treatment of patients with advanced renal cell carcinoma (RCC) following one prior anti-angiogenic therapy. The approved starting dose for LENVIMA is 18 mg daily. The objective of Study 218, a randomized, open-label, Phase 2 trial, was to assess whether the lower starting dose of LENVIMA (14 mg daily) in combination with everolimus (5 mg daily) would provide similar efficacy with an improved safety profile compared to the FDA-approved starting dose of LENVIMA (18 mg daily) plus everolimus (5 mg daily) in patients with advanced renal cell carcinoma (RCC) following prior treatment with an antiangiogenic therapy. In the US, LENVIMA is also indicated for:
  • the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (RAI-refractory DTC);
  • for the first-line treatment of patients with unresectable hepatocellular carcinoma (HCC);
  • and in combination with pembrolizumab, for the treatment of patients with advanced endometrial carcinoma that is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR), who have disease progression following prior systemic therapy, and are not candidates for curative surgery or radiation. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trial.
Please see Prescribing Information for LENVIMA (lenvatinib) at http://www.lenvima.com/pdfs/prescribing-information.pdf. (more…)
Author Interviews, Cancer Research, Genetic Research / 01.12.2020

MedicalResearch.com Interview with: Nina Bhardwaj MD PhD Director of Immunotherapy Tisch Cancer Institute Icahn School of Medicine at Mt Sinai Ward-Coleman Chair in Cancer Research Professor of Hematology and Oncology MedicalResearch.com: What is the background for this study? Response: Neoantigens are novel antigens expressed by tumors as a result of somatic mutations or frame shift mutations. They can be very immunogenic and consequently they are being incorporated into cancer vaccine platforms. In most cases it is necessary to determine each patient’s individual mutations and customize their vaccine antigens accordingly. We sought to identify shared mutations in cancer antigens which are deficient in DNA repair mechanisms namely microsatellite unstable tumors. These tumors have mutations in genes that normally are responsible for ensuring that DNA is properly replicated. Because these genes encode proteins that ensure proper repair around micro-satellite areas (which contain short repeated sequences of DNA and are present in similar regions from one person’s genome to the next), when they are mutated, these regions may not be repaired. Consequently due to nucleotide deletions and insertions one gets frame shift mutations which result in new protein expression which can be shared across tumors, as has been observed for a few regions. We therefore did a comprehensive study of a subset of tumors to determine the breadth of shared frame shift mutations. (more…)
Author Interviews, Breast Cancer, Cancer Research, Chemotherapy, JAMA, Yale / 26.11.2020

MedicalResearch.com Interview with: Lajos Pusztai, M.D, D.Phil. Professor of Medicine Director, Breast Cancer Translational Research Co-Director, Yale Cancer Center Genetics and Genomics Program Yale Cancer Center Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In HER2-positive early stage (stage I-II) breast cancer, several different preoperative (also called neoadjuvant) chemotherapy options exist, each of these is associated with a different rate of complete eradication of cancer from the breast and lymph nodes (called pathologic complete response or pCR). Patients who experience pCR have excellent long term survival. The complete response rates range from 20% to 80%, the rates are higher with regimens that include several different chemotherapy drugs and dual HER2 blockade. Unfortunately, these highly effective multi-drug treatment regimens are also more toxic and more expensive.  We also learned that patients who do not achieve pCR after preoperative therapy, have high rates of recurrence, but the recurrence rate can be improved by administering postoperative adjuvant therapy. These two observations together, (1) different regimens with different toxicities and costs resulting in different pCR rates, and (2) existence of effective postoperative therapies for patients with residual cancer after preoperative therapy, sets the stage for combining various pre- and post-operative treatment strategies. Starting with a shorter, less toxic and less expensive neoadjuvant regimen would allow a substantial minority (20-45%) of patients who archive pCR to be spared of longer and more toxic regimens, whereas those with residual disease could receive the remaining part of the currently most effective regimens post-operatively as adjuvant therapy. In this study we examined the cost effectiveness of different neoadjuvant followed by adjuvant treatment strategies from a healthcare payer perspective. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Genetic Research, Melanoma, Prostate Cancer / 23.11.2020

MedicalResearch.com Interview with: Saud H AlDubayan, M.D. Instructor in Medicine, Harvard Medical School Attending Physician, Division of Genetics, Brigham and Women's Hospital Computational Biologist, Department of Medical Oncology, Dana-Farber Cancer Institute Associate Scientist, The Broad Institute of MIT and Harvard  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The overall goal of this study was to assess the performance of the standard method currently used to detect germline (inhered) genetic variants in cancer patients and whether we could use recent advances in machine learning techniques to further improve the detection rate of clinically relevant genetic alterations. To investigate this possibility, we performed a head to head comparison between the current gold-standard method for germline analysis that has been universally used in clinical and research laboratories and a new deep learning analysis approach using germline genetic data of thousands of patients with prostate cancer or melanoma. This analysis showed that across all different gene sets that were tested, the deep learning-based framework was able to identify additional cancer patients with clinically relevant germline variants that went undetected by the standard method. For example, several patients in our study also had germline variants that are associated with an increased risk of ovarian cancer, for which the surgical removal of the ovaries (at a certain age) is highly recommended. However, these genetic alterations were only identified by the proposed deep learning framework.     (more…)
Author Interviews, Dermatology, Genetic Research, Melanoma / 19.11.2020

MedicalResearch.com Interview with: Sarah I. Estrada, M.D., FCAP  Laboratory Director Affiliated Dermatology® www.affderm.com MedicalResearch.com: What is the background for this study? What are the main findings? Response: As a dermatopathologist who makes diagnoses on lesions that may be melanoma, I’m faced with the reality that my accurate interpretation of biopsy tissue is key for the patient to be treated most effectively. Often histopathological evaluation is straightforward but not as often as I would like. The study presented here offers a new test that can be used in conjunction with my evaluation to determine if a questionable lesion is in fact melanoma. The test was developed to take into account the gene expression of the lesion which may factor in characteristics that I cannot visually observe. The test was validated and has shown very promising accuracy metrics. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Prostate Cancer, Social Issues / 18.11.2020

MedicalResearch.com Interview with: David-Dan Nguyen, MPH Research Fellow | Center for Surgery and Public Health Brigham and Women's Hospital Medical Student | McGill University  MedicalResearch.com: What is the background for this study? Response: In 2017, the US Preventive Services Task Force updated its recommendation for PSA screening for prostate cancer from a grade D to a grade C for men aged 55 to 69 years. This updated recommendation endorsed shared decision making and harmonizes with the guidelines of the American Urological Association and the American Cancer Society which also recommend shared decision making for PSA screening. Shared decision making is a meaningful dialogue between the physician and the patient that namely includes a review of risks and expected outcomes of screening as well as the patient’s preferences and values. Understandably, the patient’s ability to critically assess the medical information provided (i.e. their health literacy) likely influences this process. We sought to characterize the effect of health literacy on shared decision making for PSA screening. We used data from 2016 when PSA screening for prostate cancer was not recommended by the US Preventive Services Task Force — in other words, we also sought to understand how health literacy impacted screening rates in the context of countervailing guidelines on PSA screening. (more…)
Author Interviews, Melanoma, Vaccine Studies / 16.11.2020

MedicalResearch.com Interview with: Nina Bhardwaj MD, PhD Professor of Medicine (Hematology and Medical Oncology) and Urology Tisch Cancer Institute Icahn School of Medicine at Mount Sinai New York, NY MedicalResearch.com: What is the background for this study? What types of cancer may be amenable to this vaccine? Response: The goal was to determine if vaccine responses could be improved by increasing special white cell numbers, namely dendritic cells, which are key for jumpstarting an immune response. MedicalResearch.com: What are the main findings?  Response: We found that the agent flt3-L mobilized these dendritic cells which help to improve the vaccine’s ability to prime the immune system.  (more…)
Author Interviews, Cancer Research, JAMA, Prostate Cancer, Technology / 13.11.2020

MedicalResearch.com Interview with: Dave Steiner MD PhD Clinical Research Scientist Google Health, Palo Alto, California MedicalResearch.com: What is the background for this study? Response: For prostate cancer patients, the grading of cancer in prostate biopsies by pathologists is central to risk stratification and treatment decisions. However, the grading process can be subjective, often resulting in variability among pathologists. This variability can complicate diagnostic and treatment decisions. As an initial step towards addressing this problem, we and others in the field have recently developed artificial intelligence (AI) algorithms that perform on-par with expert pathologists for prostate cancer grading. Such algorithms have the potential to improve the quality and efficiency of prostate biopsy grading, but the impact of these algorithms when used by pathologists has not been well studied. In the current study, we developed and evaluated an AI-based assistant tool for use by pathologists while reviewing prostate biopsies. (more…)