Author Interviews, Colon Cancer, Cost of Health Care, Gastrointestinal Disease, Vanderbilt / 06.07.2016

MedicalResearch.com Interview with: Erica R. H. Sutton, MD Assistant Professor Department of Surgery, General Vanderbilt MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colorectal cancer is one of the most preventable diseases that we face; however, despite the great strides that we have made in the realm of early detection, many people still do not undergo screenings. We sought to increase the availability of screenings to those in our community who are at high risk for colorectal cancer and uninsured by providing free colonoscopies to them and to examine the cost-effectiveness of this intervention. Over a 12-month period, 682 uninsured people underwent screening colonoscopies, and 9 cancers were detected. Compared to the Surveillance, Epidemiology, and End Results (SEER) registry, our patient population included more early-stage cancers, and our program was found to be cost-neutral. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Endocrinology, JAMA / 04.07.2016

MedicalResearch.com Interview with: Aditya Bardia, MD, MPH Massachusetts General Hospital Cancer Center Harvard Medical School Boston, MA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: While endocrine therapy is the recommended therapy for Estrogen Receptor positive (ER+) breast cancer, the role of endocrine therapy in neoadjuvant (pre-surgical) setting is unclear. We performed this systematic review and meta-analysis to comprehensively evaluate the efficacy of neoadjuvant endocrine therapy, both alone and in combination with other therapies, compared to neoadjuvant chemotherapy for localized ER+ breast cancer. We found no statistically significant differences between the two treatments in regards to clinical response, imaging response, rates of breast conservation therapy, and achievement of pathologic complete response. (more…)
Addiction, Author Interviews, Cancer Research, Pharmacology / 04.07.2016

MedicalResearch.com Interview with: Dr Wai Liu Senior Research Fellow St George's University of London London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Naltrexone is a drug commonly used to wean addicts off alcohol and heroin, but clinical evidence has shown that when the drug is used at lower doses, patients would exhibit alter immunity. The symptoms that patients with a number of autoimmune diseases and those associated with chronic pain would ease significantly. Additionally, a number of reports showed patients with some forms of cancer would experience therapeutic benefit. Interestingly, the doses of the drug was crucial, and the non-conventional effects of naltrexone was only achieved at doses that were lower that what was conventionally used. We set about to understand why a drug could have such different effects when used at differing doses. Our results show that the genetic profile of the drug is subtly different at the two different doses, which helped us identify novel ways in which the drug could be used to induce an anticancer effect. (more…)
Author Interviews, Ovarian Cancer / 01.07.2016

MedicalResearch.com Interview with: Professor Richard Morgan Director, The Institute of Cancer Therapeutics University of Bradford Richmond Road Bradford UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ovarian cancer is the 5th most common cause of cancer-related death in woman and the most deadly gynaecological cancer. One of the reasons for this is its resistance to conventional chemotherapy. Although tumours often respond well at first, showing dramatic shrinkage in the first few months of treatment, they usually grow again and at this point they are no longer sensitive to the drugs. We studied the role of HOX genes in ovarian cancer. The HOX genes play an important role in the early development of the embryo but are usually switched off in adult cells. However, many cancers, including ovarian cancer, turn them back on. Previous work suggested that they might have an important role in promoting the rapid proliferation of cancer cells. (more…)
Author Interviews, Breast Cancer, Mammograms / 01.07.2016

MedicalResearch.com Interview with: Rachel Brem, MD Professor of Radiology and Director of Breast Imaging and Intervention George Washington University School of Medicine. MedicalResearch.com Editor’s note: Many states now have laws regarding patient notification of breast density after mammography screening. Dr. Brem discusses the background and implications of the new mandatory notification laws. MedicalResearch.com: What is meant by 'breast density?’ Is breast density a risk factor for breast cancer? Is breast cancer more difficult to detect in dense breasts? Dr. Brem: Breast density is a measure used to describe the proportion of fat versus breast tissue, which includes fibrous and glandular tissue. Dense breasts contain more fibrous and glandular tissue and less fatty tissue. This is important because on a mammogram dense breast tissue is white and breast cancer is white. The lack of contrast can make detecting cancer more difficult. You can only tell if your breasts are dense from the mammogram. You can’t feel dense breast tissue or see it. An estimated 40 percent of women have dense breast tissue that may mask the presence of cancerous tissue in standard mammography. Dense breast tissue decreases with age, but remains important throughout life. Over 75 percent of women in their 40s have dense breast tissue but over a third of women in their 70s have dense breast tissue. As breast density increases, mammography sensitivity decreases. This is significant, but we must consider the increased risk of breast cancer in women with dense breast tissue. Women with dense breast tissue have up to a four-fold increased risk of developing breast cancer. So, breast density is essentially the “perfect storm” where the ability to detect cancer decreases while the risk for breast cancer increases. Therefore, optimal approaches to individualized breast cancer screening are needed. (more…)
Author Interviews, Cancer Research, Leukemia, NEJM, Stanford / 29.06.2016

MedicalResearch.com Interview with: Jason R. Gotlib, MD The Clinical Investigator Pathway Hematology Division Stanford University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that advanced forms of systemic mastocytosis, which are blood cancers characterized by accumulation of abnormal mast cells in the bone marrow and additional organs, represent a group of orphan diseases with a large unmet need. Approximately 90% of patients harbor the acquired KIT D816V mutation, a mutated receptor tyrosine kinase on the surface of mast cells which a primary driver of disease pathogenesis. Only 1 drug is approved for patients with one form of advanced systemic mastocytosis, termed ‘aggressive systemic mastocytosis, or ‘ASM’. This therapy is imatinib (Gleevec), but it is only approved for patients without the KIT D816V mutation, or with KIT mutation status unknown because the KIT D816V mutation is resistant to imatinib. Therefore, this drug may only be useful for approximately 10% of patients. Other drugs that have been used off-label for systemic mastocytosis (but are not approved for this indication) include interferon-alpha or cladribine, which show some activity, but their evaluation to date has been primarily limited to small case series which are usually retrospective in nature, and include mixed populations of systemic mastocytosis patients who have both early stage disease without organ damage (e.g. indolent systemic mastocytosis) and and advanced stage patients, as included in this trial, who have one or more findings of organ damage. Also, those trials employed differing response criteria and no central adjudication of eligibility and response assessments was undertaken. Midostaurin is a multikinase inhibitor with activity against both wild-type KIT, but most importantly, KIT D816V (in contrast to imatinib). Prior work demonstrated that cell lines transformed with the KIT D816V mutation can be inhibited at relatively low concentrations of midostaurin. These concentrations could also be achieved in vivo (e.g. at concentrations achievable in the blood of patients). Cell lines transformed by KIT D816V could not be inhibited by imatinib. (more…)
Author Interviews, Brain Cancer - Brain Tumors, Pharmacology / 29.06.2016

MedicalResearch.com Interview with: Dr Kieran Breen PhD Director of Research, Brain Tumour Research University of Portsmouth, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is evidence that aspirin (acetyl salicylic acid) can be toxic to brain tumour cells. However, its existing preparations cannot readily enter the brain because the drug is a suspension rather than being completely soluble. Furthermore, there can be significant side effects associated with the existing form of the drug including gastric bleeding. The object of this research was to develop a new formulation of aspirin which is truly soluble. When combined with two other compounds, the drug enters the brain and can therefore target the tumour cells. This study also showed that aspirin can kill tumour cells without causing any damage to the normal nerve cells. (more…)
Author Interviews, Dermatology, JAMA, Melanoma / 29.06.2016

MedicalResearch.com Interview with: June K. Robinson, MD Research Professor of Dermatology Northwestern University Feinberg School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: More than 1 million patients with a history of melanoma live in the US. They are at risk to develop a second melanoma. The risk is elevated for up to 20 years and is 10 times greater than the risk of a first melanoma in the general population. This is the first randomized clinical trial to examine partner- assisted skin self-examination (SSE) . A 30 minute structured training intervention was provided to the melanoma patients and their partners with reinforcement every 4 months . The 494 pairs in the intervention performed significantly more skin self-examination  than those in the control group at 4,12 and 24 months after the education and skills training. The pairs were accurate in finding early melanoma and did not have unnecessary visits to the dermatologists. (more…)
Author Interviews, Biomarkers, Cancer Research, Prostate Cancer / 28.06.2016

MedicalResearch.com Interview with: Thomas Kislinger, PhD Senior Scientist at the Princess Margaret Cancer Centre University Health Network Associate Professor Department of Medical Biophysics University of Toronto MedicalResearch.com: What is the background for this study? Response: The goal of this study was to develop a non-invasive, prognostic biomarker that can address the worldwide clinical dilemma of over-treating low-risk prostate cancers. To accomplish this we developed highly accurate proteomics assays in urines collected after a digital rectal examination (termed post-DRE urines). (more…)
Author Interviews, Brain Cancer - Brain Tumors, Diabetes / 27.06.2016

MedicalResearch.com Interview with: Dr. Judith Schwartzbaum PhD Associate professor of epidemiology Ohio State's Comprehensive Cancer Center MedicalResearch.com: What is the background for this study? Response: Meningioma is a slow-growing brain tumor that is associated with obesity. To further understand this risk we examined records of blood sugar levels within approximately 15 years before tumor diagnosis comparing blood sugar levels of people who developed meningioma to those in people who did not. MedicalResearch.com:What are the main findings? Response: To our surprise we found that risk of this tumor was lower in people with high levels of blood sugar and diabetes. (more…)
Author Interviews, Colon Cancer, Geriatrics, Kaiser Permanente, NIH / 27.06.2016

MedicalResearch.com Interview with: Carrie N. Klabunde, PhD Office of Disease Prevention Office of the Director NIH Rockville MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many studies of colorectal cancer screening focus on adults 50-75 years of age; few specifically look at screening in the elderly. We wanted to examine colorectal cancer screening use, including follow-up diagnostic testing for those with abnormal fecal blood screening tests, in adults 65 years of age and older. We also wanted to assess whether screening use in this population is influenced more by elderly individual’s chronological age, or their health status (called comorbidity in our study). The study was conducted in three large, integrated healthcare systems: Kaiser Permanente in Northern California and Southern California, and Group Health in Washington state and Idaho. We examined data on nearly 850,000 patients aged 65-89. (more…)
Author Interviews, Breast Cancer, Microbiome / 26.06.2016

MedicalResearch.com Interview with: Gregor Reid, B.Sc. Hons., Ph.D., MBA, ARM, CCM, Dr. HS, FCAHS Director, Canadian Centre for Human Microbiome and Probiotic Research Lawson Health Research Institute London, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Women who breast feed have reduced risk of breast cancer. Human milk has bacteria passed on to the child. These bacteria reach the breast through the nipple and from the gut via the blood. Lactobacilli and Bifidobacteria, beneficial bacteria, grow well in milk. So, I wondered what if women never lactate or breast feed, could bacteria be there? Could bacteria be in the tissue itself and influence whether you got or did not get cancer. Proving there are bacteria in the actual breast tissue itself was an interesting discovery defying previous beliefs. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, MRI, Surgical Research / 24.06.2016

MedicalResearch.com Interview with: Eva C. Gombos, MD Assistant Professor, Radiology Harvard Medical School Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? Response: Treatment of early stage breast cancer, breast-conserving therapy (BCT), which consists of lumpectomy followed by whole-breast irradiation, requires re-excision 20 %–40% of patients due to positive margins. Breast MR is the imaging modality with the highest sensitivity to detect breast cancer. However, patients who undergo breast MR imaging have not experienced reduced re-excision or improved survival rates. Our hypothesis is that supine (performed with patient lying on her back) MR imaging within the operating room can be used to plan the extent of resection, to detect residual tumor immediately after the first attempt at definitive surgery, and to provide feedback to the surgeon within the surgical suite. The aim of this study was to use intraoperative supine MR imaging to quantify breast tumor deformation and displacement secondary to the change in patient positioning from imaging (prone performed the patient lying on her stomach) to surgery (supine) and to evaluate the residual tumor immediately after BCT. (more…)
Author Interviews, Cancer, Cancer Research, Nutrition / 23.06.2016

MedicalResearch.com Interview with: Lindsay Kohler MPH Mel and Enid Zuckerman College of Public Health Tucson, Arizona MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several studies have reported that following health promotion guidelines for diet, physical activity, and maintenance of a healthy body weight may reduce the risk of getting cancer or dying from cancer. We performed a systematic review to examine the associations between established cancer prevention guidelines for diet and physical activity and cancer outcomes. We found that adhering to cancer prevention guidelines set forth by the American Cancer Society or the World Cancer Research Fund/American Institute for Cancer Research consistently reduced the risk of overall cancer incidence and mortality (10-61%) in the studies included in this review. In addition, higher adherence to the guidelines consistently reduced the risk of breast, colorectal, and endometrial cancers. Adherence to a pattern of healthy behaviors may significantly reduce cancer incidence and mortality. (more…)
Author Interviews, Cancer Research, CT Scanning, Lymphoma, NEJM / 23.06.2016

MedicalResearch.com Interview with: Peter Johnson MA, MD, FRCP Professor of Medical Oncology Cancer Research UK Centre Southampton General Hospital Southampton MedicalResearch.com: What is the background for this study? What are the main findings? Prof. Johnson: Based upon retrospective series looking at the ability of interim PET to predict the outcomes of treatment, we aimed to test the idea of modulating treatment in response to an early assessment of the response to ABVD: could we safely reduce the amount of treatment by omitting bleomycin in the group who had responded well? Although the risk of severe toxicity from bleomycin is generally low, for the small number of patients who experience it, it can be life-changing or even fatal. We also wanted to test whether it might be possible to reduce the use of consolidation radiotherapy by comparison to our previous trials, and this seems to have worked too: we used radiotherapy in less than 10% of patients in RATHL, as compared to around half in our previous trials. We have seen better survival figures than in our previous studies with less treatment overall, so it feels as though we are on the right track. (more…)
Author Interviews, Cancer Research, Nature / 23.06.2016

MedicalResearch.com Interview with: Dr Stéphanie Kermorgant PhD Barts Cancer Institute Queen Mary University of London MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is an urgent need to better understand how cancer spreads around the body (a process called metastasis). Often it is metastasis that kills cancer patients and not the primary tumour. During metastasis, cancer cells detach from the primary tumour and are able to survive detached, allowing them to enter in blood vessels and colonize different parts of the body. Integrins and growth factor receptors are two classes of cell surface molecules that have been known to cooperate to promote cancer metastasis. However how they communicate is poorly understood. They have mostly been shown to exert their function at the surface of the cells. Our study reveals that one growth factor receptor, called c-Met, and one integrin, beta1-integrin, in fact communicate inside the cancer cell to increase its survival when detached. Moreover, this communication occurs in an anusual place in the cell, that we have called “Autophagy Related Endomembrane” (ARE). Autophagy is normally a process that degrades and recycles cellular material, making new building blocks for the cell. Our study reveals that intracellular structures related to the autophagy process can also help membrane receptors to communicate. Thus they may also function as “signalling platforms”. One other key finding in this study is that integrins normally have been recognized to function as “adhesion molecules”, connecting the cells to their surrounding environment, the “extracellular matrix”. Their role in metastasis has been mostly linked to their adhesive function. Our exciting study reveals a new function of integrins, a “signalling function”, which is independent from their adhesion function. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Nutrition, Prostate Cancer / 22.06.2016

MedicalResearch.com Interview with: Dr. Ying Bao Sc.D., M.D Assistant Professor of Medicine Channing Division of Network Medicine Department of Medicine Brigham and Women's Hospital Harvard Medical School, Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nuts are rich in bioactive macronutrients, micronutrients, tocopherols and phytochemicals. Current epidemiological evidence has consistently linked increased nut consumption to reduced risk of several chronic conditions including cardiovascular diseases, type 2 diabetes, and inflammation. In contrast, evidence on nut consumption and cancer risk has been insufficient and equivocal. Prostate cancer is the leading cancer among U.S. men, with approximately 220,800 new cases diagnosed in 2015. However, very few studies have investigated the association between nut intake and prostate cancer. Thus, in the current study, we followed 47,299 US men from 1986-2012, and examined (1) whether consuming more nuts prevents getting prostate cancer, and (2) whether consuming more nuts reduces death rates among non-metastatic prostate cancer patients. During 26 years of follow-up, 6,810 men were diagnosed with prostate cancer, and 4,346 of these patients were without metastasis at diagnosis. We found no association between nut intake and being diagnosed with prostate cancer. However, among non-metastatic prostate cancer patients, those who consumed nuts 5 or more times per week after diagnosis had a significant 34% lower rate of overall mortality than those who consumed nuts less than once per month. (more…)
ASCO, Author Interviews, Cancer Research, Chemotherapy, Lung Cancer / 22.06.2016

MedicalResearch.com Interview with: Dr. Lan Huang PhD Co-founder, Chairman and CEO BeyondSpring Pharmaceuticals, Inc MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is the toxicity of Docetaxel chemotherapy causes inadequate dosing with Docetaxel due to dose delay, reduction or discontinuation, thus leaving the patient with inadequate chemotherapy treatment. A main finding is a statistically significant p value of 0.002 in lower rates of grade 3 and 4 Neutropenia for patients dosed with a combination of BeyondSpring’s Plinabulin and Docetaxel compared to those patients dosed with Docetaxel alone. As a result, approximately 14 percent more patients stayed on the adequate (dense) dose of Docetaxel in the Docetaxel + Plinabulin arm as compared to Docetaxel alone. (more…)
Author Interviews, Journal Clinical Oncology, Karolinski Institute, Leukemia / 22.06.2016

MedicalResearch.com Interview with: Hannah Bower, MSc Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previously, if left untreated or with symptomatic treatment (up to the 1970’s), the median survival time of patients with chronic myeloid leukemia (CML) ranged between two and three years. Later, interferon alpha and allogeneic stem cell transplantation were introduced. However, improvements in survival were mainly seen in younger patients. Treatment with the tyrosine-kinase inhibitor (TKI) imatinib-mesylate (Glivec®, Gleevec®) began in Sweden in the early 2000 resulting in major survival improvements, with the exception of the old/very elderly. We investigated if these improvements continued to 2013 and if improvements are now observed in the elderly via the life expectancy and the loss in expectation of life; the latter of these quantifies the change in the life expectancy due to a diagnosis of CML. The great improvements in life expectancy, especially in the youngest patients, translate into great reductions in the loss in expectation of life. The major factor contributing to the improvement in the elderly is likely the increasing use of TKIs. (more…)
Author Interviews, Melanoma, Technology / 21.06.2016

MedicalResearch.com Interview with: Orit Markowitz, MD Director of Pigmented Lesions and Skin Cancer The Mount Sinai Hospital and Assistant Professor of Dermatology Icahn School of Medicine at Mount Sinai Director of Pigmented lesions clinic Brooklyn VA, Adjunct Professor, Dermatology SUNY Downstate Medical Center, Brooklyn, NY Chief of Dermatology Queens General Hospital, Jamaica, NY MedicalResearch.com Editors’ Note: As part of an ongoing series of occasional article on cancer prevention, Dr. Markowitz from The Mount Sinai Hospital discusses skin cancer and the use Optical Coherence Tomography in skin cancer diagnosis and treatment. MedicalResearch.com: How common is the problem of non-melanoma skin cancer? Are they difficult to detect and treat? Dr. Markowitz: Skin cancer is the most commonly diagnosed cancer in the United States. Non melanoma skin cancers, including basal cell carcinomas and squamous cell carcinomas, are the most common malignancies of the skin, constituting around 80 percent of all skin cancers. The annual cost of treating skin cancers in the U.S. is estimated at $8.1 billion, with $3.3 billion for melanoma. (more…)
Author Interviews, Erectile Dysfunction, Melanoma, PLoS / 16.06.2016

MedicalResearch.com Interview with: Anthony Matthews Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine London, United Kingdom MedicalResearch.com: What is the background for this study? Dr. Mathews: :The drug Viagra, which is used to treat erectile dysfunction, is one of a class of drugs called PDE5 inhibitors. Laboratory studies of cells from the skin cancer, malignant melanoma, suggest that PDE5 inhibitors might promote their growth, so there have been some concerns that people using these drugs might have an increased risk of malignant melanoma. Two previous studies comparing melanoma rates in PDE5 inhibitor users and non-users came to differing conclusions so we wanted to look further into this. To carry out the study we used anonymised GP records from the UK identifying over 150,000 men with a PDE5 inhibitor prescription, and over 500,000 men of a similar age, and from the same areas, who didn’t have a PDE5 inhibitor prescription. We then looked for later diagnoses of malignant melanoma to see how people’s exposure to PDE5 inhibitors affected their future risk of being diagnosed with melanoma. (more…)
Author Interviews, Colon Cancer, JAMA / 16.06.2016

MedicalResearch.com Interview with: Jennifer S. Lin, MD, MCR, FACP Director, Kaiser Permanente Research Affiliates Evidence-based Practice Center Investigator, The Center for Health Research, Kaiser Permanente Northwest Portland, OR 97227 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Lin: Our systematic review was commissioned by the USPSTF, in tandem with a separate modeling exercise, to help update their 2008 colorectal cancer screening recommendations. Since the previous recommendation, there has been a wealth of new evidence, including more evidence on the long-term effectiveness of flexible sigmoidoscopy for reducing colorectal cancer mortality, the screening accuracy and decreasing radiation exposure from CT colonography, and the screening accuracy for a number FDA-approved stool tests using fecal immunochemical testing (FIT). While we have large, well-designed RCTs demonstrating that screening for colorectal cancer using flexible sigmoidoscopy and older generation stool testing reduces colorectal cancer mortality, these screening tests are no longer widely used in the United States. Well-designed diagnostic accuracy studies of screening colonoscopy, CT colonography, and various stool based tests using FIT demonstrate adequate sensitivity and specificity to detect adenomas and/or colorectal cancer, making each of them viable screening options. However, each screening option has potential harms associated with their use, particularly those allowing for direct visualization of the colon. Colonoscopy harms include perforations and major bleeding events. CT colonography requires exposure to radiation; and CT colonography not uncommonly results in detection of extra-colonic findings which necessitate additional diagnostic follow-up which may result in a benefit or harm. (more…)
Annals Internal Medicine, Author Interviews, Chemotherapy, Heart Disease, Karolinski Institute, Leukemia / 15.06.2016

MedicalResearch.com Interview with: Torsten Dahlén MD Centre for Hematology Karolinska University Hospital Solna Stockholm Sweden MedicalResearch.com: What is the background for this study?  Dr. Dahlén: Patients diagnosed with CML have had a dramatic increase in life-expectancy since the widespread introduction of tyrosine kinase inhibitors (TKI) in 2001. However, treatment is today regarded as life-long. We thus need to observe for late-effects of continuous TKI exposure. Recent reports have demonstrated a linkage between TKI treatment, especially more potent 2nd and 3rd generation drugs, and to the occurrence of peripheral arterial occlusive disease (PAOD). This study aimed to use real-world data utilizing Swedish population based registries together with the dedicated Swedish CML registry which contains data and follow-up on more than 98% of all CML patients diagnosed in Sweden since 2002. (more…)
Author Interviews, Cancer Research, Chemotherapy, Immunotherapy / 15.06.2016

MedicalResearch.com Interview with: Professor Frances Balkwill OBE, FMedSci Lead, Centre for Cancer and Inflammation Barts Cancer Institute Queen Mary University of London London MedicalResearch.com: What is the background for this study? Prof. Balkwill: We wanted to find out if chemotherapy altered patients immune system especially the immune cells that co-exist with cancer cells in tumors. We studied women with ovarian cancer who often receive chemotherapy after diagnosis but before surgery. This meant, at least in some of them, we could study a biopsy taken before treatment began and also a biopsy taken during the operation. (more…)
ASCO, Author Interviews, Breast Cancer, Genetic Research, Journal Clinical Oncology, NIH / 14.06.2016

MedicalResearch.com Interview with: Valentina Petkov, MD, MPH Health Scientist/Program Officer NIH/NCI/DCCPS/Surveillance Research Program MedicalResearch.com: What is the background for this study? Dr. Petkov: The number of breast cancer diagnoses is increasing in older patients because of increasing life expectancy and changing population demographics. Despite high incidence, little is known about breast cancer biology and outcomes in patients older than 70, which are often under-represented in clinical trials. The 21-gene Oncotype DX Breast Recurrence Score assay has been used in clinical practice to predict distant recurrence risk and chemotherapy benefit in lymph node negative, hormonal receptor positive (estrogen and/or progesterone receptor positive) invasive breast cancer since 2004. The goal of our study was to evaluate the role of the 21 gene assay in older patients at population level. We used Surveillance Epidemiology and End Results (SEER) data. We included in the analysis 40,134 patients who were diagnosed with invasive breast cancer between 2004 and 2011, had negative nodes and their tumors were hormonal receptor positive and HER2 negative. Breast Cancer Specific Mortality (BCSM) was assessed at 5 years after diagnosis in patients with low risk (Recurrence Score <18), intermediate risk (Recurrence Score 18-30) and high risk (Recurrence Score >30). (more…)
Author Interviews, Biomarkers, Cancer Research, Infections, Technology, University of Pittsburgh / 13.06.2016

MedicalResearch.com Interview with: Donald S. Burke, M.D. Dean of the University of Pittsburgh Graduate School of Public Health Director of the University of Pittsburgh Center for Vaccine Research MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Burke: At the University of Pittsburgh we developed a unique method for detecting antibodies in the blood of patients in a proof-of-principle study that opens the door to development of simple diagnostic tests for diseases for which no microbial cause is known, including auto-immune diseases, cancers and other conditions. We used a technique pioneered by co-author Thomas Kodadek, Ph.D., of the Scripps Research Institute, that synthesizes random molecular shapes called “peptoids” hooked onto microscopic plastic beads. The technique can produce millions of molecular shapes. The peptoids are not organic, but if they match to the corresponding shape on an antibody, that antibody will connect to them, allowing the scientist to pull out that bead and examine that peptoid and its corresponding antibody. My team chemically generated a huge library of random molecular shapes. Then, using blood from HIV-infected patients and from non-infected people, we screened a million of these random molecular shapes to find the ones that bound only to antibodies present in the blood of HIV-infected patients, but not the healthy controls. No HIV proteins or structures were used to construct or select the peptoids, but the approach, nonetheless, successfully led to selection of the best molecular shapes to use in screening for HIV antibodies. We then resynthesized that HIV-antibody-targeting peptoid in mass and tested it by screening hundreds of samples from the Multicenter AIDS Cohort Study (MACS), a confidential research study of the natural history of treated and untreated HIV/AIDS in men who have sex with men (supported by the National Institutes of Health). Study co-author Charles Rinaldo, Ph.D., chair of Pitt Public Health’s Department of Infectious Diseases and Microbiology and director of the Pittsburgh arm of the MACS, selected the samples, but blinded the testers to which samples were HIV-positive or -negative. The test distinguished between the samples of HIV-positive blood and HIV-negative blood with a high degree of accuracy. (more…)
Author Interviews, Breast Cancer, Lipids, MRI, NYU / 09.06.2016

MedicalResearch.com Interview with: Sungheon G. Kim, PhD Associate Professor Department of Radiology NYU Langone and Researcher at the Center for Advanced Imaging, Innovation, and Research MedicalResearch.com: What is the background for this study? Dr. Kim: The role of fat in breast cancer development and growth has been studied extensively using body mass index (BMI), a measure of whole body fatness, and dietary fat intake in a number of epidemiological studies. However, there is a paucity of studies to assess the role of breast fat itself in breast cancer due to lack of a non-invasive and fast measurement method. Since breast fibroglandular cells are surrounded by breast fat cells, the characteristics of breast fat may have a stronger relationship with breast cancer development and growth than BMI and/or dietary fat. However, it is not trivial to study the role of breast fat, mainly due to the lack of a non-invasive and fast measurement method sensitive enough to important features of breast fat, such as types of fat. (more…)
ASCO, Author Interviews, Cancer Research, Immunotherapy / 08.06.2016

MedicalResearch.com Interview with: Dr. Arjun Balar MD Assistant Professor, Department of Medicine Co-Leader Genitourinary Cancers Program NYU Langone Medical Center Laura and Isaac Perlmutter Cancer Center MedicalResearch.com: What is the background for this study? Dr. Balar: Standard treatment for advanced urothelial cancer includes cisplatin chemotherapy. But more than half of patients are not expected to tolerate it well and alternative treatment is inferior to cisplatin. The average survival for these patients is in the range of 9-10 months with carboplatin-based treatment, which is the most commonly used alternative to cisplatin. Atezolizumab is a PD-L1 blocking antibody that reactivates the body¹s immune system to fight bladder cancer and has been recently FDA approved in the management of advanced urothelial cancer in the second-line setting after failure of platinum-based chemotherapy. (more…)
ASCO, Author Interviews, Cancer Research, Immunotherapy, University of Pittsburgh / 07.06.2016

MedicalResearch.com Interview with: Robert L. Ferris, M.D., Ph.D. Robert L. Ferris, M.D., Ph.D. UPMC Endowed Professor and Vice-Chair Associate Director for Translational Research Co-Leader, Cancer Immunology Program MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ferris: Investigators at the University of Pittsburgh Cancer Institute<http://upci.upmc.edu/> (UPCI) co-led CheckMate-141<https://clinicaltrials.gov/ct2/show/NCT02105636> a large, randomized international phase III clinical trial that enrolled 361 patients with recurrent or metastatic head and neck squamous cell carcinoma who had not responded to platinum-based chemotherapy, a rapidly progressing form of the disease with an especially poor prognosis. Patients were randomized to receive either nivolumab or a single type of standard chemotherapy until tumor progression was observed. Nivolumab, which belongs to a class of drugs known as immunotherapeutics, enables the body’s immune system to destroy cancer cells. It currently is approved to treat certain types of cancers, including melanoma and lung cancer. The nivolumab group achieved better outcomes than the standard chemotherapy group by all accounts. After 12 months, 36 percent of the nivolumab group was alive, compared to just 17 percent of the standard chemotherapy group. Nivolumab treatment also doubled the number of patients whose tumors shrunk, and the number whose disease had not progressed after six months of treatment. Importantly, these benefits were achieved with just one-third the rate of serious adverse events reported in the standard chemotherapy group. In addition, on average, patients receiving nivolumab reported that their quality of life remained stable or improved throughout the study, while those in the chemotherapy group reported a decline. The new trial was considered so successful that it was stopped early to allow patients in the comparison group to receive the new drug. (more…)
ASCO, Author Interviews, Dermatology, Journal Clinical Oncology, Melanoma, Primary Care, University of Pittsburgh / 07.06.2016

MedicalResearch.com Interview with: Laura Ferris, M.D., Ph.D. Associate professor, Department of Dermatology University of Pittsburgh School of Medicine and Member of the Melanoma Program University of Pittsburgh Cancer Institute MedicalResearch.com: What is the background for this study? Dr. Ferris: Rates of melanoma, the most dangerous form of skin cancer, are on the rise, and skin cancer screenings are one of the most important steps for early detection and treatment. Typically, patients receive skin checks by setting up an appointment with a dermatologist. UPMC instituted a new screening initiative, which was modeled after a promising German program, the goal being to improve the detection of melanomas by making it easier for patients to get screened during routine office visits with their primary care physicians (PCPs). PCPs completed training on how to recognize melanomas and were asked to offer annual screening during office visits to all patients aged 35 and older. In 2014, during the first year of the program, 15 percent of the 333,788 eligible UPMC patients were screened in this fashion. (more…)