Author Interviews, JAMA, Mayo Clinic, Pancreatic, USPSTF / 14.08.2019

MedicalResearch.com Interview with: Dr. Chyke A. Doubeni, M.D., M.P.H. Dr. Doubeni is a family physician and The inaugural director of the Mayo Clinic Center for Health Equity and Community Engagement Research MedicalResearch.com: What is the background for this study? Response: The U.S. Preventive Services Task Force uses systematic review of existing research to make recommendations on clinical preventive services that are delivered in primary care, with the goal to promote and improve health for all Americans. Although pancreatic cancer is an uncommon condition in the general population, it is often deadly. Pancreatic cancer is now the third most common cause of cancer death in the United States, and could become the second leading cause if current trends continue. The vast majority of people with pancreatic cancer are diagnosed at a late stage and, unfortunately, even when caught early enough when surgery could be most effective, only a little over one-third of patients survive beyond five years. (more…)
Author Interviews, Breast Cancer, JAMA, UCLA / 12.08.2019

MedicalResearch.com Interview with: Joann G. Elmore, MD, MPH Professor of Medicine, Director of the UCLA National Clinician Scholars Program David Geffen School of Medicine at UCLA  MedicalResearch.com: What is the background for this study? What are the main findings?
  • A pathologist makes the diagnosis of breast cancer versus non-cancer after reviewing the biopsy specimen. Breast biopsies are performed on millions of women each year and It is critical to get a correct diagnosis so that we can guide patients to the most effective treatments.
  • Our prior work (Elmore et al. 2015 JAMA) found significant levels of disagreement among pathologists when they interpreted the same breast biopsy specimen. We also found that pathologists would disagree with their own interpretations of breast biopsies when they where shown the same biopsy specimen a year later.
  • In this study, 240 breast biopsy images were fed into a computer, training it to recognize patterns associated with several types of breast lesions, ranging from benign (noncancerous) to invasive breast cancer. We compared the computer readings to independent diagnoses made by 87 practicing U.S. pathologists and found that while our artificial intelligence program came close to performing as well as human doctors in differentiating cancer from non-cancer, the AI program outperformed doctors when differentiating ductal carcinoma in situ (DCIS) from atypia, which is considered the greatest diagnostic challenge.
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Author Interviews, Melanoma, Vaccine Studies / 11.08.2019

MedicalResearch.com Interview with: Prof. Ronit Satchi-Fainaro, PhD Head, Cancer Research and Nanomedicine Laboratory Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv 69978, Israel Prof. Helena Florindo, PhD Head, BioNanoSciences – iMed.ULisboa Faculty of Pharmacy, University of Lisbon Lisbon, Portugal    MedicalResearch.com: What are the main findings? Response: The war against cancer in general, and melanoma in particular, has advanced over the years through a variety of treatment modalities, such as surgery, chemotherapy, radiation therapy and immunotherapy. The immune checkpoint inhibitors brought a breakthrough solution for advanced melanoma patients, but only a low percentage of those respond to this therapy, developing resistance and being affected by severe side effects. Despite the success of several vaccines against viral diseases, this success has not been materialized yet against cancer. This study led by my lab at Tel Aviv University, and Helena Florindo’s lab at the University of Lisbon, describes the development of an effective nano-vaccine against melanoma, that also sensitizes the immune system to immunotherapies. This nano-vaccine prevented melanoma, and also led to remarkable tumor inhibition and prolonged survival in mice already affected by this disease.  (more…)
Author Interviews, Breast Cancer, Cancer Research, NIH / 08.08.2019

MedicalResearch.com Interview with: Co-First author: Jamie J. Lo, MPH PhD student, Saw Swee Hock School of Public Health National University of Singapore, Singapore Co-First author & Co-Senior author: Yong-Moon (“Mark”) Park, MD, PhD Postdoctoral fellow, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health Senior author: Dale P. Sandler, PhD Chief, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health  MedicalResearch.com: What is the background for this study? Response: We were interested, generally, in the association between meat consumption and breast cancer risk. Epidemiological studies of red meat consumption and risk of breast cancer are still inconsistent, although red meat has been identified as a probable carcinogen. In addition, there is not much evidence on the association between poultry consumption and breast cancer risk. We studied around 42,000 women ages 35-74 from across the US who are enrolled in the Sister Study cohort. Women provided self-reported information on meat consumption at baseline and were followed for 7.6 years on average. (more…)
Author Interviews, Cancer Research, Genetic Research / 08.08.2019

MedicalResearch.com Interview with: Upekha Liyanage MBBS |  PhD Student School of Medicine | University of Queensland Statistical Genetics Laboratory QIMR Berghofer Medical Research Institute MedicalResearch.com: What is the background for this study? What types of skin cancers are linked to these genes? Response: Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) collectively referred to as “keratinocyte cancers” are the commonest forms of cancers of the skin. Although these cancers are less aggressive than melanoma, due to their large numbers, they pose a significant burden to the healthcare expenditure. Also, these cancers are relatively understudied when compared with melanoma. Notably, BCC and SCC are not routinely reported in cancer registries. In Australia, Medicare data are used to estimate the incidence and costs associated with these cancers. Expenditure in Australia for the diagnosis, treatment and pathology, almost exceeds $700 million for both BCC and squamous cell carcinoma. In Unites States, the average annual cost for skin cancer including melanoma is approximately $8.1 billion. Previous research has led to identification of 29 BCC and 11 squamous cell carcinoma genetic risk variants and 7 of them overlap with both BCC and SCC risk. So, to strengthen the preventive efforts and to reveal new therapeutics, it is very timely and critical to explore more on the genetic susceptibility of these deadly cancers. We analysed ~48,000 cancer cases with ~630,000 skin cancer free controls from European ancestry population in Australia, UK and USA.  (more…)
Author Interviews, Cancer Research, JAMA, MRI, Prostate Cancer / 07.08.2019

MedicalResearch.com Interview with: Dr Martha Elwenspoek PhD Research Associate in Epidemiology and Health Services Research NIHR CLAHRC West, Bristol MedicalResearch.com: What is the background for this study? Response: Prostate cancer is one of the most common cancers in men. Prostate cancer is usually diagnosed by taking 10 to 14 systematic samples from the prostate guided by ultrasound. However, these biopsies are unpleasant for patients, can miss cancer even when it’s present, can misclassify the severity of the cancer, and can cause side effects, such as bleeding and infection. If biopsies could be targeted better, men wouldn’t have to undergo so many and there would be less risk of getting a misleading result. Multiparametric MRI (mpMRI) scans are sometimes used before doing a biopsy to help diagnose prostate cancer, and while this approach is now being recommended by the UK National Institute for Clinical Excellence (NICE) their use isn’t widespread. (more…)
Author Interviews, Biomarkers, Cancer Research / 05.08.2019

MedicalResearch.com Interview with: Emeritus Professor Attila Lorincz, PhD Centre for Cancer Prevention Queen Mary University of London  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The vast majority of women with cervical lesions are not at risk for cancer, however, because there is no way to accurately identify the very small proportion of women at risk of cervical cancer a recommendation for treatment is commonly given by doctors. Surgery on women with cervical lesions is risky for future pregnancies and can cause harm to the baby. Occasionally there are also problems in physical recovery and the mental well-being of the treated women. We wanted to see if the S5 DNA methylation test could identify the women who need treatment. We ran a two-year follow-up study on 149 young women with moderate dysplasia in Finland. Our results showed that the S5 test was by far the best method to reveal which women needed treatment.  (more…)
Author Interviews, Cancer Research, Dental Research, Opiods / 23.07.2019

MedicalResearch.com Interview with: Praveen Arany, DDS, PhD Department of Oral Biology School of Dental Medicine University of Buffalo MedicalResearch.com: What is the background for this study? How is the light treatment delivered? Response: Cancers are usually treated with chemotherapy and/or radiation to destroy the tumor cells. However, an unfortunate side-effect of these treatments is pain and ulcers in the mouth due to breakdown of normal protective responses. Light has various applications in human health and normal physiology. Two good examples are vision and sunlight-Vitamin D for bone and health. The use of low dose light to alleviate pain or inflammation and promote tissue healing is termed Photobiomodulation (PBM) Therapy. This treatment can be provided with lasers or LED devices at specific wavelength (color) and dose (power). This treatment is currently being provided by a health care provider - usually a laser - either nurse or dentist prior or during the cancer treatments. There are several exciting innovation where take-home, self-use devices are becoming available. (more…)
Author Interviews, Cancer Research, Coffee / 21.07.2019

MedicalResearch.com Interview with: coffee-smell caffeineMr Jue Sheng Ong,  PhD Student  QIMR Berghofer’s Statistical Genetics Group MedicalResearch.com: What is the background for this study? Response: Previous findings have shown conflicting results on whether coffee is associated with cancer risk. To evaluate whether there’s any evidence for a causal relationship between coffee and cancer outcomes, we performed two types of association analyses using data from the half a million participants in the UK.
  • We first studied whether an individual’s self-reported coffee consumption is related to their overall risk of developing or dying from any cancers.
  • Then, we repeated the analyses using genetically predicted coffee intake (using about 35 genetic markers related with coffee intake) instead of their self-reported consumption: a technique known as mendelian randomization which is commonly used in modern epidemiology to remove bias from environmental confounders.
Using both techniques, we found no evidence to support a relationship between coffee consumption and the risk of developing or dying from cancers. (more…)
Author Interviews, Cancer Research, ENT, JAMA, Surgical Research / 18.07.2019

MedicalResearch.com Interview with: Megan Rist Haymart MD Associate Professor Metabolism, Endocrinology and Diabetes Clinic Michigan Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Thyroid cancer is a common malignancy with surgery considered one of the primary treatments. Complications from thyroid surgery can lead to long-term voice problems. However, few studies have used validated scales to quantify the impact of thyroid surgery on patient voice. Prior work has largely focused on single institution studies with high volume surgeons or claims data with reports of specific nerve injury. We surveyed a diverse cohort of patients affiliated with SEER sites Georgia and Los Angeles to identify the prevalence, severity and correlates of poor voice outcomes following surgery for differentiated thyroid cancer. We found that out of 2,325 patients 25.8% reported voice changes lasting greater than 3 months after surgery, 12.7% had abnormal voice per a validated voice scale (Voice Handicap Index- 10), and 4.7% reported a diagnosis of vocal fold motion impairment. We also identified patient factors associated with abnormal voice 2-4 years post op. (more…)
Author Interviews, Cancer Research, Hormone Therapy, JAMA, Prostate Cancer, University of Pennsylvania / 15.07.2019

MedicalResearch.com Interview with: Ravi Jayadevappa, PhD, MS Department of Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA 19104-2676  MedicalResearch.com: What is the background for this study? Response: In the US, prostate cancer is the most commonly diagnosed non-skin cancer and the second leading cause of cancer death among men. Research shows that hormone therapy or ADT reduces the levels of male hormones in the body, called androgens, to stop them from stimulating cancer cells to grow., and thus is effective in reducing the spread and progression of prostate cancer. At the same time, some research has suggested that decreasing androgen levels may increase the risk factors for Alzheimer’s and dementia, including loss of lean body mass, diabetes, cardiovascular disease, and depression. The ADT therapy may lead to impaired neuron growth and the regeneration of axons, thus affecting the cognitive function. Thus there is growing interest in the possible association between exposure to ADT and cognitive dysfunction. Our study investigates the association between exposure to ADT and subsequent diagnosis of Alzheimer’s or dementia in elderly, fee-for-service Medicare enrollees using SEER-Medicare linked databases. (more…)
Author Interviews, Cancer Research, Outcomes & Safety, Surgical Research, Yale / 12.07.2019

MedicalResearch.com Interview with: Daniel Boffa, MD Professor of Surgery Yale School of Medicine  MedicalResearch.com: What is the background for this study? Response: We have previously demonstrated that top-ranked hospitals are significantly safer than their affiliates for complex cancer surgery (patients 1.4 times more likely to die after cancer surgery at affiliate hospitals).  A logical extension of this work was to compare affiliate hospitals to hospitals that were not affiliated with a top ranked hospital. (more…)
Author Interviews, Cancer Research, JAMA / 03.07.2019

MedicalResearch.com Interview with: Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc MedicalResearch.com: What is the background for this study?   Response: In the United States, cancer is the second leading cause of death, and premature cancer deaths impose significant economic burden. Contemporary information on the economic burden of cancer mortality can inform policies and help prioritize resources for cancer prevention and control, but this information is lacking. In our study, we provide contemporary estimates for the loss of future earnings (lost earnings) due to cancer death at national and state levels for all cancers combined and for major cancers. (more…)
Author Interviews, Cancer Research, Pediatrics, Technology / 02.07.2019

MedicalResearch.com Interview with: atomwiseAbraham Heifets, PhD Department of Computer Science University of Toronto  MedicalResearch.com: What is the background for this announcement? How many children and adolescents are affected by pediatric cancer? Response: Cancer is diagnosed in more than 15,000 children and adolescents each year. Many cancers, including pediatric cancer, do not have effective treatments and for those that do, it is estimated that 80% have serious adverse effects that impact long-term health.  (more…)
AACR, Author Interviews, CT Scanning, Lung Cancer / 28.06.2019

MedicalResearch.com Interview with: Barbara Nemesure, PhD Professor, Department of Family, Population and Preventive Medicine Division Head, Epidemiology and Biostatistics Director, Cancer Prevention and Control Program Director, Lung Cancer Program, Stony Brook Cancer Center Renaissance School of Medicine Stony Brook University    MedicalResearch.com: What is the background for this study? What are the main findings? Response: Lung cancer is the most common cause of cancer death, claiming the lives of more than 150,000 people in the United States each year. While lung nodules are not uncommon, it has remained a challenge to differentiate those that will progress to cancer and those that will remain benign. Although numerous risk prediction models for lung cancer have been developed over the past 2 decades, the majority have been based on retrospective analyses or high risk groups with a strong history of tobacco use. To date, there have been a limited number of large-scale, prospective studies evaluating risk that a nodule will convert to cancer in the general population. This investigation aimed to construct a population-based risk prediction model of incident lung cancer for patients found to have a lung nodule on initial CT scan. The derived model was determined to have high accuracy for predicting nodule progression to cancer and identified a combination of clinical and radiologic predictors including age, smoking history (pack-years), a personal history of cancer, the presence of chronic obstructive pulmonary disease (COPD), and nodule features such as size, presence of spiculation and ground glass opacity type. When compared to patients in the low risk category, those defined as high risk had more than 14 times the risk of developing lung cancer. Quantification of reliable risk scores has high clinical utility, enabling physicians to better stratify treatment plans for their patients.      (more…)
Author Interviews, JAMA, Prostate, Prostate Cancer, Urology / 25.06.2019

MedicalResearch.com Interview with: Kari Tikkinen, MD, PhD, Adjunct Professor Departments of Urology and Public Health University of Helsinki and Helsinki University Hospital Helsinki, Finland MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Men’s choice of whether to undergo screening is value and preference sensitive: fully informed men will make different choices depending on their experience and perspective. For such decisions, shared decision-making represents an ideal approach to decision making. In shared decision-making both the patient and health care provider contribute to the medical decision-making process. The health care provider explains alternatives to patients, informs them of the best evidence regarding the anticipated consequences of a decision for or against the intervention, and helps them choose the option that best aligns with their preferences. All major guidelines of prostate cancer screening acknowledge the importance of informing men about risks and benefits of PSA screening. Shared decision-making is challenging because it requires time, knowledge, and specific skills. Prostate cancer screening decisions aids may, by summarizing the current best evidence and by supporting conversations that address what matters most to men, address these challenges. The impact of decision aids on the decision-making process is, however, uncertain. We therefore undertook a systematic review and meta-analysis of the randomized trials that have addressed the impact of decision aids in the context of prostate cancer screening.  (more…)
ASCO, Author Interviews, Biomarkers, Colon Cancer / 24.06.2019

MedicalResearch.com Interview with: Lawrence LaPointe, Ph.D. Chief Innovation Officer Clinical Genomics Bridgewater, New Jersey  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Colorectal cancer is a cancer of the colon and the rectum. The American Cancer Society estimates that about 1 in 21 men and 1 in 23 women in the United States will develop colorectal cancer during their lifetime. This disease is the second leading cause of cancer death in women, and the third for men. Colorectal cancer has a high 5-year recurrence rate and most likely is spread to the liver and lungs. Clinical Genomics has two decades of experience striving to save lives and reduce costs by developing easy-to-use tests for the detection of colorectal cancer. With breakthrough diagnostic tools, the company aims to offer affordable and accurate tests, supporting physicians and patients with potential life-saving knowledge about colorectal cancer. On June 3, 2019, Clinical Genomics presented research detailing breakthrough methods of colorectal cancer recurrence monitoring at the American Society of Clinical Oncology (ASCO) annual meeting in the McCormick Place Convention Center, Chicago.  (more…)
Author Interviews, Cancer Research, Genetic Research, Pediatrics / 24.06.2019

MedicalResearch.com Interview with: Philip J. Lupo, PhD, MPH Co-Director, Childhood Cancer Epidemiology and Prevention Program, Texas Children's Cancer Center Associate Professor, Department of Pediatrics Section of Hematology-Oncology, Member, Dan L. Duncan Comprehensive Cancer Center Baylor College of Medicine Adjunct Associate Professor, Human Genetics Center, Division of Epidemiology, Human Genetics and Environmental Sciences University of Texas School of Public Health   MedicalResearch.com: What is the background for this study?   Response: While cancer risk in children with certain chromosomal defects like Down syndrome is well established, much less is known for children with birth defects where there is no known genetic cause, sometimes called non-chromosomal defects. Non-chromosomal defects, as a group, affect more children, but one of the primary challenges of understanding risk among these children is that limited sample sizes make studying specific defects, like spina bifida, more difficult. Because of that, we gathered data from birth, birth defect, and cancer registries across Texas, Arkansas, Michigan, and North Carolina to generate a birth cohort of more than 10 million children born between 1992 and 2013. We looked at diagnoses of cancer until 18 years of age to determine differences in cancer risk between those with and without birth defects. (more…)
Author Interviews, Cancer Research, Cost of Health Care, JAMA, Pain Research / 21.06.2019

MedicalResearch.com Interview with: Changchuan (Charles) Jiang MD, MPH MSSLW Internal Medicine Residency Program Class of 2020 Ichan School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Chronic pain is one of the common side effects of cancer treatments and it has been linked to low life quality, lower adherence to treatment, higher medical cost. As the population of cancer survivors grows rapidly, chronic pain will be a major public health issue in this population. We know from previous studies that chronic pain is common in certain cancers such as breast cancer. However, little was known about the epidemiology of chronic pain in the cancer survivors until our study. (more…)
Author Interviews, Environmental Risks, Genetic Research, Prostate Cancer / 20.06.2019

MedicalResearch.com Interview with: Emanuela Taioli, MD, PhD, Director of the Institute for Translational Epidemiology Icahn School of Medicine at Mount Sinai Asociate director for Population Science Tisch Cancer Institute  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: An excess incidence of prostate cancer has been identified among World Trade Center responders. We wanted to study if this excess was associated with exposure to WTC dust The results suggest that respiratory exposure to WTC dust can induce inflammatory and immune responses in prostate tissue. Chronic inflammation could facilitate prostate cancer development Taken together, our results suggest that World Trade Center prostate cancer cases have a distinct gene expression pattern that may be the result of exposure to specific carcinogens during the WTC attacks. WTC dust-exposed rat prostate displayed unique changes in gene expression and immune cell infiltrates after acute dust exposure, suggesting that the effect of exposure may be measured locally in target organs such as prostate. In addition, some of the genes overexpressed in rat normal prostates as a consequence of exposure are also overexpressed in human prostate cancer tissues, suggesting a link between exposure, local immune dysregulation, and prostate cancer development (more…)
Author Interviews, Cancer Research, Lung Cancer / 19.06.2019

MedicalResearch.com Interview with: Thomas A. Quinn, DO, FAOCOPM Clinical Professor Lake Erie College of Osteopathic Medicine Bradenton  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Canine scent detection of lung cancer is showing evidence of being an effective, safe and cost effective method of early detection of lung as well as other types of cancer. Lung cancer is the leading cause of cancer deaths and early detection has proven to be one of the most effective ways to reduce the mortality and morbidity of this deadly disease.  In a collaborative study conducted by the Lake Erie College of Osteopathic Medicine (LECOM) and BioScentDX, a canine training and research facility, we were able to show that highly trained dogs can detect non-small cell cancer of the lung by scent alone.  For this study we chose to use Beagles because of their superior scent capability as well as their temperament, sociability and easy trainability.  The dogs proved to be able, in this double blind study, to detect lung cancer in blood serum with a 96.7% sensitivity and a 97.5% specificity. The dogs underwent an eight-week training program using the clicker/treat training method.  We trained four Beagles for this study but one of the dogs did not respond well to the training methods and had to be removed from the program. That dog was retrained as a service dog for a handicapped child. (more…)
Author Interviews, Chemotherapy, Leukemia / 18.06.2019

MedicalResearch.com Interview with: Dr. Carlos Buesa PhD Chief Executive Officer Oryzon Genomics  MedicalResearch.com: What is the background for this study? Response: Lysine specific demethylase 1 (LSD1, also known as KDM1A) is a histone modifying enzyme that removes methyl groups, thereby regulates the expression of many genes important in cancer progression and cell proliferation. Aberrant expression of LSD1 has been shown in many types of cancers. In particular, LSD1 expression is upregulated in bladder, small cell lung (SCLC), and colorectal clinical cancer tissues when compared with the corresponding nonneoplastic tissues. LSD1 has also been shown to be overexpressed in some breast cancers and may function as a biomarker of the aggressiveness of the disease. However, the function of LSD1 is most understood in acute leukemia, particularly Acute Myeloid Leukemia and Acute Lymphoblastic leukemia. LSD1 is crucial for the function and maintenance of the leukemic stem cells, a subset of malignant cells that is believed to be the ultimate reason for relapse in these patients. LSD1 inhibition might be a therapeutic solution to avoid those relapses. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Lung Cancer, Radiation Therapy / 10.06.2019

MedicalResearch.com Interview with:   Raymond H Mak, MD Assistant Professor of Radiation Oncology Harvard Medical School Radiation Oncology Brigham and Women's Hospital       Katelyn M. Atkins MD PhD Harvard Radiation Oncology Program Dana-Farber Cancer Institute Brigham and Women’s Hospital Boston, Massachusetts     MedicalResearch.com: What is the background for this study? What are the main findings? 
  • Lung cancer remains the leading cause of cancer-related death worldwide and nearly half of patients will require radiation therapy as part of their care.
  • Cardiac toxicity following radiotherapy has been well-studied in breast cancer and lymphomas, however the impact of cardiac toxicity following lung cancer radiotherapy has historically been under-appreciated due to the high risk of lung cancer death.
  • Recent studies highlighting cardiac toxicity following lung cancer radiotherapy have been limited by small numbers of patients and, to our best knowledge, have not included validated cardiac event endpoints defined by the American Heart Association (AHA)/American College of Cardiology (ACC).
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Author Interviews, Brigham & Women's - Harvard, Prostate Cancer, Weight Research / 10.06.2019

MedicalResearch.com Interview with: Barbra Dickerman, PhD Research Fellow Department of Epidemiology Harvard T.H. Chan School of Public Health Boston, MA MedicalResearch.com: What is the background for this study? Response: Obesity is associated with a higher risk of advanced prostate cancer and poorer prognosis after diagnosis. However, emerging evidence suggests that the specific distribution of body fat may be an important prognostic factor for prostate cancer outcomes. In this original investigation, we analyzed body fat distribution on computed tomography imaging and the risk of being diagnosed with, and dying from, prostate cancer. This study was conducted among 1,832 Icelandic men with over a decade of follow-up in the Age, Gene/Environment Susceptibility-Reykjavik Study. (more…)
Allergies, Author Interviews, Cancer Research, Immunotherapy / 07.06.2019

MedicalResearch.com Interview with: Prof. Olivier Lambotte, MD, PHD Professor of Internal Medicine Paris XI University Medical School Research Director Control of Chronic Viral Infections DepartmentProf. Olivier Lambotte, MD, PHD Professor of Internal Medicine Paris XI University Medical School Research Director Control of Chronic Viral Infections Department MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Immune checkpoint inhibitors (ICIs) anti-programmed death-1 (PD-1) or anti-programmed death ligand-1 (PD-L1) have proven efficacy in the treatment of many cancers but patients may experience immune-related adverse events (irAEs). Immune checkpoint inhibitors is usually stopped when grade 2 or higher irAE occur. Data are very limited  on the safety of resuming treatment after such an event. We  studied all adult patients referred to the ImmunoTOX toxicity review board at the Gustave Roussy cancer center (Villejuif, France) in 2015-2017 with  irAE grade 2 or higher for whom the  rechallenge was questioned. Among 93 patients with a broad spectrum of cancers, 40 patients (43%) were rechallenged with the same anti-PD-1 or anti-PD-L1. The rechallenged and non-rechallenged groups did not differ in terms of age, time to initial irAE, irAE severity, or steroid use. With a median follow-up period of 14 months, the same irAE or a different irAE occurred in 22 patients (55%). The second irAEs were not more severe than the first. Earlier initial toxicity was associated with more frequent irAE recurrence. (more…)
ASCO, Author Interviews, Cancer Research, Cost of Health Care, Race/Ethnic Diversity / 06.06.2019

MedicalResearch.com Interview with: Blythe J.S. Adamson, PhD, MPH Senior Quantitative Scientist Flatiron Health MedicalResearch.com: What is the background for this study? Response: Racial disparities in access and outcomes have been documented across the full trajectory of cancer-related care. This includes access to prevention and screening, to early diagnosis, treatment, survival and other health outcomes. While these disparities have been well documented, finding mechanisms to reduce disparities is more challenging. One potential mechanism to reduce treatment disparities is to improve access to insurance coverage. The Affordable Care Act (ACA), passed in March 2010, included as its overall goals the improvement in healthcare quality and access, and enhancing equity in treatment and outcomes. The ACA allowed states to expand Medicaid to poor and near-poor adults, and this was implemented by many states starting in 2014. In addition, the ACA established private insurance marketplaces with income-based premium subsidies and limits on out-of-pocket spending for qualifying low-income enrollees. Prior research has demonstrated that ACA Medicaid expansions are associated with increased coverage and improved overall access for cancer survivors; and for newly diagnosed patients, the ACA was associated with increased coverage and shifts to earlier stage diagnosis for some cancers. To our knowledge, no research has yet demonstrated that the ACA coverage expansions affected the process of cancer care, specific cancer treatments received or specific treatment outcomes, let alone whether disparities were reduced.  In this study we looked at the time from advanced/metastatic diagnosis to start of systemic treatment for black vs. white patients and based on whether they were diagnosed at a time and in a state that had vs. had not implemented Medicaid expansion. Our study hypothesis was that Medicaid expansion reduced disparity in timely treatment of black patients compared to white patients with advanced cancer. We defined timely treatment as start of systemic therapy within 30 days of advanced/metastatic diagnosis. This is a retrospective observational study, not a randomized controlled trial. In other words, we selected a cohort of patients diagnosed with advanced or metastatic cancers over time and observed whether they received timely treatment. The Flatiron Health EHR-derived database was the principal data source for this research. Flatiron contributing practices include 280 cancer community based clinics and academic hospital outpatient settings (~800 sites of care) representing more than 2.2 million patients with cancer in the United States. Practices are located in 40 states. To produce the database, Flatiron extracted data from structured fields, including demographics, and recorded medication orders and administrations. Flatiron also abstracted unstructured data, using technology assisted review by highly trained clinicians. Abstracted data include diagnosis date, stage, and prescribed oral anticancer medications. The database used for research purposes was de-identified. We also used data from the Kaiser Family Foundation which has tracked Medicaid implementation policies for over twenty years, and the US Bureau of Labor Statistics from which we pulled state-year unemployment rates. (more…)
Author Interviews, Bayer, Biomarkers, Colon Cancer / 05.06.2019

MedicalResearch.com Interview with: Joseph Germino, M.D., PhD Vice President US Medical Affairs Oncology Bayer Healthcare Pharmaceuticals Whippany, N.J. 07981 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Regorafenib is an oral multi-kinase inhibitor that potently blocks multiple protein kinases involved in tumor angiogenesis (VEGFR1, -2, -3, TIE2), oncogenesis (KIT, RET, RAF-1, BRAF), metastasis (VEGFR3, PDGFR, FGFR) and tumor immunity (CSF1R). This prospective pharmacokinetic (PK) ancillary study is part of a prospective phase II study evaluating treatment response with regorafenib in patients with chemorefractory metastatic colorectal cancer (mCRC) called TEXAN, which aimed to investigate correlations between overall survival (OS) and regorafenib, or its enterohepatic cycle-dependent active metabolites M-2 and M-5 concentrations. As measured by LC-MS/MS, the main findings showed that regorafenib, M-2 and M-5 were respectively 1.99 (1.03-2.73), 1.44 (0.89-2.49) and 1.61 (0.79-2.37) mg/L during the first cycle at day 15 (C1D15) and 1.90 (1.10-2.76), 1.29 (0.77-2.24) and 1.17 (0.45-2.42) mg/L at during the second cycle at day 15 (C2D15).  (more…)
ASCO, Author Interviews, Bayer, Leukemia, Pediatrics / 05.06.2019

MedicalResearch.com Interview with: Joseph Germino, M.D., PhD Vice President US Medical Affairs Oncology Bayer Healthcare Pharmaceuticals Whippany, N.J. 07981 MedicalResearch.com: What is the background for this study? Response: Sorafenib (Nexavar®) is an oral anticancer therapy approved in more than 100 countries worldwide. It is approved for the treatment of patients with advanced hepatocellular carcinoma (HCC); advanced renal cell carcinoma (RCC) who have failed prior interferon-alpha or interleukin-2 based therapy or are considered unsuitable for such therapy; progressive, locally advanced or metastatic differentiated thyroid carcinoma (papillary/follicular/Hürthle cell), that is refractory to radioactive iodine (RAI). The AAML 1031 is a recently completed Phase III clinical trial evaluating the use of bortezomib and sorafenib in patients 30 years or younger with newly diagnosed acute myeloid leukemia (AML). At the 2019 ASCO Annual meeting, results of a report from the AAML1031 trial, which assessed whether intensification of Induction II chemotherapy (ADE or AraC/ Mitoxantrone) and liberalized stem cell transplant (SCT) donor source criteria improved clinical outcomes in patients with residual AML.  (more…)
ASCO, Author Interviews, Education, Gender Differences, Surgical Research / 04.06.2019

MedicalResearch.com – Responses Marina Stasenko, MD Memorial Sloan Kettering Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sexual harassment is a form of discrimination that includes gender harassment, unwanted sexual attention, and sexual coercion. A recent report in Fortune magazine noted that over half of US women have experienced sexual harassment at some point in their lives. Until recently, much of the conversation about sexual harassment in the workplace has been relegated to private discussions behind closed doors. However, the MeToo movement has shined a spotlight on the pervasive nature of sexual harassment in various fields, like media and business world. Although there are more female physicians in practice today than ever before, with women accounting for over 50% of young physicians, sexual harassment and gender disparities continue to plague the field of medicine. Despite the large female representation, gynecologic oncology is not immune from gender disparities. The Society of Gynecologic Oncology is a professional organization of over 2000 physicians, scientists, allied health professionals, nurses, and patient advocates dedicated to the care of patients with gynecologic cancer. As of 2015, 46% of members of the SGO were women, and that number is steadily growing. SGO leadership is also increasingly female – with 2 of the last 3 presidents being women. Despite the large female representation, gynecologic oncology is not immune from gender disparities. The 2015 SGO practice survey noted that while 22% of male Gynecologic Oncologists held the rank of professor, only 11% of their female counterparts held the title. They also noted that the mean annual salary for male physicians was nearly 150,000$ greater than salary for female physicians. Given the fact that there is little objective data on sexual harassment in gynecologic oncology, the objective of our study was to evaluate perceptions of sexual harassment and gender disparities among physician members of the Society of Gynecologic Oncology. (more…)
ASCO, Author Interviews, Bayer, Cancer Research, Pediatrics / 03.06.2019

MedicalResearch.com Interview with: Douglas S. Hawkins, M.D. Hematology/Oncology Division Chief and Professor Pediatrics at Seattle Children's Hospital University of Washington School of Medicine MedicalResearch.com: What is the background for this study? Response: TRK fusion cancer is caused by a rare genomic alteration called a neurotrophic receptor tyrosine kinase (NTRK) gene fusion. Larotrectinib is a central nervous system (CNS) active, oral and highly selective TRK inhibitor used for the treatment of adult and pediatric patients with solid tumors that have a rare genomic alteration called an NTRK gene fusion. Larotrectinib was approved at the end of 2018 in the U.S. under the brand name VITRAKVI®, with European and worldwide regulatory submissions underway. At ASCO 2019, we will be presenting results from a new analysis specifically looking at the efficacy and safety of larotrectinib in pediatric patients (n=34) included in the expanded dataset from both adults and children across 24 tumor types, which was presented first at the European Society for Medical Oncology (ESMO) 2019 Annual Meeting.  (more…)