meta name="publication-media-verification"content="1ebe9089d92647b3b88294de308625d5
Author Interviews, Biomarkers, BMJ, Ovarian Cancer / 03.11.2014

Ben Van Calster PhD Department of Development and Regeneration KU Leuven, Herestraat Leuven, BelgiumMedicalResearch.com Interview with: Ben Van Calster PhD Department of Development and Regeneration KU Leuven, Herestraat Leuven, Belgium   MedicalResearch: What is the background for this study? What are the main findings? Dr. Van Calster: Ovarian cancer is a very common type of cancer among women, with over 200,000 new cases per year worldwide. It is the most lethal of gynecological malignancies. Research has shown that the referral of patients with ovarian cancer to specialized gynecological oncologists in high volume centers improves survival. However, audits in Europe and the United States also show that only a minority of women with ovarian cancer are appropriately triaged to receive specialist care. In addition, different types of malignancies are not treated in the same way. Hence optimal personalized management of an ovarian tumor hinges on the detailed preoperative diagnosis of its nature. Unfortunately, current prediction models focused on the discrimination between benign and malignant tumors without further specification of the likely type of malignancy. Various prediction models and rules have been developed to help predict whether an ovarian mass is benign or malignant. A recent systematic review meta-analysis has shown that the IOTA model LR2 and simple rules perform better than any other previous test. However none of these tests give anything other than a dichotomous outcome – i.e. cancer or non-cancer. In practice the position is more nuanced. The ADNEX model estimates the likelihood that a tumor is benign, borderline malignant, stage I cancer, stage II-IV cancer, or secondary metastatic cancer. This model is the first that is able to differentiate between benign and these four subtypes of malignancy. To do so, ADNEX uses three clinical predictors (age, serum CA-125 level, and type of center), and six ultrasound characteristics of the tumor (maximum diameter of lesion, proportion of solid tissue, more than 10 cyst locules, number of papillary projections, acoustic shadows, and ascites). The model is based on data from almost 6,000 women recruited at 24 centers in 10 countries. (more…)
Author Interviews, Biomarkers, Nature, Pancreatic / 03.11.2014

Dr. Murray Korc MD, Professor Department of Medicine, Division of Endocrinology, Biochemistry and Molecular Biology, and the Pancreatic Cancer Signature Center IU Simon Cancer Center, Indiana University School of Medicine Indianapolis, IndianaMedicalResearch.com Interview with Dr. Murray Korc MD, Professor Department of Medicine, Division of Endocrinology, Biochemistry and Molecular Biology, and the Pancreatic Cancer Signature Center IU Simon Cancer Center, Indiana University School of Medicine Indianapolis, Indiana Medical Research: What is the background for this study? What are the main findings? Dr. Korc: Pancreatic ductal adenocarcinoma (PDAC) is a deadly cancer with an overall 5-year survival rate of 6%. Currently, there are no highly specific and sensitive biomarkers in the blood that can be used for definitively diagnosing the presence of this cancer. In addition, in spite of the usefulness of CA19-9 in differentiating between patients with pancreatic cancer and chronic pancreatitis, this test may yield a significant number of false positive and false negative results, and it may be influenced by the presence of jaundice. These difficulties are compounded by the fact that patients with pancreatitis are at-risk for developing Pancreatic ductal adenocarcinoma. We decided to carry out a study of microRNAs using plasma from treatment-naïve PDAC patients, chronic pancreatitis patients, and controls without pancreatic disease. We focused on microRNAs because they are known to be present in the blood and to be very stable. We chose to conduct these assays in plasma because we reasoned that there would be fewer confounding factors by comparison with either whole blood or serum. We determined that five microRNAs were elevated in plasma from PDAC patients by comparison with either chronic pancreatitis or controls. Importantly, among these five microRNAs, high levels of miR-10b, miR-155, and miR-106b in the plasma were highly accurate in diagnosing Pancreatic ductal adenocarcinoma with ~95% sensitivity and ~100% specificity. (more…)
Author Interviews, Colon Cancer / 02.11.2014

Enrique Quintero MD, PhD President, Asociación Española de Gastroenterología (AEG) Chief of Gastroenterology, Hospital Universitario de Canarias Professor of Medicine, Universidad de La Laguna La Laguna. Tenerife SpainMedicalResearch.com Interview with: Enrique Quintero MD, PhD President, Asociación Española de Gastroenterología (AEG) Chief of Gastroenterology, Hospital Universitario de Canarias Professor of Medicine, Universidad de La Laguna La Laguna. Tenerife Spain Medical Research: What is the background for this study? What are the main findings? Dr. Quintero: First degree relatives (FDRs) of patients with colorectal cancer (CRC) are at increased risk of developing the disease compared with the general population. For that reason, clinical practice guidelines recommend colonoscopy every five years starting at the age of 40 years or ten years less than the youngest case in the family. However, this approach has some drawbacks:
  • first, several studies have shown that the benefit of colonoscopy is limited by a low uptake (less than 40%);
  • second, it represents an important colonoscopy burden, as about 70-80% of explorations are normal or without relevant lesions, which implies a high resource consumption; and
  • third, this recommendation is not based on evidence, as no randomized controlled trials have compared the efficacy of screening colonoscopy with that of other strategies.On the other hand, pilot studies have shown that one-time fecal immunochemical tests (FIT) have acceptable capacity to detect advanced neoplasia (defined as cancer or advanced adenoma) in family members of patients with CRC. For these reasons we conducted a prospective randomized trial to compare the efficacy of repeated fecal immunochemical tests versus one-time colonoscopy for detecting advanced colorectal neoplasia in asymptomatic FDRs of patients with colorectal cancer.
The main finding of our study was that cumulative fecal immunochemical tests screening (1 per year, during 3 years), yielded an equivalent detection rate to one-time colonoscopy for cancer, advanced adenoma and advanced neoplasia both by intention-to-screen and per-protocol analysis, after controlling for confounders such as age, gender, index-case age, and number of affected relatives. In fact, FIT detected all cancers and 61% of advanced adenomas. In addition, the study confirmed that the number of subjects requiring colonoscopy to detect one advanced neoplasm was 4 times less in individuals screened by FIT than in those screened by colonoscopy. Therefore, FIT may save a substantial number of unnecessary colonoscopies, preventing harms and lowering costs. (more…)
Author Interviews, Hormone Therapy, Prostate Cancer / 30.10.2014

David R. Ziehr B.S., MD Candidate Harvard Medical SchoolMedicalResearch.com Interview with: David R. Ziehr B.S., MD Candidate Harvard Medical School Medical Research: What is the background for this study? What are the main findings? Response: Androgen deprivation therapy (ADT), commonly achieved with gonadotropin-releasing hormone agonists or antagonists, is a mainstay of prostate cancer therapy. While randomized controlled trials demonstrate that ADT improves survival among men with unfavorable risk prostate cancer, retrospective studies have suggested that some men with comorbid illnesses such as heart disease may not derive a benefit from—or may even be harmed by—ADT. However, the nature of this harm has not been characterized. We studied over 5000 men with prostate cancer who were treated with brachytherapy (implanted radioactive seeds) with or without ADT. We analyzed the men based on pre-treatment cardiac comorbidity and examined the association between ADT and death from cardiac causes. We found that among men with congestive heart failure or a past myocardial infarction (MI), Androgen deprivation therapy was associated with a three-times greater risk of death from heart disease. However, Androgen deprivation therapy was not associated with greater risk of cardiac mortality in men without heart disease or with a risk factor for heart disease, such as diabetes, hypertension or hyperlipidemia. (more…)
Author Interviews, Breast Cancer, Chemotherapy / 30.10.2014

Melissa Skala, Ph.D. Assistant Professor of Biomedical Engineering Assistant Professor of Cancer Biology Vanderbilt University Nashville, TN 372MedicalResearch Interview with: Melissa Skala, Ph.D. Assistant Professor of Biomedical Engineering Assistant Professor of Cancer Biology Vanderbilt University Nashville, TN 37235 Medical Research: What is the background for this study? What are the main findings? Dr. Skala: We developed a new metabolic imaging technique that is highly sensitive to tumor cell response to anti-cancer drug treatment. We coupled this imaging technique with new, three-dimensional cultures that can be grown from breast tumor biopsies. Together, our data indicate that this approach could be used to perform rapid, low-cost, and accurate drug screens for individualized treatment of cancer patients. (more…)
Author Interviews, Breast Cancer, Cancer Research, Chemotherapy / 27.10.2014

MedicalResearch.com Interview with: Shidong Jiang Associate professor of Engineering Thayer School of Engineering at Dartmouth Medical Research: What is the background for this study? What are the main findings? Dr. Jiang: Breast cancer is the most common non-skin cancer in women worldwide, and the second leading cause of women’s cancer mortality in the United States. A common treatment strategy after diagnosis is to shrink breast cancer tumors larger than 3 centimeters with a 6 to 8 month course of Neoadjuvant Chemotherapy prior to surgery. Clinical studies have shown that patients who respond to Neoadjuvant Chemotherapy have longer disease-free survival rates, but only 20 to 30 percent of patients who receive Neoadjuvant Chemotherapy fit this profile. Our work represents the first clinical evidence that tumor total hemoglobin estimated from DOST images differentiates women with locally advanced breast cancer who have a complete pathological response with Neoadjuvant Chemotherapy from those who do not with predictive significance based on image data acquired before the initiation of therapy. The implication of this prognostic information is that certain tumors are pre-disposed to responding to Neoadjuvant Chemotherapy, and that this predisposition should be known prior to choosing the therapy.  The study also demonstrates the potential of dramatically accelerating the validation of optimal Neoadjuvant Chemotherapy regimes through future randomized clinical trials by reducing the number of patients required and the length of time they need to be followed by using a validated imaging surrogate as an outcome measure. (more…)
Author Interviews, Colon Cancer, Cost of Health Care / 25.10.2014

Dr. Christine Marie Veenstra MD Department of Internal Medicine, Division of Hematology/Oncology Division of Colorectal Surgery Center for Healthcare Outcomes and Policy Division of General Medicine Cancer Surveillance and Outcomes Research Team University of Michigan, Ann ArborMedicalResearch.com Interview with: Dr. Christine Marie Veenstra MD Department of Internal Medicine, Division of Hematology/Oncology Division of Colorectal Surgery Center for Healthcare Outcomes and Policy Division of General Medicine Cancer Surveillance and Outcomes Research Team University of Michigan, Ann Arbor Medical Research: What is the background for this study? Dr. Veenstra: Nearly 50,000 patients are diagnosed with stage III colorectal cancer each year. Chemotherapy is known to increase survival by up to 20% and is the standard recommendation for these patients after surgery. However, use of chemotherapy may be associated with financial strain. In order to better understand the financial burden and worry associated with colorectal cancer treatment, we surveyed 956 patients being treated for stage III colorectal cancer. We asked patients to answer questions about financial burden such as whether they had used savings, borrowed money, skipped credit card payments, or cut back on spending for food, clothing or recreational activities because of their cancer treatment. We also asked patients how much they worry about financial problems because of their cancer or its treatment. (more…)
Author Interviews, Cancer, Pancreatic / 24.10.2014

MedicalResearch.com Interview with: Jeremy L. Humphris MBBS The Kinghorn Cancer Center, Cancer Research Program, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia and Andrew V. Biankin Regius Professor of Surgery Director, Wolfson Wohl Cancer Research Centre, University of Glasgow Garscube Estate, Switchback Road, Bearsden, Glasgow Scotland United Kingdom Medical Research: What are the main findings of the study? Response: Familial pancreatic cancer (FPC) is a family with at least 2 first degree (parent-child or siblings) with pancreatic cancer. We found these patients represent nearly 9% of our cohort. In addition we found those with familial pancreatic cancer were more likely to have other first degree relatives with a history of extra-pancreatic cancer, in particular melanoma and endometrial cancer. Patients with familial pancreatic cancer had more high grade precursor lesions in the pancreas adjacent to the tumour but the outcome was similar. Smoking was more prevalent in sporadic pancreatic cancer and active smoking was associated with significantly younger age at diagnosis in both groups. Long-standing diabetes mellitus (> 2 years duration) was associated with poorer survival in both groups. (more…)
Author Interviews, Colon Cancer, NEJM / 22.10.2014

Alfredo Falcone MD Chiara Cremolini Fotios Loupakis University of Pisa and Azienda-Ospedaliero Universitaria Pisana ItalyMedicalResearch.com Interview with: Alfredo Falcone MD Chiara Cremolini Fotios Loupakis University of Pisa and Azienda-Ospedaliero Universitaria Pisana Italy Medical Research: What are the main findings of the study? Dr. Falcone: In the TRIBE study the main findings are that the use of an initial more intensive therapy with a triplet of cytotoxics (FOLFOXIRI) plus bevacizumab vs a doublet (FOLFIRI) + bevacizumab improves the outcome of metastatic colorectal cancer patients with unresectable metastases. In particular FOLFOXIRI + bevacizumab vs FOLFIRI+bevacizumab improved RECIST response-rate (65% vs 53%, p=0.006), progression-free survival which was the primary endpoint (median 12,1 vs 9,7 months, HR=0,75, p=0.003) and overall survival (median 31,0 vs 25,8 months, HR=0.79, p=0.054). These results, also compared to those reported in previous phase III studies in molecularly unselected patients, represent an important advance in the treatment of this disease. (more…)
CHEST, Lung Cancer / 21.10.2014

Peter J. Mazzone, MD, FCCP MPH Director of the Lung Cancer Program for the Respiratory Institute Cleveland ClinicMedicalResearch.com Interview with: Peter J. Mazzone, MD, FCCP MPH Director of the Lung Cancer Program for the Respiratory Institute Cleveland Clinic Medical Research: What are the main findings of this study? Dr. Mazzone:   There were 2 parts to this study. In the first part we looked at how the breath collection instrument and sensor were performing and made adjustments to both in order to optimize its performance. In the second part we used the improved device and sensor to see if we could accurately separate a sensor signal of our patients with lung cancer from those without lung cancer. We found good separation of lung cancer from non-cancer breath signals, and very good separation of signals of one type of lung cancer from another. We have concluded that a colorimetric sensor array based breath test is capable of separating those with lung cancer from those without. (more…)
Author Interviews, Cancer Research / 21.10.2014

Dr. Iris L. Romero MD MS Associate Professor of Obstetrics & Gynecology, Section of General Gynecology The University of Chicago Medicine Chicago, ILMedicalResearch.com Interview with: Dr. Iris L. Romero MD MS Associate Professor of Obstetrics & Gynecology, Section of General Gynecology The University of Chicago Medicine Chicago, IL   Medical Research: What are the main findings of the study? Dr. Romero: There is increasing epidemiologic and preclinical data indicating that the commonly used diabetic drug, metformin, may have anticancer effects. In ovarian cancer, in 2011 in Obstetrics & Gynecology we reported that in a retrospective cohort ovarian cancer patients that were using metformin had increased survival compared to those not using mefomrin. In this study, we expand on those findings by testing whether metformin can prevent ovarian cancer or improve response to chemotherapy in mouse models. In a prevention study, we found that mice treated with metformin before cancer was initiated developed less tumor than those treated with placebo. In a treatment study, in vitro, metformin increased the cytotoxic effect of paclitaxel. In addition, using a genetic mouse model we show that the combination of paclitaxel plus metformin results in a greater tumor reduction than either drug used alone. (more…)
Author Interviews, Breast Cancer, Chemotherapy, Journal Clinical Oncology, Mayo Clinic / 21.10.2014

dr_edith_perezMedicalResearch.com Interview with: Edith A. Perez, MD Mayo Clinic Jacksonville, FL 32224 Medical Research: What are the main findings of the study? Dr. Perez: Our joint analysis of two large prospective trials showed that adding one year of Trastuzumab to otherwise standard adjuvant chemotherapy significantly improved long term survival in women with resected HER2+ breast cancer. (more…)
Author Interviews, Dermatology, Melanoma / 21.10.2014

Prof. David Whiteman Group leader, Cancer Control Group QIMR Berghofer Herston, QueenslandMedicalResearch.com Interview with: Prof. David Whiteman Group leader, Cancer Control Group QIMR Berghofer Herston, Queensland   Medical Research: What are the main findings of the study? Dr. Whiteman: Mortality from melanoma has continued to rise in Queensland, Australia, the jurisdiction with the world’s highest incidence of this disease. We analysed more than 4000 deaths from melanoma over the last 2 decades, and calculated mortality rates according the thickness of the primary lesion. (more…)
Author Interviews, Cancer Research, Journal Clinical Oncology, MD Anderson / 21.10.2014

MedicalResearch.com Interview with: Joanna-Grace M. Manzano, MD Assistant Professor Department of General Internal Medicine Maria E. Suarez-Almazor, MD, PhD Barnts Family Distinguished Professor Chief, Section of Rheumatology & Deputy Chair, Dept. of General  Internal Medicine UT MD Anderson Cancer Center Houston, TX Medical Research: What are the main findings of the study? Response: Our study established that unplanned hospitalization among elderly patients with GI cancer are very common – 93 events per 100-person years. Certain characteristics were found to have an increased risk for an unplanned hospitalization in our cohort, namely: older age, black race, advanced disease, higher comorbidity score, residing in poor neighborhoods and dual eligibility for Medicare and Medicaid. Esophageal and gastric cancer had the highest risk for unplanned hospitalization among all GI cancer types. Some of the observed reasons for unplanned hospitalization were potentially preventable and related to the patient’s comorbid illness. (more…)
Author Interviews, Melanoma, Ophthalmology / 17.10.2014

MedicalResearch.com Interview with: Prof I. Jolanda M. de Vries Professor, Dept of Tumor Immunology Radboud University Nijmegen Medical Research: What are the main findings of the study? Prof. de Vries: Dendritic cells are antigen-presenting cells with the unique capacity to activate naive antigen-specific T cells, and by this means are very suitable to induce immunologic antitumor responses. Dendritic cells cultured from monocytes can be matured and loaded with tumor antigen ex vivo and administered back into the patient. Within the lymph node, dendritic cells present antigens to T cells to initiate an immune response. Metastatic uveal melanoma patients were vaccinated with autologous DCs loaded with tumor antigens (gp100 and tyrosinase), obtained by leukapheresis, according to a schedule of 3 biweekly vaccinations. One to 2 weeks after the last vaccination, a skin test was performed to analyse the induction of immunologic responses. We can conclude that dendritic cell vaccination is feasible and safe in metastatic uveal melanoma. Dendritic cell-based immunotherapy is potent to enhance the host’s antitumor immunity against uveal melanoma in approximately one third of patients. (more…)
Author Interviews, Cancer Research, MD Anderson / 17.10.2014

Steven J. Frank, M.D. Associate Professor of Radiation Oncology Medical Director of the Proton Therapy Center The University of Texas MD Anderson Cancer CenterMedicalResearch.com Interview with: Steven J. Frank, M.D. Associate Professor of Radiation Oncology Medical Director of the Proton Therapy Center The University of Texas MD Anderson Cancer Center MedicalResearch.com Editor’s Note: A recent research published in Oncology Payers, discusses the quality of life benefits and cost-savings of intensity modulated proton therapy (IMPT or proton therapy) with traditional x-ray therapy for advanced stage head and neck cancer. The senior author of the paper, Dr. Steven Frank, highlights two oropharyngeal cancer patients, one of whom received proton therapy and the other x-ray treatments. Both patients received chemotherapy. The study showed that although the upfront costs of proton therapy were three times that of standard x-ray treatments, the proton therapy patient was spared the necessity of a feeding tube, nutritional and supportive care and weight loss that accompanied the x-ray treatments. By the end of the treatment period, the total care costs for the proton therapy patient were 20% lower than the x-ray treatment plan. To evaluate the costs, Dr. Frank has been employing a costing tool used elsewhere at MD Anderson called Time-driven Activity-based Costing that places the emphasis on the value of medical care, both monetary and in terms of quality of life. Dr. Frank plans to enroll 360 patients over the next five years as well as to open the study to other cancer centers. He notes that the results will be especially valuable as health insurance companies look to further bundled insurance payments. Dr. Frank was kind enough to answer several questions regarding his work for the MedicalResearch.com audience. Medical Research: From a patient's perspective, what are the main differences between traditional x-ray therapy and proton therapy for cancer treatment? Dr. Frank: In proton therapy, the radiation hits the cancer, while with traditional x-ray the radiation hits the cancer and the normal tissues in the head and neck, causing more side effects during and after treatment. The main advantage is that proton therapy eliminates unnecessary radiation. As radiation oncologists, our primary goal is to effectively kill cancer while sparing the patient the side effects of excessive radiation. Proton therapy achieves this for many patients with a variety of cancers, including lymphoma, lung, head and neck, prostate, esophageal and pediatric cancers. (more…)
Author Interviews, Melanoma, UCSF / 17.10.2014

Martina Sanlorenzo, MD Department of Dermatology Mt. Zion Cancer Research Bldg. San Francisco, CA 94143-0808MedicalResearch.com Interview with: Martina Sanlorenzo, MD Department of Dermatology Mt. Zion Cancer Research Bldg. San Francisco, CA 94143-0808 Medical Research: What are the main findings of the study? Dr. Sanlorenzo: In the treatment of BRAF mutant melanoma, the combination of BRAF inhibitor and MEK inhibitor has a better cutaneous safety profile compared with BRAF inhibitor monotherapy. Combination regimen shows fewer cutaneous adverse events and longer cutaneous adverse event-free interval. In particular, the development of squamous cell carcinoma or keratoacanthoma was significantly less frequent. (more…)
Author Interviews, Melanoma, PLoS / 16.10.2014

Professor Robert Insall CR-UK Beatson Institute for Cancer Research Glasgow UKMedicalResearch.com Interview with: Professor Robert Insall CR-UK Beatson Institute for Cancer Research Glasgow UK Medical Research: What are the main findings of the study? Prof. Insall: The principal message is that melanoma cells make their own steering signals, and thus drive themselves out of the tumour and into the bloodstream.  This comes in two parts: (a) The principal steering signal when we assay melanoma spread in vitro is lysophosphatidic acid, LPA.  LPA steers cells with really remarkable accuracy; blocking LPA receptors stops them from spreading without hurting their health or ability to move. (b) Where does the LPA gradient come from?  They make it themselves.  There seems to be lots of LPA around; they break down the LPA near them, leading to a gradient that's low near the cells and high further away.  This is the gradient that steers the tumour cells. (more…)
Author Interviews, JCEM, Lipids, Prostate Cancer / 13.10.2014

Emma H. Allott PhD Division of Urology, Department of Surgery, Duke University School of Medicine Cancer Prevention, Detection, and Control Program, Duke Cancer Institute Division of Urology, Veterans Affairs Medical Center Durham Durham, North Carolina.MedicalResearch.com Interview with: Emma H. Allott PhD Division of Urology, Department of Surgery, Duke University School of Medicine Cancer Prevention, Detection, and Control Program, Duke Cancer Institute Division of Urology Veterans Affairs Medical Center Durham Durham, North Carolina. Medical Research: What are the main findings of the study? Dr. Allott: Relative to normal triglyceride levels, high triglycerides (≥150 mg/dl) were associated with 35% increased risk of prostate cancer recurrence. In addition, we found that each 10 mg/dl increase in total serum cholesterol above the abnormal cut-off value of 200 mg/dl was associated with a 9% increased risk of prostate cancer recurrence, while each 10 mg/dl increase in HDL (high density lipoprotein; “good” cholesterol) below the abnormal cut-off value of 40 mg/dl was associated with a 39% increased risk of prostate cancer recurrence. These findings suggest that normalization, or even partial normalization, of serum lipid levels among men with dyslipidemia may reduce the risk of prostate cancer recurrence. (more…)
Author Interviews, Cancer Research, Lancet, Thromboembolism / 08.10.2014

MedicalResearch.com Interview with: Prof Martin H Prins MD Maastricht University Medical Centre, Maastricht, Netherlands Medical Research: What are the main findings of the study? Dr. Prins: Patients with active cancer, i.e. a cancer that was diagnosed or treated within 6 months before the episode, that was recurrent or metastatic, or that was diagnosed during treatment, who had a symptomatic episode of venous thromboembolism, were included in this pooled subgroup analysis of the Einstein DVT and PE studies. The incidence of recurrent venous thromboembolism was similar between groups. It occurred in 16 (5%) of 354 patients allocated to rivaroxaban and 20 (7%) of 301 patients allocated to enoxaparin and vitamin K antagonist (hazard ratio [HR] 0•67, 95% CI 0•35 to 1•30). Clinically relevant bleeding was also similar and occurred in 48 (14%) of 353 patients receiving rivaroxaban and in 49 (16%) of 298 patients receiving standard therapy (HR 0•80, 95% CI 0•54 to1•20). However, major bleeding was less frequent among rivaroxaban recipients and occurred in eight (2%) of 353 patients receiving rivaroxaban and in 15 (5%) of 298 patients receiving standard therapy (HR 0•42, 95% CI 0•18 to 0•99). Mortality was also similar. (more…)
Author Interviews, Breast Cancer / 07.10.2014

Professor Xiaodong Zhang Professor of Macromolecular Structure and Function Department of Medicine Imperial College, London, UKMedicalResearch.com Interview with: Professor Xiaodong Zhang Professor of Macromolecular Structure and Function Department of Medicine Imperial College, London, UK Medical Research: What are the main findings of the study? Prof. Zhang: Since its discovery 20 years ago, the BRCA2 gene and its protein product, BRCA2, have been under intensive investigations. The importance of the BRCA2 protein lies in the central roles it plays in the most faithful DNA damage repair pathway. Mutations in BRCA2 thus can cause defects in this repair pathway, making the repair inefficient or forcing cells to use alternative repair methods that are prone to mistakes, all of which contribute to mutations in the genomic DNA, thus increase the risk of cancer development. Our study aims to understand how BRCA2 works through studying its 3-dimensional structures and its interactions with other key partners in the repair pathway. Our study provides first 3-dimensional views of BRCA2 and BRCA2-RAD51 and reveals that BRCA2 molecules exist as pairs and a BRCA2 pair recruit two sets of RAD51 molecules arranged in opposite orientations. Our study also shows a single stranded DNA binds across the BRCA2 dimer and that BRCA2 increases the frequency of RAD51 filament formation events, presumably to increase the efficiency of establishing a longer filament required for searching for matching strands of DNA in intact sister chromatin. Our results thus not only define the precise roles of BRCA2 in helping RAD51 filament formation, but how it helps RAD51 loading onto single stranded DNA. (more…)
Author Interviews, Prostate Cancer, Testosterone / 07.10.2014

Maarten C. Bosland, DVSc, PhD Professor of Pathology Department of Pathology, College of Medicine University of Illinois at Chicago Chicago, IL 60612MedicalResearch.com Interview with:  Maarten C. Bosland, DVSc, PhD Professor of Pathology Department of Pathology, College of Medicine University of Illinois at Chicago Chicago, IL 60612 Medical Research: What are the main findings of the study? Dr. Bosland: The two main findings are : (1) that long-term, low-dose testosterone treatment induces prostate cancer in rats (none occurred in control rats) and increases the number of rats with malignant tumors at any site in the body compared to control rats, and (2) that in rats treated long-term with testosterone after a single prostate-targeted chemical carcinogen treatment a high incidence of prostate cancer is induced, even at a very low testosterone dose. (more…)
Author Interviews, Melanoma, NYU / 06.10.2014

David Polsky, MD, PhD Alfred W. Kopf, MD, professor of Dermatologic Oncology Ronald O. Perelman Department of Dermatology NYU Langone Medical CenterMedicalResearch.com Interview with: David Polsky, MD, PhD Alfred W. Kopf, MD, professor of Dermatologic Oncology Ronald O. Perelman Department of Dermatology NYU Langone Medical Center Medical Research: What are the main findings of the study? Dr. Polsky: We utilized a multi-disciplinary approach including an analysis of socioeconomic factors to elucidate the evolution of attitudes and behaviors maximizing personal ultraviolet light exposure during the 20th century in the United States.  We then compared melanoma incidence rates from national cancer registries to estimated skin exposure and found that they rose in parallel. Though causation cannot be made in an analysis such as this one, this paper describes a historical context for the changing attitudes promoting increased UV exposure, and the rising incidence of melanoma throughout the past century.  It also provides a framework in which to consider public health and education measures that may ultimately help reverse melanoma incidence trends. (more…)
Author Interviews, Cancer Research, JNCI, Lung Cancer, UT Southwestern / 02.10.2014

Dr. David Gerber MD Associate Professor of Internal Medicine Division of Hematology and Oncology Harold C. Simmons Cancer Center at UT Southwestern Medical CenterMedicalResearch.com Interview with: Dr. David Gerber MD Associate Professor of Internal Medicine Division of Hematology and Oncology Harold C. Simmons Cancer Center at UT Southwestern Medical Center Medical Research: What are the main findings of the study? Dr. Gerber: Fewer than 3% of adult cancer patients in the United States are enrolled in clinical trials.  Increasingly numerous and stringent eligibility criteria are a major factor limiting participation in clinical trials.  We examined the longstanding and widespread practice of excluding patients with prior cancer from oncology clinical trials.  This policy presumably reflects concerns that a prior cancer would interfere with the conduct, outcomes, or interpretation of a clinical trial, although there is no clear evidence supporting that assumption. We examined more than 50 National Cancer Institute (NCI)-sponsored lung cancer clinical trials.  We found that 80% excluded patients with prior cancers.  This exclusion criterion was applied broadly, including to more than two-thirds of trials with non-survival endpoints.  We then examined national Surveillance Epidemiology and End Results (SEER)-Medicare linked data to estimate the proportion of patients who would be excluded from these trials due to prior cancer.  We found that up to 18% of potential patients are excluded for this reason alone.  In large phase 3 clinical trials, that corresponds to more than 200 patients. (more…)
Author Interviews, Breast Cancer, Cancer Research / 02.10.2014

Gary Ulaner, MD, PhD Assistant Attending Radiologist Memorial Sloan Kettering Cancer Center Assistant Professor of Radiology, Weill Cornell Medical School Chair, Radiology Research CommitteeMedicalResearch.com Interview with: Gary Ulaner, MD, PhD Assistant Attending Radiologist Memorial Sloan Kettering Cancer Center Assistant Professor of Radiology, Weill Cornell Medical School Chair, Radiology Research Committee Medical Research: What are the main findings of the study? Dr. Ulaner: FDG PET/CT revealed distant metastases in 17% of asymptomatic stage IIB breast cancer patients below 40 years of age.   Although NCCN guidelines recommend against systemic staging in patients with stage II disease, our data suggests that PET/CT might be valuable in younger patients at earlier stages of disease than previously expected. (more…)
Author Interviews, Cancer Research, HPV, Vaccine Studies / 01.10.2014

Elmar A. Joura, MD Department of Gynaecology and Obstetrics Medical University of Vienna, Comprehensive Cancer Center Vienna, AustriaMedicalResearch.com Interview with: Elmar A. Joura, MD Department of Gynaecology and Obstetrics Medical University of Vienna, Comprehensive Cancer Center Vienna, Austria Medical Research: What are the main findings of the study? Dr. Joura: The upcoming ninevalent vaccine has the potential to prevent 85% of the cervical precancers and surgeries such as LEEP (conization) (more…)
Author Interviews, Esophageal, JAMA, University of Michigan / 01.10.2014

Megan A. Adams, MD Gastroenterology Fellow University of MichiganMedicalResearch.com Interview with Megan A. Adams, MD Gastroenterology Fellow University of Michigan   Medical Research: What are the main findings of the study? Dr. Adams: Surveys of doctors indicate that their fear of a malpractice lawsuit for missing a diagnosis of esophageal cancer might drive the overuse of tests called upper endoscopies in patients who are at low risk for the cancer. To examine whether this perception of medical liability risk accurately reflects the real likelihood of a malpractice claim, we looked at a national database of malpractice claims, and compared the rate of claims for delay in diagnosis of esophageal cancer in patients without alarm symptoms (weight loss, dysphagia, iron deficiency anemia), with the rate of claims alleging performance of an upper endoscopy without a good reason for performing the procedure. The database contained 278,220 claims filed against physicians in 1985-2012. The incidence of reported medical liability claims for failure to screen for esophageal cancer in patients without alarm features was quite low (19 claims in 11 years, 4 paid). In contrast, there were 17 claims in 28 years for complications of upper endoscopies with questionable indication (8 paid). (more…)
Author Interviews, Melanoma, NEJM / 30.09.2014

Georgina Long BSc PhD MBBS FRACP Associate Professor of Melanoma Biology and Translational Research Melanoma Institute Australia and the University of Sydney MedicalResearch.com Interview with: Georgina Long BSc PhD MBBS FRACP Associate Professor of Melanoma Biology and Translational Research Melanoma Institute Australia and the University of Sydney Medical Research: Could you provide some background on this project? Why did you decide to do this research project? What prior work led up to this latest paper? Dr. Long: Pre-clinically, we had data that showed that the combination of BRAF inhibitor + MEK inhibitor
  • Decreased skin proliferative toxicity seen with BRAF inhibitors alone (seen as hyperproliferative lesions in rats)
  • and delayed the emergence of resistance I.e. The tumours in the mice reduced in size more, and stayed reduced for longer.We then confirmed this concept in a randomised phase 2 study, although it was not powered for a definitive progression free survival (PFS_ difference like a phase 3 trial is, we saw a strong difference in response rate and in PFS, yet there were only 54 patients per arm.
(more…)
Chemotherapy / 29.09.2014

Giuseppe Curigliano M.D. Ph.D. Medico Direttore, Director Divisione Sviluppo Nuovi Farmaci per Terapie Innovative Early Drug Development for Innovative Therapies Division Via Ripamonti, MilanoMedicalResearch.com Interview with: Giuseppe Curigliano M.D. Ph.D. Medico Direttore, Director Divisione Sviluppo Nuovi Farmaci per Terapie Innovative Early Drug Development for Innovative Therapies Division Via Ripamonti,  Milano Medical Research: What are the main findings of the study? Dr. Curigliano: In the CLEOPATRA study, 808 patients from 25 countries with HER2-positive metastatic breast cancer were randomised to receive first-line placebo/trastuzumab/docetaxel or pertuzumab/trastuzumab/docetaxel. Randomisation was stratified by geographic region and neo/adjuvant chemotherapy. At ESMO 2014 the CLEOPATRA researchers reported results of a final prespecified OS analysis (February 2014). This overall survival (OS) analysis was planned when ≥385 deaths were reported. The log-rank test, stratified by prior treatment status and geographic region, was used to compare OS between arms, applying the threshold of p ≤ 0.0456. Subgroup analyses of OS were performed for stratification factors and other key baseline characteristics.At median follow-up of 50 months (range 0 to 70 months), the statistically significant improvement in OS in favour of pertuzumab/trastuzumab/docetaxel arm was maintained (HR = 0.68, p = 0.0002). Median OS was 40.8 months in the placebo arm and 56.5 months in the pertuzumab arm, with difference of 15.7 months. The PFS in pertuzumab arm was 18.7 vs 12.4 months in placebo arm, HR 0.68 (p < 0.0001). (more…)
Author Interviews, BMJ, Breast Cancer, Weight Research / 29.09.2014

MedicalResearch.com Interview with: Professor Usha Menon,  Evangelia-Ourania Fourkala PhD and Matthew Burrell PhD Gynaecological Cancer Research Centre, Women's Cancer, UCL EGA Institute for Women's Health, University College London, UK Medical Research: What are the main findings of the study? Response: Our study has shown that skirt size is a good proxy for central obesity. Each unit increase in UK skirt size every ten years between the age of 20 and 60 was associated with a 33% increase in postmenopausal breast cancer in our cohort. (more…)