MedicalResearch.com Interview with:
Dr. Mangesh Thorat
MBBS, MS(Surgery), DNB(Surgery), MNAMS
Centre for Cancer Prevention
Wolfson Institute of Preventive Medicine
Barts & The London School of Medicine and Dentistry, London
Queen Mary University of Londonm Honorary Clinical Lecturer
Division of Surgery and Interventional Science Whittington Hospital, London
Medical Research: What are the main findings of the study?Dr. Thorat : Accumulating evidence supports an effect of aspirin in reducing cancer incidence and mortality. Our analyses show that for average-risk individuals aged 50-65y taking aspirin for 10 years, there would be a relative reduction of between 7% (women) and 9% (men) in the number of cancer, myocardial infarction or stroke events over a 15 year period and an overall 4% relative reduction in all deaths over a 20 year period. The benefits of aspirin use would be most visible in the reduction in deaths due to cancer. If the findings of our study are applied to the UK general population aged 50-64 taking aspirin for next 10 years, on an average more than 6000 lives will be saved every year.
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MedicalResearch.com Interview with: Frank van Hees MSc
Erasmus University Medical Center
Rotterdam, the Netherlands
Medical Research: What are the main findings of the study?Answer: Many U.S. elderly are screened for colorectal cancer more frequently than recommended: One in every five elderly with a negative screening colonoscopy result undergoes another screening colonoscopy within 5 years’ time instead of after the recommended 10 years. Moreover, one in every four elderly with a negative screening colonoscopy result at age 75 or older receives yet another screening colonoscopy at an even more advanced age. Our study shows that, in average risk individuals, these practices are not only a waste of scarce health care resources: often they are also associated with a balance among benefits, burden, and harms that is unfavorable for those being screened.
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MedicalResearch.com Interview with:Frank van Hees, MSc
Researcher, Department of Public Health, Erasmus MC
Rotterdam, The Netherlands
Medical Research: What are the main findings of the study?Answer: Many U.S. elderly are screened for colorectal cancer more frequently than recommended: One in every five elderly with a negative screening colonoscopy result undergoes another screening colonoscopy within 5 years’ time instead of after the recommended 10 years. Moreover, one in every four elderly with a negative screening colonoscopy result at age 75 or older receives yet another screening colonoscopy at an even more advanced age. Our study shows that, in average risk individuals, these practices are not only a waste of scarce health care resources: often they are also associated with a balance among benefits, burden, and harms that is unfavorable for those being screened.
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MedicalResearch.com Interview with: Devanand Sarkar, M.B.B.S., Ph.D
Harrison Scholar at VCU Massey Cancer Center,
Blick Scholar and Associate Professor
Department of Human and Molecular Genetics
Member of the VCU Institute of Molecular Medicine
Virginia Commonweath School of Medicine
Medical Research: What are the main findings of the study?Dr. Sarkar: Retinoic acid (Vitamin A) is an anti-cancer drug for a number of cancers including liver cancer. However, all patients do not respond to retinoic acid. Astrocyte elevated gene-1 (AEG-1) is overexpressed in a large percentage of cancer patients and promotes development and progression of cancer. In this study we document that AEG-1 inhibits retinoic acid function. Combinatorial strategy involving AEG-1 inhibition and retinoic acid synergistically blocks growth of human liver cancer cells in animal models.
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MedicalResearch.com Interview with: Dr Krishnan Bhaskaran MSc PhD.
Senior Lecturer in Statistical Epidemiology &
National Institute for Health Research Postdoctoral Fellow
London School of Hygiene and Tropical Medicine
London WC1E 7HT
Medical Research: What are the main findings of the study?Dr. Bhaskaran: Body mass index was associated with the majority of cancer types studied, and for 10 cancers, including some of the most common like colon cancer and postmenopausal breast cancer, higher body mass index was clearly associated with higher risk.
The cancer type that was most strongly related to BMI was uterine cancer, the 4th most common cancer in women. For a woman of average height, each 2 stone (13kg) increase in weight increased risk by over 60%. Body mass index also had particularly large effects on risk of kidney and gallbladder cancers.
In total, we estimated that over 12,000 cases of the 10 affected cancers may be caused each year by excess weight, and that if average body mass index in the population continues to increase, there may be several thousand more cases of these cancers each year as a result.
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MedicalResearch.com Interview with:Øyvind Holme, MD
Department of Medicine, Sorlandet Hospital Kristiansand, Kristiansand, Norway
Institute of Health and Society, University of Oslo, Oslo, Norway
Departments of Epidemiology and Biostatistics, Harvard School of Public Health,
Harvard-MIT Division of Health Sciences and Technology
Boston, Massachusetts
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
Medical Research: What are the main findings of the study?Dr. Holme: In this population-based trial, we found that once-only flexible sigmoidoscopy screening in asymptomatic 50-64 year old individuals reduces colorectal cancer mortality by 27% and colorectal cancer incidence by 20% after 11 years of follow-up. We found that the incidence reduction is as great in 50-54 year old individuals as in 55-64 old individuals. Addition of a once-only fecal occult blood test to flexible sigmoidoscopy did not lead to a larger reduction in colorectal cancer incidence or mortality compared to flexible sigmoidoscopy screening alone.
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MedicalResearch.com Interview with: Dr Sylvie Mesrine, Gynecologist, MD
Inserm, CESP Centre for Research in Epidemiology and Population
Health, U1018, Nutrition, Hormones and Women's Health Team,
Villejuif, France.
Medical Research: What are the main findings of the study?Answer:We wanted to disentangle the effect of recent physical activity (within the
previous four years) from the effect of past physical activity (5-9 years
earlier) on postmenopausal breast cancer risk. Our most important finding
was that recreational/transport physical activity (including walking,
cycling and engaging in other sports), even of modest intensity, seemed to
have a rapid impact on breast cancer risk: it was quite rapidly associated
with a decrease in breast cancer risk, which was however attenuated when
activity stops. To our knowledge, our study is the first to independently
assess the association between breast cancer risk and recreational physical
activity both 5 to 9 years earlier and within the previous 4 years.
Furthermore, the association of recent recreational physical activity and
breast cancer risk decrease was observed whatever the recent levels of
gardening or do-it yourself activities.
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MedicalResearch.com Interview with Lynn Rosenberg, ScD
Slone Epidemiology Center at Boston University
1010 Commonwealth Avenue
Boston, MA 02215
Medical Research: What are the main findings of the study?Response: With prospective data from the Black Women’s Health Study, we assessed vigorous exercise and walking in relation to incidence of invasive breast cancer . We found that the overall incidence of breast cancer was lower among women who exercised vigorously or walked briskly than among women who were sedentary. The reduction was most apparent among women who exercised at least 5 hours per week. The association of exercise with breast cancer risk did not differ by estrogen receptor status of the breast tumor, but further study is needed to firmly establish this. Sitting for long periods at work or watching television was not significantly associated with breast cancer incidence.
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MedicalResearch.com Interview with: Dr. Judith Malmgren PhD
Affiliate Assistant Professor, Epidemiology
University of Washington
School of Public Health
Seattle, WA 98177
Medical Research: What are the main findings of the study?Dr. Malmgren: We found a significant shift to lower stage breast cancer at diagnosis with an observed increase in mammography detected breast cancer over time and a significant decrease in later stage cancers found by the patient or her doctor.
Mammography detected breast cancers were more often treated with lumpectomy and radiation and less likely to require mastectomy or adjuvant chemotherapy.
We also observed better 5 year invasive breast cancer specific survival among the mammography detected patients as opposed to the patient or physician detected breast cancer cases.
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MedicalResearch.com Interview with: Professor Fritz H Schröder
Department of Urology, Erasmus University Medical Center
Rotterdam, Netherlands
Medical Research: What are the main findings of the study?Professor Schröder: I consider as the main finding that we could report a continuing effect of PSA driven screening on prostate cancer mortality for men aged 55 – 69 years in the screen arm of our study after 13 years of follow-up. The absolute reduction in the risk of death from prostate cancer amounts to 1.28 per 1000 men randomized to the screening arm. This translated into numbers to be invited to screening and numbers needed to be diagnosed to save one prostate cancer death of 781 and 27. These figures show an increasing effect with increasing time of follow-up. The relative risk reduction related to the control arm has remained unchanged with respect to the 11 year follow-up period. For men who actually participated and were screened the relative risk reduction amounted to 27%, the figure most applicable to men who consider to be tested.
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MedicalResearch.com Interview with:Dr. Tetyana Kendzerska
Institute for Clinical Evaluative Science
Women's College Research Institute
Women's College Hospital
Department of Medicine
University of Toronto
Medical Research: What are the main findings of the study?Dr. Kendzerska: In a large cohort with varying degrees of obstructive sleep apnea (OSA), severity of obstructive sleep apnea was not found to be independently associated with either prevalent or incident cancer, except in one subgroup analysis in smoking-related cancer.
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MedicalResearch.com Interview with:Dr Marc Tischkowitz MD PhD
University Lecturer (Associate Professor) and
Honorary Consultant Physician in Medical Genetics
Department of Medical Genetics, University of Cambridge
Medical Research: What are the main findings of the study?Dr. Tischkowitz: The PALB2 gene was first identified in 2006 and linked to breast cancer in 2007 but until now we have not had good breast cancer risk estimates for women who have inherited PALB2 mutations. This study was started in 2009 by an group of research institutions (The PALB2 Interest Group) in Canada, US, Europe (UK, Belgium, Greece, Italy, Finland) and Australia. We studied 362 individuals with PALB2 mutations from 154 families. We found that awomen with a PALB2 mutation will on average have a 35% risk of developing breast cancer by the age of 70, rising to 58% if there is a strong family history. Our study will help clinicians to better advise and manage such women.
There are several new aspects.
It is by far the largest study to date and provides the most accurate risk estimates for PALB2 mutation carriers.
MedicalResearch.com Interview with: Sara Tartof, PhD, MPH
Post-doctoral research fellow
Kaiser Permanente Southern California Department of Research & Evaluation.
Medical Research: What are the main findings of the study?Dr. Tartof: Our study found that the herpes zoster vaccine continues to be effective in protecting older adults against shingles, even after they undergo chemotherapy. In particular, we found that those patients who were previously vaccinated with the vaccine were 42 percent less likely to develop shingles following chemotherapy treatment. We also found that none of our vaccinated patients underwent hospitalization for shingles, while six unvaccinated patients were hospitalized with the disease.
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MedicalResearch.com Interview with:Isaac J. Powell MD
Wayne State University/Karmanos Cancer Inst
University Health Center
Detroit, MI 48201.
Medical Research: What is the background for your study?Dr. Powell: During the PSA testing era for prostate cancer, which is responsible for early treatment, survival disparity between African Americans and European Americans has been eliminated.
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MedicalResearch.com Interview with:Marianne Berwick, PhD, MPH for the GEM Study Team
Professor, Division of Epidemiology
University of New Mexico, Department of Internal Medicine
New Mexico Cancer Research Facility
University of New Mexico, Albuquerque, NM 87131
Medical Research: What are the main findings of this study?Dr. Berwick: In our study of Sun Exposure and Melanoma Survival: A GEM Study we found that there is little strong evidence that sun exposure at any time in life influences melanoma-specific survival. This study took place in Australia, Italy, Canada and the United States among 3,578 individuals newly diagnosed with melanoma, who we followed for a mean of 7.4 years.
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MedicalResearch.com Interview with: Estee L. Williams, MD
SUNY Downstate Medical Center, Brooklyn, New York
Madfes Integrated Dermatology, New York, New York
[email protected]Medical Research: What are the main findings of the study?
Dr. Williams: In our retrospective review of all melanomas diagnosed at the Veterans’ Affairs Hospital in Brooklyn since 2000, we discovered that although a majority of the melanomas (63%) were found by the dermatologist during a yearly “full body” screening examination (versus detection by the patient), melanomas found by the dermatologist were not necessarily thinner (hence, earlier, more curable) than those found by the patient.
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MedicalResearch.com Interview with: Tomasz M. Beer, M.D. FACP
OHSU Knight Cancer Institute
Oregon Health and Science University
OR 97239
Medical Research: What are the main findings of the study?Dr. Beer: In the study, we found that compared to placebo, enzalutamide improves overall survival, progression-free survival, quality of life, and delays the need for chemotherapy. Enzalutamide is superior to placebo with respect to all planned endpoints, across all subsets of the patient population in the study. Enzalutamide treatment is associated with an excellent safety profile.
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MedicalResearch.com Interview withSteven M. Hill, Ph.D.
Professor, Structural & Cellular Biology
Edmond & Lily Safra Chair for Breast Cancer Research
Co-Director, Molecular Signaling Program, Louisiana Cancer Research Consortium
Director, Tulane Circadian Biology Center
Medical Research: What are the main findings of the study?Dr. Hill: The main findings of our study are that exposure to even dim light at night can drive human breast tumors to a hyper metabolic state, activating key tumor cell signaling pathways involved in tumor cell survival and proliferation, leading to increased tumor growth, all resulting in a tumor which is completely resistant to therapy. Our work shows that this effect is due to the repression of nighttime melatonin by dim light at night. When nighttime melatonin is replace the tumors become sensitive to tamoxifen resulting in cell death and tumor regression.
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MedicalResearch.com Interview with: Rajkumar Lakshmanaswamy, PhDBasic Science Research Director of the Center of Excellence in Cancer Research.
The Paul L. Foster School of Medicine
Texas Tech University Health Sciences Center
Medical Research: What are the main findings of the study?Dr. Lakshmanaswamy: Our study supports a growing body of research suggesting a safe and effective role for natural steroid hormones in treating postmenopausal breast cancer, with fewer detrimental side effects and an improved health profile than with standard anti-hormone therapies. Using a mouse model mimicking human breast cancer after menopause, we found that treatment with estrogen, progesterone, and testosterone was associated with greater physical activity, improved cognition, and better cardiovascular and bone health, which demonstrates the potential significance of hormone treatment in postmenopausal women.
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MedicalResearch.com Interview with: Jason D. Wright, M.D.
Levine Family Assistant Professor of Women's Health
Florence Irving Assistant Professor of Obstetrics and Gynecology
Division of Gynecologic Oncology
Columbia University College of Physicians and Surgeons
161 Fort Washington Ave, New York, New York 10032
Medical Research: What are the main findings of the study?Dr. Wright:This study is one of the first large scale studies to examine the risk of cancer specifically in women who underwent hysterectomy with electric power morcellation. Among 32,000 women treated at over 500 hospitals across the US we noted cancer in 27 per 10,000 women.
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MedicalResearch.com Interview with: Qiuyin Cai, M.D., Ph.D.
Associate Professor of Medicine
Vanderbilt University
Medical Research: What are the main findings of the study?Dr. Cai: We conducted a genome-wide association study in East Asians to search for additional genetic changes that are linked to breast cancer development. The study was conducted as part of the Asia Breast Cancer Consortium, which includes 22,780 women with breast cancer and 24,181 control subjects. We found DNA sequence changes in two genes, PRC1 and ZC3H11A, and a change near the ARRDC3 gene were associated with breast cancer risk. These results were also replicated in a large consortium, including 16,003 breast cancer cases and 41,335 control subjects of European ancestry.
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MedicalResearch.com Interview with:Allison Lipitz-Snyderman, PhD
Assistant Attending Outcomes Research Scientist
Center for Health Policy and Outcomes
Department of Epidemiology and Biostatistics
Memorial Sloan Kettering Cancer Center New York, NY 10065
Medical Research: What are the main findings of the study?Dr. Lipitz-Snyderman:Long-term central venous catheters are used to administer intravenous fluids and treatments such as chemotherapy. These catheters can also be a source of bloodstream infections which can be harmful to cancer patients. However, this risk is not well understood. In our study, we found that the use of these catheters was associated with an increased risk of infections for patients with cancer. We used a population-based dataset, SEER-Medicare, to study this issue in older adult cancer patients. This dataset allowed us to study patients treated in different institutions and follow them over time.
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MedicalResearch.com Interview with Dr Lim Weng Khong
Research Fellow, National Cancer Centre Singapore.
Medical Research: What are the main findings of the study?Dr Lim Weng Khong: This study uncovered the genetic cause fibroadenomas, which are very common benign breast tumours in women. The team from National Cancer Centre Singapore, Singapore General Hospital and Duke-NUS Graduate Medical School identified a critical gene called MED12 that has frequent durations in a remarkable 60 per cent of fibroadenomas studied. Their findings have been published in the top-ranked journal Nature Genetics.
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MedicalResearch.com Interview with: Florien Boel MSc
VU University Medical Center
Department of Medical Psychology
Amsterdam, The Netherlands
Medical Research: What are the main findings of the study?Answer: In postmenopausal breast cancer patients, endocrine therapy is widely used, and often for many years on end. Endocrine therapy is thought to have an effect on cognitive functioning, but previous studies have not yet accounted for the possible influence of the diagnosis of cancer and subsequent anxiety, depression or fatigue on cognitive performance. In addition, the cognitive effects of endocrine therapy after long-term use are still mostly unknown.
Therefore, we compared cognitive functioning of postmenopausal breast cancer patients who underwent surgery and/or radiotherapy (N=43) with the cognitive performance of women who also received adjuvant endocrine therapy (tamoxifen) (N=20) and a group of healthy matched individuals (N=44). In accordance with the literature, we found that especially cognitive domains that rely heavily on verbal abilities (verbal memory and fluency) seem to be at risk for deterioration during long-term treatment (~2.5 years) with tamoxifen.
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MedicalResearch.com Interview with:Grace Lu-Yao PhD, MPH
Professor of Medicine
Robert Wood Johnson Medical School
Rutgers, The State University of New Jersey
Rutgers Cancer Institute of New Jersey
New Brunswick, NJ 08903-2681
Medical Research: What are the main findings of the study?Dr. Lu-Yao:Primary ADT (ie., use of androgen deprivation as an alternative to surgery, radiation or conservative management for the initial management of prostate cancer) is not associated with improved overall or disease specific survival.
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MedicalResearch.com Interview with: John D'Orazio, M.D., Ph.D.
Drury Pediatric Research Endowed Chair
Associate Professor, Univ. KY College of Medicine
Pediatric Hematology-Oncology
The Markey Cancer Center
Lexington, KY 40536-0096
Medical Research: What is the background for this study?Dr. D'Orazio: Malignant melanoma is the deadliest of skin cancers, and it’s incidence has increased enormously over the last several decades. In the 1930’s only one in every fifteen hundred Americans would get melanoma in his/her lifetime. Now it’s one in fifty or sixty. Plus, it often affects young adults in the prime of their lives. Altogether, nearly 10,000 Americans die of melanoma every year. However, risk is not equally shared. Fair-skinned people who tend to burn rather than tan from sun exposure have a much higher risk than dark skinned people. On the surface, it would appear that the amount of melanin in the skin would be the only determinant of melanoma risk but the truth is more complex. Our lab has been interested in a particular hormonal pathway in the skin that directly influences melanoma risk. When UV radiation (sunlight) hits the skin, it causes damage to the cells of the skin. Cells respond to this damage to protect themselves against further injury. One way in which they do this is by turning on a hormone called melanocyte stimulating hormone, abbreviated “MSH”. Made by keratinocytes, the most abundant cells in the epidermis, MSH is directly responsible for ramping up melanin production by melanocytes, the cells that make the pigment in the skin that gives us a tan. This pigment called melanin acts as natural sunscreen and blocks UV radiation from penetrating into the skin. This is very important because people who can tan are in a much safer state the next time they get sun exposure. Because they have more melanin in the skin, the UV won’t cause as much damage. The key is to realize that UV causes mutations in melanocytes, and with enough damage to the DNA, melanocytes can turn cancerous and become melanomas. People who have the melanoma-prone, “can’t tan” skin type often have problems in this MSH hormonal pathway. Specifically, they have inherited problems with the receptor on melanocytes that binds to MSH and makes the cells make more pigment. This protein, called the melanocortin 1 receptor (or “MC1R”), is the way that melanocytes sense that the skin has been injured and needs more melanin. If the MC1R won’t signal, then melanocytes just sit there and can’t be induced to make more melanin pigment. Surely this is a major reason why people with MC1R signaling defects are at high risk of melanomas.
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MedicalResearch.com Interview with Rebecca H. Johnson, MD
Assistant Professor, Clinical Genetics
University of Washington
Seattle, Washington
Medical Research: What are the main findings of the study?Dr. Johnson: We observed that, over the past two decades, there has been an increase in the incidence of testicular cancer in Hispanic American adolescents and young adults (AYAs) between 15 and 39 years of age. This increase is seen in both major subtypes of testicular cancer and affects Hispanic AYA patients with all stages of disease at the time of diagnosis. No comparable increase was observed in non-Hispanic white AYA,s or in older American men regardless of Hispanic ethnicity. Between 1992 and 2010, the incidence of testicular cancer in AYA Hispanics has increased 58% in contrast to just 7% in non-Hispanic white AYAs.
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MedicalResearch.com with:Sandip M. Prasad MD
Assistant Professor
Medical University of South Carolina, Charleston, SC and
Scott E. Eggener, MD
Associate Professor of Surgery
Co-Director, Prostate Cancer Program
Director of Translational and Outcomes Research, Section of Urology
University of Chicago Medical Center, Chicago, IL;
Medical Research: What are the main findings of the study?Answer: Depressed men with a diagnosis of intermediate- or high-risk prostate cancer have worse overall outcomes than those without baseline depression and are less likely to undergo definitive therapy. The difference in overall survival between men with and without a depression diagnosis was independent of prostate cancer treatment type.
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MedicalResearch.com Interview with:Andrea Wang-GillamMD, PhD
Assistant Professor, Department of Medicine
Oncology Division, Medical Oncology Section
Washington University School of Medicine in St. Louis
Medical Research: What are the main findings of the study?Dr. Wang-Gillam: This is a global randomized phase III trial of MM398 plus 5FU/LV vs. MM398 vs. 5FU/LV in patients with metastatic pancreatic cancer who had received prior gemcitabine-based therapy. The primary endpoint was overall survival (OS). The secondary endpoints included progression-free survival (PFS), response rate (RR), biochemical response and safety. The trial achieved its primary endpoint. The median overall survival was statistically longer with the combination of MM398 plus 5FU/LV compared with 5FU/LV alone (6.1 months vs 4.2 months; HR of 0.67; p=0.0122). A superior progression-free survival was also seen in the MM398 plus 5FU/LV group compared with the 5FU/LV alone group (3.1 months vs 1.5 months; HR of 0.56; p=0.0001). A higher response rate was observed in the combination regimen compared with the 5FU/LV group (16% vs 1%). There were no differences in overall survival or PFS between the MM 398 monotherapy and 5FU/LV groups.
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MedicalResearch.com Interview with: Dr. Olivia Pagani
Clinical Director of the Breast Unit of Southern Switzerland
Ospedale San Giovanni, Switzerland
Medical Research: What are the main findings of the study?Dr. Pagani: The study showed that the aromatase inhibitor Exemestane is superior to Tamoxifen (both given together with ovarian function suppression) in preventing breast cancer recurrence in premenopausal women with oestrogen receptor positive early breast cancer.
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