MedicalResearch.com Interview withSusan Halabi, PhD
Duke University Medical Center
Durham, NC 27710
MedicalResearch.com: What are the main findings of the study?Dr. Halabi: The purpose of assessing surrogate endpoints is to allow for a more rapid and efficient determination of whether a given therapy provides clinical benefit to patients by prolonging their life.
We sought to evaluate PSA kinetics as surrogate endpoints for overall survival (OS) in mCRPC patients who were receiving second line chemotherapy (cabazitaxel or mitoxantrone) following progression after docetaxel. Using different analytical approaches, we found that PSA declines within the first three months of treatment are not appropriate as surrogate markers of clinical benefit in men who were receiving second line chemotherapy.
This analysis has important clinical care and study design implications: it has become common to use ≥30% decline in PSA as a clinical trial endpoint for all patients with metastatic CRPC, based on the original front-line docetaxel data. The data presented in this study suggest that this is erroneous. Further we believe these data are important because they demonstrate that there are different disease states within the group of patients with “metastatic CRPC". To make the assumption that the same surrogate endpoint can be used across the board may seem like an obvious mistake, but permeates the literature. (more…)
MedicalResearch.com Interview with: Dr. Elisabeth Jeppesen MPH, PhD-fellow
National Resource Center for Late Effects after Cancer Treatment, Department of Oncology, Oslo University, Hospital, The Norwegian Radiumhospitalet, Oslo, Norway
mobil +47 951 05271 Wisit: Ullernchaussen 70 (Radiumhospitalet)
www.oslo-universitetssykehus.no
MedicalResearch.com: What is the background of this study?
Answer: Each year a considerable number of parents with children younger than 18 years of age are affected by cancer in a parent. Cancer in one of the parents might represent a potentially traumatic event and thereby may be a risk factor for psychosocial problems in the offspring. So far, teenagers’ psychosocial responses to parental cancer have only been studied to a limited extent in controlled trials. Using a trauma theory perspective many studies have shown significant direct associations between parental cancer and psychosocial problems in teenagers. However, the literature also indicates that most children and teenagers have normal stress reactions to such events. In order to identify the need for eventual prevention and intervention among teenagers exposed to such a stressor, we need more empirical knowledge of their psychosocial situation.
(more…)
MedicalResearch.com Interview with:Anil K. Sood MD
Department of Gynecologic Oncology
The University of Texas MD Anderson Cancer Center
Unit 1362, PO Box 301439, Houston, TX, 77030
MedicalResearch.com: What are the main findings of the study?Dr. Sood: For women with newly diagnosed ovarian cancer, high heart rate at diagnosis (tachycardia), venous thromboembolism (VTE) occurring after diagnosis and pulmonary hypertension post-diagnosis are independently related to reduced survival after controlling for tumor stage, grade, and extent of cytoreduction. Women with tachycardia lived an average of 4.0 years after diagnosis compared with 5.9 years for women without tachycardia, a 32% reduction in duration of survival. Patients who experienced VTE lived a median 4.1 years after diagnosis, compared with 6.4 yrs for patients who did not experience VTE.
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MedicalResearch.com Interview with:Kelly K. Hunt, MD F.A.C.S.
Professor, Department of Surgical Oncology, Division of Surgery
Chief, Breast Surgical Oncology Section, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
MedicalResearch.com: What are the main findings of the study?Dr. Hunt:We found that 40% of women who had node positive disease at initial presentation (confirmed by needle biopsy) had no evidence of residual cancer in the lymph nodes after chemotherapy.
We performed sentinel lymph node (SLN) surgery followed by axillary lymph node dissection in all of the patients and found a false negative rate of 12.6% with the SLN procedure.
The false negative rate was lower when surgeons used two mapping agents (blue dye and radioisotope) to identify the sentinel nodes and when they removed more than 2 sentinel nodes.
(more…)
MedicalResearch.com Interview with:Dr. Muy-Teck Teh BSc, PhD
Centre for Clinical and Diagnostic Oral Sciences, Institute of Dentistry
Barts & The London School of Medicine and Dentistry
Queen Mary University of London, England, United Kingdom
MedicalResearch.com: What are the main findings of the study?Answer: We found unique DNA markings (epigenetic methylation) on certain genes that may “predict” the risk of developing head and neck cancer. We identified certain DNA methylation marks unique to cancer cells and not found in normal healthy cells.
DNA methylation marks act as ‘switches’ that regulate the ‘on or off’ statuses of genes. Abnormal DNA methylation is known to precede cancer initiation. Hence, the presence of these abnormal DNA methylation marks in cells may be tell-tale signs of early cancer initiation. The chemically distinctive properties of methylated DNA provide ample opportunities for clinical exploitation as nucleic acid-based biomarkers potentially detectable in non-invasive samples such as blood, buccal scrapes, or even saliva.
(more…)
MedicalResearch.com: Interview with:Dr. Atul Butte, MD, PhD
and
Julien Sage PhD
Departments of Pediatrics and Genetics
Department of Internal Medicine, University of California Davis Cancer Center
University of California Davis School of Medicine
Sacramento, California
MedicalResearch.com: What are the main findings of the study?Answer:A major finding of the study is the identification of first-generation anti-depressants as possible drugs effective against a lethal subtype of lung cancer, small cell lung cancer.
A second important aspect of this work is the use of a bioinformatics-based drug repositioning pipeline developed by the Butte lab, which allowed us, when combined with advanced mouse models of lung cancer developed by the Sage lab, to identify a novel targeted therapy against SCLC and initiate a clinical trial in less than 2 years.
(more…)
MedicalResearch.com Interview with: Robert G Bristow MD, PhD, FRCPC
Clinician-Scientist, Ontario Cancer Institute/Princess Margaret Cancer Centre
Professor, Depts. of Radiation Oncology and Medical Biophysics, University of Toronto
Director, Core I - STTARR Innovation Facility
Canadian Cancer Society Research Scientist
http://www.uhnres.utoronto.ca/researchers/profile.php?lookup=645MedicalResearch.com: What are the main findings of the study?Dr. Bristow: We studied the more than 7 years of outcome of close to 250 patients with localized (intermediate risk) prostate cancer that received precision radiotherapy or surgery for cure. We found that up to one third of these patients fail initial radiotherapy or prostate surgery.
By using a patient’s initial diagnostic core biopsy, we studied the DNA fingerprints of the tumors. We noticed a pattern in which the patients that had failed treatment had abnormal levels of breaks at sites within the chromosomes that are sensitive to DNA damage called, “common fragile sites” (CFS).
These CFS break abnormalities have been linked to cancer in general and usually are associated with instability of the cell’s DNA-a phenomenon that is particularly associated with cancer.
So patients who have unstable chromosomes are more likely to fail precision radiotherapy or surgery.
(more…)
MedicalResearch.com Interview with:Niyati Parekh, PhD, RD
Assistant Professor of Nutrition and Public Health,
Director of Doctoral Program in Clinical Nutrition,
Department of Nutrition, Food Studies and Public Health, Steinhardt School and
Department of Population Health, NYU Langone School of Medicine, New York University
411 Lafayette Street NY. NY-10003.
MedicalResearch.com: What are the main findings of the study?Dr. Parekh: The objective of the study was to investigate disturbances in blood glucose levels in relation to risk of obesity-related cancers. We observed an increased risk of obesity-related cancers, specifically colon cancer among persons with abnormal glucose values. These findings were stronger among persons who had this abnormality for longer duration (>10years).
(more…)
MedicalResearch.com Interview with: Dr. Raphael Yechieli
Department of Radiation Oncology at Henry Ford Hospital in Detroit:
MedicalResearch.com: What are the main findings of the study?
Dr. Yechieli: The main findings of the study are that elderly patients with pancreatic cancer who also have significant co-morbidities can still be safely and effectively treated with a short course of radiation treatment. Furthermore, the local control and survival data from our study are similar to previously published data, where patients were treated with more intense and longer courses of treatment.
(more…)
MedicalResearch.com Interview with Dr. Ethan Basch MD
Memorial Sloan-Kettering Cancer Center
MedicalResearch.com: What are the main findings of the study?Dr. Basch: The primary clinical finding of this study is that treatment with abiraterone acetate delays the time until pain develops or worsens in men with advanced prostate cancer. Furthermore, abiraterone delays the time until quality of life and functioning deteriorate, compared to placebo. There is also a broader research finding of this study, which is that it is feasible to rigorously study the time until symptom progression in cancer clinical trials, which paves the way for future studies to use a similar approach.
(more…)
MedicalResearch.com Interview with: Prof Aron Goldhirsch
Department of Medicine
European Institute of Oncology
Via Ripamonti 435, 20141 Milan, Italy
MedicalResearch.com: What are the main findings of the study?Prof. Goldhirsch: Two years of adjuvant trastuzumab after standard chemotherapy is not more effective than is 1 year of treatment with the drug for patients with HER2-positive early breast cancer.
(more…)
MedicalResearch.com Interview with: Prof John R Yarnold
Division of Radiotherapy and Imaging
The Royal Marsden NHS Foundation Trust
Sutton, Surrey SM2 5PT, UK
MedicalResearch.com: What are the main findings of the study?Prof. Yarnold: A 3-week schedule of curative post-operative radiotherapy for women with breast cancer involving 15 treatments (fractions) delivered Monday to Friday each week, is at least as safe and effective as historical schedules given over 5 or 6 weeks. In fact the 3-week schedule is gentler on the healthy tissues than earlier standard regimens.
(more…)
MedicalResearch.com Interview with:Jie He, PhD, MD
Director, Laboratory of Thoracic Surgery
President, Cancer Institute & Hospital, Chinese Academy of Medical Sciences
Chaoyang District, Beijing, 100021
MedicalResearch.com: What are the main findings of the study?Dr. Jie He: The main findings of the study is that we have identified IDH1 as an effective plasma biomarker for the diagnosis of NSCLCs, particularly with high sensitivity and specificity in the diagnosis of lung adenocarcinoma.
(more…)
MedicalResearch.com Interview with: Bruno Heleno, PhD fellow
Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, 1014 Copenhagen K, Denmark
MedicalResearch.com: What are the main findings of the study?Answer: In a literature review of cancer screening trials of a wide range of screening interventions, we found that trials seldom report the information necessary to weigh benefits against harms.
(more…)
MedicalResearch.com Interview with: Aasma Shaukat, M.D., M.P.H.
Dept. of Medicine
GI Division, MMC 36
University of Minnesota
Minneapolis, MN 55455
MedicalResearch.com: What are the main findings of the study?Dr. Shaukat: The study showed that screening for colon cancer using stool cards
consistently reduces risk of death from colon cancer by one-third through
thirty years. The benefit of screening in larger in men compared to women,
and for women the benefit seems to start at age 60. However, screening did
not make people live longer. (more…)
MedicalResearch.com Interview with:Ze'ev Ronai, Ph.D.
Professor and scientific director of Sanford-Burnham Medical Research Institute La Jolla San Diego, Calif.
MedicalResearch.com: What are the main findings of the study?Answer:This study provides the first direct evidence of the importance of the PDK1 enzyme in the development of melanoma and in the metastasis of this aggressive tumor type. We demonstrate, with a genetic mouse melanoma model (harboring the Braf/Pten mutations commonly seen in human melanomas) and/or pharmacological inhibitors against PDK1, that melanoma requires this enzyme for its development, and more so – for its ability to metastasize. Since PDK1 is key kinase that regulates a number of protein kinases, which are currently being assessed in clinical trials (including AKT), our finding points to a new set of targets that could be more amenable for effective combination therapy in melanoma.
(more…)
MedicalResearch.com Interview with:
Nariya Cho, MD
Departments of Radiology
Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
MedicalResearch.com: What are the main findings of the study?Dr. Cho: Smaller reduction in tumor volume and a smaller reduction in washout component on dynamic contrast agent–enhanced MR imaging assessed by computer-aided evaluation after neoadjuvant chemotherapy were independent parameters of worse recurrence-free survival and overall survival in breast cancer patients who received neoadjuvant chemotherapy.
(more…)
MedicalResearch.com Interview with:David F Jarrard, MDVice Chair for Clinical Affairs
Professor of Urology
John Livesey Chair in Urologic OncologyMedicalResearch.com: What are the main findings of the study?
Dr. Jarrard: We have developed and externally validated an accurate nomogram for predicting Gleason score 6 upgrading for use in low-risk prostate cancer patients. This nomogram incorporates only variables available at the time of diagnosis and is unique in its assessment of clinical as well as pathological factors. Furthermore, we externally validated this study in patients with Gleason 6 prostate cancer of which 90% met the D’Amico criteria for low-risk cancer at 2 other centers (total 2000 patients). This nomogram will aid in the decision-making process of patients diagnosed with low-risk prostate cancer.
(more…)
MedicalResearch.com Interview with:Joel H. Rubenstein, MD, MSc, FACG, FASGE
Research Scientist, Veterans Affairs Center for Clinical Management Research
Assistant Professor, Division of Gastroenterology, University of Michigan Medical School
VA Medical Center Ann Arbor, MI 48105
MedicalResearch.com: What are the main findings of the study?Dr. Rubenstein: In a set of case-control studies within the same population, we found that H. pylori was inversely associated with erosive esophagitis, and with Barrett’s esophagus, but we did not find such a relation with symptoms of gastroesophageal reflux disease (GERD).
(more…)
Dr. Bettina Scholtka Universität Potsdam
Institut für Ernährungswissenschaft
Abt. Ernährungstoxikologie
Arthur-Scheunert-Allee 114-116
14558 Nuthetal, Germany.
MedicalResearch.com: What are the main findings of the study?Answer: The extremely high sensitivity of the WTB-HRM technique allows to find
very low amounts of different types of colon cancer initiating gene
mutations even in stool samples of patients. The method is able to
find the expected mutations as well as unknown mutations. So, by
applying WTB-HRM to a panel of especially selected marker genes, it is
possible to detect cancer precursors in feces before they progress
into a malignant stage.
(more…)
MedicalResearch.com Interview with:Ying Liu, MD, PhD
Instructor, Division of Public Health Sciences
Department of Surgery
Washington University School of Medicine
660 South Euclid Ave Campus Box 8100
St. Louis, MO 63110
MedicalResearch.com: What are the main findings of the study?Answer: Alcohol intake between menarche (first menstrual period) and first pregnancy was consistently associated with increased risks of breast cancer and proliferative benign breast disease. For every 10 gram/day alcohol intake (approximately a drink a day) during this specific time period, the risk for breast cancer increased by 11% and the risk for proliferative benign breast disease increased by 16%.
(more…)
MedicalResearch.com Interview with:Janet L. Stanford, MPH, PhD Full Member, Research Professor
Co-Head, Program in Prostate Cancer Research
Fred Hutchinson Cancer Research Center
1100 Fairview Ave. N. M4-B874
Seattle, WA 98109-1024
MedicalResearch.com: What are the main findings of the study?Dr. Stanford: The main finding from our research is that one or more cups of coffee per day is associated with a 56% to 59% reduction in the risk of prostate cancer recurrence or progression in men diagnosed with this common disease. In our cohort of prostate cancer patients, 61% reported drinking at least one cup of coffee per day, with 14% reporting drinking 4 or more cups per day. The lower risk for prostate cancer recurrence/progression observed in coffee drinkers, however, was seen even for those who consumed only one cup per day, suggesting that even modest intake of coffee may offer health benefits for prostate cancer patients.
(more…)
MedicalResearch.com Interview with:Solveig Hofvind, PhD
Cancer Registry of Norway, Oslo and Akershus University College of Applied Sciences, Majorstua 0403, Oslo, Norway
MedicalResearch.com: What are the main findings of the study?Dr. Hofvind: We find that if 100 women aged 50 years attend the Norwegian Breast Cancer Screening Program as recommended, every two years until they are 69 years, four women will undergo a needle biopsy with benign outcome (a false positive needle biopsy).
In the same group of women, twenty women will be recalled for further examination and have additional imaging, ultrasound, and/or a biopsy with negative outcome (a false positive screening result).
(more…)
MedicalResearch.com: Interview with:Richard R. Love, MD MS
International Breast Cancer Research Foundation
Professor of Medicine and Public Health The Ohio State University
Columbus, OH
MedicalResearch.com: What are the main findings of the study?Answer:Surgical oophorectomy and tamoxifen treatment was associated with no loss of bone mineral density (BMD) in the femoral neck, and loss of BMD in the first year, followed by stabilization in the lumbar spine.
(more…)
MedicalResearch.com Interview with:
Sandra Ryeom, PhD,
Assistant professor of Cancer Biology,
Perelman School of Medicine, University of Pennsylvania
MedicalResearch.com: What are the main findings of the study?Answer: We identified an important pathway (calcineurin-NFAT-Angiopoeitin2) in the vasculature of early metastatic lung lesions that is critical for promoting lung metastases.
MedicalResearch.com: Were any of the findings unexpected?Answer: Since there is limited understanding of regulation of tumor angiogenesis at metastatic sites, identification of the calcineurin pathway and a newly identified target of calcineurin-NFAT signaling was all unexpected.
(more…)
MedicalResearch.com Author Interview:
Steven A. Narod, MD Women’s College Research Institute
790 Bay St, 7th Floor
Toronto, ON, M5G 1N8 Canada
MedicalResearch.com: What are the main findings of the study?Answer:We found that the survival of women with breast cancer and a brca1 mutation was similar to that of women with breast cancer and no mutation.
(more…)
MedicalResearch.com Interview with: Martin Köbel M.D.
Assistant Professor, Pathology and Lab Medicine
Calgary Laboratory Services
9 3535 Research Road Nw
Calgary, Alberta T2L 2K8 Canada
MedicalResearch.com: What are the main findings of the study?Answer: Ovarian carcinomas are now divided into five histological types, which differ with respect to biology and clinical behaviour. However, the histological type assessment varies from center to center. Our study emphasizes the need for a standardized method to identify them. Until such consistent approach is established, histological types from various centers may not comprise the same entities and studies will give inconsistent results.
(more…)
MedicalResearch.com Interview with: Kornelia Polyak, MD, PhD
Professor of Medicine
Dana-Farber Cancer Institute
Harvard Medical School
Boston, MA 02215
MedicalResearch.com: What are the main findings of the study?Dr. Polyak: We found that when comparing normal breast tissue of women who have not had children (nulliparous) and those who had children in their early 20s, the largest changes are in breast epithelial progenitors. The frequency of these cells is lower in parous women (women who had children) and the properties are also altered in a way that they are less likely to proliferate. Women with high risk of breast cancer, such as BRCA1 and BRCA2 mutation carriers, have very high frequency of these cells, and also parous women who did get cancer have more than those who did not. These results indicate that the frequency of these cells may predict breast cancer risk.
(more…)
MedicalResearch.com Interview with: Prasad Adusumilli MD, FACS
Associate Member, Thoracic Surgery
Memorial Sloan-Kettering Cancer Center
New York
MedicalResearch.com: What are the main findings of the study?Answer: The current standard of care of for early-stage lung adenocarcinoma, the common form of lung cancer is curative-intent surgery either by limited resection, LR (removal of tumor with clear margins) or lobectomy, LO (removal of one-third to one-half of the lung harboring the tumor). Although lung-sparing LR is preferable, there is a reported incidence of 30-40% of recurrences within the same lung. The causative factor/s for these local recurrences is not known.
In our study, we analyzed recurrence patterns and pathological features in patients who underwent 476 LO and 258 LR performed at the Memorial Sloan-Kettering Cancer Center, New York. We investigated the morphological patterns in pathology specimens utilizing the recently proposed International Association for the Study of Lung Cancer / European Respiratory Society / American Thoracic Society (IASLC/ERS/ATS) classification. We noticed that presence of micropapillary morphology was associated with three times higher recurrences in patients undergoing LR compared to LO, these recurrences were lower when there is an adequate margin (2 cm) resected beyond the tumor. In patients undergoing LO, the recurrences were 75% less.
(more…)
MedicalResearch.com Interview with: Satish Gopal, MD, MPH
Program in Global Oncology, Lineberger Comprehensive Cancer Center
UNC Project-Malawi, Tidziwe Center, Private Bag A-104, Lilongwe, Malawi
MedicalResearch.com: What is the primary message our physician readers should take away from the piece?”Answer: Lymphoma is one of the leading causes of HIV-associated death in the modern ART era. In our analyses of a large multicenter US cohort, survival for HIV-associated lymphoma patients receiving routine care has not clearly improved since the modern ART era began, and remains significantly worse than SEER outcomes for the same lymphoma subtypes in the general population. This was somewhat surprising in an era of normalizing life expectancy for HIV-infected patients on ART, and quite different from the outstanding results achieved for this population in recent clinical trials conducted by AMC and NCI.
(more…)
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