Author Interviews, Opiods, Pancreatic, PLoS / 08.01.2021

MedicalResearch.com Interview with: [caption id="attachment_56379" align="alignleft" width="200"]Faraz Bishehsari, MD, PhD Associate Professor of Medicine and Graduate College Director of the Translational Gastroenterology Unit Division of Digestive Diseases Rush University Medical Center Dr. Bishehsari[/caption] Faraz Bishehsari, MD, PhD Associate Professor of Medicine and Graduate College Director of the Translational Gastroenterology Unit Division of Digestive Diseases Rush University Medical Center MedicalResearch.com: What is the background for this study? Response: This study builds on recent population based studies where opium use was found to be possible risk factor for pancreatic cancer. Although opium use is not a common recreational habit in the United States, opioid use has been rising remarkably over the past decade. In fact, opioid misuse and overdose have evolved into a public health crisis here with increasing opioid prescription use and abuse over the past decade.
Author Interviews, Cancer Research, Microbiome / 04.01.2021

MedicalResearch.com Interview with: [caption id="attachment_56353" align="alignleft" width="149"]Ben Boursi MD School of Medicine, Sackler Faculty of Medicine Tel Aviv University Tel Aviv, Israel Dr. Boursi[/caption] Ben Boursi MD Senior Physician in the Gastrointestinal Cancer Department at Sheba Medical Center School of Medicine, Sackler Faculty of Medicine Tel Aviv University Tel Aviv, Israel MedicalResearch.com:  What is the background for this study? What conditions have fecal matter transplants been previously studied in (ie c. diff)? Response: “Many melanoma patients do not respond to immunotherapy and even among responders, many eventually progress. Extensive research has been conducted in order to overcome resistance to immunotherapy and modulation of the gut microbiota, is one of the promising leads. The gut microbiome has been shown to influence response to immunotherapy in preclinical mouse models and observational patient cohorts. Currently FMT is being used for the treatment of C. Difficile that is resistant to antibiotics, but it is also being evaluated as a treatment option for other disease states such as inflammatory bowel disease and obesity.”
Author Interviews, Cancer Research, JAMA / 31.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56345" align="alignleft" width="130"]Deborah C. Marshall, MD New York University School of Medicine New York, New York Dr. Marshall[/caption] Deborah C. Marshall, MD New York University School of Medicine New York, New York  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Tarras ES, Marshall DC, Rosenzweig K, Korenstein D, Chimonas S. Trends in Industry Payments to Medical Oncologists in the United States Since the Inception of the Open Payments Program, 2014 to 2019. JAMA Oncol. Published online December 30, 2020. doi:10.1001/jamaoncol.2020.6591  MedicalResearch.com: What should readers take away from your report? Response: Overall, though, there has not been a dramatic shift in these interactions after the inception of Open Payments.
Author Interviews, Cancer Research, COVID -19 Coronavirus, Lung Cancer / 17.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56247" align="alignleft" width="155"]Robert Van Haren, MD, MSPH College of Medicine University of Cincinnati Dr. Van Haren[/caption] Robert Van Haren, MD, MSPH College of Medicine University of Cincinnati  MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has impacted all areas of society including the field of oncology. This study evaluated the impact of COVID-19 on lung cancer screening.  Screening with low-dose computed tomography (LDCT) scans are important because they reduce lung cancer mortality by at least 20%.  Our lung cancer screening program was closed in March 2020 due to COVID 19 and reopened again in June 2020.  We cancelled over 800 LDCTs during that time period. 
Author Interviews, Cancer Research, Immunotherapy / 17.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56238" align="alignleft" width="130"]Joshua Brody MD Director, Lymphoma Immunotherapy Program Icahn School of Medicine at Mount Sinai Hess Center for Science and Medicine New York, New York 10029 Dr. Brody[/caption] Joshua Brody MD Director, Lymphoma Immunotherapy Program Icahn School of Medicine at Mount Sinai Hess Center for Science and Medicine New York, New York 10029 MedicalResearch.com: What is the background for this study?   Response: Cancer Immunotherapies target "antigens" on the surface of cells. -CAR-T cells targets antigens e.g. CD19 -Bispecific antibodies target antigens e.g. CD20 -Anti-PD1 antibodies awaken T cells that target antigens on e.g. MHC-I Cancer Immunotherapies frequently fail because a small percent of tumor cells simply lack the antigen and cause cancer relapse ('Antigen Escape')
Author Interviews, Breast Cancer, Cancer Research, COVID -19 Coronavirus / 10.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56183" align="alignleft" width="200"]Joanne L. Blum, MD, PhD, FACP Texas Oncology and Director Hereditary Cancer Risk Program Baylor University Medical Center Dr. Blum[/caption] Joanne L. Blum, MD, PhD, FACP Texas Oncology and Director Hereditary Cancer Risk Program Baylor University Medical Center MedicalResearch.com: What is the background for this study? Would you briefly describe the POLARIS study? Response: POLARIS is an ongoing prospective, real-world, non-interventional study in patients with HR+/HER2-ABC receiving palboiclib plus endocrine therapy with a targeted enrollment of 1500 patients at 110 sites in the United States and Canada.  MedicalResearch.com: What are the main findings?
  • Because of the COVID-19 pandemic, approximately one third of the study sites experienced an impact on their responsiveness to correspondence, timely data entry, and subject management.
  • The geographic location or type (e.g., academic or community) of study site appears associated with whether the site was impacted by COVID-19.
  • Other study site characteristics were generally similar between sites that reported an impact of COVID-19 and those that were not impacted.
  • Because of inherent limitations of survey studies, these findings must be interpreted with caution.
Author Interviews, Cancer Research, CDC, JAMA, Lung Cancer / 10.12.2020

MedicalResearch.com Interview with: David A. Siegel, MD, MPH Division of Cancer Prevention and Control US Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: Why is it important to better understand the smoking histories (both current/former and never smokers) among lung cancer patients? Response: Knowledge of smoking status of patients diagnosed with lung cancer can help us understand how to best prevent, detect, and treat lung cancer in the future. More than 84% of women and 90% of men newly diagnosed with lung cancer had ever smoked cigarettes, and half of patients aged 20 to 64 years newly diagnosed with lung cancer were current cigarette smokers. These findings reinforce the importance of cigarette cessation and lung cancer screening. 1 out of every 8 people diagnosed with lung cancer had never smoked cigarettes, which reiterates the importance of learning more about their risk factors for lung cancer, which could impact prevention and treatment. 
Author Interviews, BMC, Breast Cancer, Brigham & Women's - Harvard, Cancer Research, Diabetes, Nutrition / 10.12.2020

MedicalResearch.com Interview with: Tengteng Wang, PhD, MSPH, MBBS Postdoctoral Research Fellow Department of Epidemiology Harvard T.H. Chan School of Public Health Channing Division of Network Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Type 2 diabetes (T2D) has been associated with poor progression of breast cancer. Moreover, having a breast cancer diagnosis may also increase the risk of developing T2D. Therefore, identifying strategies for T2D prevention among breast cancer survivors may play a key role in improving their survival outcomes. One approach may be through a diabetes risk reduction diet (DRRD), a dietary pattern comprised of 9 components that has been associated with 40% lower T2D risk in a previous Nurses’ Health Study publication.1 However, no studies to date have evaluated the association between adherence to the DRRD (as measured by the DRRD score) and survival outcomes following breast cancer. In this prospective cohort study among 8,320 breast cancer survivors, we found that greater adherence to the diabetes risk reduction diet after diagnosis was associated with a statistically significant 31% lower risk of overall mortality. Reduced breast cancer-specific mortality was also observed, which was more pronounced (20% lower risk) among those who improved adherence after diagnosis compared to women with consistently low DRRD adherence before and after diagnosis.
Author Interviews, Cancer Research, COVID -19 Coronavirus, Leukemia / 06.12.2020

MedicalResearch.com Interview with: William Wood, MD Associate Professor of Medicine, Division of Hematology UNC School of MedicineWilliam Wood, MD Associate Professor of Medicine, Division of Hematology UNC School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the earliest days of the COVID-19 pandemic, there were concerns that individuals with cancer, and especially those with hematologic malignancies, could be at higher risk for adverse outcomes following COVID-19 infection than the general population. For this reason the ASH Research Collaborative developed a voluntary data collection registry in which providers or sites caring for patients with hematologic malignancies and COVID-19 infection provided de-identified data via an online data collection platform. We believe that our findings – that 20% of patients with blood cancers who had COVID-19 infection died, including 33% of those who required hospital or ICU level-care – indicate that patients with blood cancers are a medically vulnerable group when it comes to COVID-19. The risk of dying was highest in patients who were older, had more severe infection, opted to forego more intensive treatment, and/or had poorer prognosis before their COVID-19 infection, as determined by their treating clinicians
Author Interviews, Cancer Research, Immunotherapy / 05.12.2020

MedicalResearch.com Interview with: Dr. Corina Dutcus MD Vice President of Clinical Research Oncology Business Group Eisai MedicalResearch.com: What is the background for this study? Would you briefly explain how lenvatinib works? Is it used for any other malignancies, ex. thyroid cancer? Dr. Corina Dutcus Response: LENVIMA (lenvatinib), discovered and developed by Eisai, is an orally available multiple receptor tyrosine kinase inhibitor that inhibits the kinase activities of vascular endothelial growth factor (VEGF) receptors VEGFR1 (FLT1), VEGFR2 (KDR), and VEGFR3 (FLT4). LENVIMA inhibits other kinases that have been implicated in pathogenic angiogenesis, tumor growth, and cancer progression in addition to their normal cellular functions, including fibroblast growth factor (FGF) receptors FGFR1-4, the platelet derived growth factor receptor alpha (PDGFRα), KIT, and RET. LENVIMA is approved in combination with everolimus for the treatment of patients with advanced renal cell carcinoma (RCC) following one prior anti-angiogenic therapy. The approved starting dose for LENVIMA is 18 mg daily. The objective of Study 218, a randomized, open-label, Phase 2 trial, was to assess whether the lower starting dose of LENVIMA (14 mg daily) in combination with everolimus (5 mg daily) would provide similar efficacy with an improved safety profile compared to the FDA-approved starting dose of LENVIMA (18 mg daily) plus everolimus (5 mg daily) in patients with advanced renal cell carcinoma (RCC) following prior treatment with an antiangiogenic therapy. In the US, LENVIMA is also indicated for:
  • the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (RAI-refractory DTC);
  • for the first-line treatment of patients with unresectable hepatocellular carcinoma (HCC);
  • and in combination with pembrolizumab, for the treatment of patients with advanced endometrial carcinoma that is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR), who have disease progression following prior systemic therapy, and are not candidates for curative surgery or radiation. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trial.
Please see Prescribing Information for LENVIMA (lenvatinib) at http://www.lenvima.com/pdfs/prescribing-information.pdf.
Author Interviews, Cancer Research, Genetic Research / 01.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56006" align="alignleft" width="130"]Dr-Nina Bhardwaj Dr. Bhardwaj[/caption] Nina Bhardwaj MD PhD Director of Immunotherapy Tisch Cancer Institute Icahn School of Medicine at Mt Sinai Ward-Coleman Chair in Cancer Research Professor of Hematology and Oncology MedicalResearch.com: What is the background for this study? Response: Neoantigens are novel antigens expressed by tumors as a result of somatic mutations or frame shift mutations. They can be very immunogenic and consequently they are being incorporated into cancer vaccine platforms. In most cases it is necessary to determine each patient’s individual mutations and customize their vaccine antigens accordingly. We sought to identify shared mutations in cancer antigens which are deficient in DNA repair mechanisms namely microsatellite unstable tumors. These tumors have mutations in genes that normally are responsible for ensuring that DNA is properly replicated. Because these genes encode proteins that ensure proper repair around micro-satellite areas (which contain short repeated sequences of DNA and are present in similar regions from one person’s genome to the next), when they are mutated, these regions may not be repaired. Consequently due to nucleotide deletions and insertions one gets frame shift mutations which result in new protein expression which can be shared across tumors, as has been observed for a few regions. We therefore did a comprehensive study of a subset of tumors to determine the breadth of shared frame shift mutations.
Author Interviews, Breast Cancer, Cancer Research, Chemotherapy, JAMA, Yale / 26.11.2020

MedicalResearch.com Interview with: [caption id="attachment_56014" align="alignleft" width="191"]Lajos Pusztai, M.D, D.Phil. Professor of Medicine Director, Breast Cancer Translational Research Co-Director, Yale Cancer Center Genetics and Genomics Program Yale Cancer Center Yale School of Medicine Dr. Pusztai[/caption] Lajos Pusztai, M.D, D.Phil. Professor of Medicine Director, Breast Cancer Translational Research Co-Director, Yale Cancer Center Genetics and Genomics Program Yale Cancer Center Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In HER2-positive early stage (stage I-II) breast cancer, several different preoperative (also called neoadjuvant) chemotherapy options exist, each of these is associated with a different rate of complete eradication of cancer from the breast and lymph nodes (called pathologic complete response or pCR). Patients who experience pCR have excellent long term survival. The complete response rates range from 20% to 80%, the rates are higher with regimens that include several different chemotherapy drugs and dual HER2 blockade. Unfortunately, these highly effective multi-drug treatment regimens are also more toxic and more expensive.  We also learned that patients who do not achieve pCR after preoperative therapy, have high rates of recurrence, but the recurrence rate can be improved by administering postoperative adjuvant therapy. These two observations together, (1) different regimens with different toxicities and costs resulting in different pCR rates, and (2) existence of effective postoperative therapies for patients with residual cancer after preoperative therapy, sets the stage for combining various pre- and post-operative treatment strategies. Starting with a shorter, less toxic and less expensive neoadjuvant regimen would allow a substantial minority (20-45%) of patients who archive pCR to be spared of longer and more toxic regimens, whereas those with residual disease could receive the remaining part of the currently most effective regimens post-operatively as adjuvant therapy. In this study we examined the cost effectiveness of different neoadjuvant followed by adjuvant treatment strategies from a healthcare payer perspective.
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Genetic Research, Melanoma, Prostate Cancer / 23.11.2020

MedicalResearch.com Interview with: [caption id="attachment_56034" align="alignleft" width="97"]Saud H AlDubayan, M.D. Instructor in Medicine, Harvard Medical School Attending Physician, Division of Genetics, Brigham and Women's Hospital
 Computational Biologist, Department of Medical Oncology,  Dana-Farber Cancer Institute Associate Scientist, The Broad Institute of MIT and Harvard Dr. AlDubayan[/caption] Saud H AlDubayan, M.D. Instructor in Medicine, Harvard Medical School Attending Physician, Division of Genetics, Brigham and Women's Hospital Computational Biologist, Department of Medical Oncology, Dana-Farber Cancer Institute Associate Scientist, The Broad Institute of MIT and Harvard  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The overall goal of this study was to assess the performance of the standard method currently used to detect germline (inhered) genetic variants in cancer patients and whether we could use recent advances in machine learning techniques to further improve the detection rate of clinically relevant genetic alterations. To investigate this possibility, we performed a head to head comparison between the current gold-standard method for germline analysis that has been universally used in clinical and research laboratories and a new deep learning analysis approach using germline genetic data of thousands of patients with prostate cancer or melanoma. This analysis showed that across all different gene sets that were tested, the deep learning-based framework was able to identify additional cancer patients with clinically relevant germline variants that went undetected by the standard method. For example, several patients in our study also had germline variants that are associated with an increased risk of ovarian cancer, for which the surgical removal of the ovaries (at a certain age) is highly recommended. However, these genetic alterations were only identified by the proposed deep learning framework.    
Author Interviews, Dermatology, Genetic Research, Melanoma / 19.11.2020

MedicalResearch.com Interview with: [caption id="attachment_55999" align="alignleft" width="142"]Sarah I. Estrada, M.D., FCAP  Laboratory Director Affiliated Dermatology® www.affderm.com Dr. Estrada[/caption] Sarah I. Estrada, M.D., FCAP  Laboratory Director Affiliated Dermatology® www.affderm.com MedicalResearch.com: What is the background for this study? What are the main findings? Response: As a dermatopathologist who makes diagnoses on lesions that may be melanoma, I’m faced with the reality that my accurate interpretation of biopsy tissue is key for the patient to be treated most effectively. Often histopathological evaluation is straightforward but not as often as I would like. The study presented here offers a new test that can be used in conjunction with my evaluation to determine if a questionable lesion is in fact melanoma. The test was developed to take into account the gene expression of the lesion which may factor in characteristics that I cannot visually observe. The test was validated and has shown very promising accuracy metrics.
Author Interviews, Brigham & Women's - Harvard, JAMA, Prostate Cancer, Social Issues / 18.11.2020

MedicalResearch.com Interview with: David-Dan Nguyen, MPH Research Fellow | Center for Surgery and Public Health Brigham and Women's Hospital Medical Student | McGill University  MedicalResearch.com: What is the background for this study? Response: In 2017, the US Preventive Services Task Force updated its recommendation for PSA screening for prostate cancer from a grade D to a grade C for men aged 55 to 69 years. This updated recommendation endorsed shared decision making and harmonizes with the guidelines of the American Urological Association and the American Cancer Society which also recommend shared decision making for PSA screening. Shared decision making is a meaningful dialogue between the physician and the patient that namely includes a review of risks and expected outcomes of screening as well as the patient’s preferences and values. Understandably, the patient’s ability to critically assess the medical information provided (i.e. their health literacy) likely influences this process. We sought to characterize the effect of health literacy on shared decision making for PSA screening. We used data from 2016 when PSA screening for prostate cancer was not recommended by the US Preventive Services Task Force — in other words, we also sought to understand how health literacy impacted screening rates in the context of countervailing guidelines on PSA screening.
Author Interviews, Melanoma, Vaccine Studies / 16.11.2020

MedicalResearch.com Interview with: [caption id="attachment_56006" align="alignleft" width="130"]Dr-Nina Bhardwaj Dr. Bhardwaj[/caption] Nina Bhardwaj MD, PhD Professor of Medicine (Hematology and Medical Oncology) and Urology Tisch Cancer Institute Icahn School of Medicine at Mount Sinai New York, NY MedicalResearch.com: What is the background for this study? What types of cancer may be amenable to this vaccine? Response: The goal was to determine if vaccine responses could be improved by increasing special white cell numbers, namely dendritic cells, which are key for jumpstarting an immune response. MedicalResearch.com: What are the main findings?  Response: We found that the agent flt3-L mobilized these dendritic cells which help to improve the vaccine’s ability to prime the immune system. 
Author Interviews, Cancer Research, JAMA, Prostate Cancer, Technology / 13.11.2020

MedicalResearch.com Interview with: [caption id="attachment_55940" align="alignleft" width="200"]Dave Steiner MD PhD Clinical Research Scientist Google Health, Palo Alto, California Dr. Steiner[/caption] Dave Steiner MD PhD Clinical Research Scientist Google Health, Palo Alto, California MedicalResearch.com: What is the background for this study? Response: For prostate cancer patients, the grading of cancer in prostate biopsies by pathologists is central to risk stratification and treatment decisions. However, the grading process can be subjective, often resulting in variability among pathologists. This variability can complicate diagnostic and treatment decisions. As an initial step towards addressing this problem, we and others in the field have recently developed artificial intelligence (AI) algorithms that perform on-par with expert pathologists for prostate cancer grading. Such algorithms have the potential to improve the quality and efficiency of prostate biopsy grading, but the impact of these algorithms when used by pathologists has not been well studied. In the current study, we developed and evaluated an AI-based assistant tool for use by pathologists while reviewing prostate biopsies.
Author Interviews, Cancer Research / 10.11.2020

MedicalResearch.com Interview with: Brianna M. Jones, MD Icahn School of Medicine at Mount Sinai New York, NY MedicalResearch.com: What is the background for this study? Response: Oral tongue cancer has traditionally been a diagnosis associated with older age and habitual tobacco or alcohol use. However, in the past few decades there has been a disproportionate increase in oral tongue cancer in young patients, particularly in those without a prior history of significant alcohol or tobacco use. In the literature, these young patients without traditional risk factors seem to represent a distinct clinical entity with worse oncologic outcomes. The purpose of this study was to compare young patients (age ≤45) to older patients (>45) with oral tongue squamous cell carcinoma (OTSCC) without habitual smoking or drinking history. 
Author Interviews, BMJ, Breast Cancer, Cancer Research, Radiation Therapy / 10.11.2020

MedicalResearch.com Interview with: Professor Jayant S Vaidya MBBS MS DNB FRCS PhD Professor of Surgery and Oncology University College London MedicalResearch.com: What is the background for this study? What type of single dose radiation is used?  [caption id="attachment_55895" align="alignleft" width="500"]Prof Jeffrey S Tobias, Prof Jayant S Vaidya, Prof Max Bulsara and Prof Michael Baum Prof Jeffrey S Tobias, Prof Jayant S Vaidya, Prof Max Bulsara.                             and Prof Michael Baum[/caption] Response: The findings of the large international randomised trial (TARGIT-A trial), published in the British Medical Journal (BMJ 2020;370:m2836), confirm the long-term effectiveness of Targeted Intraoperative Radiotherapy (TARGIT-IORT): a breast cancer treatment which is increasingly available throughout the world. For most women with early breast cancer, a single dose of targeted radiotherapy during surgery is just as effective as conventional radiotherapy, which requires several visits to hospital after surgery. Conventional external beam radiotherapy (EBRT) is delivered from outside the body via a radiotherapy machine (linear accelerator), and consists of a daily treatment session (known as fractions) to the whole breast, over a period between three to six weeks. Each of these treatments is given over a few minutes, but requires 15 to 30 hospital visits, which could be a significant distance from where the patient lives. TARGIT-IORT is delivered immediately after lumpectomy (tumour removal), via a small ball-shaped device placed inside the breast, directly where the cancer had been. The single-dose treatment lasts for around 20 to 30 minutes and replaces the need for extra hospital visits, benefiting both patient safety and well-being. The device used is called INTRABEAM. More details are described on the BMJ and UCL webpages: https://www.bmj.com/company/newsroom/single-dose-radiotherapy-as-good-as-conventional-radiotherapy-for-most-women-with-early-breast-cancer/ https://www.ucl.ac.uk/news/2020/aug/single-dose-radiotherapy-effective-treating-breast-cancer https://blogs.bmj.com/bmj/2020/08/20/targeted-intraoperative-radiotherapy-for-early-breast-cancer-new-evidence/
Author Interviews, Cancer Research, Colon Cancer / 05.11.2020

MedicalResearch.com Interview with: [caption id="attachment_55847" align="alignleft" width="200"]Hisham Hussan, MD, FACG The Ohio State University Wexner Medical Center Dr. Hussan[/caption] Hisham Hussan, MD, FACG The Ohio State University Wexner Medical Center  MedicalResearch.com: What is the background for this study? Response: Early-onset colorectal cancer (i.e., CRC diagnosed before 50 years of age) is predicted to rise to 10.9% of all colon and 22.9% of all rectal cancers by 2030. Some studies identified an association between early-onset CRC and obesity. By contrast, other studies found a similar body mass index (BMI) between adults with and without early-onset CRC. These conflicting findings are possibly due to weight loss from colorectal cancer that may obscure its relation to obesity.
Author Interviews, Cancer Research, Journal Clinical Oncology, University of Pittsburgh / 03.11.2020

MedicalResearch.com Interview with: [caption id="attachment_55817" align="alignleft" width="120"]Kristine Gade, MD Hematology/Oncology Fellow UPMC Hillman Cancer Center Dr. Gade[/caption] Kristine Gade, MD Hematology/Oncology Fellow UPMC Hillman Cancer Center MedicalResearch.com: What is the background for this study? Would you briefly describe the “surprise question”?  Response:  Via Oncology Pathways, a cancer care platform used by UPMC and other institutions across the country, asks physicians to answer the surprise question – “Would I be surprised if this patient died in the next 12 months?” – whenever a new treatment plan is implemented.   This question has been widely adopted by many oncology and palliative care frameworks and has been shown to be modestly predictive of mortality in multiple studies.  We know that advanced cancer patients have a high utilization of the emergency department, even near end of life.  Our group wanted to see if we could use the results of the surprise question to easily and quickly communicate to emergency department providers the expected prognosis for our advanced cancer patients.  First, we set out to assess the surprise question’s ability to predict survival among our UPMC Hillman Cancer Center patients with select stage IV cancer diagnoses.  
Author Interviews, Cancer Research, Dermatology, JAMA / 30.10.2020

MedicalResearch.com Interview with: Selin Tokez, PhD Student Department of Dermatology Erasmus MC, Rotterdam MedicalResearch.com: What is the background for this study? [caption id="attachment_55804" align="alignleft" width="200"]MedicalResearch.com Interview with: Selin Tokez, PhD Student Department of Dermatology Erasmus MC, Rotterdam MedicalResearch.com: What is the background for this study? Response: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer worldwide with still increasing incidence rates. Given these high incidence rates together with the associated health costs and possibility of fatal progression, it is extremely important to have accurate and complete data on the epidemiology of this disease. Nevertheless, national cancer registries in many countries do not routinely record cSCC cases and therefore currently known numbers are mainly based on incomplete data sources. Additionally, if cSCC cases are registered, this usually only concerns the first cSCC per patient while we know that, contrary to many other malignant neoplasms, patients may develop numerous cSCCs over time. MedicalResearch.com: What are the main findings? Response: In the present study, we analyzed Dutch nationwide data comprising about 145,000 patients with a first invasive cSCC diagnosis between the years 1989 and 2017. We found that the incidence rates of a first cSCC per patient almost tripled in male patients and increased about fivefold in female patients in this 30-year time period. Also, we had data on all cSCCs per patient for the year 2017 and could therefore compare this with the data on only the first cSCC per patient: incidence rates increased by 58% for men and 35% for women when multiple cSCCs were considered. In absolute numbers, this resulted in an increase of 45% in cSCC diagnoses in 2017. Lastly, we extended our analyses by predicting future cSCC incidence rates up to 2027. Given that no substantially effective measures are undertaken in the near future, current cSCC incidence rates will increase with 23% in males and 29% in females in the next decade. MedicalResearch.com: What should readers take away from your report? Response: We could summarize our main message in two points: while people generally know that cSCC is a very common disease with increasing incidence rates, it is not taken into account that these numbers are often based on incomplete data registries and that the real numbers are even higher. In this paper, we provided these numbers for a period of 30 years based on highly accurate data from the Netherlands Cancer Registry. On top of that, as a second main finding, we showed that the real burden caused by cSCC is approximately 50% higher (taken males and females together) when all cSCC diagnoses in 1 year are registered instead of only the first tumor per patient. Together with our prediction analyses that showed an on average 26% further increase for the coming decade, this will have enormous implications for the dermato-oncological health care planning and cost management. Our results urgently call for revision of skin cancer health policies to be able to cope with this rising burden of cSCC management. Ultimately, primary prevention will remain the key strategy to halt the increasing trend in cSCC incidence and the occurrence of multiple cSCCs per patient, which we hope to further stimulate with our paper as well. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: As we had data on multiple cSCCs for only one year, we would suggest to perform trend analyses for multiple cSCCs per patient as well when a longer follow-up duration has been reached. Furthermore, it would be very relevant to identify high-risk cSCCs or patients at risk for multiple cSCCs in order to be able to establish efficient follow-up regimens and take these high risk groups into account when revising skin cancer health policies. MedicalResearch.com: Is there anything else you would like to add? Response: The authors of this study have no conflicts of interest that are relevant to this article. Citation: Tokez S, Hollestein L, Louwman M, Nijsten T, Wakkee M. Incidence of Multiple vs First Cutaneous Squamous Cell Carcinoma on a Nationwide Scale and Estimation of Future Incidences of Cutaneous Squamous Cell Carcinoma. JAMA Dermatol. Published online October 28, 2020. doi:10.1001/jamadermatol.2020.3677 [subscribe] Last Modified: [last-modified] The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website. Example of one type of squamous cell skin cancer: DermNetNZ image[/caption]Response: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer worldwide with still increasing incidence rates. Given these high incidence rates together with the associated health costs and possibility of fatal progression, it is extremely important to have accurate and complete data on the epidemiology of this disease. Nevertheless, national cancer registries in many countries do not routinely record cSCC cases and therefore currently known numbers are mainly based on incomplete data sources. Additionally, if cSCC cases are registered, this usually only concerns the first cSCC per patient while we know that, contrary to many other malignant neoplasms, patients may develop numerous cSCCs over time. MedicalResearch.com: What are the main findings? Response:  In the present study, we analyzed Dutch nationwide data comprising about 145,000 patients with a first invasive cSCC diagnosis between the years 1989 and 2017. We found that the incidence rates of a first cSCC per patient almost tripled in male patients and increased about fivefold in female patients in this 30-year time period. Also, we had data on all cSCCs per patient for the year 2017 and could therefore compare this with the data on only the first cSCC per patient: incidence rates increased by 58% for men and 35% for women when multiple cSCCs were considered. In absolute numbers, this resulted in an increase of 45% in cSCC diagnoses in 2017. Lastly, we extended our analyses by predicting future cSCC incidence rates up to 2027. Given that no substantially effective measures are undertaken in the near future, current cSCC incidence rates will increase with 23% in males and 29% in females in the next decade.
Annals Internal Medicine, Author Interviews, Esophageal, Gastrointestinal Disease / 20.10.2020

MedicalResearch.com Interview with: 加藤元嗣　Mototsugu KATO MD PhD 院長  独立行政法人国立病院機構函館病院 Director, National Hospital Organization Hakodate National Hospita MedicalResearch.com: What is the background for this study? Response: The primary goal of upper gastrointestinal (GI) endoscopic examination is to detect neoplastic lesions in the pharynx, esophagus, and stomach. However, early-stage lesions may frequently be overlooked by conventional white light endoscopy. Since the recent launch of image-enhanced endoscopy, many studies have evaluated its efficacy in diagnosing upper GI neoplasms as well. Linked color imaging (LCI )emphasizes the difference in color to make it easier to detect neoplastic lesions. The aim of this trial is to compare the performance of LCI with white light imaging in detecting upper GI tract neoplastic lesions. 
AstraZeneca, Author Interviews, Cancer Research, ESMO, Lung Cancer, NEJM, Yale / 08.10.2020

MedicalResearch.com Interview with: [caption id="attachment_55606" align="alignleft" width="133"]Roy S. Herbst, M.D., Ph.D. Ensign Professor of Medicine (Medical Oncology) and Professor of Pharmacology Chief of Medical Oncology Yale Cancer Center and Smilow Cancer Hospital Associate Cancer Center Director for Translational Research Yale Cancer Center Dr. Herbst[/caption] Roy S. Herbst, M.D., Ph.D. Ensign Professor of Medicine (Medical Oncology) and Professor of Pharmacology Chief of Medical Oncology Yale Cancer Center and Smilow Cancer Hospital Associate Cancer Center Director for Translational Research Yale Cancer Center    MedicalResearch.com: What is the background for this study? How does osimertinib differ from prior versions of EGFR-TKI Inhibitors? o   ADAURA is a randomized, double-blinded, global and placebo-controlled Phase III trial in the adjuvant treatment of 682 patients with Stage IB, II, and IIIA EGFRm NSCLC following complete tumor resection and adjuvant chemotherapy as indicated. Patients were treated with osimertinib 80 mg once-daily oral tablets or placebo for three years or until disease recurrence. The primary endpoint is disease free survival (DFS) in Stage II and IIIA patients, and a key secondary endpoint is DFS in Stage IB, II and IIIA patients. Osimertinib is not currently approved in the adjuvant setting in any country. o   Osimertinib is a third-generation, irreversible EGFR-TKI with clinical activity against central nervous system metastases. The results of the Phase III ADAURA trial of osimertinib demonstrate for the first time in a global trial that an EGFR inhibitor can change the course of early-stage EGFR-mutated lung cancer for patients. o   ADAURA results were first presented in May during the American Society of Clinical Oncology ASCO20 Virtual Scientific Program.
Author Interviews, Cancer Research, Hepatitis - Liver Disease / 07.10.2020

MedicalResearch.com Interview with: [caption id="attachment_55596" align="alignleft" width="133"]Donna R. Cryer, JD Donna R. Cryer, JD[/caption] Donna R. Cryer, JD President & CEO of the Global Liver Institute  MedicalResearch.com: What is the background for this announcement? What is the mission of the GLI? Response: Global Liver Institute 's (GLI) mission is to improve the impact of the liver community by promoting innovation, collaboration, and scaling optimal approaches to eradicating liver diseases. Our vision is for liver health to take its proper place on the global public health agenda consistent with its prevalence and impact. One of the ways we seek to fulfill that mission is through a #OctoberIs4Livers worldwide awareness campaign for the fight against liver cancer, reinforcing October as liver disease and liver cancer awareness month. Not only are we seeing a continuous rise of prevalence of liver cancers, but survival rates for liver cancers are also some of the lowest of any cancer. Even more concerning is that the startling truth about the rise of liver cancer rates began before the COVID-19 pandemic. With the added burden of COVID-19, patients directly at risk from the virus may be diagnosed at a later stage due to delayed screening, and are getting sicker due to limitations on access to care during this pandemic. GLI is appealing to the US Congress to act now to secure the health and well-being of people living with liver disease and liver cancers during COVID-19. Funding is crucial to ensure federal agencies can restart and continue medical research, implement targeted prevention, and support awareness efforts for those impacted by liver disease as they are at increased risk for severe illness from COVID-19. [1]
Author Interviews, Biomarkers, Cancer Research / 07.10.2020

[caption id="attachment_55592" align="alignleft" width="133"]Padma Sundar, Senior Vice President of Commercial , OncocyteTM Padma Sundar[/caption] MedicalResearch.com Interview with: Padma Sundar, Senior Vice President of Commercial , OncocyteTM oncocyte.com MedicalResearch.com:  What is the background for this announcement? How common is Stage I-IIA non-squamous NSCLC?  DetermaRxTM is a treatment stratification test to identify patients with Stage I-IIA non-squamous NSCLC who may benefit from adjuvant chemotherapy.
  • Stage I-IIA non-squamous NSCLC represents ~20% of the lung cancer population and 40,000 patients annually in the U.S.1
  • Patients with this diagnosis usually undergo surgical resection and are presumed “cured”. While these patients are presumed “cured”, the recurrence rate in early-stage NSCLC of 30-50%. Usually, these recurrences happen within the first two years after surgery and are likely due to the presence of occult distant metastasis at the time of surgery.2
  • Until now, there has not been a validated means of identifying which early-stage patients are at a higher risk of disease recurrence and require adjuvant chemotherapy, versus those patients that are likely cured by surgery alone.
Author Interviews, Cancer Research, Tobacco Research / 05.10.2020

MedicalResearch.com Interview with: [caption id="attachment_55571" align="alignleft" width="200"]Priti Bandi PhD Principal Scientist, Risk Factors Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303 Dr. Bandi[/caption] Priti Bandi PhD Principal Scientist, Risk Factors Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Trends in e-cigarette prevalence and population count of users according to cigarette smoking histories are unknown. These data are needed to inform public health actions against a rapidly changing U.S. e-cigarette market.
Author Interviews, Cancer Research, Prostate Cancer / 01.10.2020

[caption id="attachment_55541" align="alignleft" width="160"]Dr. Maha Hussain Dr. Hussain[/caption] MedicalResearch.com Interview with: Maha Hussain, MD, FACP, FASCO Genevieve Teuton Professor of MedicineDivision of Hem/Onc Deputy Director Robert H. Lurie Comprehensive Cancer Center Northwestern University Feinberg School of Medicine MedicalResearch.com: What is the background for this study? Response: PROfound is an open-label international Phase III clinical trial which evaluated the efficacy and safety of Olaparib (Lynparza) versus enzalumatide or abiraterone and prednisone in patients with metastatic castration-resistant prostate cancer (mCRPC) who have progressed on prior treatment with NHA treatments (abiraterone and prednisone or enzalutamide) and have a qualifying tumor mutation in BRCA1/2, ATM or one of the other genes involved in the HRR pathway. The trial design included 2 cohorts; Cohort A included patients with BRCA1,2 or ATM and Cohort 2 included patients with 12 other HRR genes.
Author Interviews, Cancer Research, HPV, Karolinski Institute, NEJM, Vaccine Studies / 30.09.2020

MedicalResearch.com Interview with: Dr. Jiayao Lei PhD Prof. Pär Sparén PhD Karolinski Institute MedicalResearch.com: What is the background for this study? Response: The efficacy and effectiveness of quadrivalent HPV (qHPV) vaccine protecting against HPV infection, genital warts and high-grade precancerous cervical lesions have been shown. However, there is lack of population-based studies in examining the association between HPV vaccine and invasive cervical cancer on individual level. 
Author Interviews, Cancer Research, ESMO, Race/Ethnic Diversity, Social Issues / 21.09.2020

MedicalResearch.com Interview with: [caption id="attachment_55450" align="alignleft" width="200"]Ziad Bakouny, MD, MSc Post-doctoral research fellow Lank Center for Genitourinary Oncology Dana-Farber Cancer Institute Dr. El Bakouny[/caption] Ziad Bakouny, MD, MSc Post-doctoral research fellow Lank Center for Genitourinary Oncology Dana-Farber Cancer Institute MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has disproportionately affected patients with cancer, with these patients unfortunately having worse outcomes than the general population. In fact, a recent report by the COVID-19 and Cancer Consortium (CCC19) showed that the mortality rate in patients with cancer who develop COVID-19, at 30 days median follow-up, was 16%. Although the adverse outcomes of patients with cancer who develop COVID-19 has received much attention, few studies have thus far investigated the effects of the potential disruption to cancer care delivery caused by the pandemic. Our aim in the COVID and Cancer Outcomes Study (CCOS) was therefore to evaluate this disruption to cancer care caused by the pandemic. This is a multicenter prospective cohort study that included patients seen in the outpatient setting at the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai in New York City and the Dana-Farber Cancer Institute in Boston during one week in March (between March 2 and March 6 2020). Data was collected 3 months before this index week and 3 months prospectively (during the first peak of the pandemic in the Northeastern United States).