Author Interviews, NEJM, Prostate Cancer / 27.07.2014

Tomasz M. Beer, M.D. FACP OHSU Knight Cancer Institute, Oregon Health and Science University OR 97239MedicalResearch.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.
Author Interviews, JAMA, Prostate Cancer, Testosterone / 16.07.2014

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 08903-2681MedicalResearch.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.
Author Interviews, Depression, Journal Clinical Oncology, Metabolic Syndrome, Prostate Cancer / 14.07.2014

MedicalResearch.com with: Sandip M. Prasad MD Assistant Professor Medical University of South Carolina, Charleston, SCSandip 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;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.
Author Interviews, JNCI, Nutrition, Prostate Cancer / 24.05.2014

Edward Giovannucci, MD, ScD Department of Nutrition Harvard School of Public Health Boston, MAMedicalResearch.com Interview with: Edward Giovannucci, MD, ScD Department of Nutrition Harvard School of Public Health Boston, MA MedicalResearch: What are the main findings of the study? Dr. Giovannucci: In 50,000 men followed over 24 years, we found that those regularly consuming tomato products, which are high in lycopene, had a 30% lower risk of developing lethal prostate cancer. Among men being screened regularly with PSA, the risk reduction from high tomato consumption was 50%. We also examined the prostate cancer tissue and found that higher dietary lycopene intake was associated with less new blood vessel formation, which may help explain why the cancers were less likely to progress.
Nutrition, Prostate Cancer / 23.05.2014

Assistant Professor Department of Obstetrics & Gynecology Division of Clinical & Epidemiologic Research and Cancer Prevention, Detection and Control Research Program and Department of Surgery Division of Urology Duke University School of Medicine Durham, NC 27710 MedicalResearch.com Interview with: Adriana C. Vidal, Ph. D. Assistant Professor Department of Obstetrics & Gynecology Division of Clinical & Epidemiologic Research and Cancer Prevention, Detection and Control Research Program and Department of Surgery Division of Urology Duke University School of Medicine Durham, NC 27710 MedicalResearch: What are the main findings of the study? Dr. Vidal: Among 430 veterans at the VA Hospital in Durham, N.C., including 156 men with confirmed prostate cancer, we found that men who self-reported a higher intake of carbohydrates were at a reduced risk of both low-grade and high-grade prostate cancer. Moreover, we found that intake of foods with high glycemic index increased total prostate cancer risk in black men. However, a higher fiber intake was associated with reduced risk of high grade prostate cancer.
Author Interviews, BMJ, Prostate Cancer, Testosterone / 07.05.2014

dr_san_franciscoMedicalResearch.com Interview with: Dr. Ignacio F. San Francisco Departamento de Urología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile MedicalResearch: What are the main findings of the study? Answer: Increasingly, men with low-risk prostate cancer are undergoing a close monitoring regimen called active surveillance, instead of moving forward immediately with treatment. However it is still unclear which men will develop evidence for worsening or more aggressive disease during active surveillance. In this study of 154 men with Gleason 6 prostate cancer followed for 38 months, we found that low levels of free testosterone were significantly associated with increased risk of developing more aggressive disease. We found no significant association with total testosterone concentrations, although there was a general trend towards increased risk with lower levels.
Author Interviews, Prostate Cancer / 03.05.2014

dr_arturo_araujoMedicalResearch.com Interview with: Arturo Araujo, PhD IMO Moffitt Cancer Center Tampa, FL 33612   MedicalResearch: What are the main findings of the study? Dr. Araujo: Using in vivo approaches it is often challenging to study the multiple simultaneous interactions occurring at various time points in the setting of bone metastasis. However, integrating biological data with a powerful computational model allowed us to build a tool that could not only mimic the in vivo growth of cancer in bone but also to determine how the disease was behaving at any given time point. The key finding for us was that the computational model demonstrated the phasic or cyclical nature of how the prostate cancers grow in bone. For example, a wave of osteoclast mediated bone resorption would be followed by sustained bone formation by osteoblasts, followed again by bone reposition. We think these findings could provide novel insights into when the best time to apply therapies might be in order to obtain maximum efficiency.
Author Interviews, CMAJ, Cost of Health Care, Prostate Cancer / 26.04.2014

MedicalResearch.com Interview with: Alice Dragomir, MSc, PhD Assistant Professor, Urology/Surgery, McGill University Scientist, RI-MUHC MedicalResearch.com: What are the main findings of the study? Authors’ response: Our study demonstrates that for eligible patients, active surveillance could offer not only the known clinical advantages from the patient’s perspective, but also economic benefits from the health care system’s perspective. At the national level, the cost savings of an annual cohort of incident prostate cancers managed with active surveillance over a first year and 5 years of follow-up could be substantial. These are estimated at $96 million.
Author Interviews, Cancer Research, Johns Hopkins, Prostate Cancer / 19.04.2014

Angelo M. De Marzo MD PhD Professor of Pathology Johns Hopkins School of Medicine Baltimore, MD 21231MedicalResearch.com Interview with: Angelo M. De Marzo MD PhD Professor of Pathology Johns Hopkins School of Medicine Baltimore, MD 21231 MedicalResearch.com: What are the main findings of the study? Dr. De Marzo: Working as a team with Dr. Elizabeth Platz and a group of other investigators we found that men with chronic inflammation in their benign areas of their prostate biopsies had a higher chance of prostate cancer,  and especially higher grade cancers, which are associated with disease aggressiveness. A key unique aspect of the study is that the samples were taken from man who were enrolled in the Prostate Cancer Prevention Trial (PCPT), a trial in which all men entering the study had a relatively low PSA, and, all men at the end of study who did not already have a diagnosis of prostate cancer were offered a prostate biopsy regardless of their PSA. This study design, unlike a standard association study, allowed us to minimize the potential bias whereby inflammation is associated itself with elevations in PSA. In this standard design approach, when cancer is detected it could artifactually appear that inflammation is associated with cancer because the inflammation was in part driving the PSA elevation, which prompted the biopsy in which cancer was detected.
Author Interviews, Erectile Dysfunction, JAMA, Prostate, Prostate Cancer, Radiation Therapy / 01.04.2014

Dr. Thomas M. Pisansky MD Mayo Clinic, Rochester, MinnesotaMedicalResearch.com Interview with: Dr. Thomas M. Pisansky MD Mayo Clinic, Rochester, Minnesota MedicalResearch.com: What are the main findings of the study? Dr. Pisansky: This patient-reported outcomes research did not identify a beneficial effect of once-daily tadalafil to prevent radiotherapy-related erectile dysfunction in men with prostate cancer.
Author Interviews, Cancer, Prostate Cancer / 27.03.2014

MedicalResearch.com Interview with: Florence K. Keane, MD Harvard Radiation Oncology Program, Harvard Medical School and Anthony V. D’Amico, MD, PhD Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts MedicalResearch.com: What are the main findings of the study: Answer: Patients with unfavorable intermediate-risk prostate cancer (PC) [1] have an increased risk of PC-specific mortality (PCSM) after radiotherapy (RT) with or without androgen suppression therapy (AST) compared to favorable intermediate-risk patients [2,3]. We provided validation for this prognostic subdivision using mature data with a median follow-up of 14.3 years from a prospective randomized trial comparing RT alone with RT and 6 months of AST [4].  We also assessed the risk of PCSM in patients with unfavorable intermediate-risk PC compared with high-risk prostate cancer. Our main findings were as follows.
  • First, there were no prostate cancer deaths observed in favorable intermediate-risk patients, despite 50% receiving RT alone.
  • Second, there was not a statistically significant difference in the risk of PCSM in men with unfavorable intermediate-risk prostate cancer compared to men with high-risk PC after randomizing for age, comorbidities and treatment arm. While it is possible that a difference may emerge with longer follow-up, these results suggest that some men with unfavorable intermediate-risk PC may harbor occult GS 8-10 disease and could benefit from a 3.0-Tesla multiparametric MRI and targeted biopsy to rule out GS 8-10 disease.
Author Interviews, Prostate Cancer, Radiology / 18.03.2014

Dr. Maarten de Rooij MD, PhD Candidate Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland 6525 GA, The NetherlaMedicalResearch.com Interview with: Dr. Maarten de Rooij MD, PhD Candidate Department of Radiology Radboud University Nijmegen Medical Centre Nijmegen, Gelderland 6525 GA, The Netherlands   MedicalResearch.com: What are the main findings of the study? Dr. de Rooij : Prostate cancer is the most common cancer in men and the second leading cause of cancer related death. The current diagnosis is based on ‘random or blind’ systematic transrectal ultrasound guided prostate biopsies in men with an elevated PSA. This can lead to over-diagnosis and over-treatment of prostate cancer, but can also miss important tumors. The role of multiparametric MRI (mpMRI) to improve the diagnosis of prostate cancer is evolving. In this meta-analysis we determined the diagnostic accuracy of mpMRI for the detection of prostate cancer. Our analysis included 7 studies using mpMRI which showed high overall specificity (0.88; 95% CI 0.82-0.92), with variable but high negative predictive values (0.65 - 0.95) and sensitivities (0.74; 95% CI 0.66-0.81).
Author Interviews, Biomarkers, Electronic Records, JNCI, Prostate Cancer / 14.03.2014

Primo N. Lara, Jr, MD, Professor of Medicine, University of California Davis School of Medicine Associate Director for Translational Research UC Davis Comprehensive Cancer Center Sacramento, CA 95817MedicalResearch.com Interview with: Primo N. Lara, Jr, MD, Professor of Medicine, University of California Davis School of Medicine Associate Director for Translational Research UC Davis Comprehensive Cancer Center Sacramento, CA 95817 MedicalResearch.com: What are the main findings of the study: Dr. Lara:  “We found that blood markers of bone turnover can be used to predict outcomes in men with advanced prostate cancer with spread to bone. We also found that a small proportion of men could be predicted to benefit from an investigational drug based on these same markers.”
Author Interviews, Prostate Cancer, Race/Ethnic Diversity / 14.01.2014

David M. Albala, MD Associated Medical Professionals of NY, PLLC Syracuse, NY 13210MedicalResearch.com Interview with: David M. Albala, MD Associated Medical Professionals of NY, PLLC Syracuse, NY 13210 MedicalResearch.com: What are the main findings of the study? Dr. Albala: Prostate cancer is the second leading cause of cancer death and American man. Prostate cancer diagnosis and mortality differences between African American and Caucasian populations have been highlighted in the literature. Research has shown that African American males are at a biological predisposition for prostate cancer and that additional socioeconomic and physician-patient educational factors may contribute to a higher mortality rate among this group - over two times greater than that of Caucasian American males. At present the most commonly used to detection tools for prostate cancer are the serum prostatic specific antigen test (PSA) and a digital rectal examination (DRE). These complementary tests provide physicians with an indication of whether to proceed with biopsy for a definitive pathological diagnosis. Despite ongoing disputes regarding the effectiveness of PSA screening as an indicator for prostate cancer, a superior alternative test as yet to become available for men at risk. The American Urological Association (AUA) emphasizes the value of early detection and that sheared decision-making should not be overlooked and that shared decision making should be integral to screening decisions. The AUA urges individuals to personally assess, with their physicians, whether a PSA screen is necessary. Emphasis should be placed on the proper education of African American men who are at increased risk for the disease, as well as on their participation in repeated screening practices for the earliest possible detection of prostate cancer.
Author Interviews, Prostate Cancer, Race/Ethnic Diversity / 11.12.2013

Dr David P. Turner PhD Assistant Professor Director of shRNA Technology Medical University of South Carolina Dept of Pathology & Lab Medicine Charleston SC 29425MedicalResearch.com Interview with: Dr David P. Turner PhD Assistant Professor, Director of shRNA Technology Medical University of South Carolina Dept of Pathology & Lab Medicine Charleston SC 29425 MedicalResearch.com: What are the main findings of the study? Dr. Turner: Our research has identified a potential mechanistic link between sugar derived metabolites and cancer associated pathways which may be a biological consequence of the socioeconomic and biological factors that are known to drive cancer health disparity. African Americans develop and die more frequently of cancer than any other population in the US. We examined the levels of reactive metabolites known as advanced glycation end-products, or AGEs for short, in serum and tumor samples from African American and Non-Hispanic White prostate cancer patients. In both the serum and tumor tissue, the levels of AGE metabolites were consistently higher in the African American prostate cancer patients than their White counterparts. AGE functions as a ligand for the receptor for AGEs, or RAGE for short. We also identified that RAGE protein levels were  higher in African Americans with prostate cancer.
Author Interviews, Prostate Cancer, Weight Research / 01.11.2013

MedicalResearch.com Interview with: Reina Haque, PhD, MPH Research scientist, Kaiser Permanente Department of Research & Evaluation MedicalResearch.com: What are the main findings of the study? Answer: The main study findings are that men who are overweight or obese when they are diagnosed with prostate cancer are more likely to die from the disease than men who are of healthy weight. In patients with more aggressive forms of prostate cancer, the researchers also found an even stronger correlation between obesity and mortality. The study was restricted to patients undergoing surgical treatment for prostate cancer, rather than other treatments such as radiation or hormone therapy.
Author Interviews, Duke, Prostate Cancer / 10.10.2013

Susan Halabi, PhD Duke University Medical Center Durham, NC 2771MedicalResearch.com Interview with Susan 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.
Author Interviews, Prostate Cancer / 26.09.2013

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 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=645 MedicalResearch.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.
Author Interviews, Cancer Research, Lancet, Prostate Cancer, Sloan Kettering / 26.09.2013

Dr. Ethan Basch MD Memorial Sloan-Kettering Cancer CenterMedicalResearch.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.
Author Interviews, Prostate Cancer / 11.09.2013

David F Jarrard, MD Vice Chair for Clinical Affairs Professor of Urology John Livesey Chair in Urologic OncologyMedicalResearch.com Interview with: David F Jarrard, MD Vice Chair for Clinical Affairs Professor of Urology John Livesey Chair in Urologic Oncology   MedicalResearch.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.
Author Interviews, Coffee, Prostate Cancer, Stanford / 28.08.2013

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 98109-1024Janet 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.
Author Interviews, Cancer Research, JAMA, Nutrition, Prostate Cancer / 10.07.2013

Maarten C. Bosland, DVSc, PhD Professor of Pathology Department of Pathology University of Illinois at Chicago College of Medicine Chicago, IL 60612MedicalResearch.com Interview with: Maarten C. Bosland, DVSc, PhD Professor of Pathology Department of Pathology University of Illinois at Chicago College of Medicine Chicago, IL  60612 MedicalResearch.com: What are the main findings of the study? Dr. Bosland: Daily consumption of a supplement containing soy protein isolate for two years following radical prostatectomy did not reduce recurrence of prostate cancer in men at high risk for this (radical prostatectomy is surgical removal of the prostate to treat prostate cancer). The study showed that this soy supplementation was safe. It is not clear whether this result indicates that soy does not prevent the development of prostate cancer, but men that have the disease probably do not benefit from soy supplementation.
Author Interviews, Cancer Research, Prostate Cancer, Stanford / 29.05.2013

MedicalResearch.com eInterview with Timothy J. Daskivich, MD Robert Wood Johnson Foundation Clinical Scholars® University of California Los Angeles Division of General Internal Medicine and Health Services Research 10940 Wilshire Blvd, 7th Floor Suite 710, Room 721 Los Angeles, California 90024 MedicalResearch.com: What are the main findings of the study?  Were any of the findings unexpected? Dr. Daskivich:  We found that age and a simple count of comorbidities were strongly predictive of likelihood of dying of causes other than prostate cancer.  When we put numbers to it, it was surprising how often older men with multiple comorbidities were dying of something else than their prostate cancer within 14 years of diagnosis.  For example, a 75-year old man with 3 or more comorbidities—diabetes, high blood pressure, and history of heart attack—had a probability of death from something other than CaP of 71% at 10 years.  For a 71-year old man with 3 or more comorbidities, the probability was 60%.  We compared that to the amount of time they were dying of prostate cancer, which was 3% for low-risk disease and 7% for intermediate-risk disease.
Author Interviews, Prostate Cancer, University of Pennsylvania / 28.03.2013

MEDICALRESEARCH.COM INTERVIEW WITH Charnita Zeigler-Johnson, Ph.D., M.P.H. Research Assistant Professor CCEB University of Pennsylvania MEDICALRESEARCH.COM: What are the main findings of the study? Dr. Zeigler-Johnson: The main findings of the study are:
  • Younger African-American men diagnosed with advanced prostate cancer at an early age (under the age of 60) are more likely to have had a personal history of early-onset baldness (baldness by age 30.)
  • For older patients, this is not necessarily the case, and future studies will need to focus on which factors place men in this age group at risk for prostate cancer.