Author Interviews, Breast Cancer, Cancer Research, JAMA, MRSA, Radiation Therapy / 06.05.2023

MedicalResearch.com Interview with: [caption id="attachment_60394" align="alignleft" width="150"]Beth McLellan, M.D.Chief, Division of Dermatology Montefiore Medical Center Albert Einstein College of Medicine Dr. McLellan[/caption] Beth McLellan, M.D. Chief, Division of Dermatology Montefiore Medical Center Albert Einstein College of Medicine MedicalResearch.com: What is the background for this study? How is the decolonization initiated and maintained? Response: We were interested in exploring whether bacteria on the skin plays a role in radiation dermatitis like it does in other skin diseases that cause a breakdown in the skin barrier. We used a bacterial decolonization regimen that includes chlorhexidine 2% cleanser for the body and mupirocin 2% ointment to the inside of the nose for 5 consecutive days before starting radiation therapy and repeated for an additional 5 days every other week for the duration of radiation.
Author Interviews, Cancer Research, COVID -19 Coronavirus, Race/Ethnic Diversity, Radiation Therapy / 01.11.2021

MedicalResearch.com Interview with: [caption id="attachment_58308" align="alignleft" width="200"]Brianna M. Jones, MD Radiation Oncology Resident Icahn School of Medicine at Mount Sinai Dr. Jones[/caption] Brianna M. Jones, MD Radiation Oncology Resident Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has resulted in over 4 million deaths worldwide and, presently, there have been over 2 million cases diagnosed in New York. There have been numerous studies that demonstrate cancer patients are at increased risk of diagnosis and mortality to SARS-CoV-2 virus. Several studies have also noted socioeconomic status and race/ethnicity are associated with poorer outcomes. Within NYC, Elmhurst Hospital Center (EHC) emerged as an early epicenter in spring of 2020. The surrounding catchment area of EHC consists of a population that is 54% Latino, 33% Asian, 6% White, 4% Black, 1% Native American, and 1% other according to U.S. Census Bureau, making it one of the most racially and ethnically diverse populations in the country. Its residents are predominantly working-class immigrants with limited resources that work jobs now considered essential (e.g., delivery workers, grocery shops, et cetera). EHC continued to offer a range of cancer services throughout the pandemic. Given the high infection rate and diverse population at EHC, our study provides an opportunity to evaluate outcomes in one of the hardest hit communities to date. Therefore, our aim was to investigate patient characteristics, clinical outcomes, and predictors of COVID-19 diagnosis, severity, and mortality in patients with an active cancer diagnosis at EHC. 
Author Interviews, Brigham & Women's - Harvard, Journal Clinical Oncology, Prostate Cancer, Radiation Therapy / 04.06.2021

MedicalResearch.com Interview with: [caption id="attachment_57600" align="alignleft" width="200"]Dr. D'Amico Dr. D'Amico[/caption] Anthony D'Amico, MD, PhD Professor and Chief of Genitourinary Radiation Oncology Brigham and Women's Hospital and Dana-Farber Cancer Institute MedicalResearch.com: What is the background for this study? Response: 3 randomized trials published in Sept, 2020 in the Lancet and Lancet Oncology concluded that delivering radiation therapy (RT) after surgery for prostate cancer   when the PSA rises signaling recurrence (i.e. early salvage RT) as opposed to when the PSA is undetectable (i.e. adjuvant RT) did not compromise subsequent cancer progression. However these trials may have missed the benefit of adjuvant RT because a minority of men (9 to 17% of the study cohorts) were found to have adverse factors at prostatectomy which are associated with cancer progression and death from prostate cancer. Specifically, men with adverse pathology at prostatectomy comprise the vast majority of men who go on to die from prostate cancer and therefore have the most to gain from adjuvant RT. Yet, given the results of the 3 randomized trials many physicians are no longer offering adjuvant RT, even in men with adverse pathology at surgery.
Author Interviews, Breast Cancer, Cancer Research, Radiation Therapy / 03.06.2021

  [caption id="attachment_57547" align="alignleft" width="400"]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 BaumMedicalResearch.com Interview with:[/caption] 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? Response: The new paper published in the British Journal of Cancer (go.nature.com/3yN0mzu) expands on the previously published results of the large international randomised trial (TARGIT-A trial)(BMJ 2020;370:m2836), that confirmed the long-term effectiveness of Targeted Intraoperative Radiotherapy (TARGIT-IORT): a breast cancer treatment which is increasingly available throughout the world. The TARGIT-A trial found that a single dose of targeted radiotherapy during surgery (TARGIT-IORT) is just as effective as conventional radiotherapy, which requires several visits to hospital after surgery. From the perspective of patients, it is so much better for them and also allows prompt completion of cancer treatment during the COVID pandemic. 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 up 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. The new results are described on the Nature.com and UCL webpages https://www.ucl.ac.uk/news/2021/may/pioneering-single-dose-radiotherapy-breast-cancer-treatment and explained in a short video https://youtu.be/w0OMjVfJ5pY 
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Colon Cancer, Radiation Therapy / 04.05.2021

MedicalResearch.com Interview with: James Donald Byrne, Ph.D., M.D. Department of Radiation Oncology Massachusetts General Hospital Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: Radiation therapy is used as a treatment for more than half of all cancer patients and can be highly effective at shrinking tumors and killing cancer cells. But radiation treatment can also damage healthy tissue, including tissue in the mouth and gastrointestinal tract. This tissue injury can lead to oral mucositis, esophagitis, and proctitis — painful and sometimes debilitating tissue damage. It’s estimated that these injuries occur in over 200,000 patients in the U.S. each year. Our goal was to develop personalized shields that blocked radiation from affecting healthy GI tissue.
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, Breast Cancer, Radiation Therapy / 25.02.2020

MedicalResearch.com Interview with: [caption id="attachment_53297" align="alignleft" width="133"]Jennifer Sims-Mourtada, Ph.D. Senior Rsearch Scientist Director of Translational Breast Cancer Research Center for Translational Cancer Research ChristianaCare Dr. Sims-Mourtada[/caption] Jennifer Sims-Mourtada, Ph.D. Senior Rsearch Scientist Director of Translational Breast Cancer Research Center for Translational Cancer Research ChristianaCare MedicalResearch.com: What is the background for this study? Response: Cancer stem cells are resistant cancer cells that are able to continuously grow and are very resistant to radiation and chemotherapy. Cancer stem cells can also escape to the blood stream and travel to another site causing metastasis.
Author Interviews, Cancer Research, Radiation Therapy, University of Pennsylvania / 09.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52740" align="alignleft" width="148"]Keith A. Cengel, M.D., Ph.D. Associate Professor of Radiation Oncology Hospital of the University of Pennsylvania Dr. Cengel[/caption] Keith A. Cengel, M.D., Ph.D. Associate Professor of Radiation Oncology Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: FLASH radiotherapy involves delivering the treatment dose at a rate that is 1000s of times faster than standard radiotherapy.  Scientists have studied the differential biological effects of various dose rates for dose rates for the past ~80 years, but the unique effects of FLASH dose rates have only been appreciated in the last few years. While the mechanism(s) and applications of FLASH radiotherapy remain an area of active investigation,  t is clear so far that FLASH dose rates can provide similar levels of tumor control with less toxicity to normal tissues when compared to the same dose of radiotherapy delivered at a standard dose rate.
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Lung Cancer, Radiation Therapy / 10.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49629" align="alignleft" width="200"]Raymond H Mak, MD Assistant Professor of Radiation Oncology Harvard Medical School Dr. Mak[/caption]   Raymond H Mak, MD Assistant Professor of Radiation Oncology Harvard Medical School Radiation Oncology Brigham and Women's Hospital     [caption id="attachment_49693" align="alignleft" width="200"]Dr-Katelyn M. Atkins Dr. Atkins[/caption]   Katelyn M. Atkins MD PhD Harvard Radiation Oncology Program Dana-Farber Cancer Institute Brigham and Women’s Hospital Boston, Massachusetts     MedicalResearch.com: What is the background for this study? What are the main findings? 
  • Lung cancer remains the leading cause of cancer-related death worldwide and nearly half of patients will require radiation therapy as part of their care.
  • Cardiac toxicity following radiotherapy has been well-studied in breast cancer and lymphomas, however the impact of cardiac toxicity following lung cancer radiotherapy has historically been under-appreciated due to the high risk of lung cancer death.
  • Recent studies highlighting cardiac toxicity following lung cancer radiotherapy have been limited by small numbers of patients and, to our best knowledge, have not included validated cardiac event endpoints defined by the American Heart Association (AHA)/American College of Cardiology (ACC).
ASCO, Author Interviews, Breast Cancer, Cancer Research, Chemotherapy, Radiation Therapy / 03.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49509" align="alignleft" width="130"]Manjeet Chadha, MD, MHA, FACR, FASTRO Prof. Radiation Oncology Director of the Department of Radiation Oncology Mount Sinai Downtown  Prof. Chadha[/caption] Manjeet Chadha, MD, MHA, FACR, FASTRO Prof. Radiation Oncology Director of the Department of Radiation Oncology Mount Sinai Downtown  MedicalResearch.com: What is the background for this study? Response: Largely, the goal of cancer care among the elderly is to de-escalate therapy searching for a modality that is both an effective treatment and also associated with minimal toxicity. Approximately, 30% of new breast cancers diagnosed annually are among women older than 70 years of age. Age-adjusted trends note a relatively higher incidence of stage I breast cancer in women between the ages of 70-74 years. For this group of patients, it is imperative that we take a closer look at the evidence-base for our current practice standards, and evaluate opportunities to improve cancer care delivery in the elderly. Randomized trials have helped arrive at an acceptance of adjuvant endocrine monotherapy in older patients with ER positive, node negative breast cancer. However, in the older patients high rates of non-compliance to tamoxifen secondary to poor tolerance is widely recognized. Emerging data also detail the side effect profile of aromatase inhibitors. Most commonly observed symptoms of arthralgia, reduced bone mineral density, and increased risk of fractures throughout the duration of treatment are important considerations for an older population. At least a quarter of patients on aromatase inhibitors discontinue therapy specifically due to skeletal events and musculoskeletal symptoms. Overall, the side effects of ET contribute to a high rate of non-compliance and negative impact on patients’ quality of life.
Author Interviews, Cancer Research, JAMA, MD Anderson, Radiation Therapy / 30.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48932" align="alignleft" width="140"]Quynh-Nhu Nguyen, MDDepartment of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHouston Dr. Quynh-Nhu[/caption] Quynh-Nhu Nguyen, MD Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This is the first non-spine bone metastases trial comparing higher dose single fraction radiotherapy vs multifraction standard fractionated radiotherapy for patients with painful bone metastases. The results of this trial demonstrated more durable pain relief and superior local control for patients treated in the higher dose(12 Gy-16 Gy)  single fraction RT compared to standard 30 Gy/10 fractions multifractionated regimen.  This trial supports the previous multiple randomized trials which recommend single fraction should be standard palliative radiotherapy regimen for bone metastases.  This trial is unique in that it addressed previous criticism that single fraction does not provide durable palliation with lower 8 gy single fraction and result in higher re-irradiation rates.  This trial on the contrary with the utilization of modern radiotherapy techniques, demonstrated we can safely and more effectively deliver a higher single fraction radiotherapy regimen for improvement in the quality of life for patients.  This higher dose should be the new standard single fraction regimen for patients who are functional and have a longer life expectancy. 
Author Interviews, Cost of Health Care, Radiation Therapy / 23.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48748" align="alignleft" width="133"]Ankit Agarwal, MD, MBAPGY-3, Radiation Oncology ResidentUNC Health Care Dr. Agarwal[/caption] Ankit Agarwal, MD, MBA PGY-3, Radiation Oncology Resident UNC Health Care MedicalResearch.com: What is the background for this study? What are the main findings? Response: Medicaid provides vital health insurance for millions of mostly low income Americans throughout the United States. However, it is well known that patients with Medicaid have worse clinical outcomes than patients with private insurance or Medicare insurance. Part of the reason for this may be due to difficulties with access to care, in part due to the traditionally very low payments in the Medicaid system. We found that Medicaid payment rates for a standard course of breast cancer radiation treatment can vary over fivefold (ranging from $2,945 to $15,218) 
Author Interviews, Brigham & Women's - Harvard, Cancer Research, JAMA, Radiation Therapy, Technology / 19.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48660" align="alignleft" width="200"]Raymond H Mak, MDRadiation OncologyBrigham and Women's Hospital Dr. Mak[/caption] Raymond H Mak, MD Radiation Oncology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? 
  • Lung cancer remains the most common cancer, and leading cause of cancer mortality, in the world and ~40-50% of lung cancer patients will need radiation therapy as part of their care
  • The accuracy and precision of lung tumor targeting by radiation oncologists can directly impact outcomes, since this key targeting task is critical for successful therapeutic radiation delivery.
  • An incorrectly delineated tumor may lead to inadequate dose at tumor margins during radiation therapy, which in turn decreases the likelihood of tumor control.
  • Multiple studies have shown significant inter-observer variation in tumor target design, even among expert radiation oncologists
  • Expertise in targeting lung tumors for radiation therapy may not be available to under-resourced health care settings
  • Some more information on the problem of lung cancer and the radiation therapy targeting task here:https://www.youtube.com/watch?v=An-YDBjFDV8&feature=youtu.be
Author Interviews, Cancer Research, Dermatology, Radiation Therapy / 23.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47622" align="alignleft" width="145"]William I. Roth MD Dermatology and Dermatological Surgery Boynton Beach, FL Dr. Roth[/caption] William I. Roth MD Dermatology and Dermatological Surgery Boynton Beach, FL MedicalResearch.com: What is the background for this study?
  • This retrospective study reviewed medical records of patients with biopsy-proven, primary cutaneous basal and squamous cell carcinoma (BCC and SCC) lesions on the lower extremities. These patients were treated with the Sensus Healthcare’s Superficial Radiation Therapy SRT-100 Unit between 2011 and 2014. The SRT-100 is most amenable for treating non-melanoma skin cancer (NMSC) in patients aged 65 and older although many younger patients are treated as well when a non-scarring method is desired.
  • The types of skin cancers treated included superficial, well differentiated and moderately differentiated squamous cell carcinomas, squamous cell carcinoma in situ and basal cell carcinomas including infiltrative basal cell carcinomas. Higher energy linear accelerator radiation units have been reported to have a high incidence of healing problems. With the SRT-100 the radiation is concentrated primarily in the higher layers of the skin where the skin cancer is located and thus the treatments are well tolerated.
Author Interviews, Emory, JAMA, Prostate Cancer, Radiation Therapy / 15.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47492" align="alignleft" width="200"]Deborah Watkins Bruner RN, PhD, FAAN Senior Vice President of Research Emory University Professor and Robert W. Woodruff Chair in Nursing Nell Hodgson Woodruff School of Nursing Professor, Department of Radiation Oncology Emory University School of Medicine Dr. Bruner[/caption] Deborah Watkins Bruner RN, PhD, FAAN Senior Vice President of Research Emory University Professor and Robert W. Woodruff Chair in Nursing Nell Hodgson Woodruff School of Nursing Professor, Department of Radiation Oncology Emory University School of Medicine MedicalResearch.com: What is the background for this study? Response: In a randomized clinical trial entitled, “Quality of Life in Patients With Low-Risk Prostate Cancer Treated With Hypofractionated vs Conventional Radiotherapy” the NRG Oncology Group previously demonstrated that men with low risk prostate cancer had  similar 5-year disease- free survival of about 85%  when treated with either conventional radiotherapy  (C-RT) of 73.8 Gy in 41 fractions over 8.2 weeks, or with  hypofractionated radiotherapy (H-RT) of 70 Gy in 28 fractions over 5.6  weeks. However, late physician reported side effects of mild bowel and bladder symptoms were increased in patients treated  with H-RT and raised questions if the H-RT arm is acceptable to patients. The current study asked the patient’s directly about their bowel, bladder, sexual function, anxiety, depression and general quality of life using valid patient reported questionnaires. These questionnaires have been found to be more accurate for reporting patient symptoms than physician report alone.
Author Interviews, JAMA, Prostate Cancer, Radiation Therapy / 12.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47468" align="alignleft" width="200"]Amar U. Kishan, MD Assistant Professor Department of Radiation Oncology University of California, Los Angeles Dr. Kishan[/caption] Amar U. Kishan, MD Assistant Professor Department of Radiation Oncology University of California, Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings? Response: Typical external beam radiation courses range up to 8-9 weeks in length (39-45 treatments). There are data that shorter courses, delivering a higher dose per day, may be just as effective. Stereotactic body radiotherapy (SBRT) really pushes this concept by condensing the treatment to just four to five treatments, with a high dose per day. Here, we present the pooled results of the outcomes of 2142 men with low and intermediate risk prostate cancer and a median of 6.9 years of followup. We demonstrate a very favorable efficacy and safety profile. Specifically, the rates of recurrences were 4.5% and 10.2% for low and intermediate risk disease at 7 years, and rates of late severe toxicity were 2.4% for urinary toxicity and 0.4% for gastrointestinal toxicity.
Author Interviews, Cancer Research, Prostate Cancer, Radiation Therapy / 12.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47453" align="alignleft" width="132"]Graham Kelly, BSc (Vet) (Hons, BVSc (Hons), PhD Managing Director and Chief Executive Officer Noxopharm  Dr. Kelly[/caption] Graham Kelly, BSc (Vet) (Hons, BVSc (Hons), PhD Managing Director and Chief Executive Officer Noxopharm  MedicalResearch.com: What is the background for this announcement? What are the main findings? Response: Veyonda is an experimental drug being developed as a means of enhancing the anti-cancer effect of radiotherapy. The Phase 1b DARRT-1 study is assessing the ability of Veyonda to boost a palliative dose of external beam radiotherapy (EBRT) applied to a single lesion, to result in a systemic response in non-irradiated lesions (known as an abscopal response) in men with metastatic, end-stage prostate cancer. The aim is to provide at the least better palliation, and at best a survival advantage. The reported data concerns the study’s initial dose-finding arm involving three different dosages of Veyonda. This arm involves 12 subjects and the report concerns their clinical status at 12-weeks post-irradiation. The data provide clinical evidence of an abscopal effect in at least half of the eight subjects receiving the two highest Veyonda dosages and demonstrate that the combination of Veyonda and palliative radiotherapy was well-tolerated. The 1200 mg dosage was confirmed as the therapeutic dose.
Author Interviews, Brigham & Women's - Harvard, JAMA, Prostate Cancer, Radiation Therapy, Surgical Research / 16.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45955" align="alignleft" width="200"]Anthony Victor D'Amico, MD, PhD Professor and Chief, Genitourinary Radiation Oncology Harvard Medical School Dr. D'Amico[/caption] Anthony Victor D'Amico, MD, PhD Professor and Chief, Genitourinary Radiation Oncology Harvard Medical School MedicalResearch.com: What is the background for this study? Response: This study investigated whether surgery followed by the use of adjuvant low dose radiation and short course hormonal therapy as compared to high dose radiation and hormonal therapy could provide an equivalent low risk of death from prostate cancer amongst men presenting with aggressive and not infrequently fatal Gleason score 9 or 10 prostate cancer. It has been shown previously (https://jamanetwork.com/journals/jama/fullarticle/2673969) and validated in the current study that surgery alone in such cases leads to a more then 2.5-fold increase in the risk of death from prostate cancer as compared to high dose radiation and hormonal therapy. 
Author Interviews, Brain Cancer - Brain Tumors, Radiation Therapy, Surgical Research / 12.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45901" align="alignleft" width="148"]Dr. Stephanie E. Weiss MD FASTRO Chief, Division of Neurologic Oncology Associate Professor, Department of Radiation Oncology Director, Radiation Oncology Residency and Fellowship Training Program Fox Chase Cancer Center Philadelphia, Pennsylvania Dr. Weiss[/caption] Dr. Stephanie E. Weiss MD FASTRO Chief, Division of Neurologic Oncology Associate Professor, Department of Radiation Oncology Director, Radiation Oncology Residency and Fellowship Training Program Fox Chase Cancer Center Philadelphia, Pennsylvania MedicalResearch.com: What is the background for this study? Response: Brain metastasis are the most common form of brain tumor. Historically all patients received whole brain radiation as the primary therapy. Patients required neurosurgery to remove lesions if there was a question of diagnosis, what the diagnosis is and if there was a mass effect not relieved with steroids. Surgery was also indicated for patients with a single brain lesion because this offers a survival benefit over just receiving whole brain radiotherapy. In 2003 a randomized trial proved that radiosurgery offers a similar benefit. So the question taxing patients and doctors at tumor boards since has been: which is better? If neurosurgery is superior, we are under-treating a lot of patients with radiosurgery. If radiosurgery is superior, we are subjecting a lot of patients to unnecessary brain surgery. Attempts to study this in a head-to-head randomized trial have failed. Patient and physician preference for one treatment or the other has proven to be a barrier to randomization and accrual. The EORTC 22952-2600 trial was originally designed to compare outcomes with and without whole brain radiation for patients receiving surgery or radiosurgery for brain metastasis. We used this as the highest-quality source data available to compare local control of brain metastasis after surgery or radiosurgery, adjusted for by receipt or not of whole brain radiation.  
Author Interviews, Breast Cancer, Cancer Research, Chemotherapy, Radiation Therapy / 22.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44079" align="alignleft" width="200"]Kathleen Horst, MD Associate Professor of Radiation Oncology (Radiation Therapy) Stanford University Medical Center Dr. Kathleen Horst[/caption] Kathleen Horst, MD Associate Professor of Radiation Oncology (Radiation Therapy) Stanford University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: We were interested in focusing on young women with breast cancer as this is a high-risk patient population that is not studied on its own in clinical trials. Furthermore, the available data on treating breast cancer with neoadjuvant chemotherapy (NAC) does not include detailed outcomes for women under the age of 40 years. Because most women who are diagnosed with breast cancer in this age group will have aggressive disease, most of them will be treated with NAC followed by surgery. From prospective randomized trials we know that women with breast cancer who attain a pathologic complete response (PCR) to neoadjuvant chemotherapy fare significantly better than those who do not. In addition, existing data suggest that a complete response in the lymph nodes also portends a better prognosis. This is the foundation for the currently ongoing NSABP B-51/RTOG 1304 trial, which is evaluating the role of nodal irradiation in those women who attain a pathologic complete response in the lymph nodes after NAC. We wanted to know whether differences in pathologic response in the breast versus lymph nodes led to different clinical outcomes in this patient group. We evaluated outcomes following neoadjuvant chemotherapy for breast cancer in 155 women age 40 and younger. We focused on pathologic response in the breast and lymph nodes as predictors of disease recurrence and survival. We found that any residual disease in either the breast or lymph nodes lessened the chance of cure significantly. Importantly, women who attained a complete response in the lymph nodes but continued to have residual disease in the breast fared just as poorly as those who remained lymph node positive following neoadjuvant chemotherapy. 
Author Interviews, Breast Cancer, JAMA, Radiation Therapy / 14.08.2018

MedicalResearch.com Interview with: [caption id="attachment_43814" align="alignleft" width="200"]Steven Narod, MD, FRCPC, FRSC Senior Scientist, Women’s College Research Institute Director, Familial Breast Cancer Research Unit, Women's College Research Institute Professor, Dalla Lana School of Public Health, University of Toronto Professor, Department of Medicine Tier 1 Canada Research Chair in Breast Cancer University of Toronto Dr. Narod[/caption] Steven Narod, MD, FRCPC, FRSC Senior Scientist, Women’s College Research Institute Director, Familial Breast Cancer Research Unit, Women's College Research Institute Professor, Dalla Lana School of Public Health, University of Toronto Professor, Department of Medicine Tier 1 Canada Research Chair in Breast Cancer University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In the past we have shown that about 3 percent of women with ductal carcinoma in situ (DCIS) will die of breast cancer within 20  years of diagnosis.   In the current study, we took a very close look at how the different treatments impact on the risk of dying of breast cancer. Women with DCIS are at risk for  both a new cancer within the breast and dying of breast cancer from cells that spread beyond the breast (lung, liver, brain and bone).   About 20% of DCIS patients will get a new breast cancer within the breast at 20 years.
  • We show here that it is not necessary to develop a new cancer within the breast to die of breast cancer,  in some cases the DCIS spreads directly in the absence of local recurrence.
  • We show that radiotherapy can prevent 25% of the deaths from breast cancer after DCIS. And this has nothing to do with local recurrence.
  • We show that mastectomy reduces the chance of a getting a new cancer (local recurrence) but  doesn’t reduce the chance of dying of breast cancer.
So, if the goal is to prevent new cancers in the breast -   then mastectomy is the best treatment If the goal is to prevent the woman from dying of breast cancer - then radiotherapy is the best treatment. 
ASCO, Author Interviews, Cancer Research, Radiation Therapy / 13.06.2018

MedicalResearch.com Interview with: [caption id="attachment_42379" align="alignleft" width="150"]Jonathan Strosberg MD Moffitt Cancer Center Tampa, FL Dr. Strosberg[/caption] Jonathan Strosberg MD Moffitt Cancer Center, Tampa, FL MedicalResearch.com: What is the background for this study? Response: Neuroendocrine tumor (NET) progression is associated with deterioration in quality of life. We assessed the impact of 177Lu-Dotatate treatment on time to deterioration in health-related quality of life in patients with advanced midgut neuroendocrine tumors in the NETTER-1 study.
Author Interviews, Biomarkers, Breast Cancer, JAMA, Radiation Therapy / 03.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41471" align="alignleft" width="130"]Chelain Goodman, MD PhD PGY-3, Radiation Oncology Northwestern University Chicago, IL 60611 Dr. Goodman[/caption] Chelain Goodman, MD PhD PGY-3, Radiation Oncology Northwestern University Chicago, IL 60611 MedicalResearch.com: What is the background for this study? Response: Circulating tumor cells are cancer cells that are shed from the primary tumor into the peripheral blood stream and are hypothesized to be one of the first steps in the initiation of metastatic progression. Prospective studies have demonstrated that approximately 15-25% of patients with early-stage breast cancer can be found to have at least one circulating tumor cell in a small sample of their blood. Currently, all patients with early-stage invasive breast cancer who undergo breast conserving surgery receive adjuvant radiation therapy. In these analyses, we wanted to determine whether presence of circulating tumor cells may be predictive of benefit of radiation therapy following surgery.
Author Interviews, JAMA, Prostate Cancer, Radiation Therapy / 27.01.2018

MedicalResearch.com Interview with: [caption id="attachment_39585" align="alignleft" width="135"]Jason Alexander Efstathiou, D., PH.D Director, Genitourinary Division, Department of Radiation Oncology Clinical Co-Director, The Claire and John Bertucci Center for Genitourinary Cancers Multidisciplinary Clinic Massachusetts General Hospital Dr. Efstathiou[/caption] Jason Alexander Efstathiou, D., PH.D Director, Genitourinary Division Department of Radiation Oncology Clinical Co-Director, The Claire and John Bertucci Center for Genitourinary Cancers Multidisciplinary Clinic Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings?  Response: When surgery has probably failed to cure a patient, the best prospective data supports the use of postoperative radiation therapy. The debate now centers on the optimal timing of such post-prostatectomy radiation therapy; is it adjuvant (ART) for all (with adverse pathologic features) or early salvage (ESRT) for some (who experience biochemical failure)?
Author Interviews, Cancer Research, JAMA, Lung Cancer, Radiation Therapy / 02.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37256" align="alignleft" width="97"]Florence K Keane MD Resident, Radiation Oncology Harvard Radiation Oncology Program Boston, Massachusetts Dr. Keane[/caption] Florence K Keane MD Resident, Radiation Oncology Harvard Radiation Oncology Program Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: Checkpoint inhibitors (CPIs) have recently transformed the management of patients with metastatic lung cancer, demonstrating significant improvements in overall and progression-free survival in both the first-line setting in patients with increased expression of PD-L1 (≥50%) and in patients with previously treated NSCLC who have progressed on chemotherapy. CPIs are also moving into the treatment of patients with localized lung cancer, with the recently published PACIFIC trial demonstrating a significant improvement in progression-free survival in patients with inoperable stage III NSCLC treated with adjuvant durvalumab after definitive chemoradiotherapy. However, CPIs are associated with unique toxicities as compared to cytotoxic chemotherapy, including pulmonary, endocrine, neurologic, gastrointestinal, and dermatologic adverse events, which may be fatal in some cases. The risk of autoimmune pneumonitis with checkpoint inhibitors is estimated to be on the order of 5%. Many patients with lung cancer will require radiotherapy for palliation of symptoms. Thoracic radiotherapy (TRT) is also a risk factor for pneumonitis, with a dose- and volume-dependent impact on risk. However, it is unknown whether treatment with CPIs and TRT is associated with increased risk of toxicity.
Author Interviews, Prostate Cancer, Radiation Therapy / 26.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37181" align="alignleft" width="108"]Dr. Shuang George Zhao, MD House Officer, Radiation Oncology University Hospital Ann Arbor, MI 48109-5010 Dr. Zhao[/caption] Dr. Shuang George Zhao, MD House Officer, Radiation Oncology University Hospital Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? Response: Targeting cancer through the immune system has been a longstanding goal of cancer research, and with recent advances in immunotherapy, it is now a reality. However, the role of immunotherapy in prostate cancer is still being defined. Sipuleucel-T was the first FDA approved immunotherapy in prostate cancer, and is a personalized cellular therapy that has been shown to prolong survival in patients with metastatic prostate cancer. On the other hand, two recent phase III randomized trials looking at ipilimumab, a CTLA-4 checkpoint inhibitor in metastatic prostate cancer have both been negative for their primary endpoint of OS. Interestingly, there was a PSA response, suggesting that there may be some therapeutic effect in a subset of patients. Therefore, understanding the immune infiltrate is likely critical to selecting patients and therapeutic strategies utilizing the immune system. Unfortunately, it is difficult and laborious to histologically assess immune infiltrate directly. Therefore, we used existing high throughput transcriptomic data with new computational methods in order to more fully characterize the immune landscape of localized prostate cancer.
Author Interviews, BMC, Breast Cancer, Radiation Therapy / 02.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36286" align="alignleft" width="150"]Heiko Enderling, Ph.D. Associate Member & Director for Education and Outreach Dept. of Integrated Mathematical Oncology Dept. of Radiation Oncology H. Lee Moffitt Cancer Center & Research Institute Tampa, FL 33612 Dr.Enderling[/caption] Heiko Enderling, Ph.D. Associate Member & Director for Education and Outreach Dept. of Integrated Mathematical Oncology Dept. of Radiation Oncology H. Lee Moffitt Cancer Center & Research Institute Tampa, FL 33612 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although radiation therapy after breast-conserving surgery for early-stage breast cancer has significantly improved patient prognosis, many patients will face a second cancer diagnosis within 20 years of primary treatment. Experimental and clinical studies have shown that local radiation therapy can activate an immune response that can propagate systemically to attack distant untreated metastases. However, current radiotherapy practice has not specifically focused on enhancing immune responses. We asked the question if pre-operative irradiation, when applied to the bulk of disease, could have potentially higher immune stimulatory effects. To study this, we analyzed historic outcomes of breast cancer patients treated with either adjuvant (radiation after surgery) or neoadjuvant (radiation before surgery) radiotherapies. Our analysis showed that the risk of developing a second tumor after neoadjuvant compared with adjuvant RT was significantly lower, especially for estrogen receptor-positive women who underwent breast conserving surgery or mastectomy. Historic data revealed an increase in disease-free survival of 12% over 20 years after treatment of the original tumor.
Author Interviews, Brain Cancer - Brain Tumors, JAMA, Radiation Therapy / 01.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35007" align="alignleft" width="200"]Professor Rakesh Jalali, MD Professor of Radiation Oncology President, Indian Society of Neuro-Oncology Tata Memorial Parel, Mumbai India Dr. Jalali[/caption] Professor Rakesh Jalali, MD Professor of Radiation Oncology President, Indian Society of Neuro-Oncology Tata Memorial Parel, Mumbai India  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Randomized controlled trials to test the efficacy of radiotherapy techniques are challenging to perform. High-precision conformal techniques such as stereotactic radiosurgery/radiotherapy, intensity modulated radiotherapy (IMRT) and particle therapy, etc have been incorporated into routine clinical practice including for brain tumors without always being supported by level-1 evidence. We therefore conducted a prospective, randomized, controlled trial of stereotactic conformal radiotherapy compared to conventional radiotherapy in young patients with residual/progressive bening and low grade brain tumors requiring radiotherapy for optimal disease control.