Author Interviews, Compliance, Connective Tissue Disease, UCSF / 25.11.2013

Dr. Jinoos Yazdany MD, MPH Assistant Professor in Residence UCSF School of MedicineMedicalResearch.com Interview with: Dr. Jinoos Yazdany MD, MPH Assistant Professor in Residence UCSF School of Medicine MedicalResearch.com: What are the main findings of the study? Answer: For almost all of the drugs we examined, we found that less than half of patients adhered to treatment.  For some drugs, less than one-third of individuals were adherent. The average medication possession ratios were low across all drugs. We found that several factors played an important part in adherence.  Younger individuals were less likely to adhere to treatment for several drugs, and we also found racial/ethnic differences, with Black, Hispanic and Native populations having lower adherence.  We also found geographic variation in adherence, with individuals in the Northeast being the most likely to adhere to treatment. (more…)
Author Interviews, Blood Clots, Case Western, Cleveland Clinic, JAMA / 24.11.2013

Ilke Sipahi, MD Department of Cardiology Acibadem University Medical School, Istanbul, Turkey Harrington Heart and Vascular Institute, University Hospitals Case Medical Cente Case Western Reserve University School of Medicine, Cleveland, OhioMedicalResearch.com Interview with: Ilke Sipahi, MD Department of Cardiology Acibadem University Medical School, Istanbul, Turkey Harrington Heart and Vascular Institute, University Hospitals Case Medical Cente, Case Western Reserve University School of Medicine, Cleveland, Ohio MedicalResearch.com: Were you surprised at the extreme difference between these 2 analyses? Answer: I was surprised. However, it is not unusual to find completely contradictory results in medical studies. I was more surprised at the fact that FDA paid more attention to it administrative observational dataset rather than the huge large randomized clinical trials, all showing excess GI bleeds with dabigatran (Pradaxa). Anyone who is even slightly familiar with the medical literature knows that randomized trials are the gold standard in medical studies. (more…)
Author Interviews, Breast Cancer, Chemotherapy, Lancet, MD Anderson / 24.11.2013

Dr. Kelly K. Hunt, M.D., F.A.C.S. Professor, Department of Surgical Oncology, Division of Surgery Chief, Breast Surgical Oncology Section, Department of Surgical Oncology The University of Texas MD Anderson Cancer Center, Houston, TXMedicalResearch.com Interview with: Dr. Kelly K. Hunt, M.D., F.A.C.S. Professor, Department of Surgical Oncology, Division of Surgery Chief, Breast Surgical Oncology Section, Department of Surgical Oncology The University of Texas MD Anderson Cancer Center, Houston, TX MedicalResearch.com: What are the main findings of the study? Dr. Hunt: The primary endpoint of the Z1041 trial was the proportion of patients who had pathological complete response in the breast, defined as the percentage of women who started the neoadjuvant treatment with no histological evidence of disease in the breast at surgery.  We found that high pathologic response rates were observed in both treatment groups with similar cardiac safety profiles in both arms of the trial.  Specifically, 56.5% of patients in the sequential group (fluorouracil, epirubicin and cyclophosphamide on day one of a 21-day cycle for four cycles followed by paclitaxel plus trastuzumab weekly for 12 weeks) had a complete pathological response versus 54.2% of the patients who received the concurrent regimen (paclitaxel and trastuzumab weekly for 12 weeks followed by fluorouracil, epirubicin and cyclophosphamide on day one of a 21-day cycle with trastuzumab on days one, eight and 15 of the 21-day cycle for four cycles).  The difference in pathologic complete response rates between the treatment arms was not statistically significant.  Cardiac safety was a secondary endpoint of the trial and we found that both regimens had acceptable cardiac safety profiles. (more…)
Antioxidants, Author Interviews, Brigham & Women's - Harvard, Medical Research Centers, Nature, Nutrition, Pancreatic / 23.11.2013

MedicalResearch.com Interview with: dr_ying_baoYing Bao, MD, ScD Department of Medicine, Brigham and Women's Hospital and Harvard Medical School Boston, MA. MedicalResearch.com: What are the main findings of the study? Dr. Bao: Frequent nut consumption is inversely associated with risk of pancreatic cancer in women, independent of other potential risk factors for pancreatic cancer. (more…)
Author Interviews, Diabetes, Diabetes Care, Johns Hopkins / 21.11.2013

Caleb Alexander, MD, MS Department of Epidemiology, Bloomberg School of Public Health Center for Drug Safety and Effectiveness Johns Hopkins Bloomberg School of Public Health Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, MarylandMedicalResearch.com Interview with: Caleb Alexander, MD, MS Department of Epidemiology, Bloomberg School of Public Health Center for Drug Safety and Effectiveness Johns Hopkins Bloomberg School of Public Health Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, Maryland MedicalResearch.com: What are the main findings of the study? Dr. Alexander:
  • There have been large shifts in the types of treatments used to treat Type 2 diabetes during the past decade in the United States.
  • We document large declines in the use of glitazones and sulfonylureas and important increases in the use of the newer DPP-4 inhibitors and GLP-1 agonists.
  • We also found large shifts in the types of insulins used, with substantial reductions in the use of regular and intermediate insulins, and large increases in the use of long-acting and ultra short-acting  therapies.
  • Costs have increased significantly over the past 5 years, driven primarily by insulin and DPP-4 inhibitors
  • All of these changes notwithstanding, biguanides continue to remain a mainstay of therapy. (more…)
Author Interviews, Colon Cancer, Nature, Race/Ethnic Diversity, Stanford / 18.11.2013

James Murphy, M.D. Assistant Professor Department of Radiation Medicine and Applied Sciences Center for Advanced Radiotherapy Technologies UC San Diego Moores Cancer Center 3855 Health Sciences Drive La Jolla, CA 92093MedicalResearch.com Interview with: James Murphy, M.D. Assistant Professor, Department of Radiation Medicine and Applied Sciences, Center for Advanced Radiotherapy Technologies ,UC San Diego Moores Cancer Center La Jolla, CA 92093 MedicalResearch.com: What are the main findings of the study? Dr. Murphy: This study evaluated racial disparity in metastatic colorectal cancer. In a large population-based cohort we found of over 11,000 patients we found that black patients were less likely to be seen in consultation by a cancer specialist, and were less likely to receive treatment with chemotherapy, surgery, or radiation. Furthermore, we found that this disparity in treatment accounted for a substantial portion of the race-based differences between black and white patients. (more…)
Author Interviews, Karolinski Institute, OBGYNE, Weight Research / 16.11.2013

MedicalResearch.com: Interview with: Olof Stephansson MD, PhD Associate professor, senior consultant in obstetrics and gynaecologyDepartment of Medicine, Clinical Epidemiology Unit, Karolinska InstitutetDepartment of Women’s and Children’s Health, Division of Obstetrics and Gynaecology Karolinska Institutet, Stockholm, Sweden MedicalResearch.com: What are the main findings of the study? Answer: Women with a history of bariatric surgery have an increased risk of preterm delivery, a doubled risk for small-for-gestational-age births and a reduction in large-for-gestational-age births. Also when considering maternal weight, education, age, parity and year of birth. There was no increased for stillbirth or neonatal mortality. (more…)
Author Interviews, Johns Hopkins, Stroke / 12.11.2013

Yogesh Moradiya MBBS From the Neurosciences Critical Care Division Johns Hopkins University, Baltimore, MD;MedicalResearch.com Interview with: Yogesh Moradiya MBBS From the Neurosciences Critical Care Division Johns Hopkins University, Baltimore, MD;   MedicalResearch.com: What are the main findings of the study? Answer: We studied 712,433 stroke cases in 6,839 hospital samples in United States over 11-year study period (2000-2010) and found that hospitals with neurology residency training program treated stroke patients with tissue plasminogen activator (tPA) more frequently than other teaching or non-teaching hospitals. The higher tPA utilization in hospitals with neurology residencies was independent of patient age, gender, ethnicity, insurance status, comorbidities, hospital geographic location, stroke case volume, calendar year and the Joint Commission Primary Stroke Center certification. (more…)
Antioxidants, Author Interviews, Hearing Loss, Nutrition, University of Michigan / 12.11.2013

http://ajcn.nutrition.org/content/early/2013/11/06/ajcn.113.068437.abstractMedicalResearch.com Interview with: Sung Kyun Park, Sc.D., M.P.H Assistant Professor, Epidemiology Assistant Professor, Environmental Health Sciences Departments of Epidemiology and Environmental Health Sciences University of Michigan School of Public Health Ann Arbor, MI MedicalResearch.com: What are the main findings of the study?
 Answer: This study reports that persons who eat more dietary antioxidants (beta carotene and vitamin C) or magnesium have a lower risk of hearing loss. This finding was seen in the levels currently observed in the general US population and independent of demographic and socioeconomic factors, noise exposures from workplaces, recreations or firearms, and other potential risk factors. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Yale / 09.11.2013

MedicalResearch.com Interview with: John Ney, MD, MPH Clinical Assistant Professor, Department of Neurology, University of Washington [email protected] MedicalResearch.com: What are the main findings of the study? Dr. Ney: My colleagues and I used a large, publicly available dataset to examine the usage and effectiveness of electroencephalography (EEG) in adult intensive care units (ICUs) in the United States over a five year period.  We compared routine EEG, which consists of a portable machine hooked up to the patient to record brainwaves for a short duration, usually 20-40 minutes, with continuous EEG monitoring, where a patient’s brainwaves are recorded continuously for 24 hours or more and examined, ideally in real-time.  Because most patients in the ICU are comatose, we have generally poor and crude indicators of their brain function.  ICU patients are particularly at risk for non-convulsive seizures, where the brain is seizing, but there are few outward signs of a seizure.  EEG is the only means of detecting non-convulsive seizures, and is useful in determining the brain’s reactions to drugs, monitoring for stroke and other abnormal activity. Our main finding is that ICU patients receiving continuous EEG monitoring was associated with increased survival relative to those who received routine EEG only.    In our sample, 39% of ICU patients who received routine EEG died compared to only 25% of those with continuous EEG monitoring. This finding was both substantial and statistically significant, even after adjustment for age and other demographics, clinical disease comorbidity severity measures, and hospital factors.  Although continuous EEG monitoring was more expensive, the increase in hospital charges were not significant after adjustment. (more…)
Author Interviews, Diabetes, NYU, Weight Research / 06.11.2013

Manish Parikh MD Associate Professor of Surgery, NYU School of Medicine Director of Bariatric Surgery, Bellevue Hospital Center 550 First Ave NBV 15 South 7 New York, NY 10010MedicalResearch.com Interview with: Manish Parikh MD Associate Professor of Surgery, NYU School of Medicine Director of Bariatric Surgery, Bellevue Hospital Center 550 First Ave NBV 15 South 7 New York, NY 10010 MedicalResearch.com: What are the main findings of the study? Dr. Parikh: The main findings of this study is that surgery is safe and effective in patients with type 2 diabetes and BMI under 35.  The overall estimated rate of diabetes remission was 55% at 12 months, ranging from 33% for the adjustable gastric banding, 49% for the “mini” gastric bypass, 54% for the sleeve gastrectomy, 64% for the gastric bypass, 71% for the biliopancreatic diversion, and 81% for ileal transposition. (more…)
Author Interviews, Blood Pressure - Hypertension, University of Michigan / 05.11.2013

Jeremy Sussman, MD, MS Division of General Internal Medicine University of Michigan Staff Scientist, Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare SystemMedicalResearch.com Interview with: Jeremy Sussman, MD, MS Division of General Internal Medicine University of Michigan Staff Scientist, Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare System MedicalResearch.com: What are the main findings of the study? Dr. Sussman: We could prevent up to 180,000 more heart attacks and strokes in America every year using less medication overall. (more…)
Aging, General Medicine, McGill / 05.11.2013

Dr. Laurent Azoulay Project Leader, Lady Davis Institute Assistant Professor, Department of Oncology, McGill UniversityMedicalResearch.com Interview with: Dr. Laurent Azoulay Project Leader, Lady Davis Institute Assistant Professor, Department of Oncology, McGill University MedicalResearch.com: What are the main findings of the study? Dr. Azoulay: Using large population-based databases from the UK, we assembled a cohort of men newly-diagnosed with non-metastatic prostate cancer. Within this group of men, the use of statins after prostate cancer diagnosis was associated with a 24% decreased risk in cancer-related mortality. We observed duration- as well as a dose-response relationships. Furthermore, in a secondary analysis, we observed that the benefits were greater among men who used also used statins before their diagnosis, with more modest yet significant benefits among men who initiated the treatment after their diagnosis. The latter result is one of the novelties of this study, as it provides an estimate of the potential benefits of statins, if used in the adjuvant setting. (more…)
Author Interviews, Heart Disease, JAMA, Wake Forest / 05.11.2013

Elsayed Z Soliman MD, MSc, MS, FAHA, FACC Director, Epidemiological Cardiology Research Center (EPICARE) Wake Forest School of Medicine Medical Center Blvs, Winston Salem, NC 27157MedicalResearch.com Interview with: Elsayed Z Soliman MD, MSc, MS, FAHA, FACC Director, Epidemiological Cardiology Research Center (EPICARE) Wake Forest School of Medicine Medical Center Blvs, Winston Salem, NC 27157 Atrial Fibrillation and the Risk of Myocardial Infarction MedicalResearch.com: What are the main findings of the study? Dr. Soliman: Using data from the REGARDS study, one of the largest US cohorts, we examined the risk of incident myocardial infarction (MI) associated with atrial fibrillation (AF). Overall, AF was associated with almost double the risk of MI. When we adjusted for common cardiovascular risk factors and potential confounders, the risk remained significantly high; about 70% increased risk. When we looked at women, men, blacks, and whites separately,  we found significant differences between races and sex.  AF in women and blacks was associated with more than double the risk of MI. This compares to less than 50% increased risk of heart attack associated with AF in men and whites . So AF is basically bad for all, but the risk of MI associated with AF is more pronounced in women and blacks. (more…)
Cancer Research, MD Anderson, Radiation Therapy / 01.11.2013

Steven J. Frank, M.D., associate professor of Radiation Oncology at The University of Texas MD Anderson Proton Therapy CenterMedicalResearch.com Interview with: Steven J. Frank, M.D., associate professor of Radiation Oncology at The University of Texas MD Anderson Proton Therapy Center discusses the findings of his latest study, “Gastrostomy Tubes Decrease by Over 50% with Intensity Modulated Proton Therapy during the Treatment of Oropharyngeal Cancer Patients.” MedicalResearch.com: What are the main findings of the study? Dr. Frank: The study found that the use of feeding tubes in oropharyngeal carcinoma (OPC) cancer patients treated with intensity modulated proton therapy (IMPT) decreased by more than 50% percent compared to patients treated with intensity modulated radiation therapy (IMRT). This suggests that proton therapy may offer vital quality of life benefits for patients with tumors occurring at the back of the throat. Of the 50 OPC patients enrolled in the study:
  • Twenty-five patients were treated with IMPT and 25 received IMRT.
  • Five patients treated with IMPT required the use of feeding tubes (20%) compared to 12 patients treated with IMRT (48%).
  • IMPT patients were spared from serious side effects, usually a result of IMRT, such as loss of taste, vomiting, nausea, pain, mouth and tongue ulcers, dry mouth, fatigue, and swallowing difficulty.
  • IMPT patients could better sustain their nutrition and hydration levels, often leading to faster recovery during and after treatment.
IMPT is an advanced form of proton radiation therapy and a treatment currently only offered in North America at The University of Texas MD Anderson Proton Therapy Center. It delivers protons to the most complicated tumors by focusing a narrow proton beam and essentially “painting” the radiation dose onto the tumor layer by layer. Unlike IMRT, which destroys both cancerous and healthy cells, IMPT has the ability to destroy cancer cells while sparing surrounding healthy tissue from damage. Therefore, important quality of life outcomes such as neurocognitive function, vision, swallowing, hearing, taste and speech can be preserved in head and neck patients. (more…)
Author Interviews, Heart Disease, Mayo Clinic, Rheumatology / 30.10.2013

Eric Matteson, M.D. Rheumatology Chair Mayo Clinic in Rochester, Minn.MedicalResearch.com Interview with: Eric Matteson, M.D. Rheumatology Chair Mayo Clinic in Rochester, Minn. MedicalResearch.com:   What are the main findings of the studies? Dr. Matteson: “The main finding is that patients with severe rheumatoid arthritis have a higher risk of heart disease.  Further, women who experience early menopause also have a higher risk of heart disease.” (more…)
Author Interviews, Johns Hopkins, Pediatrics, Vitamin D / 24.10.2013

Meredith Atkinson, MD, MHS Assistant Professor of Pediatrics Division of Pediatric Nephrology Johns Hopkins University School of Medicine Baltimore, MD 21287 MedicalResearch.com Interview with: Meredith Atkinson, MD, MHS Assistant Professor of Pediatrics Division of Pediatric Nephrology Johns Hopkins University School of Medicine Baltimore, MD 21287   MedicalResearch.com: What are the main findings of the study? Dr. Atkinson: First, among a healthy cross-section of U.S. children, vitamin D deficiency defined as levels below 30 ng/mL (the currently accepted threshold for adequate vs. inadequate vitamin D) were associated with nearly twice the risk for anemia compared to those with sufficient vitamin D levels.  Secondly, when we looked specifically at Caucasian and African-American children, we found that children with the lowest vitamin D levels were at increased risk for anemia in both groups, but that the specific vitamin D level below which the anemia risk started to increase was much lower in the African-American children (12 ng/mL) than in the Caucasian children (20 mg/mL). (more…)
Author Interviews, Johns Hopkins, Sleep Disorders / 22.10.2013

MedicalResearch.com Interview with: Ruth Tamrat, Minh-Phuong Huynh-Le, and Madhav Goyal Johns Hopkins University School of Medicine, MSIV MedicalResearch.com: What are the main findings of the study? Answer: Despite the known adverse effects of sleep deprivation on recovery from illness, studies have shown that sleep deprivation remains an incompletely addressed problem among inpatients.  Behavioral interventions are recommended as first line therapy prior to using pharmacologic therapy due to the adverse side effects of sedative hypnotics. This systematic review sought to identify the efficacy of non-pharmacologic interventions that have been used to improve the sleep of general inpatients.  The results of this review demonstrate a lack of high quality evidence regarding the efficacy of these non-pharmacologic interventions in improving the sleep quality or quantity of patients in the hospital. (more…)
Author Interviews, Brigham & Women's - Harvard, Hearing Loss, Medical Research Centers, Vitamin D, Weight Research / 22.10.2013

MedicalResearch.com Interview with: Sharon Curhan, MD, ScM Channing Division of Network Medicine Brigham and Women's Hospital Harvard Medical School Boston, MA 02115 MedicalResearch.com: What are the main findings of the study? Dr. Curhan: The main findings of our study are that higher body mass index and larger waist circumference are associated with an increased risk of acquired hearing loss, and higher level of physical activity is associated with a decreased risk of acquired hearing loss in women. Specifically, after adjusting for potential confounders, compared with women with BMI <25 kg/m2, the relative risk for hearing loss was 25% higher for women with BMI >40. Compared with women with waist circumference <71 cm, the relative risk for hearing loss was 27% higher for women with waist circumference >88 cm. Higher physical activity was inversely related to risk; compared with women in the lowest quintile of physical activity, women in the highest quintile of physical activity had a 17% lower risk of hearing loss. Walking, the most common form of physical activity among these women, was associated with a lower risk; women who walked 2 hours per week or more had a 15% lower risk of hearing loss than women who walked less than one hour per week. These findings provide evidence that maintaining healthy weight and staying physically active, potentially modifiable lifestyle factors, may help reduce the risk of hearing loss. (more…)
Cost of Health Care, Emergency Care, Pediatrics, University of Michigan / 20.10.2013

Adrianne Haggins, MD, MS University of Michigan Health System Department of Emergency Medicine Ann Arbor, MI 48109-5303MedicalResearch.com Interview with: Adrianne Haggins, MD, MS University of Michigan Health System Department of Emergency Medicine Ann Arbor, MI  48109-5303 MedicalResearch.com: What are the main findings of the study? Dr. Haggins: Since the implementation of the Children’s Health Insurance Program (CHIP) in 1997, the last national health care reform that broadly expanded insurance coverage, adolescent use of primary care and specialty care has increased substantially in comparison to no change seen among the comparison group (young adults, who were not covered).  Broadening insurance coverage for adolescents did not result in a decrease in emergency department use, while ED use in the comparison group increased over time.   (more…)
Author Interviews, Thyroid, University of Pennsylvania / 11.10.2013

David Goldenberg MD, FACS Professor of Surgery and Oncology Director of Head and Neck Surgery Associate Director of Surgical Services- Penn State Hershey Cancer Institute Division of Otolaryngology-Head and Neck Surgery The Pennsylvania State UniversityThe Milton S. Hershey Medical Center 500 University Drive, P.O. Box 850 H091 Hershey, PA 17033MedicalResearch.com Interview with: David Goldenberg MD, FACS Professor of Surgery and Oncology Director of Head and Neck Surgery Associate Director of Surgical Services- Penn State Hershey Cancer Institute Division of Otolaryngology-Head and Neck Surgery The Pennsylvania State UniversityThe Milton S. Hershey Medical Center, Hershey, PA  17033 MedicalResearch.com: What are the main findings of this study? Dr. Goldenberg: The incidence of thyroid cancer is on the rise and has nearly tripled in the last thirty years. Some authors have attributed this increase in incidence to improved sensitivity of diagnostic techniques and imaging allowing for diagnosis of small insignificant thyroid cancers. Others do not agree and state that is a real rise in this disease. Many patients have their cancer discovered by accident when they undergo a diagnostic study for some other reason- such as trauma, neck pain, or carotid artery studies (for clogged arteries). We aimed to compare incidentally discovered versus non incidentally discovered thyroid cancers to determine whether the thyroid cancers in both groups harbor different characteristics. (more…)
Author Interviews, Duke, Social Issues, Vanderbilt / 10.10.2013

Kaitlin Toner, Ph.D. Vanderbilt Institute for Energy and Environment Vanderbilt Climate Change Research Network 2301 Vanderbilt Place Nashville, TN 37240MedicalResearch.com Interview with: Kaitlin Toner, Ph.D. Vanderbilt Institute for Energy and Environment Vanderbilt Climate Change Research Network Nashville, TN 37240 Dr. Kaitlin Toner, is a postdoctoral researcher at Vanderbilt University. The study was conducted colleagues Mark Leary, Michael Asher, and Katrina Jongman-Sereno while Dr. Toner was a graduate student at Duke University. MedicalResearch.com: What are the main findings of the study? Dr. Toner: The take home message is that people who hold more extreme attitudes also tend to feel superior about those attitudes, whereas people with moderate attitudes aren't as convinced of the superiority of their own beliefs.  Although it might seem that this connection between attitude extremity and superiority seems reasonable, there’s no logical reason why people who hold moderate, middle-of-the-road attitudes should not think that their moderate attitudes are superior to other people’s.  But they don’t tend to do that; it’s the people with extreme attitudes who are inordinately convinced that they are right. These findings are important because it sheds some light on how people become so polarized in their opinions: they don't just take a side, but they believe everyone who disagrees with that view must be wrong. Importantly, it's not just one political party who thinks this way, as previous research had suggested, but rather that it happens for both liberal and conservative attitudes.  And, given the stalemate in Washington, understanding why people become so entrenched in their views – even when there is often not an objectively correct answer – is more important than ever. (more…)
Author Interviews, Erasmus, Social Issues / 10.10.2013

Ioannis Evangelidis, Ph.D. candidate Department of Marketing Management, Rotterdam School of Management Erasmus University, RotterdamMedicalResearch.com Interview with: Ioannis Evangelidis, Ph.D. candidate Department of Marketing Management, Rotterdam School of Management Erasmus University, Rotterdam MedicalResearch.com: What are the main findings of the study? Answer: We find that donors pay more attention to the number of people killed when donating to a disaster, than to the number of people who are affected (survive but need money).  In other words, people are more likely to donate, and donate more money, the more people die in a disaster, but not when more people survive and need assistance. (more…)
Author Interviews, Breast Cancer, Chemotherapy, MD Anderson, Vanderbilt / 10.10.2013

MedicalResearch.com Interview with: Hiroko Masuda MD

Morgan Welch Inflammatory Breast Cancer Research Program and Clinic; Departments of 2Breast Medical Oncology, 3Bioinformatics and Computational Biology The University of Texas MD Anderson Cancer Center, Houston, Texas;

W. Fraser Symmans, MD Anderson Cancer Center, Department of Pathology, Unit 85, 1515 Holcombe Blvd., Houston, TX 77030-4009;

Naoto T. Ueno, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1354, Houston, TX 77030.

MedicalResearch.com: What are the main findings of the study?

Answer: Triple-negative breast cancer (TNBC) could be classified into 7 subtypes: basal-like 1 (BL1), basal-like 2 (BL2), immunomodulatory (IM), mesenchymal (M),mesenchymal stem-like (MSL), luminal androgen receptor (LAR), and unstable (UNS). Using cluster analysis, Lehmann and Bauer et al. identified these TNBC subtypes in 21 public mRNA gene expression profiles of breast cancer. However, the clinical relevancy of these novel molecular subtypes has not been established. To establish the clinical relevancy, we determined if the subtypes of TNBC have different rates of pathological complete response (pCR) to standard neoadjuvant chemotherapy regimens. In this study, we confirmed that TNBC is heterogeneous and that pCR differs by TNBC subtype using the algorithm proposed by Lehmann and Bauer et al. The BL1 subtype had the highest pCR rate (52%), and BL2 and LAR had the lowest pCR rates (0% and 10%, respectively). TNBC subtype was an independent predictor of pCR status (P=0.022) via a likelihood ratio test. To our knowledge, this was the first study to show that the TNBC subtype can serve as an independent predictor of pCR status in patients who received standard chemotherapy regimens. This confirms the possible clinical relevance of the 7 molecular subtypes, and these subtypes may lead to innovative clinical trials of personalized medicine for patients with TNBC. (more…)

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. (more…)
Author Interviews, JAMA, UT Southwestern / 08.10.2013

Roshni Rao, MD Division of Surgical Oncology, Department of Surgery University of Texas Southwestern Medical Center, DallasMedicalResearch.com Interview with: Roshni Rao, MD Division of Surgical Oncology, Department of Surgery University of Texas Southwestern Medical Center, Dallas MedicalResearch.com: What are the main findings of the study?  Dr. Rao: That in most women with small breast cancer (<3.0cm in size), it is not necessary to removal all the lymph nodes underneath the arm, even if those nodes do have cancer. Radiation therapy, which is required after a partial mastectomy for breast cancer, can prevent these nodes from growing or becoming clinically significant. (more…)
Cancer Research, Heart Disease, MD Anderson, Ovarian Cancer / 08.10.2013

Anil K. Sood MD Department of Gynecologic Oncology The University of Texas MD Anderson Cancer Center Unit 1362, PO Box 301439, Houston, TX, 77030MedicalResearch.com Interview with: Anil K. Sood MD Department of Gynecologic Oncology The University of Texas MD Anderson Cancer Center Unit 1362, PO Box 301439, Houston, TX, 77030 MedicalResearch.com: What are the main findings of the study? Dr. Sood: For women with newly diagnosed ovarian cancer, high heart rate at diagnosis (tachycardia), venous thromboembolism (VTE) occurring after diagnosis and pulmonary hypertension post-diagnosis are independently related to reduced survival after controlling for tumor stage, grade, and extent of cytoreduction.  Women with tachycardia lived an average of 4.0 years after diagnosis compared with 5.9 years for women without tachycardia, a 32% reduction in duration of survival.  Patients who experienced VTE lived a median 4.1 years after diagnosis, compared with 6.4 yrs for patients who did not experience VTE. (more…)
Author Interviews, Breast Cancer, JAMA, MD Anderson / 08.10.2013

Kelly K. Hunt, MD F.A.C.S. Professor, Department of Surgical Oncology, Division of Surgery Chief, Breast Surgical Oncology Section, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TXMedicalResearch.com Interview with: Kelly K. Hunt, MD F.A.C.S. Professor, Department of Surgical Oncology, Division of Surgery Chief, Breast Surgical Oncology Section, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX MedicalResearch.com: What are the main findings of the study? Dr. Hunt: We found that 40% of women who had node positive disease at initial presentation (confirmed by needle biopsy) had no evidence of residual cancer in the lymph nodes after chemotherapy. We performed sentinel lymph node (SLN) surgery followed by axillary lymph node dissection in all of the patients and found a false negative rate of 12.6% with the SLN procedure. The false negative rate was lower when surgeons used two mapping agents (blue dye and radioisotope) to identify the sentinel nodes and when they removed more than 2 sentinel nodes. (more…)
Author Interviews, Cognitive Issues, Johns Hopkins, Mental Health Research / 07.10.2013

MedicalResearch.com Interview with: Dr. Seth S. Martin, MD Division of Cardiology, Johns Hopkins Hospital 600 North Wolfe Street Baltimore, Maryland 21287 Johns Hopkins Hospital Baltimore, MD 21287. MedicalResearch.com: What are the main findings of the study? Dr. Martin: Our systematic review identified 16 studies for qualitative synthesis and 11 for quantitative synthesis. In individuals without baseline cognitive dysfunction, statins did not adversely affect memory when used in the short-term (<1 year). Long-term cognition studies including 23,433 patients with a mean exposure duration of 3 to 24.9 years showed a 29% relative reduction in incident dementia related to statin use (hazard ratio, 0.71; 95% CI 0.61-0.82) and a 2% absolute risk reduction (number needed to treat for 6.2 years: 50). (more…)