Author Interviews, Brigham & Women's - Harvard, Journal Clinical Oncology, Prostate Cancer, Radiation Therapy / 04.06.2021
High Risk Prostate Cancer: Adjuvant Radiation May Reduce Risk of Death
MedicalResearch.com Interview with:
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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.
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.
Dr. Chien-Wen Tseng[/caption]
Chien-Wen Tseng, M.D., M.P.H., M.S.E.E.
The Hawaii Medical Service Association Endowed Chair
Health Services and Quality Research
Professor, and Associate Research Director
Department of Family Medicine and Community Health
University of Hawaii John A. Burns School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Gaining weight during pregnancy is natural but gaining too little or too much weight can be harmful for pregnant people and their babies. For the first time, the Task Force reviewed the evidence and found that counseling pregnant people on healthy weight gain during pregnancy can lower their risk for diabetes during pregnancy, emergency cesarean deliveries, and babies born with a birth weight that is too high. Pregnant people may not know what amount of weight gain is healthy during pregnancy, or how weight gain can affect their pregnancy and baby.
We recommend that clinicians offer all pregnant people counseling on healthy weight gain throughout their pregnancy for healthier, safer pregnancies.
Dr. Carlson[/caption]
Susan E. Carlson Ph.D.
Associate Dean for Research
Program Director,, AJ Rice Professor
Department of Dietetics and Nutrition
University of Kansas Medical Center
Kansas City, KS
MedicalResearch.com: What is the background for this study? What are its benefits?
Response: DHA is an omega-3 fatty acid. Good food sources include some types of seafood (e.g., salmon, tuna, trout) and chicken eggs. Persons in the USA and in much of the developing world consume little dietary DHA. DHA supplements in pregnancy have been linked to lower risk of preterm birth for 20 years, especially early preterm births (<34 weeks gestation). For about 10 years, prenatal supplements with about 200 mg DHA have been readily available in the USA, however, no study has asked if this amount of DHA is optimal to reduce early preterm birth. Participants were given a supplement of 1000 mg or 200 mg DHA beginning before 20 weeks gestation using an adaptive randomization that periodically assigned more participants to the group with the fewest early preterm births.
Dr. Clarke[/caption]
Katherine Clark, MD MBA
Division of Cardiovascular Medicine
Department of Internal Medicine
Yale School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Racial and ethnic disparities affect cardiac transplantation outcomes. In cohort analyses of racial and ethnic groups from the previous three decades, Black patients were constantly at a higher risk of mortality after cardiac transplantation. In 2018, the United Network for Organ Sharing (UNOS) revised the allocation system to expand access to organs for the most medically urgent patients and reduce disparities and regional differences. We sought to evaluate contemporary trends and impact of the new 2018 allocation system.
Dr. Andersson[/caption]
Niklas Worm Andersson, MD
Department of Epidemiology Research
Statens Serum Institut,
Copenhagen Denmark
MedicalResearch.com: What is the background for this study?
Response: "Findings from some previous fetal safety studies on topical corticosteroid use in pregnancy have raised concerns for an increased risk of newborns being small for gestational age or having low birth weight, in particular among pregnancies where larger amounts of potent to very potent agents have been used."
Dr. Mezue[/caption]
Kenechukwu Ndubisi Mezue, M.D
Fellow in
Dr. Wong[/caption]
John B. Wong, M.D.
Chief Scientific Officer
Vice chair for Clinical Affairs
Chief of the Division of Clinical Decision Making and
Primary care Clinician
Department of Medicine at Tufts Medical Center
MedicalResearch.com: What is the background for this study?
Response: Hypertension affects nearly half of all adults in the United States and is a major risk factor for many serious health conditions. Fortunately, by screening all adults for hypertension, clinicians can improve their patient’s health. The Task Force continues to recommend screening all adults for hypertension so that they can get the care they need to help prevent health conditions such as heart attack, stroke, and kidney failure.
Dr. Yun Liu[/caption]
Yun Liu, PhD
Google Health
Palo Alto, California
MedicalResearch.com: What is the background for this study? Would you describe the system? Does it use dermatoscopic images?
Response: Dermatologic conditions are extremely common and a leading cause of morbidity worldwide. Due to limited access to dermatologists, patients often first seek help from non-specialists. However, non-specialists have been reported to have lower diagnostic accuracies compared to dermatologists, which may impact the quality of care.
In this study, we built upon prior work published in
Prof. Reich[/caption]
Prof. Kristian Reich, MD, PhD
Professor for Translational Research in Inflammatory Skin Diseases
Institute for Health Services Research in Dermatology and Nursing
University Medical Center Hamburg-Eppendorf
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Complete skin clearance is an important treatment goal for patients with psoriasis and is closely associated with treatment satisfaction and improved quality of life. However, it remains an unmet need for many patients.
The interleukin (IL)-17 isoforms IL-17A and IL-17F play central roles in psoriasis pathophysiology and are overexpressed in psoriatic tissues. Existing biologic therapies, such as secukinumab, inhibit IL-17A only. However, increasing evidence indicates that IL-17F contributes independently to the pathobiology of plaque psoriasis, and that blocking both IL-17A and IL-17F may lead to more complete suppression of inflammation and superior clinical outcomes, compared with blocking IL‑17A alone.
Bimekizumab is a humanized monoclonal IgG1 antibody that has been designed to selectively inhibit IL-17F in addition to IL-17A.
Prof. Papageorghiou[/caption]
Aris Papageorghiou MBChB, MRCOG
Professor of Fetal Medicine and the Clinical Research Director
Oxford Maternal and Perinatal Health Institute
University of Oxford
MedicalResearch.com: What is the background for this study?
Response: Our study was really guided by a key question: does Covid-19 in pregnancy increase the risk of adverse maternal and neonatal outcomes as compared with pregnant women who do not have the infection?
The question is highly relevant because of the known deleterious effects of other coronavirus infections in pregnancy, e.g. SARS (severe acute respiratory syndrome) and MERS-CoV (Middle East respiratory syndrome coronavirus).
In order to answer this question we undertook this multinational cohort study.
Dr. Blankson[/caption]
Joel N. Blankson, MD, PhD
Department of Infectious Diseases
Associate Professor
Cellular and Molecular Medicine Program
Johns Hopkins
MedicalResearch.com: What is the background for this study? Which vaccines did you evaluate?
Response: Prior studies from several groups including our own have found T cell cross-recognition of peptides from SARS-CoV-2 and the common cold coronaviruses.
We asked whether as a result of this cross-reactivity, immunization with the SARS-CoV-2 vaccine would also enhance T cell responses to the common cold coronaviruses.
Prior studies also suggested that antibodies elicited from the mRNA vaccines had a reduced ability to neutralize the emerging variants of concern.
Most of the study participants had received the Pfizer vaccine, but a few had received the Moderna vaccine.
Dr. Virani[/caption]
Senior & Corresponding Author
Salim S. Virani, MD, PhD, FACC, FAHA, FASPC
Professor, Section of Cardiovascular Research
Director, Cardiology Fellowship Training Program
Baylor College of Medicine
Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center
Co-Director, VA Advanced Fellowship in Health Services Research & Development Michael E. DeBakey VA Medical Center, Houston, TX
Investigator, Health Policy, Quality and Informatics Program
Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation
Houston, TX
MedicalResearch.com: What is the background for this study?
Response: Atherosclerotic cardiovascular disease (ASCVD), defined as ischemic heart disease (IHD), ischemic cerebrovascular disease (ICVD), or peripheral arterial disease (PAD), is the leading cause of death globally. Particularly in young ASCVD patients, secondary prevention with antiplatelet therapy and statins are extremely important in reducing disease burden.
Prof. Monsonego Ornan[/caption]
Efrat Monsonego Ornan, Ph.D
Head of School of Nutritional Sciences
Institute of Biochemistry and Nutrition
The Robert H. Smith Faculty of Agriculture,
Food and Environment
The Hebrew University of Jerusalem
MedicalResearch.com: What is the background for this study?
Response: Food supplies in recent decades have been dominated by heavily processed, ready-to-eat products. Essentially, 75% of all world food sales are of processed foods. Over the past 30 years, children’s ultra-processed food intake has increased markedly, with 50% of the children in the US consuming these foods. Only in the US does UPF comprise 58% of energy intake, of which 90% is derived from added sugars. This reflects children’s excessive consumption of food and drink that are high in fat and refined sugars but do not provide appropriate levels of the proteins, vitamins and minerals required for growth.
The negative health outcomes of excessive consumption of Ultra-processed food are well known, include obesity, metabolic syndrome and diabetes, and considered as the current world epidemic; the fact that children, during their postnatal development period (birth to adolescent), are the target of the Ultra-processed food industry is very disturbing in terms of public health. Bone development and growth are the characteristic phenomena of the childhood period. Yet, in spite of the huge importance of nutrition to bone development, the impact of Ultra-processed food consumption on skeleton development during childhood has never been studied directly, and this was the purpose of our study.
To this end, we used young rats which are an excellent pre-clinical model for growth and fed them with either the recommended diet for their age or a diet comprised of a typical Ultra-processed meal (a roll, hamburger, tomatoes, lettuce, ketchup and French fries) and a caloric soft drink.
Dr. McPeek Hinz[/caption]
Eugenia McPeek Hinz MD MS FAMIA
Associate CMIO - DHTS
Duke University Health System
MedicalResearch.com: What is the background for this study?
Response: Clinician burnout rates have hovered around 50% for much of the past decade. Burnout is a significant concern in healthcare for its effects on care givers and associated downstream adverse implications on patient care for quality and safety. The ubiquitous presence of Electronic Health Records (EHR) along with the increased clerical components and after hours use has been a significant concern for contributing to provider burnout.
Dr. Sickbert-Bennett[/caption]
Emily Sickbert-Bennett PhD, MS, CIC, FSHEA
Director, Infection Prevention, UNC Hospitals
Administrative Director, Carolina Antimicrobial Stewardship Program, UNC Hospitals
Associate Professor of Medicine-Infectious Diseases, UNC School of Medicine
Associate Professor of Epidemiology, UNC Gillings School of Global Public Health
MedicalResearch.com: What is the background for this study?
Response: Recently public health officials have recommended doubling masks, although the