Author Interviews / 14.10.2020

MedicalResearch.com Interview with: Chuan-Liang Xu, MD, PhD Changhai Hospital of Shanghai MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with urothelial carcinoma usually have to undergo lifelong cystoscopy for surveillance, because it recurred often. Cystoscopy is an examination which inserted a catheter with light and camera into the urethra and inspect the lining of the bladder. Cystoscopy is invasive and uncomfortable for the patients, and also cost a lot of money. Urothelial carcinoma is in direct contact with the urine, just like fish and water, and tumor cells might be flushed out by urine. Traditional method urine cytology is trying to find tumor cells in the urine by cytopathologist, but this method may miss up to 50 to 70% of tumor patient. So, the main purpose of our study is to establish a new non-invasive, and more accurate method to detect urothelial cancer by analyzing the chromosomal alterations from the urine exfoliated cells, and reduce the use of cystoscopy. 
Author Interviews, Cancer Research, Lancet, Nature / 19.05.2020

MedicalResearch.com Interview with: [caption id="attachment_53818" align="alignleft" width="130"]Matthew Galsky, MD Icahn School of Medicine at Mount Sinai New York, NY Dr. Galsky[/caption] Matthew Galsky, MD Icahn School of Medicine at Mount Sinai New York, NY MedicalResearch.com: What is the background for this study? Response: Standard first-line treatment for metastatic urothelial (bladder) cancer has been platinum-based chemotherapy for decades. In 2016, atezolizumab, an immunotherapy that inhibits PD-L1, received accelerated approval by the FDA for the treatment of metastatic urothelial cancer for patients progressing despite prior platinum-based chemotherapy and this was followed by approvals for 4 additional PD-1 or PD-L1 inhibitors in this setting over the next couple years. With this first new drug class approved, representing the first new drugs approved for metastatic urothelial cancer for decades, logical question arose (a) should we combine these drugs with platinum-based chemotherapy in the first-line metastatic treatment setting and (b) is there a role to replace first-line chemotherapy with atezolizumab monotherapy. The IMvigor 130 trial was designed to address these questions. The trial enrolled 1213 patients who were randomized to treatment with (a) atezolizumab plus platinum-based chemotherapy, (b) placebo + platinum-based chemotherapy, or (c) atezolizumab monotherapy. The trial employed a hierarchical analysis plan such that comparisons between arms for certain endpoints could only be formally tested if other the preceding comparisons demonstrated a significant improvement. 
ASCO, Author Interviews, Cancer Research, Journal Clinical Oncology / 10.04.2020

MedicalResearch.com Interview with: [caption id="attachment_53818" align="alignleft" width="130"]Matthew Galsky, MD Icahn School of Medicine at Mount Sinai New York, NY Dr. Galsky[/caption] Matthew Galsky, MD Icahn School of Medicine at Mount Sinai New York, NY MedicalResearch.com: What is the background for this study? Would you explain what is meant by switch maintenance immunotherapy? Response: For decades, platinum-based chemotherapy has been standard first-line treatment for metastatic urothelial (bladder) cancer. The standard approach to first-line chemotherapy is to administered approximately 6 cycles of treatment (in the absence of disease progression or prohibitive side effects), and then to stop treatment and monitor. Unfortunately, virtually all patients with metastatic disease will experience disease progression after stopping chemotherapy. However, we know that if we just continue the same platinum-based chemotherapy until progression of cancer (rather than stopping after ~6 cycles), the side effects continue to accumulate but the benefits plateau. Approximately 5 years ago, the first new systemic therapies were approved to treatment metastatic urothelial cancer in decades, immune checkpoint inhibitors (PD-1 or PD-L1 inhibitors). In fact, 5 PD-1/PD-L1 inhibitors have been approved by the FDA for the treatment of patients with metastatic urothelial cancer progressing despite prior platinum-based chemotherapy. Given that these drugs are non-cross resistant with chemotherapy in at least a subset of patients (i.e., they can provide benefit even when chemotherapy is no longer working), and because they are well tolerated by a large proportion of patients, a logical question is rather than waiting until cancer progresses after stopping first-line chemotherapy, what if we started immunotherapy immediately. Switch maintenance refers to switching from chemotherapy to a different class of drug (e.g., immunotherapy) and maintenance refers to trying to "maintain" the response achieved with initial chemotherapy.
Author Interviews, Cancer Research, HPV, Urology / 13.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49147" align="alignleft" width="200"]Lael S. Reinstatler, MD, MPH.PGY 4 Urology ResidencyDartmouth Hitchcock Dr. Reinstatler[/caption] Lael S. Reinstatler, MD, MPH. PGY 4 Urology Residency Dartmouth Hitchcock MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Human Papillomavirus is an oncogenic virus associated with other genitourinary cancers including penile cancer. HPV is detectable in urine and in urethral swabs and it interacts with stratified squamous epithelium which lines the majority of the genitourinary tract. Prior research has identified HPV in bladder tumors but detection methods are inconsistent. In this study, we looked for an association with HPV serology (indicating prior HPV systemic exposure) and bladder cancer.
Author Interviews, Cancer Research, NYU, Smoking / 17.05.2017

MedicalResearch.com Interview with: [caption id="attachment_34281" align="alignleft" width="120"]Moon-shong Tang, Ph</strong>D Professor of Environmental Medicine, Pathology and Medicine New York University School of Medicine Tuxedo Park, New York 10987 Dr. Moon-shong Tang[/caption] Moon-shong Tang, PhD Professor of Environmental Medicine, Pathology and Medicine New York University Langone School of Medicine Tuxedo Park, New York 10987 MedicalResearch.com: What is the background for this study? Response: E-cigarettes (E-cigs) are designed to deliver the stimulant nicotine through aerosols, commonly referred as vapors. Nicotine is dissolved in organic solvents such as glycerin and propylene glycol. The nicotine is then aerosolized by controlled electric heating. E-cigs do not use tobacco leaves and E-cig smoke does not involve the burning process. Hence, E-cig smoke (ECS) contains only nicotine and the gas phase of the solvent. Because ECS contains neither carcinogens nor allergens or odors from the tobacco burning process, E-cigs have been promoted as an invention that can deliver a TS ‘high’ without TS negative effects. The population of E-cig users is rapidly rising, particularly in young adults. It has been estimated that 16% of high school students are E-cig smokers. Therefore, the health effects of E-cig smoke, particularly its carcinogenicity, deserve careful scrutiny.
Author Interviews, Chemotherapy, Urology / 24.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24650" align="alignleft" width="198"]Alejandro Sousa, MD, PhD Department of Urology, Comarcal Hospital Monforte, Spain Dr. Alejandro Sousa[/caption] Alejandro Sousa, MD, PhD Department of Urology, Comarcal Hospital Monforte, Spain MedicalResearch.com: What is the background for this study? Dr. Sousa: Bladder Cancer management has remained stable over the past 25 years, with very little in the way of new therapies or approaches being developed. Traditional treatment using intravesical Mitomycin C for Non Muscle Invasive Bladder Cancer (NMIBC) patients is limited due it's low absorption levels. Device assisted therapies that deliver Chemo-hyperthermia offer a new hope, with the potential for improved outcomes and better disease management due the the increased drug activity and better efficacy. We wanted to investigate the optimal treatment regime for this new therapy and whether it provides a safe and effective alternative to current standard treatment.
Author Interviews, Biomarkers, Cancer Research / 02.07.2015

MedicalResearch.com Interview with: Chao Cheng, Ph.D. Assistant Professor Department of Genetics Institute for Quantitative Biomedical Sciences Geisel School of Medicine at Dartmouth Hanover NH, 03755 Medical Research: What is the background for this study? Dr. Cheng: Bladder cancer is a common tumor type, with non-muscle-invasive bladder cancer (NMIBC) representing the majority of cases. Bacillus Calmette-Guerin (BCG) treatment is an effective immunotherapy that is commonly used to treat cancers of this subtype. However, this treatment fails to suppress tumor recurrence in up to 40% of patients. For this reason, biomarkers that predict the recurrence/progression of bladder cancer and patient response to BCG therapy are needed to tailor treatment strategies to individual patients. Medical Research: What are the main findings? Dr. Cheng: We had previously developed an E2F4 signature that consisted of the E2F4 transcription factor and its target genes identified by ChIP-seq and ChIP-chip experiments. Here, we found that the E2F4 signature is predictive of the progression of both non-muscle-invasive and muscle-invasive bladder cancer. Furthermore, this signature is also predictive of patient responsiveness to intravesical BCG immunotherapy. Our results suggest that patients with positive E2F4 scores (indicating high E2F4 activity) benefit significantly from BCG therapy, while the progression of patients with negative E2F4 scores (indicating low E2F4 activity) does not show significant difference from untreated patients.