Aging, Author Interviews, Cancer Research, Genetic Research / 16.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30561" align="alignleft" width="70"]Jerry W. Shay PhD Professor Department of Cell Biology, UT Southwestern Medical Center Dr. Jerry Shay[/caption] Jerry W. Shay PhD Professor Department of Cell Biology, UT Southwestern Medical Center MedicalResearch.com: What did you find? Response: Telomeres are the ends of chromosomes and they gradually shortened with every cell division. There have been multiple studies proposing that shortened telomeres correlate with human aging. Most cancers overcome the shortening of telomeres and aging by activating the enzyme, telomerase. Surprisingly, the human telomerase gene (hTERT) is very close to the telomere on chromosome 5p. During human development telomerase is active until about 18 weeks of gestation. It has been a mystery until this present work of what actually causes telomerase to become silenced. We found in this current work that when telomeres are long during development the telomere loops over and helps to silence the telomerase gene. However, as we age and telomeres get progressively shorter, then telomerase becomes permissive for activation and possibly initiation of cancer. This study in part explain why most cancers are in the 65 and older segment of the population.
Aging, Author Interviews, Cancer Research, Global Health, JAMA / 06.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30284" align="alignleft" width="200"]Christina Fitzmaurice, MD, MPH Assistant Professor Department of Medicine, Division of Hematology Institute for Health Metrics and Evaluation University of Washington Seattle, WA Dr. Christina Fitzmaurice[/caption] Christina Fitzmaurice, MD, MPH Assistant Professor Department of Medicine, Division of Hematology Institute for Health Metrics and Evaluation University of Washington Seattle, WA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cancer is the second leading cause of death worldwide behind cardiovascular diseases. We found that cancer cases increased by 33% from 13.1 million cases in 2005 to 17.5 million in 2015. The largest driver behind this increase was an aging population, followed by a growing population worldwide. The smallest factor contributing to this increase was a rise in cancer incidence rates. Because of increasing life expectancy and better control of communicable diseases cancer will remain a major burden in the foreseeable future. Adjusting and building health systems that can appropriately deal with this challenge is only possible with good data on the burden of cancer. In our study we estimate the number of cancer cases, and cancer deaths over time for 32 cancers in 195 countries and territories from 1990 to 2015. We also estimate how many years of life were lost due to cancer as well as disability adjusted life years and a summary measure that combines these two into disability adjusted life years.
Author Interviews, Cancer Research, Cost of Health Care, JAMA, Johns Hopkins / 02.12.2016

MedicalResearch.com Interview with: [caption id="attachment_29945" align="alignleft" width="80"]Dr. Amol K. Narang, MD Instructor of Radiation Oncology and Molecular Radiation Sciences Johns Hopkins Sidney Kimmel Comprehensive Cancer Center Dr. Amol  Narang[/caption] Dr. Amol K. Narang, MD Instructor of Radiation Oncology and Molecular Radiation Sciences Johns Hopkins Sidney Kimmel Comprehensive Cancer Center MedicalResearch.com: What is the background for this study? Response: We know that cancer care is becoming increasingly expensive in the U.S., but the financial impact on patients in the form of out-of-pocket expenses is not well understood, in part because of the lack of data sources that track this information. As such, we used the Health and Retirement study, a national panel study that closely tracks the out-of-pocket medical expenditures of older Americans, to understand the level of financial strain that Medicare patients experience after a new diagnosis of cancer. We further investigated what factors were associated with high financial strain and what type of health services were driving high costs in this population.
Author Interviews, Cancer Research, Nature / 01.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30081" align="alignleft" width="150"]Sudarshan Anand, PhD Department of Cell, Developmental and Cancer Biology Department of Radiation Medicine Oregon Health and Science University Portland, Oregon Dr. Sudarshan Anand[/caption] Sudarshan Anand, PhD Department of Cell, Developmental and Cancer Biology Department of Radiation Medicine Oregon Health and Science University Portland, Oregon MedicalResearch.com: What is the background for this study? What are the main findings? Response: Almost half of all cancer patients receive radiation therapy during the course of their disease. While the impact of radiation on the cancer cells has been well studied in experimental models, its effects on the accessory cells that are present in the tumor are not well known. One of the major interests of our lab is studying these accessory cells of the tumor aka “the tumor microenvironment”. These group of cells consists of blood vessel cells, fibroblasts and immune cells that are normal cells that have been recruited by the tumor and generally support tumor growth. The goal of this study was to understand the impact of radiation (and broadly DNA damaging agents) on the blood vessel cells in the tumor. We focused on a specific type of molecule called microRNAs (miRs) in these cells. miRs are small RNA molecules that bind to dozens of messenger RNAs and the production of proteins. We discovered a group of microRNAs that was induced in blood vessel cells by radiation, a chemotherapy agent cisplatin and peroxide an agent that mimics oxidative stress that is often present in cancers. We found that the top candidate on this list was a microRNA that mimicked radiation by inducing DNA damage and eventually killing the blood vessel cells. Administering this microRNA, either within a tumor or using a specific nanoparticle that delivers cargo to the tumor blood vessels, decreased tumor growth in mouse models of breast cancer, brain cancer and colorectal cancer. We found that the efficacy of this agent was a result of its ability to suppress a protein TREX1, that is often mutated in human lupus. In other words, this microRNA was able to create some of the immune and inflammatory features of lupus within a tumor and induce proteins that triggered cell death on tumor cells. Overall, our work illustrates how the tumor accessory cells respond to radiation and highlights the cross-talk between different accessory cells and the tumor cells.
Author Interviews, Cancer Research, Dermatology, JAMA, UCLA / 22.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29923" align="alignleft" width="200"]Albert Yoon-Kyu Han, PhD Class of 2017 Medical Scientist Training Program David Geffen School of Medicine at UCLA Dr. Albert Han[/caption] Albert Yoon-Kyu Han, PhD Class of 2017 Medical Scientist Training Program David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Squamous cell carcinoma (SCC) of the lip makes up a large portion of oral cancers (25%). Most of the demographic and prognostic indicators for lip SCC are only available through retrospective case series. Thus, we used the national cancer database (Surveillance, Epidemiology, and End Results, or SEER) to examine the incidence, treatment, and survival of patients with lip SCC. The main findings of this study were that lip Squamous cell carcinoma predominantly affects white men in their mid-60s. We also found that the determinants of survival for lip SCC include age at diagnosis, primary site, T stage, and N stage. More specifically, on the primary site, SCC of the upper and lower lip had similar survival, whereas SCC of the oral commissure was associated with decreased survival.
Author Interviews, BMJ, Cancer Research, Cost of Health Care, Imperial College / 11.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29575" align="alignleft" width="200"]Peter Wise MD Charing Cross Hospital and Imperial College School of Medicine London, UK Dr. Peter Wise[/caption] Peter Wise MD Charing Cross Hospital and Imperial College School of Medicine London, UK MedicalResearch.com: What is the background for this analysis? Response: As a medical ethicist, I wished to know how much patients with advanced – metastatic – cancer knew about the drugs that were being used to treat it. What were their perceptions of likely treatment success and how did that tally with our knowledge of what drugs could actually achieve – and at what cost to the body and to the pocket. Did patients actually have a choice – and how did the drugs get approved for use in the first place?
Author Interviews, Cancer Research, Immunotherapy / 11.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29564" align="alignleft" width="75"]Dr. Michael Lotze, MD Chief Scientific Officer, Lion Biotechnologies San Carlos, CA 94070 Dr. Lotze[/caption] Dr. Michael Lotze, MD Chief Scientific Officer, Lion Biotechnologies San Carlos, CA 94070 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Adoptive cell therapy (ACT) with Tumor-infiltrating Lymphocytes (TIL) has shown promise in mediating cancer regression which rely on activation in vivo compared to other immunotherapies that utilize genetically modified T-cells. In TIL therapy, autologous administration of TIL expanded outside the body elicits a highly individualized, specific and potent attack against the tumor. Clinical trials conducted at the National Cancer Institute evaluating TIL therapy for the treatment of metastatic melanoma reported overall response rates of up to 56%. The durable responses observed in these metastatic melanoma patients as well as other patients with cervical cancer, cholangiocarcinoma, and head and neck cancer signal the potential for broader application of TIL therapy to treat patients with other solid tumors, currently an area of substantial unmet clinical need. Lion’s study, recently presented at the Society for Immunotherapy of Cancer, sought to demonstrate the feasibility of culturing and expanding TIL isolated from non-melanoma tumors. We were successful in culturing TIL from tumors obtained from bladder, cervical, head and neck, lung and triple negative breast cancer.
Author Interviews, Cancer Research, JAMA / 04.11.2016

MedicalResearch.com Interview with: Ayako Okuyama, RN, PHN, MW, PhD Center for Cancer Control and Information Services National Cancer Center, Japan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Chemotherapy-induced nausea and vomiting (CINV) is a major concern for chemotherapy patients. Despite widespread concern, not all chemotherapeutic drugs cause severe CINV. Our study illustrated that the potential for overuse of prophylactic antiemetics for chemotherapy with minimal and low emetic risks according to the antiemetic guidelines.
Author Interviews, Cancer Research, ESMO, Immunotherapy, NYU / 16.10.2016

MedicalResearch.com Interview with: [caption id="attachment_28911" align="alignleft" width="200"]Arjun Balar, M.D. Assistant Professor of Medicine Director - Genitourinary Medical Oncology Program NYU Perlmutter Cancer Center New York, NY 10016 Dr. Arjun Balar[/caption] Arjun Balar, M.D. Assistant Professor of Medicine Director - Genitourinary Medical Oncology Program NYU Perlmutter Cancer Center New York, NY 10016 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Standard treatment for advanced urothelial cancer includes cisplatin-based chemotherapy which has been shown to improve survival. But more than half of patients are not expected tolerate it well and alternative treatment is inferior to cisplatin. The average survival for these patients is in the range of 9-10 months with carboplatin-based treatment, which is the most commonly used alternative to cisplatin. Pembrolizumab is a PD-1 blocking antibody that reactivates the body’s cancer-fighting T-cells (part of the immune system) to fight urothelial cancer. The trial overall enrolled 374 patients who had not yet received any treatment for advanced urothelial cancer, but were considered ineligible for cisplatin chemotherapy.
Author Interviews, Cancer Research, ESMO, Immunotherapy / 13.10.2016

MedicalResearch.com Interview with: [caption id="attachment_28855" align="alignleft" width="130"]Dr. Mathew Galsky MD Associate Professor, Medicine, Hematology and Medical Oncology Assistant Professor, Urology Director, Genitourinary Medical Oncology The Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai Dr. Mathew Galesky[/caption] Dr. Mathew Galsky MD Associate Professor, Medicine, Hematology and Medical Oncology Assistant Professor, Urology Director, Genitourinary Medical Oncology The Tisch Cancer Institute Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: Since the development of combination cisplatin-based chemotherapy for the treatment of metastatic bladder (urothelial) cancer several decades ago, there have been few advances in the treatment of this disease. Further, until recently, there had been no global standard treatment options for patients with metastatic urothelial cancer progressing despite platinum-based chemotherapy. Several lines of evidence suggest that urothelial cancer may be sensitive to immunotherapeutic treatment strategies. Recently, in a phase I/II study published by Sharma and colleagues in Lancet Oncology, the anti-PD-1 antibody Nivolumab demonstrated a durable objective response rate of 24% in patients with metastatic urothelial cancer progressing despite platinum-based chemotherapy. To confirm to antitumor effects of Nivolumab in this patient population, we conducted a large global multicenter single-arm phase II study
Author Interviews, Cancer Research, Cost of Health Care, JAMA, Pharmacology / 12.10.2016

[caption id="attachment_28580" align="alignleft" width="200"]MedicalResearch.com Interview with: Dr. Sham Mailankody, MBBS Dr. Sham Mailankody[/caption] MedicalResearch.com Interview with: Dr. Sham Mailankody, MBBS Memorial Sloan Kettering Cancer Center MedicalResearch.com: What is the background for this study? Response: The high price of older drugs has been increasingly criticized in part because of recent dramatic price hikes. There are some well known examples like pyrimethamine and more recently EpiPen. Whether and to what degree examples like pyrimethamine represent a common problem or exceptional cases remains unknown. Using Medicare data available for Part B, we sought to analyze the change in average sales price of cancer drugs between January 2010 and January 2015, and whether older drugs were more likely to undergo price increases than newer drugs.
AACR, Author Interviews, Cancer Research, Genetic Research / 07.10.2016

MedicalResearch.com Interview with: Riccardo Taulli, PhD Assistant Professor of Biochemistry Dept. of Oncology, University of Turin Via Santena 5, 10126 Torino, Italy MedicalResearch.com: What is the background for this study? Response: Rhabdomyosarcoma is a muscle-derived pediatric cancer for which therapeutic options have not improved significantly over the past decades, especially for its metastatic form. MicroRNAs are small regulatory molecules that control gene expression at the post-transcriptional level, fine tuning a wide number of cellular mechanisms, processes and behaviors. In our work, we underwent a large microRNA isolation and sequencing effort using human samples of the three major rhabdomyosarcoma subtypes, along with cell lines and normal muscle, to identify novel molecular circuits with therapeutic potential.
Author Interviews, Cancer Research, ENT, HPV / 04.10.2016

MedicalResearch.com Interview with: [caption id="attachment_28537" align="alignleft" width="133"]Eric M Genden, MD, FACS Isidore Friesner Professor and Chairman Department of Otolaryngology-Head and Neck Surgery The Icahn School of Medicine at Mount Sinai Dr. Eric Genden[/caption] Eric M Genden, MD, FACS Isidore Friesner Professor and Chairman Department of Otolaryngology-Head and Neck Surgery The Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this report? How has the clinical picture of HPV infections of oral and throat cancers changed over the past two decades? Response: There has been no change however there has been a epidemic of viral induced throat cancer in men. The HPV virus has been established a the causative agent in cervical cancer in women. It has now been identified as a major causative agent in tonsillar and base of tongue cancer.
Author Interviews, Journal Clinical Oncology, Prostate Cancer, Surgical Research, Urology / 30.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28482" align="alignleft" width="134"]Eric Jacobs, PHD | Strategic Director, Pharmacoepidemiology American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 Dr. Eric Jacobs[/caption] Eric Jacobs, PHD Strategic Director, Pharmacoepidemiology American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Vasectomy is a common, inexpensive, and very effective method of long-term birth control. However, in 2014, an analysis from a large epidemiologic cohort study, the Health Professionals Follow-Up Study, found that vasectomy was associated with about 10% higher overall risk of prostate cancer and about 20% higher risk of fatal prostate cancer. Together with other researchers at the American Cancer Society, I analyzed the association between vasectomy and fatal prostate cancer among more than 363,000 men in the Cancer Prevention Study II (CPS-II) cohort, age 40 and older, who were followed for up to 30 years. This is the largest prospective analysis of vasectomy and fatal prostate cancer to date. We also examined vasectomy and prostate cancer in a subset of about 66,000 CPS-II study participants who were followed for new diagnoses of prostate cancer. We found no link between having had a vasectomy and risk of either developing or dying from prostate cancer.
Author Interviews, Cancer Research, Science / 30.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28461" align="alignleft" width="180"]Paola Scaffidi, PhD Group Leader Cancer Epigenetics Laboratory The Francis Crick Institute London Dr. Paola Scaffidi[/caption] Paola Scaffidi, PhD Group Leader Cancer Epigenetics Laboratory The Francis Crick Institute London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Every cancer is different, but even within the same tumor cells are highly diverse, and only some of them are truly immortal and drive tumor growth. This is quite surprising if we think that cancer arises from one cell that keeps replicating itself. So why are some cancer cells more dangerous than others? And why do some cells "get tired" along the way and, at some point, stop dividing? In our study we describe one cellular mechanism that provides some answers to these questions. We have found that to be able to divide indefinitely, cancer cells have to strongly reduce the levels of a nuclear protein called histone H1.0. This is needed to allow activation of many genes important for cancer cell proliferation, which otherwise would be somehow "hidden" within the cell nucleus. Importantly, though, while tumors grow, some cells raise back the levels of H1.0, which hides these genes again and makes the cells stop proliferating. So the end result is that within the same tumor we have a mix of cells, some which keep these important genes on, while others switch them off and, as a consequence, lose their ability to divide, and differentiate into a more mature state.
Author Interviews, Breast Cancer, Cancer Research, Education / 30.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28448" align="alignleft" width="120"]Adam Brufsky, MD, PhD, FACP Medical Director of the Women's Cancer Center University of Pittsburgh Medical Center Dr. Adam Brufsky[/caption] Adam Brufsky, MD, PhD, FACP Medical Director of the Women's Cancer Center University of Pittsburgh Medical Center MedicalResearch.com: What is the background for this study? What are the main findings?
  • The Make Your Dialogue Count survey was conducted by Harris Poll on behalf of Novartis between June 20 and August 22, 2014. A total of 359 surveys were collected among women 21 years+ living with advanced breast cancer in addition to 234 caregivers of women with advanced breast cancer and 252 licensed oncologists who treat at least five advanced breast cancer patients per month within the United States. Novartis conducted the survey with guidance from oncologists, patient advocacy experts and a psychologist to better understand the dialogue around treatment goals and decisions that takes place among advanced breast cancer patients, caregivers and oncologists.
  • Main survey findings show communication gaps exist in discussions between patients and oncologists, particularly around treatment plans and goals.
  • 89% of patients and 76% of oncologists said that it’s important or very important to discuss long-term treatment plans beyond the current recommended treatment at their initial advanced breast cancer diagnosis. Yet, 43% of patients reported that this did not take place.
  • 70% of patients and 65% of oncologists said that it’s important or very important to refer patients to support services at their initial advanced breast cancer diagnosis. Yet, only 36% of patients reported that this was something their doctor did.
  • 23% of oncologists said that at times their emotions have kept them from sharing certain information with their advanced breast cancer patients, and 27% of oncologists said that, in certain situations, they do not discuss with patients the fact that advanced breast cancer is incurable.
ASCO, Author Interviews, Cancer Research, Journal Clinical Oncology / 22.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28253" align="alignleft" width="200"]Darren R. Feldman, MD Medical Oncologist Memorial Sloan Kettering Cancer Center Dr. Darren Feldman[/caption] Darren R. Feldman, MD Medical Oncologist Memorial Sloan Kettering Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is limited knowledge as to why a minority of patients with advanced germ cell tumors are resistant to chemotherapy while the majority achieve complete responses. Patients with cisplatin-resistant disease require intensive salvage treatment and are at high risk of dying from their disease. We sought to determine whether certain genomic alterations within tumors might be associated with cisplatin-resistance in GCT. We also wanted to identify the spectrum of genomic alterations in this population which might represent novel targets for existing or new drug development in this disease.
Author Interviews, Dermatology, Journal Clinical Oncology, Melanoma / 21.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28154" align="alignleft" width="150"]Reza Ghiasvand, PhD Postdoctoral fellow, Department of Biostatistics, Faculty of Medicine, University of Oslo. Oslo, Norway Dr. Reza Ghiasvand[/caption] Reza Ghiasvand, PhD Postdoctoral fellow, Department of Biostatistics, Faculty of Medicine, University of Oslo. Oslo, Norway MedicalResearch.com: What is the background for this study? What are the main findings? Response: To date, findings from studies have been inconsistent. Some studies found a decreased risk of melanoma among sunscreen users, while others found no association or a higher risk of melanoma among sunscreen users. Several studies found that many sunscreen users do not apply sunscreens properly and do not reapply as recommended and stay longer in the sun after using sunscreen and as a result get sunburn and increase their risk of skin cancer. Our findings suggest higher UV exposure among sunscreen users compared to nonusers. However, those who used sunscreen with high SPF had 33% lower risk of melanoma compared to users of low SPF sunscreens.
AACR, Author Interviews, Cancer Research / 21.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28144" align="alignleft" width="150"]Nancy Davidson, MD President of the American Association for Cancer Research (AACR) and Director, University of Pittsburgh Cancer Institute Dr. Nancy Davidson[/caption] Nancy Davidson, MD President of the American Association for Cancer Research (AACR) and Director,  Cancer Institute University of Pittsburgh Dr. Davidson discusses the 2016 AACR Cancer Progress Report. “The report serves as an educational document for both Congress and the public, alike. The report is a call to action, designed to urge Congress and the American public to stand firm in their commitment to the conquest of cancer”. MedicalResearch.com: What is the background and goals for this report? Dr. Davidson:
  • This is the sixth edition of our annual Cancer Progress Report.
  •  The annual report is the cornerstone of the AACR’s educational and advocacy efforts:
  • The report outlines efforts to increase public and Congressional understanding of cancer and the importance of cancer research to public health and
  • Efforts to advocate for increased federal funding for the NIH, NCI, FDA, and other federal agencies that are vital for fueling progress against cancer
  • The first report was written in 2011, the year that marked the 40th anniversary of the signing of the National Cancer Act of 1971, to commemorate the advances in cancer research that had been made to date and to paint a picture of where the science was leading us.
ASCO, Author Interviews, Journal Clinical Oncology, MD Anderson, Ovarian Cancer / 14.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27715" align="alignleft" width="114"]Larissa A. Meyer, MD MPH F.A.C.O.G. Assistant Professor Dept of Gynecologic Oncology and Reproductive Medicine Houston, TX 77030-1362 Dr. Larissa Meyer[/caption] Larissa A. Meyer, MD MPH F.A.C.O.G. Assistant Professor Dept of Gynecologic Oncology and Reproductive Medicine Houston, TX 77030-1362 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite the completion of two randomized controlled trials, controversy regarding the optimal approach for the treatment of advanced ovarian cancer remains. Our observational study highlights the importance of thoughtful selection of individuals for primary cytoreductive surgery for advanced ovarian cancer. Our results suggest that primary cytoreductive surgery may improve survival for patients with stage IIIC ovarian cancer who are likely to achieve an optimal cytoreduction, while neoadjuvant chemotherapy may be the preferred option for many women with stage IV ovarian cancer.
Author Interviews, Cancer, Cancer Research, OBGYNE, Pediatrics / 14.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27794" align="alignleft" width="144"]Pooja Rao, MD, MSCE Assistant Professor Division of Pediatric Hematology/Oncology Milton S. Hershey Medical Center Penn State College of Medicine Dr. Pooja Rao[/caption] Pooja Rao, MD, MSCE Assistant Professor Division of Pediatric Hematology/Oncology Milton S. Hershey Medical Center Penn State College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although many chemotherapy drugs can cause birth defects, no standardized guidelines exist for pregnancy screening in adolescent female patients with cancer. Additionally, little is known about how often they are screened prior to receiving treatment. Our study found that adolescent girls are not adequately screened for pregnancy prior to receiving chemotherapy or CT scans that could potentially harm a developing fetus. Adolescents with acute lymphoblastic leukemia, the most common childhood cancer, had the lowest pregnancy screening rates of the patients studied.
Author Interviews, Chemotherapy, Immunotherapy, Lung Cancer / 13.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27869" align="alignleft" width="95"]Chih-Hsin Yang MD PhD Department of Oncology National Taiwan University Hospital Dr. Chih-Hsin Yang[/caption] Chih-Hsin Yang MD PhD Department of Oncology National Taiwan University Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: LUX-Lung 3 and LUX-Lung 6 are multicenter, randomized, open-label, Phase III trials of afatinib versus chemotherapy (pemetrexed / cisplatin and gemcitabine / cisplatin, respectively) as first-line treatment for patients with EGFR mutation-positive, advanced and metastatic non-small-cell lung cancer (NSCLC). Both trials met their primary endpoint of PFS with afatinib significantly delaying tumor growth when compared to standard chemotherapy. A post-hoc analysis of the studies was conducted to look at the incidence and severity of common adverse events (AEs) before and after afatinib dose reduction and the PFS was compared between patients who dose reduced within the first 6 months of treatment and those who did not. The results showed dose reductions were associated with decreases in the incidence and severity of treatment-related AEs, while median progression-free survival (PFS) was similar in patients who dose-reduced within the first six months of treatment versus those who did not (LUX-Lung 3, 11.3 vs 11 months; LUX-Lung 6, 12.3 vs 11 months).
Author Interviews, Nature, Pancreatic / 09.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27789" align="alignleft" width="200"]Armando E. del Río Hernández, PhD European Research Council Fellow Head, Cellular and Molecular Biomechanics Laboratory http://biomechanicalregulation-lab.org/ Senior Lecturer, Department of Bioengineering Imperial College London Dr. del Río Hernández[/caption] Armando E. del Río Hernández, PhD European Research Council Fellow Head, Cellular and Molecular Biomechanics Laboratory http://biomechanicalregulation-lab.org/ Senior Lecturer, Department of Bioengineering Imperial College London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pancreatic cancer is an extremely aggressive disease with an unacceptably low survival rate that has not changed during the last 40 years despite significant efforts aimed at developing therapies against cancer cells. Pancreatic cancer is characterised by an extensive desmoplasia, which forms the majority of the tissue around the tumour. This desmoplastic tissue is known to help the tumour to grow and metastasize, and hinders drug delivery. We have focused our efforts on understanding how pancreatic stellate cells (PSCs), which are the key effectors that orchestrate the desmoplastic reaction in pancreatic cancer, can promote tumour progression. PSCs in healthy pancreas have abundant vitamin A storage in their cytoplasm and exist in a quiescent state that guarantees a balanced tissue homeostasis. In pancreatic cancer, loss of this balance activates PSCs, which lose the vitamin A content and remodel the surrounding tissue to make it favourable for cancer cell invasion. We found that treating PSCs which ATRA (All trans-retinoic acid), the active metabolite of vitamin A mechanically reprograms PSCs to promote quiescence in vitro. Quiescent PSCs are unable to remodel the microenvironment to allow pancreatic cancer cell invasion. To get more information about our findings please find the article in the open access journal Nature Communications:http://www.nature.com/articles/ncomms12630
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Colon Cancer, End of Life Care, Lung Cancer / 09.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27780" align="alignleft" width="253"]Joseph A. Greer, Ph.D. Program Director, Center for Psychiatric Oncology & Behavioral Sciences Associate Director, Cancer Outcomes Research Program, Massachusetts General Hospital Cancer Center Yawkey Center, Boston, MA 02114 Dr. Joseph Greer[/caption] Joseph A. Greer, Ph.D. Program Director, Center for Psychiatric Oncology & Behavioral Sciences Associate Director, Cancer Outcomes Research Program, Massachusetts General Hospital Cancer Center Yawkey Center, Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many patients with advanced cancer have a high symptom burden, increased depression symptoms, misperceptions about their prognosis, and difficulties in making decisions about care at the end of life. To address these challenges and improve care for this vulnerable population, our research team initially conducted a small, single-group pilot study of early palliative care integrated with standard oncology care for patients with advanced lung cancer. This study showed that the model of integrated care was feasible and acceptable to patients and their families. Specifically, the majority of patients in the study were able to meet with a palliative care clinician at least monthly from the time of diagnosis of metastatic lung cancer, in order to receive help with managing symptoms as well as support for coping with the disease and making decisions about treatment. We then conducted a follow-up randomized controlled trial of early, integrated palliative care in a sample of approximately 150 patients with metastatic non-small cell lung cancer. This study was published in the New England Journal of Medicine in 2010 and showed that those patients who received early palliative care reported significantly improved quality of life, mood, prognostic awareness, and end-of-life care compared to those who received standard oncology care alone. To confirm the findings of our prior research and to determine whether the benefits of early integrated palliative care would apply to a larger sample of patients with diverse malignancies, we recently completed another randomized trial of this same model of care in a sample of 350 patients with incurable lung and gastrointestinal cancers. In this trial, we observed that patients who received the early palliative care intervention reported higher quality of life and improved mood by 24 weeks but not at the primary end-point of 12 weeks. Our team was surprised to find that the trajectory of quality of life and depression symptoms over time was different for individuals with incurable lung versus gastrointestinal cancers in this study. As expected, the palliative care intervention positively buffered the decline in quality of life by 12 weeks for patients with incurable lung cancer, as we had seen in our prior trial. However, the group of patients with gastrointestinal cancers reported an improvement in their quality of life by the 12-week time point regardless of whether they received the palliative care intervention. We are still exploring possible reasons for this difference, such as whether changes in cancer therapy may have reduced symptoms and improved quality of life in the group of patients with gastrointestinal cancer. In addition, we were pleased to learn that the early integrated palliative care intervention led to improvements in how patients cope with their illness. For example, compared to patients in the usual oncology care group, those who received early, integrated palliative care were more likely to learn ways to accept their diagnosis and to take positive actions to make their lives better. So, in addition to treating patients’ symptoms, the palliative care clinicians in this study were bolstering people’s adaptive coping skills.
Author Interviews, Cancer Research / 09.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27765" align="alignleft" width="150"]Professor David Adelson PhD Chair of Bioinformatics The University of Adelaide Dr. David Adelson[/caption] Professor David Adelson PhD Chair of Bioinformatics The University of Adelaide MedicalResearch.com: What is the background for this study? What are the main findings? Response: Chinese Medicine has been used for thousands of years to treat a number of diseases, but with few exceptions, has not been linked to specific molecular mechanisms that might explain its mode of action. This is because the Chinese Medicine formulations are often combinations of multiple plant extracts and are thus complex molecular mixtures. Fractionation of these extracts to test individual components often demonstrates low or no activity for individual components of these mixtures. We decided to use a Systems Biology approach to investigate a well characterized, injectable extract from two plants that has been commonly used in conjunction with Western chemotherapy to treat cancer patients in China. We do not fractionate the mixture, but test it “as is” in order to determine the molecular consequences of the complex mixture. We limited this study to a specific breast cancer cell line (MCF-7) in order to determine if this preparation, Compound Kushen Injection (CKI), can directly affect cancer cells. We found that CKI can kill MCF-7 cells and can also alter gene expression patterns associated with cell cycle control and cell death. The gene expression networks/pathways altered by CKI are similar to those altered by the Western chemotherapeutic drug 5-Fluorouracil (5FU), but the specific genes in those pathways with expression altered by CKI are often different to those affected by 5FU.
ASCO, Author Interviews, Cancer Research, End of Life Care / 09.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27738" align="alignleft" width="133"]Erin Kent, PhD, MS Program Director Outcomes Research Branch of the Healthcare Delivery Research Program National Cancer Institute Dr. Erin Kent[/caption] Erin Kent, PhD, MS Program Director Outcomes Research Branch of the Healthcare Delivery Research Program National Cancer Institute MedicalResearch.com: What is the background for this study? Response: Informal or family caregivers assist loved ones by providing care which is typically uncompensated, takes place typically at home, and often involves significant efforts for an extended period of time. Caregiving can require the performance of demanding tasks, which include managing symptom burden, monitoring for side effects from treatment, coordinating care, administering medication, and managing a care recipient’s financial and social obligations. In addition, there are many unique aspects of cancer that can place unique demands on caregivers, including sometimes a rapid deterioration of health, the receipt of multi-modal therapy (eg. surgery, chemotherapy, and radiation), and the possibility of cancer recurrence.
Author Interviews, Breast Cancer, JAMA / 08.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27762" align="alignleft" width="200"]Conny Vrieling, M.D., Ph.D. Radiation Oncologist Clinique des Grangettes Geneva Dr. Conny Vrieling[/caption] Conny Vrieling, M.D., Ph.D. Radiation Oncologist Clinique des Grangettes Geneva MedicalResearch.com: What is the background for this study? Response: In the early ’90s, the EORTC (European Organisation for Research and Treatment of Cancer) ran the “boost no-boost” trial, randomizing 5569 early-stage breast cancer patients, treated with breast-conserving surgery and whole-breast irradiation, between no boost and a 16-Gy boost. A third of the patients were included in a central pathology review. The 10-year follow-up results of this subpopulation showed that young age and high-grade invasive carcinoma were the most important risk factors for ipsilateral breast tumor recurrence (IBTR). In this study, we re-analyzed with long-term follow-up the pathological prognostic factors related to IBTR, with a special focus on the evolution of these effects over time.
Author Interviews, Cancer Research, Heart Disease, Pediatrics / 06.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27606" align="alignleft" width="133"]Steven E. Lipshultz, MD, FAAP, FAHA Schotanus Family Endowed Chair of Pediatrics / Carman and Ann Adams Endowed Chair in Pediatric Research / Professor, Carman and Ann Adams Department of Pediatrics / Professor of Medicine (Cardiology), Oncology, Obstetrics/Gynecology, Molecular Biology/Genetics, Family Medicine/Public Health Sciences, & Pharmacology / Member, Center for Urban Responses to Environmental Stressors, Wayne State University School of Medicine / Professor in the Center for Molecular Medicine and Genetics, Wayne State University School of Medicine President, University Pediatricians & Interim Director, Children’s Research Center of Michigan Pediatrician-in-Chief, Children’s Hospital of Michigan / Specialist-in-Chief, Pediatrics, Detroit Medical Center Scientific Member, Karmanos Cancer Institute, an NCI-designated Comprehensive Cancer Center Dr. Steven Lipshultz[/caption] Steven E. Lipshultz, MD, FAAP, FAHA Schotanus Family Endowed Chair of Pediatrics / Carman and Ann Adams Endowed Chair in Pediatric Research / Professor, Carman and Ann Adams Department of Pediatrics / Professor of Medicine (Cardiology), Oncology, Obstetrics/Gynecology, Molecular Biology/Genetics, Family Medicine/Public Health Sciences, & Pharmacology /Professor in the Center for Molecular Medicine and Genetics Wayne State University School of Medicine President, University Pediatricians & Interim Director, Children’s Research Center of Michigan Pediatrician-in-Chief, Children’s Hospital of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Surviving childhood cancer has dramatically and increasing improved to the point where more than 80% will achieve a 5-year event free survival. Many of these survivors look forward to decades of active productive life. More than half of these survivors have been treated with therapies know to be associated with late cardiotoxicity that can be pervasive, persistent, and progressive and associated with cardiovascular morbidity and mortality. In this article we review both the course and prevention of this cardiotoxicity. We focus in part on anthracycline chemotherapy that is widely used and known to be cardiotoxicity. We further review studies we and others have conducted to examine the effectiveness of dexrazoxane, an iron chelator, that when given before each anthracycline dose results in anthracycline cardioprotection for long term survivors. In some reported studies this has allowed for higher cumulative anthracycline doses to be safely given. In other cases this has allowed for simultaneously being able to safely treat children with malignancies that would be refractory to conventional therapy more potent therapies that would normally have additive cardiotoxicity.
AACR, Author Interviews, Cancer Research, Prostate Cancer / 04.09.2016

MedicalResearch.com Interview with:  

Ilaria Stura PhD

Università degli Studi di Torino Turin, Piedmont, Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Man has always tried to predict the future, especially to prevent catastrophes, diseases and death. In this case, we want to prevent the ‘personal catastrophe’, i.e. the spread of the disease (recurrence of prostate cancer) in the patient. Our work therefore belongs to the so-called ‘personalized medicine’, a very important and innovative clinical approach.

In particular this study may potentially improve the quality of life of the patients and help the clinicians, since it could give valuable information to the urologist, for example reporting that the growth velocity of the tumor is increasing and that a relapse is expected within few months. With this information, the clinician could chose the best therapy for the patient (e.g. hormone or radio therapy) in order to stop the spread of the disease or, conversely, the use of drugs can be delayed if not necessary. Obviously clinicians already try to do this, based on their experience, but our method provides further confidence in their 'investigation' work, since the algorithm is validated on data coming from a database much larger than his/her personal experience.