Author Interviews, JAMA, Lung Cancer, Pulmonary Disease / 15.04.2014

Renda Soylemez Wiener, MD, MPH Assistant Professor of Medicine The Pulmonary Center Boston University School of Medicine Center for Healthcare Organization & Implementation Research Edith Nourse Rogers Memorial VA HospitalMedicalResearch.com Interview with: Renda Soylemez Wiener, MD, MPH Assistant Professor of Medicine The Pulmonary Center Boston University School of Medicine Center for Healthcare Organization & Implementation Research Edith Nourse Rogers Memorial VA Hospital MedicalResearch.com: What are the main findings of the study? Dr. Soylemez Wiener: The main finding is that evaluation of pulmonary nodules to determine whether or not they are cancerous is inconsistent with clinical practice guideline recommendations in almost half of cases, suggesting there is room for improvement in clinical care of these patients. Patients with pulmonary nodules are sometimes evaluated more aggressively than they should be (18%), which can cause harms to patients from unnecessary invasive tests (biopsies or surgery) or unneeded radiation exposure from imaging studies. Still more patients (27%) are followed less aggressively than they should be, which in the worst case scenario could lead to delays in the diagnosis and treatment of cancer. It is particularly important to improve care of these patients now, because new guidelines from the US Preventive Services Task Force recommend CT screening for lung cancer screening, which often finds pulmonary nodules that require evaluation. (more…)
Chemotherapy, Lung Cancer / 06.04.2014

Dr. Heather Wakalee MD Associate Professor of Medicine (Oncology) Stanford University Medical CenterMedicalResearch.com Interview with: Dr. Heather Wakalee MD Associate Professor of Medicine (Oncology) Stanford University Medical Center   MedicalResearch.com: What are the main findings of the study? Dr. Wakalee: CO-1686, with the new hydrobromide formulation, has been active at multiple dose levels (500, 750 or 1000 mg orally twice daily). The response rate in patients with EGFR mutant (non-small-cell Lung Cancer) NSCLC that has progressed after therapy with EGFR TKI, and has centrally confirmed T790M, is 64% per RECIST.  The majority of responses are ongoing at the time of this report.  The drug has been overall very well tolerated. (more…)
Author Interviews, Case Western, Chemotherapy, Genetic Research, Lung Cancer, UT Southwestern / 22.03.2014

Dr. Azi Gazdar, MD UT Southwestern Medical Center W. Ray Wallace Distinguished Chair in Molecular Oncology Research Hamon Center for Therapeutic Oncology, PathologyMedicalResearch.com Interview with: Dr. Azi  Gazdar, MD UT Southwestern Medical Center W. Ray Wallace Distinguished Chair in Molecular Oncology Research Hamon Center for Therapeutic Oncology, Pathology MedicalResearch.com: What are the main findings of the study? Dr. Gazdar: We describe the characteristics of lung cancers arising in subjects who inherited a germline mutation that predisposes to lung cancer.  The mutation is rare in the general populations, and is inherited equally by both sexes.  However it is a potent predisposing gene, and one third of the never smoking carriers will develop lung cancer.  Thus, about 1% of patients who develop lung cancer carry the germline mutation.  This figure may rise as awareness of the condition and its link to lung cancer is raised among doctors diagnosing lung cancer. However, lung cancers mainly develop in women who are lifetime never smokers.  Lung cancer development is much less common among smokers and men, although accurate figures are not yet available. So the risk among carriers is somewhat similar to the BRCA genes predisposing to breast cancer, where a female carrier has about a 50% lifetime chance of developing breast cancer. The specific germline mutation (known as T790M) occurs in a gene known as epidermal growth factor receptor (EGFR) gene.  Sporadic mutations in this gene usually predict for effective responses to a class of drugs known as tyrosine kinase inhibitors (TKIs), which are widely used in the treatment of lung cancer.  However, the T790M mutation, when it occurs in sporadic tumors not associated with germline inheritance are resistant to TKI therapy.  Thus the prediction is that lung cancers arising in carriers with the germline mutation would also be resistant to TKI therapy. (more…)
Author Interviews, CHEST, Pulmonary Disease, Smoking / 23.02.2014

Chunxue Bai, MD & PhD Director, Shanghai Respiratory Research Institute Professor of Medicine, Chairman, Shanghai Leading academic discipline Chair, Chinese Alliance against Lung Cancer Vice President of Respiratory Society, Chinese Medical Association Editor-in-Chief, Translational Respiratory Medicine (Springer) Editor-in-Chief, International journal of Respiration (China) Editor-in-Chief, Perspectives of Respiratory Medicine (China)MedicalResearch.com Interview with: Chunxue Bai, MD & PhD Director, Shanghai Respiratory Research Institute Professor of Medicine, Chairman, Shanghai Leading academic discipline Chair, Chinese Alliance against Lung Cancer MedicalResearch.com: What are the main findings of the study? Dr. Bai: Recently, we found a dilemma phenomenon that the incidence of chronic obstructive pulmonary disease (COPD) and lung cancer has remained high in southwest China despite the 1976 National Stove Improvement Program for indoor air quality. However, little information is known to the public about a regional endemic related to Chinese waterpipe smoking, which is different from the Arabic waterpipe. The Chinese waterpipe has been traditionally misconceived as less harmful for three reasons:
  • (1) no charcoal was used in contrast to the Arabic waterpipe,
  • (2) tobacco smoke passed through the water as opposed to cigarette smoking and
  • (3) smoking through a large volume waterpipe could “improve lung function.”
In our study, we provide robust results that the large volume Chinese waterpipe use and exposure are associated with the elevated prevalence of COPD, which have been identified by epidemiologic, physiologic, radiology, and toxicologic findings for the first time. (more…)
Allergies, Author Interviews, Lung Cancer / 09.02.2014

Mariam El-Zein, PhD. Associée de recherche/ Research associate Unité d'épidémiologie et biostatistique / Epidemiology & Biostatistics Unit INRS-Institut Armand-Frappier Université du QuébecMedicalResearch.com Interview with: Mariam El-Zein, PhD. Associée de recherche/ Research associate Unité d'épidémiologie et biostatistique / Epidemiology & Biostatistics Unit INRS-Institut Armand-Frappier Université du Québec MedicalResearch.com: What are the main findings of the study? Answer: The overall indication is that a prior history of allergic diseases (asthma, eczema or hay fever) might decrease lung cancer risk. There was a 36% (odds ratio= 0.64, 95% confidence intervals: 0.44-0.93) reduction in lung cancer risk among subjects who reported a history of asthma. Hay fever was associated with a 67% (odds ratio= 0.33, 95% confidence intervals: 0.19-0.59) reduction in lung cancer risk. Smoking was accounted for using a comprehensive smoking index that takes into account multiple dimensions of smoking behaviour (i.e., smoking status, intensity, duration, and time since cessation). A lower risk of lung cancer (reduction by 37%; odds ratio= 0.63, 95% confidence intervals: 0.38-1.07) was found among those having had eczema, but was not statistically significant. (more…)
Annals Internal Medicine, Author Interviews, CT Scanning, Lung Cancer / 31.12.2013

dr_harry_j_dekonigMedicalResearch.com Interview with: Harry J de Koning, MD PhD Professor of Public Health & Screening Evaluation Rotterdam, The Netherlands. MedicalResearch.com: What are the main findings of the study? Dr. de Koning: Annual CT screening for lung cancer has a favorable benefit-to-harm ratio for individuals ages 55 through 80 years with 30 or more pack-years’ exposure to smoking. It would lead to 50% (model ranges, 45% to 54) of cases of cancer being detected at an early stage (stage I/II), 575 screenings examinations per lung cancer death averted, a 14% (range, 8.2% to 23.5%) reduction in lung cancer mortality, 497 lung cancer deaths averted, and 5250 life-years gained per the 100 000-member (1950-) cohort. Harms would include 67 550 false-positive test results, 910 biopsies or surgeries for benign lesions, and 190 overdiagnosed cases of cancer (3.7% of all cases of lung cancer [model ranges, 1.4% to 8.3%]), again for a 100 000-member (1950-) cohort. (more…)
Author Interviews, Lung Cancer / 30.09.2013

MedicalResearch.com: Interview with: Dr. Atul Butte, MD, PhDDr.  Atul Butte, MD, PhD and Julien Sage Ph. DJulien Sage PhD Departments of Pediatrics and Genetics Department of Internal Medicine, University of California Davis Cancer Center University of California Davis School of Medicine Sacramento, California MedicalResearch.com: What are the main findings of the study? Answer: A major finding of the study is the identification of first-generation anti-depressants as possible drugs effective against a lethal subtype of lung cancer, small cell lung cancer. A second important aspect of this work is the use of a bioinformatics-based drug repositioning pipeline developed by the Butte lab, which allowed us, when combined with advanced mouse models of lung cancer developed by the Sage lab, to identify a novel targeted therapy against SCLC and initiate a clinical trial in less than 2 years. (more…)
Author Interviews, General Medicine, Lung Cancer / 19.09.2013

MedicalResearch.com Interview with: Jie He, PhD, MD Director, Laboratory of Thoracic Surgery President, Cancer Institute & Hospital, Chinese Academy of Medical Sciences Chaoyang District, Beijing, 100021 MedicalResearch.com: What are the main findings of the study? Dr. Jie He:  The main findings of the study is that we have identified IDH1 as an effective plasma biomarker for the diagnosis of NSCLCs, particularly with high sensitivity and specificity in the diagnosis of lung adenocarcinoma. (more…)
Author Interviews, Lung Cancer, University of Pennsylvania / 20.08.2013

Sandra Ryeom, PhD, Assistant professor of Cancer Biology, Perelman School of Medicine, University of Pennsylvania MedicalResearch.com Interview with: Sandra Ryeom, PhD, Assistant professor of Cancer Biology, Perelman School of Medicine, University of Pennsylvania MedicalResearch.com: What are the main findings of the study? Answer: We identified an important pathway (calcineurin-NFAT-Angiopoeitin2) in the vasculature of early metastatic lung lesions that is critical for promoting lung metastases. MedicalResearch.com: Were any of the findings unexpected? Answer: Since there is limited understanding of regulation of tumor angiogenesis at metastatic sites, identification of the calcineurin pathway and a newly identified target of calcineurin-NFAT signaling  was all unexpected. (more…)
Author Interviews, Cancer Research, Lung Cancer, Radiology, Smoking / 31.07.2013

MedicalResearch.com Interview with: Linda L. Humphrey, M.D., M.P.H. Professor of Medicine Informatics and Clinical Epidemiology and Public Health for Oregon Health & Science University;Associate Chief of Medicine at the Portland VA Medical Center Dr. Humphrey comments on this important study on Screening for Lung Cancer With Low-Dose Computed Tomography: Lung cancer is the 3rd leading cause of cancer in the United States and the leading cause of cancer related death.  It is estimated that in 2012 there were 226,160 cases of lung cancer and 160, 340 lung cancer related death in the US.   In addition, lung cancer is the leading cause of years of life lost to cancer.   Cigarette smoking is by far the leading cause of lung cancer in the US and while many people have quit smoking, data in the US indicate that 37% of adults are either current or former smokers and at risk of lung cancer.    (more…)
Author Interviews, Environmental Risks, Lancet, Lung Cancer / 30.07.2013

Ole Raaschou-Nielsen, MSc, PhD Head of Research Group for Work, Environment & Cancer Danish Cancer Society Research Center Strandboulevarden 49 2100 Copenhagen ØMedicalResearch.com Interview with: Ole Raaschou-Nielsen, MSc, PhD Head of Research Group for Work, Environment & Cancer Danish Cancer Society Research Center Strandboulevarden 49 2100 Copenhagen Ø MedicalResearch.com: What are the main findings of the study? Answer: The study shows that people who live at locations with higher levels of particles in the air are at higher risk for development of lung cancer. It seems that there is no threshold for air pollution with particles below which there is no risk; the results show that it is more like “the more air pollution the worse and the less pollution the better”. The strongest association was seen for adenocarcinoma of the lung. (more…)
Author Interviews, Cancer Research, CT Scanning, Heart Disease, JACC, Lung Cancer, Medical Imaging / 08.07.2013

Dr. Pim A. de Jong, Department of Radiology University Medical Center Utrecht, Heidelberglaan 100, E.01.132, 3508GA Utrecht, the Netherlands. MedicalResearch.com: What are the main findings of the study? Dr. de Jong: The main findings of the study is that lung cancer screening CT scans can predict future cardiovascular events. MedicalResearch.com: Where any of the findings unexpected? Dr. de Jong: The unexpected aspect is that the CT scans were not-ECG gated, but even these non-gated scans were good enough to quantify arterial calcifications and predict risk. (more…)
Author Interviews, Cancer Research, Genetic Research, Lung Cancer / 26.05.2013

MedicalResearch.com Authors’ Interview: Sophie Rousseaux and Saadi Khochbin INSERM, U823; Université Joseph Fourier, Grenoble 1; Institut Albert Bonniot, Grenoble F-38700, France. MedicalResearch.com: What are the main findings of the study? Answer: We first discovered that all cancer cells lose the ability to maintain gene silencing and therefore activate genes that should normally remain silent. Although present in all cells, some genes are normally expressed (or “active”) only in one cell type. For example, normal lung cells do not express genes that are only active in germ cells (i. e., cells that will become spermatozoa), but lung cancerous cells activate some of these germ cells-specific genes. In this work we designed a specific approach to detect these aberrant gene expressions and found that they occur in all cancers of all origins. We then decided to exploit this phenomenon to help the detection of cancers and predict their evolution. For this purpose, we chose to focus on lung cancer to establish “a proof of principle”. We found that, among all the genes wrongly expressed in the tumour cells, the activation of 26 of them enabled us to identify the most aggressive lung cancers. Compared with the existing information currently available for doctors (i.e.; tumour size, its pathological subtype…), our approach brings much more precision in predicting the evolution of the tumours and the prognosis of the patients. (more…)
Author Interviews, Cancer Research, JNCI, Lung Cancer, NEJM / 08.03.2013

Dr. Martin C. Tammemägi Professor (Epidemiology) Brock University Department of Community Health Sciences Walker Complex – Academic South, Room 306 St. Catharines, Ontario, Canada L2S 3A1Medical Research.com Author Interview: Dr. Martin C. Tammemägi Professor (Epidemiology) Brock University Department of Community Health Sciences St. Catharines, Ontario, Canada L2S 3A1 Medical Research.com What are the main findings of the study?  Dr. Tammemägi: Our study accomplished three things: 1. We presented an updated Lung Cancer Risk Prediction Model, which compared to our previously JNCI-published model, incorporates more predictors but is simpler to use because we changed the way we modeled nonlinear effects. 2. We demonstrated that using the Lung Cancer Risk Prediction Model to select individuals for lung cancer screening was much more effective than using the National Lung Screening Trial (NLST) enrolment criteria.  41.3% fewer lung cancers were missed.  Sensitivity and positive predictive value of identifying individuals who develop lung cancer were significantly improved.  Shortly after our NEJM paper was published, Ma et al published in CANCER their findings that 8.6 million Americans are NLST-criteria positive and if they were CT screened under ideal conditions 12,000 lung cancer deaths would be averted.  Our NEJM article findings indicate that an additional 2,764 lives would be saved if the selection criteria had enrolled 8.6 million individuals for screening based on highest risk by our Lung Cancer Risk Prediction Model. 3. Importantly, using NLST data we demonstrated that the beneficial effect of CT screening did not vary by model predicted lung cancer risk. (more…)