Author Interviews, Breast Cancer, Brigham & Women's - Harvard, NEJM / 22.04.2021
Triple Negative Breast Cancer: TRODELVY® (sacituzumab govitecan) Trial Demonstrates Significant Improvement Compared to Standard Chemo
MedicalResearch.com Interview with:
Aditya Bardia MD, MPH
Director, Breast Cancer Research Program,
Attending Physician, Massachusetts General Hospital
Harvard Medical School
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Dr. Bardia[/caption]
MedicalResearch.com: What is the background for this study?
Response: Triple negative breast cancer (TNBC) represents an aggressive subtype of breast cancer associated with guarded prognosis. For patients with pre-treated metastatic TNBC, standard chemotherapy is associated with low response rate (5-10%) and poor progression-free survival (2-3 months), highlighting need for better therapies.
Sacituzumab govitecan is an antibody drug conjugate (ADC) which combines SN-38, an active metabolite of irinotecan, with an antibody against Trop-2, an antigen overexpressed in majority of triple negative breast cancer.
Dr. Bardia[/caption]
MedicalResearch.com: What is the background for this study?
Response: Triple negative breast cancer (TNBC) represents an aggressive subtype of breast cancer associated with guarded prognosis. For patients with pre-treated metastatic TNBC, standard chemotherapy is associated with low response rate (5-10%) and poor progression-free survival (2-3 months), highlighting need for better therapies.
Sacituzumab govitecan is an antibody drug conjugate (ADC) which combines SN-38, an active metabolite of irinotecan, with an antibody against Trop-2, an antigen overexpressed in majority of triple negative breast cancer.
Dr. Kruger[/caption]
Daniel J. Kruger Ph.D.
Research Investigator, Population Studies Center
University of Michigan
MedicalResearch.com: What is the background for this study?
Response: Thorstein Veblen coined the terms “conspicuous consumption” and “conspicuous leisure” to describe the wasteful habits of the upper classes in amassing and displaying expensive goods that did not have inherent practical benefits and devoting time to pursuits such as sports and fine arts. The purpose of these socially conspicuous displays and behaviors was to advertise one’s membership in the upper, leisure class, as only the very wealthy could afford them. Veblen was inspired in part by Charles Darwin’s theory of biological evolution. Darwin himself was greatly puzzled by what he considered wasteful investments of energy in elaborate physiological displays. He saw these features as the greatest threat to his theory of natural selection. Why would something like the peacock’s tail feathers evolve, as they actually threatened survival because of their impediment to foraging and avoiding predators? Darwin was so troubled by this dilemma that the sight of a peacock’s tail feather would make him feel sick. Darwin later realized that these features provided a reproductive advantage, leading to his theory of sexual selection, including the processes of inter-sexual selection and intra-sexual competition. 
Dr. Bullard[/caption]
Jared Bullard MD FRCPC
Associate Professor, Departments of Pediatrics & Child Health and Medical Microbiology & Infectious Diseases
Max Rady College of Medicine
Rady Faculty of Health Sciences
Cadham Provincial Laboratory
Children’s Hospital Research Institute of Manitoba
MedicalResearch.com: What is the background for this study?
Response: Children are well known to transmit epidemic/endemic respiratory viruses like influenza. Initial public health policy was based on that children were likely to transmit SARS-CoV-2 effectively within a community and subsequently in-person school and extracurricular activities were suspended.
Initial research did not show a clear association with children driving transmission. The purpose of our study was to take respiratory samples from both children and adults with COVID-19 (all had SARS-CoV-2 detected by RT-PCR) and compare those samples by their ability to grow in cell culture and amount of virus in samples.
We took 175 samples from children (97 younger than 10 years of age and 78 between 11-17 years) and compared them to 130 adult samples from the same communities in Manitoba experiencing outbreaks of COVID-19. 
Prof. Koehler[/caption]
Prof. Dr. Karsten Koehler
Department of Sport and Health Sciences
Technical University of Munich
MedicalResearch.com: What is the background for this study?
Response: The primary background is the phenomenon that most people fail to loose (meaningful) weight through exercise alone, which is related to what we call compensatory eating – an increase in food intake to compensate for the increased energy expenditure of exercise. This is been described in a number of studies and is considered a key weight loss barrier – yet few have come up with solutions to overcome this problem. Therefore, we wanted to see if the timing of food choices has an impact on how much and what we want to eat in the context of exercise.
Sarah Windle[/caption]
Sarah Windle, MPH
PhD Student in Epidemiology
Department of Epidemiology, Biostatistics, and Occupational Health
McGill University (Montréal, Québec, Canada)
MedicalResearch.com: What is the background for this study?
Response: Concerns have been raised about the potential for increases in impaired driving following the legalization of recreational cannabis use in Canada in October 2018. Data from Statistics Canada suggest that cannabis use in the previous three months increased among adults (15 and older) from 14% before legalization in 2018 to 17% in 2019. Among those users with a driver’s license, 13% reported driving within two hours of cannabis use. While this proportion remained the same before and after legalization, this indicates that the absolute number of individuals who reported driving within two hours of use has increased following legalization (due to an increase in the number of users).
Prof. Mainous[/caption]
Arch G. Mainous III, PhD
Professor
Department of Health Services Research, Management and Policy
Professor and Vice Chair for Research
Department of Community Health and Family Medicine
University of Florida
MedicalResearch.com: What is the background for this study?
Response: We are always concerned about infections from antibiotic resistant bacteria. When the bacteria are resistant to our current treatments this lengthens the time and severity of the illness. Staphylococcus aureus is a major cause of community and healthcare associated infections. These range from skin infections to invasive infections and even death. Methicillin-resistant S. aureus (MRSA) is of particular concern and is a burden on the health care system. Importantly, patients colonized, not infected, with MRSA are more likely to develop MRSA infections and patients with MRSA infections have increased risk of hospital length of stay and even death.
We are always concerned about infections from antibiotic resistant bacteria. When the bacteria are resistant to our current treatments this lengthens the time and severity of the illness. Staphylococcus aureus is a major cause of community and healthcare associated infections. These range from skin infections to invasive infections and even death. Methicillin-resistant S. aureus (MRSA) is of particular concern and is a burden on the health care system. Importantly, patients colonized, not infected, with MRSA are more likely to develop MRSA infections and patients with MRSA infections have increased risk of hospital length of stay and even death.
Dr. Rettew[/caption]
David C. Rettew, MD
Child & Adolescent Psychiatrist
Associate Professor of Psychiatry and Pediatrics
University of Vermont Larner College of Medicine
MedicalResearch.com: What is the background for this study?
Response: Our group, the Wellness Environment Scientific Team at the University of Vermont, hadn’t planned to look at COVID at the outset of this study and instead were going to look at mental health and engagement in wellness activities in college students across a semester. The pandemic disrupted that plan when students were abruptly sent home but fortunately, they continued to do their daily app-based ratings of their mood, stress levels, and engagement in healthy activities. We then realized we had some interesting pre-COVID to COVID data that was worth exploring. 
Prof.Auger[/caption]
Nathalie Auger
Professeure agrégée de clinique
École de santé publique - Département de médecine sociale et preventive
University of Montreal
MedicalResearch.com: What is the background for this study?
Response: COVID-19, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been a major public health concern. The number of infected pregnant women continues to increase. Pregnant women and infants are particularly susceptible to COVID-19 because the physiologic changes of pregnancy involve cardiovascular, respiratory, and immune changes that may alter the response to SARS-CoV-2 infection. Fetuses may be exposed to SARS-CoV-2 during critical periods of development. The nature of the association between COVID-19 and pregnancy outcomes remains unclear and meta-analyses of pregnant women with COVID-19 are lacking.
Benjamin E. Gewurz MD, PhD
Broad Institute of MIT and Harvard, Cambridge,
Division of Infectious Disease, Department of Medicine, Brigham and Women’s Hospital,
Department of Microbiology, Harvard Medical School
Boston, MA
MedicalResearch.com: What is the background for this study?
Response: When the Covid-19 virus infects cells, it takes over and redirects our cells resources towards the projection of virus building blocks and new viruses. Building blocks include large amounts of RNAs that encode for the viral proteins, much as the mRNA vaccines direct our bodies to make the spike protein. We wondered how the virus changes cell metabolism in order to support the synthesis of vast amounts of viral RNAs within hours of infection.
Dr. Saha[/caption]
Abhishek Saha, PhD
Assistant Professor
Department of Mechanical and Aerospace Engineering
University of California San Diego
MedicalResearch.com: What is the background for this study?
Response: At a very early stage of COVID 19 pandemic, the scientific community identified that respiratory droplet is the primary mode of transmission of the SARS-CoV2 virus. Naturally, the health agencies have encouraged facemasks to restrict these droplets from spreading during respiratory events, like coughing, sneezing, talking, etc. While WHO recommended using either N95 masks or other types of three-layer masks, due to a sharp increase in demand and scarcity in supplies, a variety of either home-made or locally purchased masks became popular. Naturally, one wonders if these single- and double-layer masks provide enough protection. To provide some insight into this critical question, our team, which also includes Professor Swetaprovo Chaudhuri from the University of Toronto, and Professor Saptarshi Basu of the Indian Institute of Science, experimentally analyzed what happens to the respiratory droplets when they impact single- and multi-layer masks. 
Dr. Jacob[/caption]
Jesse T. Jacob, MD
School of Medicine
Director, Antibiotic Stewardship Program
Emory University, Atlanta, Georgia
MedicalResearch.com: What is the background for this study?
Response: Since coronavirus disease 2019 (COVID-19) was recognized in the United States in January 2020, the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) attributed to exposures in the health care workplace has been studied with conflicting results, and the role of job functions (such as nurse) or specific workplace activities, including care for individuals with known and unknown SARS-CoV-2 positivity, increase the risk of SARS-CoV-2 infection.
We assessed more than 24,000 healthcare providers between April and August 2020 across four large academic medical systems (Emory, Johns Hopkins, Rush University Medical Center, and University of Maryland) which collaborate in the CDC’s Prevention Epicenter Program and conduct innovative infection prevention research. Each site conducted voluntary COVID-19 antibody testing on its health care workers, as well as offered a questionnaire/survey on the employees’ occupational activities and possible exposures to individuals with COVID-19 infection both inside and outside the workplace. We also looked at three-digit residential zip-code prefixes to determine COVID-19 prevalence in communities. 
Anne Yuk-Lam Ho, MPH
Million Veteran Program (MVP) Data Core
MVP Coordinating Center
VA Boston Healthcare System
MedicalResearch.com: What is the background for this study?
Response: Cardiovascular disease (CVD) has been the leading cause of morbidity and mortality globally. Prevalence of CVD among US population is approximately 7% which places huge burden on our healthcare systems. And prevalence of CVD is as high as 28% among veterans at the VA healthcare system as veteran users are primarily older male with more histories of comorbidities. Most CVD risk factors including lipids and blood pressure can be controlled by lifestyle modifications, such as diet.
Chocolate is among dietary factors that play a role in modulating CVD risk factors is widely consumed in the US (~2.8 billion pounds annually. Although previous studies have reported beneficial effects of chocolate and/or cacao products (rich in flavonoids) on lipids, glucose metabolism and risk of diabetes, and lipids, little is known about the association of chocolate intake with coronary artery disease (CAD) among US veterans. Thus, sought to test the hypothesis that chocolate consumption is associated with a lower risk of CAD among xxx US veterans enrolled in the Million Veteran Program.
Dr. Lee[/caption]
Brian P. Lee, MD, MAS
Assistant Professor Clinical Medicine
University of Southern Californi
Keck School of Medicine
Los Angeles, California
MedicalResearch.com: What is the background for this study?
Response: The COVID-19 pandemic has been associated with mental health stressors, including anxiety, loneliness, and social instability. We hypothesized the pandemic may have led to increased alcohol and tobacco use as a coping mechanism for these stressors. National retrospective questionnaires had suggested higher reports of substance use, but these are limited by selection and recall biases, in addition to subjective report – we sought to address this knowledge gap by using a nationally-representative longitudinal cohort (Nielsen National Consumer Panel) tracking real-time purchases of households across the US. 
