MRI-Guided Prostate Biopsy Improves Precision Diagnosis of Cancer

MedicalResearch.com Interview with:

Veeru Kasivisvanathan MBBS BSc MRCS MSc PGCert Lead for CPD, Division of Surgery and Interventional Science, UCL Academic Section Committee, British Association of Urological Surgeons Twitter: @veerukasi PRECISION Study Coordinator https://clinicaltrials.gov/ct2/show/NCT02380027  

Dr. Kasivisvanathan

Veeru Kasivisvanathan MBBS BSc MRCS MSc PGCert
Lead for CPD, Division of Surgery and Interventional Science, UCL
Academic Section Committee, British Association of Urological Surgeons
Twitter: @veerukasi
PRECISION Study Coordinator
https://clinicaltrials.gov/ct2/show/NCT02380027  

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

  • We knew that there were limitations in the standard of care pathway for the diagnosis of prostate cancer, TRUS biopsy which missed harmful cancers and over diagnosed harmless cancers.
  • Emerging reports in the literature showed that using an alternative diagnostic pathway, MRI and MRI-targeted biopsy, showed promising prostate cancer detection rates
  • In 2012 we set out in an international working group to design a study that could change clinical practice and replace the standard of care with a pathway involving MRI 

Continue reading

Personalized Medicine Tool Helps Direct Cardiac Care in Elderly Patients

MedicalResearch.com Interview with:

Joseph A. Ladapo, MD, PhD Principal Substudy Investigator, PRESET Registry Subgroup Analysis, Elderly Patients Associate Professor, Division of General Internal Medicine and Health Services Research David Geffen School of Medicine University of California, Los Angeles

Dr. Ladapo

Joseph A. Ladapo, MD, PhD
Principal Substudy Investigator, PRESET Registry
Subgroup Analysis, Elderly Patients
Associate Professor, Division of General Internal Medicine and Health Services Research
David Geffen School of Medicine
University of California, Los Angeles

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

Response: The mapping of the Human Genome 14 years ago ushered in a new era of precision medicine. Many people are familiar with advances in oncology using precision medicine, but recently, new developments in precision medicine in cardiology have allowed us to develop a tool to differentiate patients likely to have obstructive coronary artery (CAD) from those who have non-cardiac causes of their symptoms.

Diagnosing CAD in the elderly is challenging. Aging individuals often present with atypical symptoms of CAD which can complicate the evaluation process. The typical diagnostic pathway for possible CAD often starts with less invasive testing and progresses to invasive testing, especially in older patients. Invasive procedures pose greater risk in the elderly population than they do in younger patients because of the higher risk of side effects, including bleeding, vascular complications and kidney injury.

Elderly adults evaluated for CAD have a higher pretest probability of CAD and are also at higher risk of experiencing procedure-related complications during their evaluation.[i],[ii] It is also important to note that elderly patients are often underrepresented in clinical trials and other types of comparative effectiveness research.[iii],[iv] For example, the 2013 American College of Cardiology/American Heart Association Atherosclerotic Cardiovascular Disease Risk Algorithm is only formally approved to be used in individuals up to the age of 75, despite the fact that individuals exceeding this threshold in age experience higher rates of adverse cardiovascular events.[v]

All of this means that the elderly population may have the most to gain from timely and accurate determination of their currently likelihood of obstructive CAD.
This precision medicine tool, the age, sex and gene expression score (ASGES), and its clinical utility in the elderly population is the focus of this study. It was based on patient data from the PRESET Registry, a prospective, multicenter, observational study enrolling stable, symptomatic outpatients from 21 U.S. primary care practices from August 2012 to August 2014.

Continue reading

Molecular Imaging as a Clinical Tool for Precision Oncology

MedicalResearch.com Interview with

David A Mankoff, MD, PhD

Dr. David Mankoff

David A Mankoff, MD, PhD
Gerd Muehllehner Professor of Radiology
Attending Physician
University of Pennsylvania Health System
PET Center Director
Vice-Chair of Research, Department of Radiology
University of Pennsylvania

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

Response: This review was designed to describe the current status of molecular imaging, especially positron emission tomography (PET) as a clinical tool for helping to direct precision oncology.

We found that while there had been a number of promising methods tested in small, single research studies, the number of new molecular imaging tests translated to the clinic was small. In addition, the application of molecular methods as tools for therapeutic decision making (versus use for disease detections and staging) was even smaller. We noted that some recently published studies, including a few large multi-center trials, indicated the considerable potential of new molecular imaging tests to identify therapeutic targets for cancer treatment, to evaluate early response to targeted cancer therapy, and to predict downstream outcomes such as progression free survival. We made some observations and recommendations in the review for directing these potentially powerful imaging tools towards use as biomarkers for precision oncology.

Continue reading

Supermagnetized Crystals May Deliver Precision Drugs Directly To Medical Targets

MedicalResearch.com Interview with:
Dr. Kezheng Chen

Lab of Functional and Biomedical Nanomaterials
College of Materials Science and Engineering
Qingdao University of Science and Technology
Qingdao China

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

Response: From a view point of practical applications, superparamagnetism is usually highly desirable, because it can prevent the magnetic particles from irreversible aggregation and ensure an excellent dispersity once the applied magnetic field is removed.

Up to now, the largest size of reported superparamagnetic clusters is around several hundreds of nanometers, which are composed of numerous nanocrystals, and hence exhibiting polycrystalline nature. In this sense, how to realize well pronounced superparamagnetism in large-size single crystals is of great interest to the general public.

Continue reading

Virtual Tumor Model Allows Precision Treatment of Glioblastomas

Dr. Chirag Patil, MD American Board Certified Neurosurgeon, Brain & Spine Tumor Program Lead Investigator, Precision Medicine Initiative Against Brain Cancer Program Director, Neurosurgical Residence training program Director, Center for Neurosurgical Outcomes Research – Cedars-Sinai Medical Center, Los Angeles, California

Dr. Chirag Patil

MedicalResearch.com Interview with:
Dr. Chirag Patil, MD

American Board Certified Neurosurgeon
Brain & Spine Tumor Program
Lead Investigator, Precision Medicine Initiative Against Brain Cancer
Program Director, Neurosurgical Residence training program
Director, Center for Neurosurgical Outcomes Research Cedars-Sinai Medical Center, Los Angeles, California

MedicalResearch.com Editor’s note: Dr. Patil’s research is focused on developing a method of personalized cancer treatment through the harnessing of genome wide mutational analysis of a specific patient’s cancer.

MedicalResearch.com: Would you tell us a little about yourself and your research interests?

Dr. Patil: I am a Stanford-trained, Board Certified Neurosurgeon and cancer researcher at Cedars-Sinai Medical Center in Los Angeles, California. I primarily focus on the care of patients with malignant brain tumors, particularly glioblastomas. I received my undergraduate degree from Cornell, followed by a medical degree from the University of California, San Francisco (UCSF), where I was a Regent’s scholar. I completed a residency in neurosurgery and a fellowship in stereotactic radiology at Stanford University. I also have a master’s degree in epidemiology with a focus on clinical trial design and mathematical modeling from Stanford.

MedicalResearch.com: Can you tell us about some of your research interests?

Dr. Patil: I am keenly interested in and focused on developing precision science-powered novel brain tumor therapies, immuno-therapies, and patient-centered “big data” outcomes research. I lead the recently-funded Cedars-Sinai Precision Medicine Initiative Against Brain Cancer, which utilizes tumor genomics to build a mathematical computer model, i.e., a virtual cancer cell of each patient’s unique tumor. The White House and several other stakeholders have taken keep interest in this research initiative as an example of a leading precision medicine program.

Continue reading

Shape Differences of Brain Important For Individualized Precision Medicine

MedicalResearch.com Interview with:
Chun Chieh Fan
Ph.D student
USCD Cognitive Science and
Professor Anders M. Dale Ph.D
Department of Cognitive Science,
Multimodal Imaging Laboratory, Department of Radiology
University of California, San Diego School of Medicine
La Jolla, CA 92037

Medical Research: What is the background for this study? What are the main findings?

Response: The shape of human skull is closely associated with the ancestral background. Forensics uses it for determining ethnicity. Anthropologists use it to infer neuroanatomical change in human evolution. Yet it is unclear the inner content of skull, human brain, contains how much information about individual’s ancestry.

Our study found that different continental ancestries are associated with unique cortical folding patterns. Even for contemporary populations in modern day USA, a melting pot of ethnicities, cortical folding patterns are highly predictive of the percentage of each continental ancestry, as determined based on the person’s genotype. These shape differences between ancestral heritages are not necessarily related to brain function. It is highly possible that the shape differences are resulting from a random process accumulated along human history, without significant functional consequences.

Continue reading