Women with High Body Fat, Normal BMI at Increased Breast Cancer Risk

A new study by MSK’s Dr. Neil Iyengar and colleagues published in JAMA Oncology finds that women with normal BMIs but high levels of overall body fat are at an increased risk for invasive breast cancer. The cohort study followed 3,460 postmenopausal women for a median 16.4 years. Researchers measured body fat using Dual-energy X-ray absorptiometry five times throughout the course of the study. They concluded that for each five kilogram increase in trunk fat, women had a 56% increase in risk of developing estrogen-receptor (ER) positive breast cancers, even when BMI remained in the healthy range.

Learn more about this study:
MediBulletin
MedicalResearch.com
MedPage Today

Featured Researcher: Dr. Deborah Korenstein

Each month on our blog, we feature posts on grounding breaking cancer research news. Our new “Featured Researcher” series will highlight the work and recent research activities of MSK cancer researchers in their own words. This month we feature Dr. Deborah Korenstein, MD, Chief, General Internal Medicine Service.

One area of your research is the health effects of marijuana. Based on your research findings, what have you discovered about this topic that has surprised you the most?
I got involved in this work through my colleague Salomeh Keyhani. In the context of expansion of legalization of marijuana across the country and endorsement of its use in lieu of opioids, it is important to understand its potential toxicities. In one of our first projects we found that media messages regarding health effects of marijuana are overwhelmingly positive, despite little evidence for health benefits. We have also published systematic reviews/metaanalyses looking at the long-term pulmonary and cardiovascular harms, finding that the evidence is insufficient to assess these important toxicities, and we have an ongoing systematic review of the effect of marijuana use on cancer diagnoses. Most surprising (but perhaps not surprising at all) has been the willingness of the public and the medical community to embrace marijuana as a health promoter despite very little evidence. It speaks to the need for the medical community to maintain a healthy skepticism and demand solid evidence before endorsing products or habits.

You also study medication and medical testing overuse. What are your future plans for research on this topic?
I have been involved in research related to overuse of medical tests and treatments for a long time and have been working to reduce unnecessary care. Currently I am working to understand what drives physicians to overuse; we are conducting a multi-site survey study measuring physician attributes and clinical tendencies. Our group here at MSK recently published a framework for understanding harms of overused tests and treatments and the mechanisms through which they occur. Our next step is to work with patients to explore their understanding of these harms, in particular the relative importance of different types of harms.

Could you tell us about your other research plans for 2019 you’re particularly excited about?
I am working on several interesting projects, including a small study of factors associated with the volume of tests ordered by residents, an exploration of executive physicals and their inclusion of recommended and non-recommended services. I am also continuing my work in systematic reviews, including a review of the effects of marijuana in the treatment of cancer-related symptoms and a review of whether for-profit health care entities in the US provide better quality care compared with not-for-profit entities.

FDA Approves Cancer Drug Based on Genetic Mutation

Last week, the Food and Drug Administration (FDA) for the first time approved a cancer drug, larotrectinib (Vitrakvi), based on a genetic mutation rather than type of cancer. The FDA’s approval drew on the findings of three clinical trials comprised of 55 patients, the results of which were compiled and reported in the New England Journal of Medicine by MSK’s Dr. David Hyman, Dr. Alexander Drilon, and collaborators.

The NTRK gene fusion mutation can only be identified through broad genetic tumor testing. While the mutation occurs in less than one percent of solid tumors, it has been identified in dozens of often rare tumor types in adults and children. In the three trials, patients given the drug had a 75% overall response rate.

Learn More:
OncLive
Washington Post
MSK On Cancer blog