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Anchor lead: While more testing is being developed for COVID-19 it still falls far short of the goal, Elizabeth Tracey reports.

Weeks ago, Johns Hopkins researcher Heba Mostafa and colleagues developed a rapid test for COVID-19, that is being used at the hospital to identify those infected.

Mostafa: We are looking at the genome of the virus using this test. So this will tell us whether the virus exists in the specimen or not.   :07

Mostafa says even though Hopkins and other institutions have developed tests of their own, much more testing is needed to assist in mitigation efforts.

Mostafa: If you have sick people in the area or in the population or even if you have carriers it’s better to be able to diagnose who has the virus. This will help infection control, so we can identify and we can contain and we can limit the further spread of the virus. So this is basically why the diagnosis and the detection is really important.  :20

Testing is even more critical as more evidence mounts that people are infectious even before they show symptoms. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How can we explain the increase in colorectal cancer in younger people? Elizabeth Tracey reports

Colorectal cancer is cropping up more frequently in people in their forties, often enough that the American Cancer Society recently modified their guidelines for screening to begin at age 45, and younger in those with a family history of the disease. Now a recent study suggests that obesity is a major driver. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, affirms the notion.

Nelson: Obesity and inactivity they probably run in opposing directions most people think. There is a strong belief that at this point since the obesity is increasing and the age of onset of colorectal cancer appears to be decreasing that they may be related. Certainly what you see in this reasonably critical evaluation of risk associations they definitely ferret out obesity as a risk for colorectal cancer.  :25

Nelson notes that people should ask their primary care physician for the best screening method for them. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  How much is what you’re eating impacting your risk for cancer? Elizabeth Tracey reports

Your diet, including how much you eat, may have a big impact on your risk for cancers of the digestive tract, a recent study found. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says the findings make sense.

Nelson: People eat a pound to a pound and a half of food a day, it’s the most complicated chemical mixture on the planet, far greater exposure than any other you get. So the idea that this would affect particularly those organs is a reasonable thought. In the end they believe there’s a fairly consistent deleterious effect of obesity and alcohol intake on these oropharyngeal, digestive kind of cancers. The estimate in the United Kingdom was that obesity would be responsible for six percent of cancers and alcohol intake for three percent of cancers.  :33

Nelson says the good news is these risk factors are in your control. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Can an artificial intelligence approach to looking at drugs and cancer find promising treatments? Elizabeth Tracey reports

Can combing through vast databases using tools such as artificial intelligence or machine learning help find new cancer treatments? That’s the hope of one recent study, but William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says the chances of success are slim.

Nelson: The best of these are the countries that have a better pharmacovigilance database, which typically are the Scandinavian countries, where they actually know who got what drug and they actually know what health conditions they got, in a larger more comprehensive way. Here we have non-interoperable patient medical records. The best and most comprehensive database we have is probably from the Centers for Medicare and Medicaid Services, but the countries with registries have done these kinds of questions and the easy answer is you’re not going to find that some random drug is going to cure everybody’s cancer.  :33

Nelson says at best such studies may find a signal for a successful therapy that will then need further study. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Could an existing drug be repurposed to treat cancer? Elizabeth Tracey reports

Metformin, a drug long used to treat diabetes, might be helpful for some cancers, a recent report states, with the recommendation that investigating drug libraries may yield some great therapeutics. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says, well maybe.

Nelson: The real value the drug repurposing, I believe, is in a modern era where you can think about targets that have been credentialed to participate in the way cancer cells work. To build a new drug for that target, even get it into clinical trials takes usually on the order of 18 months and costs between eight to twelve million dollars, and so one attractive notion is that you then looked at the target and say is there any drug that’s out there, perhaps not as its primary effect but has some effect that hits the target in the same way you’d want to make a drug.  :31

Nelson says both basic science approaches and searches of drug libraries will help. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What are barriers to clinical trial participation for those with cancer? Elizabeth Tracey reports

Clinical trials offer both the best care and the greatest hope for many people with cancer, yet a recent study indicates that one barrier to enrolling may be the bias of trial managers, whose own perceptions may keep eligible participants out. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, comments.

Nelson: What’s interesting about this whole field is I think many of the general thoughts about barriers to participation by different race and ethnic groups, and different folks from socioeconomic status I think they’re beginning to be a little bit more clarified and they aren’t I think what people had initially thought. Some of them really are logistical and financial and other things and then with this then they can be more directly addressed.  :27

Nelson says the best advice to someone with a cancer diagnosis is to ask to participate in a clinical trial and be up front about issues such as transportation that may prove to be a problem so a solution can be found. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How can we tell if an existing drug might be used to treat COVID-19? Elizabeth Tracey reports

Hydroxychloroquine, a malaria drug, and azithromycin, an antibiotic, are two existing drugs now in clinical trials to treat COVID-19. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says an existing Johns Hopkins database can help in the search for additional potential therapies.

Nelson: You then look at the target and say is there any drug that’s out there, perhaps not as its primary effect, but has some effect that hits the target in the same way that you’d want to make a drug? Can we just get a sense of whether there’s any beneficial action of this drug, in this context where we know what the target is? Here, Jun Liu built one of the great libraries of drugs that are approved for any use anywhere, and also drugs that were taken into phase two clinical trials, so there’s a safety data behind them, built this library so it could be used by anybody to screen for particular targets.  :34

The Johns Hopkins Drug Library can be accessed by anyone using those terms to search. At Johns Hopkins, I’m Elizabeth Tracey.