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Bibliography on: Publications by FHCRC Researchers

RJR-3x

Robert J. Robbins is a biologist, an educator, a science administrator, a publisher, an information technologist, and an IT leader and manager who specializes in advancing biomedical knowledge and supporting education through the application of information technology. More About:  RJR | OUR TEAM | OUR SERVICES | THIS WEBSITE

RJR: Recommended Bibliography 06 Jun 2025 at 01:48 Created: 

Publications by FHCRC Researchers

The Fred Hutchinson Cancer Research Center began in 1975, with critical help from Washington State's U.S. Senator Warren Magnuson. Fred Hutch quickly became the permanent home to Dr. E. Donnall Thomas, who had spent decades developing an innovative treatment for leukemia and other blood cancers. Thomas and his colleagues were working to cure cancer by transplanting human bone marrow after otherwise lethal doses of chemotherapy and radiation. At the Hutch, Thomas improved this treatment and readied it for widespread use. Since then, the pioneering procedure has saved hundreds of thousands of lives worldwide. While improving bone marrow transplantation remains central to Fred Hutch's research, it is now only part of its efforts. The Hutch is home to five scientific divisions, three Nobel laureates and more than 2,700 faculty, who collectively have published more than 10,000 scientific papers, presented here as a full bibliography.

NOTE: From 1995 to 2009 I served as the Hutch's vice president for information technology — hence my interest in the organization. Although my role was in the admin division, if you dig through this bibliography, you will find a couple of papers with me as an author.

Created with PubMed® Query: ( fhcrc[Affiliation] OR "fred hutchinson"[Affiliation] OR "Fred Hutchinson Cancer Research"[Affiliation] OR "Fred Hutch"[affiliation] ) NOT pmcbook NOT ispreviousversion

Citations The Papers (from PubMed®)

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RevDate: 2025-06-03

Owens K, Rahman A, I Bozic (2025)

Spatiotemporal dynamics of tumor-CAR T-cell interaction following local administration in solid cancers.

PLoS computational biology, 21(6):e1013117 pii:PCOMPBIOL-D-24-01849 [Epub ahead of print].

The success of chimeric antigen receptor (CAR) T-cell therapy in treating hematologic malignancies has generated widespread interest in translating this technology to solid cancers. However, issues like tumor infiltration, the immunosuppressive tumor microenvironment, and tumor heterogeneity limit its efficacy in the solid tumor setting. Recent experimental and clinical studies propose local administration directly into the tumor or at the tumor site to increase CAR T-cell infiltration and improve treatment outcomes. Characteristics of the types of solid tumors that may be the most receptive to this treatment approach remain unclear. In this work, we develop a simplified spatiotemporal model for CAR T-cell treatment of solid tumors, and use numerical simulations to compare the effect of introducing CAR T cells via intratumoral injection versus intracavitary administration in diverse cancer types. We demonstrate that the model can reproduce tumor and CAR T-cell data from small imaging studies of local administration of CAR T cells in mouse models. Our results suggest that locally administered CAR T cells will be most successful against slowly proliferating, highly diffusive tumors. In our simulations, assuming equal detectable tumor diameters at the time of treatment, low average tumor cell density is a better predictor of treatment success than total tumor burden or volume doubling time. These findings affirm the clinical observation that CAR T cells will not perform equally across different types of solid tumors, and suggest that measuring tumor density may be helpful when considering the feasibility of CAR T-cell therapy and planning dosages for a particular patient. We additionally find that local delivery of CAR T cells can result in deep tumor responses, provided that the initial CAR T-cell dose does not contain a significant fraction of exhausted cells.

RevDate: 2025-06-05

Appelbaum FR (2025)

Graft-versus-leukemia.

Haematologica, 110(6):1243-1244.

RevDate: 2025-06-03

Marc A, Schiffer JT, Mentré F, et al (2025)

Viral Dynamic Models During COVID-19: Are We Ready for the Next Pandemic?.

CPT: pharmacometrics & systems pharmacology [Epub ahead of print].

Mathematical models have been used for about 30 years to improve our understanding of virus-host interaction, in particular during chronic infections. During the COVID-19 pandemic, these models have been used to provide insights into the natural history of acute SARS-CoV-2 infection, optimize antiviral treatment strategies, understand factors associated with transmission, and optimize surveillance systems. The impact of modeling has been accelerated by the availability of unprecedented multidimensional immune data from animal and human systems, which enhanced partnerships between experimentalists and theorists and led to exciting new modeling and statistical developments. In this mini review, we examine the lessons learned from the COVID-19 pandemic and discuss the main insights provided by mathematical models of viral dynamics at the different stages of the outbreak. Although we focus on respiratory infection, we also consider the new areas for development in anticipation of future acute infections from new or reemerging pathogens.

RevDate: 2025-06-02

Hoffman-Censits J, Tsiatas M, Chang PM, et al (2025)

Avelumab plus sacituzumab govitecan versus avelumab monotherapy as first-line maintenance treatment in patients with advanced urothelial carcinoma: JAVELIN Bladder Medley interim analysis.

Annals of oncology : official journal of the European Society for Medical Oncology pii:S0923-7534(25)00202-9 [Epub ahead of print].

BACKGROUND: Avelumab first-line maintenance is a recommended treatment option for patients with locally advanced or metastatic urothelial carcinoma (la/mUC) without progression following platinum-based chemotherapy (PBC). The JAVELIN Bladder Medley phase II trial is investigating the efficacy and safety of maintenance treatment with avelumab combined with other antitumor agents versus avelumab monotherapy. We report an interim analysis of avelumab plus sacituzumab govitecan (SG) versus avelumab monotherapy.

PATIENTS AND METHODS: Patients with la/mUC without progression after first-line PBC were randomized 2 : 1 to receive avelumab (800 mg every 2 weeks) plus SG (10 mg/kg on days 1 and 8 of 21-day cycles) or avelumab monotherapy (800 mg every 2 weeks). Primary endpoints are investigator-assessed progression-free survival (PFS) and safety. For PFS and overall survival (OS), data in the avelumab monotherapy arm were extended per protocol using propensity score-weighted JAVELIN Bladder 100 data.

RESULTS: At data cut-off (16 September 2024), 38/74 patients (51.4%) in the avelumab plus SG arm and 10/37 patients (27.0%) in the avelumab monotherapy arm were still receiving study treatment. Median PFS with avelumab plus SG versus avelumab monotherapy was 11.17 versus 3.75 months, respectively [hazard ratio (HR) 0.49, 95% confidence interval (CI) 0.31-0.76; prespecified efficacy boundary: HR ≤ 0.60]. OS data were immature; median OS was not reached versus 23.75 months, respectively (HR 0.79, 95% CI 0.42-1.50). In patients treated with avelumab plus SG or avelumab monotherapy, any-grade treatment-related adverse events (TRAEs) occurred in 97.3% versus 63.9% (grade ≥3 in 69.9% versus 0%), respectively.

CONCLUSION: In patients with la/mUC without progression after first-line PBC, PFS was prolonged with avelumab plus SG versus avelumab monotherapy as maintenance treatment. TRAEs were more frequent with the combination and were consistent with known safety profiles of SG and avelumab. Combining avelumab with anti-Trop-2 antibody-drug conjugates may be a promising strategy to improve patient outcomes in la/mUC.

RevDate: 2025-06-02

Tsai J, Grassberger C, Nyflot MJ, et al (2025)

Functional liver imaging and dosimetry for risk stratification in patients with hepatocellular carcinoma undergoing radiotherapy: validation study.

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology pii:S0167-8140(25)04467-6 [Epub ahead of print].

BACKGROUND: Functional liver imaging has potential to personalize management of Hepatocellular Carcinoma (HCC) by mitigating hepatotoxicity risk. We validated functional liver imaging and dosimetric parameters for risk-stratification in an expanded cohort of HCC patients.

METHODS: We reviewed 109 consecutive HCC patients who underwent Sulfur Colloid (SC)-SPECT/CT scans for radiation therapy (RT) planning and extracted previously reported functional liver imaging metrics. We generated elastic net multivariable Cox models with event-stratified and nested cross-validation folds to predict Overall Survival (OS) and increase in Child-Pugh score ≥ 2 (CP + 2). Test-fold patients were risk-stratified, and time-dependent model performance was characterized. ROC analysis generated prognostic cutoffs with confidence intervals to guide functional liver avoidance treatment planning.

RESULTS: Cross-validated model concordance was 0.70 (95 %CI: 0.67-0.73) for OS and 0.67 (95 %CI: 0.63-0.71) for CP + 2. Top-ranked OS predictors included tumor volume (HR = 1.56, 1.54-1.58), CP-score (HR = 1.36, 1.34-1.38), Liver-GTV V20 (HR = 1.310, 1.306-1.314), prior liver-directed therapy (HR = 0.83, 0.82-0.85), functional liver volume dosimetry (FLV-V20) (HR = 1.19, 1.14-1.23), and RT-year (HR = 0.89, 0.88-0.91). Top-ranked CP + 2 predictors were total liver function (TLF) (HR = 0.64, 0.63-0.66), Liver-GTV mean dose (HR = 1.40, 1.36-1.49), and CP-score (HR = 1.19, 1.16-1.23). Test-fold risk groups were defined for each endpoint (log-rank P < 0.001). OS model performance stabilized beyond 2 years; CP + 2 model stability peaked within 1 year. Optimal strata for 2-yr OS were FLV V20 < 25.8 % and Liver-GTV V20 < 25.4 %; 1-yr CP + 2 strata were TLF < 0.91 and Liver-GTV mean dose < 18.9 Gy.

CONCLUSION: Functional liver metrics on SC-SPECT/CT were validated alongside clinical and dosimetric factors within robust outcome models. Testing of personalized RT planning for HCC patients to preserve liver function is warranted in clinical trials.

RevDate: 2025-06-05
CmpDate: 2025-06-02

Huang Y, RL Prentice (2024)

Biomarker-assisted reporting in nutritional epidemiology: addressing measurement error in exposure-disease associations.

Biostatistics (Oxford, England), 26(1):.

In nutritional epidemiology, self-reported dietary data are commonly used to investigate diet-disease relationships. However, the resulting association estimates are often subject to biases due to random and systematic measurement errors. Regression calibration has emerged as a crucial method for addressing these biases by refining self-reported nutrient intake with objective biomarkers, which differ from the true values only by a random "noise" component. This paper presents methodological tools for analyzing nutritional epidemiology cohort studies involving time-to-event data when a biomarker subsample is available alongside dietary assessments. We introduce novel regression calibration methods to tackle two common challenges in this field. First, a widely used approach assumes that the log hazard ratio (HR) follows a linear function of dietary exposure. However, assessing whether this assumption holds-or if a more flexible model is needed to capture potential deviations from linearity-is often necessary. Second, another prevalent analytical strategy involves estimating HRs based on categorized dietary exposure variables. New methods are critically needed to minimize bias in defining category boundaries and estimating hazard ratios within exposure categories, both of which can be distorted by measurement error. We apply these methods to reassess the relationship between sodium and potassium intake and cardiovascular disease risk using data from the Women's Health Initiative.

RevDate: 2025-06-05

Shaukat A, Burke CA, Chan AT, et al (2025)

Clinical Validation of a Circulating Tumor DNA-Based Blood Test to Screen for Colorectal Cancer.

JAMA [Epub ahead of print].

IMPORTANCE: Colorectal cancer screening is widely recommended but underused. Blood-based screening offers the potential for higher adherence compared with endoscopy or stool-based testing but must first be clinically validated in a screening population.

OBJECTIVE: To evaluate the clinical performance of an investigational blood-based circulating tumor DNA test for colorectal cancer detection in an average-risk population using colonoscopy with histopathology as the reference method.

Prospective, multicenter, cross-sectional observational study enrolling participants between May 2020 and April 2022 who were asymptomatic adults aged 45 to 85 years, at average risk of colorectal cancer, and willing to undergo a standard-of-care screening colonoscopy. Participants, staff, and pathologists were blinded to blood test results, and laboratory testing was performed blinded to colonoscopy findings. The study was conducted at 201 centers across 49 US states and the United Arab Emirates. Site-based and mobile phlebotomy were used for blood collection.

EXPOSURES: Participants were required to complete a screening colonoscopy after blood collection.

MAIN OUTCOMES AND MEASURES: The primary end points were sensitivity for colorectal cancer, specificity for advanced colorectal neoplasia (colorectal cancer or advanced precancerous lesions), negative predictive value for advanced colorectal neoplasia, and positive predictive value for advanced colorectal neoplasia. The secondary end point was sensitivity for advanced precancerous lesions.

RESULTS: The median age of participants in the evaluable cohort (n = 27 010) was 57.0 years, and 55.8% were women. Sensitivity for colorectal cancer was 79.2% (57/72; 95% CI, 68.4%-86.9%) and specificity for advanced colorectal neoplasia was 91.5% (22 306/24 371; 95% CI, 91.2%-91.9%). The negative predictive value for advanced colorectal neoplasia was 90.8% (22 306/24 567; 95% CI, 90.7%-90.9%) and the positive predictive value for advanced colorectal neoplasia was 15.5% (378/2443; 95% CI, 14.2%-16.8%). All primary end points met prespecified acceptance criteria. The sensitivity for advanced precancerous lesions was 12.5% (321/2567; 95% CI, 11.3%-13.8%), which did not meet the prespecified acceptance criterion.

CONCLUSIONS AND RELEVANCE: In an average-risk colorectal cancer screening population, a blood-based test demonstrated acceptable accuracy for colorectal cancer detection, but detection of advanced precancerous lesions remains a challenge, and ongoing efforts are needed to improve test sensitivity.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04369053.

RevDate: 2025-06-02

van den Bruele AB, Rosenberger LH, Downs-Canner S, et al (2025)

ASO Author Reflections: Contralateral Axillary Lymph Node Metastasis of Breast Cancer: Time to Re-evaluate Conventional Thinking.

Annals of surgical oncology [Epub ahead of print].

RevDate: 2025-06-05
CmpDate: 2025-06-02

DiPeso L, Pendyala S, Huang HZ, et al (2025)

Image-based identification and isolation of micronucleated cells to dissect cellular consequences.

eLife, 13:.

Recent advances in isolating cells based on visual phenotypes have transformed our ability to identify the mechanisms and consequences of complex traits. Micronucleus (MN) formation is a frequent outcome of genome instability, triggers extensive changes in genome structure and signaling coincident with MN rupture, and is almost exclusively defined by visual analysis. Automated MN detection in microscopy images has proved challenging, limiting discovery of the mechanisms and consequences of MN. In this study we describe two new MN segmentation modules: a rapid model for classifying micronucleated cells and their rupture status (VCS MN), and a robust model for accurate MN segmentation (MNFinder) from a broad range of cell lines. As proof-of-concept, we define the transcriptome of non-transformed human cells with intact or ruptured MN after chromosome missegregation by combining VCS MN with photoactivation-based cell isolation and RNASeq. Surprisingly, we find that neither MN formation nor rupture triggers a strong unique transcriptional response. Instead, transcriptional changes appear correlated with small increases in aneuploidy in these cell classes. Our MN segmentation modules overcome a significant challenge with reproducible MN quantification, and, joined with visual cell sorting, enable the application of powerful functional genomics assays to a wide-range of questions in MN biology.

RevDate: 2025-06-05
CmpDate: 2025-06-02

Duan Z, Shi M, Kumaraswamy A, et al (2025)

PROX1 is an early driver of lineage plasticity in prostate cancer.

The Journal of clinical investigation, 135(11):.

Lineage plasticity is recognized as a critical determinant of lethality and resistance to AR pathway inhibitors in prostate cancer. Lineage plasticity is a continuum, ranging from AR activity-low tumors, AR-null tumors that do not express a neuroendocrine prostate cancer (NEPC) program (i.e., double-negative prostate cancer [DNPC]), and AR-null NEPC tumors. Factors upregulated early in lineage plasticity are not well-characterized. The clarification of such factors is essential to identify tumors undergoing lineage plasticity or at risk of this occurring. Our integrative analysis of metastatic prostate cancer patient tumors, patient-derived xenografts, and cell models determined that PROX1 is upregulated early in the lineage plasticity continuum and progressively increases as tumors lose AR activity. We determined DNA methylation is a key regulator of PROX1 expression. PROX1 suppression in DNPC and NEPC reduces cell survival and impacts apoptosis and differentiation, demonstrating PROX1's functional importance. PROX1 is not directly targetable with standard drug development approaches. However, affinity immunopurification demonstrated histone deacetylases (HDACs) are among the top PROX1-interacting proteins; HDAC inhibition depletes PROX1 and recapitulates PROX1 suppression in DNPC and NEPC. Altogether, our results suggest PROX1 promotes the emergence of lineage plasticity, and HDAC inhibition is a promising approach to treat tumors across the lineage plasticity continuum.

RevDate: 2025-06-05
CmpDate: 2025-06-05

Xu J, Sussman JH, Yang A, et al (2025)

STAT1-mediated interferon signatures are associated with preclinical JAK inhibitor sensitivity in T-ALL.

Blood, 145(23):2793-2798.

We used single-cell genomics to characterize a patient with T-cell acute lymphoblastic leukemia treated in the Children's Oncology Group AALL0434 trial with poor clinical outcome despite favorable genomic features, identifying a STAT1-mediated interferon-related transcriptional signature and inflammatory microenvironment associated with sensitivity to small-molecule JAK inhibition.

RevDate: 2025-06-03

Stone D, Takeuchi R, Dulin H, et al (2025)

Serum factors create species-specific barriers to hepatic gene transfer by lipid nanoparticles in liver-humanized mice.

Molecular therapy. Methods & clinical development, 33(2):101470.

Lipid nanoparticles (LNPs) can efficiently deliver nucleic acid therapeutics to a range of tissues, particularly hepatocytes to treat diseases of the liver. We initially investigated whether three LNPs with different ionizable lipids, previously validated in non-human primates (NHPs), could deliver functional GFP mRNA to human hepatocytes in chimeric NSG-PiZ and FRG mice. After intravenous delivery, GFP expression was observed throughout the livers but was restricted to mouse hepatocytes because the payload mRNA was not internalized by human hepatocytes. LNP transfection was also restricted to mouse hepatocytes in NSG-PiZ mice administered a different LNP containing the ionizable lipid SM-102. In vitro, primary human hepatocytes (PHHs) were transfected by LNPs containing lipids SM-102, LP01, or ALC0315 in the presence of normal mouse serum, but not chimeric NSG-PiZ serum. SM-102 LNP transfection of PHH was also inhibited by naive untransplanted NSG-PiZ serum. However, serum from NSG mice supported PHH transfection by SM-102 LNP. These results suggest that inhibitory factors in NSG-PiZ mouse serum are responsible for the lack of human hepatocyte transduction in chimeric mice. Finally, we found that LNPs displaying trivalent N-acetylgalactosamine (TriGalNAc), which targets them to the asialoglycoprotein receptor, can overcome species restriction, transfecting both mouse and human hepatocytes in chimeric NSG-PiZ mice.

RevDate: 2025-06-03

DeZern AE, Goll JB, Jensen TL, et al (2024)

Correlation between peripheral blood and bone marrow mutations among patients with MDS from the National MDS Study.

Blood neoplasia, 1(3):100026.

RevDate: 2025-06-01

Kmail ZM, Shannon Dorcy K, SS Laing (2025)

Burnout Predictors Among Direct Clinical Services Health Care Professionals in Community Health Centers: A Cross-Sectional Study.

American journal of health promotion : AJHP [Epub ahead of print].

PurposeAssess burnout prevalence, identify the healthcare professionals experiencing burnout, and identify organizational predictors of burnout in community health centers (CHCs) nationwide.ApproachIn 2022 the Health Resources and Services Administration administered surveys to assess health center workforce well-being among the 1400+ community health centers that it oversees. Our team statistically evaluated the findings to isolate the factors likely to predict burnout among center healthcare professionals.SettingData completed by staff in 694 CHCs.ParticipantsRespondents were 52 568 healthcare professionals.MethodsChi-squared tests derived homogeneity in burnout among occupations; proportion tests evaluated differences in burnout indicators; and structural equation modeling with latent variables estimated direct and indirect effects of organizational burnout predictors and mediators.ResultsUp to 77% of direct clinical service professionals endorsed at least one symptom of burnout and reported higher burnout rates than management (P < .001). The most significant burnout predictors were engagement (-0.263***), work-life balance (0.281***), workload (0.174***) and professional growth (0.143***). For engagement, a perception of disconnection with the CHC predicted heightened burnout. Work-life balance, workload, and professional growth each had a positive effect on burnout, demonstrating that higher perceived work demands, greater work-life imbalance, and increased professional growth opportunities equated to higher burnout.ConclusionResults highlight the need to redesign healthcare delivery models to mitigate burnout, promote provider engagement and enhance workforce well-being.

RevDate: 2025-06-01

St Laurent MP, SP Psutka (2025)

Reply to Chang-kun Mao, Chao-Yang, and Jun-ting Li's Letter to the Editor re: Marie-Pier St-Laurent, Bernard Bochner, James Catto, et al. Increasing Life Expectancy in Patients with Genitourinary Malignancies: Impact of Treatment Burden on Disease Management and Quality of Life. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2024.11.026.

RevDate: 2025-06-01

Stein MN, Vinceneux A, Robbrecht D, et al (2025)

Pasritamig, a First-in-Class, Bispecific T-Cell Engager Targeting Human Kallikrein 2, in Metastatic Castration-Resistant Prostate Cancer: A Phase 1 Study.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology [Epub ahead of print].

BACKGROUND: We report Phase 1 trial results for pasritamig, a first-in-class, T-cell engaging bispecific antibody targeting human kallikrein 2 (KLK2) expressed on the surface of prostate cancer (PC) cells.

METHODS: Participants had metastatic castration-resistant PC and ≥1 prior therapy. Pasritamig was escalated from 0.5 mg to 2000 mg for subcutaneous administration and from 150 mg to 900 mg for intravenous (IV) administration at dosing frequencies ranging from every week to every 6 weeks with different step-up dosing schedules. The primary objectives were to determine safety and the recommended Phase 2 dose (RP2D) of pasritamig. Secondary objectives included preliminary assessment of antitumor activity.

RESULTS: 174 participants received pasritamig, with a median of 4 prior lines of systemic therapy. Treatment-related adverse events (TRAEs) occurred in 144/174 (82.8%) participants, with 17/174 (9.8%) experiencing Grade ≥3 TRAEs. The RP2D was determined to be 3.5 mg (Day 1), 18 mg (Day 8), 300 mg (Day 15), then 300 mg IV every 6 weeks. In the RP2D safety population (N=45), infusion-related reactions (11/45, 24.4%), fatigue (7/45, 15.6%), cytokine release syndrome (CRS; 4/45, 8.9%, all Grade 1), and lipase increase (4/45, 8.9%) were the most frequent TRAEs; all were Grade 1 or 2. In the RP2D efficacy population (N=33), median radiographic progression-free survival was 7.85 (95% CI 2.89, not estimable) months, and 14/33 (42.4%) participants achieved a ≥50% decline in prostate-specific antigen.

CONCLUSIONS: Pasritamig demonstrated a favorable safety profile with very low rates of CRS and could be safely administered in an outpatient setting. Preliminary antitumor activity demonstrated proof of concept for KLK2 as a target in PC, warranting further development of pasritamig.

RevDate: 2025-05-31

Cabahug JPC, Cruzpero RC, de Los Santos LEF, et al (2025)

Radiotherapy medical physics in the Philippines: A contemporary overview.

Journal of applied clinical medical physics [Epub ahead of print].

PURPOSE: With cancer ranking as the third leading cause of death in the Philippines and a disparity in healthcare resources across regions, this research aimed to assess the state of radiotherapy medical physics in the country.

METHODOLOGY: The study utilized a comprehensive online survey with 94 structured questions answered by 19 clinics.

RESULTS: Most of the participants were within 1-3 years of training (41%), with a slight majority working in private hospitals (55%). linear accelerators (LINACs) were universally used with one Co-60 unit available, and High Dose Rate (HDR) brachytherapy was common. Intensity-Modulated Radiotherapy (IMRT) and 3D-Conformal Radiotherapy (3D-CRT) are practiced in all 19 clinics, with advanced techniques like Stereotactic Body Radiotherapy (SBRT), Stereotactic Radiosurgery (SRS), and Intraoperative Radiotherapy (IORT) limited to NCR, while modalities such as Volumetric Modulated Arc Therapy (VMAT) (21%) and 2D RT (68%) are more widely practiced. Imaging modalities included the wide adoption of Computed Tomography (CT), though only 64% of respondents had dedicated CT simulators in their clinics. Gynecologic and breast cancers were frequently treated, while bone marrow transplants (total body irradiation) were rare. For quality assurance (QA) devices, Solid Water Phantoms and Scanning Water Tanks (86%) were the most common devices for dosimetry and measurement. 82% reported performing patient-specific QA (PSQA), with EPID dosimetry being the most common (55%) PSQA device used. Quality management practices varied between Qualified Medical Physicists and Medical Physics Trainees, with most Qualified Medical Physicists performing routine checks. Treatment interruptions were mainly due to staffing and machine downtime, rather than power outages or natural disasters. Most clinics had their own systems (86%) to document safety incidents, but only a few reported incidents (32%) to the IAEA SAFRON program. Lastly, participants expressed a willingness to collaborate in research despite limited time.

CONCLUSION: This study provides an understanding of the current landscape of radiation therapy physics in the Philippines, highlighting the need to address workforce disparities, ensure equitable cancer treatment access, optimize dosimetric tools and QA devices, and prioritize resource allocation and research collaboration to advance radiation oncology practices.

RevDate: 2025-05-31

Hasenstab KA, Lu J, Leong LT, et al (2025)

Relationship between spleen volume and diameter for assessment of response to treatment on CT in patients with hematologic malignancies enrolled in clinical trials.

Abdominal radiology (New York) [Epub ahead of print].

PURPOSE: Investigate spleen diameter (d) and volume (v) relationship in patients with hematologic malignancies (HM) by determining volumetric thresholds that best correlate to established diameter thresholds for assessing response to treatment. Exploratorily, interrogate the impact of volumetric measurements in response categories and as a predictor of response.

METHODS: Secondary analysis of prospectively collected clinical trial data of 382 patients with HM. Spleen diameters were computed following Lugano criteria and volumes using deep learning segmentation. d and v relationship was estimated using power regression model, volumetric thresholds ([Formula: see text]) for treatment response estimated; threshold search to determine percentual change ([Formula: see text] and minimum volumetric increase ([Formula: see text]) that maximize agreement with Lugano criteria performed. Spleen diameter and volume predictive performance for clinical response investigated using random forest model.

RESULTS: [Formula: see text] describes the relationship between spleen diameter and volume. [Formula: see text] for splenomegaly was 546 cm³. [Formula: see text], [Formula: see text], and [Formula: see text] for assessing response resulting in highest agreement with Lugano criteria were 570 cm[3], 73%, and 170 cm[3], respectively. Predictive performance for response between diameter and volume were not significantly different (P=0.78).

CONCLUSION: This study provides empirical spleen volume threshold and percentual changes that best correlate with diameter thresholds, i.e., Lugano criteria, for assessment of response to treatment in patients with HM. In our dataset use of spleen volumetric thresholds versus diameter thresholds resulted in similar response assessment categories and did not signal differences in predictive values for response.

RevDate: 2025-05-31

Shadman M, Munir T, Ma S, et al (2025)

Zanubrutinib and Venetoclax for Patients With Treatment-Naïve Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma With and Without Del(17p)/TP53 Mutation: SEQUOIA Arm D Results.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology [Epub ahead of print].

PURPOSE: Several chronic lymphocytic leukemia (CLL) studies have demonstrated promising efficacy with the combination of BCL2 and Bruton tyrosine kinase inhibitors; however, patients with CLL with del(17p) and/or TP53 mutation (TP53mut) comprised a small percentage of study populations or were excluded entirely. The purpose of the SEQUOIA Arm D cohort was to evaluate the combination of zanubrutinib + venetoclax in treatment-naïve (TN) patients with CLL/small lymphocytic lymphoma (SLL), in a large population of patients with TP53-aberrant disease.

PATIENTS AND METHODS: Arm D is a nonrandomized cohort of patients aged 65 years and older (or 18-64 years with comorbidities). Patients received zanubrutinib from cycle 1 and venetoclax from cycle 4 (ramp-up) to cycle 28, followed by continuous zanubrutinib monotherapy until progressive disease (PD), unacceptable toxicity, or meeting undetectable minimal residual disease (uMRD)-guided stopping criteria.

RESULTS: Between November 2019 and July 2022, 114 patients were enrolled: 66 (58%) with TP53-aberrant disease, 47 (41%) without TP53-aberrant disease, and 1 with missing TP53 results. At a median follow-up of 31.2 months, 85 patients (75%) remained on zanubrutinib monotherapy; 29 patients (25%) discontinued zanubrutinib because of adverse event, uMRD-guided stopping criteria, PD, or other. In the intention-to-treat population, 59% of patients achieved peripheral blood uMRD. The 24-month progression-free survival estimate was 92% (95% CI, 85% to 96%). The most common any-grade treatment-emergent AEs (TEAEs) were COVID-19 (54%), diarrhea (41%), contusion (32%), and nausea (30%). The most common grade ≥3 TEAEs were neutropenia (17%), hypertension (10%), diarrhea (6%), and decreased neutrophil count (6%).

CONCLUSION: Zanubrutinib + venetoclax demonstrated impressive efficacy and a favorable safety profile in patients with TN CLL/SLL, regardless of the presence of TP53-aberrant disease.

RevDate: 2025-06-02
CmpDate: 2025-05-30

Sankaranarayanan A, Khachaturov G, Smythe KS, et al (2025)

Quantitative benchmarking of nuclear segmentation algorithms in multiplexed immunofluorescence imaging for translational studies.

Communications biology, 8(1):836.

Multiplexed imaging techniques require identifying different cell types in the tissue. To utilize their potential for cellular and molecular analysis, high throughput and accurate analytical approaches are needed in parsing vast amounts of data, particularly in clinical settings. Nuclear segmentation errors propagate in all downstream steps of cell phenotyping and single-cell spatial analyses. Here, we benchmark and compare the nuclear segmentation tools commonly used in multiplexed immunofluorescence data by evaluating their performance across 7 tissue types encompassing ~20,000 labeled nuclei from human tissue samples. Pre-trained deep learning models outperform classical nuclear segmentation algorithms. Overall, Mesmer is recommended as it exhibits the highest nuclear segmentation accuracy with 0.67 F1-score at an IoU threshold of 0.5 on our composite dataset. Pre-trained StarDist model is recommended in case of limited computational resources, providing ~12x run time improvement with CPU compute and ~4x improvement with the GPU compute over Mesmer, but it struggles in dense nuclear regions.

RevDate: 2025-06-03
CmpDate: 2025-05-30

Hazelwood E, Canson DM, Deslandes B, et al (2025)

Multi-tissue expression and splicing data prioritise anatomical subsite- and sex-specific colorectal cancer susceptibility genes.

Nature communications, 16(1):5043.

Genome-wide association studies have suggested numerous colorectal cancer (CRC) susceptibility genes, but their causality and therapeutic potential remain unclear. To prioritise causal associations between gene expression/splicing and CRC risk (52,775 cases; 45,940 controls), we perform a transcriptome-wide association study (TWAS) across six tissues with Mendelian randomisation and colocalisation, integrating sex- and anatomical subsite-specific analyses. Here we reveal 37 genes with robust causal links to CRC risk, ten of which have not previously been reported by TWAS. Most likely causal genes with evidence of cancer cell dependency show elevated expression linked to risk, suggesting therapeutic potential. Notably, SEMA4D, encoding a protein targeted by an investigational CRC therapy, emerges as a key risk gene. We also identify a female-specific association with CRC risk for CCM2 expression and subsite-specific associations, including LAMC1 with rectal cancer risk. These findings offer valuable insights into CRC molecular mechanisms and support promising therapeutic avenues.

RevDate: 2025-05-30

Svatek RS, Ankerst DP, D' Amico AV, et al (2025)

A festschrift in honor of Ian M. Thompson Jr., MD.

Urologic oncology, 43(7):423-435.

RevDate: 2025-06-02
CmpDate: 2025-05-30

Liang M, Zhao Y, Lin DW, et al (2025)

Estimating optimally tailored active surveillance strategy under interval censoring.

Biometrics, 81(2):.

Active surveillance (AS) using repeated biopsies to monitor disease progression has been a popular alternative to immediate surgical intervention in cancer care. However, a biopsy procedure is invasive and sometimes leads to severe side effects of infection and bleeding. To reduce the burden of repeated surveillance biopsies, biomarker-assistant decision rules are sought to replace the fix-for-all regimen with tailored biopsy intensity for individual patients. Constructing or evaluating such decision rules is challenging. The key AS outcome is often ascertained subject to interval censoring. Furthermore, patients will discontinue participation in the AS study once they receive a positive surveillance biopsy. Thus, patient dropout is affected by the outcomes of these biopsies. This work proposes a non-parametric kernel-based method to estimate a tailored AS strategy's true positive rates (TPRs) and true negative rates (TNRs), accounting for interval censoring and immediate dropouts. We develop a weighted classification framework based on these estimates to estimate the optimally tailored AS strategy and further incorporate the cost-benefit ratio for cost-effectiveness in medical decision-making. Theoretically, we provide a uniform generalization error bound of the derived AS strategy, accommodating all possible trade-offs between TPRs and TNRs. Simulation and application to a prostate cancer surveillance study show the superiority of the proposed method.

RevDate: 2025-05-30

Jacobs JM, Traeger L, Freese M, et al (2025)

BMT-CARE App: A Randomized Controlled Trial of a Psychosocial Digital Application for Caregivers of Patients Undergoing Hematopoietic Stem-Cell Transplantation.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology [Epub ahead of print].

PURPOSE: Family and friend caregivers of patients undergoing hematopoietic stem-cell transplantation (HSCT) struggle with immense caregiving burden, leading to substantial quality of life (QOL) impairments and psychological distress. Yet, interventions to address caregivers' needs are limited.

MATERIALS AND METHODS: We conducted a randomized controlled trial of a psychosocial digital application (BMT-CARE App) versus usual care for adult caregivers of patients with hematologic malignancies undergoing HSCT. The BMT-CARE App included five modules combining psychoeducation and evidence-based behavior change strategies. Participants completed self-report measures at baseline and day 60 post-HSCT. The primary end point was QOL at day 60 assessed by the CareGiver Oncology QOL (CarGOQOL) measure. We also assessed caregiving burden (Caregiver Reaction Assessment), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), and post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist [PCL-5]). We used analysis of covariance adjusting for baseline scores to assess the effect of the intervention on study outcomes.

RESULTS: Between February 2023 and July 2024, we enrolled 125 of 174 approached caregivers (71.8%). Participants assigned to the BMT-CARE App used the app for a median of 146.9 minutes (range, 0-384.8). At day 60, BMT-CARE App caregivers reported clinically and significantly better QOL than those assigned to usual care (adjusted means = 76.3 v 69.9, P = .006). BMT-CARE App participants also reported significantly lower caregiving burden (11.2 v 12.3, P = .023), depression (3.8 v 5.6, P = .002), and PTSD symptoms (26.1 v 31.3, P = .012). The groups did not differ significantly in anxiety symptoms at day 60.

CONCLUSION: The BMT-CARE App led to significantly improved QOL, caregiving burden, depression, and PTSD symptoms among HSCT caregivers. This intervention should be tested in a multicenter study with a diverse HSCT caregiver population to determine generalizability and scalability.

RevDate: 2025-06-02
CmpDate: 2025-05-30

Brixner D, Richardson T, Lockhart CM, et al (2025)

Optimization of oncology biomarker testing in managed care: Best practices and consensus recommendations from an AMCP Market Insights program.

Journal of managed care & specialty pharmacy, 31(6-a Suppl):S1-S14.

Precision medicine in oncology using actionable molecular biomarkers to guide treatment selection has been associated with favorable outcomes; however, many potentially eligible patients do not receive it. This Academy of Managed Care Pharmacy Market Insights program sought to characterize unmet needs in biomarker testing among managed care stakeholders, to develop best practice and consensus recommendations to support addressing these needs, and to gain insights on potential quality measures related to biomarker testing. The program used a modified Delphi process and included in-depth interviews with expert panelists, a national survey of managed care professionals, and a consensus survey of experts. Areas of unmet need in biomarker testing identified were education, guidelines and protocols, timeliness, process, and equity. Twenty-two best practices were suggested by managed care experts and other stakeholders; 9 of these best practices achieved consensus. These consensus recommendations addressed biomarker test ordering and test performance, treatment decisions based on biomarker testing, cost-effectiveness of biomarker testing, and health disparities in access to biomarker testing. Opportunities for education and improvements in infrastructure to implement these recommendations were identified. Further investigation is needed to develop quality measures; although, valuable insights were gained.

RevDate: 2025-05-29

Nugent PJ, Park H, Wladyka CL, et al (2025)

Decoding post-transcriptional regulatory networks by RNA-linked CRISPR screening in human cells.

Nature methods [Epub ahead of print].

RNAs undergo a complex choreography of metabolic processes that are regulated by thousands of RNA-associated proteins. Here we introduce ReLiC, a scalable and high-throughput RNA-linked CRISPR approach to measure the responses of diverse RNA metabolic processes to knockout of 2,092 human genes encoding all known RNA-associated proteins. ReLiC relies on an iterative strategy to integrate genes encoding Cas9, single-guide RNAs (sgRNAs) and barcoded reporter libraries into a defined genomic locus. Combining ReLiC with polysome fractionation reveals key regulators of ribosome occupancy, uncovering links between translation and proteostasis. Isoform-specific ReLiC captures differential regulation of intron retention and exon skipping by SF3B complex subunits. Chemogenomic ReLiC screens decipher translational regulators upstream of messenger RNA (mRNA) decay and identify a role for the ribosome collision sensor GCN1 during treatment with the anti-leukemic drug homoharringtonine. Our work demonstrates ReLiC as a powerful framework for discovering and dissecting post-transcriptional regulatory networks in human cells.

RevDate: 2025-05-29
CmpDate: 2025-05-29

Seaton KE, Paez CA, Yu C, et al (2025)

Safety, pharmacokinetics, and neutralisation activity of PGDM1400LS, a V2 specific HIV-1 broadly neutralising antibody, infused intravenously or subcutaneously in people without HIV-1 in the USA (HVTN 140/HPTN 101 part A): a first-in-human, phase 1 randomised trial.

The lancet. HIV, 12(6):e405-e415.

BACKGROUND: PGDM1400LS is a human monoclonal antibody targeting the HIV envelope V2 apex with a lysine-serine modification intended to enhance serum and tissue half-lives and is being considered for use in combination monoclonal antibody trials. We sought to test whether PGDM1400LS was safe and had favourable serum concentration, pharmacokinetics, and neutralising ability in healthy adults.

METHODS: HVTN 140/HPTN 101 part A is an open-label, dose escalation, first-in-human phase 1 trial of PGDM1400LS given intravenously or subcutaneously to healthy adults aged 18-50 years without HIV-1. The study enrolled participants at four sites in the USA, across five groups, each receiving one dose of PGDM1400-LS intravenously (group 1: 5 mg/kg; group 2: 20 mg/kg; and group 4: 40 mg/kg) or subcutaneously (group 3: 20 mg/kg; and group 5: 40 mg/kg). Participants in group 1 were enrolled sequentially without random assignment. Participants in groups 2 and 3 were block randomised and enrolled simultaneously after group 1 safety review. Groups 4 and 5 followed the same process, contingent on groups 2 and 3 safety review. The primary endpoints were safety and tolerability of PGDM1400LS, serum concentration of PGDM1400LS, and serum neutralising activity after single administration of PGDM1400LS. Serum PGDM1400LS concentrations collected at seven timepoints (day 0, day 3, day 6, day 28, day 56, day 112, and day 168) were assessed via an anti-idiotype binding assay and characterised via non-compartmental pharmacokinetic analysis. Serum neutralisation activity (ID80) was assessed by a TZM-bl assay. The study is registered with ClinicalTrials.gov, NCT05184452.

FINDINGS: Between Nov 15, 2021, and March 4, 2022, 15 participants were enrolled into the five study groups (three participants per group) with 6 months of follow-up. Ten of 15 participants were female, 14 of 15 participants were non-Hispanic, and 11 of 15 participants were White, with a median age of 27 years (range 24-47). PGDM1400LS was safe and well tolerated, with mild to moderate solicited symptoms. Serum concentrations showed dose proportionality by administration route, with peak concentrations observed immediately after intravenous infusion (range 95·7-727·4 μg/mL) or on day 6 after subcutaneous infusion (205·6-547·1 μg/mL). The median elimination half-life was 55 days (range 48-59), representing a 2-to-3-times increase versus parental PDGM1400. Estimated subcutaneous (vs intravenous) bioavailability was 50-60%. ID80 titres showed agreement with concentration-predicted ID80 titres, indicating maintenance of neutralisation activity in vivo.

INTERPRETATION: PGDM1400LS is a promising candidate for combination monoclonal antibody efficacy trials going forward.

FUNDING: National Institute of Allergy and Infectious Diseases-National Institutes of Health.

RevDate: 2025-05-30

Triplette M, Omernik B, Snidarich M, et al (2025)

Tailored Patient Navigation to Support Lung Cancer Screening and Smoking Cessation in LGBTQ+ Individuals: A Pilot Study.

Annals of the American Thoracic Society [Epub ahead of print].

RATIONALE: Lung cancer is the leading cause of cancer death, with most cases attributable to cigarette smoking. People who identify as LGBTQ+ are more likely to smoke; however, there are limited interventions to support lung cancer prevention in this community. Through prior community-engaged work we developed a patient navigation intervention to support smoking cessation and lung cancer screening (LCS) for LGBTQ+ adults.

OBJECTIVE: To conduct a prospective pilot study of the patient navigation intervention to evaluate patient satisfaction, acceptability and knowledge change as well as LCS care completion and smoking cessation.

METHODS: We enrolled participants who currently smoked, identified as LGBTQ+ and were eligible for LCS into a patient navigation intervention and assessed outcomes over a 90-day period. We administered pre- and post-intervention surveys, tracked navigation and LCS activities in the electronic health record and verified tobacco cessation with exhaled carbon monoxide (CO) measurements. Primary outcomes included post-intervention Acceptability of Intervention Measure (AIM) scores, the Patient Satisfaction with Navigator Interpersonal Relationship (PSN-I) score, and knowledge change on two validated measures. Secondary outcomes included being appropriately up-to-date on LCS and smoking cessation, measured as reported >7 day floating abstinence and end-of-study CO-confirmed ≥30 day cessation.

RESULTS: Forty-one participants enrolled in the study and participated in the navigation program, with 34 completing post-intervention surveys at day 90. Acceptability (mean AIM score 4.5) and patient satisfaction (mean PSN-I score 40.8) were both high. Fifty-nine percent of individuals were appropriately up-to-date on LCS at day 90 compared to 22% at baseline. Of post-survey respondents, 41% reported a period of >7 day smoking abstinence during the study, with 18% reporting CO-confirmed abstinence of ≥30 days at study end.

CONCLUSIONS: Tailored patient navigation is a promising approach to enhance LCS uptake and smoking cessation in LCS-eligible LGBTQ+ individuals.

CLINICAL TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov NCT05304390. Primary Source of Funding. This work was funded through a grant from LUNGevity Foundation to Dr. Triplette.

RevDate: 2025-05-29

Agrawal P, Khechaduri A, Salladay KR, et al (2025)

Increased immunogen valency improves the maturation of vaccine-elicited HIV-1 VRC01-like antibodies.

PLoS pathogens, 21(5):e1013039 pii:PPATHOGENS-D-25-00601 [Epub ahead of print].

Antibodies belonging to the VRC01-class display broad and potent neutralizing activities and have been isolated from several people living with HIV (PLWH). A member of that class, monoclonal antibody VRC01, was shown to reduce HIV-acquisition in two phase 2b efficacy trials. VRC01-class antibodies are therefore expected to be one component of an effective HIV-1 vaccine elicited response. In contrast to the VRC01-class antibodies that are highly mutated, their unmutated forms do not engage HIV-1 envelope (Env) and do not display neutralizing activities. Hence, specifically modified Env-derived proteins have been designed to engage the unmutated forms of VRC01-class antibodies, and to activate the corresponding naïve B cells. Selected heterologous Env must then be used as boost immunogens to guide the proper maturation of these elicited VRC01-class antibodies. Here we examined whether and how the valency of the prime and boost immunogens influences VRC01-class antibody-maturation. Our findings indicate that, indeed the valency of the immunogen affects the maturation of elicited antibody responses by preferentially selecting VRC01-like antibodies that have accumulated somatic mutations present in broadly neutralizing VRC01-class antibodies isolated from PLWH. As a result, antibodies isolated from animals immunized with the higher valency immunogens display broader Env cross-binding properties and improved neutralizing potentials than those isolated from animals immunized with the lower valency immunogens. Our results are relevant to current and upcoming phase 1 clinical trials that evaluate the ability of novel immunogens aiming to elicit cross-reactive VRC01-class antibody responses.

RevDate: 2025-05-29

Ding Y, KN Naresh (2025)

Primary myelofibrosis involving lymph nodes with the same mutational profile in bone marrow.

Blood, 145(22):2672.

RevDate: 2025-05-29

Bondeelle L, Cheng GS, A Bergeron (2025)

What's new in the management of pulmonary complications in allogeneic stem cell transplantation?.

Expert review of respiratory medicine [Epub ahead of print].

INTRODUCTION: As survival increases after allogeneic hematopoietic stem cell transplantation (allo-HCT), several organ complications have emerged, including those involving the lung, which require a multidisciplinary management approach. The constant evolution of allo-HCT procedures, advances in diagnostic tools for infections and pulmonary disease, as well as new treatment approaches, require frequent updating of knowledge in this field.

AREAS COVERED: We review the multiple infectious and noninfectious lung complications that occur both early and late after allo-HCT. This includes an updated description of these complications, risk factors, diagnostic approach and outcome. A literature search was performed using PubMed-indexed journals.

EXPERT OPINION: The diagnosis of pulmonary complications after allo-HCT remains challenging, further complicated by the frequent association of co-infections and/or links between infection and noninfectious complications. The development of metagenomic next-generation sequencing (mNGS) should enhance the diagnostic yield of bronchoalveolar lavage but its clinical relevance remains to be evaluated. A better understanding of the pathophysiology of the lung chronic graft-versus-host disease (GVHD) and improved phenotyping are essential for advancing its diagnostic and therapeutic management. This requires a revision of diagnostic criteria and the identification of new biomarkers of early disease.

RevDate: 2025-05-31
CmpDate: 2025-05-29

Creighton RL, Hughes SM, Hladik F, et al (2025)

The intestinal interferon system and specialized enterocytes as putative drivers of HIV latency.

Frontiers in immunology, 16:1589752.

The barrier to HIV cure is the HIV reservoir, which is composed of latently infected CD4[+] T cells and myeloid cells that carry stably integrated and replication-competent provirus. The gastrointestinal tract (GIT) contains a substantial part of the HIV reservoir and its immunophysiology could be especially conducive for HIV persistence and reactivation. However, the exact cellular microenvironment and molecular mechanisms that govern the renewal of provirus-harboring cells and proviral reactivation in the GIT remain unclear. In this review, we outline the evidence supporting an overarching hypothesis that interferon activity driven by specialized enterocytes creates a microenvironment that fosters proliferation of latently infected CD4[+] T cells and sporadic HIV reactivation from these cells. First, we describe unique immunologic features of the gastrointestinal associated lymphoid tissue (GALT), specifically highlighting IFN activity in specialized enterocytes and potential interactions between these cells and neighboring HIV susceptible cells. Then, we will describe dysregulation of IFN signaling in HIV infection and how IFN dysregulation in the GALT may contribute to the persistence and reactivation of the latent HIV reservoir. Finally, we will speculate on the clinical implications of this hypothesis for HIV cure strategies and outline the next steps.

RevDate: 2025-05-31
CmpDate: 2025-05-29

Ackerley CG, Edupuganti S, Yu C, et al (2025)

Retrospective analysis of sex-disaggregated immune responses to ALVAC-HIV and bivalent subtype C gp120/MF59 HIV vaccines.

Frontiers in immunology, 16:1557009.

INTRODUCTION: Generally, individuals assigned female at birth (AFAB) develop greater immunogenicity to various vaccines than individuals assigned male at birth (AMAB). Little is known about sex-disaggregated immunogenicity to HIV-1 vaccines. We disaggregated immune responses to an experimental HIV vaccine regimen.

METHODS: We retrospectively analyzed data from HVTN 100, a clinical trial conducted in South Africa during which 143 adults AMAB and 109 AFAB aged 18-40 years without HIV received ALVAC-HIV vCP2438 plus bivalent subtype C gp120/MF59 or placebo at 0, 1, 3, 6, and 12 months. Eligible data were from per-protocol vaccine recipients at month 6.5. We measured IgG binding antibodies, neutralizing antibodies, antibody-dependent cell-mediated cytotoxicity (ADCC), antibody-dependent cellular phagocytosis (ADCP), and CD4+ IFNγ and/or II-2 responses. We compared sex-based differences in response rates using Barnard's test and response magnitudes using Wilcoxon Rank Sum test. P-values were Holm-adjusted for multiple comparisons.

RESULTS: Of 185 vaccine recipients, 73 were AFAB and 112 were AMAB. Vaccine recipients AFAB had greater ADCC response rate (57.5% versus 29.5%; padj = 0.0003) and greater ADCC magnitude (area under the net % granzyme B activity vs log10 curve (AUC), 16.1 versus 11.2; padj = 0.05) to vaccine-matched antigen TV1.C gp120 compared to AMAB. Vaccine recipients AMAB had higher CD4+ T cell response rates to 2/3 vaccine-matched antigens at month 6.5 (ZM96.C gp120, [54.1% versus 36.8%; padj = 0.04]; 1086.C gp120, [44.1% versus 29.4%; padj = 0.05]) than AFAB. CD4+ T cell response magnitudes were similar by sex. IgG binding antibody response rate to B.CaseA V1V2 antigen (associated with reduced HIV acquisition risk in the RV144 trial) was 56.8% among AMAB vaccine recipients versus 38.9% among AFAB (padj = 0.08). There were no sex-based differences in neutralizing antibody or ADCP responses.

DISCUSSION: We identified sex-based differences in immune responses to an HIV vaccine regimen, but they varied by immunologic assay. While vaccine recipients AFAB demonstrated higher ADCC responses, AMAB exhibited higher CD4+ T cell response rates. Future analyses should investigate whether vaccine factors such as platform, dosing and adjuvants contribute to sex-based differences in immunogenicity of experimental HIV vaccines.

RevDate: 2025-05-28

Wudhikarn K, Herr MM, Chen M, et al (2025)

Infection after CD19 chimeric antigen receptor T cell therapy for large B cell lymphoma: Real-world analysis from CIBMTR.

Blood advances pii:537515 [Epub ahead of print].

Infection is increasingly recognized as a significant cause of morbidity and mortality in patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL) receiving CD19 chimeric antigen receptor (CAR) T-cell therapy. The current study analyzed the natural history, risk factors, and outcomes of infection in 3350 R/R LBCL patients receiving commercial CD19 CAR T-cell (n=2804 axicabtagene ciloleucel, n=546 tisagenlecleucel) from December 2017 to June 2022. Infection developed in 834 (24.9%) patients within 100 days post-infusion, resulting in an infection density of 0.43 per 100 patient-days and a 100-day cumulative incidence of 22%. Bacterial, viral, and fungal infections were recorded in 527 (15.7%), 374 (11.2%), and 108 (3.2%) patients, respectively, with corresponding infection densities of 0.23, 0.15, and 0.04 per 100 patient-days. After a 24-month median follow-up, 1482 (44%) patients had died, with infection as the primary cause in 173 cases (12%). The 100-day infection-related mortality (IRM) was 1.6% (95% confidence interval, 1.2-2.0%). Patients with Karnofsky score ≤80, infection history pre-CAR-T, axicabtagene ciloleucel therapy, severe cytokine release syndrome (grade ≥3), and severe immune effector cell-associated neurotoxicity syndrome (grade ≥3) had increased infection risk. Infections within 100 days were an independent risk factor for inferior overall survival beyond day 100 after CD19 CAR T-cell therapy. In conclusion, study results show a significant incidence of infection and IRM in patients with R/R LBCL treated with CD19 CAR T-cell. Furthermore, results identify patients at heightened risk for infection, offering insights to guide potential interventions aimed at mitigating infection and improving patient outcomes after CAR T-cell therapy.

RevDate: 2025-05-28

Nakasone ES, SA Cohen (2025)

Secondary Acute Myeloid Leukemia following Treatment for Metastatic Poorly Differentiated Pancreatic Neuroendocrine Carcinoma: A Cautionary Sequel to an Exceptional Response.

Pancreas pii:00006676-990000000-00311 [Epub ahead of print].

RevDate: 2025-05-28
CmpDate: 2025-05-28

Daca-Álvarez M, Brunori A, Carbone A, et al (2025)

Emerging Strategies for Drug-Based Cancer Risk Reduction.

American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting, 45(3):e473708.

Chemoprevention has emerged as a promising strategy to reduce cancer incidence by using pharmacologic agents that interrupt the carcinogenesis process. This review discusses emerging insights and recent advancements in chemoprevention, emphasizing novel approaches in several cancer types. Specifically, we examine breast cancer prevention, focusing on optimized endocrine therapy dosing to enhance adherence and minimize adverse effects while maintaining efficacy. Additionally, the potential of glucagon-like peptide-1 receptor agonists to mitigate obesity-related cancer risks is evaluated, highlighting their role in addressing an increasingly prevalent risk factor in the general population. The review further explores strategies targeting colorectal cancer (CRC), specifically in familial adenomatous polyposis, a hereditary CRC syndrome that exemplifies the complex interplay between chemoprevention, genetic risk, and patient management. In prostate cancer, we highlight the evidence supporting the use of 5-alpha reductase inhibitors, detailing their effectiveness in reducing cancer incidence as well as their safety profile. Across these areas, this review underscores the importance of precision medicine, advocating for personalized approaches that balance efficacy, safety, and quality-of-life considerations. Ultimately, advancing chemopreventive strategies through targeted research and clinical trials is essential for reducing cancer burden and improving patient outcomes.

RevDate: 2025-05-31
CmpDate: 2025-05-28

Marsh NM, MacEwen MJS, Chea J, et al (2025)

Mitochondrial calcium signaling regulates branched-chain amino acid catabolism in fibrolamellar carcinoma.

Science advances, 11(22):eadu9512.

Metabolic adaptations are essential for survival. The mitochondrial calcium uniporter plays a key role in coordinating metabolic homeostasis by regulating mitochondrial metabolic pathways and calcium signaling. However, a comprehensive analysis of uniporter-regulated mitochondrial pathways has remained unexplored. Here, we investigate consequences of uniporter loss and gain of function using uniporter knockout cells and fibrolamellar carcinoma (FLC), which we demonstrate to have elevated mitochondrial calcium levels. We find that branched-chain amino acid (BCAA) catabolism and the urea cycle are uniporter-regulated pathways. Reduced uniporter function boosts expression of BCAA catabolism genes and the urea cycle enzyme ornithine transcarbamylase. In contrast, high uniporter activity in FLC suppresses their expression. This suppression is mediated by the transcription factor KLF15, a master regulator of liver metabolism. Thus, the uniporter plays a central role in FLC-associated metabolic changes, including hyperammonemia. Our study identifies an important role for the uniporter in metabolic adaptation through transcriptional regulation of metabolism and elucidates its importance for BCAA and ammonia metabolism.

RevDate: 2025-05-31
CmpDate: 2025-05-28

Andrews LIB, Halloran ME, Neuzil KM, et al (2025)

Evaluating the Test-Negative Design for COVID-19 Vaccine Effectiveness Using Randomized Trial Data: A Secondary Cross-Protocol Analysis of 5 Randomized Clinical Trials.

JAMA network open, 8(5):e2512763.

IMPORTANCE: The test-negative design (TND) has been widely used to assess postmarketing COVID-19 vaccine effectiveness but requires further evaluation for this application.

OBJECTIVE: To determine whether the TND reliably evaluates vaccine effectiveness against symptomatic COVID-19 using placebo-controlled vaccine efficacy randomized clinical trials (RCTs).

This secondary cross-protocol analysis constructed TND study datasets from study sites in 16 countries across 5 continents using the blinded phase cohorts of 5 harmonized phase 3 COVID-19 Prevention Network RCTs: COVE (Coronavirus Vaccine Efficacy and Safety), AZD1222, ENSEMBLE, PREVENT-19 (Prefusion Protein Subunit Vaccine Efficacy Novavax Trial COVID-19), and VAT00008. Participants included adults who received the intended number of doses, experienced COVID-19-like symptoms, and obtained SARS-CoV-2 testing. Start dates ranged from July 27, 2020, to October 19, 2021; data cutoff dates ranged from March 26, 2021, to March 15, 2022. Statistical analysis was performed from May 11, 2023, to February 25, 2025.

INTERVENTIONS: Participants received vaccines consisting of messenger RNA-1273 (COVE; 2 doses 28 days apart), ChAdOx1 nCoV-19 (AZD1222; 2 doses 28 days apart), Ad26.COV2.S (ENSEMBLE; 1 dose), NVX-CoV2373 (PREVENT-19; 2 doses 21 days apart), CoV2 preS dTM-AS03 (VAT00008; D614) (2 doses 21 days apart), or CoV2 preS dTM-AS03 (D614 plus B.1.351) (VAT00008; 2 doses 21 days apart) or placebo.

MAIN OUTCOMES AND MEASURES: Main outcomes were symptomatic COVID-19 according to each trial's primary efficacy definition and the Centers for Disease Control and Prevention definition. Vaccine effectiveness was estimated using targeted maximum likelihood estimation under a semiparametric logistic regression model and ordinary logistic regression. Noncase exchangeability, a core TND assumption for unbiased estimation, was also assessed by estimating vaccine efficacy against non-COVID-19 illness.

RESULTS: Among the 12 157 participants included in the analysis, mean (SD) age was 45 (15) years, 6414 were female (53%), 5858 were vaccinated (48%), 2835 experienced primary COVID-19 (23%), and 2992 experienced Centers for Disease Control and Prevention-defined COVID-19 (25%). TND vaccine effectiveness estimates were concordant with RCT vaccine efficacy estimates (concordance correlation coefficient, 0.86 [95% CI, 0.58-0.96] for both outcomes). The semiparametric method had 48% smaller variance estimates than ordinary logistic regression. Noncase exchangeability was generally supported with a median vaccine efficacy against non-COVID-19 illness of 7.7% (IQR, 2.7%-16.8%) across trial cohorts and most 95% CIs including 0.

CONCLUSIONS AND RELEVANCE: In this cross-protocol analysis, the TND provided reliable inferences on COVID-19 vaccine effectiveness in health care-seeking populations for multiple vaccines and symptom definitions when confounding and selection bias were absent. A machine-learning approach for robust confounding control in postmarketing TND studies was also introduced.

RevDate: 2025-05-31

Dahlberg A, Stevenson P, Bhatt NS, et al (2025)

Disease Burden at the Time of Transplantation Is a Primary Predictor of Outcomes in Pediatric MDS: A Single-Center Experience.

Cancers, 17(10):.

BACKGROUND: Hematopoietic cell transplantation (HCT) remains the only curative therapy for pediatric myelodysplastic syndrome (MDS) in all but rare cases. While HCT outcomes for pediatric MDS are similar across the largest registry and single-center trials, factors identified as contributing to inferior outcomes vary from study to study. We performed an analysis to provide more clarity on the prognostic implications of disease characteristics, including blast burden and cytogenetic abnormalities, in the current era.

METHODS: We conducted a retrospective analysis of 36 consecutive children (<18 years of age at HCT) who underwent allogeneic HCT for MDS between June 2000 and October 2019 at the Fred Hutchinson Cancer Center.

RESULTS: Overall survival (OS) was 77% (95% CI 64-92%) and relapse-free survival (RFS) was 71% (95% CI 57-88%) at 2 years post-HCT. Patients with <5% blasts by morphology in the bone marrow at the time of HCT showed superior 2-year OS at 87% (95% CI 74-100%) as compared to 54% (95% CI 32-93%) in patients with ≥5% blasts, consistent with an HR of 4.6 (CI 1.14-18.7, p = 0.03). The inferior outcomes in patients with ≥5% blasts were due to increased relapse incidence (HR 7.6, CI 1.5-39.3) with no difference in NRM or acute GVHD.

CONCLUSIONS: OS and RFS were comparable to what has been observed in other large, single-center studies (OS 77%, RFS 71% at 2 years) and compared favorably to outcomes from the largest multi-center retrospective analyses.

RevDate: 2025-05-27

Kwan EM, Ng SWS, Tolmeijer SH, et al (2025)

Lutetium-177-PSMA-617 or cabazitaxel in metastatic prostate cancer: circulating tumor DNA analysis of the randomized phase 2 TheraP trial.

Nature medicine [Epub ahead of print].

The prostate-specific membrane antigen (PSMA)-targeted radioligand [[177]Lu]Lu-PSMA-617 is a new standard treatment for metastatic castration-resistant prostate cancer (mCRPC), but predictive genomic biomarkers informing its rational use are unknown. We performed detailed dissection of prostate cancer driver genes across 290 serial plasma cell-free DNA samples from 180 molecular imaging-selected patients with mCRPC from the randomized TheraP trial of [[177]Lu]Lu-PSMA-617 (n = 97) versus cabazitaxel chemotherapy (n = 83). The primary endpoint was PSA50 biochemical response, with secondary endpoints of progression-free survival (PFS) and overall survival (OS). In this post-hoc biomarker analysis, a low pretreatment circulating tumor DNA (ctDNA) fraction predicted a superior biochemical response (100% versus 58%, P = 0.0067) and PFS (median 14.7 versus 6.0 months; hazard ratio 0.12, P = 2.5 × 10[-4]) on [[177]Lu]Lu-PSMA-617 independent of predictive PSMA-positron emission tomography imaging parameters, although this benefit did not extend to OS. Deleterious PTEN alterations were associated with worse PFS and OS on cabazitaxel, whereas ATM defects were observed in select patients with favorable [[177]Lu]Lu-PSMA-617 outcomes. Comparing pretreatment and progression ctDNA revealed population flux but no evidence that alterations in individual mCRPC genes (or FOLH1) are dominant causes of acquired [[177]Lu]Lu-PSMA-617 or cabazitaxel resistance. Our results nominate new candidate biomarkers for [[177]Lu]Lu-PSMA-617 selection and ultimately expand the mCRPC predictive biomarker repertoire. We anticipate our ctDNA fraction-aware analytical framework will aid future precision management strategies for [[177]Lu]Lu-PSMA-617 and other PSMA-targeted therapeutics. ClinicalTrials.gov identifier: NCT03392428 .

RevDate: 2025-05-30
CmpDate: 2025-05-27

Borot F, Humbert O, Ehmsen JT, et al (2025)

Multiplex base editing to protect from CD33 directed drugs for immune and gene therapy.

Nature communications, 16(1):4899.

The selection of genetically engineered immune or hematopoietic cells in vivo after gene editing remains a clinical problem and requires a method to spare on-target toxicity to normal cells. Here, we develop a base editing approach exploiting a naturally occurring CD33 single nucleotide polymorphism leading to removal of full-length CD33 surface expression on edited cells. CD33 editing in human and nonhuman primate hematopoietic stem and progenitor cells protects myeloid progeny from CD33-targeted therapeutics without affecting normal hematopoiesis in vivo, thus demonstrating potential for improved immunotherapies with reduced off-leukemia toxicity. For broader application to gene therapies, we demonstrate highly efficient (>70%) multiplexed adenine base editing of the CD33 and gamma globin genes, resulting in long-term persistence of dual gene-edited cells with HbF reactivation in nonhuman primates. Using the CD33 antibody-drug conjugate Gemtuzumab Ozogamicin, we show resistance of engrafted, multiplex edited human cells in vivo, and a 2-fold enrichment for edited cells in vitro. Together, our results highlight the potential of adenine base editors for improved immune and gene therapies.

RevDate: 2025-05-27

Swaminathan M, Holt SK, Gore JL, et al (2025)

Association Between Rheumatoid Arthritis, Frailty Status, and Mortality in Older Adults with Bladder Cancer.

Clinical genitourinary cancer pii:S1558-7673(25)00070-9 [Epub ahead of print].

BACKGROUND: To evaluate the associations between rheumatoid arthritis (RA) and all-cause (ACM) and cancer-Specific mortality (CSM) in older adults with bladder cancer and examine how frailty may affect these associations.

METHODS: Retrospective cohort study derived from the Surveillance Epidemiology and End Results (SEER) cancer registry and linked to Medicare claims data (SEER-Medicare). The cohort consisted of patients ≥ 65 years diagnosed with bladder cancer between 2004 and 2017. RA and frailty status were derived using validated administrative algorithms. ACM and CSM as derived from the SEER registry.

RESULTS: Frailty modified the relationship between RA and mortality outcomes (interaction P value for ACM: .002 and for CSM: .007). We observed that RA was associated with a higher risk of CSM (aHR 1.17, 95% CI, 1.01-1.35) and ACM (aHR 1.12, 95% CI, 1.05-1.20) in nonfrail patients. In frail patients with bladder cancer, RA was not independently associated with CSM (aHR 0.81, 95% CI, 0.62-1.06) or ACM (aHR 0.93, 95% CI, 0.83-1.05).

CONCLUSION: Frailty is associated with adverse health outcomes. As people are living longer, it is becoming increasingly prevalent among patients with chronic conditions such as RA. We observed that RA is associated with increased risk of ACM and CSM among nonfrail older adults with bladder cancer. The lack of an association between RA and mortality in frail patients with RA suggests that the effect of frailty on mortality may overpower the effect that RA may exert-this information can help prognosticate outcomes in patients with bladder cancer, RA, and frailty.

RevDate: 2025-05-27
CmpDate: 2025-05-27

Tatunay K, Cohen S, Naylor LV, et al (2025)

Does paired genetic testing improve targeted therapy choices and screening recommendations for patients with upper gastrointestinal cancers and their families? A prospective cohort of 42 patients.

BMJ open, 15(5):e091745.

OBJECTIVES: Our study was designed to assess whether paired normal-tumour testing increased access to targeted therapy, clinical trials and influenced cancer screening recommendations given to patients and their families.

DESIGN: Prospective cohort study.

SETTING: Academic cancer centre in the Pacific Northwest region of the USA.

PARTICIPANTS: Patients newly diagnosed between 01 January 2021 and 31 December 2022 with cancers of the oesophagus, gastro-oesophageal junction and stomach (CEGEJS) were included. All other cancer diagnoses such as head and neck, duodenal and lower gastrointestinal tract cancers were excluded.

INTERVENTION: Paired germline and tumour genetic test within 90 days of new patient visit.

PRIMARY OUTCOME MEASURES: Number of targeted therapies received (or not) when eligible, follow-up treatment data and number of inherited predispositions to cancers identified. No secondary outcome measures.

RESULTS: Of 42 patients, 32 (76.2%) were eligible for at least one targeted therapy. 19 patients received immunotherapy, when 16 had a biomarker predicting immunotherapy benefit, and benefit of immunotherapy was unclear for 3. Another 11 did not have this biomarker, and 6 of them received immunotherapy. Six pathogenic variants were identified in four high-risk genes. By 01 January 2024, 18 patients (42.9%) had died of complications of cancer.

CONCLUSION: More than 75% of patients who received tumour testing were eligible for a targeted therapy regardless of their stage at diagnosis, emphasising the need to expand access to testing with staging workup to improve survival outcomes. Six families received personalised screening recommendations, thanks to this study.

RevDate: 2025-05-27

Zeller M, Chang J, Trevisan G, et al (2025)

Nextclade data set for the ORF5-based lineage classification of PRRSV-1.

Microbiology resource announcements [Epub ahead of print].

A Nextclade data set for PRRSV-1 ORF5 based on a global nomenclature for standardized lineage classification was developed. This tool enables rapid sequence analysis, visualization, and comparison with reference strains and vaccines. By providing accessibility, it facilitates broader adoption of PRRSV-1 classification frameworks for research and surveillance.

RevDate: 2025-05-27
CmpDate: 2025-05-27

Spencer KR, GG King (2025)

MDM2 as a therapeutic target in advanced biliary tract cancers.

The oncologist, 30(5):.

Biliary tract cancers (BTCs) are a heterogeneous group of tumors arising from cells in the bile ducts and gallbladder. The 5-year overall survival rate for all BTC stages combined is ~20%, and treatment options for patients with unresectable disease are limited, leaving an unmet clinical need. In recent years, significant efforts have been made to refine and implement targeted therapeutic approaches for patients with BTC. The adoption of early and comprehensive molecular profiling is crucial to identifying patients who may be candidates for effective targeted therapies. Characterization of the molecular landscape of BTCs led to the identification of murine double minute 2 homolog gene (MDM2) amplification across all BTC subtypes. The MDM2 protein is a critical negative regulator of p53 stabilization and activity that is an emerging actionable biomarker in BTCs. There are multiple therapeutic approaches that aim to target MDM2 activity, thereby restoring the intrinsic tumor suppressor function of p53 and halting oncogenesis. However, these have been limited by our evolving understanding of the role of MDM2 in BTC pathogenesis. Here, we offer a review of the current understanding of the role of MDM2 in BTC biology and its therapeutic implications.

RevDate: 2025-05-27
CmpDate: 2025-05-27

Paktinat S, Gravett MG, Tobey C, et al (2025)

Extracellular vesicles from human semen induce unique tolerogenic phenotypes in vaginal dendritic cells and regulatory T lymphocytes.

Frontiers in immunology, 16:1564002.

INTRODUCTION: The regulation of immune responses to promote tolerance to the fetus is critical for successful pregnancy. An understudied aspect of this process is the initiation of regulation pre-conception via exposure to semen. Our study aimed to understand how semen impacts recipient dendritic cells (DCs) and their subsequent role in shaping CD4 T cell differentiation.

METHODS: Monocyte-derived DCs (MoDCs) were exposed to semen extracellular vesicles (SEV) or vesicle-depleted semen plasma (VDSP). Phenotypic and functional markers were analyzed using flow cytometry. We also exposed epithelial sheets from vaginal tissue to SEV and VDSP, and measured the number and marker expression of emigrating cells. Finally, we tested how SEV- or VDSP-exposed DCs altered CD4 T cell differentiation by co-culturing exposed MoDCs or tissue emigrated cells with autologous naïve CD4 T cells.

RESULTS: MoDCs exhibited a significant increase of CD141, CD1a, CD38, and ILT4 expression when exposed to SEV or VDSP. A unique feature of semen-treated MoDCs was expression of indoleamine 2,3-dioxygenase (IDO), a potent contributor to the induction of regulatory T cells (Tregs). SEV but not VDSP significantly increased the emigration of intraepithelial DCs. Additionally, SEV significantly enhanced the expression of multiple immunoregulatory markers in the emigrated DCs. After co-culture, we observed significantly more FOXP3+ Tregs expressing high levels of TIGIT in the groups that were initially exposed to SEV.

DISCUSSION: These findings indicate that exposure to SEV induces a tolerogenic program in DCs that can direct differentiation of a unique memory Treg subset, primed for expansion and presumably destined to support a successful pregnancy.

RevDate: 2025-05-27

Hansen SG, Schell JB, Marshall EE, et al (2025)

Glycoprotein L-deleted single-cycle rhesus cytomegalovirus vectors elicit MHC-E-restricted CD8+ T cells that protect against SIV.

Journal of immunology (Baltimore, Md. : 1950) pii:8150972 [Epub ahead of print].

Strain 68-1 rhesus CMV (RhCMV) vectors induce immune responses that mediate early, complete replication arrest of SIV infection in ∼60% of vaccinated rhesus macaques (RMs). This unique efficacy depends on the ability of these vectors to elicit effector memory (EM)-biased CD8+ T cells recognizing SIV peptides presented by MHC-E, rather than MHC-Ia. These efficacious responses still occurred when spread of the 68-1 vector was impaired by deletion of the viral anti-host intrinsic immunity factor phosphoprotein 71 (pp71), but efficacy was lost with a more stringent attenuation strategy based on destabilization of Rh108, the ortholog of the essential human CMV (HCMV) transcription factor UL79 that is required for late viral gene expression. Although unable to produce infectious progeny (ie single-cycle infection), Rh108-deficient vectors elicited durable, high frequency, EM-biased, SIV-specific CD8+ T-cell responses in RMs, but these responses were MHC-Ia-restricted and therefore non-efficacious. Here, we tested a different single-cycle attenuation strategy based on deletion (Δ) of the glycoprotein L (gL) that is essential for viral entry but allows for late gene expression and viral assembly. ΔgL 68-1 RhCMV/SIV vectors, grown on gL-complementing fibroblasts, were robustly immunogenic at doses above 105 PFU, generating high frequency, EM-biased, SIV-specific CD8+ T-cell responses that were also unconventionally restricted, including the MHC-E restriction associated with efficacy. Indeed, these single-cycle vectors manifested replication arrest efficacy in 70% of vaccinated RMs, further linking MHC-E restriction with efficacy, and demonstrating that 68-1 RhCMV/SIV efficacy does not require vector dissemination within the host.

RevDate: 2025-05-26
CmpDate: 2025-05-26

Raychaudhuri S, Gem H, Chung K, et al (2025)

Distal gut colonization by oral bacteria during intensive chemotherapy: direct evidence from strain-level analysis of paired samples.

NPJ biofilms and microbiomes, 11(1):88.

Oral bacteria have been found in the colon in pathologies such as inflammatory bowel disease. To ascertain niche coalescence, 2 elements are essential: (i) paired oral/fecal samples and (ii) strain-level resolution. We profiled the microbiota in 283 samples from 39 patients undergoing intensive chemotherapy at baseline (saliva: 49, plaque: 51, stool: 43), week 2 (saliva: 18, plaque: 17, stool: 17), week 3 (saliva: 18, plaque: 21, stool: 21), and week 4 (saliva: 8, plaque: 10, stool: 10) of chemotherapy. Through strain-level analysis of paired samples, we demonstrate strong evidence for a breakdown of niche separation in most patients. The extent of overlap increased with time, particularly in patients with intestinal mucositis. Our findings provide definitive evidence for ectopic colonization of the distal gut by oral bacteria in a disease state, likely facilitated by intestinal mucositis. Microbiota contribution by the mouth to the colon may have consequences for the host.

RevDate: 2025-05-26
CmpDate: 2025-05-26

Dobersch S, Yamamoto N, Schutter A, et al (2025)

HMGA2 and protein leucine methylation drive pancreatic cancer lineage plasticity.

Nature communications, 16(1):4866.

Basal pancreatic ductal adenocarcinoma (PDAC) has the worst overall survival and is the only subtype that serves as an independent poor prognostic factor. We identify elevated levels of LIN28B and its downstream target, HMGA2, in basal PDAC. Notably, LIN28B significantly accelerates KRAS-driven PDAC progression in a mouse model. Here, we show that HMGA2 promotes basal PDAC pathogenesis by enhancing mRNA translation downstream of LIN28B. Mechanistically, HMGA2 suppresses leucine carboxyl methyltransferase 1 (LCMT1) at the chromatin level, reducing PP2A methylation and activity. This leads to increased phosphorylation of S6K and eIF4B, boosting mRNA translation. Additionally, HMGA2 downregulates B56α (PPP2R5A), disrupting functional PP2A holoenzyme assembly and further sustaining phosphorylated S6K levels. Impaired PP2A function mimics HMGA2's effects, reinforcing increased mRNA translation and basal lineage features. This work uncovers a critical link between the LIN28B/HMGA2 axis, protein synthesis, and PDAC lineage specificity via LCMT1-mediated PP2A methylation and B56α-PP2A disruption.

RevDate: 2025-05-26

Ahmed S, Blosser C, Israni AK, et al (2025)

Reply to "Real-world registry evidence beware: Old-world risk analysis may not be applicable to new world belatacept utilization".

RevDate: 2025-05-26

Mehta RS, Schmidt G, Williams K, et al (2025)

Choosing between HLA-Mismatched Unrelated and Haploidentical donors: Donor age considerations.

Transplantation and cellular therapy pii:S2666-6367(25)01203-5 [Epub ahead of print].

BACKGROUND: Haploidentical donors and HLA-mismatched unrelated donors (MMUDs) are increasingly utilized for hematopoietic cell transplantation (HCT), with post-transplantation cyclophosphamide (PTCy) emerging as an effective graft-versus-host disease (GVHD) prophylaxis strategy. Despite the growing use of these donor types, comparative data to guide donor selection remain limited. Donor age is a known predictor of HCT outcomes, yet its specific impact when choosing between haploidentical and MMUD donors with PTCy-based prophylaxis has not been thoroughly explored.

OBJECTIVES: This study aimed to evaluate the influence of donor age on HCT outcomes in patients receiving haploidentical or MMUD HCT with PTCy-based GVHD prophylaxis, hypothesizing that younger donors (<30 years) would be associated with improved outcomes compared to older donors (≥30 years) regardless of donor type.

STUDY DESIGN: We conducted a retrospective analysis of 7,116 patients with hematologic malignancies from the Center for International Blood and Marrow Transplant Research (CIBMTR) database, transplanted between 2013 and 2021. Donors were categorized into four groups: younger haploidentical (<30 years), older haploidentical (≥30 years), younger MMUD (<30 years), and older MMUD (≥30 years). The primary outcome was GVHD-free relapse-free survival (GRFS), defined as the absence of grade III-IV acute GVHD, chronic GVHD requiring systemic immunosuppressive therapy (IST), relapse, or death. Secondary outcomes included overall survival (OS), treatment-related mortality (TRM), relapse, grade III-IV acute GVHD, overall chronic GVHD, and chronic GVHD requiring IST. Comparisons were made between (a) younger MMUD vs. older haploidentical and (b) younger haploidentical vs. older MMUD groups using multivariable Cox proportional hazards models.

RESULTS: In multivariable analysis, the older MMUD group exhibited inferior GRFS (Hazard Ratio [HR] 1.20; 95% confidence interval [CI], 1.06-1.36; p=0.003), higher TRM (HR 1.49; 95% CI, 1.13-1.96; p=0.005), and increased grade III-IV acute GVHD (HR 2.88; 95% CI, 1.43-5.80; p=0.003) compared to the younger haploidentical group. The younger MMUD group had modest GRFS improvement over the older haploidentical group (HR 0.87; 95% CI, 0.78-0.98; p=0.02) and significantly reduced risks of grade II-IV acute GVHD (HR 0.67; 95% CI, 0.51-0.88; p=0.003) and chronic GVHD (HR 0.78; 95% CI, 0.65-0.94; p=0.009).

CONCLUSIONS: Younger donor age is associated with superior HCT outcomes, emphasizing the importance of prioritizing donors aged <30 years regardless of donor type when feasible.

RevDate: 2025-05-27
CmpDate: 2025-05-26

Yang Z, Rizopoulos D, Heijnsdijk EAM, et al (2025)

Personalized Biopsy Schedules Using an Interval-Censored Cause-Specific Joint Model.

Statistics in medicine, 44(10-12):e70134.

Active surveillance (AS), where biopsies are conducted to detect cancer progression, has been acknowledged as an efficient way to reduce the overtreatment of prostate cancer. Most AS cohorts use fixed biopsy schedules for all patients. However, the ideal test frequency remains unknown, and the routine use of such invasive tests burdens the patients. An emerging idea is to generate personalized biopsy schedules based on each patient's progression-specific risk. To achieve that, we propose the interval-censored cause-specific joint model (ICJM), which models the impact of longitudinal biomarkers on cancer progression while considering the competing event of early treatment initiation. The underlying likelihood function incorporates the interval-censoring of cancer progression, the competing risk of treatment, and the uncertainty about whether cancer progression occurred since the last biopsy in patients that are right-censored or experience the competing event. The model can produce patient-specific risk profiles up to a horizon time. If the risk exceeds a certain threshold, a biopsy is conducted. The optimal threshold can be chosen by balancing two indicators of the biopsy schedules: The expected number of biopsies and the expected delay in detection of cancer progression. A simulation study showed that our personalized schedules could considerably reduce the number of biopsies per patient by 41%-52% compared to the fixed schedules, though at the cost of a slightly longer detection delay.

RevDate: 2025-05-25

Ahmed SO, Fakih RE, Kharfan-Dabaja MA, et al (2025)

Setting up a CAR-T Program: A Framework for Delivery from the Worldwide Network for Blood & Marrow Transplantation.

Transplantation and cellular therapy pii:S2666-6367(25)01196-0 [Epub ahead of print].

Chimeric antigen receptor therapy (CAR-T therapy) is a genetically engineered cellular therapy that is currently integrated into the management of hematological malignancies. Institutions treating patients with CAR-T therapy need to establish a framework of delivery that covers all the main components of the patient journey including intake of patients into the program from referring centers, patient selection according to established eligibility criteria, apheresis, logistics, bridging therapy, infusion and post-infusion care. A CAR-T therapy program, with its unique requirements, needs to be delivered by a multidisciplinary team (MDT). Prior to the establishment of the program, a well-structured business plan should be developed with a clear financial and/or reimbursement model. Consideration should be given to the overall capacity and staffing requirements. Standard operating procedures and guidelines are vital for ensuring that quality standards are clearly defined and adhered to. Institutions should develop a research plan for CAR-T that may incorporate not only industry sponsored trials but also in-house CAR-T manufacture of investigational CAR-T constructs. This report presents recommendations from a group of international experts highlighting the priorities and considerations when developing a new CAR-T program.

RevDate: 2025-05-27
CmpDate: 2025-05-24

Zanti M, O'Mahony DG, Parsons MT, et al (2025)

Analysis of more than 400,000 women provides case-control evidence for BRCA1 and BRCA2 variant classification.

Nature communications, 16(1):4852.

Clinical genetic testing identifies variants causal for hereditary cancer, information that is used for risk assessment and clinical management. Unfortunately, some variants identified are of uncertain clinical significance (VUS), complicating patient management. Case-control data is one evidence type used to classify VUS. As an initiative of the Evidence-based Network for the Interpretation of Germline Mutant Alleles (ENIGMA) Analytical Working Group we analyze germline sequencing data of BRCA1 and BRCA2 from 96,691 female breast cancer cases and 302,116 controls from three studies: the BRIDGES study of the Breast Cancer Association Consortium, the Cancer Risk Estimates Related to Susceptibility consortium, and the UK Biobank. We observe 11,207 BRCA1 and BRCA2 variants, with 6909 being coding, covering 23.4% of BRCA1 and BRCA2 VUS in ClinVar and 19.2% of ClinVar curated (likely) benign or pathogenic variants. Case-control likelihood ratio (ccLR) evidence is highly consistent with ClinVar assertions for (likely) benign or pathogenic variants; exhibiting 99.1% sensitivity and 95.3% specificity for BRCA1 and 93.3% sensitivity and 86.6% specificity for BRCA2. This approach provides case-control evidence for 787 unclassified variants; these include 579 with strong or moderate benign evidence and 10 with strong pathogenic evidence for which ccLR evidence is sufficient to alter clinical classification.

RevDate: 2025-05-24

Raychaudhuri R, Cheng HH, Gulati R, et al (2025)

Results from a Phase 2 Study of Induction Docetaxel and Carboplatin Followed by Maintenance Rucaparib in the Treatment of Patients with Metastatic Castration-resistant Prostate Cancer with DNA Homologous Recombination Repair Deficiency.

European urology oncology pii:S2588-9311(25)00123-3 [Epub ahead of print].

BACKGROUND AND OBJECTIVE: Our aim was to determine whether induction chemotherapy followed by PARP inhibitor (PARPi) maintenance improves outcomes for patients with metastatic castration-resistant prostate cancer (mCRPC) harboring alterations in homologous recombination repair (HRR) genes in comparison to a historical control cohort treated with PARPi monotherapy.

METHODS: This single-arm, open-label, investigator-initiated phase 2 trial (NCT02985021) enrolled 18 patients with mCRPC with pathogenic alterations in HRR genes between 2018 and 2021 at a single center. Patients received four cycles of induction chemotherapy with docetaxel (60 mg/m[2]) and carboplatin (area under the curve 5) every 21 d, followed by maintenance rucaparib (600 mg twice daily) until progression or unacceptable toxicity. The primary outcome was radiographic progression-free survival (rPFS). Subsequent to study inception, multiple other studies reported alterations in genes of the BRCA complex (BRCA-C: BRCA1, BRCA2, PALB2) as most predictive of PARPi response; therefore, a post hoc analysis comparing patients with alterations in BRCA-C genes to a historical control cohort was performed.

KEY FINDINGS AND LIMITATIONS: After median follow-up of 40.3 mo (interquartile range 38.5-not reached [NR]), the median rPFS for all patients was 8.1 mo (95% confidence interval [CI] 6.5-31.2), similar to a historical control cohort treated with PARPi monotherapy. Among the 12 patients with BRCA-C alterations, median rPFS was 17.7 mo (95% CI 7.5-NR; p = 0.05). A key limitation is the single-arm design.

Induction platinum-based chemotherapy followed by maintenance PARPi therapy did not improve outcomes for patients with mCRPC broadly selected for HRR deficiency. However, results were promising in the more stringently selected group with BRCA-C gene alterations. Further studies comparing this approach to PARPi monotherapy are warranted.

RevDate: 2025-05-24
CmpDate: 2025-05-24

Leng T, Kessou L, Heitner J, et al (2025)

Potential impact and cost-effectiveness of oral HIV pre-exposure prophylaxis for men who have sex with men in Cotonou, Benin: a mathematical modelling study.

The Lancet. Global health, 13(6):e1111-e1121.

BACKGROUND: Oral HIV pre-exposure prophylaxis (PrEP) can effectively reduce HIV incidence. A 2020-21 demonstration project assessed the feasibility and health outcomes of offering oral PrEP to men who have sex with men (MSM) in Cotonou, Benin. We evaluated the epidemiological impact and cost-effectiveness of this project and the potential scale-up of oral HIV PrEP for MSM in Cotonou.

METHODS: We calibrated an HIV transmission-dynamic model structured by age and risk within a Bayesian framework to MSM-specific HIV prevalence and treatment data, parameterised with project behavioural and cost (including PrEP drug, implementation, and HIV care costs) data. We estimated the impact and cost-effectiveness of the 2020-21 Cotonou demonstration project (PrEP coverage, 5-10% of all MSM who are not living with HIV in Grand Cotonou; and adherence, 13-21% taking at least four of seven required doses [ie, at least four doses per week for daily users and at least four of seven expected doses given reported sexual activity for on-demand users]) and of its potential scale-up over 5 years (from 2022 to 2027), reaching 30% coverage of MSM in Grand Cotonou and with demonstration project adherence levels. We additionally modelled ideal PrEP adherence (100% taking at least four of seven required doses). We estimated the percentage of cumulative new HIV infections averted among participating MSM over 1 year and among all MSM in Grand Cotonou and their female partners over 20 years, and cost-effectiveness as cost per disability-adjusted life-year (DALY) averted over 20 years. Costs and DALYs were discounted 3% annually.

FINDINGS: We found that the demonstration project averted an estimated 21·5% (95% uncertainty interval 16·6 to 26·2) of HIV infections among participants over 1 year. With ideal adherence, cases that would be averted increased to 95·2% (90·8 to 98·8). A 5-year PrEP scale-up could avert 3·2% (1·6 to 4·8) of HIV infections among all MSM and female partners over 20 years, at US$388 (36 to 2792) per DALY averted. With ideal adherence, this decreased to -$28 (-126 to 589) per DALY averted.

INTERPRETATION: Low adherence to PrEP restricted the impact of the demonstration project. At 30% coverage among MSM by 2027, PrEP scale-up would be cost-effective at a $1225 threshold with 86·6% probability, and it could be more cost-effective if high adherence could be reached without substantially increasing costs.

FUNDING: Canadian Institutes of Health Research and US National Institutes of Health.

TRANSLATION: For the French translation of the abstract see Supplementary Materials section.

RevDate: 2025-05-24
CmpDate: 2025-05-24

Bansi-Matharu L, Moolla H, Citron DT, et al (2025)

Identifying gaps in the HIV treatment cascade in Africa: a model comparison study.

The Lancet. Global health, 13(6):e1006-e1019.

BACKGROUND: Although HIV incidence has considerably decreased in eastern, central, and southern Africa, new HIV infections continue to be a major public health challenge in the region. We aimed to investigate where in the HIV treatment cascade new transmissions are occurring in Malawi, Zimbabwe, and South Africa (the three countries involved in the Modelling to Inform HIV Programmes in Sub-Saharan Africa project).

METHODS: In this model comparison study, we used six well described and independently calibrated HIV transmission dynamics models that have been used to inform HIV policy in Africa (Optima HIV, EMOD, Goals, Thembisa, PopART-IBM, and HIV Synthesis) to estimate and predict the proportion of annual new HIV transmissions attributable to people living with HIV who are undiagnosed, have been diagnosed but have not yet started antiretroviral therapy (ART), are receiving ART, and have interrupted ART in Malawi, Zimbabwe, and South Africa from 2010 to 2040 stratified by the age and sex of the individual acquiring HIV.

FINDINGS: Despite the different model structures and underlying assumptions, the six models were well aligned in relation to key HIV epidemic characteristics (including population estimates and HIV prevalence) in each of the three settings. There was, however, considerable variation in the predicted number of new infections, particularly in Malawi and Zimbabwe where this number ranged from fewer than 10 000 new infections to over 30 000 new infections in 2024. Most model results suggested that the mean age of HIV acquisition has been increasing since 2000, with men acquiring HIV at an older age than women in all three settings. All models attributed fewer than 5% of transmissions to individuals who had been diagnosed but had not yet started ART. In Malawi, the proportion of transmissions attributable to undiagnosed people with HIV in 2024 ranged from 33·3% to 75·3% across the models, and transmissions attributable to individuals who had experienced interrupted treatment ranged from 8·4% to 20·1%. In Zimbabwe, the proportion of transmissions attributable to undiagnosed individuals in 2024 ranged from 29·8% to 64·6% across the models and the proportion of transmissions attributable to individuals who had interrupted treatment ranged from 4·7% to 21·5%. In South Africa, 21·8-46·4% of transmissions in 2024 were attributable to undiagnosed individuals and 27·6-58·9% of transmissions were attributable to individuals who had interrupted treatment.

INTERPRETATION: Across the three study settings, a substantial proportion of new HIV transmissions were attributable to undiagnosed individuals and people who have received interrupted ART, reinforcing the importance of continuing HIV testing and ART re-engagement and retention interventions.

FUNDING: The Bill & Melinda Gates Foundation.

RevDate: 2025-05-24

Heffner JL, Baker K, Georgiou K, et al (2025)

ACT on Vaping: Pilot Randomized Controlled Trial of a Novel Digital Health App with Text Messaging for Young Adult Vaping Cessation.

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco pii:8145603 [Epub ahead of print].

BACKGROUND: There is no published evidence to support the efficacy of any digital vaping cessation program for young adults (YAs) at differing levels of readiness to quit. In this pilot randomized controlled trial, we evaluated the preliminary acceptability and efficacy of a program for vaping cessation based on acceptance and commitment therapy (ACT on Vaping), delivered via a smartphone app and text messaging.

METHODS: YAs age 18-30 (n=61) were randomized 1:1 to ACT on Vaping (n=31) or incentivized text message control (n=30). Outcome data were collected at 3 months post-randomization. Results were compared against a priori benchmarks for acceptability (satisfaction of ≥ 3.5 on 5-point scale) and efficacy relative to control (meeting at least one of three): ≥ 1-point difference in Contemplation Ladder change scores; ≥ 5 percentage difference in 24-hour quit attempts, ≥ 5 percentage difference in cotinine-confirmed 30-day point prevalence abstinence (PPA) from all non-therapeutic nicotine/tobacco.

RESULTS: Satisfaction with ACT on Vaping averaged 3.8, exceeding the acceptability benchmark. A higher proportion of participants in the ACT on Vaping arm reported a 24-hour quit attempt (87.5% vs. 75.9%), exceeding the efficacy benchmark. Both change in quit readiness (+0.96 in ACT on Vaping vs. +0.72 in control) and cotinine-confirmed 30-day PPA (4.2% in ACT on Vaping vs. 0% in control) were descriptively higher for ACT on Vaping but did not reach the benchmark level for efficacy.

CONCLUSIONS: ACT on Vaping had promising acceptability and preliminary efficacy. A fully-powered trial of ACT on Vaping is warranted to evaluate its efficacy.

IMPLICATIONS: Digital interventions are a promising yet under-researched approach for reaching and supporting young adults to quit vaping. This proof-of-concept pilot randomized controlled trial evaluated a novel mobile health application and associated text messaging program (ACT on Vaping) for young adult vaping cessation and found preliminary evidence for acceptability and efficacy relative to an incentivized text message control arm, warranting evaluation in a fully-powered trial as a next step.

RevDate: 2025-05-26

Dhodapkar KM, Castellino S, Kapadia S, et al (2025)

Immune-aging at diagnosis determines T-cell recovery in childhood leukemia survivors.

npj aging, 11(1):39.

We show that T cells in survivors of childhood leukemia exhibit distinct profiles dominated by aging-associated changes and consistent with premature immune aging. Immune profiles during survivorship in biospecimens (n = 251) from uniformly-treated children with B-acute lymphoblastic leukemia recapitulate heterogeneity at diagnosis in individual patients and correlate with genetic-risk subtypes. These data suggest that pre-therapy immune aging may determine variance in immune status during survivorship.

RevDate: 2025-05-23

Thomas AB, Van Son CR, Nelson LA, et al (2025)

A Principle-Based Concept Analysis of Supported Conversation for Adults With Aphasia.

Research and theory for nursing practice pii:RTNP-2024-0094 [Epub ahead of print].

Background and Purpose: Supported Conversation for Adults with Aphasia (SCA[™]), an evidence-based framework to improve communicative access, is a unique concept to nursing with theoretical and technical components. Effective communication is essential in all patient interactions, and SCA™ could aid health care professionals in meeting the needs of people with aphasia. Methods: A principle-based concept analysis was conducted using a systematic and conceptually driven literature search. A review of literature from 1998 to 2024 contained in CINAHL, PubMed, and PsycINFO databases was performed on the concept of SCA[™] The concept was explored for (a) definitional clarity (epistemological principle), (b) relevance to nursing (pragmatic principle), (c) consistency in meaning (linguistic principle), and (d) differentiation from related concepts (logical principle). Results: The final dataset consisted of 49 articles. Findings revealed that (a) SCA[™] is composed of theoretical and technical components used to acknowledge and reveal the competence of a person with aphasia, but there is a vague use and a lack of definitional clarity; (b) the philosophical framework and techniques outlined by the concept are relevant and useful for nursing; (c) there is variability in the use, nomenclature, and conceptualization of SCA[™]; and (d) the concept is poorly differentiated from other similar concepts. Implications for Practice: Nurses working with people diagnosed with aphasia and other communication disorders should consider SCA[™] and its application in nursing practice. Findings from this concept analysis stress the importance of an interdisciplinary approach to future SCA[™] studies, as nursing can lend its distinct viewpoint to integrate SCA[™] techniques into practice.

RevDate: 2025-05-23

Lee SJ, Williams KM, Sarantopoulos S, et al (2025)

NIH Chronic Graft-versus-Host Disease Consensus Conference 2025 Update.

Transplantation and cellular therapy pii:S2666-6367(25)01202-3 [Epub ahead of print].

In 2020, the third NIH Consensus Development Project on Criteria for Chronic Graft-versus-Host Disease (GVHD) Clinical Trials was held with the goals of identifying gaps in understanding, prevention and treatment of chronic graft-versus-host disease (GVHD) and making actionable recommendations that would advance the field. An interim meeting was held in October 2024 to review progress on the 2020 recommendations. Each group was charged with reviewing their previous recommendations, assessing whether the field is on track to eventually achieve the goals, and considering whether recommendations should be modified in light of new data or insufficient progress. This manuscript summarizes the Working Groups' reports and helps define the research agenda for future studies in chronic GVHD. Overall, modest progress has been made on most initiatives. Some studies in progress will address key recommendations and results are eagerly anticipated.

RevDate: 2025-05-23

Kampouri E, Handley G, Phan TL, et al (2025)

American Society for Transplantation and Cellular Therapy Series #9: Management of HHV-6B After Hematopoietic Cell Transplantation and Chimeric Antigen Receptor (CAR)-T-Cell Therapy.

Transplantation and cellular therapy pii:S2666-6367(25)01164-9 [Epub ahead of print].

The Practice Guidelines Committee and the Transplant Infectious Disease Special Interest Group of the American Society for Transplantation and Cellular Therapy developed guidelines focusing on human herpes virus 6B (HHV-6B). A compendium-style approach was used to address a series of standalone frequently asked questions (FAQs), supported by tables and figures to spotlight key concepts. Adult and pediatric infectious disease and hematopoietic cell transplantation (HCT) content experts developed these FAQs, and finalized recommendations after consensus was reached. This ninth topic in the series focuses on the relevant risk factors, diagnostic considerations, prophylaxis, and treatment approaches relevant to HHV-6B infections after HCT and Chimeric Antigen Receptor (CAR)-T-Cell Therapy.

RevDate: 2025-05-23

Wu RL, Houser KV, Gaudinski MR, et al (2025)

Safety and pharmacokinetics of N6LS, a broadly neutralising monoclonal antibody for HIV: a phase 1, open-label, dose-escalation study in healthy adults.

The lancet. HIV pii:S2352-3018(25)00041-4 [Epub ahead of print].

BACKGROUND: Broadly neutralising antibodies (bNAbs) have shown promise as both prevention and treatment strategies against HIV-1. The clinical effectiveness of bNAbs depends on enhancing their neutralisation breadth and extending their serum half-lives. In this study, we aimed to assess the safety, tolerability, pharmacokinetic profile, and neutralisation activity in serum of N6LS, a HIV-1 bNAb.

METHODS: In this first-in-human, dose-escalation, open-label, phase 1 trial, healthy adult participants (aged 18-50 years) who were HIV-1 negative were recruited to the National Institutes of Health Clinical Center (Bethesda, MD, USA). Three groups received one intravenous administration of N6LS at 5 mg/kg (n=3), 20 mg/kg (n=3), or 40 mg/kg (n=3); one group received one subcutaneous administration of 5 mg/kg N6LS (n=3); two groups received three administrations of either 5 mg/kg subcutaneous (n=5) or 20 mg/kg intravenous (n=5) N6LS every 12 weeks; and two groups received one subcutaneous administration of either 5 mg/kg (n=5) or 20 mg/kg (n=5) N6LS with ENHANZE drug product (EDP), recombinant human hyaluronidase PH20. The primary objectives were the safety and tolerability of N6LS with and without EDP. All participants who received N6LS were included in the primary safety analyses. This trial is registered at ClinicalTrials.gov, NCT03538626, and is complete.

FINDINGS: Between June 18, 2018, and April 11, 2022, we enrolled 33 healthy adults (19 female individuals and 14 male individuals). One participant did not receive N6LS and one participant was lost to follow-up after 8 weeks. N6LS had an encouraging safety profile similar to other HIV-1 bNAbs, with no serious adverse events. Local reactogenicity was observed after administration of N6LS, with the most common symptom being mild to moderate injection site pain or tenderness in subcutaneous groups, reported in six of eight participants. All ten participants who received N6LS with EDP had mild to severe injection site erythema, which, despite being graded as severe in size, was generally not noticed by participants or deemed bothersome, and resolved without intervention. Systemic reactogenicity was mild in all groups. N6LS had an overall mean serum half-life of 48·6 days and retained its broad and potent neutralisation characteristics in serum. EDP administration increased N6LS bioavailability. No functional anti-drug antibodies to N6LS were detected following administration.

INTERPRETATION: N6LS showed a promising safety and pharmacokinetics profile while retaining its potent neutralisation characteristics in serum, making it a promising candidate for inclusion in HIV-1 prevention and therapeutic combination strategies. The addition of EDP can enable safe subcutaneous administration of higher doses and larger volumes of N6LS, supporting additional methods for prophylactic and therapeutic bNAb administration.

FUNDING: US National Institute of Allergy and Infectious Diseases Intramural Research Program, National Institutes of Health.

RevDate: 2025-05-23
CmpDate: 2025-05-23

Marsh TL, Johnston JM, Homan C, et al (2025)

HCC surveillance in hepatitis C: A longitudinal algorithm improves alpha-fetoprotein screening.

Hepatology communications, 9(6): pii:02009842-202506010-00015.

BACKGROUND: Surveillance for HCC remains important after hepatitis C cure. Improved sensitivity of screening with alpha-fetoprotein (AFP) by using a parametric empirical Bayes (PEB) algorithm, which incorporates an individual patient's longitudinal AFP measurements, was previously demonstrated in a retrospective analysis of clinical trial data prior to widespread hepatitis C cure.

METHODS: We analyzed de-identified data extracted from the medical records of participants in the Alaska Hepatitis C Study, which aims to enroll all Alaska Native persons living in Alaska with a history of hepatitis C.We compared the performance characteristics of AFP as a screening test using the PEB method versus a fixed cutoff (FC) method in an observational setting, separately for HCC surveillance in active and cured hepatitis C.

RESULTS: The PEB and FC methods were applied to AFP levels from participants with F3/F4 fibrosis who had active hepatitis C (173 no HCC, 14 HCC) or after they achieved hepatitis C cure (162 no HCC, 12 HCC). Compared to a fixed 20 ng/mL cutoff, demonstrating 91.2% specificity in active hepatitis C, PEB increased sensitivity from 64.3% to 71.4%. After cure, a fixed 7.2 ng/mL cutoff demonstrated 91.2% specificity, and PEB increased sensitivity from 58.3% to 91.7%.

CONCLUSIONS: The PEB algorithm can increase sensitivity and lead to earlier detection of HCC among patients with F3/F4 fibrosis, both in active and even more so in cured hepatitis C. Lower AFP levels after cure indicate that for either PEB or FC methods, screening parameters, such as cutoffs for a target specificity, should be specified separately by hepatitis C treatment status for HCC surveillance.

RevDate: 2025-05-27

Landazuri Vinueza J, Salisbury NJH, Dye KN, et al (2025)

Delta-catenin is required for cell proliferation in virus-positive Merkel cell carcinoma cell lines but not in human fibroblasts.

mBio [Epub ahead of print].

Merkel cell carcinoma (MCC) is a highly aggressive neuroendocrine skin cancer often driven by the integration of Merkel cell polyomavirus (MCPyV) into the host genome and the persistent expression of its viral oncoproteins, small tumor (ST) antigen, and truncated large tumor (t-LT) antigen. While human fibroblasts support MCPyV replication, the cell of origin for MCC remains unknown. We hypothesized that MCPyV initially replicates in fibroblasts but, in rare cases, infects Merkel cell progenitors, contributing to MCC development. Using TurboID mass spectrometry, we identified δ-catenin as a novel ST interactor in fibroblasts. However, while ST binds δ-catenin in fibroblasts, this interaction is absent in virus-positive (VP)-MCC cell lines. Despite this, δ-catenin is essential for VP-MCC, but not for fibroblast cell proliferation. We found that fibroblasts predominantly express δ-catenin isoform 1, whereas VP-MCC cells mainly express isoform 3. Overexpression of isoform 1 in VP-MCC failed to restore ST binding. δ-Catenin promotes VP-MCC proliferation by regulating cell cycle gene expression through its interaction with Kaiso, a transcriptional repressor. Additionally, we found that lysine-specific histone demethylase 1 (LSD1, also known as KDM1A) regulates δ-catenin isoform 3 expression by modulating ESRP1, a δ-catenin splicing factor. Our findings reveal novel host factors involved in MCPyV infection and MCC tumorigenesis, suggesting that the host cell supporting viral replication and the MCC cell of origin may be distinct cell types.IMPORTANCEMerkel cell polyomavirus (MCPyV), the only known human oncogenic polyomavirus, is the primary cause of Merkel cell carcinoma (MCC), a rare and aggressive type of skin cancer. MCC is driven by two viral proteins: small T (ST) and large T (LT). While the virus can replicate in skin fibroblasts, it is still unknown which type of skin cell becomes cancerous. We found that ST binds to a host protein, δ-catenin in fibroblasts, potentially playing a role in the virus lifecycle, but this interaction is missing in the cancer cells. Our study provides evidence that the cells in which the virus replicates and causes cancer are different.

RevDate: 2025-05-23

GBD 2021 Global Subarachnoid Hemorrhage Risk Factors Collaborators, Rautalin I, Volovici V, et al (2025)

Global, Regional, and National Burden of Nontraumatic Subarachnoid Hemorrhage: The Global Burden of Disease Study 2021.

JAMA neurology pii:2834680 [Epub ahead of print].

IMPORTANCE: Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure.

OBJECTIVE: To estimate the worldwide burden of SAH.

Based on the repeated cross-sectional Global Burden of Disease (GBD) 2021 study, the global burden of SAH in 1990 to 2021 was estimated. Moreover, the SAH burden was compared with other diseases, and its associations with 14 individual risk factors were investigated with available data in the GBD 2021 study. The GBD study included the burden estimates of nontraumatic SAH among all ages in 204 countries and territories between 1990 and 2021.

EXPOSURES: SAH and 14 modifiable risk factors.

MAIN OUTCOMES AND MEASURES: Absolute numbers and age-standardized rates with 95% uncertainty intervals (UIs) of SAH incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) as well as risk factor-specific population attributable fractions (PAFs).

RESULTS: In 2021, the global age-standardized SAH incidence was 8.3 (95% UI, 7.3-9.5), prevalence was 92.2 (95% UI, 84.1-100.6), mortality was 4.2 (95% UI, 3.7-4.8), and DALY rate was 125.2 (95% UI, 110.5-142.6) per 100 000 people. The highest burden estimates were found in Latin America, the Caribbean, Oceania, and high-income Asia Pacific. Although the absolute number of SAH cases increased, especially in regions with a low sociodemographic index, all age-standardized burden rates decreased between 1990 and 2021: the incidence by 28.8% (95% UI, 25.7%-31.6%), prevalence by 16.1% (95% UI, 14.8%-17.7%), mortality by 56.1% (95% UI, 40.7%-64.3%), and DALY rate by 54.6% (95% UI, 42.8%-61.9%). Of 300 diseases, SAH ranked as the 36th most common cause of death and 59th most common cause of DALY in the world. Of all worldwide SAH-related DALYs, 71.6% (95% UI, 63.8%-78.6%) were associated with the 14 modeled risk factors of which high systolic blood pressure (population attributable fraction [PAF] = 51.6%; 95% UI, 38.0%-62.6%) and smoking (PAF = 14.4%; 95% UI, 12.4%-16.5%) had the highest attribution.

CONCLUSIONS AND RELEVANCE: Although the global age-standardized burden rates of SAH more than halved over the last 3 decades, SAH remained one of the most common cardiovascular and neurological causes of death and disabilities in the world, with increasing absolute case numbers. These findings suggest evidence for the potential health benefits of proactive public health planning and resource allocation toward the prevention of SAH.

RevDate: 2025-05-23

Feng E, Feng E, Berg T, et al (2025)

Identifying prognostic targets in metastatic prostate cancer beyond AR.

FEBS open bio [Epub ahead of print].

Genome-wide screens using CRISPR/RNAi can identify new therapeutic vulnerabilities in prostate cancer. In this study, we combine DepMap functional screen data with a large gene expression database (N = 1012) and clinical outcomes to identify potentially druggable targets. Eight genes (CYC, CYP51A1, DHFR, EBP, KIF15, PPM1D, SQLE, and UMPS) demonstrated strong dependency in cell lines and were also associated with worse prognosis clinically, representing potential therapeutic targets in metastatic prostate cancer. Four of these (DHFR, EBP, KIF15, and PPM1D) demonstrated higher expression in neuroendocrine prostate cancer. Furthermore, all but one (KIF15) were not significantly decreased from pretreatment to posttreatment, suggesting that they may remain targetable postabiraterone therapy. All eight genes showed evidence of protein expression in prostate cancers or cell lines. These potentially druggable targets associated with prostate cancer cell line dependency and worse clinical outcomes have also demonstrated literature support as potential targets, supporting further research into their potential clinical relevance as therapeutic targets in prostate cancer.

RevDate: 2025-05-23

Jones DC, Elz AE, Hadadianpour A, et al (2025)

Cell simulation as cell segmentation.

Nature methods [Epub ahead of print].

Single-cell spatial transcriptomics promises a highly detailed view of a cell's transcriptional state and microenvironment, yet inaccurate cell segmentation can render these data murky by misattributing large numbers of transcripts to nearby cells or conjuring nonexistent cells. We adopt methods from ab initio cell simulation, in a method called Proseg (probabilistic segmentation), to rapidly infer morphologically plausible cell boundaries. Benchmarking applied to datasets generated by three commercial platforms shows superior performance and computational efficiency of Proseg when compared to existing methods. We show that improved accuracy in cell segmentation aids greatly in detection of difficult-to-segment tumor-infiltrating immune cells such as neutrophils and T cells. Last, through improvements in our ability to delineate subsets of tumor-infiltrating T cells, we show that CXCL13-expressing CD8[+] T cells tend to be more closely associated with tumor cells than their CXCL13-negative counterparts in data generated from samples from patients with renal cell carcinoma.

RevDate: 2025-05-22

Lee W, Chung JY, Baidoo KE, et al (2025)

Glypican-3 as a Radiotheranostic Target for Neuroendocrine Prostate Cancer.

RevDate: 2025-05-22

Mahalingam D, Saeed A, Powell SF, et al (2025)

Phase II study of elraglusib (9-ING-41), a GSK-3β inhibitor, in combination with gemcitabine plus nab-paclitaxel in previously untreated metastatic pancreatic cancer.

ESMO open, 10(6):105122 pii:S2059-7029(25)00991-3 [Epub ahead of print].

INTRODUCTION: The purpose of this study was to assess the efficacy and safety of elraglusib (9-ING-41), a GSK-3β inhibitor, in combination with gemcitabine/nab-paclitaxel (GnP) in previously untreated metastatic pancreatic ductal adenocarcinoma (mPDAC).

MATERIAL AND METHODS: In a nonrandomized, Simon's two-stage, phase II study, patients with mPDAC received elraglusib 15 mg/kg on days 1 and 4 each week and GnP on days 1, 8, and 15 in a 28-day cycle. The primary endpoint was disease control rate (DCR); secondary endpoints were objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and treatment-emergent adverse events (TEAEs).

RESULTS: A total of 42 patients, who were enrolled and treated, had a median age of 67 years and were 57.1% male. Overall, 38 patients received elraglusib at 15 mg/kg and 4 at 9.3 mg/kg with GnP. DCR was 35.7% [95% confidence interval (CI) 21.6% to 52.0%], and ORR was 26.2%. The median PFS and OS were 5.4 months (95% CI 4.4-9.2 months) and 11.9 months (95% CI 7.8-16.5 months), respectively. Most common TEAEs were visual impairment (83.3%), fatigue (69%), and nausea (66.7%). Grade ≥3 TEAEs occurred in 85.7% of patients and included neutropenia (52.4%), leukopenia (42.9%), and fatigue (21.4%). The dose of elraglusib was reduced to 9.3 mg/kg due to increased exacerbation of GnP-related toxicities and frequent dose interruptions and reductions of elraglusib.

CONCLUSIONS: Elraglusib/GnP showed preliminary clinical activity. In terms of safety, elraglusib resulted in a modest exacerbation of GnP-related toxicities, leading to a dose reduction of elraglusib to 9.3 mg/kg twice a week. Based on the initial efficacy and safety data, the study was amended to a randomized phase II study that will evaluate the 9.3 mg/kg dose.

RevDate: 2025-05-25

Li T, Su YR, Lee JM, et al (2025)

Tomosynthesis vs Digital Mammography Screening in Women with a Family History of Breast Cancer.

JAMA oncology [Epub ahead of print].

IMPORTANCE: Evidence on screening outcomes with digital breast tomosynthesis (DBT) vs digital mammography (DM) in women with a family history of breast cancer is limited.

OBJECTIVE: To compare the performance of DBT and DM screening in women with a family history of breast cancer overall and subdivided by breast cancer family history category, breast density, age group, screening interval, and screening round, and to describe characteristics of cancers detected on screening vs interval cancers.

In this comparative cohort study at imaging facilities affiliated with the Breast Cancer Surveillance Consortium, adult women 18 years and older with a self-reported family history of breast cancer who underwent DBT or DM from 2011 to 2018 were included, with a 1-year follow-up for breast carcinoma. Data analysis was performed between November 2023 and August 2024.

EXPOSURES: DBT or DM.

MAIN OUTCOMES AND MEASURES: The main outcomes were absolute risk difference (ARD) between DBT and DM for recall rate, cancer detection rate, interval cancer rate, advanced cancer rate, biopsy rate, positive predictive values, sensitivity, and specificity, with inverse probability of treatment weighting.

RESULTS: A total of 208 945 women with a family history of breast cancer undergoing 502 357 screening examinations were included in the sample. Median (IQR) age was 58 (50-66) and 57 (49-66) years for the DBT and DM groups, respectively. Adjusted ARDs (DBT vs DM) were significant for recall rate (-1.51%; 95% CI, -2.42% to -0.59%) and specificity (1.56%; 95% CI, 0.65%-2.46%) in the overall cohort of 121 698 DBT and 380 561 DM examinations and among women with 1 first-degree relative (recall rate ARD, -1.72%; 95% CI, -2.70% to -0.74%; specificity ARD, 1.75%; 95% CI, 0.81%-2.69%). Among those with only second-degree relatives, the biopsy rate for DBT was significantly higher (ARD, 0.39%; 95% CI, 0.18%-0.61%). Significant ARDs were observed for the ductal carcinoma in situ detection rate (-0.71 per 1000 examinations; 95% CI, -1.03 to -0.38 per 1000 examinations) in women with almost entirely fatty breasts; recall rate (-1.90%; 95% CI, -2.88% to -0.92%) and specificity (1.93%; 95% CI, 0.97%-2.89%) in women with scattered fibroglandular densities. Significant ARDs were also observed for the positive predictive value for recall (1.75%; 95% CI, 0.84%-2.67%) in heterogeneously dense breasts, as well as the biopsy rate (0.48%; 95% CI, 0.16%-0.80%) and advanced cancer rate (-0.61 per 1000 examinations; 95% CI, -1.02 to -0.20 per 1000 examinations) in extremely dense breasts. DBT screening had a higher proportion than DM of screen-detected early-stage, invasive cancers with favorable prognostic characteristics.

CONCLUSIONS AND RELEVANCE: In this cohort study of women with a family history of breast cancer, DBT screening reduced recall rates and increased specificity compared to DM, particularly in women with 1 first-degree relative with breast cancer and those with scattered fibroglandular breast density, and reduced advanced cancer rates in women with extremely dense breasts.

RevDate: 2025-05-22

Moosavi D, Curtis KR, Randolph TW, et al (2025)

Stability and Variability of the Human Fecal Microbiome Over Two Years in the Multiethnic Cohort Study: A Metagenomic Analysis.

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology pii:762605 [Epub ahead of print].

BACKGROUND: Understanding the longitudinal variability of the gut microbiome is essential for advancing microbiome-based measurements and designing robust sampling protocols in observational and intervention studies of cancer and other health outcomes. The aim of this study was to explore the temporal variability and stability of the fecal microbiome over a 2-year period, using intraclass correlation (ICC) analysis of metagenomic sequencing data.

METHODS: We studied 25 older adults from the Multiethnic Cohort Adiposity Phenotype Study (MEC-APS, 2013-2016). Stool samples were collected every six months over a two-year period (5 samples) and analyzed using metagenomic sequencing. The temporal stability was evaluated using ICCs across taxonomic levels, diversity, and functional genes and pathways.

RESULTS: The microbial community showed stability in alpha diversity and overall structure, with no significant changes across time points (Shannon diversity, p = 0.95). Taxonomic composition showed strong reliability over time, with median ICCs of 0.7 at the genus level and 0.75 at species level. Functional genes also demonstrated good stability (median ICC = 0.68). However, microbial pathways were more variable, with a fair median ICC of 0.49.

CONCLUSION: While the fecal microbiome was generally stable, some taxa and functions were more dynamic and responsive to external influences.

IMPACT: Findings highlight the need for reliable microbiome measurements and sampling strategies to reduce bias in studies of the microbiome and cancer.

RevDate: 2025-05-26

Yeung CCS, Narava SK, Chang TC, et al (2025)

Analytical Performance of the NCI-myeloMATCH Assay: A Rapid Turnaround Genomic Profiling Assay for Myeloid Disorders.

The Journal of molecular diagnostics : JMD pii:S1525-1578(25)00116-3 [Epub ahead of print].

myeloMATCH is a National Cancer Institute precision medicine clinical trial initiative to evaluate treatments for acute myeloid leukemia and myelodysplastic syndrome based on a patient's diagnostic presenting clinical and genetic profile. The National Cancer Institute myeloid assay version 2 (NMAv2) uses the Ion Torrent Genexus System, an automated platform with <48-hour turnaround from specimen receipt to reporting, to provide regulatory-compliant use for myeloMATCH across two independent clinical laboratories with harmonized workflows. Using marrow aspirate or peripheral blood clinical specimens, cell lines, and contrived reference materials, NMAv2 exhibited 99% sensitivity for 291 known mutations and 100% specificity. High reproducibility detecting all reportable variants was observed, with >98% mean positive percentage agreement and 100% negative percent agreement across six reproducibility assessments. Reproducibility experiments of companion diagnostic biomarkers (1 to 1.5× clinical limit of reporting) showed 100% positive percentage agreement and negative percent agreement. The limit of detection was 0.06% for hotspot single-nucleotide variants, 0.16% for non-hotspot single-nucleotide variants, 0.51% for hotspot insertion/deletions, approximately 1% for non-hotspot insertion/deletions, 0.23% for FLT3-internal tandem duplications, and ≤40 reads at 0.1% tumor content for fusions. Concordance of 99.39% was observed in orthogonal assays testing 76 blinded myeloid specimens in the sensitivity study, and 100% concordance was observed in testing 54 FLT3-internal tandem duplication specimens. The results show that NMAv2 has high specificity, sensitivity, accuracy, and reproducibility, and it can rapidly characterize genomic alterations in acute myeloid leukemia and myelodysplastic syndrome.

RevDate: 2025-05-21

Rademaker G, Hernandez GA, Seo Y, et al (2025)

PCSK9 drives sterol-dependent metastatic organ choice in pancreatic cancer.

Nature [Epub ahead of print].

To grow at distant sites, metastatic cells must overcome major challenges posed by the unique cellular and metabolic composition of secondary organs[1]. Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease that metastasizes to the liver and lungs. Despite evidence of metabolic reprogramming away from the primary site, the key drivers that dictate the ability of PDAC cells to colonize the liver or lungs and survive there remain undefined. Here we identified PCSK9 as predictive of liver versus lung colonization by integrating metastatic tropism data of human PDAC cell lines[2], in vivo metastasis modelling in mice and gene expression correlation analysis. PCSK9 negatively regulates low density lipoprotein (LDL)-cholesterol import and, accordingly, PCSK9-low PDAC cells preferentially colonize LDL-rich liver tissue. LDL-cholesterol taken up by liver-avid PCSK9-low cells supports activation of pro-growth mTORC1 activation at the lysosome, and through conversion into the signalling oxysterol, 24(S)-hydroxycholesterol, reprogrammes the microenvironment to release nutrients from neighbouring hepatocytes. Conversely, PCSK9-high, lung-avid PDAC cells rely on transcriptional upregulation of the distal cholesterol synthesis pathway to generate intermediates-7-dehydrocholesterol and 7-dehydrodesmosterol-with protective action against ferroptosis, a vulnerability in the oxygen-rich microenvironment of the lung. Increasing the amount of PCSK9 redirected liver-avid cells to the lung whereas ablating PCSK9 drove lung-avid cells to the liver, thereby establishing PCSK9 as necessary and sufficient for secondary organ site preference. Our studies reveal PCSK9-driven differential utilization of the distal cholesterol synthesis pathway as a key and potentially actionable driver of metastatic growth in PDAC.

RevDate: 2025-05-21

Lammi V, Nakanishi T, Jones SE, et al (2025)

Genome-wide association study of long COVID.

Nature genetics [Epub ahead of print].

Infections can lead to persistent symptoms and diseases such as shingles after varicella zoster or rheumatic fever after streptococcal infections. Similarly, severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection can result in long coronavirus disease (COVID), typically manifesting as fatigue, pulmonary symptoms and cognitive dysfunction. The biological mechanisms behind long COVID remain unclear. We performed a genome-wide association study for long COVID including up to 6,450 long COVID cases and 1,093,995 population controls from 24 studies across 16 countries. We discovered an association of FOXP4 with long COVID, independent of its previously identified association with severe COVID-19. The signal was replicated in 9,500 long COVID cases and 798,835 population controls. Given the transcription factor FOXP4's role in lung physiology and pathology, our findings highlight the importance of lung function in the pathophysiology of long COVID.

RevDate: 2025-05-21

R SS, S X, Temitope O, et al (2025)

Current Activity Trends and Outcomes in Hematopoietic Cell Transplantation and Cellular Therapy - A report from the CIBMTR.

Transplantation and cellular therapy pii:S2666-6367(25)01198-4 [Epub ahead of print].

The Center for International Blood and Marrow Transplant Research (CIBMTR) compiles annual summary slides describing trends in hematopoietic cell transplantation (HCT) and cellular therapy (CT) practice and outcomes. This year's report includes all patients receiving their first autologous and/or allogeneic HCT/CT in the United States between 2013 and 2023 or chimeric antigen receptor T-cell (CAR-T) from 2016 and 2023, reported to CIBMTR. Relative proportion of allogeneic and autologous HCT/CT was generated as percentage of total for donor type and for patient age, disease indication, graft-versus-host disease (GVHD) prophylaxis, and race and ethnicity. Causes of death were summarized using frequencies, and the Kaplan-Meier estimator was used for estimating overall survival. New for this year, disease risk stratification reflects European LeukemiaNet cytogenetic risk score for acute myeloid leukemia (AML) and the Revised International Prognostic Scoring System for myelodysplastic syndromes (MDS). Use of allogeneic HCT increased substantially in 2023, recovering from a decline in activity during the COVID-19 pandemic, with growth predominately in the 65-74 year-old age group. Overall, matched unrelated donors (MUD) continue as the most common allogeneic donor source (45%) followed by haploidentical related donors (Haplo) (21%), matched related donors (MRD) (18%), mismatched unrelated donors (MMUD) (12%) and cord blood (Cord) (3%). These trends hold in the adult patient population with a notable doubling of MMUD utilization since 2020 driven by the rapid shift to post-transplant cyclophosphamide based GVHD prophylaxis (PTCy) in this setting. In the pediatric setting, Haplo was the most common donor source surpassing MRD use in 2023 followed by MUD, Cord and MMUD. Autologous HCT continued to decline slightly while use of CAR-T therapy has rapidly increased since commercial approval in 2017 with lymphoma and multiple myeloma reaching 45% and 16%, respectively in 2023. Significant recent changes in GVHD prophylaxis in the adult allogeneic HCT setting have occurred. PTCy is most common in Haplo HCT with >90% since 2016. Among other donor sources, the most rapid adoption is in MMUD HCT at 82% in 2023. In MRD and MUD, PTCy use differs by conditioning intensity with RIC/NMA higher (58% and 64%, respectively), reflecting the standard of care established by BMT CTN 1703, compared to MAC (43% and 46%, respectively). In pediatrics, calcineurin inhibitor ± others remains the most common GVHD prevention strategy for MRD (88%) and MUD (68%). Although common in the pediatric Haplo HCT setting at 68% in 2023, use of PTCy is less common across other mismatched donor types where use of abatacept or ex-vivo T cell depletion/CD34 selection accounts for 28% and 17% in MMUD, respectively. Three-year overall survival continues to significantly improve among patients receiving allogeneic (62.1% vs 55.8%) and autologous (82.6% vs 79.6%) HCT when comparing HCT from 2017-2022 versus 2012-2016 (p<0.001), respectively. In both the adult and pediatric settings, primary cause of mortality after 100 days post-HCT remains primary disease in both allogeneic (47% and 45%, respectively) and autologous (60% and 79%, respectively). HCT/CT and CAR-T use continues to grow. Relapse remains the primary cause of death in the malignant setting supporting further efforts to mitigate risk.

RevDate: 2025-05-21

Burleigh K, Stratton KG, Smith JL, et al (2025)

Low Peripheral Blood Counts and Elevated Proinflammatory Cytokines Signal a Poor CD19 CAR-T Response in ALL: Immune correlates of CAR-T response.

Transplantation and cellular therapy pii:S2666-6367(25)01165-0 [Epub ahead of print].

BACKGROUND: CD19 chimeric antigen receptor T-cell (CAR-T) therapy has significantly improved outcomes for patients with relapsed/refractory B-cell acute lymphoblastic leukemia (R/R B-ALL). However, approximately 20% of patients fail to achieve a complete remission (CR), and some develop severe, life-threatening toxicities. Understanding the biological mechanisms underlying both dysfunctional responses and severe toxicity is essential for optimizing patient management and improving therapeutic efficacy.

OBJECTIVES: This study aimed to (1) characterize cytokine profiles associated with dysfunctional responses and severe toxicity following CAR-T infusion, (2) examine the timing and trajectory of cytokine changes in relation to treatment outcomes and evaluate potential strategies for mitigating toxicity and treatment failure.

STUDY DESIGN: We conducted a comprehensive analysis of serum cytokine profiles in 86 adult and pediatric patients undergoing autologous CD19 CAR-T therapy for B-ALL. Patients were categorized into three groups: 1. Dysfunctional response- Patients who failed to achieve a minimal residual disease-negative complete remission (MRD- CR) by Day 63 or who experienced recurrence of CD19+ disease in the setting ongoing CAR T cell detection before Day 63. 2. Functional response with severe cytokine release syndrome (CRS) and/or Neurotoxicity (NTX)- Patients with best response of MRD- CR by Day 63 who experienced grade 3 or higher CRS or NTX. 3. Functional response without severe CRS or NTX- Patients with best response of MRD- CR by Day 63 who did not experience grade ≥ 3 CRS or neurotoxicity. Cytokine levels were measured during the first week post-infusion and correlated with treatment efficacy, toxicity outcomes, complete blood counts (CBCs), and CAR-T expansion dynamics. This analysis aimed to better understand how cytokine profiles relate to patient outcomes and immune responses in CAR-T therapy.

RESULTS: Patients with dysfunctional response exhibited decreased neutrophils, platelets and levels of granulocytic cytokines (suggestive of low bone marrow reserve) alongside elevated pro inflammatory cytokines by Day 1. Functional response with severe toxicity patients showed a progressive rise in proinflammatory cytokines, reaching similar levels to dysfunctional response patients by Day 7. We observed that high cytokines at both the Day 1 and Day 7 timepoints were associated with poor survival. These findings remained significant when adjusting for high disease burden, a known predictor of severe inflammatory toxicity and lack of response.

CONCLUSION: Early post-CAR-T infusion inflammation is associated with both dysfunctional response and severe toxicity-even after adjusting for disease burden. This suggests that inflammation, in addition to disease burden, plays a role in determining patient outcome. Therefore, strategies aimed at reducing the pro-inflammatory state prior to or early after CAR T cell infusion may improve outcomes for R/R B-ALL patients.

RevDate: 2025-05-21

Aditham AK, Radford CE, Carr CR, et al (2025)

Deep mutational scanning of rabies glycoprotein defines mutational constraint and antibody-escape mutations.

Cell host & microbe pii:S1931-3128(25)00151-9 [Epub ahead of print].

Rabies virus causes nearly 60,000 human deaths annually. Antibodies that target the rabies glycoprotein (G) are being developed as post-exposure prophylactics, but mutations in G can render such antibodies ineffective. Here, we use pseudovirus deep mutational scanning to measure how all single-amino-acid mutations to G affect cell entry and neutralization by a panel of antibodies. These measurements identify sites critical for G function and define constrained regions that are attractive epitopes for clinical antibodies, including at the apex and base of the protein. We provide complete maps of escape mutations for eight monoclonal antibodies, including some in clinical use or development. Escape mutations for most antibodies are present in some natural rabies strains. Overall, this work provides comprehensive information on the functional and antigenic effects of G mutations that can inform development of stabilized vaccine antigens and antibodies that are resilient to rabies genetic variation.

RevDate: 2025-05-21
CmpDate: 2025-05-21

Ramsey SD, Sun Q, Fedorenko CR, et al (2025)

Telehealth and Emergency Department Use Among Commercially Insured, Medicaid, and Medicare Patients Receiving Systemic Cancer Therapy in Washington State After COVID-19.

JCO clinical cancer informatics, 9:e2400217.

PURPOSE: In oncology, telehealth services were adopted as a means of mitigating the risk of COVID-19 transmission. We hypothesized that Medicaid enrollees would have less access to telehealth than commercially insured or Medicare enrollees during the pandemic, resulting in higher rates of emergency department (ED) visits during systemic cancer treatment.

METHODS: Linking Washington State SEER records with commercial, Medicaid, and Medicare records, we evaluated adults with new solid tumor malignancies who received initial systemic treatment before the COVID-19 pandemic (January 1, 2017-December 31, 2019) and after the pandemic (March 1, 2020-November 30, 2021). Poisson and logistic regressions were used to evaluate differences in the number of office visits, telehealth visits, and ED visits in the 3 months after starting systemic anticancer treatment between insurance groups before versus after the pandemic.

RESULTS: Among 2,936 commercial, 2,039 Medicaid, and 7,333 Medicare enrollees who met inclusion criteria, office-based visits fell substantially for all groups during the COVID-19 period. Medicare enrollees had fewer telehealth visits while Medicaid had more telehealth visits, compared with commercial enrollees. ED visits declined for all patients, but there were no differences between insurance groups.

CONCLUSION: In Washington State, COVID-19 resulted in a substantial decrease in office-based visits, with an accompanying increase in telehealth visits partially offsetting the difference in overall access to care. ED visit rates fell substantially, without differences between insurance groups.

RevDate: 2025-05-21

Watling CZ, Petrick JL, Graubard BI, et al (2025)

Circulating per- and polyfluoroalkyl substances and liver cancer risk: a nested case-control analysis of individual participant data from 12 prospective cohorts.

Environmental health perspectives [Epub ahead of print].

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) have been associated with numerous deleterious health outcomes including liver damage. However, whether exposure to PFAS is associated with liver cancer risk remains unclear.

METHODS: We conducted a matched nested case-control study among 12 prospective cohort studies located in the United States. Pre-diagnostic PFAS, namely perfluorooctanesulfonate (PFOS), perfluorooctanoate (PFOA), and perfluorohexanesulfonate (PFHxS), were measured from blood samples among 853 individuals who developed liver cancer and 853 matched control participants. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multivariable-adjusted conditional logistic regression for liver cancer risk by study-specific quartiles of concentrations and per 90[th] vs. 10[th] percentile incremental increase.

RESULTS: In the main multivariable-adjusted model, circulating PFOS, PFOA, and PFHxS levels were not associated with liver cancer risk (OR per 90[th] vs. 10[th] percentile increase: 1.00, 95% CI: 0.79-1.28; 0.92, 0.73-1.15; and 0.95, 0.75-1.21, respectively). However, when analyses were stratified by sex, PFOA concentrations were positively associated with liver cancer risk in males (OR per 90[th] vs. 10[th] percentile increase: 1.62 95% CI:1.07-2.45), whereas an inverse association was observed amongst females (OR per 90[th] vs. 10[th] percentile increase:0.68, 0.50-0.92; p-interaction=0.005). Analyses separating liver cancer subtypes, hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma, showed no evidence of heterogeneity, although associations were stronger but not significant for HCC. No evidence of interaction was observed by time to diagnosis, time period of blood draw, body mass index, alcohol intake, ethnicity, or diabetes status.

CONCLUSIONS: In the largest study to date, none of the measured circulating PFAS were associated with liver cancer risk; however, PFOA associations appeared to differ by sex and further research is needed to explore these apparent differences by sex. https://doi.org/10.1289/EHP16980.

RevDate: 2025-05-21

Wadden E, Yogeswaran V, Ray RM, et al (2025)

Social determinants of cardiovascular disease in women with and without breast cancer.

Breast cancer research and treatment [Epub ahead of print].

PURPOSE: Social determinants of health (SDOH) may impact cardiovascular (CV) risk in women with and without breast cancer (BC).

METHODS: In 153,401 participants without prevalent CV disease from the Women's Health initiative (WHI), we assessed key SDOH factors: geographic region, rurality, insurance status, and household income. Multivariable Cox proportional hazards models were used to assess associations between SDOH factors and a composite CV outcome, which included incident myocardial infarction, incident stroke, hospitalization for heart failure, or CV death.

RESULTS: In the final cohort, 10,954 (mean ± standard deviation [SD] age 62 ± 7 years) women developed BC, and 142,144 (mean age 63 ± 7 years) women remained free of BC. During a median follow-up time of 13 years, 18,148 women experienced the composite CV outcome. Rurality, low household income, and non-private insurance were associated with an increased risk of the composite CV outcome and CV death, both in women with and without BC.

CONCLUSIONS: SDOH factors are associated with an increased risk of CV events among women, irrespective of BC status. These associations highlight the importance of socioeconomic factors across cardiovascular health outcomes.

RevDate: 2025-05-21

Ghodsi A, Demirci RA, Chen DL, et al (2025)

The Role of SPECT/CT in 177Lu-PSMA-617 Theranostics: Case-based Review of Response and Progression Patterns.

Clinical nuclear medicine pii:00003072-990000000-01752 [Epub ahead of print].

Lutetium-177 prostate-specific membrane antigen-617 (Lu-PSMA) has demonstrated efficacy in improving progression-free survival and overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC). Post-treatment single photon emission tomography/computed tomography (SPECT/CT) imaging is an emerging tool for monitoring treatment response, enabling the tracking of functional changes during therapy. While quantitative SPECT analysis can predict patient outcomes, qualitative assessments are more practical and time-efficient in clinical settings. This case-based review examines treatment responses based on post-treatment SPECT/CT imaging, categorizing them into favorable response, progression, and mixed response patterns to improve interpretation and guide therapeutic adjustments, aiming to optimize management of mCRPC with Lu-PSMA therapy.

RevDate: 2025-05-21

Marks DI, Cassaday RD, Ribera JM, et al (2025)

Identifying people with acute lymphoblastic leukemia who are most suitable for treatment with inotuzumab ozogamicin: a plain language summary.

Expert review of hematology [Epub ahead of print].

RevDate: 2025-05-23
CmpDate: 2025-05-21

Christofferson RC, Giovanni JE, Koumans EH, et al (2025)

A Systematic Review of Prolonged SARS-CoV-2 Shedding in Immunocompromised Persons.

Influenza and other respiratory viruses, 19(5):e70121.

BACKGROUND: Although reports have documented prolonged SARS-CoV-2 RNA detection in immunocompromised patients, few studies have systematically analyzed data on duration of SARS-CoV-2 in respiratory specimens of immunocompromised patients.

METHODS: A systematic review was undertaken to describe SARS-CoV-2 RNA and infectious virus detection in immunocompromised patients from published data between January 1, 2020 and July 1, 2022. Patients were included if there was ≥ 1 positive SARS-CoV-2 RNA result in respiratory specimens collected > 20 days since symptom onset or first positive SARS-CoV-2 RT-PCR result.

RESULTS: Of the 183 patients, 175 were symptomatic with 83 (47.4%) that experienced intermittent relapsing symptoms, while pneumonia was reported in 122 (66.7%). Immunocompromising conditions represented were hematologic malignancy treatment (89, 48.6%), solid organ transplant (47, 25.7%), autoimmune disease treatment (14, 7.7%), solid tumor treatment (3, 1.6%), HIV infection (15, 8.2%), and primary immunodeficiency (15, 8.2%). Median duration from the first to the last positive SARS-CoV-2 RT-PCR result was 56 days in upper respiratory and 60 days in lower respiratory tract specimens. Significant differences in median duration of SARS-CoV-2 RNA detection were observed between patients with and without pneumonia and for patients with hematologic malignancies compared to solid organ transplant patients. Among patients with viral culture performed, median duration of replication-competent SARS-CoV-2 was 60.5 days from symptom onset (maximum 238 days) and 59 days from first RT-PCR positive result (maximum 268 days).

CONCLUSIONS: Immunocompromised persons can have replication-competent SARS-CoV-2 in respiratory tissues for months, including while asymptomatic. Serial SARS-CoV-2 testing can inform the duration of isolation for immunocompromised patients with SARS-CoV-2 infection.

RevDate: 2025-05-23
CmpDate: 2025-05-21

Hamoud J, Devkota J, Regan T, et al (2025)

Smoking cessation message testing to inform app-based interventions for young adults - an online experiment.

BMC public health, 25(1):1852.

BACKGROUND: To improve the efficacy of digital smoking cessation interventions for young adults, intervention messages need to be acceptable and appropriate for this population. The current study compared ratings of smoking cessation and urge reduction messages based on Cognitive Behavioral Therapy (distraction themed) and Acceptance and Commitment Therapy (acceptance themed) in young adults who smoke.

METHODS: A total of 124 intervention messages were rated by an online Qualtrics panel of N = 301 diverse young adults who currently smoked tobacco cigarettes (Age M = 26.6 years; 54.8% male; 51.5% racial/ethnic minority; 16.9% sexual or gender minority (SGM); 62.5% daily smoking). Each participant rated 10 randomly selected messages (3,010 total message ratings; 24.3 ratings per message) on 5-point scales (higher scores representing more favorable ratings) evaluating quality of content, quality of design, perceived support for coping with smoking urges, and perceived support for quitting smoking. Mixed models examined associations between message category (distraction vs. acceptance), participant level predictors (sociodemographic variables, readiness and motivation to quit, daily smoking, psychological flexibility), and message ratings.

RESULTS: Overall ratings ranged from M = 3.61 (SD = 1.25) on support for coping with urges to M = 3.90 (SD = 1.03) on content, with no differences between distraction and acceptance messages. Male participants gave more favorable ratings on the dimensions of support for coping (p < 0.01) and support for quitting (p < 0.01). Participants identifying as SGM gave lower ratings for message design (p < 0.05). Participants with a graduate degree gave higher ratings on support for coping with urges and support for quitting (both p < 0.05). Higher motivation to quit was associated with more favorable scores across all dimensions (all p < 0.01). Those smoking daily rated messages as less helpful for coping with urges (p < 0.01) and quitting smoking (p < 0.05) compared to those smoking non-daily. Few interactions were found between message category distraction vs. acceptance and participant characteristics.

CONCLUSIONS: Distraction and acceptance messages received similar ratings among young adults who smoke cigarettes. Message revisions may be needed to increase appeal to women, SGM, those with lower education, and those less motivated to quit. Messages will be refined and used in an ongoing micro-randomized trial to investigate their real-time impact on smoking urges and behaviors.

RevDate: 2025-05-20

Flanagan MR, van den Bruele AMB, Downs-Canner SM, et al (2025)

A Multi-Institutional Analysis of Contralateral Axillary Metastases: Advanced Local-Regional Disease Divergent from Stage IV Breast Cancer.

Annals of surgical oncology [Epub ahead of print].

BACKGROUND: Contralateral axillary metastasis (CAM) is a rare event and is considered stage IV disease. We sought to evaluate outcomes in a CAM cohort treated with curative intent and contemporary systemic and locoregional therapy.

PATIENTS AND METHODS: A retrospective multi-institutional review was conducted from 2016 to 2022 of patients with CAM who underwent axillary surgery. Survival outcomes were compared with those with locally advanced breast cancer (LABC) and metastatic breast cancer (MBC).

RESULTS: In total, 754 patients were included in the study (63 CAM, 188 LABC, and 503 MBC). The median age at CAM diagnosis was 62 years [(interquartile range (IQR) 49.2-69.3)], and the majority demonstrated invasive ductal histology (74.6%). Over half of the patients with CAM received neoadjuvant chemotherapy (55.6%) followed by axillary dissection (82.5%) and adjuvant radiation (74.6%) in most cases. On unadjusted analysis, the LABC cohort demonstrated the highest 3-year unadjusted overall survival (OS) (89.4%), followed by CAM (79.7%) and MBC (53%) (p < 0.001). On multivariable analysis adjusting for age, race/ethnicity, insurance, and hormone receptor status, patients with MBC had inferior survival compared with LABC [hazard ratio (HR) 6.59, 95% confidence interval (CI) 4.22-10.28, p < 0.001], while CAM had similar survival to that seen in LABC (HR 2.13, 95% CI 0.82-5.52, p = 0.12).

CONCLUSIONS: Survival was higher for patients with CAM compared with MBC and was similar to patients with LABC. Though the LABC group demonstrated better recurrence-free survival than the CAM group, these numbers were comparable within the first 2 years of follow-up. Our data provides additional support for the consideration of curative intent management for patients with CAM.

RevDate: 2025-05-23
CmpDate: 2025-05-21

Naudin S, Wang M, Dimou N, et al (2025)

Alcohol intake and pancreatic cancer risk: An analysis from 30 prospective studies across Asia, Australia, Europe, and North America.

PLoS medicine, 22(5):e1004590.

BACKGROUND: Alcohol is a known carcinogen, yet the evidence for an association with pancreatic cancer risk is considered as limited or inconclusive by international expert panels. We examined the association between alcohol intake and pancreatic cancer risk in a large consortium of prospective studies.

METHODS AND FINDINGS: Population-based individual-level data was pooled from 30 cohorts across four continents, including Asia, Australia, Europe, and North America. A total of 2,494,432 participants without cancer at baseline (62% women, 84% European ancestries, 70% alcohol drinkers [alcohol intake ≥ 0.1 g/day], 47% never smokers) were recruited between 1980 and 2013 at the median age of 57 years and 10,067 incident pancreatic cancer cases were recorded. In age- and sex-stratified Cox proportional hazards models adjusted for smoking history, diabetes status, body mass index, height, education, race and ethnicity, and physical activity, pancreatic cancer hazard ratios (HR) and 95% confidence intervals (CI) were estimated for categories of alcohol intake and in continuous for a 10 g/day increase. Potential heterogeneity by sex, smoking status, geographic regions, and type of alcoholic beverage was investigated. Alcohol intake was positively associated with pancreatic cancer risk, with HR30-to-<60 g/day and HR≥60 g/day equal to 1.12 (95% CI [1.03,1.21]) and 1.32 (95% CI [1.18,1.47]), respectively, compared to intake of 0.1 to <5 g/day. A 10 g/day increment of alcohol intake was associated with a 3% increased pancreatic cancer risk overall (HR: 1.03; 95% CI [1.02,1.04]; pvalue < 0.001) and among never smokers (HR: 1.03; 95% CI [1.01,1.06]; pvalue = 0.006), with no evidence of heterogeneity by sex (pheterogeneity = 0.274) or smoking status (pheterogeneity = 0.624). Associations were consistent in Europe-Australia (HR10 g/day = 1.03, 95% CI [1.00,1.05]; pvalue = 0.042) and North America (HR10 g/day = 1.03, 95% CI [1.02,1.05]; pvalue < 0.001), while no association was observed in cohorts from Asia (HR10 g/day = 1.00, 95% CI [0.96,1.03]; pvalue = 0.800; pheterogeneity = 0.003). Positive associations with pancreatic cancer risk were found for alcohol intake from beer (HR10 g/day = 1.02, 95% CI [1.00,1.04]; pvalue = 0.015) and spirits/liquor (HR10 g/day = 1.04, 95% CI [1.03,1.06]; pvalue < 0.001), but not wine (HR10 g/day = 1.00, 95% CI [0.98,1.03]; pvalue = 0.827). The differential associations across geographic regions and types of alcoholic beverages might reflect differences in drinking habits and deserve more investigations.

CONCLUSIONS: Findings from this large-scale pooled analysis support a modest positive association between alcohol intake and pancreatic cancer risk, irrespective of sex and smoking status. Associations were particularly evident for baseline alcohol intake of at least 15 g/day in women and 30 g/day in men.

RevDate: 2025-05-21
CmpDate: 2025-05-21

Zhu L, Beichman A, K Harris (2025)

Population size interacts with reproductive longevity to shape the germline mutation rate.

Proceedings of the National Academy of Sciences of the United States of America, 122(21):e2423311122.

Mutation rates vary across the tree of life by many orders of magnitude, with fewer mutations occurring each generation in species that reproduce quickly and maintain large effective population sizes. A compelling explanation is that large effective population sizes facilitate selection against weakly deleterious "mutator alleles" such as variants that modulate cell division or interfere with the molecular efficacy of DNA repair. However, while the fidelity of a single cell division largely determines microorganisms' mutation rates, the relationship of the mutation rate to the molecular determinants of DNA damage and repair is more complex in multicellular species with long generation times. Since long generations leave more time for mutations to accrue each generation, we posit that a long generation time likely amplifies the fitness consequences of any damage agent or DNA repair defect that creates extra mutations in the spermatogonia or oocytes. This leads to the counterintuitive prediction that the species with the highest germline mutation rates per generation are also the species with most effective mechanisms for avoiding and repairing mutations in their reproductive cells. Consistent with this, we show that mutation rates in the reproductive cells are inversely correlated with generation time; in contrast, the number of germline mutations that occur during prepuberty development trends weakly upward as generation time increases. Our results parallel recent findings that the longest-lived species have the lowest mutation rates in adult somatic tissues, potentially due to selection to keep the lifetime mutation load below a harmful threshold.

RevDate: 2025-05-23
CmpDate: 2025-05-23

Chandra AA, Duran Luciano P, Swett K, et al (2025)

Association of Lp(a) With Stroke and Cerebral Injury on MRI: Insights From the HCHS/SOL (Hispanic Community Health Study/Study of Latinos) and Investigation of Neurocognitive Aging MRI (SOL-INCA MRI).

Stroke, 56(6):1492-1504.

BACKGROUND: Lp(a) (lipoprotein[a]) is a risk factor for cardiovascular disease; however, its association with cerebrovascular disease is not as well established.

METHODS: Data from a population-based cohort of Hispanics/Latinos included 16 333 individuals with baseline Lp(a) levels (nmol/L) and self-reported prevalent stroke or transient ischemic attack (TIA). A subset of 2642 individuals with brain magnetic resonance imaging was also included. Linear and multivariate logistic regression assessed the association of Lp(a) with (1) self-reported stroke or TIA, (2) cerebral injury defined as self-reported stroke or TIA or evidence of a stroke on brain magnetic resonance imaging, (3) white matter hyperintensity volume, and (4) silent brain infarcts. Sampling weights were utilized given the HCHS/SOL (Hispanic Community Health Study/Study of Latinos) complex sample design.

RESULTS: Mean age±SE was 41.1±0.3 years, 52.0% women, and median interquartile range (Q1, Q3) Lp(a) level of 19.7 (7.3-60.6) nmol/L; brain magnetic resonance imaging subset mean age±SE was 49.9±0.4 years, 56.4% women, and median (interquartile range) Lp(a) level of 21.7 (8.1-62.9) nmol/L. Each unit increase in log-transformed Lp(a) was associated with higher odds of self-reported stroke or TIA (odds ratio, 1.13 [95% CI, 1.01-1.27]; P=0.03). Lp(a) levels in the highest quintile (>77 nmol/L) were significantly associated with higher odds of prevalent stroke or TIA compared with Lp(a) <6 nmol/L (first quintile: odds ratio, 1.74 [95% CI, 1.09-2.77]; P=0.02). The highest proportion of cerebral injury was noted in Q5, while the lowest proportion was noted in Q2. When comparing Lp(a) >77 nmol/L with Lp(a) of 6 to <13 nmol/L (second quintile), a significant association was found between Lp(a) and cerebral injury that persisted after fully adjusted models (odds ratio, 2.03 [95% CI, 1.05-3.93]; P=0.03). Each unit increase in log-Lp(a) was associated with a 0.10 increase in log-white matter hyperintensity (β, 0.10; P=0.005). No significant association was found between Lp(a) and silent brain infarcts.

CONCLUSIONS: Lp(a) is independently and significantly associated with prevalent stroke/TIA, and white matter hyperintensity, in a large diverse population of Hispanics/Latinos.

RevDate: 2025-05-20

Hery CM, Zhang X, McLaughlin E, et al (2025)

Association of Cancer History with COVID-19 Risk and Outcomes Among Older Postmenopausal Women: Results from the Women's Health Initiative.

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology pii:762540 [Epub ahead of print].

BACKGROUND: Several studies early in the COVID-19 pandemic suggested those with a cancer history had higher risk of COVID-19 infections and complications. However, few prospective studies evaluated the association of cancer with COVID-19 in older women. We aimed to examine the association of cancer history with risk of COVID-19 and various COVID-19 outcomes among older women.

METHODS: The Women's Health Initiative (WHI) is an ongoing cohort study that recruited 161,808 postmenopausal women aged 50-79 from 1993-1998. Those who completed the COVID-19 survey (2021-2022) were included (n=35,623). Multivariable linear and logistic regression were used to examine COVID-19 positivity, symptoms severity, long COVID, and COVID concerns/anxiety outcomes.

RESULTS: 28% (n=9,901) of participants had a history of cancer. Cancer history was not significantly associated with COVID-19 positivity (OR: 0.94, 95% CI: 0.81-1.08), COVID-19 hospitalization (OR: 1.21, 95% CI: 0.85-1.72), number of symptoms (LS Mean: 0.33, 95% CI: -0.20, 0.85), and long COVID (OR: 1.18, 95% CI: 0.88-1.58).

CONCLUSIONS: History of cancer was not associated with most COVID-19 outcomes. Future studies should continue to examine physiological mechanisms contributing to differences within cancer survivors and prioritize the inclusion of underserved populations to identify strategies to address the impact of COVID-19.

IMPACT: These findings may assure cancer survivors their diagnosis alone does not increase their risk of COVID-19 and suggests older women with a history of cancer may have similar risk of COVID-19 outcomes compared to their non-cancer counterparts.

RevDate: 2025-05-22
CmpDate: 2025-05-20

Arimura Y, Konishi HA, H Funabiki (2025)

MagIC-Cryo-EM, structural determination on magnetic beads for scarce macromolecules in heterogeneous samples.

eLife, 13:.

Cryo-EM single-particle analyses typically require target macromolecule concentration at 0.05~5.0 mg/ml, which is often difficult to achieve. Here, we devise Magnetic Isolation and Concentration (MagIC)-cryo-EM, a technique enabling direct structural analysis of targets captured on magnetic beads, thereby reducing the targets' concentration requirement to <0.0005 mg/mL. Adapting MagIC-cryo-EM to a Chromatin Immunoprecipitation protocol, we characterized structural variations of the linker histone H1.8-associated nucleosomes that were isolated from interphase and metaphase chromosomes in Xenopus egg extract. Combining Duplicated Selection To Exclude Rubbish particles (DuSTER), a particle curation method that excludes low signal-to-noise ratio particles, we also resolved the 3D cryo-EM structures of nucleoplasmin NPM2 co-isolated with the linker histone H1.8 and revealed distinct open and closed structural variants. Our study demonstrates the utility of MagIC-cryo-EM for structural analysis of scarce macromolecules in heterogeneous samples and provides structural insights into the cell cycle-regulation of H1.8 association to nucleosomes.

RevDate: 2025-05-19

Khyzha N (2025)

SLAM-RT&Tag: spatiotemporal profiling of RNA within nuclear compartments in situ.

Nature reviews. Genetics [Epub ahead of print].

RevDate: 2025-05-19

Yang H, Wang Y, Luo K, et al (2025)

Dietary patterns, serum metabolites and risk of cardiovascular disease in US Hispanic/Latino adults: a prospective analysis of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

The American journal of clinical nutrition pii:S0002-9165(25)00261-8 [Epub ahead of print].

BACKGROUND: Healthy dietary patterns are recommended to prevent cardiovascular disease (CVD), yet the relationships among healthy dietary patterns, blood metabolite profile, and incident CVD are not well-understood.

OBJECTIVE: This study aimed to assess the associations of healthy dietary patterns and related serum metabolite profile with incident CVD in US Hispanic/Latino adults.

METHODS: The study included 13,922 participants aged 18-74 years from the Hispanic Community Health Study/Study of Latinos. Dietary pattern scores, including Healthy Eating Index (HEI)-2020, healthful Plant-based Diet Index (hPDI), and alternate Mediterranean diet score (aMED), were constructed at baseline (2008-2011) based on two 24-hour dietary recalls. The primary outcome was incident CVD, encompassing myocardial infarction, heart failure, and stroke. Dietary-pattern-associated metabolites were identified in a subsample of participants free of diabetes at baseline (n=4,096). Associations of dietary pattern scores, individual metabolites and metabolite scores with incident CVD were evaluated using multivariable Cox regression.

RESULTS: During a median 9.7-year follow-up period, 260 CVD events occurred among 13,922 participants. After adjusting for demographic, socioeconomic and behavioral factors, higher dietary pattern scores were associated with lower risk of CVD (hazard ratios [HRs]=0.53 [95% confidence interval: 0.30, 0.92], 0.50 [0.27, 0.91] and 0.62 [0.36, 1.07] for HEI-2020, hPDI and aMED, respectively, by comparing the highest tertile to the lowest tertile). A total of 60 metabolites were identified to be associated with all three dietary pattern scores, including 45 metabolites positively and 15 metabolites negatively associated with dietary pattern scores. A total metabolite score based on these 60 dietary-pattern-associated metabolites was negatively associated with risk of CVD after multivariable adjustment (HR=0.57 [0.35, 0.92] by comparing the highest tertile to the lowest tertile).

CONCLUSIONS: Healthier diet patterns and related serum metabolite profile were associated with lower risk of CVD in US Hispanic/Latino adults.

RevDate: 2025-05-19

Ashford NK, Rane S, Farris KM, et al (2025)

Acute cerebral blood flow response to heavy cream ingestion in older adults: A non-randomized pilot study.

Journal of Alzheimer's disease : JAD [Epub ahead of print].

BackgroundHypertension and the APOE4 allele are known risk factors for Alzheimer's disease (AD) and E4 carriers show different blood pressure (BP) and cognitive responses to high fat feeding.ObjectiveWe investigated the influence of these factors on global cerebral blood flow (CBF) and four regions of interest (ROIs) (angular gyrus, hippocampus, posterior cingulate, temporal lobe) using arterial spin labeling (ASL) MRI in fasting state and after ingestion of heavy cream in older adults.Methods29 adults (age in years 66.8 ± 4.1) underwent baseline and 1, 2, 3-h ASL MRI after ingestion of 100 mL heavy cream. We used pCASL MRI with background suppression to measure CBF in ml/100 g/min. Statistical analyses included mixed-effects modeling and Pearson correlation to ascertain whether CBF changed over time and how variables influenced results.ResultsGlobal CBF decreased at 1-, 2-, and 3-h post-heavy cream, compared to time 0 (overall change 7.11%, p < 0.01); recapitulated in 3 of 4 ROIs. Mean arterial pressure emerged as a predictive variable for both baseline and post-heavy cream CBF (β = -0.25, 95% CI = -0.39, -0.10, p = 0.002). Individuals with higher BP demonstrated reduced CBF, particularly in posterior cingulate and temporal lobe (β = -5.50, 95% CI = -9.9, -1.09; β = -6.28, 95% CI = -12.35, -0.21, respectively, both p < 0.05). Examination of correlations with BP and change scores revealed that this relationship was driven largely by E4 carriers.ConclusionsCBF decreased after ingestion of heavy cream, globally and in regions known to be important in AD, and this finding was driven by E4 carriers with higher BP.

RevDate: 2025-05-20

Alabi A, Ainsworth V, Lawal A, et al (2025)

Key stakeholders' experiences, knowledge and perspectives regarding care quality for breast cancer in South-West Nigeria.

Frontiers in oncology, 15:1418649.

The landscape of breast cancer care in Nigeria is complex, with various structural and individual barriers impacting patient care. Breast cancer (BC) is the most common cancer and a leading cause of cancer deaths among women worldwide. In Africa, the cancer burden is expected to rise significantly, with projections estimating an increase of 50% by 2050. Rising incidence rates and barriers to care contribute to a healthcare crisis, leading to late-stage presentation and high mortality rates for women with breast cancer in Nigeria. Quality healthcare must be patient-centered, involving stakeholders - patients, clinical and community partners, and other healthcare stakeholders to achieve a desired outcome. Understanding the cancer journey from different perspectives allows for targeted approaches for increasing access to quality healthcare as well as reducing morbidity and mortality rates. To address this, healthcare provider perspectives about breast cancer care were compared with the lived experiences of breast cancer patients to emphasize the need to increase access and quality of care. A mixed method study was conducted in 2 phases: Phase I: 3 Focus group discussions (FGDs) with breast cancer patients and their care givers were conducted at the NSIA-LUTH Cancer Centre in Lagos, Nigeria. Phase II: A pre and post-survey of a continuing medical education course focused on breast cancer was delivered to healthcare providers in southwest Nigeria. Survey responses regarding causes for delays and barriers to care indicated financial strain, fear, and alternative treatments as the largest hurdles, coinciding with patient testimony from the FGD. Fear of mastectomy was a perceived barrier to care for 90% of healthcare providers while 87% and 86% of providers perceived seeking spiritual and herbal treatments as the largest delays of care. Despite this, a significant number of focus group participants (39%) presented within the first month of noticing a breast symptom to a proper healthcare provider. Data from our study reports that 70% of patients receive help from family to fund treatment highlighting why cancer can be a poverty trap for families and the need for universal health insurance. Half of the focus group participants had a positive interaction with their doctors, with the rest reporting neutral (19%) or even negative (31%) interactions. Our study also reports 42% of healthcare providers feeling only "somewhat" qualified to deal with breast cancer, highlighting the significant need for more education, with a further 14% feeling neutral or negative about their qualification, a potential contributing factor in negative interactions recalled by patients. Knowledge increase was consistent for best practice diagnostic modalities among healthcare providers (p < 0.05). At the same time, items related to symptoms and risks of breast cancer had inconsistent knowledge increases, indicating why further courses like these should be pursued. With the success of the course and the inspiration of breast cancer survivors, a proposed expansion into community awareness is discussed along with enlisting local practitioners in the fight against breast cancer in hopes of lowering the barriers to and delays of care in Nigeria.

RevDate: 2025-05-21

Halloran ME (2025)

Designs for Vaccine Studies.

Annual review of statistics and its application, 12:1-18.

Due to dependent happenings, vaccines can have different effects in populations. In addition to direct protective effects in the vaccinated, vaccination in a population can have indirect effects in the unvaccinated individuals. Vaccination can also reduce person-to-person transmission to vaccinated individuals or from vaccinated individuals compared with unvaccinated individuals. Design of vaccine studies has a history extending back over a century. Emerging infectious diseases, such as the SARS-CoV-2 pandemic and the Ebola outbreak in West Africa, have stimulated new interest in vaccine studies. We focus on some recent developments, such as target trial emulation, test-negative design, and regression discontinuity design. Methods for evaluating durability of vaccine effects were developed in the context of both blinded and unblinded placebo crossover studies. The case-ascertained design is used to assess the transmission effects of vaccines. The novel ring vaccination trial design was first used in the Ebola outbreak in West Africa.

RevDate: 2025-05-20

Sanchez-Youngman S, Jacquez B, Adsul P, et al (2025)

Engage for equity plus: Transforming academic health centers to sustain patient/community engaged research structures, policies, and practices.

Journal of clinical and translational science, 9(1):e80.

INTRODUCTION: Community-based participatory research (CBPR) and patient/ community engaged research (P/CEnR) are shown to be effective approaches that improve health inequities, particularly among disadvantaged populations. While the science of CBPR demonstrates promising partnering practices that lead to effective interventions, there are institutional and structural barriers to creating and sustaining patient/community research within academic health centers (AHCs). As the field matures, there is a growing need to enhance patient/community leadership so that communities can set their own research agendas and priorities.

METHODS: Engage for Equity PLUS sought to address these challenges by implementing an engagement intervention aimed at transforming AHCs through supporting champion teams of academic, community, and patient partners to strengthen research infrastructures for P/CEnR. This paper uses a qualitative, case study analysis to describe how E2PLUS enabled champion teams at Stanford School of Medicine, Fred Hutchinson/University of Washington Cancer Consortium, and Morehouse School of Medicine to pursue institutional change strategies through coaching, workshops, contextual data analysis, and a community of practice.

RESULTS: This paper describes key themes of how E2Plus helped identify targets of change by a) using institutional data collection as core to generating critical consciousness of contextual conditions; b) implementing feasible E2PLUS strategies to leverage conditions for catalyzing a champion team for advocacy and achievable actions; c) identifying the critical role of patients/community members in stimulating change; and d) the role of continual collective reflection.

CONCLUSION: We discuss the overall implications for E2 PLUS for other AHCs working toward sustainable community/patient engaged research policies and practices.

RevDate: 2025-05-21
CmpDate: 2025-05-19

Bell-Brown A, Tawfik B, Segarra-Vazquez B, et al (2025)

Addressing Challenges in Research Aimed at Reducing Financial Toxicity Among Cancer Patients and Caregivers: An Example From the CREDIT Study (SWOG S1912CD).

Cancer control : journal of the Moffitt Cancer Center, 32:10732748251344469.

IntroductionCancer-related financial hardship is pervasive, impacting both patients and caregivers, making it crucial to address financial hardship at the household level. The CREDIT (S1912CD) study was designed to enroll and randomize cancer patients and spousal caregivers as dyads to proactive financial navigation compared to usual care. The study faced several challenges to recruitment. This paper discusses the changes made to successfully complete the study.MethodsThe study took place among NCI Community Oncology Research Program (NCORP) sites and allowed several venues for protocol feedback, including SWOG group meetings, NCORP administrator meetings, and individual calls with recruiting sites. A patient advocate worked with the study team to review and update documents to ensure the study was relevant and accessible to potential participants.ResultsSeveral barriers were identified including sites facing challenges in enrolling patient-spouse dyads, multiple financial navigation partners causing confusion and delays in delivery of the intervention, eligibility criteria concerns, and participant discomfort with providing social security numbers. Several modifications were made to address these obstacles during a study restructure, including making caregiver participation optional, streamlining intervention delivery, and modifying eligibility criteria to allow more time between diagnosis and enrollment. Changes from the restructure resulted, on average, in a 9.5 patient per month increase in accrual (4.1 to 13.6) and has enabled the study to reach overall accrual within the study timeline. Importantly, the study maintained diverse accrual and continued to accrue willing caregivers to enable exploratory analysis of caregiver outcomes.ConclusionInterventions examining how to mitigate financial hardship for cancer patients and those affected by cancer, must be pragmatic in order to be translated into sustainable programs in real world settings. Providing recruiting sites an avenue for feedback ensured that the study team could adjust the protocol to meet site needs and successfully complete this financial navigation study.

RevDate: 2025-05-21

Moore M, Glidden D, Anderson P, et al (2025)

Dosing forgiveness of oral PrEP for cisgender women remains uncertain.

Journal of the International AIDS Society, 28(5):e26496.

RevDate: 2025-05-19
CmpDate: 2025-05-19

Dashevsky BZ, Fish LJ, Breit S, et al (2025)

Contrast-Enhanced Mammography Implementation: Early Struggles and Successes.

Journal of breast imaging, 7(3):345-354.

We used focus groups of radiologists who led the implementation of contrast-enhanced mammography (CEM) in their practice to identify barriers and strategies for adoption. Members of the Society of Breast Imaging in the United States who served as lead on CEM implementation were invited to participate in 2 separate focus groups. Ten breast imaging radiologists with varied geographic and practice type (60% academic, 30% private, and 10% community practice) participated. There were 4 major themes identified: patient selection, workflow, contrast, and billing. Patient selection varied widely among practices, with some limiting CEM to patients unable to obtain MRI and others routinely using CEM for diagnostic workup. Lack of Food and Drug Administration approval limited screening applications in some practices. Workflow challenges were numerous, and site-specific solutions were developed for ordering, scheduling, staffing, and intravenous access. There were universal concerns regarding contrast, including safe administration, response to reactions, and biopsy planning for findings only visible on CEM. Contrast reaction training, including conducting mock codes at some practices, helped alleviate concerns of the radiologists and technologists. Finally, billing was an administrative hurdle that influenced patient selection. Ample preparation is needed to successfully start a CEM program with particular attention to patient selection, workflow, contrast administration/reactions, and billing.

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RJR Experience and Expertise

Researcher

Robbins holds BS, MS, and PhD degrees in the life sciences. He served as a tenured faculty member in the Zoology and Biological Science departments at Michigan State University. He is currently exploring the intersection between genomics, microbial ecology, and biodiversity — an area that promises to transform our understanding of the biosphere.

Educator

Robbins has extensive experience in college-level education: At MSU he taught introductory biology, genetics, and population genetics. At JHU, he was an instructor for a special course on biological database design. At FHCRC, he team-taught a graduate-level course on the history of genetics. At Bellevue College he taught medical informatics.

Administrator

Robbins has been involved in science administration at both the federal and the institutional levels. At NSF he was a program officer for database activities in the life sciences, at DOE he was a program officer for information infrastructure in the human genome project. At the Fred Hutchinson Cancer Research Center, he served as a vice president for fifteen years.

Technologist

Robbins has been involved with information technology since writing his first Fortran program as a college student. At NSF he was the first program officer for database activities in the life sciences. At JHU he held an appointment in the CS department and served as director of the informatics core for the Genome Data Base. At the FHCRC he was VP for Information Technology.

Publisher

While still at Michigan State, Robbins started his first publishing venture, founding a small company that addressed the short-run publishing needs of instructors in very large undergraduate classes. For more than 20 years, Robbins has been operating The Electronic Scholarly Publishing Project, a web site dedicated to the digital publishing of critical works in science, especially classical genetics.

Speaker

Robbins is well-known for his speaking abilities and is often called upon to provide keynote or plenary addresses at international meetings. For example, in July, 2012, he gave a well-received keynote address at the Global Biodiversity Informatics Congress, sponsored by GBIF and held in Copenhagen. The slides from that talk can be seen HERE.

Facilitator

Robbins is a skilled meeting facilitator. He prefers a participatory approach, with part of the meeting involving dynamic breakout groups, created by the participants in real time: (1) individuals propose breakout groups; (2) everyone signs up for one (or more) groups; (3) the groups with the most interested parties then meet, with reports from each group presented and discussed in a subsequent plenary session.

Designer

Robbins has been engaged with photography and design since the 1960s, when he worked for a professional photography laboratory. He now prefers digital photography and tools for their precision and reproducibility. He designed his first web site more than 20 years ago and he personally designed and implemented this web site. He engages in graphic design as a hobby.

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Cancer is the generic name for more than 100 diseases in which cells begin to grow and divide in an uncontrolled manner. Usually, when cells get too old or damaged, they die and new cells take their place. Cancer begins when genetic changes impair this orderly process so that some cells start to grow uncontrollably. The Emperor of All Maladies is a "biography" of cancer — from its first documented appearances thousands of years ago through the epic battles in the twentieth century to cure, control, and conquer it to a radical new understanding of its essence. This is a must read book for anyone with an interest in cancer. R. Robbins

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Collection of publications by R J Robbins

Reprints and preprints of publications, slide presentations, instructional materials, and data compilations written or prepared by Robert Robbins. Most papers deal with computational biology, genome informatics, using information technology to support biomedical research, and related matters.

Research Gate page for R J Robbins

ResearchGate is a social networking site for scientists and researchers to share papers, ask and answer questions, and find collaborators. According to a study by Nature and an article in Times Higher Education , it is the largest academic social network in terms of active users.

Curriculum Vitae for R J Robbins

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Curriculum Vitae for R J Robbins

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