Volume 30 Issue 1, January 2024

High financial costs and limited evidence restrict the adoption of robotic surgery, but new uses for robots and attempts to assess efficacy could widen access.

CAR T cell therapy has transformed the treatment of B cell cancers and is now being pursued by biotech companies for conditions as varied as systemic lupus erythematosus, diabetes and organ rejection.

Social determinants of health can only be tackled through collaborations between public health leaders, economists, sociologists, and other non-medical stakeholders, as well as involvement from the community.

GLP-1 receptor agonists are effective treatments for obesity but are less accessible worldwide than pharmacological treatments for diabetes, reflecting biases and lack of education, and perpetuating health inequalities.

A six-tiered governance framework for federated health data, with varying levels of data access and sharing, is proposed to facilitate the use of health data held within more than one secure environment, while preserving privacy.

Therapeutic genome editing has great potential to cure some rare diseases, but germline editing is banned. With a broad societal discussion supported by national and transnational legislation, it could be allowed in certain circumstances.

New data show that electronic clinical decision support systems integrated with point-of-care tests can lead to meaningful reductions in antibiotic use in children in low- and middle-income countries, without compromising health outcomes — but investment in human resources is crucial to their success.

As populations age, falls are an increasing public health problem; strategies to prevent them should incorporate new technologies and insights into the sensory, perceptual and motor systems controlling balance.

Two malaria vaccines are approved and several prophylactic antibodies are in development, but a combination of strategies tailored to different epidemiological situations will be needed if malaria is to be eliminated.

The largest whole-genome sequencing study thus far has revealed myriad actionable alterations and potential biomarkers for 33 cancer types, but various logistical, technical and economic challenges must be overcome before this technique can become standard of care.

A prognostic model for invasive breast cancer that is based on interpretable measurements of epithelial, stromal, and immune components outperforms histologic grading by expert pathologists. This model could improve clinical management of patients diagnosed with invasive breast cancer and address the concerns of pathologists about artificial intelligence (AI) trustworthiness by providing transparent and explainable predictions.

We deeply characterized the early-life gut virome, which consists mainly of bacteriophages (phages) and the diversity of which greatly exceeds bacterial diversity. The virome was associated with later asthma development, independently of the bacterial hosts of the phages; we further uncovered intriguing interactions with immune genetics.

Semaglutide, also known as Ozempic for treating type 2 diabetes and as Wegovy for treating obesity, compared with other weight management or diabetic medications, is not associated with higher risk of suicidal ideations in patients with obesity (or who are overweight) or patients with type 2 diabetes.

In one person with Parkinson’s disease, freezing of gait was averted through the use of a soft robotic apparel that provided a moderate level of hip-flexion assistance during the swing phase of walking. This approach delivered instantaneous effects and consistently improved walking quality and function across a range of conditions.

We profiled human central nervous system (CNS)-associated macrophages (CAMs) in anatomically dissected CNS interface tissue from typical, fetal and glioblastoma-affected brains using single-cell multi-omics and spatially resolved transcriptomic techniques. Analyses of CAM (and microglia) turnover rates in stem-cell-transplanted glioblastoma and prenatal tissues highlighted the developmental phenotypes of these cells in patients, which lays the groundwork for potential replacement therapies.

The unique risks and needs of women in relation to noncommunicable diseases offer myriad opportunities to intervene and prevent disease, but several key barriers to implementation must be addressed.

To guide the safe implementation of the next generation of surgical robots, the IDEAL Robotics Colloquium provides recommendations for their evaluation throughout the product life cycle—considering multiple perspectives within and beyond the surgical team.

A cluster randomized trial in Tanzania showed that the implementation of a decision support algorithm decreased antibiotic prescriptions to children considerably, without impacting clinical outcomes.

Deep learning enables comprehensive and interpretable scoring for breast cancer prognosis prediction, outperforming pathologists in multicenter validation and providing insight on prognostic biomarkers.

In a randomized clinical trial enrolling older people living in a community setting, exergame step training on a computerized mat, but not seated cognitive training, decreased the rate of falls over the course of a year, as compared to a control group provided with an education booklet on healthy aging and fall prevention.

In a phase 2 clinical trial, an inhibitor of the K_Ca2 potassium channel, which conducts a repolarizing current in the heart, met the primary endpoint of promoting cardioversion from atrial fibrillation to sinus rhythm within 90 minutes of drug administration.

Analysis of electronic health records of nirmatrelvir/ritonavir use in pregnant women shows that the treatment is associated with a lower risk of pregnancy-related adverse outcomes, including maternal morbidity, premature birth and cesarean section.

Isolation and optimization of antibodies targeting the malaria parasite may offer the potential for immediate protection as a prophylactic intervention to prevent severe disease.

In a proof-of-concept randomized trial in schoolchildren from Northern Senegal, artesunate–mefloquine at antimalarial dosage was noninferior to standard-care praziquantel for the treatment of schistosomiasis.

Components of the gut virome of 1-year-old children are associated with increased risk of development of asthma later in life, probably through direct interaction between phages and the host immune system.

A meta-analysis using the Burden of Proof method reported consistent evidence supporting harmful associations between exposures to secondhand smoke and nine health outcomes.

A real-world retrospective cohort study provides evidence that semaglutide prescription is not associated with higher risks of suicide ideation when compared with other anti-obesity or anti-diabetic medications.

A soft wearable robotic device significantly reduces freezing of gait in a single individual with Parkinson’s disease.

A single-cell spatial transcriptomic and proteomic study of immune cells in the human CNS border compartments reveals differences in CNS-associated macrophages across age, perturbation and disease.

Two-year interim data from an ongoing phase 1/2 trial of the AAV-based gene therapy bidridistrogene xeboparvovec in six patients with limb-girdle muscular dystrophy show a safe profile and preliminary increased expression of the β-sarcoglycan protein.

In a phase 2 trial, the oral type II RAF inhibitor tovorafenib exhibited an overall response rate of 67% in patients with BRAF-altered relapsed/refractory pediatric low-grade glioma.

Analysis of the phase 3 CheckMate 816 trial shows that the depth of pathologic response as assessed by percent residual viable tumor is correlated with event-free survival following neoadjuvant immunotherapy plus chemotherapy, supporting pathologic response as a biomarker of survival.

In an ongoing phase 1/2 trial, mosunetuzumab, a CD20xCD3 bispecific antibody, plus polatuzumab vedotin, an anti-CD79B antibody–drug conjugate, had an overall response rate of 59.2%, supporting the potential of this combination for second-line treatment of patients with transplant-ineligible or CAR-T-cell-ineligible relapsed or refractory large B cell lymphoma.

In a large single-arm phase 2 trial, the anti-PD-1 inhibitor tislelizumab combined with the next-generation BTK inhibitor zanubrutinib had an overall response rate of 58.3% and was well tolerated in patients with Richter’s transformation.

In this prespecified analysis of the ongoing TORCHLIGHT phase 3 trial, first-line treatment with toripalimab and nab-paclitaxel in patients with advanced triple-negative breast cancer led to significantly longer progression-free survival in the PD-L1-positive population compared to nab-paclitaxel alone.

In the homologous recombination repair-deficient population of TALAPRO-2, a placebo-controlled phase 3 trial, treatment of patients with metastatic castration-resistant prostate cancer with the poly(ADP-ribose) polymerase inhibitor talazoparib plus enzalutamide led to prolonged progression-free survival compared with placebo plus enzalutamide.

A substudy of the CodeBreaK 101 trial, this phase 1b trial testing the KRAS-G12C inhibitor sotorasib with an anti-EGFR antibody shows an acceptable safety profile of this combination and encouraging preliminary clinical efficacy in patients with chemotherapy-refractory colorectal cancer.

In an arm of a phase 1b trial, the combination of divarasib, a KRAS G12C inhibitor, and cetuximab, an epidermal growth factor receptor inhibitor, was well tolerated with an encouraging overall response rate of 62.5% in patients with KRAS G12C-positive colorectal cancer.

The first report from the Cancer Programme of the 100,000 Genomes Project presents whole-genome sequencing profiles of 13,880 solid tumors spanning 33 cancer types, combined with real-world clinical data, providing insights for precision oncology.

Systematic evaluation of literature in four databases to generate an evidence gap map for noncommunicable disease interventions in children and adolescents shows that over 90% of studies have been done in high-income countries and that evidence for interventions for mental health conditions, obesity and substance misuse is lacking globally.