Volume 30 Issue 8, August 2024

Dozens of clinical trials are testing new mRNA vaccines, using machine learning to identify antigens, and embracing new technologies such as self-amplifying RNA.

As growing evidence shows that engagement with politics is associated with worsening mental and physical health, a bumper election year and increasing polarization could affect millions.

Politics affects women’s health, from abortion access to funding for health systems, and voters should choose their politicians accordingly.

The treaty is a grand social bargain of open sharing of crucial scientific data in real time and equitable allocation of lifesaving medical countermeasures.

An argument framework, grounded in the sciences of reasoning, provides an alternative to medicine’s measurement framework for evaluating and synthesizing evidence in healthcare.

The National Cancer Institute’s Office of Data Sharing is implementing a framework for data sharing and public access policies, which will empower innovation and maximize therapeutic benefits for the cancer community.

Alzheimer’s disease can be treated by targeting amyloid-β plaques and diagnosed in vivo by biomarkers, prompting the revision of criteria for the diagnosis and staging of this disease.

The liver can create a uniquely favorable milieu for early colonization by metastatic pancreatic cancer cells. A study now highlights mechanisms — such as neutrophil extracellular traps, or NETs — that drive this process; this could inform strategies for intercepting metastasis and improving survival.

For patients with shortness of breath, a new, simplified screening tool — relying only on basic clinical information — can estimate the probability of heart failure with preserved ejection fraction, providing the opportunity for improved detection in non-specialist settings.

A large clinical trial supports the incorporation of qiliqiangxin, a traditional Chinese medicine, into standard treatment regimens for heart failure — highlighting a promising integration of ancient wisdom with modern medical practices through rigorous science.

Although gut microorganisms have been associated with type 2 diabetes, the mechanisms involving specific microbial strains remain unidentified. Now, a comprehensive study has analyzed 8,117 shotgun metagenomes from the USA, Europe, Israel and China, providing cross-population microbial signatures in a strain-resolved manner and new mechanistic insights into type 2 diabetes.

This Review outlines how Western-style diets contribute to the rising incidence of chronic, noncommunicable diseases by converging on key mechanisms, including gut microbial rarefaction and chronic inflammation.

This Review outlines the current state of scientific evidence on long COVID, discusses its impacts on patients, health systems, economies and global health metrics, and proposes a forward-looking research and policy roadmap.

Mutations in a small noncoding gene called RNU4-2 are responsible for one of the most common neurodevelopmental disorders that is mediated by a single gene.

A multi-modal analysis of pre-metastatic liver biopsies from patients with localized pancreatic cancer with a minimum of 3 years of follow-up shows that immunological, proliferative and metabolomic features distinguish patients who develop metastases from disease-free survivors and can be used to predict outcomes.

In a phase 3 randomized controlled trial comparing secondary cytoreduction plus chemotherapy versus chemotherapy alone in patients with relapsed ovarian cancer, the coprimary endpoint of overall survival was not statistically different, but in a prespecified sensitivity analysis adjusted for patients who underwent crossover surgery following tumor relapse, there was an increase in overall survival.

In a randomized, double-blind, placebo-controlled phase 3 trial, the anti-vascular endothelial growth factor receptor small-molecule inhibitor fruquintinib plus chemotherapy significantly extended progression-free survival, but not overall survival, as second-line therapy in patients with advanced gastric or gastroesophageal junction cancers.

Results of the phase 2 trial of CD19 CAR T cell therapy lisocabtagene maraleucel in patients with relapsed or refractory follicular lymphoma, most of whom were treated in a third-line or later setting, show encouraging objective response rates in these high-risk patients.

Secondary and selected exploratory endpoints of the DESTINY-Breast03 trial of trastuzumab deruxtecan or trastuzumab emtansine in patients with advanced HER2-positive breast cancer are reported, including updated efficacy and safety data after a median follow-up of 41 months.

In a single-arm phase 2 trial evaluating intravesical delivery of the oncolytic adenovirus cretostimogene grenadenorepvec with systemic anti-PD-1 in patients with BCG-unresponsive non-muscle-invasive bladder cancer with carcinoma in situ, the complete response rate at 12 months was 57.1%, meeting the primary endpoint.

In the largest study so far of CAR T cells in patients with solid tumors, autologous CLDN18.2-targeting CAR T cell therapy was well tolerated in patients with advanced CLDN18.2-positive gastrointestinal cancers, with an overall response rate of 42.2% and a disease control rate of 91.1%.

In patients with newly diagnosed, transplant-ineligible multiple myeloma, addition of weekly bortzomib to isatuximab, lenalidomide and dexamethasone leads to increased minimal residual disease negativity compared with isatuximab, lenalidomide and dexamethasone.

In this phase 1 trial, treatment of patients with ER⁺HER2⁻ metastatic breast cancer with a selective catalytic inhibitor of the lysine acetyltransferase KAT6 shows a manageable safety profile and encouraging preliminary clinical efficacy.

In a real-world Swedish cohort of 28,017 women, screening for cervical cancer using a DNA methylation-based tool, the WID-qCIN test, either alone or in combination with HPV16/18 genotyping, showed better performance than cytology in triaging HPV-positive women.

A risk score using only three clinical variables—age, body mass index and history of atrial fibrillation—predicts heart failure with preserved ejection fraction, an underdiagnosed condition, without the need for echocardiographic imaging.

Using an international collection of population-based microbiome studies of participants in the MicroCardio Consortium, a cross-cohort meta-analysis identified several phylogenetically diverse, species- and strain-level microbial features as well as community-level functional shifts encompassing diverse pathways to type 2 diabetes.

In a randomized, double-blind phase 3 trial, the anti-α₄β₇ integrin monoclonal antibody vedolizumab plus standard prophylaxis was superior to placebo plus prophylaxis for prevention of lower gastrointestinal acute graft-versus-host disease in patients following allogeneic hematopoietic stem cell transplantation.

Atrial fibrillation is associated with an increased risk of thromboembolic events and vascular dementia in patients with no previous history of stroke or any conventional risk factors, compared to patients without atrial fibrillation.

In a randomized controlled trial involving patients with heart failure with reduced ejection fraction, treatment with Qiliqiangxin, a traditional Chinese medicine derived from 11 types of plants, decreased the incidence of cardiac events, as compared to placebo.

In a randomized trial testing two types of catheter ablation treatments for persistent atrial fibrillation, a large-tip, dual pulsed field and radiofrequency catheter with a large footprint was non-inferior to a conventional radiofrequency catheter.

A natural experiment reports that US healthcare systems have substantial adaptability but only a moderate level of resilience to disruptions due to the COVID-19 pandemic.

A prospective observational study including 2,882 kidney allograft recipients from 14 transplantation centers in Europe and the United States shows that cell-free DNA can be used to detect kidney allograft rejection.

In a randomized clinical trial, treatment using a monoclonal antibody targeting interleukin-6 (IL-6) in patients with cardiovascular disease and/or diabetes who were receiving maintenance kidney dialysis reduced levels of inflammatory biomarkers at 12 weeks, including C-reactive protein, paving the way for a phase 3 trial.

In a retrospective study of individuals living with diabetes and obesity, conducted from 2008 through 2021, treatment with bariatric metabolic surgery was more effective than treatment with GLP-1 receptor agonists for prevention of incident congestive heart failure.

An economic evaluation of the E-MOTIVE intervention for postpartum hemorrhage (PPH) compared with usual care in 210,132 women, carried out from a healthcare system perspective, uncovered the cost per case of severe PPH prevented and cost per disability-adjusted life-year averted.

Multimodal approaches combining various numbers of behavioral, neuroimaging and electrophysiological markers improves neuroprognosis performance in clinically unresponsive critical-care patients.

The 5-Cog paradigm, a culturally fair and non-literacy biased cognitive detection tool paired with a clinical decision support improved cognitive impairment diagnosis and management threefold in primary care patients with cognitive concerns.

Reduced mitochondrial respiration in peripheral blood cells is associated with faster vision loss in glaucoma patients with controlled intraocular pressure.