Synopsis

• The EMPHASIS study tested the efficacy and safety of minocycline against acute ischaemic stroke. Preclinical and small-scale studies showed that minocycline was able to inhibit neuroinflammation.

• This double-blind study conducted in 58 hospitals in China enrolled 1724 patients who were randomly assigned to minocycline (862) or placebo (862) groups.

• After 90 days of treatment, minocyline improved the functionality of patients (adjusted risk ratio 1·11, 95% CI 1·03-1·20; p=0·0061; odds ratio 1·19 (95% CI 1·03-1·38; p=0·018). Both groups had similar adverse events such as intracranial hemorrhage.

Conclusion

Minocyline was effective in treating ischaemic stroke if started within 72 hours. 

Synopsis

• The authors tested if camrelizumab (a programmed death 1 inhibitor) is effective when used in addition to chemotherapy and as a maintenance treatment for patients with high-risk nasopharyngeal carcinoma.

• 390 adults with this carcinoma from 8 hospitals were randomly (1:1) assigned to standard treatment (cisplatin) or 19 cycles of intravenous camrelizumab (200 mg) once every three weeks (camrelizumab group).

• At 40 months, more patients treated with camrelizumab survived than patients receiving standard treatment (stratified hazard ratio 0.51, 95% confidence interval 0.34 to 0.77, P=0.001).

Conclusion

Adding camrelizumab to chemoradioatherapy and as a maintenance treatment increased progression-free survival in patients with high-risk nasopharyngeal carcinoma.

Synopsis

• This study evaluated the mechanisms by which a severe form of acute myeloid leukemia (AML) resists treatment and relapses. Single cell RNA sequencing of bone marrow samples from 30 AML patients suggested ferroptosis resistance, leukemia-T cell dysfunction, and stromal remodeling.

• In TP53-mutated AML, stem cells differentiated into granulocytes and late-stage myeloid progenitors that promoted inflammation and ferroptosis-mediated resistance.

• Dysfunctional T cells accumulated and suppressor myeloid cells converted into osteogenic programs. Additional analysis found different prognostic fates which is helpful for clinical stratification.

Conclusion

Single cell RNA analysis of bone marrow from AML patients showed the mechanism leading to resistance and revealed potential therapeutic targets.

Synopsis

• This study evaluated health-system factors required for safe world-wide implemention of minimally invasive cholecystectomy as a tracer procedure.

• In 52 187 patients, the rate of procedure-specific complication was not associated with income levels and it differed 40-fold between hospitals.

• Three factors increased safety: local simulation-based training (adjusted OR 0·78 [0·71–0·86]; p<0·0001), intraoperative safety and communication methods (0·87 [0·79–0·96]; p=0·0046), and on-site CT diagnostics (0·79 [0·65–0·97]; p=0·0220).

Conclusion

Therefore, more safety and improved diagnostics supports the worldwide use of minimally invasive surgery.

Synopsis

• This study estimated the effectiveness of COVID-19 vaccine a few days or more (7-89, 90-179, and ≥180 days) before onset of COVID-19. 

• The study enrolled 8493 patients including 1888 patients with COVID-19 and 6605 control patients. The patients with COVID-19 included 348 (36.6%) infected with KP.3.1.1, 218 (22.9%) with XEC, and 134 (14.1%) with LP.8.1.

• ·The vaccine was effective in 40% of the patients for 90-179 days after vaccination. It was more effective (79%) against mechanical ventilation or death. Against COVID-19 variants, it was effective in 49% of the patients infected with KP.3.1.1, 34% infected with XEC, and 24% infected with LP.8.1.

Conclusion

The COVID-19 vaccine when given at 90 to 179 days before onset of disease was effective in preventing severe disease outcomes in patients infected with various strains of COVID-19. 

Synopsis

• The long-term effect of combination treatment with lenalidomide plus rituximab versus rituximab with placebo was tested in the phase lll AUGMENT trial in patients with relapsed or refractory (R/R) indolent non-Hodgkin lymphoma (iNHL).

• Among 395 patients with iNHL, 295 had follicular lymphoma (FL). In the FL group, 66 patients were older than 70 years.

• At 66 months, the combination treatment prevented disease progression (hazard ratio [HR], 0.50 [95% CI, 0.38 to 0.66]) and improved survival (HR, 0.59 [95% CI, 0.37 to 0.95]) in the iNHL group and in those with follicular lymphoma (FL). Toxic effects were similar in both treatment groups.

Conclusion

This study supports the use of lenalidomide plus rituximab as standard treatment for patients with iNHL.

Synopsis

• It is unknown whether manipulating the tumor-stroma interaction in esophageal carcinoma (EAC) would improve the response to treatment. The authors studied the role of GDF15 in cancer associated fibroblast (CAF) signaling and if this signaling is the reason for treatment resistance and poor safety. 

• CAFs increased resistance to treatment and secreted GDF15. Deleting GDF15 and restoring it showed that GDF15 is required for resistance. 

• GDF15 functions by AKT signaling and by adapting mitochondrial activity. Hence, cisplatin treatment was more effective when oxidative phosphorylation was suppressed.

Conclusion

​Targeting GDF15 in CAFs is a clinically relevant method to reduce resistance to chemotherapy treatment.

Synopsis

• The authors evaluated the long-term risk, clinical factors, and disease patterns of secondary primary cancers (SPCs) in gastric cancer (GC) survivors. In 11,027 GC survivors, 241 (2.19%) had SPC at 16 years; 1.25% were affected at 5 years, 2.97% at 10 years, and 4.15% at 15 years.

• Most SPCS were lung (23.2%), colorectal (21.6%), and esophageal (12.9%) cancers. Lung cancer affected males and cervical cancer affected females.

• Old age, sustained hepatitis infection, family history of cancer, and high inflammation before surgery contribute to SPC. Patients affected by SPC were grouped into low (2.07%), intermediate 3.61%, and high risk (4.33%). Those without symptoms were often diagnosed at stage 1 (47.4%).

Conclusion

​SPCs are a long-term risk in patients recovering from GC. Additional studies about the risk of SPCs affecting specific organs and gender could provide more information.