Researchers behind the Optima trial found that a genomic test called Prosigna can identify patients who are unlikely to benefit from chemotherapy after surgery. For many of these patients, hormone therapy alone produced similar outcomes.

The findings could help doctors personalize treatment decisions and reduce unnecessary exposure to chemotherapy and its side effects.

How the Study Was Conducted

The Optima trial enrolled 4,429 patients aged 40 and older with hormone receptor-positive breast cancer. This is the most common type of breast cancer worldwide.

Doctors typically recommend chemotherapy for patients in this group because they face a higher risk of recurrence. Researchers from institutions including University College London and the University of Glasgow used genomic testing to determine whether some patients could safely avoid the treatment.

The study focused on the Prosigna test, which examines the activity of 50 genes within a tumor. The test estimates the likelihood that cancer will return within 10 years and helps identify patients who may benefit most from chemotherapy.

Similar Outcomes Without Chemotherapy

Researchers reported that patients classified as lower risk achieved similar results whether they received chemotherapy or not.

Five years after treatment, 93.7% of patients who received hormone therapy without chemotherapy remained alive and free from breast cancer recurrence. Among those who underwent both chemotherapy and hormone therapy, the figure was 94.9%.

The researchers concluded that omitting chemotherapy did not significantly worsen outcomes for patients identified as lower risk through genomic testing.

Reducing Treatment Burden

Chemotherapy remains an important treatment for many breast cancer patients. However, it can cause significant side effects, including fatigue, nausea, hair loss, fertility complications and cognitive difficulties.

As a result, researchers have increasingly explored ways to identify patients who can safely avoid the treatment.

The Optima investigators estimated that more than two-thirds of patients in the study could potentially skip chemotherapy when doctors used genomic testing to guide treatment decisions.

The findings support the growing use of precision oncology, an approach that tailors treatment based on the biological characteristics of an individual’s tumor rather than relying solely on traditional risk factors.

Part of a Broader Shift in Breast Cancer Care

The results add to a growing body of evidence supporting genomic testing in breast cancer treatment.

Earlier studies involving genomic tools such as Oncotype DX also found that many patients with hormone receptor-positive, HER2-negative breast cancer can safely forgo chemotherapy when genetic testing indicates a low likelihood of benefit.

However, treatment recommendations still depend on several factors, including age, menopausal status, lymph node involvement and specific tumor characteristics.

Researchers stressed that the Prosigna test is not intended to replace chemotherapy altogether. Instead, it helps identify patients who are less likely to benefit from the treatment.

Potential Impact on Future Care

The Optima trial could influence future breast cancer treatment guidelines and help reduce unnecessary chemotherapy use.

Beyond improving patient quality of life, a more targeted treatment approach could lower healthcare costs by avoiding therapies that provide limited benefit.

Researchers said they will continue monitoring trial participants to assess long-term outcomes and confirm the durability of the findings.

The results highlight the increasing role of genomic medicine in cancer care and suggest that many patients may be able to receive effective treatment with fewer side effects.

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Autoimmune diseases occur when the body’s immune system mistakenly attacks its own cells and tissues, potentially causing chronic, sometimes life-threatening conditions. Affecting tens of millions globally, these diseases are particularly common among women and often present with vague or overlapping symptoms that complicate diagnosis.

Recent research is exploring treatments that go beyond symptom management, aiming to reprogram the immune system or delay disease onset. Clinical trials targeting conditions such as lupus, myositis, and type 1 diabetes have shown early promise, signaling a potentially transformative era in autoimmune care.

What Are Autoimmune Diseases?

Autoimmune diseases encompass more than 100 distinct conditions, each defined by the specific tissues or organs they impact. Examples include:

• Rheumatoid arthritis and psoriatic arthritis: primarily attack joints.

• Sjögren’s disease: leads to dry eyes and mouth.

• Myositis and myasthenia gravis: weaken muscles through different mechanisms.

• Lupus: can cause skin rashes, joint pain, fevers, and organ damage affecting the kidneys, heart, and lungs.

Symptoms can be unpredictable. Patients may experience long periods of stability punctuated by sudden flares, often without identifiable triggers.

Challenges in Diagnosis

Diagnosing autoimmune conditions is often complex. Early symptoms may be nonspecific, intermittent, or resemble other illnesses. Overlapping effects on major organs further complicate detection.

Diagnosis usually involves multiple blood tests to identify antibodies that mistakenly target healthy tissue, combined with symptom evaluation and ruling out other conditions. Some diseases, like multiple sclerosis, now benefit from updated guidelines and physician education aimed at streamlining the diagnostic process.

How the Immune System Malfunctions

The human immune system is a sophisticated network of cells and proteins designed to recognize and neutralize threats such as viruses, bacteria, or cancer cells. Normally, it can distinguish between foreign invaders and the body’s own tissues — a state known as tolerance.

Autoimmune diseases emerge when this balance fails. Misguided immune cells or antibodies attack healthy tissue, while regulatory mechanisms fail to restore order. Over time, this misdirected response can lead to chronic illness.

Triggers and Risk Factors

Most autoimmune conditions result from a combination of genetic susceptibility and environmental triggers rather than a single gene defect. Potential triggers include infections, pollutants, or lifestyle factors like smoking. For instance, Epstein-Barr virus exposure is linked to multiple sclerosis.

Emerging research identifies key molecular actors in disease onset. Neutrophils, white blood cells that respond to infection or tissue injury, are now believed to play a central role in conditions like lupus and rheumatoid arthritis when overactive.

Why Women Are More Vulnerable

Women account for roughly 80% of autoimmune patients, often developing conditions at a young age. Hormones are a factor, but genetic differences may also contribute. Females carry two X chromosomes, and abnormalities in how one is silenced can increase susceptibility.

Men, while less frequently affected, can develop severe autoimmune conditions. VEXAS syndrome, discovered in 2020, primarily affects men over 50 and can cause blood clots, respiratory issues, and night sweats.

Certain populations face higher risks: lupus is more prevalent among Black and Hispanic women, while Northern Europeans are more likely to develop multiple sclerosis.

Treatment and Management

The global market for autoimmune disease treatments exceeds $100 billion annually, excluding healthcare visits and productivity losses. Treatments are generally lifelong and, while often covered by insurance, can be costly.

Historically, high-dose steroids and broad immunosuppressants were standard, carrying risks such as infections or cancer. Today, newer therapies target specific molecules, reducing some side effects. Nonetheless, treatment remains largely trial-and-error, with limited predictive tools to guide patient choices.

Advances in research, including immunomodulatory therapies and early intervention strategies, aim to improve outcomes and quality of life for patients worldwide. Clinical trials are testing approaches to reset immune function, offering hope for more durable solutions

Source: AP News – There are more than 100 autoimmune diseases, and they mostly strike women. Here’s what to know

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The NHS app is about to become the go-to way for millions more patients in England to receive important health information — from test results and screening invitations to appointment reminders. The government says this shift will save the NHS £200 million over the next three years, all while making healthcare communication faster and more convenient.

From Letters to Smartphones: A Digital Revolution in Healthcare

Currently, the NHS sends out at least 50 million letters to patients every year. But with a £50 million investment, the focus is shifting towards sending millions more messages directly to smartphones via the NHS app. This means fewer letters cluttering up mailboxes and quicker access to vital information at your fingertips.

This year alone, the Department of Health and Social Care expects around 270 million messages to be sent through the app — a jump of 70 million compared to last year.

Smarter Notifications to Cut Missed Appointments

One of the key benefits? Push notifications will remind patients about upcoming appointments. With approximately eight million elective care appointments missed in 2023/24, these reminders could help reduce no-shows and keep clinics running smoothly.

The app is also being enhanced to allow users to add appointments directly to their phone calendars and even request help from their local GP surgeries — making healthcare management easier than ever.

Making Healthcare More Accessible — But Not Leaving Anyone Behind

More than 11 million people in the UK log into the NHS app every month, and nearly 20 million are signed up to receive messages through it. NHS services via the app are now available in 87% of hospitals across England.

But the government is mindful that not everyone can or wants to use digital tools. For those who can’t access app messages — like many elderly patients — the NHS will still send text messages and, if needed, follow up with letters. This approach also aims to free up NHS phone lines, helping staff focus on patients who need more direct support.

A Step Toward a More Modern, Convenient NHS

Health Secretary Wes Streeting describes this investment as a way to bring the NHS into the digital age — making the patient experience as seamless as online banking or ordering food delivery.

“The move away from paper communication will also free up funds for frontline services,” Streeting adds.

Rachel Power, chief executive of the Patient’s Association, welcomed the upgrade, calling it a “significant step in modernising how patients receive information.”

Concerns About Digital Exclusion

However, not everyone is fully on board. The British Medical Association (BMA) has warned that relying too heavily on apps could risk leaving behind patients who don’t have access to or struggle with digital technology.

The government’s plan follows earlier announcements this year to expand the app’s features — including letting more patients book treatments and appointments directly through it.

What’s Next? Prescription Tracking and More

Last month, NHS England revealed that millions of patients would soon get “Amazon-style” tracking updates for their prescriptions via the app — so they can see if their medicines are ready to collect or have been sent out for delivery. This small but powerful feature aims to reduce waiting times and improve communication.

In short, the NHS app is evolving rapidly, aiming to give patients more control over their healthcare journeys while saving time and money for the system. But as the NHS embraces digital tools, it’s crucial to ensure no patient is left behind.

Source: BBC – Millions more to get test results via NHS app, government says

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A promising new drug, tavapadon, has shown significant potential in treating Parkinson’s disease, offering relief from motor symptoms like tremors, stiffness, and coordination issues—without the common side effects associated with current treatments.

In clinical trials, tavapadon—a once-daily pill—has proven to be effective for patients already taking at least 400 mg of levodopa a day. It specifically benefits those experiencing “motor fluctuations,” a situation where levodopa’s effects wear off, causing symptoms to resurface. Researchers found that tavapadon provided more sustained “on time” (periods when symptoms are controlled) while reducing “off time” (when symptoms return), without the typical negative side effects that often accompany levodopa.

Levodopa has long been the standard treatment for Parkinson’s, but it can come with a range of side effects such as sleep disorders, hallucinations, and impulse control issues. Tavapadon works by mimicking dopamine in the brain and targeting different dopamine receptors (D1/D5), which offers the same symptom relief as levodopa but with fewer adverse effects.

Dr. Hubert H. Fernandez, the lead study author from the Cleveland Clinic, expressed optimism about tavapadon’s potential: “It provides patients with another option to alleviate motor fluctuations in the moderate to advanced stages of Parkinson’s. This is a promising step forward for both patients and doctors.”

The clinical trial, called TEMPO 3, was a multi-center, pivotal study that measured various side effects such as excessive daytime sleepiness, weight gain, and blood pressure changes. Remarkably, the side effects from tavapadon were no worse than those experienced by patients receiving a placebo.

Dr. Fernandez cautioned that while the results are promising, this study was short-term, and further long-term research is needed to fully confirm the drug’s benefits. Nonetheless, he remains hopeful, saying, “We’re very encouraged by these preliminary findings. Whether used at the beginning of treatment or alongside levodopa for more advanced cases, tavapadon represents a significant gain for Parkinson’s patients.”

For recently diagnosed patients with less severe symptoms, tavapadon may replace levodopa altogether, potentially reducing the need for frequent doses of the standard drug. This could minimize the risk of motor fluctuations and dyskinesia (involuntary movements), which are common side effects of levodopa use over time.

For more advanced Parkinson’s cases, tavapadon can be used in combination with levodopa, providing more consistent symptom relief without the typical side effects.

Parkinson’s disease is expected to become a global health crisis, with cases projected to increase to 25 million worldwide by 2050. The biggest surge is expected among people aged 80 and older, with the number of cases in that age group predicted to rise by 196%. This highlights the urgent need for improved treatments like tavapadon.

AbbVie, the pharmaceutical company behind tavapadon, is preparing to file for approval with the U.S. Food and Drug Administration (FDA). Once submitted, the FDA will review the application, which could lead to the drug being approved for widespread use. If approved, tavapadon could offer a new, more effective treatment option for people living with Parkinson’s disease, improving their quality of life and providing a much-needed alternative to existing therapies.

Dr. Mary Ann Picone, a medical director at Holy Name Medical Center, praised the trial results, calling the drug “very interesting and encouraging” for Parkinson’s patients. She highlighted that one of the major challenges of current Parkinson’s treatments is the wearing-off phenomenon, where the drug’s effects diminish over time, leading to “freezing” episodes and increased stiffness.

Tavapadon’s ability to target different dopamine receptors could extend the beneficial effects of treatment, offering patients more “on time” without the involuntary movements that often interfere with their ability to function. As Dr. Picone noted, this new therapy could be a game-changer in improving quality of life for those living with Parkinson’s.

As the long-term clinical trials continue, there’s growing hope that tavapadon will become a vital part of Parkinson’s treatment. With its potential to reduce motor symptoms and side effects, this new drug could offer a better, more sustainable treatment option for patients at every stage of the disease.

Stay tuned for further updates as the FDA review process moves forward, with the possibility of a new chapter in Parkinson’s disease treatment just around the corner.

Source: FOX News – New drug for Parkinson’s shown to be effective in clinical trials: ‘Very encouraged’

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China is intensifying its efforts to track and manage respiratory illnesses, particularly with the anticipated rise in cases during the winter and spring seasons. The National Disease Control and Prevention Administration announced on Friday that it is piloting a specialized monitoring system for pneumonia of unknown origin, signaling a proactive approach to identifying and handling potential outbreaks.

Aiming for Better Preparedness

The new system is designed to improve China’s ability to detect and manage unknown pathogens, a critical step forward from the lower preparedness levels seen five years ago when COVID-19 first emerged. According to state broadcaster CCTV, the initiative includes:

• Standardized Reporting Procedures: Laboratories will be required to report findings, while disease control agencies will verify and address cases promptly.
• Comprehensive Protocols: Authorities aim to establish clear guidelines for handling emerging respiratory illnesses.

Rising Respiratory Infections

Recent data highlights an increase in acute respiratory diseases. Between December 16 and 22, overall infections showed an upward trend. Respiratory illnesses such as rhinovirus and human metapneumovirus have been identified, with the latter notably rising among individuals under 14, especially in northern provinces.Winter and Spring Outlook

Kan Biao, a senior official from the administration, emphasized that while respiratory infections are expected to rise, the total number of cases this year is projected to be lower than in 2022.

Warnings on Treatment Practices

Medical experts caution against the improper use of antiviral drugs, particularly for human metapneumovirus. A respiratory specialist from a Shanghai hospital advised the public to avoid self-medicating, noting that while symptoms mimic those of the common cold, there is currently no vaccine available for this virus.

A Proactive Approach to Public Health

China’s heightened monitoring and proactive measures reflect its commitment to improving public health preparedness. By addressing respiratory diseases early and developing robust reporting systems, the country aims to minimize the impact of emerging pathogens and ensure timely intervention.

Source

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Millions of teenagers in Africa are suffering from asthma with no formal diagnosis as the continent undergoes rapid urbanisation, researchers have found.

The study, published in the Lancet Child and Adolescent Health, involved 27,000 pupils from urban areas in Malawi, South Africa, Zimbabwe, Uganda, Ghana and Nigeria. It found more than 3,000 reported asthma symptoms, but only about 600 had a formal diagnosis.

Many of the children reported missing school or having their sleep disrupted by wheezing.

“If our data are generalisable, there are millions of adolescents with undiagnosed asthma symptoms in sub-Saharan Africa,” said Dr Gioia Mosler of Queen Mary University of London, the study’s research manager.

The team that led the study, whose research on the impact of pollution on lung health was instrumental in introducing the ultra low-emission zone (Ulez) in London, said there was an urgent need for medicines and diagnostic tests in the region.

Rates of asthma have increased in sub-Saharan Africa over the past few decades, a trend attributed to rapid urbanisation which exposes children to more risk factors such as air pollution. The climate crisis was also likely to have an impact, experts said.

The Achieving Control of Asthma in Children and Adolescents in Africa (Acacia) study recruited pupils aged between 12 and 14. Screening revealed that while 12% reported asthma symptoms, only 20% of that group had received a formal diagnosis of asthma.

Lung function tests suggested nearly half of undiagnosed participants with severe symptoms were “very likely” to have asthma.

Even among those who had received a formal diagnosis, about a third were not using any medicine to control their condition, according to the study.

Dr Rebecca Nantanda of Makerere University in Kampala, who led the research in Uganda, said: “Undiagnosed and poorly controlled asthma greatly impacts on the physical and psychosocial wellbeing of the affected children and their caregivers. The high burden of severe undiagnosed asthma revealed by the Acacia study requires urgent attention, including access to medicines and diagnostics.”

Prof Jonathan Grigg of Queen Mary University of London, said asthma was made worse by exposure to small particles of pollutants, with the impact of the climate crisis yet to become clear. “In some areas in sub-Saharan Africa, climate change is likely to result in increased exposure of these vulnerable children to dust and natural fires.

“On the other hand, climate change mitigation will, hopefully, reduce exposure to fossil fuel-derived particles in this region.

“The pharmaceutical industry has been hesitant to support asthma research and initiatives. For example, companies may feel that they cannot support research in countries where they do not intend to market their asthma product,” he said.

“Innovations such as handheld wheeze detectors and asthma clinics delivered at schools also have the potential to substantially reduce the burden of asthma.”

Source

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