Daily Archives: April 28, 2024
M-A: Neoadjuvant chemoimmunotherapy enhances event-free survival in resectable NSCLC with low PD-L1 expression
28 Apr, 2024 | 20:20h | UTCThis meta-analysis evaluated the impact of neoadjuvant chemoimmunotherapy versus chemotherapy on resectable non-small cell lung cancer (NSCLC) patients, particularly focusing on those with tumor PD-L1 levels below 1%. The study synthesized data from 43 trials, encompassing 5431 patients, to assess clinical outcomes such as overall and event-free survival, alongside major and complete pathological responses. Findings highlighted that neoadjuvant chemoimmunotherapy significantly improved event-free survival (hazard ratio, 0.74; 95% CI, 0.62-0.89) compared to chemotherapy alone, particularly in patients with low PD-L1 expression, though overall survival benefits were not observed. The pooled analysis from randomized clinical trials showed favorable outcomes across all examined endpoints, supporting the superiority of neoadjuvant chemoimmunotherapy in these settings.
Reference (link to free full-text):
RCT: Efficacy and safety of microaxial flow pump in STEMI-related cardiogenic shock
28 Apr, 2024 | 20:17h | UTCThis randomized clinical trial assessed the impact of a microaxial flow pump (Impella CP) on mortality in 355 patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock. Patients were randomly assigned to receive either the microaxial flow pump plus standard care or standard care alone. The primary outcome was mortality at 180 days. Results showed a significant reduction in death rates in the microaxial flow pump group (45.8%) compared to the standard care group (58.5%) with a hazard ratio of 0.74 (95% CI, 0.55 to 0.99; P=0.04). However, the incidence of severe adverse events was notably higher in the microaxial flow pump group, including severe bleeding and device-related complications.
Reference (link to abstract – $ for full-text):
RCT: No improvement in OS with atezolizumab plus cabozantinib vs. docetaxel in metastatic NSCLC post Anti-PD-L1/PD-1 therapy
28 Apr, 2024 | 20:15h | UTCIn a phase III trial, 366 patients with metastatic non-small cell lung cancer (NSCLC) were evaluated to determine the efficacy of atezolizumab combined with cabozantinib versus docetaxel following progression after anti–PD-L1/PD-1 and platinum-based chemotherapy. The study randomly assigned patients to receive either atezolizumab 1,200 mg every 3 weeks plus cabozantinib 40 mg daily or docetaxel 75 mg/m2 every 3 weeks. The results showed no significant difference in median overall survival (OS) between the two groups, with 10.7 months for the combination therapy and 10.5 months for docetaxel (HR 0.88, 95% CI, 0.68-1.16; P = .3668). The safety profiles were consistent with the known risks associated with these treatments.
Reference (link to free full-text):
Meta-Analysis: Efficacy of MRI in prostate cancer screening for reducing unnecessary biopsies
28 Apr, 2024 | 20:13h | UTCThis meta-analysis evaluated the effectiveness of incorporating magnetic resonance imaging (MRI) into prostate cancer screening pathways, compared to prostate-specific antigen (PSA)–only screening strategies. Analyzing data from 80,114 men across 12 studies, the findings demonstrate that MRI-based screening, particularly when using a sequential approach and a PI-RADS score ≥3 cutoff for biopsy, significantly increases the odds of detecting clinically significant prostate cancers (OR, 4.15) while reducing unnecessary biopsies (OR, 0.28) and detection of clinically insignificant cancers (OR, 0.34). Implementing a higher PI-RADS score of ≥4 further decreased the detection of insignificant cancers and biopsies performed, without impacting the detection rate of significant cancers. These results support the integration of MRI into screening programs to enhance diagnostic precision and reduce patient harm.
Reference (link to abstract – $ for full-text):
RCT: Reduction in cardiac events through preventive PCI in vulnerable atherosclerotic coronary plaques
28 Apr, 2024 | 17:39h | UTCThis multicenter, open-label, randomized controlled trial assessed the effectiveness of preventive percutaneous coronary intervention (PCI) versus optimal medical therapy alone in treating patients with non-flow-limiting vulnerable coronary plaques identified by intracoronary imaging. Conducted across 15 research hospitals in four countries, the trial enrolled 1,606 patients, with 803 in each treatment group. After 2 years, major adverse cardiac events were significantly lower in the PCI group (0.4%) compared to the medical therapy group (3.4%), with a p-value of 0.0003. These results suggest that preventive PCI can effectively reduce cardiac events in patients with high-risk vulnerable plaques, supporting the expansion of PCI indications to these patients.
Reference (link to abstract – $ for full-text):
RCT: Intravascular ultrasound guidance improves outcomes in percutaneous coronary intervention for acute coronary syndrome
28 Apr, 2024 | 17:22h | UTCThis randomized clinical trial evaluated 3505 acute coronary syndrome (ACS) patients across 58 centers in China, Italy, Pakistan, and the UK, comparing intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) with angiography-guided PCI. The study’s primary endpoint was target vessel failure—comprising cardiac death, myocardial infarction, or revascularisation—after 1 year. The IVUS-guided group showed significantly lower rates of the primary endpoint (4.0%) compared to the angiography-guided group (7.3%), with a hazard ratio of 0.55. This outcome was primarily driven by reductions in myocardial infarction and revascularisation, with similar safety profiles between the two groups.
Reference (link to abstract – $ for full-text):
Systematic Review: Diagnostic accuracy of clinical examination for dislocated hips in infants
28 Apr, 2024 | 16:52h | UTCThis systematic review assesses the diagnostic accuracy of clinical examinations in identifying dislocated hips in infants, using data from nine studies that compared clinical examinations to diagnostic ultrasound as the reference. The study involved 37,859 hips with a dislocation prevalence of 0.94%. The Barlow and Ortolani maneuvers showed a sensitivity of 46% and a specificity of 99.1%, with a positive likelihood ratio of 52, highlighting their effectiveness in predicting hip dislocation. Other methods such as limited hip abduction and a clicking sound were found to have minimal diagnostic utility. This evidence supports the clinical utility of specific maneuvers in early detection to prevent long-term complications.
Reference (link to abstract – $ for full-text):
RCT: Olezarsen effectively reduces triglyceride levels and pancreatitis episodes in familial chylomicronemia Syndrome
28 Apr, 2024 | 16:47h | UTCThis phase 3, double-blind, placebo-controlled trial evaluated olezarsen in 66 patients with familial chylomicronemia syndrome. Participants received 80 mg or 50 mg of olezarsen or a placebo subcutaneously every 4 weeks for 49 weeks. The study found significant reductions in fasting triglyceride levels at the 6-month mark in the 80 mg olezarsen group compared to the placebo (-43.5 percentage points), with a similar trend observed in apolipoprotein C-III levels. Furthermore, the incidence of acute pancreatitis was significantly lower in both olezarsen groups compared to placebo by the 53-week endpoint. The findings suggest olezarsen as a potent therapy for reducing triglyceride levels and preventing pancreatitis in this population.
Reference (link to abstract – $ for full-text):
Pooled Analysis: Semaglutide improves symptoms and reduces weight in obesity-related heart failure with preserved ejection fraction
28 Apr, 2024 | 16:33h | UTCThis pooled analysis of the STEP-HFpEF and STEP-HFpEF DM randomized trials assessed the efficacy of semaglutide in 1,145 participants with obesity-related heart failure and preserved ejection fraction, across 129 research sites globally. Participants, who had a BMI of at least 30 kg/m2 and varied cardiovascular conditions, were administered 2.4 mg of semaglutide weekly for 52 weeks. Semaglutide significantly improved heart failure-related symptoms (7.5 points increase in KCCQ-CSS), reduced body weight by 8.4%, and increased the 6-min walk distance by 17.1 meters, compared to placebo. The treatment also demonstrated safety, with fewer serious adverse events than the placebo group. These benefits were consistent across various subgroups, confirming semaglutide’s potential as a treatment in this patient population.
Reference (link to abstract – $ for full-text):