Curated News: NEJM

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A study led by researchers from The University of Texas MD Anderson Cancer Center showed a significant overall survival benefit with ribociclib plus endocrine therapy for postmenopausal patients with hormone receptor-positive (HR+) human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer. The results were published today in The New England Journal of Medicine and were first reported at the European Society for Medical Oncology (ESMO) Congress 2021.

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Diagnosing heart attacks after heart surgery remains difficult due to shortcomings of current diagnostic tools when applied to postoperative patients, including the electrocardiogram and blood tests to detect levels of cardiac troponins, according to an editorial in the New England Journal of Medicine (NEJM) written by two UT Southwestern faculty members.

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Nirsevimab showed 74.5 percent efficacy against medically attended lower respiratory tract infections caused by respiratory syncytial virus (RSV) in healthy infants, according to an international, randomised, placebo-controlled Phase 3 clinical trial. It is the first potential immunization against RSV in the general infant population, with a single dose providing safe protection across the entire RSV season. Results were published in the New England Journal of Medicine.

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This study, published in the New England Journal of Medicine, assessed patients having heart surgery, measured troponin before and daily for the first few days after surgery, and assessed death and the incidence of major vascular complications – such as heart attack, stroke or life-threatening blood clot – after heart surgery. The study involved 15,984 adult patients with an average age just over 63 years undergoing cardiac surgery. Patients were from 12 countries, with more than a third of the countries being outside of North America and Europe.

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Antibiotics provide no benefit in preventing future recurrent wheezing in babies hospitalized with respiratory syncytial virus (RSV), according to a new study led by Washington University School of Medicine in St. Louis. And there is some evidence that antibiotics may make wheezing worse.

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Over 90 percent of patients with transfusion-dependent thalassemia, an inherited blood disorder, no longer needed monthly blood transfusions years after receiving gene therapy, according to an international Phase 3 clinical trial that for the first time included children younger than 12 years of age. Twenty-two patients were evaluated (ranging in age 4-34 years), including pediatric patients enrolled at Ann & Robert H. Lurie Children’s Hospital of Chicago.

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Sickle cell anemia is an inherited blood disorder where red blood cells become sickle/crescent shaped. It causes frequent infections, swelling in the hands and legs, pain, severe tiredness and delayed growth or puberty.

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In adults who had previously received a full regimen of any of three COVID-19 vaccines granted Emergency Use Authorization (EUA) or approved by the Food and Drug Administration (FDA), an additional booster dose of any of these vaccines was safe and prompted an immune response, according to preliminary clinical trial results reported in The New England Journal of Medicine.

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A Smidt Heart Institute analysis of lung transplantations performed nationally shows significant help for patients with severe, irreversible lung damage from COVID-19.

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For research to be applicable to all segments of the population, Swenor and her co-author, Jennifer Deal, Ph.D., M.H.S., assistant professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, say that guidelines for including people in specific studies should avoid ruling out people with disabilities.

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In patients with untreated, advanced melanoma, the combination of immune checkpoint inhibitors relatlimab and nivolumab doubled the progression-free survival benefit compared to nivolumab alone, with a manageable safety profile.

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Making initiation of buprenorphine easy and timely was associated with a 25 percent increase in the likelihood of its use of treatment in Penn Medicine emergency departments

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Axicabtagene ciloleucel, known by the brand name Yescarta, is significantly more effective than the current standard of care in treating people with large B-cell lymphoma who relapse after the first line of treatment.

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Although unproven, this novel sickle cell therapy serves as a potential cure. More measures need to be taken to determine long-term function and organ improvement.

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Research Shows Vaccine Has 90 Percent Efficacy at Preventing Infections; Moderate to Severe Disease Occurred Only in Placebo Recipients

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The anti-cancer effect of the drug may help those with rare, hereditary cancer syndromes avoid surgeries by shrinking tumors via a daily oral dose.

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Chimeric antigen receptor T-cell therapy or CAR T is a breakthrough treatment for patients with certain types of blood cancers. The cellular therapy uses a patient’s own immune cells that are reengineered to better seek out and destroy cancer cells. The single infusion treatment is approved for patients who have relapsed after two or more types of therapy but results from the ZUMA-7 clinical trial show lymphoma patients can benefit from receiving the CAR T product axicabtagene ciloleucel (Yescarta) sooner.

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Investigators at Rutgers Cancer Institute of New Jersey and Rutgers New Jersey Medical School (NJMS) explored how Artificial Intelligence/Machine Learning will complement existing approaches focused on genome-protein sequence information, including identifying mutations in human tumors published online December 2 in The New England Journal of Medicine.

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Results from a Phase II trial led by researchers at The University of Texas MD Anderson Cancer Center showed that treatment with belzutifan, a small-molecule inhibitor of hypoxia-inducible factor (HIF)-2a, achieved strong clinical activity in patients with renal cell carcinomas (RCC) and non-renal cell carcinoma neoplasms associated with von Hippel-Lindau (VHL) disease. The study was published today in the New England Journal of Medicine.

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A new article published in The New England Journal of Medicine suggests that secondary antibodies known as “anti-idiotype antibodies” could be responsible for some of the side effects of COVID-19 vaccines and the symptoms of long-haul COVID.

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An international study of more than 400 adults concludes that people who undergo mitral valve surgery (between the left atrium and the left ventricle of the heart) and also have less than severe leakage of the tricuspid valve (a section of the heart that directs blood from the right atrium to the ventricle) may benefit from having both valves repaired at the same time.

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Researchers compared milvexian with enoxaparin for prevention of blood clots in 1,242 patients from18 countries undergoing knee replacement surgery who were enrolled between June 2019 and February 2021.They found that at a total daily dose of 100 mg or more, milvexian resulted in better clot protection but no increase in bleeding compared with enoxaparin, the control drug. Milvexian was evaluated in daily doses ranging from 25 to 400 mg; there was no increase in bleeding over this wide range of doses.

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In a new review article, published today in The New England Journal of Medicine, researchers from University Hospitals (UH), Case Western Reserve University and Boston College discuss evidence linking pollution and cardiovascular disease. The research team highlights strategies for reducing individual exposure to pollution, and the importance of government-supported interventions encouraging clean energy.

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A commentary, published in the Nov. 3 issue of the journal NEJM Catalyst Innovations in Care Delivery, highlights how defects in surgical care could be diminished or eliminated for the benefit of patients and to lower costs in American health care spending. Using colorectal surgery to provide examples and national estimates of the costs of defects in surgical care, the paper summarizes a holistic approach to eliminating defects in surgical care and offers a framework for centers of excellence for removing them. The paper estimates that defects in colorectal surgery cost the American health care system more than $12 billion. The authors discuss eight areas (or domains) of defects that waste money and/or contribute to lower value in care for colorectal surgery patients.

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SEATTLE — Nov. 2, 2021 — Below are summaries of recent Fred Hutch research findings and other news.

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Researchers published interim results in The New England Journal of Medicine from a Phase 3 study of the COVID-19 monoclonal antibody treatment sotrovimab, sponsored by Vir Biotechnology and GlaxoSmithKline. The study found that compared to the placebo group, COVID-19 patients who received sotrovimab had a significantly reduced risk of hospitalization or death and that the treatment, which was administered by intravenous infusion on an outpatient basis, was safe.

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Research uncovers racial bias in oxygen readings during the COVID-19 pandemic, even amongst patients needing ECMO.

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A new report finds women physicians across all races and ethnicities earn less than their male counterparts. This new data reinforces that academic medicine must find a better approach to how they pay physicians. The authors of a NEJM perspective lay out some potential solutions.

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Yale Cancer Center and Smilow Cancer Hospital experts explain why the PALB2 gene can increase your breast cancer risk.

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Health care personnel who received a two-dose regimen of Pfizer–BioNTech vaccine had an 89% lower risk for symptomatic illness than those who were unvaccinated. For those who received the two-dose regimen of the Moderna vaccine, the risk was reduced by 96%.

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International group of researchers identify new childhood genetic condition and a potential cure that can be delivered during pregnancy.

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New data published in the New England Journal of Medicine (NEJM) and featured at the European Society for Medical Oncology (ESMO) Congress 2021 highlights a promising new treatment for individuals with HER2-mutant non-small cell lung cancer (NSCLC).

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More than half of patients with non-small cell lung cancer (NSCLC) bearing a mutation in the HER2 gene had their tumors stop growing or shrink for an extended time after treatment with a drug that hitches a chemotherapy agent to a highly targeted antibody, an international clinical trial led by investigators at Dana-Farber Cancer Institute has found.

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Ischemic stroke patients treated on a mobile stroke unit (MSU) received anti-clot medication faster and ended up with less disability at 90 days, according to a study published today in the New England Journal of Medicine led by researchers at UTHealth Houston and Memorial Hermann-Texas Medical Center.

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A study measured effectiveness of COVID-19 mRNA vaccines among health workers, most notably during the emergence of delta virus variant and coincident with end of state’s mask mandate, finding protection waned over time, dropping sharply 6-8 months after full vaccination.