ONCOLOGY

Crossover in cancer drug trials sparks debate! In a randomized trial, patients in the control arm can receive the experimental agent upon disease progression. ASCO Annual Meeting highlighted various trials with crossover designs, raising concerns. Oncology experts remain divided on the significance of such crossovers, stressing their context dependence. Examples from ASCO 2023 shed light on the matter, exploring the pros and cons of incorporating crossovers in clinical trials.

ASCO Annual Meeting 2023: Exploring the Impact of Crossover Designs in Cancer Drug Trials - Pros and Cons Revealed

UROLOGY

Study finds 7.86% lead migration after sacral neuromodulation, with higher odds observed for Axonics devices.

Sacral Neuromodulation Lead Migration: Risk Factors and Outcomes

A retrospective study of 445 patients undergoing sacral neuromodulation found confirmed lead migration in 7.86% of cases, occurring mainly in the forward direction. Migration had a median onset of 16 months and led to revision or device removal in 82.9% of affected patients. Axonics devices showed higher adjusted odds of migration than Medtronic devices, although the finding remains hypothesis-generating.

GYNAECOLOGY - IVF

Study finds no sustained increase in offspring GI morbidity following exposure to maternal chronic hypertension.

Maternal Chronic Hypertension and Offspring GI Health

A 30-year population-based cohort study of 342,635 singleton deliveries found no evidence that maternal chronic hypertension independently increased gastrointestinal morbidity in offspring through age 18. GI risk was lower among exposed children during early childhood, while rates were similar by late adolescence, suggesting a time-varying association rather than sustained excess risk.

CARDIOLOGY

Study identifies FGFR1/KLB-MFG-E8 signaling as a potential mechanism protecting diabetic hearts from vascular and cardiac dysfunction.

FGFR1/KLB Pathway May Protect Diabetic Hearts

A study in diabetic mice and human heart tissue identified an FGFR1/KLB pathway in cardiomyocytes that supports myocardial capillary health through MFG-E8 signaling. Loss of FGFR1 or KLB reduced capillary density and worsened cardiac remodeling, while enhancing MFG-E8 restored vascularity and improved cardiac function, with stronger effects observed in males.

Study finds observed links between gestational age and neurodevelopment may partly reflect underlying prenatal factors.

Gestational Age and Neurodevelopmental Disability Risk

A Norwegian cohort study of 2.9 million births found substantially higher observed risks of cerebral palsy, intellectual impairment, epilepsy, autism and ADHD after very preterm birth. However, sibling-matched analyses showed attenuated associations, while similar patterns for birth defects suggested that underlying prenatal factors may explain part of the observed relationship.

SEER study links nephrectomy delays beyond 3 months with higher cancer-specific mortality in selected RCC patients.

Delayed Surgery and Mortality in Renal Cell Carcinoma

A SEER database study of 16,322 patients with pT1b–2N0M0 renal cell carcinoma found that delaying nephrectomy beyond 3 months was associated with higher cancer-specific mortality. After propensity matching, 60-month mortality was 7.6% versus 5.9%, with risk increasing further when surgery was delayed beyond 6 months. The association was not seen in non-clear cell RCC.

Study finds parental and socioeconomic factors largely explain differences in school performance among ART-conceived children.

ART Conception and School Performance in Children

A Norwegian cohort study of 929,017 children found higher school grades among ART-conceived children than spontaneously conceived peers in unadjusted analyses, particularly among those with less-educated mothers. After adjusting for parental and family characteristics, differences were small and slightly negative in both education groups, suggesting socio-demographic selection largely explains the observed advantage.

Different LGA definitions substantially influenced reported outcomes after changes to gestational diabetes diagnostic criteria.

LGA Definitions Influence Gestational Diabetes Trial Outcomes

A Swedish analysis of 47,080 pregnancies found that the reported prevalence of large-for-gestational-age (LGA) infants varied substantially according to the growth reference used. After adopting WHO-2013 gestational diabetes criteria, LGA prevalence fell from 19.4% to 13.1% using Swedish references, while severe LGA findings differed across reference charts.

NEUROLOGY

Additional ultrasound detected fetal anomalies and vasa previa after initially normal mid-trimester screening.

Late-Detected Fetal Anomalies and Vasa Previa After Mid-Trimester Scan

A retrospective study of 14,579 singleton pregnancies found that 47 fetuses had structural anomalies newly detected after an initially normal mid-trimester scan, with a detection proportion of 3.22 per 1,000 pregnancies. Digestive/hepatobiliary and central nervous system anomalies were most common. Vasa previa was identified in three pregnancies, while overall survival to hospital discharge was 61.7%.

A systematic review found distinct sex-based differences in OSA risk factors and diagnostic parameters.

Sex Differences in Obstructive Sleep Apnea Diagnostic Findings

A systematic review of 33 studies involving 37,159 adults with obstructive sleep apnea found important sex-based differences in diagnostic features. Females generally presented at an older age and with higher BMI, while males had greater neck circumference and higher apnea-hypopnea indices. Recognizing these differences may help improve OSA detection and reduce delayed diagnosis.

Cochlear implantation improved hearing after NPC radiation, with high rates of audiometric benefit and few surgical complications.

Cochlear Implantation After Nasopharyngeal Cancer Radiation

A systematic review of 12 studies involving 69 ears found that cochlear implantation can provide meaningful auditory rehabilitation for patients with nasopharyngeal carcinoma who develop hearing loss after radiation. Audiometric improvement occurred in 91.3% of patients, while intraoperative and postoperative complications were uncommon, supporting timely hearing surveillance and referral.

PULMONOLOGY

Illness perception patterns at asthma diagnosis may help predict medication adherence and identify patients needing targeted support.

Illness Perception Clusters Predict Asthma Medication Adherence

A prospective cohort study of 212 newly diagnosed asthma patients identified four distinct illness perception patterns. Patients in the Hypersensitive–Anxious cluster had the greatest concerns about asthma but showed the poorest medication adherence and suboptimal disease control over 6 months. Baseline illness perception patterns independently predicted subsequent adherence, highlighting a potential role in personalized asthma care.

RHEUMATOLOGY

Neutrophil activation and reduced PSTPIP2 protein were linked to disease burden in children with CRMO and normalized with anti-TNF therapy.

Neutrophil Activation and PSTPIP2 Changes in Pediatric CRMO

A study of 34 children with chronic recurrent multifocal osteomyelitis (CRMO) found persistent neutrophil activation and reduced PSTPIP2 protein levels, with neutrophil activation correlating with MRI lesion burden. Anti-TNF therapy normalized both abnormalities. Transcriptomic analysis also revealed inflammatory and chemotaxis pathway changes, identifying potential biomarkers and mechanisms underlying human CRMO.

DENTISTRY

NSPT improved periodontal health, reduced inflammatory biomarkers, and increased HDL cholesterol in young adults with severe periodontitis.

Non-Surgical Periodontal Treatment Improves Systemic Inflammation

A prospective study of 30 young adults with severe periodontitis found that non-surgical periodontal treatment significantly improved periodontal health and reduced several systemic inflammatory and endothelial biomarkers over 6 months. hs-CRP, IL-6, IL-1ra, sTNFRI, and tPA decreased, while HDL cholesterol increased, although several biomarkers remained abnormal compared with healthy controls.

A mentored regional pacemaker program achieved improving procedural safety and quality of life in older adults.

Regional Pacemaker Implantation Program Shows Safe Outcomes in Older Adults

A 2-year prospective study of 173 patients with a mean age of 78.1 years found that a regional hospital could establish a high-volume pacemaker program with structured mentorship from a tertiary cardiac center. Complications occurred in 5.7% of procedures, falling from 8.7% during initial training to 3.4% after expertise was achieved, while quality of life improved at 6 months.

DERMATOLOGY

Immune-related adverse events occurred in 8.4% of mogamulizumab-treated patients with mycosis fungoides or Sezary syndrome.

Mogamulizumab-Associated Immune-Related Adverse Events in MF and SS

A nationwide French study of 403 patients with mycosis fungoides or Sezary syndrome found that 8.4% developed immune-related adverse events during mogamulizumab treatment, excluding mogamulizumab-associated rash. Endocrine, skin, and liver events were most common, while about one-third were severe or serious and 29% led to permanent treatment discontinuation. Late-onset events highlight the need for prolonged monitoring.

Problematic crossovers in...

Problematic crossovers in cancer drug trials