Objective: Correct an omitted author affiliation in the original article. Approach: Correction: Affiliation number 10 identifies Tariq Jaber’s institution as Ki
Objective: The article examines the objective, findings, and clinical context described in FDA raises TMB threshold for pembrolizumab. Approach: Regulatory deci
The FDA raised the TMB threshold for pembrolizumab and pembrolizumab/berahyaluronidase alfa-pmph from 10 to 13 mutations per megabase.
The traditional approval covers adults and pediatric patients with unresectable or metastatic TMB-high solid tumors that progressed after prior treatment and have no satisfactory alternatives.
TMB status must be determined with an FDA-authorized test, and efficacy was not confirmed in patients with TMB levels of 10 to less than 13 mutations per megabase.
In KEYNOTE-158, the efficacy population included 220 patients with TMB levels of at least 13 mutations per megabase, and there was no randomized comparator.
Across the trial groups, the objective response rate was 36%, and 58% of responders maintained their response for at least 12 months.
Objective: Review evidence on H2-receptor antagonists for laryngopharyngeal reflux (LPR), including tolerance with continuous use and their role in current mana
Continuous H2-receptor antagonist therapy can lose acid-suppressive efficacy within days, with evidence showing loss by about day 5.
Dose escalation does not overcome H2-receptor antagonist tachyphylaxis, and a bedtime H2-receptor antagonist added to a PPI lost its initial benefit within 1 week.
Contemporary gastroenterology guidance supports H2-receptor antagonists mainly for intermittent or as-needed use, not as daily adjunctive therapy.
Persistent LPR symptoms may reflect nonacid reflux components or mechanisms unrelated to reflux, rather than inadequate acid suppression.
For persistent symptoms, investigators favored reassessing adherence and diagnosis and considering objective reflux testing over indefinite escalation of empiric therapy.
Objective: The article examines the objective, findings, and clinical context described in FDA clears at-home risankizumab induction. Approach: Approval: The FD
The FDA approved subcutaneous risankizumab induction for adults with moderately to severely active Crohn's disease, allowing at-home administration with an on-body injector.
In the phase 3 AFFIRM trial, 274 adults were randomly assigned 2:1 to risankizumab or placebo, and about 65% had prior advanced therapy failure.
At week 12, clinical remission occurred in 56% of risankizumab recipients and 30% of placebo recipients; endoscopic response occurred in 43% and 15%, respectively.
The approved induction regimen is 720 mg at weeks 0, 2, 4, and 8, followed by subcutaneous maintenance every 8 weeks starting at week 12; intravenous induction remains an option.
Prescribing information advises liver blood tests before, during, and for at least 12 weeks of treatment, and permits clinical judgment on pretreatment tuberculosis evaluation.
Objective: To examine associations between adolescents’ caffeine consumption, sleep duration, cortical structure, and later mental health problems. Approach: Pa
Objective: To describe renal and HIV outcomes during immunosuppressive treatment for biopsy-confirmed lupus nephritis in a patient with HIV. Approach: Case: Res
A 50-year-old woman with well-controlled HIV had biopsy-confirmed class III lupus nephritis, with preserved CD4 counts and low viral load before treatment.
She received corticosteroids, mycophenolate mofetil, and hydroxychloroquine while continuing antiretroviral therapy.
By day 120, urinary protein excretion fell from 1,600 to 230 mg/day, and the urine protein-to-creatinine ratio declined from 1.8 to 0.3.
Complete renal remission occurred by 6 months with preserved kidney function, while HIV viral load and CD4 count remained stable.
The single-patient report had no repeat renal biopsy and limited follow-up, restricting generalization, particularly to people with uncontrolled HIV or advanced immunodeficiency.
Objective: To assess whether restoring habitual myopia could relieve persistent dizziness and visual discomfort after cataract surgery in a patient with strong
Objective: The article discusses limitations of current sepsis diagnosis, the potential role of emerging biomarkers in risk stratification, and challenges in tr
Sepsis is difficult to diagnose because its symptoms are varied and nonspecific, and current blood tests often detect inflammation without identifying a dangerous trajectory.
Blood cultures can identify an organism and guide antibiotic selection, but results may take 48 hours or more, while sepsis can progress rapidly.
Simon Walker and Cathal McElgunn say an earlier sepsis-risk test could complement microbiological testing and help clinicians assess whether to escalate treatment.
Published research suggests that a higher oxidized-to-total PTX3 ratio correlates with more severe sepsis and that the ratio declines as patients improve.
MicrosensDx is developing an immunoassay to distinguish oxidized from nonoxidized PTX3; its antibody pair is in optimization, with the linearity range established.
Objective: Review developments in wearable diagnostic systems and assess their potential applications and barriers to clinical use. Approach: Scope: The review
Objective: Present expert perspectives on the main barriers to making cell and gene therapies widely accessible and where the industry should focus its efforts.
Cell and gene therapies have demonstrated potential to transform medicine, but broad access remains challenging.
The discussion identifies complex manufacturing, fragmented data systems, regulatory requirements, limited care sites, and uncertain reimbursement as potential bottlenecks.
Experts from across the cell and gene therapy ecosystem discuss where the industry should focus its efforts.
The roundtable considers whether the sector is addressing the right problems and where greater collaboration is needed.
Participants discuss how AI and other emerging technologies could help address barriers between therapeutic innovation and patient access.
In exploratory post hoc analyses, 90-day mortality was 27% with LVEF >70% and 23% with LVEF 50%–70%, with no significant adjusted difference.
Patients with LVEF >70% had greater absolute GLS magnitude and modestly higher MAPSE than those with LVEF 50%–70%; S′ did not differ significantly.
No distinct MAPSE, GLS, or S′ threshold corresponding to a hyperdynamic LVEF profile was identified.
High-value GLS, MAPSE, and S′ groups were not associated with 90-day mortality in unadjusted or adjusted analyses.
The exploratory findings suggest hyperdynamic LVEF may not reflect a comparably hyperdynamic longitudinal systolic profile and warrant cautious interpretation.
Objective: To assess whether neighborhood disadvantage is associated with differences in atrial fibrillation (AF) diagnosis and treatment. Approach: Population
The analysis included 425 Medicare Advantage contracts covering 29.0 million enrollees and evaluated 13 components of 11 measures removed from 2026 Star Ratings.
Only 5 of the 13 removed measures were topped out, while none of the 30 retained measures met the study’s topping-out definition.
Removed measures had higher average scores than retained measures, but their removal lowered composite scores in the simulation.
After measure removal, ratings decreased for 35.1% of contracts, remained unchanged for 62.6%, and increased for 2.4%.
The modeled annual 2026 quality bonus payment pool fell by $2.09 billion, or 13.9%, as 33 contracts lost eligibility and 6 gained it.
Objective: To describe an atypical initial presentation of childhood-onset granulomatosis with polyangiitis (GPA) involving suspected necrotizing myositis. Appr
Objective: Assess the safety, optimal dose, and preliminary antitumor activity of invikafusp alfa (invika) in patients with advanced cancers, many resistant to
In phase 1 and early phase 2 testing, invikafusp alfa selectively stimulated two groups of tumor-infiltrating T cells in patients with advanced cancers.
Among 27 participants treated at the optimal dose, 16 (59.3%) had no disease progression and 4 (14.8%) had tumor reductions exceeding 30%.
Tumor shrinkage occurred in two patients with metastatic colorectal cancer and one with stage 4 non-small cell lung cancer, all resistant to prior treatments.
At the optimal dose, invikafusp alfa was generally well tolerated; reported flu-like effects were typically manageable with medication and supportive care.
The investigators described the results as preliminary and said immune activation did not always produce a measurable clinical response.