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HCC is the fourth-leading cause of cancer mortality worldwide, and is driven mostly by viral hepatitis B (HBV) and viral hepatitis C (HCV) infection. The risk of hepatocellular carcinoma (HCC) was reduced by 31% compared with no aspirin use, and liver-related mortality dropped by 27%, as long as aspirin use continued. The analysis showed that in aspirin users, the 10-year cumulative incidence of HCC was 4% compared with 8.3% in nonusers. After multivariable adjustment, aspirin users had a risk of HCC that was 31% lower compared with nonusers (adjusted subhazard ratio, 0.69; 95% confidence interval.

Source: New England Journal of Medicine

Chronic immune-related adverse events (irAEs) associated with anti-programmed cell death-1 (PD-1) therapy for melanoma were more common than previously thought in a retrospective multicenter study.

As reported in JAMA Oncology, Dr. Johnson and colleagues analyzed data on 387 melanoma patients treated at eight academic medical centers between 2015-2020. The median age was 63, 61% were men, and all received adjuvant anti-PD-1 for stage III-IV melanomas.

Sixty-nine percent of patients had any acute irAE, defined as arising during anti-PD-1 treatment, including 19.5% with grades 3-5 events. One patient had neurotoxicity and one had fatal myocarditis.

Chronic irAEs – those that persisted beyond 12 weeks after anti-PD-1 discontinuation – developed in 43.2% of patients; most (96.4%) were grade 1 or 2 and only 14% had resolved by the last available follow-up.

Source: Medscape

When esophageal or gastroesophageal-junction cancer remains a threat after chemoradiotherapy and surgery because of residual pathological disease, treatment with the checkpoint inhibitor nivolumab doubles disease-free survival, according to the results of the large international CheckMate 577 trial.

The treatment, also used for kidney, liver, lung and a host of other cancers, is designed to block the cancer’s defense mechanism against the immune system. It costs about $165,000, sells under the brand name Opdivo.

Source: The New England Journal of Medicine

Women with a BRCA1 or BRCA2 mutation have an increased risk for endometrial cancer (EC), and the greatest risk is for the rare subgroup of serous-like and p53-abnormal endometrial cancers in BRCA1 mutation carriers, according to a Dutch study.

BRCA1 and BRCA2 mutation carriers had a significant two- to three-fold increase in EC risk, with the highest risk increases found for two EC subgroups with “unfavorable” clinical outcomes: serous-like histology (8-10 fold) and p53-abnormal EC (11-12 fold), the researchers report in the Journal of the National Cancer Institute.

Source: Journal of the National Cancer Institute.

Researchers examined data on adolescents (mean age 16.4 years) hospitalized with anorexia nervosa who were randomized to higher-calorie refeeding (n=60) or lower-calorie refeeding (n=51). Patients started higher-calorie refeeding (2,000 kcals/day, increasing by 200 kcals per day) or lower-calorie refeeding (1,400 kcals/day, increasing by 200 kcals every other day) within 24 hours of admission.

The primary endpoints were clinical remission at one year, defined by reaching a weight of at least 95% of median body mass index (BMI) based on U.S. Centers for Disease Control and Prevention growth charts, and psychological recovery, defined by achieving a global score within one standard deviation of community norms on the Eating Disorder Examination Questionnaire (EDE-Q).

Source: Reuters

The discovery of this new gene, PCDHA3, could enhance the development of genetic-risk calculators “that may help us understand vulnerability to schizophrenia in high-risk individuals and identify individuals with schizophrenia who have a greater risk for poor outcomes,” said Todd Lencz, PhD, a professor at the Feinstein Institutes for Medical Research in New York, and lead author of this research. It blocks neuron communication in the brain may lead to novel treatment strategies and improve understanding of the mechanics of this disease.

Source: Medscape

Abuse or misuse of the over-the-counter nasal decongestant propylhexedrine can cause serious harm that can lead to hospitalization, disability, or death, the US Food and Drug Administration (FDA) warns in a safety communication.

“Major issues” that may have to be managed in the context of acute intoxication with propylhexedrine include severe agitation, tachycardia, hypertension, myocardial infarction, hyperthermia, stroke, bowel obstruction, pulmonary hypertension, and seizures, the FDA said.

There is no specific agent for reversing the effects of acute propylhexedrine intoxication, so management is symptomatic and supportive, the FDA notes.

Source: FDA

Hormone therapy as a possible solution for postmenopausal women with nocturia.

A significant reduction in prevalence of nocturia ≥ twice per night was seen after treatment, as the prevalence decreased from 27.7% (59/213) to 16.4% (35/213). Specified per therapy, a significant reduction in nocturnal voiding frequency was observed in patients treated with E+P and TSEC (P = 0.018 and P = 0.018, respectively). This improvement could be explained by a significant reduction in SLEEP sum score in patients treated with E+P and TSEC (P < 0.001, P = 0.013, respectively). Estrogen-only led to a significant change in URINARY TRACT sum score, which is the result of a reduction in urgency prevalence (P = 0.039).

Estrogen + Progesterone (E+P), tissue-selective estrogen complex (TSEC) treatment led to a significant reduction in nocturia prevalence and bother in women with ≥ 2 nocturnal voids.

Source: Menopause Journal

The Infectious Diseases Society of America (IDSA) continues to examine available and potential treatments as new evidence emerges.

Combination use of the monoclonal antibodies bamlanivimab and etesevimab to treat outpatients with mild-to-moderate disease at risk of progressing to severe COVID-19, for example, is a new recommendation in IDSA guidelines.

The society also updated its guidance on use of tocilizumab, pointed to less evidence on bamlanivimab monotherapy, and recommended against use of ivermectin outside of clinical trials.

Source: IDSA

Ertugliflozin, the sodium-glucose cotransporter 2 (SGLT2) inhibitor class, now has shown evidence of renal benefits roughly on par with the other three drugs.

Treatment of patients with type 2 diabetes and established atherosclerotic cardiovascular disease (CVD) with ertugiflozin (Steglatro) led to significant reductions in the incidence of four prespecified, exploratory kidney endpoints in the VERTIS CV trial, which included more than 8200 patients.

Most notable of the new exploratory analyses is a composite of time to a sustained 40% reduction from baseline in estimated glomerular filtration rate (eGFR) or time to renal dialysis, transplant, or death, the incidence for which was a significant 34% lower with ertugliflozin treatment.

Source: Medscape