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The People-First Liver Charter 以人为本的肝脏宪章
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-06-05 DOI: 10.1038/s41591-025-03759-8
Jeffrey V. Lazarus, Dana Ivancovsky Wajcman, Silvana Pannain, Paul N. Brennan, Melina I. Manolas, Peter Jepsen, Carla Treloar, Anish K. Arora, Philippa C. Matthews, Camila A. Picchio, Trenton M. White, Jason Grebely, Juan Vaz, Hannes Hagström, Kenneth H. Rabin, Scott Isaacs, Rogério T. Ribeiro, Michael Roden, Michael Betel, José Willemse, Luis Antonio Díaz, Alina M. Allen, Naim Alkhouri, Jörn M. Schattenberg, Dídac Mauricio, Mary E. Rinella, Elisa Pose, Emmanuel A. Tsochatzis, Michael Ninburg, Kenneth Cusi, William Alazawi, Ajay Duseja, Gema Frühbeck, Holly Lofton, Priya Jaisinghani, Fasiha Kanwal, Gamal Shiha, Shira Zelber-Sagi, Larry Holden, Marcela Villota-Rivas
{"title":"The People-First Liver Charter","authors":"Jeffrey V. Lazarus, Dana Ivancovsky Wajcman, Silvana Pannain, Paul N. Brennan, Melina I. Manolas, Peter Jepsen, Carla Treloar, Anish K. Arora, Philippa C. Matthews, Camila A. Picchio, Trenton M. White, Jason Grebely, Juan Vaz, Hannes Hagström, Kenneth H. Rabin, Scott Isaacs, Rogério T. Ribeiro, Michael Roden, Michael Betel, José Willemse, Luis Antonio Díaz, Alina M. Allen, Naim Alkhouri, Jörn M. Schattenberg, Dídac Mauricio, Mary E. Rinella, Elisa Pose, Emmanuel A. Tsochatzis, Michael Ninburg, Kenneth Cusi, William Alazawi, Ajay Duseja, Gema Frühbeck, Holly Lofton, Priya Jaisinghani, Fasiha Kanwal, Gamal Shiha, Shira Zelber-Sagi, Larry Holden, Marcela Villota-Rivas","doi":"10.1038/s41591-025-03759-8","DOIUrl":"https://doi.org/10.1038/s41591-025-03759-8","url":null,"abstract":"Reducing the stigma and discrimination that people living with liver conditions experience requires rethinking how diagnoses, diseases, etiologies and circumstances are perceived — a shift that begins with the language used to name and describe them.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"36 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ethics and integrity in uncertain times 动荡时期的道德与诚信
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-06-05 DOI: 10.1038/s41591-025-03795-4
{"title":"Ethics and integrity in uncertain times","authors":"","doi":"10.1038/s41591-025-03795-4","DOIUrl":"https://doi.org/10.1038/s41591-025-03795-4","url":null,"abstract":"The newly launched PREPARED Code presents a much-needed framework to ensure that research during pandemics is trustworthy and accessible to all.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"124 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144219234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A microRNA-based dynamic risk score for type 1 diabetes 基于微rna的1型糖尿病动态风险评分
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-06-05 DOI: 10.1038/s41591-025-03730-7
Mugdha V. Joglekar, Wilson K. M. Wong, Pooja S. Kunte, Hrishikesh P. Hardikar, Reshmi A. Kulkarni, Ikhlak Ahmed, Ryan J. Farr, Nhan Ho Trong Pham, Madilyn Coles, Simranjeet Kaur, Cody L. Maynard, Riley Hayward, Vinod Thorat, Aniruddha Pant, Ammira A. Akil, Kim C. Donaghue, Alicia J. Jenkins, Milan K. Piya, Maria E. Craig, William M. Hague, Chittaranjan S. Yajnik, Juliana C. N. Chan, A. M. James Shapiro, Elizabeth A. Davis, Timothy W. Jones, Stephen E. Gitelman, Ronald C. W. Ma, Flemming Pociot, Anandwardhan A. Hardikar
{"title":"A microRNA-based dynamic risk score for type 1 diabetes","authors":"Mugdha V. Joglekar, Wilson K. M. Wong, Pooja S. Kunte, Hrishikesh P. Hardikar, Reshmi A. Kulkarni, Ikhlak Ahmed, Ryan J. Farr, Nhan Ho Trong Pham, Madilyn Coles, Simranjeet Kaur, Cody L. Maynard, Riley Hayward, Vinod Thorat, Aniruddha Pant, Ammira A. Akil, Kim C. Donaghue, Alicia J. Jenkins, Milan K. Piya, Maria E. Craig, William M. Hague, Chittaranjan S. Yajnik, Juliana C. N. Chan, A. M. James Shapiro, Elizabeth A. Davis, Timothy W. Jones, Stephen E. Gitelman, Ronald C. W. Ma, Flemming Pociot, Anandwardhan A. Hardikar","doi":"10.1038/s41591-025-03730-7","DOIUrl":"https://doi.org/10.1038/s41591-025-03730-7","url":null,"abstract":"<p>Identifying individuals at high risk of type 1 diabetes (T1D) is crucial as disease-delaying medications are available. Here we report a microRNA (miRNA)-based dynamic (responsive to the environment) risk score developed using multicenter, multiethnic and multicountry (‘multicontext’) cohorts for T1D risk stratification. Discovery (wet and dry lab) analysis identified 50 miRNAs associated with functional β cell loss, which is a hallmark of T1D. These miRNAs measured across <i>n</i> = 2,204 individuals from four contexts (4C: Australia, Denmark, Hong Kong SAR People’s Republic of China, India) led to a four-context, miRNA-based dynamic risk score (DRS) that effectively stratified individuals with and without T1D. Generative artificial intelligence was used to create an enhanced four-context, miRNA-based DRS, which offered good predictive power (area under the curve = 0.84) for T1D stratification in a separate multicontext validation dataset (<i>n</i> = 662), and accurately predicted future exogenous insulin requirement at 1 hour of islet transplantation. In a clinical trial assessing the imatinib drug therapy, baseline miRNA signature, rather than clinical characteristics, distinguished drug responders from nonresponders at 1 year. This study harnessed machine learning/generative artificial intelligence approaches, identifying and validating a miRNA-based DRS for T1D discrimination and treatment efficacy prediction.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"9 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144219316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inherited mitochondrial genetics as a predictor of immune checkpoint inhibition efficacy in melanoma 遗传线粒体遗传学作为黑色素瘤免疫检查点抑制效果的预测因子
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-06-05 DOI: 10.1038/s41591-025-03699-3
Kelsey R. Monson, Robert Ferguson, Joanna E. Handzlik, Leah Morales, Jiahan Xiong, Vylyny Chat, Sasha Dagayev, Alireza Khodadadi-Jamayran, Danny Simpson, Esther Kazlow, Anabelle Bunis, Chaitra Sreenivasaiah, Milad Ibrahim, Iryna Voloshyna, Wouter Ouwerkerk, Rosalie M. Luiten, Mariaelena Capone, Gabriele Madonna, Yuting Lu, Yongzhao Shao, Anna Pavlick, Michelle Krogsgaard, Janice Mehnert, Hao Tang, Sonia Dolfi, Daniel Tenney, John B. A. G. Haanen, Thomas F. Gajewski, F. Stephen Hodi, Keith T. Flaherty, Kasey Couts, William Robinson, Igor Puzanov, Marc S. Ernstoff, Osama Rahma, Michael Postow, Ryan J. Sullivan, Jason J. Luke, Paolo A. Ascierto, Iman Osman, Tomas Kirchhoff
{"title":"Inherited mitochondrial genetics as a predictor of immune checkpoint inhibition efficacy in melanoma","authors":"Kelsey R. Monson, Robert Ferguson, Joanna E. Handzlik, Leah Morales, Jiahan Xiong, Vylyny Chat, Sasha Dagayev, Alireza Khodadadi-Jamayran, Danny Simpson, Esther Kazlow, Anabelle Bunis, Chaitra Sreenivasaiah, Milad Ibrahim, Iryna Voloshyna, Wouter Ouwerkerk, Rosalie M. Luiten, Mariaelena Capone, Gabriele Madonna, Yuting Lu, Yongzhao Shao, Anna Pavlick, Michelle Krogsgaard, Janice Mehnert, Hao Tang, Sonia Dolfi, Daniel Tenney, John B. A. G. Haanen, Thomas F. Gajewski, F. Stephen Hodi, Keith T. Flaherty, Kasey Couts, William Robinson, Igor Puzanov, Marc S. Ernstoff, Osama Rahma, Michael Postow, Ryan J. Sullivan, Jason J. Luke, Paolo A. Ascierto, Iman Osman, Tomas Kirchhoff","doi":"10.1038/s41591-025-03699-3","DOIUrl":"https://doi.org/10.1038/s41591-025-03699-3","url":null,"abstract":"<p>Response to immune checkpoint inhibitors (ICIs) in metastatic melanoma (MM) varies among patients, and current baseline biomarkers predicting treatment outcomes are limited. As mitochondrial (MT) metabolism has emerged as an important regulator of host immune function, we explored the association of host MT genetics (MT haplogroups) with ICI efficacy in 1,225 ICI-treated patients with MM from the clinical trial CheckMate-067 and the International Germline Immuno-Oncology Melanoma Consortium. We discovered and validated significant associations of MT haplogroup T (HG-T) with resistance to anti-programmed cell death protein-1-based ICI (both single-agent and combination) and have shown that HG-T is independent from established tumor predictors. We also found that patients belonging to HG-T exhibit a unique nivolumab-resistant baseline peripheral CD8<sup>+</sup> T cell repertoire compared to other MT haplogroups, providing, to our knowledge, the first link between MT inheritance, host immunity and ICI resistance. The study proposes a host blood-based biomarker with stand-alone clinical value predicting ICI efficacy and points to an ICI-resistance mechanism associated with MT metabolism, with clinical relevance in immuno-oncology.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"31 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144219312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Stem cell therapies advance in Parkinson’s disease and beyond 干细胞治疗在帕金森病及其他疾病中取得进展
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-06-04 DOI: 10.1038/d41591-025-00036-6
{"title":"Stem cell therapies advance in Parkinson’s disease and beyond","authors":"","doi":"10.1038/d41591-025-00036-6","DOIUrl":"https://doi.org/10.1038/d41591-025-00036-6","url":null,"abstract":"Landmark trials using stem cells to treat Parkinson’s disease in the USA and Japan mark a turning point for cell therapy in neurodegeneration. Similar approaches to Alzheimer’s disease and amyotrophic lateral sclerosis are also showing early signs of promise.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"1 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Individual variations in glycemic responses to carbohydrates and underlying metabolic physiology 碳水化合物对血糖反应的个体差异和潜在的代谢生理学
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-06-04 DOI: 10.1038/s41591-025-03719-2
Yue Wu, Ben Ehlert, Ahmed A. Metwally, Dalia Perelman, Heyjun Park, Andrew Wallace Brooks, Fahim Abbasi, Basil Michael, Alessandra Celli, Caroline Bejikian, Ekrem Ayhan, Yingzhou Lu, Samuel M. Lancaster, Daniel Hornburg, Lucia Ramirez, David Bogumil, Sarah Pollock, Frank Wong, Denver Bradley, Georg Gutjahr, Ekanath Srihari Rangan, Tao Wang, Lettie McGuire, P. Venkat Rangan, Helge Ræder, Zohar Shipony, Doron Lipson, Tracey McLaughlin, Michael P. Snyder
{"title":"Individual variations in glycemic responses to carbohydrates and underlying metabolic physiology","authors":"Yue Wu, Ben Ehlert, Ahmed A. Metwally, Dalia Perelman, Heyjun Park, Andrew Wallace Brooks, Fahim Abbasi, Basil Michael, Alessandra Celli, Caroline Bejikian, Ekrem Ayhan, Yingzhou Lu, Samuel M. Lancaster, Daniel Hornburg, Lucia Ramirez, David Bogumil, Sarah Pollock, Frank Wong, Denver Bradley, Georg Gutjahr, Ekanath Srihari Rangan, Tao Wang, Lettie McGuire, P. Venkat Rangan, Helge Ræder, Zohar Shipony, Doron Lipson, Tracey McLaughlin, Michael P. Snyder","doi":"10.1038/s41591-025-03719-2","DOIUrl":"https://doi.org/10.1038/s41591-025-03719-2","url":null,"abstract":"<p>Elevated postprandial glycemic responses (PPGRs) are associated with type 2 diabetes and cardiovascular disease. PPGRs to the same foods have been shown to vary between individuals, but systematic characterization of the underlying physiologic and molecular basis is lacking. We measured PPGRs using continuous glucose monitoring in 55 well-phenotyped participants challenged with seven different standard carbohydrate meals administered in replicate. We also examined whether preloading a rice meal with fiber, protein or fat (‘mitigators’) altered PPGRs. We performed gold-standard metabolic tests and multi-omics profiling to examine the physiologic and molecular basis for interindividual PPGR differences. Overall, rice was the most glucose-elevating carbohydrate meal, but there was considerable interindividual variability. Individuals with the highest PPGR to potatoes (potato-spikers) were more insulin resistant and had lower beta cell function, whereas grape-spikers were more insulin sensitive. Rice-spikers were more likely to be Asian individuals, and bread-spikers had higher blood pressure. Mitigators were less effective in reducing PPGRs in insulin-resistant as compared to insulin-sensitive participants. Multi-omics signatures of PPGR and metabolic phenotypes were discovered, including insulin-resistance-associated triglycerides, hypertension-associated metabolites and PPGR-associated microbiome pathways. These results demonstrate interindividual variability in PPGRs to carbohydrate meals and mitigators and their association with metabolic and molecular profiles.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"260 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Atezolizumab plus paclitaxel and bevacizumab as first-line treatment of advanced triple-negative breast cancer: the ATRACTIB phase 2 trial Atezolizumab联合紫杉醇和贝伐单抗作为晚期三阴性乳腺癌的一线治疗:ATRACTIB 2期试验
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-06-04 DOI: 10.1038/s41591-025-03734-3
María Gion, Isabel Blancas, Patricia Cortez-Castedo, Alfonso Cortés-Salgado, Frederik Marmé, Salvador Blanch, Serafín Morales, Nieves Díaz, Isabel Calvo-Plaza, Sabela Recalde, Alejandro Martínez-Bueno, Manuel Ruiz-Borrego, Elisenda Llabrés, María Teresa Taberner, Michelino de Laurentiis, Silvia García-Vicente, José Antonio Guerrero, Olga Boix, Jose Rodríguez-Morató, Miguel Sampayo-Cordero, Gabriele Antonarelli, José Manuel Pérez-García, Javier Cortés, Antonio Llombart-Cussac
{"title":"Atezolizumab plus paclitaxel and bevacizumab as first-line treatment of advanced triple-negative breast cancer: the ATRACTIB phase 2 trial","authors":"María Gion, Isabel Blancas, Patricia Cortez-Castedo, Alfonso Cortés-Salgado, Frederik Marmé, Salvador Blanch, Serafín Morales, Nieves Díaz, Isabel Calvo-Plaza, Sabela Recalde, Alejandro Martínez-Bueno, Manuel Ruiz-Borrego, Elisenda Llabrés, María Teresa Taberner, Michelino de Laurentiis, Silvia García-Vicente, José Antonio Guerrero, Olga Boix, Jose Rodríguez-Morató, Miguel Sampayo-Cordero, Gabriele Antonarelli, José Manuel Pérez-García, Javier Cortés, Antonio Llombart-Cussac","doi":"10.1038/s41591-025-03734-3","DOIUrl":"https://doi.org/10.1038/s41591-025-03734-3","url":null,"abstract":"<p>Triple-negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer with poor prognosis. The current first-line treatment for advanced TNBC (aTNBC) is determined by the expression of programmed cell death-ligand 1 (PD-L1). In the ATRACTIB trial—a multicenter, single-arm, phase 2 study—we evaluated the combination of atezolizumab, paclitaxel and bevacizumab as first-line treatment for patients with aTNBC, independently of PD-L1 status. The primary endpoint was investigator-assessed progression-free survival. One hundred female patients were enrolled, with most evaluable tumors being PD-L1-negative (97.6%). The primary endpoint was met, with a median progression-free survival of 11.0 months (95% confidence interval (CI): 9.0–13.4; <i>P</i> &lt; 0.001). The objective response rate was 63.0% (95% CI: 52.8–72.4) and median overall survival was 27.4 months (95% CI: 23.4–37.4). No treatment-related deaths or new safety signals were observed. This combination demonstrated significant antitumor activity as first-line therapy for aTNBC patients and merits further investigation. ClinicalTrials.gov Identifier: NCT04408118.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"8 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Peri-operative atezolizumab in early-stage triple-negative breast cancer: final results and ctDNA analyses from the randomized phase 3 IMpassion031 trial 围手术期atezolizumab治疗早期三阴性乳腺癌:来自随机3期IMpassion031试验的最终结果和ctDNA分析
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-06-04 DOI: 10.1038/s41591-025-03725-4
Elizabeth A. Mittendorf, Zoe June Assaf, Nadia Harbeck, Hong Zhang, Shigehira Saji, Kyung Hae Jung, Roberto Hegg, Andreas Koehler, Joohyuk Sohn, Hiroji Iwata, Melinda L. Telli, Cristiano Ferrario, Kevin Punie, Aditi Qamra, Max Dieterich, Yun Xu, Mario Liste-Hermoso, Esther Shearer-Kang, Luciana Molinero, Stephen Y. Chui, Carlos H. Barrios
{"title":"Peri-operative atezolizumab in early-stage triple-negative breast cancer: final results and ctDNA analyses from the randomized phase 3 IMpassion031 trial","authors":"Elizabeth A. Mittendorf, Zoe June Assaf, Nadia Harbeck, Hong Zhang, Shigehira Saji, Kyung Hae Jung, Roberto Hegg, Andreas Koehler, Joohyuk Sohn, Hiroji Iwata, Melinda L. Telli, Cristiano Ferrario, Kevin Punie, Aditi Qamra, Max Dieterich, Yun Xu, Mario Liste-Hermoso, Esther Shearer-Kang, Luciana Molinero, Stephen Y. Chui, Carlos H. Barrios","doi":"10.1038/s41591-025-03725-4","DOIUrl":"https://doi.org/10.1038/s41591-025-03725-4","url":null,"abstract":"<p>Previously published results demonstrated that the randomized phase 3 IMpassion031 trial met its primary objective: adding atezolizumab to neoadjuvant chemotherapy significantly improved pathologic complete response (pCR) rate in patients with stage II/III triple-negative breast cancer (TNBC). Here we report the prespecified final analysis of the secondary endpoints with 3 years’ follow-up, together with exploratory analyses of circulating tumor (ct)DNA. Patients with previously untreated stage II/III TNBC enrolled in 75 academic and community sites in 13 countries were randomized 1:1 to receive neoadjuvant chemotherapy with either peri-operative atezolizumab (<i>n</i> = 165) or preoperative placebo (<i>n</i> = 168). Descriptive secondary endpoints included event-free, disease-free and overall survival. Long-term outcomes favored the atezolizumab group (event-free survival hazard ratio (HR), 0.76; 95% confidence interval (CI), 0.47–1.21; disease-free survival HR, 0.76; 95% CI, 0.44–1.30; overall survival HR, 0.56; 95% CI, 0.30–1.04). Among patients without pCR, 14 of 70 (20%) atezolizumab-treated and 33 of 99 (33%) placebo-treated patients received additional adjuvant therapy, frequently capecitabine. In exploratory biomarker analyses, patients with baseline ctDNA-negative status (6%) had excellent long-term outcomes. Most patients (87%) had cleared ctDNA at surgery. ctDNA-positive status at surgery identified a subset of non-pCR patients with poorest prognosis. Long-term safety was consistent with primary results. These data show that adding atezolizumab to chemotherapy for stage II/III TNBC is associated with favorable long-term outcomes, and ctDNA dynamics provide prognostic value beyond pCR. ClinicalTrials.gov identifier: NCT03197935.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"313 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anti-sporozoite monoclonal antibody for malaria prevention: secondary efficacy outcome of a phase 2 randomized trial 抗孢子子单克隆抗体用于疟疾预防:一项2期随机试验的次要疗效结果
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-06-03 DOI: 10.1038/s41591-025-03739-y
Jeff Skinner, Kassoum Kayentao, Aissata Ongoiba, Sara A. Healy, Zonghui Hu, Anne C. Preston, Amadou Niangaly, Philipp Schwabl, Hamidou Cisse, Safiatou Doumbo, Didier Doumtabe, Abdrahamane Traore, Shanping Li, Mary E. Peterson, Annette M. Seilie, Chris Chavtur, Weston Staubus, Ming Chang, Katrina Kelley, Hamadi Traore, Adama Djiguiba, Mamadou Keita, Adama Ouattara, M’Bouye Doucoure, Mohamed Keita, Djelika Diarra, Mamadou Sylla, Dramane Diakite, Mamadou Konate, Siriman Traore, Amatigué Zéguimé, Amagana Dolo, Daniel E. Neafsey, Sean C. Murphy, Boubacar Traore, Robert A. Seder, Peter D. Crompton
{"title":"Anti-sporozoite monoclonal antibody for malaria prevention: secondary efficacy outcome of a phase 2 randomized trial","authors":"Jeff Skinner, Kassoum Kayentao, Aissata Ongoiba, Sara A. Healy, Zonghui Hu, Anne C. Preston, Amadou Niangaly, Philipp Schwabl, Hamidou Cisse, Safiatou Doumbo, Didier Doumtabe, Abdrahamane Traore, Shanping Li, Mary E. Peterson, Annette M. Seilie, Chris Chavtur, Weston Staubus, Ming Chang, Katrina Kelley, Hamadi Traore, Adama Djiguiba, Mamadou Keita, Adama Ouattara, M’Bouye Doucoure, Mohamed Keita, Djelika Diarra, Mamadou Sylla, Dramane Diakite, Mamadou Konate, Siriman Traore, Amatigué Zéguimé, Amagana Dolo, Daniel E. Neafsey, Sean C. Murphy, Boubacar Traore, Robert A. Seder, Peter D. Crompton","doi":"10.1038/s41591-025-03739-y","DOIUrl":"https://doi.org/10.1038/s41591-025-03739-y","url":null,"abstract":"<p>CIS43LS is a long-acting monoclonal antibody specific for the <i>Plasmodium falciparum</i> circumsporozoite protein expressed on sporozoites. We previously reported that CIS43LS is protective against <i>P.</i> <i>falciparum</i> infection as detected by thick blood smear (TBS; primary endpoint) in a phase 2 double-blind randomized trial involving 330 healthy Malian adults receiving placebo or a single intravenous infusion of 10 mg kg<sup>−1</sup> or 40 mg kg<sup>−1</sup> of CIS43LS (1:1:1). At enrollment, all participants received artemether–lumefantrine to clear possible <i>P.</i> <i>falciparum</i> infection. Although TBS examination is the standard assay to assess efficacy in malaria vaccines trials in endemic areas, it has poor analytical sensitivity; therefore, it remained unknown whether CIS43LS had achieved sterile protection against infection. Here we report the prespecified secondary efficacy endpoint that used a <i>Plasmodium</i> 18S rRNA quantitative reverse transcription–PCR (qRT–PCR) assay that is ~2,000-fold more sensitive than TBS. We analyzed 5,015 dried blood spots collected before CIS43LS or placebo administration and biweekly thereafter over a 6-month malaria season. At 6 months, efficacy of CIS43LS against qRT–PCR-detected infection assessed in a time-to-event analysis was 87.4% for 40 mg kg<sup>−1</sup> (adjusted 95% confidence interval (CI), 79.5–92.3; <i>P</i> &lt; 0.001) and 77.0% for 10 mg kg<sup>−1</sup> (adjusted 95% CI, 65.0–84.0; <i>P</i> &lt; 0.001) versus placebo. A post hoc analysis with a gametocyte mRNA-specific qRT–PCR assay showed 6-month efficacy against gametocytemia of 87.7% for 40 mg kg<sup>−1</sup> (adjusted 95% CI, 75.6–93.8; <i>P</i> &lt; 0.001) and 73.0% for 10 mg kg<sup>−1</sup> (adjusted 95% CI, 54.0–84.0; <i>P</i> &lt; 0.001), versus placebo. These data indicate that a single dose of anti-sporozoite monoclonal antibodies can achieve durable, sterile protection against <i>P.</i> <i>falciparum</i> infection, underscoring their potential to reduce malaria disease burden and transmission. ClinicalTrials.gov identifier: NCT04329104.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"112 2 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An international Delphi consensus for reporting of setting in psychedelic clinical trials 致幻剂临床试验环境报告的国际德尔菲共识
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-06-03 DOI: 10.1038/s41591-025-03685-9
Chloé Pronovost-Morgan, Kyle T. Greenway, Leor Roseman
{"title":"An international Delphi consensus for reporting of setting in psychedelic clinical trials","authors":"Chloé Pronovost-Morgan, Kyle T. Greenway, Leor Roseman","doi":"10.1038/s41591-025-03685-9","DOIUrl":"https://doi.org/10.1038/s41591-025-03685-9","url":null,"abstract":"<p>Psychedelic substances exhibit complex interactions with the ‘set and setting’ of use, that is, the mental state of the user and the environment in which a psychedelic experience takes place. Despite these contextual variables’ known importance, psychedelic research has lacked methodological rigor in reporting extra-pharmacological factors. This study aimed to generate consensus-based guidelines for reporting settings in psychedelic clinical research, according to an international group of psychedelic researchers, clinicians and past trial participants. We conducted a Delphi consensus study composed of four iterative rounds of quasi-anonymous online surveys. A total of 89 experts from 17 countries independently listed potentially important psychedelic setting variables. There were 770 responses, synthesized into 49 distinct items that were subsequently rated, debated and refined. The process yielded 30 extra-pharmacological variables reaching predefined consensus ratings:i.e., ‘important’ or ‘very important’ for ≥70% of experts. These items compose the Reporting of Setting in Psychedelic Clinical Trials (ReSPCT) guidelines, categorized into physical environment, dosing session procedure, therapeutic framework and protocol, and subjective experiences. Emergent findings reveal significant ambiguities in current conceptualizations of set and setting. The ReSPCT guidelines and accompanying explanatory document provide a new standard for the design and documentation of extra-pharmacological variables in psychedelic clinical research.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"35 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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