Nature MedicinePub Date : 2025-06-03DOI: 10.1038/s41591-025-03743-2
Zuojun Xu, Feng Ren, Ping Wang, Jie Cao, Chunting Tan, Dedong Ma, Li Zhao, Jinghong Dai, Yipeng Ding, Haohui Fang, Huiping Li, Hong Liu, Fengming Luo, Ying Meng, Pinhua Pan, Pingchao Xiang, Zuke Xiao, Sujata Rao, Carol Satler, Sang Liu, Yuan Lv, Heng Zhao, Shan Chen, Hui Cui, Mikhail Korzinkin, David Gennert, Alex Zhavoronkov
{"title":"A generative AI-discovered TNIK inhibitor for idiopathic pulmonary fibrosis: a randomized phase 2a trial","authors":"Zuojun Xu, Feng Ren, Ping Wang, Jie Cao, Chunting Tan, Dedong Ma, Li Zhao, Jinghong Dai, Yipeng Ding, Haohui Fang, Huiping Li, Hong Liu, Fengming Luo, Ying Meng, Pinhua Pan, Pingchao Xiang, Zuke Xiao, Sujata Rao, Carol Satler, Sang Liu, Yuan Lv, Heng Zhao, Shan Chen, Hui Cui, Mikhail Korzinkin, David Gennert, Alex Zhavoronkov","doi":"10.1038/s41591-025-03743-2","DOIUrl":"https://doi.org/10.1038/s41591-025-03743-2","url":null,"abstract":"<p>Despite substantial progress in artificial intelligence (AI) for generative chemistry, few novel AI-discovered or AI-designed drugs have reached human clinical trials. Here we present the results of the first phase 2a multicenter, double-blind, randomized, placebo-controlled trial testing the safety and efficacy of rentosertib (formerly ISM001-055), a first-in-class AI-generated small-molecule inhibitor of TNIK, a first-in-class target in idiopathic pulmonary fibrosis (IPF) discovered using generative AI. IPF is an age-related progressive lung condition with no current therapies available that reverse the degenerative course of disease. Patients were randomized to 12 weeks of treatment with 30 mg rentosertib once daily (QD, <i>n</i> = 18), 30 mg rentosertib twice daily (BID, <i>n</i> = 18), 60 mg rentosertib QD (<i>n</i> = 18) or placebo (<i>n</i> = 17). The primary endpoint was the percentage of patients who have at least one treatment-emergent adverse event, which was similar across all treatment arms (72.2% in patients receiving 30 mg rentosertib QD (<i>n</i> = 13/18), 83.3% for 30 mg rentosertib BID (<i>n</i> = 15/18), 83.3% for 60 mg rentosertib QD (<i>n</i> = 15/18) and 70.6% for placebo (<i>n</i> = 12/17)). Treatment-related serious adverse event rates were low and comparable across treatment groups, with the most common events leading to treatment discontinuation related to liver toxicity or diarrhea. Secondary endpoints included pharmacokinetic dynamics (<i>C</i><sub>max</sub>, <i>C</i><sub>trough</sub>, <i>t</i><sub>max</sub>, AUC<sub>0–<i>t</i>/<i>τ</i>/∞</sub> and <i>t</i><sub>1/2</sub>), changes in lung function as measured by forced vital capacity, diffusion capacity of the lung for carbon monoxide, forced expiry in 1 s and change in the Leicester Cough Questionnaire score, change in 6-min walk distance and the number and hospitalization duration of acute exacerbations of IPF. We observed increased forced vital capacity at the highest dosage with a mean change of +98.4 ml (95% confidence interval 10.9 to 185.9) for patients in the 60 mg rentosertib QD group, compared with −20.3 ml (95% confidence interval −116.1 to 75.6) for the placebo group. These results suggest that targeting TNIK with rentosertib is safe and well tolerated and warrants further investigation in larger-scale clinical trials of longer duration. ClinicalTrials.gov registration number: NCT05938920.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"135 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201542","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}
Nature MedicinePub Date : 2025-06-03DOI: 10.1038/s41591-025-03693-9
Gianmarco Piccinno, Kelsey N. Thompson, Paolo Manghi, Andrew R. Ghazi, Andrew Maltez Thomas, Aitor Blanco-Míguez, Francesco Asnicar, Katarina Mladenovic, Federica Pinto, Federica Armanini, Michal Punčochář, Elisa Piperni, Vitor Heidrich, Gloria Fackelmann, Giulio Ferrero, Sonia Tarallo, Long H. Nguyen, Yan Yan, Nazim A. Keles, Bilge G. Tuna, Veronika Vymetalkova, Mario Trompetto, Vaclav Liska, Tomas Hucl, Pavel Vodicka, Beatrix Bencsiková, Martina Čarnogurská, Vlad Popovici, Federica Marmorino, Chiara Cremolini, Barbara Pardini, Francesca Cordero, Mingyang Song, Andrew T. Chan, Lisa Derosa, Laurence Zitvogel, Curtis Huttenhower, Alessio Naccarati, Eva Budinska, Nicola Segata
{"title":"Pooled analysis of 3,741 stool metagenomes from 18 cohorts for cross-stage and strain-level reproducible microbial biomarkers of colorectal cancer","authors":"Gianmarco Piccinno, Kelsey N. Thompson, Paolo Manghi, Andrew R. Ghazi, Andrew Maltez Thomas, Aitor Blanco-Míguez, Francesco Asnicar, Katarina Mladenovic, Federica Pinto, Federica Armanini, Michal Punčochář, Elisa Piperni, Vitor Heidrich, Gloria Fackelmann, Giulio Ferrero, Sonia Tarallo, Long H. Nguyen, Yan Yan, Nazim A. Keles, Bilge G. Tuna, Veronika Vymetalkova, Mario Trompetto, Vaclav Liska, Tomas Hucl, Pavel Vodicka, Beatrix Bencsiková, Martina Čarnogurská, Vlad Popovici, Federica Marmorino, Chiara Cremolini, Barbara Pardini, Francesca Cordero, Mingyang Song, Andrew T. Chan, Lisa Derosa, Laurence Zitvogel, Curtis Huttenhower, Alessio Naccarati, Eva Budinska, Nicola Segata","doi":"10.1038/s41591-025-03693-9","DOIUrl":"https://doi.org/10.1038/s41591-025-03693-9","url":null,"abstract":"<p>Associations between the gut microbiome and colorectal cancer (CRC) have been uncovered, but larger and more diverse studies are needed to assess their potential clinical use. We expanded upon 12 metagenomic datasets of patients with CRC (<i>n</i>‚Äâ=‚Äâ930), adenomas (<i>n</i>‚Äâ=‚Äâ210) and healthy control individuals (<i>n</i>‚Äâ=‚Äâ976; total <i>n</i>‚Äâ=‚Äâ2,116) with 6 new cohorts (<i>n</i>‚Äâ=‚Äâ1,625) providing granular information on cancer stage and the anatomic location of tumors. We improved CRC prediction accuracy based solely on gut metagenomics (average area under the curve‚Äâ=‚Äâ0.85) and highlighted the contribution of 19 newly profiled species and distinct <i>Fusobacterium nucleatum</i> clades. Specific gut species distinguish left-sided versus right-sided CRC (area under the curve‚Äâ=‚Äâ0.66) with an enrichment of oral-typical microbes. We identified strain-specific CRC signatures with the commensal <i>Ruminococcus bicirculans</i> and <i>Faecalibacterium prausnitzii</i> showing subclades associated with late-stage CRC. Our analysis confirms that the microbiome can be a clinical target for CRC screening and characterizes it as a biomarker for CRC progression.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"30 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201541","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}
Nature MedicinePub Date : 2025-06-02DOI: 10.1038/s41591-025-03728-1
Nicaise Ndembi, Leon Mutesa, Claude Mambo Muvunyi, Jerome H. Kim
{"title":"Bridging the vaccine divide","authors":"Nicaise Ndembi, Leon Mutesa, Claude Mambo Muvunyi, Jerome H. Kim","doi":"10.1038/s41591-025-03728-1","DOIUrl":"https://doi.org/10.1038/s41591-025-03728-1","url":null,"abstract":"<p>The African Union (AU) has prioritized local production of health countermeasures since its inception, with heightened focus following the COVID-19 pandemic and challenges such as cholera, Ebola, malaria, mpox, Marburg and other emerging diseases. One of its efforts was the development of the Pharmaceutical Manufacturing Plan for Africa in 2007<sup>1</sup>. The plan aims to strengthen the continental capacity to produce affordable, high-quality essential medicines, improving health outcomes while fostering economic benefits. The AU’s Agenda 2063 further reinforces the development of resilient health systems and local pharmaceutical manufacturing to achieve health sovereignty<sup>2</sup>.</p><p>These goals confront a stark reality in Africa. In 2024 alone, the continent had to deal with over 160 disease outbreaks<sup>3</sup>. Yet as many as 70–90% of drugs consumed in sub-Saharan Africa are imported, and <1% of global vaccine production occurs on the continent<sup>4</sup>. This limited manufacturing capacity exacerbates delays in accessing life-saving vaccines during public health crises, as exemplified during the COVID-19 pandemic<sup>5</sup> and the current mpox outbreak<sup>6</sup>. Moreover, over-reliance on imports — often coupled with inadequate cold-chain infrastructure — hinders the timely distribution of vaccines<sup>7</sup>. Diseases such as cholera and typhoid further emphasize the necessity of regional solutions and end-to-end vaccine production systems. The oral cholera vaccine (OCV) technology transfer from the International Vaccine Institute to the Biovac Institute in South Africa exemplifies how strengthening manufacturing capacity can address vaccine shortages amid recurring outbreaks.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"36 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144193126","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}
Nature MedicinePub Date : 2025-06-01DOI: 10.1038/s41591-025-03745-0
Stephen J. Bagley, Arati S. Desai, Joseph A. Fraietta, Dana Silverbush, Daniel Chafamo, Nelson F. Freeburg, Gayathri Konanur Gopikrishna, Andrew J. Rech, Ali Nabavizadeh, Linda J. Bagley, Jungmin Park, Danuta Jarocha, Rene Martins, Nicolas Sarmiento, Eileen Maloney, Lester Lledo, Carly Stein, Amy Marshall, Rachel M. Leskowitz, Julie K. Jadlowsky, Shane Mackey, Shannon Christensen, Bike Su Oner, Gabriela Plesa, Andrea Brennan, Vanessa Gonzalez, Fang Chen, David Barrett, Robert Colbourn, MacLean P. Nasrallah, Zissimos Mourelatos, Wei-Ting Hwang, Cecile Alanio, Donald L. Siegel, Carl H. June, Elizabeth O. Hexner, Zev A. Binder, Donald M. O’Rourke
{"title":"Intracerebroventricular bivalent CAR T cells targeting EGFR and IL-13Rα2 in recurrent glioblastoma: a phase 1 trial","authors":"Stephen J. Bagley, Arati S. Desai, Joseph A. Fraietta, Dana Silverbush, Daniel Chafamo, Nelson F. Freeburg, Gayathri Konanur Gopikrishna, Andrew J. Rech, Ali Nabavizadeh, Linda J. Bagley, Jungmin Park, Danuta Jarocha, Rene Martins, Nicolas Sarmiento, Eileen Maloney, Lester Lledo, Carly Stein, Amy Marshall, Rachel M. Leskowitz, Julie K. Jadlowsky, Shane Mackey, Shannon Christensen, Bike Su Oner, Gabriela Plesa, Andrea Brennan, Vanessa Gonzalez, Fang Chen, David Barrett, Robert Colbourn, MacLean P. Nasrallah, Zissimos Mourelatos, Wei-Ting Hwang, Cecile Alanio, Donald L. Siegel, Carl H. June, Elizabeth O. Hexner, Zev A. Binder, Donald M. O’Rourke","doi":"10.1038/s41591-025-03745-0","DOIUrl":"https://doi.org/10.1038/s41591-025-03745-0","url":null,"abstract":"<p>Glioblastoma (GBM) is the most common primary brain cancer in adults and carries a median overall survival (OS) of 12–15 months. Effective therapy for recurrent GBM (rGBM) following frontline chemoradiation is a major unmet medical need. Here we report the dose escalation and exploration phases of a phase 1 trial investigating intracerebroventricular delivery of bivalent chimeric antigen receptor (CAR) T cells targeting epidermal growth factor receptor (EGFR) epitope 806 and interleukin-13 receptor alpha 2 (IL-13Rα2), or CART-EGFR-IL13Rα2 cells, in patients with EGFR-amplified rGBM. Primary endpoints included dose-limiting toxicity, determination of the maximum tolerated dose and recommended dose for expansion, and occurrence of adverse events. Secondary endpoints included objective radiographic response, duration of response, progression-free survival and OS. A total of 18 patients received CART-EGFR-IL13Rα2 cells. The maximum tolerated dose was determined to be 2.5 × 10<sup>7</sup> cells. Of the 18 patients, 10 (56%) experienced grade 3 neurotoxicity; none had grade 4–5 neurotoxicity. Of 13 patients, 8 (62%) with measurable disease at the time of CAR T cell infusion experienced tumor regression, with one confirmed partial response by Modified Response Assessment in Neuro-Oncology criteria (objective radiographic response, 8%; 90% confidence interval, 0–32%) and one patient with ongoing durable stable disease lasting over 16 months. Median progression-free survival was 1.9 months (90% confidence interval, 1.1–3.4 months), and median OS was not yet reached at the time of data cut-off (median follow-up time, 8.1 months). These findings indicate that intracerebroventricular delivery of bivalent CART-EGFR-IL13Rα2 is feasible and appears safe. CART-EGFR-IL13Rα2 cells are bioactive and exhibit a signal of antitumor effect in rGBM. ClinicalTrials.gov registration: NCT05168423.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"7 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188934","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}
Nature MedicinePub Date : 2025-05-31DOI: 10.1038/s41591-025-03746-z
Tina Cascone, Laura Bonanno, Florian Guisier, Amelia Insa, Moishe Liberman, Olivier Bylicki, Lorenzo Livi, Thomas Egenod, Romain Corre, Dong-Wan Kim, Maria Rosario Garcia Campelo, Mariano Provencio Pulla, Byoung Yong Shim, Giulio Metro, Jaafar Bennouna, Agata A. Bielska, Alula R. Yohannes, Yun He, Adam Dowson, Gozde Kar, Lara McGrath, Rakesh Kumar, Italia Grenga, Jonathan Spicer, Patrick M. Forde
{"title":"Perioperative durvalumab plus chemotherapy plus new agents for resectable non-small-cell lung cancer: the platform phase II NeoCOAST-2 trial","authors":"Tina Cascone, Laura Bonanno, Florian Guisier, Amelia Insa, Moishe Liberman, Olivier Bylicki, Lorenzo Livi, Thomas Egenod, Romain Corre, Dong-Wan Kim, Maria Rosario Garcia Campelo, Mariano Provencio Pulla, Byoung Yong Shim, Giulio Metro, Jaafar Bennouna, Agata A. Bielska, Alula R. Yohannes, Yun He, Adam Dowson, Gozde Kar, Lara McGrath, Rakesh Kumar, Italia Grenga, Jonathan Spicer, Patrick M. Forde","doi":"10.1038/s41591-025-03746-z","DOIUrl":"https://doi.org/10.1038/s41591-025-03746-z","url":null,"abstract":"<p>In the phase II NeoCOAST-2 platform study, 202 patients with untreated, resectable stage IIA–IIIB non-small-cell lung cancer (NSCLC) were randomized to receive neoadjuvant durvalumab plus platinum-doublet chemotherapy with oleclumab, a CD73 inhibitor (Arm 1), or with monalizumab, a NKG2A inhibitor (Arm 2), or neoadjuvant durvalumab plus single-agent platinum chemotherapy with the TROP-2 antibody–drug conjugate (ADC) datopotamab deruxtecan (Arm 4), followed by surgical resection and adjuvant durvalumab with oleclumab or monalizumab (Arms 1 and 2) or durvalumab alone (Arm 4). Primary endpoints were pathological complete response (pCR) rate and safety; secondary endpoints included feasibility of surgery and major pathological response (mPR) rate. In the modified intention-to-treat population (<i>n</i> = 198; Arm 1, <i>n</i> = 74; Arm 2, <i>n</i> = 70; Arm 4, <i>n</i> = 54), pCR rates were 20.3% (15/74; 95% CI, 11.8–31.2), 25.7% (18/70; 95% CI, 16.0–37.6) and 35.2% (19/54; 95% CI, 22.7–49.4), and mPR rates were 41.9% (31/74; 95% CI, 30.5–53.9), 50.0% (35/70; 95% CI, 37.8–62.2) and 63.0% (34/54; 95% CI, 48.7–75.7) in arms 1, 2, and 4, respectively. In the safety population, 69/74 (93.2%), 66/71 (93.0%), and 51/54 (94.4%) patients underwent surgery, respectively. Overall, grade ≥3 treatment-related adverse events occurred in 27/74 (36.5%), 29/71 (40.8%) and 11/54 (20.4%) patients, respectively. In NeoCOAST-2, the first neoadjuvant trial examining an ADC plus chemo-immunotherapy in resectable NSCLC, pCR rates were highest in the datopotamab-deruxtecan-containing arm, warranting further investigation in larger trials of ADCs and checkpoint inhibition in the neoadjuvant setting. ClinicalTrials.gov identifier: NCT05061550.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"7 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188994","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}
Nature MedicinePub Date : 2025-05-31DOI: 10.1038/s41591-025-03738-z
Neal D. Shore, Thomas B. Powles, Jens Bedke, Matthew D. Galsky, Joan Palou Redorta, Ja Hyeon Ku, Michal Kretkowski, Evanguelos Xylinas, Boris Alekseev, Dingwei Ye, Félix Guerrero-Ramos, Alberto Briganti, Girish S. Kulkarni, Julia Brinkmann, Anna-Maria Calella, Rossano Cesari, Anthony Eccleston, Elisabete Michelon, Jennifer Vermette, Caimiao Wei, Gary D. Steinberg
{"title":"Sasanlimab plus BCG in BCG-naive, high-risk non-muscle invasive bladder cancer: the randomized phase 3 CREST trial","authors":"Neal D. Shore, Thomas B. Powles, Jens Bedke, Matthew D. Galsky, Joan Palou Redorta, Ja Hyeon Ku, Michal Kretkowski, Evanguelos Xylinas, Boris Alekseev, Dingwei Ye, Félix Guerrero-Ramos, Alberto Briganti, Girish S. Kulkarni, Julia Brinkmann, Anna-Maria Calella, Rossano Cesari, Anthony Eccleston, Elisabete Michelon, Jennifer Vermette, Caimiao Wei, Gary D. Steinberg","doi":"10.1038/s41591-025-03738-z","DOIUrl":"https://doi.org/10.1038/s41591-025-03738-z","url":null,"abstract":"<p>Bacillus Calmette–Guérin (BCG) induction and maintenance (I+M) after transurethral resection of bladder tumor is standard of care (SOC) in high-risk non-muscle invasive bladder cancer (NMIBC). However, disease recurrence/progression occurs in approximately 40% of patients at 2 years, with unfavorable prognosis. Limited bladder-sparing therapeutic options exist, and no improvements to response durability have been observed in decades. CREST is a global, phase 3, randomized trial evaluating subcutaneous sasanlimab in combination with BCG-I+M (Arm A), sasanlimab in combination with BCG-I (Arm B) or BCG-I+M (Arm C) in BCG-naive high-risk NMIBC. The primary endpoint was investigator-assessed event-free survival (EFS) for Arm A versus Arm C; key secondary endpoints were EFS (Arm B versus Arm C) and overall survival. Patients were randomized 1:1:1 to Arm A (<i>N</i> = 352), Arm B (<i>N</i> = 352) and Arm C (<i>N</i> = 351). The trial met its primary endpoint with a statistically significant and clinically meaningful prolongation of EFS (Arm A versus Arm C); hazard ratio, 0.68 (95% confidence interval: 0.49–0.94); one-sided <i>P</i> = 0.0095. The 36-month estimated EFS rates were 82.1% (Arm A) and 74.8% (Arm C). EFS benefit for Arm A versus Arm C was observed across prespecified subgroups, including carcinoma in situ (CIS) and T1. The safety profile of the combination was consistent with the known profiles. To our knowledge, sasanlimab is the first anti-PD-1 antibody to show a clinically meaningful prolongation of EFS when combined with BCG-I+M versus SOC in patients with BCG-naive high-risk NMIBC. Sasanlimab combined with BCG-I+M has the potential to redefine the treatment paradigm and clinical decision-making for patients with BCG-naive high-risk NMIBC. ClinicalTrials.gov identifier: NCT04165317.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"6 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188920","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}
Nature MedicinePub Date : 2025-05-30DOI: 10.1038/s41591-025-03744-1
Matthias Preusser, Javier Garde-Noguera, Juan José García-Mosquera, María Gion, Richard Greil, Miriam Arumi, Manuel Ruiz-Borrego, Antonio Llombart-Cussac, María Valero, Javier Cortés, Marta Campolier, José Antonio Guerrero, Paula González-Alonso, Carlos Jiménez-Cortegana, Jose Rodríguez-Morató, Marta Vaz-Batista, Felicitas Oberndorfer, Maximilian Marhold, Anna Sophie Berghoff, Julia Furtner, Thorsten Fuereder, Rupert Bartsch
{"title":"Patritumab deruxtecan in leptomeningeal metastatic disease of solid tumors: the phase 2 TUXEDO-3 trial","authors":"Matthias Preusser, Javier Garde-Noguera, Juan José García-Mosquera, María Gion, Richard Greil, Miriam Arumi, Manuel Ruiz-Borrego, Antonio Llombart-Cussac, María Valero, Javier Cortés, Marta Campolier, José Antonio Guerrero, Paula González-Alonso, Carlos Jiménez-Cortegana, Jose Rodríguez-Morató, Marta Vaz-Batista, Felicitas Oberndorfer, Maximilian Marhold, Anna Sophie Berghoff, Julia Furtner, Thorsten Fuereder, Rupert Bartsch","doi":"10.1038/s41591-025-03744-1","DOIUrl":"https://doi.org/10.1038/s41591-025-03744-1","url":null,"abstract":"<p>Leptomeningeal metastatic disease (LMD) is a severe complication of solid cancers with poor outcomes and limited treatment options. The antibody–drug conjugate patritumab deruxtecan (HER3-DXd) demonstrated efficacy in breast and lung cancers, and HER3 is involved in central nervous system metastases, particularly in parenchymal colonization. In this study, we investigated HER3-DXd efficacy and safety in patients with LMD in cohort 3 of the TUXEDO-3 phase 2 trial. Key eligibility criteria included age ≥18 years, treatment-naive LMD or LMD progressing after radiotherapy from any solid tumor and Eastern Cooperative Oncology Group performance status of 0–2. Between January and July 2024, 20 evaluable patients (nine with type I and 11 with type II LMD) were accrued and received HER3-DXd 5.6 mg kg<sup>−1</sup> intravenously every 3 weeks. Main primary tumor types included breast (60%) and lung (30%) cancers. Median follow-up time was 5.4 months. The primary endpoint was met with 65.0% patients alive after 3 months. The Kaplan–Meier-estimated 3-month and 6-month overall survival rates were 69.6% and 58.9%, respectively. Overall response rate was 11.1% for intracranial, 30.8% for extracranial and 26.3% for overall lesions. Clinical benefit rate was 50.0% for intracranial, 38.5% for extracranial and 47.4% for overall lesions. Neurological symptoms and quality of life remained stable or improved during study treatment. No new neurological adverse events were observed. The most common adverse events of any grade were anemia (nine (40.9%) patients, one (4.5%) grade ≥3), nausea (seven (31.8%) patients, no grade ≥3), neutropenia (six (27.3%) patients, three (13.6%) grade ≥3), diarrhea (six (27.3%) patients, one (4.5%) grade ≥3), asthenia (six (27.3%) patients, no grade ≥3) and thrombocytopenia and headache (five (22.7%) patients, one (4.5%) grade ≥3 each). TUXEDO-3 showed clinically relevant HER3-DXd activity in patients with LMD. ClinicalTrials.gov identifier: NCT05865990.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"28 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184112","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}
Nature MedicinePub Date : 2025-05-29DOI: 10.1038/s41591-025-03720-9
Harris Onywera, Nicola Mulder, Yenew Kebede, Sofonias K. Tessema
{"title":"How to sustain a public-health genomics and bioinformatics workforce in Africa","authors":"Harris Onywera, Nicola Mulder, Yenew Kebede, Sofonias K. Tessema","doi":"10.1038/s41591-025-03720-9","DOIUrl":"https://doi.org/10.1038/s41591-025-03720-9","url":null,"abstract":"African countries have made progress in expanding their genomics and bioinformatics workforces for public health, yet several barriers pose risks to workforce retention and long-term sustainability.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"147 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144165355","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}
Nature MedicinePub Date : 2025-05-29DOI: 10.1038/d41591-025-00035-7
{"title":"Hyperimmune volunteer enables discovery of a potent snake antivenom","authors":"","doi":"10.1038/d41591-025-00035-7","DOIUrl":"https://doi.org/10.1038/d41591-025-00035-7","url":null,"abstract":"Researchers studied the antibody library of a venom-immune person with extensive snakebite exposure — and generated a three-agent, broadly neutralizing cocktail that protected mice against venoms from high-priority species.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"134 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144165354","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}