The LancetPub Date : 2024-11-21DOI: 10.1016/s0140-6736(24)01967-6
Cristian Udovicich, Andrew Loblaw
{"title":"Prostate radiotherapy in the era of intensified systemic treatment of metastatic prostate cancer","authors":"Cristian Udovicich, Andrew Loblaw","doi":"10.1016/s0140-6736(24)01967-6","DOIUrl":"https://doi.org/10.1016/s0140-6736(24)01967-6","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The LancetPub Date : 2024-11-21DOI: 10.1016/s0140-6736(24)02136-6
Steven H Woolf
{"title":"Understanding disparities in life expectancy","authors":"Steven H Woolf","doi":"10.1016/s0140-6736(24)02136-6","DOIUrl":"https://doi.org/10.1016/s0140-6736(24)02136-6","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"254 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The LancetPub Date : 2024-11-21DOI: 10.1016/s0140-6736(24)02077-4
Abdullah A Al Rabeeah, Ziad A Memish
{"title":"The UN World Conjoined Twins Day—a call to global action","authors":"Abdullah A Al Rabeeah, Ziad A Memish","doi":"10.1016/s0140-6736(24)02077-4","DOIUrl":"https://doi.org/10.1016/s0140-6736(24)02077-4","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The LancetPub Date : 2024-11-21DOI: 10.1016/s0140-6736(24)02376-6
Howard Lopes Ribeiro Junior
{"title":"AI ethics in medical research: the 2024 Declaration of Helsinki","authors":"Howard Lopes Ribeiro Junior","doi":"10.1016/s0140-6736(24)02376-6","DOIUrl":"https://doi.org/10.1016/s0140-6736(24)02376-6","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The LancetPub Date : 2024-11-21DOI: 10.1016/s0140-6736(24)01495-8
Laura Dwyer-Lindgren, Mathew M Baumann, Zhuochen Li, Yekaterina O Kelly, Chris Schmidt, Chloe Searchinger, Wichada La Motte-Kerr, Thomas J Bollyky, Ali H Mokdad, Christopher JL Murray
{"title":"Ten Americas: a systematic analysis of life expectancy disparities in the USA","authors":"Laura Dwyer-Lindgren, Mathew M Baumann, Zhuochen Li, Yekaterina O Kelly, Chris Schmidt, Chloe Searchinger, Wichada La Motte-Kerr, Thomas J Bollyky, Ali H Mokdad, Christopher JL Murray","doi":"10.1016/s0140-6736(24)01495-8","DOIUrl":"https://doi.org/10.1016/s0140-6736(24)01495-8","url":null,"abstract":"<h3>Background</h3>Nearly two decades ago, the Eight Americas study offered a novel lens for examining health inequities in the USA by partitioning the US population into eight groups based on geography, race, urbanicity, income per capita, and homicide rate. That study found gaps of 12·8 years for females and 15·4 years for males in life expectancy in 2001 across these eight groups. In this study, we aimed to update and expand the original Eight Americas study, examining trends in life expectancy from 2000 to 2021 for ten Americas (analogues to the original eight, plus two additional groups comprising the US Latino population), by year, sex, and age group.<h3>Methods</h3>In this systematic analysis, we defined ten mutually exclusive and collectively exhaustive Americas comprising the entire US population, starting with all combinations of county and race and ethnicity, and assigning each to one of the ten Americas based on race and ethnicity and a variable combination of geographical location, metropolitan status, income, and Black–White residential segregation. We adjusted deaths from the National Vital Statistics System to account for misreporting of race and ethnicity on death certificates. We then tabulated deaths from the National Vital Statistics System and population estimates from the US Census Bureau and the National Center for Health Statistics from Jan 1, 2000, to Dec 31, 2021, by America, year, sex, and age, and calculated age-specific mortality rates in each of these strata. Finally, we constructed abridged life tables for each America, year, and sex, and extracted life expectancy at birth, partial life expectancy within five age groups (0–4, 5–24, 25–44, 45–64, and 65–84 years), and remaining life expectancy at age 85 years.<h3>Findings</h3>We defined the ten Americas as: America 1—Asian individuals; America 2—Latino individuals in other counties; America 3—White (majority), Asian, and American Indian or Alaska Native (AIAN) individuals in other counties; America 4—White individuals in non-metropolitan and low-income Northlands; America 5—Latino individuals in the Southwest; America 6—Black individuals in other counties; America 7—Black individuals in highly segregated metropolitan areas; America 8—White individuals in low-income Appalachia and Lower Mississippi Valley; America 9—Black individuals in the non-metropolitan and low-income South; and America 10—AIAN individuals in the West. Large disparities in life expectancy between the Americas were apparent throughout the study period but grew more substantial over time, particularly during the first 2 years of the COVID-19 pandemic. In 2000, life expectancy ranged 12·6 years (95% uncertainty interval 12·2–13·1), from 70·5 years (70·3–70·7) for America 9 to 83·1 years (82·7–83·5) for America 1. The gap between Americas with the lowest and highest life expectancies increased to 13·9 years (12·6–15·2) in 2010, 15·8 years (14·4–17·1) in 2019, 18·9 years (17·7–20·2) in 2020, and 20·4 y","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The LancetPub Date : 2024-11-21DOI: 10.1016/s0140-6736(24)01865-8
Alberto Bossi, Stéphanie Foulon, Xavier Maldonado, Paul Sargos, Ray MacDermott, Paul Kelly, Aude Fléchon, Bertrand Tombal, Stephane Supiot, Dominik Berthold, Philippe Ronchin, Gabriel Kacso, Naji Salem, Fabio Calabro, Jean-François Berdah, Ali Hasbini, Marlon Silva, Jihane Boustani, Hélène Ribault, Karim Fizazi, Karim Fizazi
{"title":"Efficacy and safety of prostate radiotherapy in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2 × 2 factorial design","authors":"Alberto Bossi, Stéphanie Foulon, Xavier Maldonado, Paul Sargos, Ray MacDermott, Paul Kelly, Aude Fléchon, Bertrand Tombal, Stephane Supiot, Dominik Berthold, Philippe Ronchin, Gabriel Kacso, Naji Salem, Fabio Calabro, Jean-François Berdah, Ali Hasbini, Marlon Silva, Jihane Boustani, Hélène Ribault, Karim Fizazi, Karim Fizazi","doi":"10.1016/s0140-6736(24)01865-8","DOIUrl":"https://doi.org/10.1016/s0140-6736(24)01865-8","url":null,"abstract":"<h3>Background</h3>The 2 × 2 PEACE-1 study showed that combining androgen-deprivation therapy with docetaxel and abiraterone improved overall and radiographic progression-free survival in patients with de novo metastatic castration-sensitive prostate cancer. We aimed to examine the efficacy and safety of adding radiotherapy in this population.<h3>Methods</h3>We conducted an open-label, randomised, controlled, phase 3 trial with a 2 × 2 factorial design (PEACE-1) at 77 hospitals across Europe. Eligible participants were male patients (aged ≥18 years) with de novo metastatic castration-sensitive prostate cancer confirmed by bone scan, CT, or MRI, and an Eastern Cooperative Oncology Group performance status of 0–1 (or 2 in the case of bone pain). Participants were randomly assigned (1:1:1:1) to standard of care (androgen-deprivation therapy alone or with six cycles of intravenous docetaxel 75 mg/m<sup>2</sup> every 3 weeks), standard of care plus abiraterone (oral 1000 mg abiraterone once daily plus oral 5 mg prednisone twice daily), standard of care plus radiotherapy (74 Gy in 37 fractions to the prostate), or standard of care plus radiotherapy and abiraterone. Participants and investigators were not masked to treatment allocation. The coprimary endpoints were radiographic progression-free survival and overall survival, analysed by intention to treat in patients with low-volume metastatic disease and in the overall study population. This ongoing study is registered with EudraCT, 2012-000142-35.<h3>Findings</h3>Between Nov 27, 2013, and Dec 20, 2018, 1173 patients were enrolled and 1172 were randomly assigned to receive standard of care (n=296 [25·3%]), standard of care plus abiraterone (n=292 [24·9%]), standard of care plus radiotherapy (n=293 [25·0%]), and standard of care plus abiraterone and radiotherapy (n=291 [24·8%]). Median follow-up was 6·0 years (IQR 5·1–7·0) at the time of radiographic progression-free survival and overall survival analysis. A qualitative interaction between radiotherapy and abiraterone for radiographic progression-free survival in the population of patients with low-volume disease prevented the pooling of intervention groups for analysis (p=0·026). Adding radiotherapy to standard of care improved radiographic progression-free survival in patients with low-volume disease treated with abiraterone (median 4·4 years [99·9% CI 2·5–7·3] in the standard of care plus abiraterone group <em>vs</em> 7·5 years [4·0–not reached] in the standard of care plus abiraterone and radiotherapy group; adjusted hazard ratio [HR] 0·65 [99·9% CI 0·36–1·19]; p=0·019), but not in patients not treated with abiraterone (median 3·0 years [99·9% CI 2·3–4·8] in the standard of care group <em>vs</em> 2·6 years [1·7–4·6] in the standard of care plus radiotherapy group; 1·08 [0·65–1·80]; p=0·61). For overall survival, the predefined threshold for a statistical interaction was not reached (p=0·12); therefore, the two intervention groups receiving radiother","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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