Volume 29 Issue 4, April 2023

Nature Medicine explores the latest translational and clinical research news, with Moderna’s clinical trial of a vaccine against respiratory syncytial virus in older adults.

Nature Medicine explores the latest translational and clinical research news, with a monoclonal antibody that blocks the transfer of maternal immunoglobulins in pregnancy.

They focus on primary health and disease prevention through behavioral change, while building trust with the local community.

Vaccines against different SARS-CoV-2 variants have been approved, but continued surveillance is needed to determine when the antigen composition of vaccines should be updated, together with clinical studies to assess vaccine efficacy.

Mobile diagnostics and point-of-care tests can improve patient outcomes by allowing remote monitoring during routine clinical care and in digital clinical trials.

The composition of the intestinal microbiome may predict clinical outcomes of CAR-T cell therapy for lymphoma, which could inform microbiota-based intervention strategies.

Integrative approaches continue to improve diagnostic accuracy for pediatric brain cancers, but much more is needed from researchers, governments and regulators if precision medicine with curative treatments are to become a reality.

Salt substitutes can lower blood pressure and the incidence of cardiovascular disease, according to a new study — that also provides reassurance on safety.

A new study highlights the importance of dietary intake and a health-promoting food environment for diabetes prevention, but translating this into meaningful outcomes requires urgent government action.

We used deep neural networks trained on optical histology and open-source genomic data to predict the molecular genetics of brain tumors during surgery. Our results represent how AI-based diagnostics can provide a valuable adjunct to wet laboratory methods for molecular testing in patients with cancer.

Lung adenocarcinomas (LUADs) encompass a broad spectrum of histological appearances. We use multi-region, prospective and longitudinal sampling from the TRACERx dataset to show the relationship between LUAD morphologies and their underlying evolutionary genomic landscape, as well as clinical risk and the nature of metastatic dissemination.

Data from circulating tumor DNA (ctDNA) testing were generated for over 1,900 samples across at least 3 time points in a phase 3 clinical trial and used to build a machine learning model to predict patient survival. The model accurately identified patients with a high risk of disease recurrence and could provide a basis for assigning therapies in phase 1/2 clinical trials.

A large meta-analysis of genome-wide association studies (N >40,000) on perivascular space (PVS) burden, an emerging brain imaging marker of cerebral small vessel disease, has revealed 24 genetic risk loci for extensive PVS burden. These findings provide novel insights into the biology and clinical significance of this trait.

Body mass index (BMI) is a clinically useful obesity measure that shows an association with healthspan and lifespan. We developed ‘biological BMI’ scores, calculated from multi-omics data (proteins and metabolites) and clinical laboratory tests from blood. We show that a biological BMI more accurately reflects metabolic health and is more responsive to lifestyle changes than a classically measured BMI.

The authors describe a localized toxicity syndrome that is associated with immunotherapy treatment for CNS tumors and propose a new grading scale—with the goal of promoting research and standardizing both reporting and management.

The Outcome4Medicine consensus group outline recommendations for postoperative outcome assessment, with the ultimate goal of improving care quality and patient health.

DeepGlioma, a multimodal deep learning approach for intraoperative diagnostic screening of diffuse glioma, trained on stimulated Raman histology and large-scale public genomic data, can predict molecular alterations for diffuse glioma diagnosis with high accuracy.

Analyses of the TRACERx study unveil the relationship between tissue morphology, the underlying evolutionary genomic landscape, and clinical and anatomical relapse risk of lung adenocarcinomas.

Results of the TRACERx study shed new light into the association between body composition and body weight with survival in individuals with non-small cell lung cancer, and delineate potential biological processes and mediators contributing to the development of cancer-associated cachexia.

A machine learning model that uses longitudinal ctDNA metrics robustly predicts survival in two phase 3 trials of patients with metastatic NSCLC, which may improve therapy selection and risk stratification.

The phase 3 GENESIS trial reports the superiority of the novel CXCR4 inhibitor motixafortide with G-CSF in mobilizing hematopoietic progenitor cells for autologous stem cell transplantation in multiple myeloma.

In a phase 2 trial of pembrolizumab and cabozantinib in patients with advanced head and neck cancer, a high clinical benefit rate was achieved, which positively correlated with levels of CD8⁺ T cell infiltration but not tumor mutational burden.

In a single-arm phase 2 study, enoblituzumab (a humanized, Fc-engineered, B7-H3-targeting antibody) was found to be safe and showed preliminary evidence of potential clinical activity in men with high-risk localized prostate cancer.

In an interim analysis of a phase 1 trial of concurrent intrathecal and intravenous anti-PD1 delivery in patients with leptomeningeal disease and melanoma, treatment was feasible and well-tolerated with no dose-limiting toxicities.

Conserved microbiome features across clinical and geographical variations may enable microbiome-based predictions of outcomes in CD19-targeted CAR-T cell immunotherapy

The integration of DNA methylation profiling and targeted sequencing with neuropathology improves the diagnostic accuracy of central nervous system tumors in a population-based cohort of more than 1,200 newly diagnosed pediatric patients.

The ASPIRE Mayuge trial in rural Uganda showed that implementation of door-to-door HPV screening led to better attendance of follow-up treatment services but requires more personnel compared to community health days.

Detailed analyses pairing deep phenotyping and molecular profiles reveal mediating roles of plasma lipids in genetic and environmental factors associated with autism-related traits in children.

Genomic analyses of large population-based cohorts uncover the genetic determinants of perivascular space burden, an MRI marker of cerebral small vessel disease, across the lifespan, and reveal potential pathways implicated in the etiology of stroke and dementia.

Comparison of intermittent fasting plus early time-restricted eating (iTRE) to calorie restriction, as well as standard care, in adults at risk of type 2 diabetes in a three-arm randomized controlled study demonstrated that iTRE was associated with greater improvements in postprandial glucose metabolism at 6 months.

In a cluster-randomized trial performed in 48 residential elderly care facilities in China, use of a low-sodium salt substitute instead of regular salt decreased blood pressure and cardiovascular events, whereas an alternative strategy of restricting salt consumption was not successful and did not have these beneficial effects.

Modeling analysis from the Global Dietary Database estimated that 70% of new global cases of type 2 diabetes are attributable to suboptimal intake of 11 dietary factors, with substantial differences in dietary risks across world regions and nations.

Integrated analyses reveal that multiomics captured the heterogeneity of metabolic states accompanying obesity and changes in metabolic health in response to lifestyle intervention that are not apparent in body mass index measurements.

Better approaches are crucial to improve identification of people with active tuberculosis (TB), accelerate treatment and curtail disease transmission. A randomized trial suggests that a mobile clinic using DNA-based diagnosis is one such tool to reduce time to treatment of individuals with TB.

Dysbiosis of the gut microbiome in critically ill patients, coupled with impaired innate immune responses, may lower the barrier to acquiring infectious pathogens in the hospital setting.