From No Hope to a Potential Cure for a Deadly Blood Cancer
A group of 97 patients had longstanding multiple myeloma, a common blood cancer that doctors consider incurable, and faced a certain, and extremely painful, death within about a year.
They had gone through a series of treatments, each of which controlled their disease for a while. But then it came back, as it always does. They reached the stage where they had no more options and were facing hospice.
They all got immunotherapy, in a study that was a last-ditch effort.
A third responded so well that they got what seems to be an astonishing reprieve. The immunotherapy developed by Legend Biotech, a company founded in China, seems to have made their cancer disappear. And after five years, it still has not returned in those patients — a result never before seen in this disease.
These results, in patients whose situation had seemed hopeless, has led some battle-worn American oncologists to dare to say the words 'potential cure.'
'In my 30 years in oncology, we haven't talked about curing myeloma,' said Dr. Norman Sharpless, a former director of the National Cancer Institute who is now a professor of cancer policy and innovation at the University of North Carolina School of Medicine. 'This is the first time we are really talking seriously about cure in one of the worst malignancies imaginable.'
The new study, reported Tuesday at the annual conference of the American Society of Clinical Oncology and published in The Journal of Clinical Oncology, was funded by Johnson & Johnson, which bought Legend Biotech.
Want all of The Times? Subscribe.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Skift
15 minutes ago
- Skift
Making Sense of the JetBlue and United Partnership
We sort the speculation from the facts, contextualize the JetBlue-United deal, and ask what it really means for the carriers and the wider industry. For this episode of the Airline Weekly Lounge, hosts Gordon Smith and Jay Shabat delve into the recently announced partnership between JetBlue and United Airlines. They discuss the implications of this collaboration, the financial struggles faced by JetBlue, and the potential benefits for both airlines. The conversation also touches on regulatory considerations and industry reaction. Listen to This Podcast Apple Podcasts | Spotify | YouTube | RSS Takeaways
Medscape
21 minutes ago
- Medscape
GLP-1 Users Should Fast 24 Hours Before Anesthesia
Patients taking the new class of weight-loss drugs do not need to stop these medications prior to procedures requiring anesthesia, but they should adhere to longer preoperative fasting times, according to a new multidisciplinary consensus statement. The statement, led by the Society for Perioperative Assessment and Quality Improvement, recommends patients without significant gastrointestinal symptoms associated with glucagon-like peptide 1 receptor agonists (GLP-1 RAs) should fast from solid foods for 24 hours and stick to clear liquids prior to a procedure requiring anesthesia. This extended fasting time can help mitigate aspiration risk in these patients with delayed gastric emptying while retaining the benefits of continuing GLP-1 RAs, such as improved glycemic control. The statement is 'the first to provide recommendations for perioperative management of patients taking GLP-1 RAs based on an in-depth systematic literature review of both clinical perioperative studies and gastric emptying data,' Adriana Oprea, MD, the first author of the document, and her colleagues wrote. Changing Guidance In June 2023, the American Society of Anesthesiologists (ASA) released the first guidance statement regarding preoperative management of patients on GLP-1 RAs, after some case reports documented aspiration events in these patients. While the number of these events is generally low and rates of aspiration appear to be similar between patients on GLP-1 RAs and the general population, 'people got really worried with these drugs because of [the] delayed gastric emptying,' Oprea, an associate professor of anesthesiology at Yale School of Medicine in New Haven, Connecticut, told Medscape Medical News . The 2023 ASA guidance recommended holding GLP-1 RAs for one half-life — a week for patients on long-acting medication and a day for short-acting GLP-1s. Due to a lack of adequate evidence at the time, the document suggested these patients should follow the standard ASA fasting guidelines of 8 hours after a full meal. However, evidence suggests stopping GLP-1s for one half-life is not enough for the effects on gastric emptying to subside, according to the new statement. For longer-acting drugs like dulaglutide, semaglutide, and tirzepatide, patients would need to discontinue these medications for several weeks to restore normal gastrointestinal motility. For patients with type 2 diabetes, discontinuation of these medications over this period could lead to poor glycemic control, which is linked to worse postoperative outcomes. For patients taking GLP-1 RAs for weight loss, restarting these medications can result in increased gastrointestinal symptoms, Oprea said, such as nausea, vomiting, diarrhea, or constipation. 'Because adverse effects are more prevalent at higher GLP-1 RA doses, discontinuation of these medications might lead to a high likelihood of side effects upon medication reinitiation or require reinitiation of therapy at lower doses followed by dose reescalation,' Oprea's group wrote. 'This is logistically difficult for both patients and treating clinicians.' In October 2024, the ASA, along with other professional societies, published updated practice guidance stating GLP-1 RAs may be continued preoperatively in patients without an elevated risk for delayed gastric emptying and aspiration. Those defined as 'higher risk' included patients in the escalation phase, on weekly dosing, on higher doses, and with gastrointestinal symptoms. The guidance advised these patients at higher risk for delayed stomach emptying can help mitigate aspiration risk by following a 24-hour liquid diet. This updated guidance also received some criticism. 'As of yet, no studies have reported a difference in the incidence of increased residual gastric content that would justify treating patients differently on the basis of dose regimen and/or treatment phase,' wrote Glenio B. Mizubuti, MD, PhD, of the Kingston General Hospital, in Kingston, Ontario, Canada, and his colleagues in a letter to Anesthesiology . 'Similarly, the absence of ongoing digestive symptoms, while somewhat reassuring, should not be taken as a definitive sign of an empty stomach in GLP-1 RA users,' they wrote. Continue Meds, Extend Fasting Times This new consensus statement, published last month in the British Journal of Anaesthesia , recommends patients doing well on GLP-1 RAs should continue these medications preoperatively and follow a clear liquid diet for 24 hours before procedures requiring anesthesia. The recommendations were based on a systematic review of 112 studies and a modified Delphi process and were co-sponsored and endorsed by the American Association of Clinical Endocrinology. 'From our review of the literature, we feel that the fasting times are the most important factor that could decrease the risk of having residual gastric content in the stomach in a patient on GLP-1 RAs when they're scheduled to have a procedure that requires anesthesia,' Oprea said. The consensus also recommends patients on GLP-1s fast from high-carbohydrate-content clear liquids (containing 10% or more glucose) for 8 hours before and stop drinking any liquids four hours before these procedures. Inpatient and outpatients can restart GLP-1 RAs when they resume their original diets. Patients with significant gastrointestinal symptoms including severe nausea, vomiting, and inability to tolerate oral intake should postpone elective procedures that require anesthesia and refer to their prescribing physician for diet and medication modifications to manage symptoms, the authors advised. 'Our recommendation for a clear liquid diet for 24 hours preprocedurally might appear overly restrictive. However, evidence points to the safety of this approach in patients on GLP-1 RAs,' they wrote.
Washington Post
22 minutes ago
- Washington Post
It's finally time to bid farewell to the ‘face of the NBA'
The question persists, oblivious to the NBA's new countermovement. Who will be the next face of the league? Everyone wants to know; no one wants to claim it. LeBron James, whose kingly mug has dominated attention for two decades, got in his feelings earlier this season and downplayed the importance of a line of succession. 'Why do you want to be the face of a league when all the people that cover and talk about our game on a day-to-day basis s--- on everybody?' James wondered. 'To have that responsibility is just weird. It's weird energy.' His frustration is reasonable, actually, even though James has benefited from being the superstar of all superstars far more than he has suffered. The league has grown to a point at which the unofficial role should be outdated. It had long come with savior vibes, dating from when Larry Bird and Magic Johnson boosted the NBA's popularity and Michael Jordan took it to a new stratosphere of cultural resonance. Today, the fate of the sport doesn't sit on the shoulders of any single, transcendent star. All 30 franchises are estimated to be worth more than $3 billion. In March, the Boston Celtics' sale came with a record $6.1 billion valuation. The face of the NBA is a title with diminished meaning and murky criteria that punishes candidates as much as it promotes them. There won't be another rivalry as significant as Bird vs. Magic. Changes to marketing and celebrity culture ensure no icon will enjoy a journey as dramatic and intoxicating as Jordan's. There is no template to be like James or Stephen Curry, either. Who's the new face of the NBA? The question is in conflict with where the league is headed. It's a facile concern as the Finals begin with the Oklahoma City Thunder and the Indiana Pacers — both among the league's 10 smallest markets — providing the most compelling evidence to date that the sport functions like never before. If parity is the expectation, if the size or prestige of a city matters less than ever, the assumption of individual dominance must be reconsidered as well. After the Pacers defeated the New York Knicks in six games in the Eastern Conference finals, center Myles Turner celebrated the new day. 'It's a new blueprint for the league, man,' he said. James, who plays for the high-profile Los Angeles Lakers, couldn't get out of the first round despite playing with 26-year-old savant Luka Doncic. Curry, who's trying to extend the Golden State Warriors' dynasty, couldn't get out of the second round after injuring his hamstring. Kevin Durant, the third signature star of this era, missed the playoffs with a Phoenix Suns roster that includes Devin Booker and Bradley Beal. The younger megastars suffered, too. Nikola Jokic, the best player in the game and a 2023 champion with the Denver Nuggets, went home in the second round. Anthony Edwards, the legend-killing young marvel for the Minnesota Timberwolves, lost in the conference finals for the second straight season. Jayson Tatum, the franchise player on a star-studded Celtics roster with multi-championship potential, ruptured his Achilles' tendon trying to defend Boston's 2024 title. That NBA face card keeps declining. 'The years of the super teams and stacking [talent] is not as effective as it once was,' Turner said. 'Since I've been in the league, this NBA is very trendy. It just shifts. But the new trend now is just what we're doing. OKC does the same thing. The young guys get out and run, defend and use the power of friendship.' The power of influence used to control the league. Before the NBA introduced a parity-enforcing business model, it was easier for great players to get what they wanted. And because they usually wanted to play for the most glamorous franchises, it led to a decade — starting with James's infamous decision to join the Miami Heat in 2010 — in which the imbalance became exaggerated. The NBA had always been a league of dynasties because, in five-on-five basketball, one dominant player has an outsize impact on the game. Give a giant a gigantic ally, and it's game over. In 2023, new rules were implemented to tax both the bank accounts and team-building tactics of franchises that hope to stack stars. It's almost impossible to build a complete team through free agency now. And even if you build a great squad through the draft, retention becomes a chore. One consequence, perhaps unintended, is that it will be difficult for one star to stand above the rest. Face of the NBA is a cumbersome aspiration, especially when it means different things to different people. In general, the title comes with an expectation of a clean image, multiple championships, consistent MVP-caliber performances, a level of charisma and marketability that transcends basketball and the confidence to be a league spokesman. In an age of distraction, who can command that much attention? In a sport dictating balance, who will win enough to get the chance? Thunder guard Shai Gilgeous-Alexander just won his first MVP award at 26, and if Oklahoma City finishes its historically dominant season with a championship, he will vault into that conversation. But similar to Tatum, SGA isn't a big personality. And similar to the Celtics, money and the league's two-apron tax system will pose as much of a threat to a potential Thunder dynasty as the other 29 teams. Regardless of the Finals outcome, the NBA will crown its seventh different champion in seven seasons. If the Thunder wins, Gilgeous-Alexander will be the first MVP since Curry in 2015 to capture the regular season honor and hoist the Larry O'Brien Trophy in the same season. Ten years is a long drought for MVPs. In the NBA's first 69 seasons, 14 MVPs ended their remarkable runs with a parade. Because several of them did it multiple times, there have been 23 instances in which the MVP winner captured the most coveted prize. In other words, one-third of the time the MVP went home satisfied through 2015. In the decade since, the award has culminated in postseason chatter about that superstar's shortcomings. Even though Jokic (a three-time MVP) and Giannis Antetokounmpo (twice the MVP) eventually won titles, they endured plenty of criticism about their worthiness because they didn't have great playoff results during their MVP seasons. Joel Embiid, the oft-injured 2023 MVP, still hears it. There are fewer guarantees in the NBA, but current superstars are judged by a standard that the league has all but destroyed. That's the 'weird energy' that James referenced in his gripe. The NBA is different, lucrative, stable now. It doesn't want a face anymore. It wants more teams to have an opportunity. The transition will be uncomfortable. The television ratings for the 2025 Finals seem certain to reflect that. There will be as much talk about a Greek Freak trade as dissection of the Thunder's defense. That's sad, but it will make clear how much work remains for the league and its television partners to sell this newfound parity. If the dynasty era is over, so are the days of the savior. But until the kingdom completes its rebranding, some will always pine for a king.
