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FDA placed clinical hold on Gilead HIV treatment trials of GS-1720

FDA placed clinical hold on Gilead HIV treatment trials of GS-1720

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The Food and Drug Administration has placed a clinical hold on Gilead's (GILD) HIV treatment trials of GS-1720 and/or GS-4182, the company said in a statement. The clinical hold is due to the identification of a safety signal of decreases in CD4+T-cell and absolute lymphocyte counts in a subset of participants receiving the combination of GS-1720 and GS-4182, the company explained. It added, 'Clinical trial investigators involved in the trials have been informed of these actions. GS-1720 and GS-1482 are investigational agents and have not been approved anywhere globally. We intend to investigate and pursue the potential of both agents and are committed to working with regulatory authorities to resolve the issues underlying the clinical hold. Gilead has multiple other long-acting oral and injectable investigational HIV treatment combinations under evaluation in clinical and preclinical studies, including combinations with weekly, monthly, quarterly, and twice-yearly dosing. This hold does not impact these combinations or their respective clinical or pre-clinical development programs.'
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How stress shapes cancer's course
How stress shapes cancer's course

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time31 minutes ago

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How stress shapes cancer's course

About two millennia ago, the Greek physicians Hippocrates and Galen suggested that melancholia—depression brought on by an excess of "black bile" in the body—contributed to cancer. Since then, scores of researchers have investigated the association between cancer and the mind, with some going as far as to suggest that some people have a cancer-prone or "Type C" personality. Most researchers now reject the idea of a cancer-prone personality. But they still haven't settled what influence stress and other psychological factors can have on the onset and progression of cancer, Knowable Magazine notes. More than a hundred epidemiological studies—some involving tens of thousands of people—have linked depression, low socioeconomic status and other sources of psychological stress to an increase in cancer risk, and to a worse prognosis for people who already have the disease. However, this literature is full of contradictions, especially in the first case. In recent decades, scientists have approached the problem from another angle: experiments in cells and animals. These have revealed important mechanisms by which stress can alter tumors, says Julienne Bower, a health psychologist at UCLA who coauthored a 2023 article on the connection between the brain and the immune system in diseases, including cancer, in the Annual Review of Clinical Psychology. Such studies are showing that "psychological factors can influence aspects of actual tumor biology," she says. On the flip side, studies in people and animals suggest that blocking the chemical signals of stress may improve cancer outcomes. Today, a growing number of researchers think that psychological factors can influence cancer's progression once someone has the disease. "I don't think anyone appreciated the magnitude by which even mild stress, if it's chronic, can have such a negative influence on cancer growth," says Elizabeth Repasky, a cancer immunologist at the Roswell Park Comprehensive Cancer Center in Buffalo, New York. New interest in the relationship between stress and cancer growth emerged in part from research into how stress affects the body's response to human immunodeficiency virus (HIV). In the 1990s and early 2000s, genomics researcher Steve Cole and his team at UCLA investigated why people infected with HIV who were under high stress tended to have worse outcomes, including larger viral loads and poorer responses to antiretroviral drugs. Cole's team discovered several routes through which stress could worsen HIV infections. In monkeys, they found, the lymph nodes of stressed animals had many more connections to sympathetic nerve cell fibers—which execute the body's fight-or-flight response—than the nodes of unstressed monkeys. Lymph nodes contain immune cells, and the nerve fibers reduced the antiviral function of these cells, which, in turn, led to an increase in the replication of a version of HIV that infects monkeys and apes. Lymph nodes, in addition to housing immune cells, also act as the body's drainage system, flushing away toxins through a network of tissues, organs and nodes called the lymphatic system. Importantly, cancer cells can hijack this system, using it to travel through the body. Erica Sloan, a postdoctoral trainee of Cole who was involved in the HIV work, wondered whether stress, via the sympathetic nervous system, might also affect lymph nodes in those with cancer. Sloan, now a cancer researcher at Monash University in Australia, went on to discover in mice that chronic stress increases the number of connections between the lymphatic system and breast tumors, making the cancer cells more likely to spread. Strikingly, treatment with a drug—a beta blocker that blunts the activity of key molecules of the sympathetic nervous system such as norepinephrine—prevented these effects. Research by other groups has shown that stress can lead to molecular changes, particularly within the immune system, that influence how cancer progresses. Some of this work suggests that, when stress leads to inflammation—a broad immune reaction typically brought on by injuries and infections—it can boost the growth of tumors. Stress can also impair the activity of immune cells that play an active role in fighting cancer. In the early 2000s, research by University of Iowa behavioral scientist Susan Lutgendorf and her colleagues found that in patients with ovarian cancer, depression and anxiety were associated with impaired tumor-fighting immune cells. In another study of people with ovarian cancer, the researchers found that poor social support was linked to higher levels of a growth factor that stimulates blood vessel growth around tumors. This growth, called angiogenesis, enables new blood vessels to supply nutrients to tumors and—like the lymphatic system—provide pathways through which cancer cells can spread to other parts of the body. Lutgendorf and her colleagues have since found that stressful situations have a similar effect on mice with ovarian cancer, enhancing tumor angiogenesis and cancer spread. Equally important, they've found that these effects can be reversed with beta blockers. Other groups have found similar effects of blocking stress signals on other types of cancer in rodents, including blood and prostate cancer. In addition, researchers have found that increasing levels of stress hormones such as norepinephrine and cortisol in mice can make previously dormant cancer cells more likely to divide and form new tumors. Studies like these are revealing that stress can trigger a cascade of biochemical changes and alter a cancer cell's environment in a way that may promote its spread. "Stress signaling and stress biology really have an impact on most—if not all—of these processes," says Jennifer Knight, a cancer psychiatrist at the Medical College of Wisconsin. If stress can make cancer worse, how can the process be stopped? Little by little, new treatments are emerging. For about half a century, clinicians have used beta blockers to treat hypertension. By scouring data from patient registries, researchers found that people with cancer who already had been taking certain kinds of beta blockers at the time of diagnosis often had better outcomes, including longer survival times, than those who were not on the medicines. Over the past few years, several clinical trials—most of which are small and early-stage—have directly tested whether beta blockers could benefit people with cancer. In one pair of studies, a research team led by neuroscientist Shamgar Ben-Eliyahu at Tel Aviv University, administered the beta blocker propranolol along with an anti-inflammatory drug to people with colorectal or breast cancer five days before surgery. The team chose this timing because earlier research had shown that while surgery is an opportunity to remove the tumor, it can also paradoxically provide the chance for the cancer to spread. So blocking any potential effects of stress on cancer spread, they reasoned, could be crucial to a patient's long-term prognosis. These trials, which involved dozens of patients, revealed that the tumor cells of those who received the drugs showed fewer molecular signs of being able to spread—a process known as metastasis—less inflammation, and an increase in some tumor-fighting immune cells. For colorectal cancer patients, there were also hints that the intervention could reduce cancer recurrence: Three years after the procedure, cancer returned in two of the 16 patients who received the drugs, compared to six of 18 patients who didn't receive those meds. Other studies have assessed the effect of using beta blockers alone, without anti-inflammatory drugs. In 2020, Sloan and her colleagues published a study including 60 breast cancer patients, half of whom were randomly assigned to receive propranolol a week before surgery, while the other half received a placebo. They, too, found that tumor cells from patients who received beta blockers had fewer biomarkers of metastasis. Stress-reducing beta blockers may also benefit other cancer treatments. In a 2020 study, Knight and her team looked at the effect of beta blockers in 25 patients with multiple myeloma who were receiving blood stem cell transplants. Patients who took beta blockers had fewer infections and faster blood cell recovery—although the study was too small to properly evaluate clinical outcomes. And in a small study of nine people with metastatic skin cancer, Repasky and her colleagues found hints that beta blockers might boost the effectiveness of cancer immunotherapy treatments. While studies on beta blockers are promising, it's not clear that these drugs will improve outcomes in all kinds of cancers, such as lung cancer and certain subtypes of breast cancer. Some patients can react badly to taking the medications—particularly those with asthma or heart conditions such as bradycardia, in which the heart beats unusually slowly. And, crucially, the drugs only block the endpoint of stress, not its cause, Repasky says. They will therefore likely need to be combined with mindfulness, counseling and other stress-reducing strategies that get closer to the root of the problem. Such interventions are also in the works. Bower and her team have conducted clinical trials of mind-body interventions such as yoga and mindfulness meditation with breast cancer survivors, to improve health and promote lasting remission. They've found that these therapies can decrease inflammatory activity in circulating immune cells, and they speculate that this may help to reduce tumor recurrence. Ultimately, bigger clinical trials are needed to firmly establish the benefits of beta blockers and other stress-reducing interventions on cancer survival outcomes—and determine how long such effects might last. The timing of treatment and the type of cancer being treated may play a role in how well such therapies work, researchers say. But lack of funding has been a barrier to conducting the larger follow-up studies needed to answer such questions. The work isn't yet backed by pharmaceutical companies or other organizations that support large studies in oncology, Knight says. And for now, whether stress can increase a person's risk of developing cancer in the first place, as the ancient Greeks once postulated, remains a mystery. Population studies linking stress to cancer risk are often complicated by other factors, such as smoking, poor nutrition and limited access to health care. "We have no definitive way of saying, 'If you're stressed out, you're going to develop cancer,'" says Patricia Moreno, a clinical psychologist at the University of Miami Miller School of Medicine and coauthor of an article in the 2023 Annual Review of Psychology about stress management interventions in cancer. But for people who already have a cancer diagnosis, many researchers argue that the evidence is strong enough to include stress management in clinical practice. On average, cancer patients do not receive psychological therapies that can reduce stress at the level for which they are needed, says Barbara Andersen, a clinical psychologist at Ohio State University. Although they won't be necessary for every patient, many can benefit from mind-body interventions, she says. "I'm not saying they should be a first priority, but they shouldn't be the last." This story was produced by Knowable Magazine and reviewed and distributed by Stacker.

DOGE cuts pass House, despite some GOP opposition
DOGE cuts pass House, despite some GOP opposition

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DOGE cuts pass House, despite some GOP opposition

WASHINGTON — The House advanced the first round of requested spending cuts from the Trump administration in a narrow party-line vote, overcoming the first hurdle to enact a slew of recommendations made by the Department of Government Efficiency earlier this year. Lawmakers voted 214-212 to approve the $9.4 billion rescissions package specifically targeting foreign aid as well as federal funding for organizations the Trump administration has accused of being anti-conservative. The package now heads to the Senate, which will have until July 18 to approve the requests otherwise the halted funding must be continued. All four members of Utah's House delegation voted in favor of the package. The fate of the bill appeared to be in peril when six Republicans initially voted against the measure on the floor, setting it up to fail. However, GOP leaders huddled with holdouts on the floor and managed to get two of those defectors to flip. The package looks to cut $1.1 billion from the Corporation for Public Broadcasting, a nonprofit organization authorized by Congress in 1967. Every year, Congress appropriates funds to the CPB which are then distributed to more than 1,500 public media stations through community service grants. The spending cuts specifically target stations such as PBS and NPR, which the Trump administration claims unfairly target conservatives and the Republican Party. The package also cuts funding to the United States Agency for International Development, which provides foreign aid, as well as funds for the World Health Organization. The bill proposes millions of dollars in cuts to the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), a program started under the George W. Bush administration focusing on the prevention and treatment of HIV/AIDS. The rescissions package would cut more than $8 million dedicated to the program. Those provisions initially put the package in murky territory as several moderate Republicans opposed cuts to the programs, specifically pointing to PEPFAR as 'one of the most successful public health programs in the world.' Other Republicans questioned the slashed funding to public broadcasting stations, citing strong relationships with their local news outlets. The package now heads to the Senate where it must be passed within 36 days to adhere to rescissions rules. Otherwise, the funds must be unfrozen and allocated to the appropriate agencies. The package will only require a simple majority in the Senate as rescissions packages are exempt from filibuster rules, relieving Republicans from needing to rely on any Democrats to help pass Trump's proposed cuts.

Texas public health departments brace for another $119 million in federal cuts
Texas public health departments brace for another $119 million in federal cuts

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timean hour ago

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Texas public health departments brace for another $119 million in federal cuts

Texas officials have notified local public health departments to brace for $119 million in another round of federal cuts at the end of the month that could impact the state's efforts on disease detection and prevention efforts, including for HIV, diabetes, vaccine outreach and emergency preparedness. The news comes three months after the federal government notified Texas officials it was clawing back $700 million in unspent COVID pandemic funding early, some of which was used to fight the spread of measles in West Texas. With the state's regular biennial legislative session ending less than two weeks ago, the Texas Department of State Health Services has lost its opportunity to ask the state for more money. Lawmakers left Austin increasing state funds to the agency by $86 million over the next two years, but it also expects to lose $685 million in federal funds, due largely to the end of the COVID funds. Imelda Garcia, chief deputy commissioner for the state health agency, made the disclosure on the latest potential cuts at the agency's committee on public health funding and policy on Wednesday. 'We have staff checking the federal grant solution system every day, multiple times a day. We've made phone calls to our federal partners. However, we still don't have any additional information at this time,' Garcia said. Expiring at the end of June, the $119 million involves Centers for Disease Control and Prevention grants that trickle down to local public health departments. Among the hardest potentially hit would be: $28 million to increase vaccine coverage. $36.4 million to prepare local communities for infectious diseases, natural disasters, man-made events and other public health threats. $20 million to help with hospital preparedness during emergency disasters. $25.5 million for HIV prevention. Other programs facing cuts include those to address diabetes, cardiovascular disease, tuberculosis, tobacco use prevention, wastewater testing and some public health-related school funding. Garcia stressed that while none of the $119 million has been formally cut, Texas health officials have not received word yet that the funding would be renewed. 'I wanted to put them on your radar in case there are additional delays that we may see in the coming weeks,' she said. On May 30, Garcia notified health departments to pause HIV prevention and testing spending because the federal government hadn't notified the state that it will be renewing funding for those services. Local public health departments were also told this week at the meeting that there could be more cuts by the end of the year. This comes as Texas ranks among the worst in the country for public health funding. 'In a post-covid COVID world, in a world where we've got this measles outbreak and … you're cutting immunizations. I mean, this just does not make any sense,' Dr. Philip Huang, director of the Dallas County Health and Human Services and the committee's vice chair. He said the cuts ran counter to the messaging from U.S. Health Secretary Robert F. Kennedy who has emphasized his agency should be focused on reducing the impact of chronic disease. 'You say your priorities are chronic disease, and you eliminate the whole Office on Smoking and Health and the FDA tobacco control program,' Huang said. 'I mean, this doesn't make sense at all.' When the federal government abruptly cut off $700 million that the state had up until next year to spend, both state and local public health departments laid off employees. In May, the agency offered 63 employees transfers to other divisions and 32 employees were terminated. Of those laid off, 19 were fellows whose tenure ended a week early. Huang noted that he had to lay off more than 20 employees. Amy Yeager, director of the Bell County Public Health District, noted that the day after she had to temporarily close the district's health clinic in Temple, the city reported its first measles case involving an unvaccinated man. Texas has been at the center of a historic measles outbreak that has infected close to 750 people statewide and even more across state and international borders. Two children have died and although the number of new cases have decreased in recent weeks, the state can't consider the outbreak over until there are 42 days without a new infection. Huang asked Garcia if the CDC could provide any leeway, perhaps, in light of the fact that Texas has been spending so many resources battling the measles outbreak. 'I think they're sympathetic, but there's so much going on. So, CDC doesn't have a full time director as yet, so they are just having difficulty getting decisions made, is what we have heard,' Garcia said. Big news: 20 more speakers join the TribFest lineup! New additions include Margaret Spellings, former U.S. secretary of education and CEO of the Bipartisan Policy Center; Michael Curry, former presiding bishop and primate of The Episcopal Church; Beto O'Rourke, former U.S. Representative, D-El Paso; Joe Lonsdale, entrepreneur, founder and managing partner at 8VC; and Katie Phang, journalist and trial lawyer. Get tickets. TribFest 2025 is presented by JPMorganChase.

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