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BBC News
2 days ago
- Health
- BBC News
Major study proves exercise improves cancer survival
An exercise programme for colon cancer patients can cut the risk of dying by a third, a major international trial researchers said it was "not a large amount" of exercise and any type of workout from swimming to salsa classes results could change the way colon cancer is treated around the are already investigating whether similar exercise regimes could improve survival for people with other diseases, such as breast cancer. "It's a bit of a mind-shift, thinking of treatment as something you do, not just something you take," says researcher Prof Vicky Coyle from Queen's University the trial, the three-year exercise programme started soon after aim was to get people doing at least double the amount of exercise set out in the guidelines for the general could be three-to-four sessions of brisk walking a week, lasting 45-60 minutes, Prof Coyle got weekly face-to-face coaching sessions for the first six months, which then dropped to once a trial, involving 889 patients, put half on the exercise programme. The other half were given leaflets promoting a healthy results, published in the New England Journal of Medicine, showed after five years:80% of people exercising remained cancer-freecompared with 74% in the other groupmeaning a 28% reduction in the risk of the cancer coming back, or a new one formingMeanwhile, eight years after the initial cancer treatment:10% of people on the exercise programme diedcompared with 17% in the group given only health advicemarking a 37% lower risk of deathExactly why exercise has this beneficial effect is unknown, but ideas include the impact on growth hormones, inflammation levels in the body and how the immune system functions - which patrols the body for Joe Henson, from the University of Leicester, said the results were "exciting".He added: "I saw first-hand that this reduced fatigue, lifted people's mood and boosted their physical strength."We know that physical activity regulates several key biological processes that could explain these results, and further research will help us uncover why exercise is having such a positive impact."Colon cancer is the fourth most common cancer in the UK, with around 31,800 people diagnosed each Geraghty, from Cancer Research UK, said: "This trial has the potential to transform clinical practice, but only if health services have the necessary funding and staff to make it a reality for patients."
Yahoo
3 days ago
- Business
- Yahoo
'Liquid biopsies' alert advanced breast cancer patients when new drugs are needed
New research suggests that blood tests known as 'liquid biopsies' can improve the treatment of some people with metastatic breast cancer and help their tumors remain under control for more than a year. For many, it's been a long time coming: More than a decade ago, researchers and investors predicted that liquid biopsies — which are sensitive enough to detect tumor cells and DNA in the blood — would be 'game changers' in the realm of cancer. Although liquid biopsies haven't replaced standard cancer screening methods like mammograms and colonoscopies, the new study and others like it demonstrate that the blood tests can help doctors monitor cancer and help them select treatments most likely to work. Liquid biopsies are so sophisticated that they can detect minuscule bits of DNA that have leaked out of tumor cells and are floating freely in the blood. The most sensitive liquid biopsies, like those used in the new study, go one step further, detecting ominous changes in key proteins in cancer cells. The research — published Sunday in The New England Journal of Medicine and presented at the American Society of Clinical Oncology's annual meeting in Chicago — focused on people whose breast cancers are fueled by estrogen. The most effective treatment for this type of advanced disease includes drugs designed to target specific proteins in breast cancer cells. If those proteins mutate, the drugs stop working, and it's only a matter of time before the cancer begins growing again. By detecting these mutations, liquid biopsies serve as an early warning system that people need a different medication, said Dr. Nicholas Turner, study co-author and a professor of molecular oncology at the Institute of Cancer Research and The Royal Marsden hospital in the United Kingdom. In the new study, people who changed their treatment based on liquid biopsy results were twice as likely to have their tumors controlled than study participants who didn't change therapy. Turner said the approach offers a significant improvement compared with current practice. Currently, doctors look for signs that a cancer treatment is no longer working by performing imaging tests, such as CT scans or PET scans, every three months. These scans allow doctors to see if tumors are getting bigger. The study found that liquid biopsies can detect mutations up to nine months before the changes would have become apparent on scans, Turner said. That gives people the opportunity to abandon ineffective treatments as early as possible and switch to ones with a better chance of controlling the cancer. In about 1 in 10 people in the study, liquid biopsies found that their cancer had developed mutations that would make their current treatment less effective. 'We have very effective treatments, but they can wear off,' Turner said. 'And if they wear off and the cancer starts growing again, it can make the person unwell. If they have cancer in the bones, it can start to cause pain.' Researchers randomly assigned half of the 315 people with mutations to change therapy right away and the other half to continue their medications as usual, said Dr. Massimo Cristofanilli, an author of the study and director of breast medical oncology at Weill Cornell Medicine and NewYork-Presbyterian Hospital. One percent of study participants were men. For the people who changed therapy early, researchers replaced a hormonal drug they had been taking with an experimental cancer drug called camizestrant, which isn't yet approved by the Food and Drug Administration. Camizestrant interferes with estrogen's ability to stimulate cancer growth. AstraZeneca funded the clinical trial, which was built on early, basic research funded by the National Institutes of Health, Cristofanilli said. In study participants who switched to camizestrant, their cancers remained stable — without significant tumor growth — for 16 months, compared with nine months for people who didn't switch medications, according to the study. After one year, 61% of study participants who switched to camizestrant had stable disease, compared with 33% of those who didn't change treatment, according to the study. After two years, 30% of people who switched still had stable disease, compared with 5% who didn't. Study participants who switched therapies reported good overall health and quality of life for 23 months, compared to others in the study, who reported a deterioration in health and quality of life after 6.4 months. 'If we switch the treatment at just the right time, we can keep the cancer asleep, stop it from progressing and keep the person well,' Turner said. 'Many of my patients get back to work and just keep going with normal lives. They get time with their kids.' Although camizestrant is only available through clinical trials, a similar drug, Faslodex, has been approved by the FDA. Although camizestrant caused more side effects than the hormonal drugs, most people continued taking it. About 1.3% of participants stopped taking camizestrant because of side effects, compared with 1.9% who discontinued therapy with the hormonal drug. Side effects of camizestrant included a reduction in white blood cells and a heart rate that is slower than normal. People taking the drug also were more likely to see flashes or floating spots in their peripheral vision. Dr. Heather Parsons, a medical oncologist at Dana-Farber Cancer Institute in Boston and an assistant professor of medicine at Harvard Medical School, who wasn't involved with the research, said: 'This is an important study, but the results are immature.' 'We need to understand if changing therapy early helps patients or if it leads us to use more toxic therapies sooner,' Parsons said. The study didn't answer a major question: whether the new approach helps patients live longer. Turner said he plans to follow the participants to learn whether the new regimen improves survival. Thanks to better treatments, people with metastatic breast cancer now live about five years after their cancer spreads. That means that it can take several years to detect whether one treatment extends life more than another, Turner said. Doctors don't know if all patients would respond as well as those in the study. Most people in the study were white, with very few Black participants. About 317,000 new cases of invasive breast cancer will be diagnosed in women in the U.S. this year, in addition to 2,800 cases in men, according to the American Cancer Society. About 42,170 people will die from the disease. Dr. Kelly Shanahan, a physician who has lived with estrogen-driven metastatic breast cancer since 2013, called the results 'exciting' and 'compelling.' 'I would certainly want to talk to my oncologist about an early switch if I were in this situation, especially if the side effects of camizestrant were acceptable to me,' said Shanahan, who serves as the director of research and president of the board of METAvivor, an advocacy group for people with metastatic disease. Scientists are developing liquid biopsies to improve the treatment of many types of cancer. In a study published in The New England Journal of Medicine in 2022, researchers in Australia used tumor DNA in the blood to predict which people with early colon cancer would need chemotherapy after surgery — and who could skip it without increasing their risk of relapse. Many doctors now use liquid biopsies when treating colon cancer patients, although the tests used in the study aren't available in all countries, said Dr. Jeanne Tie, the first author of that study and a senior research fellow of personalized oncology at the Walter and Eliza Hall Institute of Medical Research in Victoria, Australia. Liquid biopsies are also being studied to screen healthy people for cancer. For example, the FDA last year approved the first blood test, called Shield, to screen for colorectal cancer. The blood test is not meant to replace the colonoscopy, however, which is still required as part of a definitive diagnosis, and neither the American Cancer Society nor the U.S. Preventive Services Task Force has endorsed Shield as a form of cancer screening. While the Shield test correctly identified 83% of colon cancers, it hasn't been shown to save lives. Doctors might one day use liquid biopsies to provide further answers when mammogram results are unclear, particularly for women with dense breasts, whose tumors are often missed by standard screenings, Cristofanilli said. He hopes that blood tests will reduce the number of painful needle biopsies. This article was originally published on
New York Times
3 days ago
- Health
- New York Times
Exercise Extends Life for People With Cancer, Study Shows
A first-of-its kind study adds powerful new evidence to research showing that exercise improves cancer survival. The study, a randomized controlled trial of nearly 900 patients at 55 cancer centers in six countries, showed that people who participated in a structured exercise program lived longer without their cancer coming back and without the occurrence of new cancers. Participants in the exercise program had a 37 percent lower risk of dying and a 28 percent lower risk of recurrent or new cancer than those in the control group. Earlier research had suggested such a benefit, but the data were from observational studies that did not prove a causal link, experts said. 'We now have definitive evidence that exercise is not just an intervention for quality of life and fitness. This is an intervention that improves survival and should be standard of care,' said Dr. Christopher Booth, the senior author of the paper and a professor of oncology at Queen's University in Canada. The study, which was published Sunday in the New England Journal of Medicine, looked at patients with Stage III or high-risk Stage II colon cancer who received standard surgery and chemotherapy treatment. Researchers randomly assigned these patients to a control group, which received educational materials promoting physical activity and healthy nutrition, or to a treatment group, which also received support from a 'physical activity consultant' — a hybrid of personal trainer and life coach — over three years to increase their aerobic exercise and sustain it. Patients could choose a number of activities, such as biking, jogging, swimming or kayaking, but most opted for a brisk walk of 45 minutes four times a week, Dr. Booth said. Eighty percent of patients in the exercise group remained disease-free after five years, compared to 74 percent of patients in the control group. After eight years, the exercise program had prevented one death for every 14 people who participated in the exercise arm of the study. Want all of The Times? Subscribe.
New York Times
23-05-2025
- Health
- New York Times
The F.D.A. May Restrict Covid Shots. Who Will Be Able to Get Them?
The Food and Drug Administration announced this week that it was likely to limit access to Covid vaccines among healthy children and adults this fall. While the shots will most likely still be available for people 65 and older or with certain underlying conditions, F.D.A. officials say more research is needed to determine whether healthy Americans need a shot every year. But critics say it is dangerous to limit access to vaccines for a virus that still leads to hospitalizations and deaths every day, and continues to evolve. Covid has been linked to more than 1.2 million deaths in the United States, though the rate of hospitalizations and deaths has fallen considerably. The ongoing risk means that many people in the healthy category may still want a vaccine to avoid virus complications, or to protect a high-risk loved one or an infant who has never had Covid. Here's what experts expect if the plan goes forward. Who will be eligible for the vaccine? Historically, almost everyone has been eligible for Covid vaccines; the C.D.C. recommended the most recent vaccine for all Americans over 6 months of age. But in an article published in The New England Journal of Medicine on Tuesday, F.D.A. officials said they would require new research into how effective the Covid vaccines are in healthy people before issuing an updated approval for a broader population. The vaccine is expected to remain available for anyone who is at least 65 or who has a medical condition that can increase the risk of severe illness or death. Those conditions, laid out in a list from the Centers for Disease Control and Prevention, include asthma, cancer, heart disease, diabetes, obesity and mood disorders, among other common conditions. It also includes people with compromised immune systems. The article says an estimated 100 million to 200 million Americans will have access because of underlying conditions, which would amount to roughly 30 to 60 percent of the U.S. population. But that would still leave many Americans ineligible to be vaccinated, including people who are themselves healthy but live with someone who is at high risk. Can people still get the shot at a pharmacy? Right now, yes. For the new round of shots expected this fall, though, the picture is less clear for anyone who isn't deemed eligible. It's possible that some doctors could prescribe Covid vaccines 'off label' — meaning for reasons not included in the F.D.A.'s approval — to people who don't qualify under the agency's proposed plan. But in some states, pharmacists cannot provide an off-label medical product, said Richard Hughes, a lawyer who specializes in vaccine policy. Pharmacies and insurers are also likely to vary in how they deal with people who say they have a qualifying condition, which can be as vague as 'physical inactivity.' Samuel Bagenstos, a law professor at the University of Michigan who served as general counsel to the Department of Health and Human Services under the Biden administration, said the government could potentially require documentation that people meet the eligibility criteria, but that it would be 'extraordinarily unusual.' More likely, Mr. Bagenstos said, insurance companies will serve as the gatekeepers by demanding medical documentation of an underlying condition before agreeing to cover the cost. Currently, neither the government nor major pharmacy chains require medical documentation for people to get a shot, even for the more frequent boosters recommended for some immunocompromised people. Experts say that many of the potential barriers could be overcome by motivated patients who can search for an individual doctor or pharmacist willing to administer the vaccine, and who can afford to pay out of pocket if insurance denies coverage. But, they warn, people with lower incomes — who also face some of the worst outcomes from Covid — may not have the time or resources to find a willing provider or pay for the shots. Will the changes affect insurance coverage? Those who are eligible should see no change, said Troyen Brennan, an adjunct professor at the Harvard T.H. Chan School of Public Health and the former chief medical officer of CVS Health. But everyone else is likely to face new costs, if they're able to get the vaccine at all, he said. That could leave many people in the position of having to pay out of pocket — roughly $140 for the Pfizer or Moderna shot — or appealing after an insurer denies them coverage. These appeals could waste time and money, said Jesse Goodman, the director of Georgetown University's Center on Medical Product Access, Safety and Stewardship. What will the restrictions mean for children? Experts are concerned about how the plan could affect healthy infants and toddlers; the C.D.C. currently recommends that they get a series of Covid shots starting at 6 months. This is because very young children are at higher risk of serious illness. The hospitalization risk for children from birth to 6 months is on par with the risk faced by people who are 65 to 74 years old, and there is also an elevated risk of hospitalization for children up to 2 years old, said Dr. Sean O'Leary, a vaccine expert for the American Academy of Pediatrics. The youngest infants can be covered by immunity from their mothers. The F.D.A. listed pregnant women as a group that would likely be eligible to get the vaccine. But under the new F.D.A. framework, healthy children 6 months or older do not appear to be eligible for Covid vaccinations. Dr. O'Leary said he would be concerned if that were put into practice. A spokeswoman for H.H.S. did not respond to a question about whether children could still get initial vaccines.
CNN
21-05-2025
- Health
- CNN
FDA may limit future Covid-19 shots to older people and those at risk of serious infection
Source: CNN The US Food and Drug Administration is changing the way it approves Covid-19 vaccines for Americans, a move that may limit future shots to older Americans and people at higher risk of serious Covid-19 infection. The agency is changing the type of evidence it will accept from vaccine manufacturers to approve updated Covid-19 shots, Dr. Vinay Prasad, the new director of the FDA's Center for Biologics Evaluation and Research, and FDA Commissioner Dr. Marty Makary said in an editorial published Tuesday in the New England Journal of Medicine. The change means the updated shots will probably be available this fall for adults 65 and older and those with underlying conditions that may put them at higher risk of a severe Covid-19 infection, but they may not be for everyone who was previously eligible. Nearly three-quarters of Americans 6 months and older have at least one of these underlying medical conditions, according to the US Centers for Disease Control and Prevention. The change, which was already being studied by experts who advise the CDC on its vaccine recommendations, will more closely align the United States with guidelines in the UK, Canada and Australia. But millions of healthy adults and kids stand to lose access to updated vaccines under the new criteria. Prasad and Makary say there's not enough evidence that healthy children and adults get clinically meaningful benefit from regular Covid-19 shots, and they want to see more placebo-controlled trials, particularly in adults 50 to 64, before recommending the shots for other groups. It's not clear whether Covid-19 vaccine manufacturers, including Pfizer, Moderna and Novavax, will decide to conduct the randomized controlled trials the FDA is seeking for certain age groups. These kinds of studies are expensive and typically take months or even years. Moderna said in a statement Tuesday, 'We appreciate the FDA's clear guidance and remain committed to working with the Agency to provide the data they need to ensure access for Americans.' Pfizer and Novavax did not respond to requests for comment on the FDA's new regulatory framework. Just days before the FDA's announcement, it approved the Novavax Covid-19 vaccine, which was six weeks past its planned approval deadline. The FDA restricted the use of the vaccine to people 65 and older and those 12 and up with underlying health conditions. 'Market research and US C.D.C. statistics indicate that older individuals and those with underlying conditions are the populations most likely to seek out COVID-19 vaccination seasonally,' Novavax President and CEO John Jacobs said at the time. 'This significant milestone demonstrates our commitment to these populations and is a significant step towards availability of our protein-based vaccine option.' In a discussion shared online Tuesday, Prasad answered some questions about the new requirements that were posed to him by Makary. 'This is a free country, and companies are, of course, free to conduct their own randomized studies in younger populations, in people without risk factors for severe Covid-19,' Prasad said. 'They can run the research agenda they see fit, and we will consider the results of those studies.' Prasad also sought to flesh out why the FDA settled on these age groups and risk factors for vaccine recommendations. For the 50-to-65 age group, 'we are genuinely uncertain, globally, if those patients benefit,' he said, with some countries recommending Covid vaccination for people 65 and older and others as young as 40. 'Fifty to 65, we feel, is an area where there's disagreement among our peer nations. It's a place [where] we can bring data to this question,' he added. Dr. Noel Brewer, a professor of public health and health behavior at the University of North Carolina at Chapel Hill, said he supports the change. 'The proposed policy moves the US in line with other countries. This global view of public health is a welcome development,' said Brewer, who sits on the CDC's Advisory Committee on Immunization Practices and was part of the working group mulling the change to Covid vaccine recommendations. But he and other experts say they're still worried about the youngest children, those under age 2, who have higher rates of hospitalizations from Covid-19 compared with some other age groups. Dr. Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia and a member of the FDA's independent advisory group on vaccines, says he disagrees with the underlying premise of the new framework, which is that previous Covid-19 vaccine recommendations haven't been based on good evidence. 'We have been using an evidence-based approach to Covid-19 vaccination, but they kind of swoop in and believe that for the first time, we're going to get, as they say, 'gold standard' data, robust data, for the first time, because according to them, we don't have that. But we do have that,' Offit said. 'That's why we've made good decisions about the vaccine. That's why that vaccine is remarkably safe. The mRNA vaccines are remarkably safe.' Dr. Jodie Guest, senior vice chair of epidemiology at Emory University's Rollins School of Public Health, said that restricting access to Covid-19 vaccines is a mistake. 'This policy change will increase likelihood of variant emergence and worsen health inequities. Broad vaccination protects more people, reduces disruptions, and is essential for community-wide immunity and pandemic control. It is also likely to make these vaccines less insurable,' Guest said in an email to CNN. The editorial says that going forward, Covid-19 vaccines for people 65 and older and those 6 months and older with underlying health conditions that put them at higher risk from Covid-19 infections will be approved after pharmaceutical companies can demonstrate that they create protective antibody concentrations. These types of studies are called immunobridging studies. They're typically done in a smaller number of people or even in animals, and they can be done quickly so vaccine manufacturing can ramp up in time to have large numbers of shots ready for an expected wave of illness, usually over the fall and winter. This is largely how seasonal flu vaccinations are approved each year in the US, and it's the way the FDA has been approving Covid-19 vaccines for the past few years. For everyone else, the FDA says it will approve vaccines only after studies that prove the shots can prevent symptomatic Covid-19 better than a placebo. The agency will also consider several secondary outcomes, including severe illness, hospitalization and death. The new plan doesn't take into account other effects of Covid-19 infections, such as long Covid. Studies have shown that vaccination may cut the risk of long Covid between 25% and 60%. Covid-19 infections also increase the risk of heart attacks and strokes, and vaccines can help prevent those complications, said Dr. Peter Hotez, director of the Center for Vaccine Development at Texas Children's Hospital in Houston. The FDA is focusing on the short-term impacts of Covid-19 infections but not the long-term ones, he said. 'The reason that's relevant is because that's a major reason why we vaccinate otherwise healthy, younger adults and adolescents, maybe even kids,' Hotez said. 'It's almost as though they forgot about that.' It also doesn't consider whether vaccination may be a good idea for healthy people who want to safeguard vulnerable friends and loved ones who may have depleted immune function. Prasad and Makary say the new policy balances the need to swiftly approve vaccines to have them ready by the fall for the most vulnerable adults and children against the need for more evidence before offering them to others. Additionally, they say, millions of Americans under the age of 65 will still qualify to get a Covid-19 vaccine if they want one if they have any of the health conditions identified by the CDC as raising someone's risk of severe disease from Covid-19. 'Estimates suggest that 100 million to 200 million Americans will have access to vaccines in this manner,' the FDA officials wrote. However, many Americans now get their vaccinations from pharmacies or other settings outside the doctor's office. It's not clear who might be determining or checking to see whether someone is at high risk. 'Do you have to tell the pharmacist why you're at high risk?' Offit asked. 'They're not going to supervise that.' Prasad and Makary say their goal in requiring more evidence for other groups is to restore public trust in vaccines. They noted that for the past two respiratory virus seasons, less than 25% of Americans have received a Covid-19 shot, including less than 10% of kids and less than 50% of adults over the age of 75. They say broad Covid-19 vaccine recommendations and mandates during the pandemic eroded public trust and caused falling vaccination rates for other types of shots too, such as the measles, mumps and rubella vaccine. 'I don't think that's why rates are down. I think rates were down because people don't fear the disease anymore,' Offit said. There's also 'booster fatigue,' public health shorthand for the burnout some people may feel after a steady stream of Covid-19 vaccine recommendations in recent years. 'It has nothing to do with the loss of trust,' Offit added. 'I think the premise is wrong.' CNN's Katherine Dillinger contributed to this report. See Full Web Article
