Medical Bulletin 19/October/2023

Lung cancer treatment research enters a new era

Advances in lung cancer treatment highlight importance of tumour testing at diagnosis

Research presented at the ESMO Congress 2023 sets potential major changes in first-line treatment for patients with NSCLC with targetable tumour cell mutations

More people with non-small cell lung cancer (NSCLC) are likely to benefit from new drugs that target molecular alterations in tumour cells, with less need for chemotherapy, following results of multiple landmark clinical trials reported for the first time in late-breaking presentations at the ESMO Congress 2023.

Better outcomes were achieved with combinations of experimental new drugs targeting common and rare tumour mutations than with standard treatments, with improvements seen in both early and late-stage NSCLC – the type of lung cancer responsible for approximately eight out of 10 cases of the disease.

Results of NSCLC studies presented at the ESMO Congress 2023 also suggest that using mutation-targeted treatment can reduce the need for chemotherapy in some patients, including those with some rarer tumour alterations for which targeted treatment options have previously been limited.

In addition, study data reinforce the value of adding immunotherapy to chemotherapy in some types of NSCLC, including the use of this treatment before surgery for patients with operable cancers to shrink tumours and indicate likely response to further treatment after surgery (so called, neoadjuvant treatment).

Reference: Lung cancer treatment research enters a new era; EUROPEAN SOCIETY FOR MEDICAL ONCOLOGY

Practicing mindfulness with an app may improve children’s mental health

Many studies have found that practicing mindfulness-defined as cultivating an open-minded attention to the present moment-has benefits for children. Children who receive mindfulness training at school have demonstrated improvements in attention and behavior, as well as greater mental health.

When the Covid-19 pandemic began in 2020, sending millions of students home from school, a group of MIT researchers wondered if remote, app-based mindfulness practices could offer similar benefits. In a study conducted during 2020 and 2021, they report that children who used a mindfulness app at home for 40 days showed improvements in several aspects of mental health, including reductions in stress and negative emotions such as loneliness and fear.

The findings suggest that remote, app-based mindfulness interventions, which could potentially reach a larger number of children than school-based approaches, could offer mental health benefits, the researchers say.

“There is growing and compelling scientific evidence that mindfulness can support mental well-being and promote mental health in diverse children and adults,” says John Gabrieli, the Grover Hermann Professor of Health Sciences and Technology, a professor of brain and cognitive sciences at MIT, and the senior author of the study, which appears this week in the journal Mindfulness.

Reference: Treves, I.N., Olson, H.A., Ozernov-Palchik, O. et al. At-Home use of App-Based Mindfulness for Children: A Randomized Active-Controlled Trial. Mindfulness (2023). https://doi.org/10.1007/s12671-023-02231-3.

Low Vitamin D levels associated with worse cognitive function in multiple sclerosis

Low serum 25-OH-vitamin D associated with worse cognitive function in multiple sclerosis suggests a new study published in the Multiple Sclerosis and related disorders.

Cognitive impairment frequently affects people with multiple sclerosis (MS). Low vitamin D has been associated with cognitive dysfunction in different neurodegenerative diseases, and, in MS, with motor disability and disease activity. We aim to investigate associations between vitamin D and cognitive status in MS.

In this cross-sectional study, we included 181 MS patients, recruited consecutively at the MS Unit of the Policlinico Federico II University Hospital of Naples, Italy, between January and April 2022, with serum 25 hydroxy (25-OH) vitamin D measurements using Chemiluminescence-ImmunoAssay, and cognitive assessment using the Brief International Cognitive Assessment for MS (BICAMS), which includes Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT-II) and Brief Visuospatial Memory Test-Revised (BVMT-R).

Lower serum 25-OH-vitamin D was associated with worse cognitive function in MS. Future studies should consider longitudinal variations in cognitive function in relation to vitamin D supplementation.

Reference:Antonio Luca Spiezia, Fabrizia Falco, Andrea Manganelli, Roberta Lanzillo, Vincenzo Brescia Morra, Marcello Moccia.Low serum 25 hydroxy-vitamin D levels are associated with cognitive impairment in multiple sclerosis. Open AccessPublished:September 30, 2023DOI:https://doi.org/10.1016/j.msard.2023.105044