Medical Bulletin 16/ October/ 2024 - Video

Doctors are hailing a new treatment regime for cervical cancer that could possibly reduce the risk of dying by 40%, in the biggest advance against the disease in 25 years. In research led by University College London, it has been reported that the results of the phase-three clinical trial showed a 40% reduction in the risk of death from the disease and a 35% reduction in the risk of cancer coming back within at least five years. Their findings have been published in the Lancet.

The new treatment plan was tested in patients recruited over 10 years from the UK, Mexico, India, Italy and Brazil.

Dr Mary McCormack, the lead investigator of the trial at UCL, said “This is the biggest gain in survival since the adoption of chemoradiation in 1999”

“Every improvement in survival for a cancer patient is important, especially when the treatment is well-tolerated and given for a relatively short time, allowing women to get back to their normal lives relatively quickly.”

Researchers at UCL and University College London hospital (UCLH) completed a long-term follow-up of patients who were given the short course of chemotherapy before chemoradiation.

The Interlace trial, funded by Cancer Research UK and UCL Cancer Trials Centre, looked at whether a short course of induction chemotherapy prior to chemoradiation could cut relapses and deaths among patients with locally advanced cervical cancer that had not spread to other organs.

The trial recruited 500 women who were randomly allocated to receive either the new treatment regime or the standard chemoradiation treatment. In the study, one group received the new regime of six weeks of carboplatin and paclitaxel chemotherapy. This was followed by standard radiotherapy plus weekly cisplatin and brachytherapy chemotherapy, known as chemoradiation. The control group received only the usual chemoradiation.

After five years, 80% of those who received a short course of chemotherapy first were alive and for 72% their cancer had not returned nor spread. In the standard treatment group, 72% were alive and 64% had not had their cancer return or spread.

Reference: Induction chemotherapy followed by standard chemoradiotherapy versus standard chemoradiotherapy alone in patients with locally advanced cervical cancer (GCIG INTERLACE): an international, multicentre, randomised phase 3 trial McCormack, MaryReed, Nicholas et al.The Lancet, Volume 0, Issue 0

Ahead of the 2024 World Health Summit, in which the World Health Organization (WHO) is a partner, a new report by the Lancet Commission on 'Investing in Health' has set a goal of cutting the probability of premature deaths around the world in half by 2050.

Seven of the 30 most populous countries, including Bangladesh, Ethiopia, Iran, and Turkiye, are on track to meeting the "ambitious," yet "feasible" goal, which the report's authors have called '50-by-50'.

The international team includes authors from institutions such as Harvard University's School of Public Health, the WHO, and Public Health Foundation of India, New Delhi.

They explained that on average, a 2019-born person had a 31 per cent chance of dying before turning 70 years of age. If the 50-by-50 goal was achieved globally, a 2050-born individual can expect to have only a 15 per cent chance of dying before turning 70, they said.

The authors said that the gains made by the seven countries in slashing chances of early death can be achieved early on the route to providing full universal health coverage.

To achieve the 50-by-50 goal, tobacco control, including taxation, is the most important policy that governments can adopt, given the tobacco-related deaths and the established capacity of governments to implement tobacco policy, the team said.

With regards to the exceptionally high death risk from pandemics, the authors attributed the success of the best-performing nations, such as China and Japan, to national implementation of public health fundamentals -- early action, isolation and quarantine, along with financial support for the exposed.

They said that scaling up investments and services for only 15 priority health conditions -- eight infectious and maternal health conditions, and seven non-communicable disease and injury-related conditions -- could cut premature deaths by 50 per cent by mid-century in the countries choosing to do so.

A decline in deaths due to these 15 conditions were key to the gains made in life expectancy between 2000 and 2019, the authors said.

However, the interventions addressing these 15 conditions continue to be inaccessible to millions, they said and attributed it to the lack of focus in the high-priority initial steps of universal health coverage.

Other fiscal policies, including taxation of unhealthy food and drinks and removing fossil fuel subsidies, would benefit health directly and create revenue that can be invested in health services, the authors said.

"The 50-by-50 goal, with an interim milestone of a 30 per cent reduction in the probability of premature death by 2035, remains within reach," the authors wrote.

Reference: Global health 2050: the path to halving premature death by mid-century Jamison, Dean T et al. The Lancet, Volume 0, Issue 0

Using gene therapy, Shriners Children’s St. Louis Director of Research Dr. Farshid Guilak and Senior Scientist Dr. Ruhang Tang have discovered a revolutionary new way to convert harmful fatty acids into beneficial ones, making it possible for children battling obesity to lower the risk of other health problems, particularly arthritis. The findings were published in Proceedings of the national academy of sciences.

According to the Centers for Disease Control, nearly 20% of children and teens are considered obese. Research shows it can have a dramatic impact on a variety of health conditions, including arthritis, heart conditions and other metabolic problems, and the American Academy of Pediatrics now recommends early and intensive treatment to combat obesity.

"We’ve learned that the number one preventable risk factor for arthritis in children is being overweight,” said Dr. Guilak. “Our typical response is simply telling kids to lose weight, without addressing the larger issue. Childhood obesity has become an epidemic, and as a result, arthritis is becoming increasingly common in children. One of our key findings is that it’s not just the obesity itself that’s harmful, but also the diet. The types of fatty acids children consume play a significant role in a child’s weight gain. And once children are obese, it opens the door for other significant health problems that can be hard to reverse.”

Dr. Tang said their gene therapy technique involves utilizing an inactive virus, adeno-associated virus (AAV), to deliver the gene for a specific enzyme into cells. The new gene therapy automatically converts highly inflammatory Omega-6 fatty acids to Omega-3 fatty acids, which are better for the body’s metabolic health. Dr. Guilak said Omega-6 acid tend to promote inflammation and can lead to health issues such as arthritis, heart disease, and metabolic problems. Omega-3 can support a healthier metabolic profile by improving insulin sensitivity, promoting fat metabolism, and reducing inflammation and the risk of obesity-related diseases.

In this study, the researchers studied a type of arthritis that is very common in children, termed “post-traumatic arthritis”, caused by injury to the knee such as a tear in the meniscus tissue that serves as a stabilizer and cushion in the knee. The team found that one injection of the gene therapy significantly decreased the effects of a high-fat, omega-6-rich diet on overall metabolic health and knee arthritis. Of particular interest was the finding that diet-induced obesity led to premature “aging” in these mice, which was prevented by gene therapy.

Reference: Tang, R., et al. (2024). Gene therapy for fat-1 prevents obesity-induced metabolic dysfunction, cellular senescence, and osteoarthritis. Proceedings of the National Academy of Sciences. doi.org/10.1073/pnas.2402954121.

People with a preference for sweets are at a higher risk of developing depression, diabetes, and suffering a stroke, according to new research from the University of Surrey.

The study, published in the Journal of Translational Medicine, took anonymised information on the food preferences of 180,000 volunteers within the UK Biobank and used artificial intelligence to group them into three general profiles:

Health-conscious: prefer fruits and vegetables over animal-based and sweet foods.

Omnivore: Likes most foods, including meats, fish, and some vegetables, as well as sweets and desserts.

Sweet tooth: Prefer sweet foods and sugary drinks and is less interested in healthier options like fruit and vegetables.

The Surrey team looked at UK Biobank data on blood samples where 2,923 proteins and 168 metabolites had been measured to see how these levels changed in each group.

By comparing these blood-based proteins and metabolites, the researchers could get a clearer picture of the biological differences between the groups.

Professor Nophar Geifman, senior author of the study and Professor of Health and Biomedical Informatics at the University of Surrey, said:

"The foods that you like or dislike seem to directly link to your health. If your favourite foods are cakes, sweets, and sugary drinks, then our study's results suggest that this may have negative effects on your health. We found that the sweet tooth group are 31% more likely to have depression. We also found that the sweet tooth group had higher rates of diabetes, as well as vascular heart conditions, compared to the other two groups.

"Importantly, by using data-driven Artificial Intelligence methods, we were able to identify groups of people defined by their food preferences, and these groups are meaningful in that they are linked to health outcomes as well as biological markers.

The researchers also looked at differences between the three groups in standard blood biochemistry tests.

Professor Geifman continues:

"In the sweet tooth group, they had higher levels of C reactive protein, which is a marker for inflammation. Their blood results also show higher levels of glucose and poor lipid profiles, which is a strong warning sign for diabetes and heart disease."

Conversely, the health-conscious group, which also had higher dietary fibre intake, had lower risks for heart failure, chronic kidney diseases and stroke, while the omnivore group had moderate health risks.