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Lung cancer survival boosted with immunotherapy treatment



A regimen of pre-surgical immunotherapy and chemotherapy followed by post-surgical immunotherapy significantly improved lung cancer survival rates, according to a new study.

This was compared to the use of chemotherapy alone for patients with operable non-small cell lung cancer.

The findings of the Phase III trial by researchers at The University of Texas MD Anderson Cancer Center were published in the New England Journal of Medicine.

The AEGEAN trial evaluated durvalumab given peri-operatively, meaning therapy is given both before and after surgery.

Participants received pre-surgical (neoadjuvant) durvalumab and platinum-based chemotherapy followed by post-surgical (adjuvant) durvalumab.

Others received a pre-surgical placebo and chemotherapy followed by a post-surgical placebo.

AEGEAN was the first Phase III trial investigating peri-operative immunotherapy in patients with resectable non-small cell lung cancer to report positive outcomes.

“Our goal is to increase cures for lung cancer,” said principal investigator Dr John Heymach, chair of thoracic/head and neck medical oncology at MD Anderson Cancer Center.

“Throughout decades of research with post-surgical and pre-surgical chemotherapy, we only succeeded in increasing cures by around 5%.

“This one study alone has the potential to increase that percentage significantly, and we look forward to many more improvements going forward.”

Success rates

Of the patients receiving peri-operative durvalumab, 17.2% had a pathologic complete response compared to just 4.3% of those receiving chemotherapy alone.

At the first interim analysis of event-free survival, with a median follow-up of 11.7 months, the median event-free survival was 25.9 months in the placebo arm, but had not been reached in the durvalumab arm.

These data correspond to a 32% lower chance of patients experiencing disease recurrence, progression events or death with the immunotherapy-based treatment when compared to chemotherapy alone.

About four times as many patients treated with peri-operative durvalumab plus chemotherapy achieved a pathologic complete response when compared to those treated with chemotherapy alone.

Durvalumab, an immune checkpoint inhibitor targeting PD-L1, has previously been approved for treating patients with biliary tract cancer, liver cancer, small cell lung cancer and non-small cell lung cancer.

Currently, durvalumab is used for treating patients with locally advanced, un-resectable non-small cell lung cancer following definitive chemoradiotherapy, and for patients with metastatic non-small cell lung cancer in combination with tremelimumab and platinum-based chemotherapy.

For resectable non-small cell lung cancer, previous studies have shown some benefit from using post-surgical or pre-surgical immunotherapy, but Heymach explained the benefits have been modest so far.

MD Anderson is engaged in longstanding multidisciplinary efforts to use pre-surgical treatments to improve outcomes for patients.

Numerous clinical studies, such as the NEOSTAR and NeoCOAST trials, are evaluating pre-surgical immunotherapy and novel combinations to eliminate viable tumours before surgery and to reduce recurrence rates.

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CT scan can reveal immune system ageing, research finds



The thymus, a small and relatively unknown organ, may play a bigger role in the immune system of adults than was previously believed, according to a recent study.

Researchers from Linkoping University in Sweden have found that with age, the glandular tissue in the thymus is replaced by fat and the level of its degeneration reflects the ageing of the immune system.

The rate at which this happens is linked to sex, age and lifestyle factors, the study found.

“We doctors can assess the appearance of the thymus from largely all chest CT scans, but we tend to not see this as very important,” said researcher Mårten Sandstedt of the Faculty of Medicine and Health Sciences.

“But now it turns out that the appearance of the thymus can actually provide a lot of valuable information that we could benefit from and learn more about.”

Fatty degeneration

The thymus is a gland located in the upper part of the chest. It has been long known that this small organ is important for immune defence development in children.

After puberty, the thymus decreases in size and is eventually replaced by fat, in a process known as fatty degeneration.

This has been taken to mean that it loses its function, which is why the thymus has for a long time been considered as being not important in adult life.

This view has however been challenged in some minor research studies that indicate that having an active thymus as an adult may be an advantage and could provide increased resilience against infectious disease and cancer.

Only very few studies so far have examined the thymus in adults.

In the latest study, published in Immunity & Ageing, the researchers examined the thymus’ appearance in chest CT scans of more than 1,000 Swedish individuals aged 50 to 64.

They were participating in the large SCAPIS study, which includes both extensive imaging and comprehensive health assessments including lifestyle factors, such as dietary habits and physical activity.

In their sub-study of SCAPIS, the researchers also analysed immune cells in the blood.

“We saw a huge variation in thymus appearance,” Sandstedt said.

“Six out of ten participants had complete fatty degeneration of thymus, which was much more common in men than in women, and in people with abdominal obesity.

“Lifestyle also mattered. Low intake of fibres in particular was associated with fatty degeneration of thymus.”

Immune system

The Linköping researchers’ study provides new knowledge by associating thymus appearance with lifestyle and health factors, and the immune system.

In the development of the immune system, the thymus acts like a school for a type of immune cells known as T-cells.

This is where the T-cells learn to recognise bacteria, viruses and other things that are alien to the body.

They also learn to be tolerant and not attack anything that is part of the person’s own body, which could otherwise lead to various autoimmune diseases.

Researchers saw that individuals with fatty degeneration of the thymus showed lower T-cell regeneration.

“This association with T-cell regeneration is interesting. It indicates that what we see in CT scans is not only an image, it actually also reflects the functionality of the thymus,” said researcher Lena Jonasson.

“You can’t do anything about your age and your sex, but lifestyle-related factors can be influenced. It might be possible to influence immune system ageing.”

But more research is needed before it will be possible to know whether thymus appearance, and thereby immune defence ageing, will have any implications for general health.

The researchers are now moving on to follow-up studies of the thymus of all 5,000 participants in SCAPIS Linköping to see whether CT scan thymus images can provide information on future risk of disease.

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Two out of three UK GPs want more supportive tech for dementia patients



More than two-thirds (67%) of GPs in the United Kingdom would like to be able to prescribe assistive technology to their dementia patients, according to new research.

The Longevity.Technology poll found family doctors were especially keen to see more tech designed to help patients to maintain their independence.

Nearly nine in 10 (88%) GPs think people with dementia who can stay in their own homes will live more fulfilling lives, with over three quarters (77%) saying it will help them to live longer.

Dame Louise Robinson, GP and professor of primary care and ageing at Newcastle University, said GPs are increasingly ‘prescribing’ non-drug interventions to people with long term conditions.

“Technology, especially if it is used as part of a package of person-centred support, can help people with dementia live at home longer which is the ultimate goal,” she added.

However, existing technologies designed for people with dementia mostly focus on monitoring a person living with the condition rather than supporting them to help them maintain independence for longer.

This was a concern shared by 86% of the GPs surveyed.

The Longitude Prize on Dementia, which is funded by Alzheimer’s Society and Innovate UK, and delivered by Challenge Works, conducted the nationally representative poll of GPs.

Kate Lee, CEO of Alzheimer’s Society, said: “It’s encouraging that many GPs join us in seeing the huge potential that tech could bring for the 900,000 people in the UK living with dementia.

“Dementia is a progressive condition set to affect one in three people born today, so we must think more broadly about how to end the devastation it causes, by helping people manage their symptoms and stay independent for longer.

“It’s exciting that soon we may have potential new treatments that could slow the progress of Alzheimer’s disease, but alongside this we need to urgently push forward ways of helping people with dementia right now.

“We believe tech involving people with dementia, for people with dementia, can be a key way of doing this.”

Assistive technologies

Remaining at home can present challenges for people with dementia.

Issues include loss of confidence or developing anxiety when navigating their local area, remembering to take medication or struggling to recognise people.

In the poll, 76% of GPs surveyed said they worry that their patients may become trapped in their own homes because of anxiety and fear about getting lost.

Many of the GPs polled believe their patients would benefit from responsive tech such as an intuitive app to help them navigate their community, tech that reminds people to take medications, or smart glasses that could tell them who they are looking at.

George MacGinnis, healthy ageing challenge director of Innovate UK, explained that the UK has an ageing population with more than 11 million people over 65, which comes with more people living with dementia.

“Assistive technologies that can deploy artificial intelligence to adapt to the changing needs of people living with dementia could offer affordable solutions that help people remain independent in their own homes for many more years than at present,” he said.

Existing technology

Challenging the outdated stereotype that older people are tech-averse, half (49%) of GPs say that the majority of their early-stage dementia patients use technology in their everyday lives.

Many GPs are already advising their dementia patients to use existing technology to manage their conditions, with 64% of family doctors recommending tech-related hacks.

These could include adding simple reminders to take medications on phones and smart speakers.

Of those surveyed, 69% say their patients with dementia are increasingly relying on technology as a memory tool, such as storing relationship details in their phone contacts.

The findings also highlight the need for innovators to consider the progressive nature of dementia in the design of new assistive technologies to adapt to the person’s changing condition.

The Longitude Prize on Dementia is a £4.42 million ($5.12 million) prize to drive the creation of personalised, technology-based tools that are co-created with people in early stages of dementia.

In total, £3.42 million will be awarded in seed funding and development grants to the most promising solutions, with a £1 million first prize to be awarded in 2026.

In June 2023, it announced 24 semi-finalists developing new assistive technologies for people living with dementia, each receiving grants of £80,000.

Between now and next summer, tech creators will work with people living with dementia and their carers to refine their solutions before the five most promising ideas progress to the final stages of the competition.

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