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Good morning. Liz Cooney here filling in for Theresa. Our colleague, Europe correspondent Andrew Joseph, has been covering the European Society of Cardiology meeting in Munich this past weekend (more below). I typically pick up American Heart Association meetings stateside.
Which group has the better venues, assuming one ever escapes the giant conference halls long enough to find out? ESC was in Madrid last year and will land in Milan in 2027. AHA has recently toggled between Chicago and New Orleans, but Boston (STAT’s HQ, btw) gets the nod next year. Tell me your preferences as a conference-goer, or a global traveler.
Maybe ‘mRNA’ is no longer a four-letter word
Maybe, just maybe, using mRNA technology to beat back cancer will mean “mRNA” and “vaccine” are no longer taboo. That hope comes after Moderna and Merck’s stunning success with an mRNA vaccine that lowered the odds of surgically removed melanoma spreading or coming back. Reports on top-line results released last week for the neoantigen cancer immunotherapy seemed to dance around calling it an mRNA vaccine.
“There’s a possibility that people will say, ‘Oh, if we can vaccinate against cancer, that’s good,’” Ryan Sullivan, a Mass General Brigham melanoma physician and immunologist who has worked with Moderna, told STAT’s Angus Chen. “Maybe that will thaw some of the stigma around vaccines. I don’t think it’ll fix all of it, but maybe just a little bit helps us think of ‘vaccine’ not as a dirty word, ‘mRNA’ as not a four-letter word.”
The caution makes sense, given the post-pandemic backlash against all vaccines and Moderna in particular. The same agency that funded Operation Warp Speed’s swift success with Moderna’s Covid-19 vaccine later stripped the company of more than half a billion dollars in grants supporting mRNA vaccine development projects.
Read more about the whiplash — not the first for mRNA therapies.
At ESC, a winner, a loser, and a mid-stage signal
The European Society of Cardiology Congress is wrapping up later today. Here are some highlights from STAT’s Andrew Joseph in Munich:
- A newly acquired Novartis drug successfully lowered signs of inflammation in a mid-stage study attracting attention for targeting interleukin-6, a protein involved in regulating immune responses. Pacibekitug is an antibody that targets the IL-6 pathway, although some experts maintain skepticism about the approach. The hope is that targeting inflammation can reduce people’s risk of heart disease or emergencies like heart attack or stroke.
- If “autopsy” is in the headline, the news can’t be good. And it wasn’t for AstraZeneca. The company disclosed details on the surprise failure of its experimental “silencer” drug to offer additional benefits for patients with the progressive condition ATTR-CM who were largely already on another type of medicine, called a “stabilizer”— the latest twist in a multibillion-dollar market.
- It took Cytokinetics 27 years to win its first regulatory approval. The second one could happen much faster than that. The company unveiled the full pivotal study data of its drug aficamten in an inherited heart condition called non-obstructive hypertrophic cardiomyopathy, showing that the medicine helped patients feel better and exercise more. Already approved for the obstructive form of HCM, if it wins approval for what’s known as nHCM, it would be the first treatment specifically cleared for the non-obstructive kind.
What could be worse after the Lindsay Clancy case
In the Lindsay Clancy case, it sometimes looks like the mental health system is also on trial. While few would say that system is perfect, there could be a dangerous, unintended consequence, two forensic psychiatrists write in a STAT First Opinion. The legal and public scrutiny around the deaths of Clancy’s three young children could make psychiatrists more reluctant to treat mothers with mental illness.
There are too few reproductive psychiatrists to meet the need, leaving general psychiatrists and OB-GYNs to care for mothers with mental illnesses before and after childbirth. Fears of liability could make these doctors wary of treating mothers who need psychiatric help.
“The many psychiatrists and trainees following this case may be more likely to err on the side of caution by overtreating these symptoms with unneeded hospitalization (and possible separation from their infant), and potentially inappropriate referrals to child protective services,” say Renee Sorrentino, a forensic psychiatrist in Boston, and Susan Hatters Friedman, a forensic and reproductive psychiatrist at Case Western Reserve University. “This then would paradoxically make mothers less likely to report their symptoms, to get the treatment that reduces their risk.”
A solution starts with awareness. Read more about what they suggest.
Pushing boundaries for new radiopharmaceuticals
Radiopharmaceuticals are all the rage in some biotech circles, but some voices of caution are saying slow down. That doesn’t sit well with Louise Emmett, a leader in the field who works with such global drugmakers as AstraZeneca and Novartis. She told STAT’s Allison DeAngelis the time to speed up is now, despite safety concerns in some studies about adverse effects on patients’ kidneys, liver, or bone marrow from the targeted treatment. Radiopharmaceuticals work by directing toxic radiation specifically to cancer cells, decimating them on site.
“I’m interested in how we actually improve survival in our patients, not the toxicities,” said Emmett, who is the director of nuclear medicine at St. Vincent’s Hospital in Sydney.
Her study, called OPTIMAL-PSMA, front-loads doses of radiopharmaceuticals, giving more frequent infusions in the first few weeks of treatment than is the industry standard. The one approved drug in this class, Novartis’ Pluvicto, is administered once every six weeks, adhering to dosing guidelines used for external beam radiation.
So far, results have looked promising in Emmett’s trial. Full data will be reported early next year, potentially at the ASCO Genitourinary Cancers Symposium in February.
Read more about who else is trying this approach.
2.7 million
That’s how many more people around the world will be living with type 1 diabetes by 2049. In the U.S., that means an increase of more than half a million cases, topping out at 2,055,235. The global estimate, presented Friday at the annual meeting of the European Association for the Study of Diabetes in Milan, reflects a 29% jump from 9.4 million in 2025 to 12.1 million near the mid-century mark. New cases per year, projected to grow by 14%, are rising more sharply in low-income countries, but absolute numbers remain higher in high-income countries. The researchers say those differences likely stem from a combination of genetics, environmental triggers, and higher case-detection rates in high-income countries.
Who left the dog out?
We all know service animals, often dogs that help humans better navigate the world. Some of us may have seen therapy dogs in the hospital, offering comfort and bringing smiles to patients young and old. But the bond between animals and humans can sometimes get in the way of health, rather than promoting it, if having to care for a dog, for example, means the human says no to a recommended hospital admission.
In their perspective published Saturday in the New England Journal of Medicine, a veterinarian and an oncologist quickly point out the social determinants of health at play in this scenario. What if pet care costs too much? What if the patient is unhoused?
They offer a simple way to solve the problem: talk to the patient.
“Asking about a patient’s pets can improve clinical encounters and strengthen the clinician-patient relationship,” Rustin Moore of the College of Veterinary Medicine at Ohio State University and Reshma Jagsi in the department of radiation oncology at Emory University School of Medicine write. “Physicians who initiate such conversations report improved communication, greater patient openness, and disclosure of information relevant to care, such as responsibilities and routines that shape how patients’ decisions are made.”
No word from the dogs.
What we’re reading
- Juul gets OK to sell updated vaping device with age-gating technology,
Associated Press
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Forced birth control in Greenland violated women’s rights but didn’t constitute genocide, experts find, Reuters
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Celebrities are raving about full-body scans. Doctors urge caution, New York Times
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Listen to 911 calls from inside an immigration detention center: ‘We just need to take him to the hospital,’ ProPublica
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Opinion: The most shocking thing about the latest statistics on CTE in football is that we find them so shocking, STAT