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Tag: Los Angeles (UCLA)

  • About 22 high school age adolescents died each week from overdoses in 2022, driven by fentanyl-laced prescription pills

    About 22 high school age adolescents died each week from overdoses in 2022, driven by fentanyl-laced prescription pills

    BYLINE: Enrique Rivero

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    About 22 high school age adolescents died each week from overdoses in 2022, driven by fentanyl-laced prescription pills

    Newswise — An average of 22 adolescents 14 to 18 years of age died in the U.S. each week in 2022 from drug overdoses, raising the death rate for this group to 5.2 per 100,000– driven by fentanyl in counterfeit pills, new research finds.

    Adolescent overdoses had more than doubled among this group between 2019 and 2020, and have since intensified to such an extent that the death count equals a high school classroom each week, and is now the third largest cause of pediatric deaths behind firearm-related injuries and motor vehicle collisions. 

    The increase is, however, not due to more illicit drug use – which has in fact fallen over the years; for example, excluding cannabis, the rate of any illicit drug use among just 12th graders had fallen from about 21% to 8% in the 20 years since 2002. Instead, the increase is the result of drugs becoming deadlier due to fentanyl, which is increasingly found in counterfeit oxycodone, benzodiazepines and other prescription pills that fall into the hands of adolescents.

    But educators, physicians, and mental health practitioners can be instrumental in helping to stem this tide through pointed questions and guidance about drug use and the dangers that counterfeit pills present, the researchers write in a paper published in the New England Journal of Medicine. In addition, policymakers can focus on “hotspot” counties, most in western states, with particularly high overdose deaths.

    “Teenagers are likely to be unaware of just how high-risk experimenting with pills has become, given the recent rise in counterfeit tablets” said study co-author Joseph Friedman, a researcher at UCLA. “It’s often impossible to tell the difference with the naked eye between a real prescription medication obtained from a doctor and a counterfeit version with a potentially deadly dose of fentanyl. It’s urgent that teenagers be given accurate information about the real risks, and strategies to keep themselves and their friends safe.” 

    The researchers found that adolescent overdoses were occurring at double the national average in Arizona, Colorado and Washington State between 2020 and 2022. They identified 19 hotspot counties – that is, those with at least 20 overdose deaths and death rates higher than the national average, with Maricopa County in Arizona and Los Angeles County having the most fatal overdoses at 117 and 111, respectively, during this period. 

    The other 17 counties are Orange County, California (61 deaths), Cook County, Illinois (56), San Bernardino County, California (54), King County, Washington (52), Riverside County, California (41), San Diego County, California (36), Tarrant County, Texas (35), Clark County, Nevada (31), Kern County, California (30), Pima County, Arizona (29), Adams County, Colorado (25), Denver County, Colorado (24), Jackson County, Missouri (24), Santa Clara County, California (24), Bernalillo County, New Mexico (23), Davidson County, Tennessee (21), and Marion County, Indiana (21). 

    In addition, American Indian and Alaska Native adolescents had 1.82 times the overdose rates of whites between 2020 and 2022. And adolescents are overall likelier to use the pill form of the drug rather than powder, which was previously the main fentanyl source. For instance, while 0.3% of high school seniors in 2022 reported using heroin, which comes in powder form, 5% reported nonmedical use of prescription pills the same year.

    The researchers provide the following recommendations to combat these trends:

    • Pediatricians, other primary care physicians, and mental health practitioners should ask their adolescent patients if they or their peers were approached either in person or via social media about buying pills, or if they have used them without prescriptions
    • Educators, along with parents, can discuss with adolescents the dangers associated with counterfeit pills; these efforts should be especially prioritized in hotspot locations
    • Clinicians, educators and parents can highlight the Safety First curriculum that emphasizes abstinence from drugs and provides information about risk reduction for those who do experiment with drugs, such as where to find and how to use the overdose-reversal agent naloxone
    • Finally, naloxone should be available in schools, which should also adopt “no-questions-asked” pill-disposal programs as well as provide anonymous mechanisms such messaging services that students can use to ask about counterfeit pills and substance use without risk of punishment or embarrassment.

    “Fentanyl has rapidly become a leading cause of death in American teens,” said Dr. Scott Hadland, chief of adolescent medicine at Mass General for Children and senior author on the paper. “Policymakers, clinicians, families and communities need to partner together to address this worsening public health threat.”

    University of California, Los Angeles (UCLA), Health Sciences

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  • Antibody-drug conjugate helps patients with metastatic non-small cell lung cancer live longer, delaying disease progression

    Antibody-drug conjugate helps patients with metastatic non-small cell lung cancer live longer, delaying disease progression

    BYLINE: Denise Heady

    Newswise — Treatment with datopotamab deruxtecan (Dato-DXd), a novel Trop-2 directed antibody-drug conjugate, was found to significantly improve progression-free survival in patients with metastatic non-small cell lung cancer, an improvement that was primarily driven by patients with non-squamous tumors.

    These results from the TROPION-Lung01 Phase III trial, which compared the standard of care in second-line docetaxel, a type of chemotherapy, with Dato-DXd, an antibody drug conjugate, in patients with pretreated metastatic non-small cell lung cancer, were presented at the European Society for Medical Oncology 2023 Congress by Dr. Aaron Lisberg, assistant professor of medicine and thoracic medical oncologist at the UCLA Health Jonsson Comprehensive Cancer Center and the David Geffen School of Medicine at UCLA.

    Lisberg and the team found that patients treated with Dato-DXd experienced a 25% reduction in the risk of disease progression or death compared to patients treated with docetaxel.

    “While there was an overall reduction of disease progression, the data clearly indicates that this benefit was primarily driven by patients with non-squamous tumors,” Lisberg said.

    More than 75% of enrolled patients had non-squamous tumors, noted Lisberg. And in that group alone, the therapy reduced the risk of disease progression or death by 37%, while patients with squamous tumors did not appear to derive a therapeutic benefit from Dato-DXd on trial.

    In addition, a trend in favor of Dato-DXd was observed in the interim overall survival analysis. In those assessments of how long a patient will live after receiving a therapy for their cancer, the improvement was most pronounced in the non-squamous population with a reduction in the risk of death of 23% with Dato-DXd.

    The improvements in progression-free and overall survival observed in the Dato-DXd treated patients were accompanied by significant tumor shrinkage with Dato-DXd (26.4%) vs docetaxel (12.8%), a difference that was more pronounced in patients with non-squamous tumors (31.2% vs 12.8%).

    The overall safety profile of Dato-DXd was superior to docetaxel as fewer patients had high grade drug related toxicities with Dato-DXd (25%) compared to docetaxel (41%). Common side effects of Dato-DXd included mild to moderate mouth sores and nausea. There were also fewer severe side effects leading to dose reduction or treatment discontinuation in Dato-DXd treated patients compared to those treated with docetaxel.

    “Dato-DXd is the first antibody-drug conjugate in metastatic non-small cell lung cancer to demonstrate a statistically significant improvement in progression-free survival over the standard of care chemotherapy drug docetaxel, while evidencing a more favorable safety profile due to its unique ability to selectively delivers a potent chemotherapy directly into tumor cells,” said Lisberg.

    These findings are encouraging, noted Lisberg, since the current standard of care second-line chemotherapy docetaxel is associated with modest benefit and substantial toxicity and suggest that Dato-DXd has the potential to be new therapy for patients with previously treated non-squamous non-small cell lung cancer.

    TROPION-LUNG01 Study Design

    Researchers on the global TROPION-LUNG01 trial compared the effectiveness and tolerability of Dato-DXd vs docetaxel by randomizing 604 patients to receive either Dato-DXd (299 patients) or docetaxel (305) patients. Patients both with and without genetic driver mutations such as EGFR were enrolled and must have received multiple therapies for metastatic non-small cell lung cancer prior to enrollment. No minimum level of TROP-2 expression on the tumor surface was required for enrollment, as TROP-2 expression has not been found to correlate with Dato-DXd effectiveness, to date.

    UCLA Leadership in Dato-DXd Development

    UCLA’s thoracic medical oncology team has been at the forefront of Dato-DXd’s global development punctuated by Lisberg’s ESMO 2023 TROPION-LUNG01 Presidential Symposium. Critical support has been provided by the Hematology/Oncology Clinical Research Unit, as well as Lisberg’s UCLA thoracic medical oncology colleagues Dr. Edward Garon, Dr. Jonathan Goldman, and Dr. Amy Cummings, who identified the potential of Dato-DXd early on in development and prioritized Dato-DXd for their heavily pretreated non-small cell lung cancer patients. These patients had a paucity of effective treatment options at the time of Dato-DXd trial enrollment and their participation was essential to the success of the TROPION-LUNG01 study, with many experiencing a prolonged improvement in their lives, as result of Dato-DXd. The TRIO-US network also made significant contributions to the TROPION-LUNG01 study under the direction of Lisberg.

    UCLA and TRIO-US Network at Forefront of Future Dato-DXd Lung Cancer Trials

    This antibody-drug conjugate is now being evaluated as potential first-line therapy for patients with newly diagnosed metastatic non-small cell lung cancer on the TROPION-LUNG07/08 studies (NCT05555732/NCT05215340), both of which were recently opened at UCLA clinics throughout Southern California. In addition, the TRIO-US network is participating in the TROPION-LUNG07 trial, as it did for TROPION-LUNG01. These trials hold the promise to improve clinical outcomes for patients with metastatic non-small cell lung cancer by providing Dato-DXd to an even larger number of patients with non-squamous tumors.

    Datopotamab deruxtecan is a specifically engineered TROP2-directed DXd antibody drug conjugate being jointly developed by AstraZeneca and Daiichi Sankyo.

    University of California, Los Angeles (UCLA), Health Sciences

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  • Overdose deaths from fentanyl laced stimulants have risen 50-fold since 2010

    Overdose deaths from fentanyl laced stimulants have risen 50-fold since 2010

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    Newswise — Overdose deaths from fentanyl laced stimulants have risen 50-fold since 2010

     

    The trend marks the fourth wave in the US overdose crisis, which began with prescription opioid deaths in the early 2000s and has since continued with other drugs

    New UCLA-led research has found that the proportion of US overdose deaths involving both fentanyl and stimulants has increased more than 50-fold since 2010, from 0.6% (235 deaths) in 2010 to 32.3% (34,429 deaths) in 2021. 

    By 2021, stimulants such as cocaine and methamphetamine had become the most common drug class found in fentanyl-involved overdoses in every US state.  This rise in fentanyl/stimulant fatalities constitutes the ‘fourth wave’ in the US’s long-running opioid overdose crisis –the death toll of which continues to rise precipitously. 

    “We’re now seeing that the use of fentanyl together with stimulants is rapidly becoming the dominant force in the US overdose crisis,” said lead author Joseph Friedman, an addition researcher at the David Geffen School of Medicine at UCLA. “Fentanyl has ushered in a polysubstance overdose crisis, meaning that people are mixing fentanyl with other drugs, like stimulants, but also countless other synthetic substances. This poses many health risks and new challenges for healthcare providers. We have data and medical expertise about treating opioid use disorders, but comparatively little experience with the combination of opioids and stimulants together, or opioids mixed with other drugs. This makes it hard to stabilize people medically who are withdrawing from polysubstance use.”

    The findings will be published in the peer-reviewed journal Addiction.

    The analysis illustrates how the US opioid crisis began with an increase in deaths from prescription opioids (wave 1) in the early 2000s and heroin (wave 2) in 2010.  Around 2013, an increase in fentanyl overdoses signalled the third wave.  The fourth wave – fentanyl overdoses with stimulants – began in 2015 and continues to grow.

    Further complicating matters is that people consuming multiple substances may also be at increased risk of overdose, and many substances being mixed with fentanyl are not responsive to naloxone, the antidote to an opioid overdose.  

    The authors also found that fentanyl/stimulant overdose deaths disproportionately affect racial/ethnic minority communities in the US, including Black and African American people and Native American people. For instance, in 2021, the prevalence of stimulant involvement in fentanyl overdose deaths was 73% among 65 to 74-year-old Non-Hispanic Black or African American women living in the western US and 69% among 55 to 65-year-old Black or African American men living in the same area.  The rate among the general US population in 2021 was 49%.

    There are also geographical patterns to fentanyl/stimulant use.  In the northeast US, fentanyl tends to be combined with cocaine; in the southern and western US, it appears most commonly with methamphetamine. 

    “We suspect this pattern reflects the rising availability of, and preference for, low-cost, high-purity methamphetamine throughout the US, and the fact that the Northeast has a well-entrenched pattern of illicit cocaine use that has so far resisted the complete takeover by methamphetamine seen elsewhere in the country,” Friedman said.

    The study was funded by the UCLA Medical Scientist Training Program (National Institute of General Medical Sciences training grant GM008042) and the National Institute on Drug Abuse at the National Institutes of Health (K01DA050771). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

    University of California, Los Angeles (UCLA), Health Sciences

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  • Study could help explain why certain brain tumors don’t respond well to immunotherapy

    Study could help explain why certain brain tumors don’t respond well to immunotherapy

    BYLINE: Denise Heady

    Newswise — A study led by researchers at the UCLA Jonsson Comprehensive Cancer Center sheds new light on why tumors that have spread to the brain from other parts of the body respond to immunotherapy while glioblastoma, an aggressive cancer that originates in the brain, does not.

    In people with tumors that originated in other parts of the body but spread to the brain, treatment with a type of immunotherapy called immune checkpoint blockade appears to elicit a significant increase in both active and exhausted T cells — signs that the T cells have been triggered to fight the cancer. The reason the same thing doesn’t occur in people with glioblastoma is that anti-tumor immune responses are best initiated in draining lymph nodes outside of the brain, and that process does not occur very effectively in glioblastoma cases.

    To date, immunotherapy has not been effective in treating glioblastoma, but it has been shown to slow or even eradicate other types of cancer, such as melanoma, which frequently metastasizes to the brain.

    The new research, published in the Journal of Clinical Investigation, could help improve the effectiveness of immunotherapy for people with brain tumors and it could suggest new paths in the effort to help develop more effective therapies.

    “If we’re going to try to develop new therapies for solid tumors, like glioblastoma, which are not typically responsive, we need to understand the tumor types that are responsive, and learn the mechanisms by which that happens,” said the study’s senior author, Robert Prins, a professor of molecular and medical pharmacology and of neurosurgery at the David Geffen School of Medicine at UCLA.

    The researchers studied the immune cells obtained from nine people with metastatic brain tumors who had been treated with immune checkpoint blockade — which works by harnessing the body’s immune system to destroy cancer cells — and compared their observations with immune cells taken from 19 patients with brain metastases that not been treated with immunotherapy.

    They used a technique called single-cell RNA sequencing to examine the genetic material in both sets of samples, and then compared the data to previously published analyses of 25 recurrent glioblastoma tumors to better understand the effect the immunotherapy had on T cells.

    “We really were trying to figure out which immune cells are changing in the more responsive tumors in order to better explain the higher response rate to the treatment,” said the study’s co-first author, Lu Sun, a project scientist in the Geffen School of Medicine’s neurosurgery department. “No study has comprehensively examined the differential effect of immune checkpoint blockade treatment on these two types of brain tumors before.”

    In the tumors that had spread to the brain, the researchers saw that the T cells had specific characteristics associated with fighting tumors entering the brain, most likely due to a more effective priming step that occurs outside of the brain.

    Before traveling to the brain, T cells are first activated in the lymph nodes. During this process, a type of immune cells called dendritic cells share information about the tumor to T cells so they can better attack the tumor. This priming process, however, doesn’t work very effectively when doctors attempt to use immune checkpoint blockade for treating glioblastoma.

    The researchers also found that a specific subgroup of those exhausted T cells was associated with longer overall survival in people whose cancer had metastasized to the brain.

    “We found quite a significant difference between the two types of brain tumors and how they respond to immunotherapies,” said study author Dr. Won Kim, surgical director of UCLA Health’s brain metastasis program and a member of the Jonsson Cancer Center. “There was a tremendous number of T cell lymphocytes that were found within brain metastases following immunotherapy, and while the number of T cell lymphocytes also increased in glioblastoma patients, it wasn’t anywhere near the same extent.”

    Prins, who is also a researcher at the Jonsson Cancer Center, said that finding “suggests that enhancing the activation and presentation of T cells by dendritic cells could be a potential treatment strategy.”

    In future studies, the researchers plan to analyze data from a larger, more uniform group of people who were diagnosed with melanoma that had spread to the brain.

    The study’s other co-first author is Jenny Kienzler, who was a UCLA fellow in neurosurgery when the research was conducted. Other UCLA authors are Jeremy Reynoso, Alexander Lee, Eileen Shiuan, Shanpeng Li, Jiyoon Kim, Lizhong Ding, Amber Monteleone, Geoffrey Owens, Dr. Richard Everson, David Nathanson, Dr. Timothy Cloughesy, Gang Li, Dr. Linda Liau and Willy Hugo.

    The research was supported by grants from the National Institutes of Health Specialized Programs of Research Excellence in Brain Cancer, National Cancer Institute, National Institutes of Health National Center for Advancing Translational Science, Parker Institute for Cancer Immunotherapy, Brain Tumor Funder’s Collaborative and Cancer Research Institute.

    University of California, Los Angeles (UCLA), Health Sciences

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  • E. Dale Abel Receives Endocrine Society Lifetime Achievement Award

    E. Dale Abel Receives Endocrine Society Lifetime Achievement Award

    Newswise — E. Dale Abel, MD, PhD, chair of the Department of Medicine at the David Geffen School of Medicine at UCLA and executive medical director of the UCLA Health Department of Medicine has received the Endocrine Society Fred Conrad Koch Lifetime Achievement Award. The award, the group’s highest honor, recognizes individuals who have made exceptional contributions to the field of endocrinology through their lifetime.

    Dr. Abel’s pioneering work on glucose transport and mitochondrial metabolism in the heart guided his research interest in molecular mechanisms responsible for cardiovascular complications of diabetes. His laboratory has provided important insights into the contribution of mitochondrial dysfunction and aberrant insulin signaling to heart failure risk in diabetes.

    Dr. Abel’s research on cardiovascular complications of obesity and insulin resistance has garnered recognition and continuous support from the National Institutes of Health (NIH) for over two decades. Among the honors he has received for scholarship, scientific and academic achievement, Dr. Abel is an elected member of the National Academy of Medicine, the National Academy of Sciences, the Association of American Physicians and the American Society for Clinical Investigation.

    In addition, Dr. Abel has been recognized for a longstanding commitment to mentoring the next generation of endocrine researchers and biomedical scientists. He has served as the program chair for the annual Network of Minority Investigators workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Disorders to increase the success of minority biomedical researchers.  Since 2012, he has been a principal investigator for the Endocrine Society’s FLARE program, which has successfully increased the pipeline of underrepresented groups into productive careers in endocrinology and diabetes research.

    “I am humbled to be the recipient of the highest award from the Endocrine Society, the world’s largest professional association of endocrinologists,” said Dr. Abel. “The Endocrine Society has been my professional home for nearly 30 years. During this time, I have benefitted immensely through the Society, from mentorship to numerous opportunities for professional development within the field. As such it has been easy to give back and provide mentorship to emerging leaders in the field. My accomplishments as an endocrine investigator reflects the efforts of many trainees with whom I have been privileged to work over the past three decades and generosity of mentors and collaborators. I hope that our work, will ultimately impact the lives of many patients with diabetes.”

    Abel has held several leadership positions at the Endocrine Society including Past President. He is currently a Deputy Editor for the peer-reviewed journal Endocrine Reviews. Before joining the David Geffen School of Medicine at UCLA, he served as the Chair and Executive Officer of the Department of Internal Medicine and Professor of Medicine, Biochemistry and Biomedical Engineering at the University of Iowa in Iowa City, Iowa. Since 2012, he has been a principal investigator for the Endocrine Society’s Future Leaders Advancing Research in Endocrinology (FLARE) program, which has helped individuals from underrepresented groups establish successful careers in endocrinology and diabetes research.

    University of California, Los Angeles (UCLA), Health Sciences

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  • The expanded Child Tax Credit led to improved health and nutrition among adults

    The expanded Child Tax Credit led to improved health and nutrition among adults

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    Newswise — Monthly cash payments to eligible families under the temporary pandemic-era expansion of the federal Child Tax Credit led to better adult health and food security, new UCLA-led research suggests.

    The policy, which expired at the end of 2021, has not been renewed due to concerns among legislators over the credit being overly generous, particularly to lower-income families with limited tax liability, and the lack of an associated work requirement. The findings, to be published June 24 in JAMA Health Forum, could inform the debate over the policy’s future, said Dr. Jordan Rook, a fellow in the National Clinician Scholars Program at UCLA and the study’s lead author.

    “Cash transfer programs like the 2021 Child Tax Credit expansion may be powerful tools in improving the health, wellbeing, and nutrition of families,” said Rook, who is also a general surgery resident at the David Geffen School of Medicine at UCLA.  “Evidence like this can help guide the public, the media, and politicians as they advocate for and debate the policy’s future.

    Currently about one in six U.S. families with children lives in poverty, leading to poorer health and shorter life expectancy, according to the research team.

    Prior to the pandemic, the Child Tax Credit provided up to $2,000 per child ages 16 or younger for families with eligible incomes. Under the pandemic-era American Rescue Plan signed into law on March 11, 2021, the credit increased to $3,600 per child ages five or younger, and $3,000 per child ages 6 to 17. Families were eligible to receive half of this amount in the form of monthly checks, which each month were worth between $250 to $300 per child. The credit was fully refundable, meaning that all low-income families with children were eligible to receive the entire credit, regardless of their work status or income.

    These monthly payments reduced poverty by 40% in households with children, according to the researchers. But the policy, a temporary measure to assist families during the pandemic, expired on December 31, 2021.

    The researchers used data taken from about 39,500 respondents to the National Health Interview Survey from January 2019 to December 2021. They found that prior to initiation of the monthly payments, 60% of credit-eligible adults reported excellent or very good health and 88% reported having food security– that is, access to sufficient food to meet normal dietary needs. Among ineligible adults, 55% said they had excellent or very good health and 89% reported food security.

    They then used a study design known as a “difference-in-differences” technique to compare changes in health and food security between credit-eligible families and credit-ineligible families to estimate the impact of the Child Tax Credit monthly payments. Based on this technique, they estimate that following the start of the payments, eligible adults were 3 percentage points more likely to report excellent or very good health and 1.9 percentage points more likely to report food security than ineligible adults.

    “Assuming the conservative estimate of one adult per household, this represents improved health for 1.08 million adults, and newfound food security for 684,000 households,” Rook said. “These changes potentially represent important gains in health and nutrition for hundreds of thousands of US families because of this pandemic-era policy.”

    The study has some limitations, among them the possibility that job losses and expansions to other social programs such as unemployment and SNAP during the pandemic might have affected the findings.

    Additional study authors are Dr. Cecile Yama, Dr. Adam Schickedanz, Dr. Steven Lee, and Lauren Wisk of UCLA; and Dr. Alec Feuerbach of SUNY Downstate /Kings County.

    The study was funded by the VA Office of Academic Affiliations and the Los Angeles County Department of Health Services, both through the National Clinician Scholars Program Fellowship; the National Institute of Diabetes and Digestive and Kidney Diseases (K01 DK116932 and R03 DK132439); the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD099308); and the Health Resources and Services Administration of the U.S. Department of Health and Human Services (UA6MC32492, the Life Course Intervention Research Network). The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.

    University of California, Los Angeles (UCLA), Health Sciences

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  • UCLA Health seeks applicants for next TechQuity Accelerator to support startups with solutions for health inequity

    UCLA Health seeks applicants for next TechQuity Accelerator to support startups with solutions for health inequity

    Newswise — UCLA Health is now accepting applications for a new cohort of innovators to be part of its TechQuity Accelerator for 2023, an initiative that supports startups and other fledgling companies with technologies that can improve health equity among underserved and vulnerable patient populations.

    Launched in 2022 in response to COVID-19’s disproportionate impact on minority communities, the TechQuity Accelerator strives to strengthen health security by targeting four overall areas: prevention, diagnosis, treatment and community impact.

    “Following last year’s highly successful inaugural program, we are excited to launch a new accelerator to support early-stage companies driven by a commitment to develop inclusive technologies and boost health equity within diverse populations,” said Jennifer McCaney, executive director of UCLA Biodesign and associate director of the UCLA Clinical and Translational Science Institute. “We look forward to receiving applications from across our region’s robust tech ecosystem.”

    UCLA Health operates the TechQuity Accelerator in partnership with UCLA Biodesign and BioscienceLA, with a laser focus on supporting teams that feature innovative concepts and a mission to improve long-term community health resilience. The four-month program provides selected startups with personalized mentorship, access to clinical expertise and product-development support, culminating in a final pitch showcase with UCLA Health leaders and community stakeholders.

    Selected accelerator companies are paired with student interns subsidized by BioscienceLA through its BioFutures Internship Program. This collaboration also represents a shared commitment with UCLA Health and UCLA Biodesign to build a diverse life science workforce by providing career-building opportunities for people from historically underrepresented backgrounds.

    For 2023, the initiative seeks companies that have developed solutions to overcome any of the following barriers to more equitable health outcomes:

    Healthcare Access – The pandemic strained an existing health system fraught with challenges for people with cultural, geographic or financial limitations to access care and services. Prospective applicants may have innovations in these areas:

    • Telemedicine
    • Wearables, remote monitoring devices
    • Online pharmacies
    • Direct-to-consumer healthcare delivery
    • Encrypted mobile communication software
    • Medical translation and transcription
    • Gender-affirming care

    Environmental Justice – Traditionally, underserved communities are mostly likely to suffer the health, financial and political consequences caused by global climate change. Prospective applicants might have solutions for:

    • Removing, reducing or preventing pollution in vulnerable communities
    • Improving access to healthy food options
    • Leveraging community leaders to ensure equitable environmental and land-use decisions
    • Safe housing and recreational facilities
    • Expanding social service programs

    Mental Health and Youth Wellbeing – Limited resources are available for low-income residents and adolescent patients to ensure their long-term care and access to mental health professionals. Potential areas of focus include:

    • Pediatric healthcare delivery in collaboration with schools
    • Broadening medication access for substance-abuse patients
    • Teletherapy
    • Self-care mobile applications
    • Platforms to better identify resources, including mental health experts and treatment centers

    For more information or to apply, visit the UCLA Health TechQuity Accelerator website.

     

    University of California, Los Angeles (UCLA), Health Sciences

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  • UCLA-led research suggests no difference in health outcomes, care costs for patients treated by traditional MDs or osteopaths

    UCLA-led research suggests no difference in health outcomes, care costs for patients treated by traditional MDs or osteopaths

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    Newswise — New UCLA-led research suggests that patient mortality rates, readmissions, length of stay, and health care spending were virtually identical for elderly hospitalized patients who were treated by physicians with Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degrees.

    While both traditional, or allopathic, medical schools and osteopathic medical schools provide the same rigorous health education, osteopathic training adds a more holistic, hands-on component involving manipulation of the musculoskeletal system – for instance, the use of stretching and massage to reduce pain or improve mobility.

    “These findings offer reassurance to patients by demonstrating that they can expect high-quality care regardless of whether their physicians received their training from allopathic or osteopathic medical schools,” said senior author Dr. Yusuke Tsugawa, associate professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA and associate professor of health policy and management at the UCLA Fielding School of Public Health.

    The study will be published May 30 in the peer-reviewed Annals of Internal Medicine.

    Both types of physicians are licensed to practice medicine in every state. Currently about 90% of practicing physicians hold MD degrees and 10% have DO degrees. But the latter group is rapidly growing due to an increasing number of osteopathic medical schools, with their numbers having swelled by 72% between 2010 and 2020 compared with a 16% increase in MDs during the same period, and their ranks are expected to continue expanding.

    In addition, osteopathic physicians are more likely than their MD counterparts to serve patients in rural and underserved areas.

    The researchers relied on four data sources: a 20% sample of Medicare fee-for-service beneficiaries, amounting to about 329,500 people aged 65 years and older who were hospitalized between Jan. 1, 2016 and Dec. 31 2019; Medicare Data on Provider Practice and Specialty; a comprehensive physician database assembled by Doximity, and the American Hospital Association’s annual survey on hospital characteristics. Of the patients, 77% were treated by MDs and 23% were treated by DOs.

    The researchers found that patient mortality rates were 9.4% among MDs vs. 9.5% among DOs, patient readmission rates were 15.7% vs. 15.6% respectively, healthcare spending was $1004 vs. $1003, and lengths of stay were 4.5 days for both.

    The results are similar because both types of medical schools deliver rigorous, standardized medical education and comply with comparable accreditation standards, including four-year curriculums mixing science and clinical rotations, Tsugawa said.

    The study does have some limitations, the researchers write, primarily the fact that they focused on elderly Medicare beneficiaries who were hospitalized with medical conditions, so the results may not apply to other population groups. In addition, they limited outcomes to specific measures of care quality and resource use, so these findings may not generalize to other outcomes.

    But the findings “should be reassuring for policymakers, medical educators, and patients because they suggest that any differences between allopathic and osteopathic medical schools, either in terms of educational approach or students who enroll, are not associated with differences in quality or costs of care, at least in the inpatient setting,” the researchers write.

    Additional study authors are Dr. Atsushi Miyawaki of UCLA and the University of Tokyo; Dr. Anupam Jena of Harvard University, Massachusetts General Hospital and the National Bureau of Economic Research; and Dr. Nate Gross of Doximity.

    The study was funded by the National Institutes of Health’s National Institute on Aging (R01AG068633) and the Social Science Research Council.

    University of California, Los Angeles (UCLA), Health Sciences

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  • UCLA Health tip sheet: Pesticides & Parkinson’s symptoms; Gender-affirming hormones improve mental health; Body composition & cardiovascular disease

    UCLA Health tip sheet: Pesticides & Parkinson’s symptoms; Gender-affirming hormones improve mental health; Body composition & cardiovascular disease

    UCLA Health Tip Sheet Feb. 21, 2023

    Below is a brief roundup of news and story ideas from the experts at UCLA Health. For more information on these stories or for help on other stories, please contact us at [email protected].

    Body composition, not BMI, may signal risk for cardiovascular disease  Body mass index has long been a measure of a person’s risk of developing cardiovascular disease, but body composition and its role in the disease have not been well studied. In a new study, UCLA researchers predicted higher fat mass would be linked to higher levels of coronary artery calcification (CAC) — a marker of subclinical cardiovascular disease – and higher fat-free mass would be linked to lower levels of CAC. Using computed tomography scans and bioelectrical impedance analysis to study CAC and body composition in 3,129 non‐Hispanic Whites, Blacks, Hispanics, and Chinese patients, the researchers unexpectedly found that higher fat-free mass and, to a lesser extent, higher fat mass were linked to high levels of CAC. The researchers cautioned that bioelectrical impedance analysis could not identify the quality of fat or fat-free mass. Given these findings, the researchers say measuring body composition rather than using BMI to assess obesity may be a better approach to evaluating cardiovascular disease risk. Read the study published Feb. 8, 2023 in the Journal of the American Heart Association.

    Bariatric surgery reduces risks of hospitalization for heart failure Bariatric surgery has been found to reverse the ill effects of diabetes and may be protective against obesity-related cancers. Because obesity rates are on the rise across the globe, UCLA researchers set out to study other health benefits weight loss surgeries confer, in particular the link between the procedures and acute heart failure hospitalizations. After analyzing data from the Nationwide Readmissions Database from 2016 to 2019, the researchers found bariatric surgery was associated with lower odds of being hospitalized with acute heart failure. Among patients hospitalized with acute heart failure, prior bariatric surgery was associated with lower risks of death, prolonged ventilation, and acute renal failure. Beyond the health benefits, those who had undergone surgery stayed one fewer day in the hospital and incurred about $1,200 less in hospital costs compared to age matched cohorts. Read the study in Surgery for Obesity and Related Diseases. 

    Pesticides may also worsen Parkinson’s symptoms: While researchers have consistently found an association between pesticide exposure and higher risk of developing Parkinson’s disease, there has been little study of whether such exposure can accelerate the course of the disease. In a new study of 53 pesticides associated with Parkinson’s onset, researchers led by UCLA assistant professor of neurology Kimberly Paul, PhD, identified 10 pesticides that are associated with faster progression of motor and non-motor symptoms. Furthermore, exposure to six of those pesticides was associated with worsening of multiple endpoints researchers measured. Two pesticides, copper sulfate (pentahydrate) and MCPA (dimethylamine salt), were associated with all three endpoints measured: motor function, cognitive function, and depressive symptoms. Read the study in the journal Science of the Total Environment.

    Repurposing an old drug for a rare disease: A drug used to treat epilepsy, retigabine, may help manage episodic attacks of paralysis in patients with the rare inherited muscle disease Hypokalemic Periodic Paralysis (HypoPP), according to a new study that tested retigabine in genetically engineered mice. There’s a strong need to identify new HypoPP treatments since existing ones only improve symptoms in about half of patients and have considerable side effects. HypoPP is often marked by reduced potassium levels in the blood during episodes of muscle weakness. While it was known that retigabine affects a potassium channel that plays an important role in the heart and brain, the channel wasn’t previously known to exist in skeletal muscle. However, the new study led by Dr. Stephen C. Cannon, chair of the physiology department at the UCLA David Geffen School of Medicine, found that retigabine helps stabilize the membrane potential of skeletal muscle, thereby protecting against attacks of muscle weakness. Read the study, published online Jan. 30, in the journal Brain.

    Women treated with thrombectomy for pulmonary embolism fare worse A new study led by UCLA researchers analyzed the different outcomes in men and women with a pulmonary embolism who are treated by a percutaneous pulmonary artery thrombectomy- a procedure in which a catheter is placed in a patient’s lung to dissolve or remove a blood clot. After analysis of a national cohort of US patients from an inpatient claims-based database, researchers reported that women had higher rates of procedural bleeding, vascular complications, and needed more blood transfusions compared to men. They also found that women had higher in-hospital death rates and were more likely to go a nursing home or an assisted living facility instead of returning home after discharge. Given these disparities in outcomes, study authors are calling for more sex-based research. Read the study in the January 1, 2023 issue of CHEST. 

    A new clue about Parkinson’s progression The transmission of misfolded proteins in the brain is a key mechanism for the progression of various neurodegenerative diseases including Parkinson’s disease and Alzheimer’s disease. Chao Peng, PhD, an assistant professor of neurology, found a novel mechanism that regulates the transmission of one of these pathological proteins, misfolded alpha-synuclein, which leads to disease progression in Parkinson’s. This mechanism is the discovery that many modifications that a cell makes in these proteins alter their ability for transmission in the brain and disease progression. This discovery not only provides critical insights into disease mechanism but also facilitates the development of novel therapy for neurodegenerative diseases. Read the study, published Jan. 23, in Nature Neuroscience.

    Urban heat islands, redlining and kidney stones The persistent rise in kidney stone prevalence in recent decades has prompted much speculation as to the causes. There has been some discussion about the effect of heat on nephrolithiasis. A review of recent data suggests that heat may play a role in stone formation on a large scale and among African-Americans in particular. A new UCLA-led study led by Dr. Kymora B. Scotland states that African-Americans are the race/ancestry group with faster rates of increasing incidence and prevalence of kidney stones. Researchers also found that urban heat islands in the United States have resulted in part from the effects of redlining, a practice of systematic segregation and racism in housing that led to the development of neighborhoods with substantial disparities in environmental conditions. Dr. Scotland and her team hypothesize that the increased temperatures experienced by residents in redlined communities, many of whom are African American may contribute to the 150% increase in the prevalence of kidney stones in African Americans in recent decades. Read the study in the January 1, 2023 issue of Current Opinion in Nephrology and Hypertension.

    Gender-affirming hormones tied to mental health for transgender youth Transgender and nonbinary teens who receive gender-affirming hormones experience improvement in body satisfaction, life satisfaction and less depression and anxiety than before treatment. These findings are according to newly-published research by a four-site prospective, observational study and co-authored by Marco A. Hidalgo, PhD. Dr. Hidalgo is a clinical psychologist and Associate Clinical Professor of Medicine at the David Geffen School of Medicine at UCLA. Read the study published January 19, 2023 in the New England Journal of Medicine.

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  • Tobacco and e-cigs may put healthy young people at risk of severe COVID illness, new UCLA research suggests

    Tobacco and e-cigs may put healthy young people at risk of severe COVID illness, new UCLA research suggests

    EMBARGOED FOR USE UNTIL 5 p.m. PT/8 p.m. ET on Thursday, Feb. 9, 2023

    Newswise — New UCLA research suggests that smoking tobacco and vaping electronic cigarettes may increase healthy young people’s risk for developing severe COVID illness.

    This is among the first studies to find that not only smoking tobacco, but also vaping, may predispose people to increased inflammation and future development of severe COVID-19 and the lingering cardiovascular complications that can occur after initial illness from the virus, said Dr. Theodoros Kelesidis, the study’s lead author.

     “The key message is that smoking is the worst, but vaping is not innocent,” said Kelesidis, associate professor of medicine in the division of infectious diseases at the David Geffen School of Medicine at UCLA. “This has been shown for many lung diseases but not for COVID. It was a quite interesting and novel finding that vaping changed the levels of key proteins that the virus uses to replicate.”

    The study will be published Feb.9 in the peer-reviewed Journal of Molecular Medicine.

    The investigators examined plasma collected before the pandemic from 45 non-smokers, 30 electronic cigarette vapers, and 29 tobacco cigarette smokers, testing it to measure levels of since-identified proteins that SARS-CoV-2, the virus at the heart of the pandemic, needs in order to replicate. These proteins are ACE2, furin, Ang II, Ang 1–7, IL-6R, sCD163, L-selectin. The three latter proteins are collectively regulated in cells by a protein known as ADAM17.

    They found that plasma from healthy young people who smoke tobacco or vape had increased levels of furin, sCD163, and L-selectin compared to non-smokers. These data suggest that there may be increased activity of the proteins furin and ADAM17 in the immune cells as well as surface cells, such as those lining the lungs, in healthy young smokers and vapers.

    “E-cigarette vapers may be at higher risk than non-smokers of developing infections and inflammatory disorders of the lungs,” Kelesidis said.  “Electronic cigarettes are not harmless and should be used for only the shortest time possible in smoking cessation, and not at all by nonsmokers.”

    Limitations include the small size of the study, which suggests the need for research with a larger sample size; the reliance on testing blood plasma rather than tissue samples such as lung cells that are believed to be affected by smoking and vaping, which also warrants deeper research; and a lack of evidence of the role that the ADAM17 proteins may play in severe COVID illness among non-smokers.

    Study co-authors are Madhav Sharma, Sandro Satta, Elizabeth Tran, Rajat Gupta, Dr. Jesus Araujo, and Dr. Holly Middlekauff of UCLA.

    The study was funded by the National Institutes of Health (NIH), the Tobacco-Related Disease Research Program (TRDRP 28IR0065), the University of California Office of the President (R00RG2749 Emergency COVID-19 Research Seed Funding), and by the NIH National Center for Advancing Translational Science (NCATS) UCLA CTSI (L1TR001881).

     

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  • Commonly used antiretroviral drugs used to treat HIV and hepatitis B reduce immune cells’ energy production

    Commonly used antiretroviral drugs used to treat HIV and hepatitis B reduce immune cells’ energy production

    FINDINGS

    New UCLA-led research suggests that antiretroviral drugs called TAF and TDF directly reduce energy production by mitochondria, structures inside cells that generate the power that cells use to function. Both drugs led to reduced cellular oxygen consumption rates, a measure of the ability of the mitochondria to produce energy, compared with controls. But in combination with other antiretrovirals, TAF appeared to result in a larger energy reduction than TDF did. Whether this is a cause for concern is not known at this point.

    BACKGROUND                                                                                         

    The antiretroviral drugs tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) are used to treat HIV and hepatitis B infection in millions of people around the world. These drugs are also used as pre-exposure prophylaxis (PrEP) against HIV in uninfected people.

    METHOD

    Using both a human clinical trial and experimental lab studies, the researchers assessed the impact of TAF and TDF in combination with other antiretrovirals on the ability of blood immune cells to make energy. In the clinical trial, 26 people with HIV switched antiretrovirals over nine months and the researchers assessed how the drugs affected their cells’ energy production. The investigators confirmed these findings experimentally in the lab by directly adding the drugs to healthy immune cells and analyzing their impact on the cells’ metabolism.

    IMPACT

    The clinical implications of the findings are unclear at this point, a question that requires more research. These drugs are well tolerated by millions of people worldwide, but the long-term clinical implications of these drugs on the ability of human cells to make energy is unclear.

    COMMENT

    “Mitochondria are key structures inside the cells. This is the among the first demonstrations that antiretrovirals used in humans in HIV and hepatitis B directly change the function of mitochondria to make energy,” said senior author Dr. Theodoros Kelesidis, associate professor-in-residence of medicine in the division of infectious diseases at the David Geffen School of Medicine at UCLA. “We utilized independent research methods to confirm our findings. This is an important message, given that millions of people are on these antiretrovirals. It remains to be shown whether the effects of these antiretrovirals on mitochondria are mechanistically linked to certain metabolic changes that may be seen with the use of these antiretrovirals such as weight gain.”

    AUTHORS

    Study co-authors are Eleni Ritou, Sandro Satta, Anton Petcherski, Maria Daskou, Madhav Sharma, Hariclea Vasilopoulos, and Dr. Orian Shirihai of UCLA, and Eisuke Murakami of Gilead Sciences.

    JOURNAL

    The study is published in the peer-reviewed journal Metabolism.

    FUNDING

    The study was supported by Gilead Sciences, Inc. (CO-US-311-4393) and the National Institutes of Health (R01AG059501).

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  • New Onset Chronic Kidney Disease in People with Diabetes Highest Among Ethnic, Racial Minorities

    New Onset Chronic Kidney Disease in People with Diabetes Highest Among Ethnic, Racial Minorities

    Newswise — New onset chronic kidney disease (CKD) in people with diabetes is highest among racial and ethnic minority groups compared with white persons, a UCLA-Providence study finds.

    The study, published as a letter to the editor in the New England Journal of Medicine, found that new onset CKD rates were higher by approximately 60%, 40%, 33%, and 25% in the Native Hawaiian/Pacific Islander, Black, American Indian/Alaska Native, and Hispanic/Latino populations, respectively, compared to white persons with diabetes.

    Although high CKD incidence in diabetes persists, the rate declined from 8% of the overall diabetes population in 2015-2016 to 6.4% in 2019-2020”.

    “The results of our study constitute a call to action to institute directed, targeted efforts aimed at deliberately shifting the trajectory of persistently high rates of diabetes-related CKD and kidney failure that disproportionately affect racial and ethnic minority groups,” said co-author Dr. Susanne Nicholas, associate professor of medicine in the division of nephrology at the David Geffen School of Medicine at UCLA and chair of the UCLA Nephrology Racial and Health Equity Committee. “The first step should be to increase the rates of screening and detection of CKD in individuals with diabetes.”

    Researchers from the Geffen School, Providence, and the Centers for Disease Control and Prevention tracked 654,549 adults with diabetes from 2015 through 2020 using electronic health records from Providence Health and UCLA Health, two large not-for-profit health systems serving the Western United States.

    The prevalence of kidney failure requiring dialysis or transplant more than doubled to nearly 800,000 persons in the United States between 2000 and 2019, with diabetes as the leading cause. The rate of new onset of CKD in people with diabetes was previously unknown, yet the value of such incidence data is vital for identifying high-risk populations, determining the effectiveness of interventions, and assessing the effects on health care delivery and public health responses. Even more striking, less than 10% of patients with early stage kidney disease are aware of having CKD at this stage in its progression, when therapies are most effective. 

    “Given the rapidly growing population with diabetes in the United States and the corresponding high rates of kidney failure, the persistently high incidence of CKD marked by racial and ethnic disparities is troubling,” said lead author Dr.  Katherine Tuttle, executive director for research at Providence Inland Northwest Health and professor of medicine at the University of Washington. “Inclusive strategies for prevention, detection, and intervention are needed to reduce CKD risk in people with diabetes.”

    Additional study authors are Dr. O. Kenrik Duru and Dr. Keith Norris of UCLA; Cami Jones, Kenn Daratha, Dr. Radica Alicic, and Joshua Neumiller of Providence; and Nilka Ríos Burrows, Alain Koyama, and Dr. Meda Pavkov of the Centers for Disease Control and Prevention.

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  • New Analysis Led by Ucla Jonsson Comprehensive Cancer Center Finds Timing Androgen-Deprivation Therapy with Radiation Therapy Improves Outcomes in Localized Prostate Cancer

    New Analysis Led by Ucla Jonsson Comprehensive Cancer Center Finds Timing Androgen-Deprivation Therapy with Radiation Therapy Improves Outcomes in Localized Prostate Cancer

    Newswise — UCLA Research Brief

    BOTTOM LINE:

    Men with prostate cancer who are receiving radiation often benefit from adding to the treatment androgen deprivation therapy, a form of medication that reduces testosterone. Historically, men have been placed on androgen deprivation therapy prior to beginning radiation. In a large analysis of over 7,000 men treated internationally across 12 randomized trials, Dr. Kishan and colleagues have shown that it is almost universally optimal for men to begin androgen deprivation therapy when starting radiation, so that most of the period of having a low testosterone is “backloaded” after radiation is complete.

    BACKGROUND

    Androgen-deprivation therapy (ADT), also called hormone-suppression therapy, has consistently been shown to improve survival rates when added to radiation therapy (RT) for lower-risk patients with localized prostate cancer. However, the optimal sequencing of ADT for these patients remains controversial. Two previous studies suggested that ADT beginning with RT and continuing afterward may be superior to the before-and-during RT sequencing option, but both randomized trials had limitations that made it difficult to infer broad conclusions, according to the authors. 

    Based on those trials, this study’s researchers theorized that concurrent/adjuvant ADT sequencing would offer improved metastasis-free survival compared with neoadjuvant/ concurrent ADT sequencing in patients receiving short-term (four to six months) therapy in a RT field size-dependent manner.

    This meta-analysis was designed to investigate how the sequencing of ADT combined with RT administered via prostate-only RT or whole-pelvis RT might impact outcomes for prostate cancer patients.

    FINDINGS

    The analysis examined more than 7,400 patient records, including 6,325 patients who had received ADT before and during (neoadjuvant/concurrent) their radiation therapy and 1,084 patients who received ADT during and after (concurrent/adjuvant) undergoing RT. The median follow-up period was 10.2 years.

    Researchers observed a significant interaction between ADT sequencing and RT field size for all study endpoints except overall survival. For patients receiving prostate-only RT, ADT occurring during and after radiation was associated with improved metastasis-free survival compared with neoadjuvant/concurrent ADT.

    However, with patients receiving whole-pelvis RT, no significant difference was observed with ADT sequencing, except greater distant metastasis occurrence among those who had concurrent/adjuvant ADT.  However, that finding should be interpreted with caution due to details on how the individual trials were structured.

    The study appears in the Journal of Clinical Oncology.         

    CONCLUSION

    The authors concluded that ADT sequencing demonstrated a significant impact on clinical outcomes with a strong correlation to RT field size. They believe that concurrent and adjuvant ADT should be the standard of care where short-term ADT is indicated in combination with prostate-only RT.

    METHODS

    The researchers conducted a new analysis of individual patient data from 12 randomized trials in which patients received short-term ADT either before and during their radiation therapy or during and after for localized prostate cancer. Data was obtained through the Meta-Analysis of Randomized Trials in Cancer of the Prostate (MARCAP) Consortium, a first-of-its-kind repository for worldwide clinical trials involving patients with prostate cancer. The consortium was co-founded in 2020 by Drs. Amar Kishan of the UCLA Jonsson Comprehensive Cancer Center and Daniel Spratt with University Hospitals Seidman Cancer Center in Cleveland.

    Their analysis included performing inverse probability of treatment weighting (IPTW) with propensity scores derived from factors such as age, initial PSA score, Gleason score, T stage, RT dose and mid-trial enrollment year. Metastasis-free survival and overall survival were assessed by Cox regression models adjusted for IPTW and analyzed independently for men receiving prostate-only RT versus whole-pelvis RT. Adjusted Fine and Gray competing risk models were built to evaluate distant metastasis (DM) and prostate cancer-specific mortality.

    EXPERT COMMENTS

    “To our knowledge, this study represents the first time a significant association has been demonstrated between concurrent and adjuvant ADT sequencing and overall survival rates among prostate cancer patients,” said Kishan, corresponding author for the study. “For patients receiving prostate-only RT, concurrent/adjuvant sequencing is associated with optimal outcomes.”

    Kishan, who is vice-chair of Clinical and Translational Research and chief of genitourinary oncology for Radiation Oncology at UCLA, noted that the results should be “considered practice-changing with regards to how ADT is sequenced with radiation for patients getting short courses of ADT with prostate radiation.”

    He says future trials currently in the pipeline may yield more answers about the benefit of neoadjuvant/concurrent ADT sequencing with whole-pelvis RT in patients with intermediate- and high-risk prostate cancer.

    AUTHORS

    First author Ting Martin Ma is with the UCLA Department of Radiation Oncology, as is corresponding author Kishan, who also represents the MARCAP consortium. Yilun Sun, an equal contributor to the study, is with Case Western Reserve University School of Medicine. MARCAP co-founder Spratt also was an equal study contributor. Other authors are listed in the publication.  

    FUNDING / POTENTIAL CONFLICTS OF INTEREST

    Kishan reports funding support from grant P50CA09213 from the Prostate Cancer National Institutes of Health Specialized Programs of Research Excellence and grant W81XWH-22-1-0044 from the Department of Defense, as well as grant RSD1836 from the Radiological Society of North America. Additional funding came from the STOP Cancer organization, UCLA Jonsson Comprehensive Cancer Center, Prostate Cancer Foundation and American Society of Radiation Oncology, as well as donations from the DeSilva, McCarrick and Bershad families.

    No other authors had conflicts to declare.

    DOI: 10.1200/JCO.22.00970

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