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  • Autoimmune Diseases Are Frequent, Debilitating Among People with T1D

    Autoimmune Diseases Are Frequent, Debilitating Among People with T1D

    For patients living with type 1 diabetes (T1D), instances of additional autoimmune diseases (ADs) are frequent and significantly impact mental and physical health burdens, according to a study published in Diabetes & Metabolism.1 Researchers’ findings showed a heightened need for additional mental and physical health support among the T1D population.

    “T1D is an AD that results in the destruction of insulin producing beta cells in the pancreas,” wrote the authors of the study. “It is well established that ADs tend to co-occur; around 1 in 4 adults with T1D live with one or more other ADs and adolescents with T1D have nearly 5-fold higher rates of AD than those without T1D diagnosis.”

    Before the onset of additional ADs, people with T1D already live difficult lives because of the various responsibilities they need to manage to control their disease. According to the Mayo Clinic, the treatment regimen for T1D typically includes 5 actions: taking insulin; counting carbohydrates, fats, and protein; monitoring blood sugar often; eating healthy foods; and exercising regularly and keeping a healthy weight.2

    Of the total study population, 36.3% had additional ADs, with autoimmune thyroid diseases (hypo and hyperthyroidism) being the most prevalent. | image credit: Alina / stock.adobe.com

    READ MORE: Diabetes Care Is Significantly Lacking for People With HIV

    As authors of the current study mentioned, both adults and children with T1D are significantly more susceptible to additional ADs when compared with other populations.1 According to a study in the Journal of Personalized Medicine, researchers previously uncovered associations between T1D and ADs affecting the endocrine, digestive, skin, and musculoskeletal systems. Some of those specific diseases include celiac disease, autoimmune gastritis, rheumatoid arthritis, and many more.3

    “Despite the frequency of co-occurrence of T1D with additional AD, the literature remains scarce on the association of multiple ADs with diabetes-related complications, as well as mental health complications, but even more on the impact of living with other ADs on T1D management,” continued the authors.1 “Thus, our aim is to complement the current literature by investigating the associations of the presence of one or more additional AD with diabetes management, the presence of acute and chronic T1D complications, and mental health indicators in Canadian adults living with T1D.”

    Conducting a cross-sectional analysis of Canadians with T1D, researchers gathered data from the Behaviors, Therapies, Technologies, and Hypoglycemic Risk in T1D (BETTER) registry in Canada. This data included questionnaire responses from Canadian adults 18 or older between April 2019 and March 2024. To be included in the study, participants answered questions on ADs and took insulin. Over 20 diseases were included as additional ADs among patients with T1D, such as ulcerative colitis, Crohn disease, alopecia areata, and Guillain-Barre syndrome, among many others.

    The analysis featured a total of 3222 participants (66.2% women; mean age, 42.7 years old) with T1D. Of the total study population, 36.3% had additional ADs, with autoimmune thyroid diseases (hypo- and hyperthyroidism) being the most prevalent among all ADs uncovered (25.8%). Celiac disease was the next most prominent at 6.4% of those having an additional AD, followed by inflammatory joint diseases like rheumatoid arthritis and psoriasis.

    Aside from the ADs associated with patients having T1D, those who reported any additional AD also had higher risks of CVD, nephropathy, neuropathy, and retinopathy. The presence of any additional AD was also associated with high cholesterol. Finally, researchers discovered that patients with T1D and an additional AD were taking more depression or anxiety medications than their counterparts without additional AD.

    “Living with T1D and one or more AD+ is frequent, and this co-occurrence is associated with higher rates of level 2 and 3 hypoglycemia, long-term complications, as well as depression and anxiety medication use,” they wrote.1 “This indicates a need for additional mental and physical health support for this population with T1D.”

    Throughout the researchers’ cross-sectional analysis, they uncovered several results mirroring previous studies on the association between T1D and additional AD risk.

    From common risk factors among the T1D population to the physical and mental burdens the disease presents, results of the study further highlighted the greater need for personalized care among patients with T1D. Researchers suggested further attention on disease screening in this population going forward, with costs as well as physical and mental burdens in mind.

    “In light of the present findings, screening for ADs may be justified in attempts to prevent the negative associations discussed herein,” concluded the authors.1 “Optimal timing and diseases to be screened will need additional research to ensure a positive cost-benefit of these procedures.”

    READ MORE: Diabetes Resource Center

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    REFERENCES
    1. Locatelli CAA, Talbo MK, Messier V, et al. In adults living with type 1 diabetes, additional autoimmune diseases are associated with more chronic complications and depression. a BETTER registry analysis. Diabetes Metab J. June 20, 2025:101667. https://doi.org/10.1016/j.diabet.2025.101667
    2. Type 1 diabetes. Mayo Clinic. March 27, 2024. Accessed September 16, 2025. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/diagnosis-treatment/drc-20353017
    3. Popoviciu MS, Kaka N, Sethi Y, et al. Type 1 diabetes mellitus and autoimmune diseases: a critical review of the association and the application of personalized medicine. J Pers Med. 2023 Feb 26;13(3):422. doi: 10.3390/jpm13030422.

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  • Postmortem Analysis Reveals Distinct Patterns of Aquaporin-4 in Parkinson Disease and Multiple System Atrophy

    Postmortem Analysis Reveals Distinct Patterns of Aquaporin-4 in Parkinson Disease and Multiple System Atrophy

    A recently published study in Movement Disorders investigated the localization and abundance of aquaporin-4 (AQP4), a protein involved in clearing amyloidogenic proteins, in patients with Parkinson disease and multiple system atrophy (MSA).1,2 Researchers reported that AQP4 exhibited distinct patterns in these movement disorders, particularly in the superficial cortical layers, indicating different astrocytic responses in neuronal versus glial synucleinopathies.

    The study analyzed postmortem brain tissue from 29 patients with PD, 19 patients with MSA, and 17 controls. In this immunohistochemical analysis, researchers focused on the motor cortex and subcortical white matter. Investigators observed that AQP4 polarization, measured by area, was significantly increased in PD compared with controls and MSA, whereas AQP4 abundance correlated with age-associated neuritic plaques and showed a trend for higher levels in women controls. In MSA, results showed that polarization decreased in MSA-parkinsonian type (MSA-P) but unaltered in MSA-cerebellar type (MSA-C).

    “This study shows AQP4 changes in the motor cortex with plaque formation, Lewy pathology, and MSA pathology. The most consistent region affected was the superficial cortical layers, where intracortical arterioles penetrate through the gray matter to form the capillary network, suggesting a potentially faster interstitial fluid turnover compared to the deeper layers,” senior author YuHong Fu, MD, PhD, senior research fellow in neuroscience at The University of Sydney, and colleagues wrote.1 “In controls, the increased abundance of AQP4 in those with mild neuritic plaques implies some astrocytic reaction to this aging-associated change by increasing glymphatic clearance capacity.”

    Authors first examined correlations between AQP4 polarization and abundance across all cohorts. Polarization measured by area and intensity showed a positive correlation. However, AQP4 abundance negatively correlated with polarization area and did not correlate with polarization intensity. In control cases, additional analyses considered factors such as neuritic plaque formation, arteriolosclerosis, immunosuppressant medication use, and sex. Mild neuritic plaques significantly increased AQP4 abundance, particularly in the superficial gray matter, whereas women tended to have higher levels of AQP4. Neither arteriolosclerosis, immunosuppressant use, nor age had a significant impact on AQP4 parameters.

    In PD, researchers observed an increase in AQP4 polarization mainly in the superficial gray and white matter regions, noting that this increase was not related to plaque formation. Furthermore, early PD cases without plaques showed decreased polarization and increased abundance, suggesting that astrocytic responses vary with the stage of cortical Lewy pathology. Findings from the morphological analysis showed that PD astrocytes were dysmorphic, with disorganized AQP4 processes and visible α-synuclein aggregates.

    READ MORE: Teva’s Emrusolmin Granted Fast Track Designation for Multiple System Atrophy

    By contrast, MSA cases exhibited reactive astrocytes with strong AQP4 labeling, but researchers observed no prominent α-synuclein aggregates. In MSA subtypes, MSA-P cases showed decreased AQP4 polarization, whereas MSA-C cases remained similar to controls. Authors noted that this difference could not be explained by cortical α-synuclein load, which was comparable between subtypes, although MSA-P cases had more white matter pathology. No significant correlations were reported between α-synuclein scores and either AQP4 polarization or abundance in either disease.

    Across all cohorts, investigators observed that overall astrocytic density, the percentage of AQP4-positive astrocytes, and segmental ratios of glial fibrillary acidic protein and AQP4-positive end-feet were largely unchanged. However, early PD cases exhibited reduced segmental ratios, in which authors noted that could indicate lower AQP4 end-feet recruitment. Moreover, findings showed that MSA-C cases maintained preserved end-feet recruitment compared with MSA-P and controls.

    “Our study suggests that [early] PD and MSA-P have compromised AQP4 polarization, impacting glymphatic function that is consistent with these neuroimaging changes. However, we saw no AQP4 polarization change in MSA-C and an increased polarization in [late] PD with progression. These different alterations suggest the disease’s impact on AQP4 is dynamic. Although our neuropathological study reveals distinct AQP4 alterations in the human motor cortex of synucleinopathies, further imminent questions are pending to be validated,” Fu et al noted.1

    REFERENCES
    1. Wang L, Tanglay O, Su F, et al. Distinct AQP4 Alterations in Movement Disorders with Primary Synucleinopathy. Mov Disord. Published online August 27, 2025. doi:10.1002/mds.70023
    2. Salman MM, Kitchen P, Halsey A, et al. Emerging roles for dynamic aquaporin-4 subcellular relocalization in CNS water homeostasis. Brain. 2022;145(1):64-75. doi:10.1093/brain/awab311

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  • Osimertinib Plus Chemotherapy Expands Frontline Choices in EGFR+ NSCLC

    Osimertinib Plus Chemotherapy Expands Frontline Choices in EGFR+ NSCLC

    Findings from the phase 3 FLAURA2 trial (NCT04035486) confirmed the overall survival (OS) benefit with osimertinib (Tagrisso) plus chemotherapy vs osimertinib monotherapy in patients with EGFR-mutated non–small cell lung cancer (NSCLC), but the survival benefit alone may not be enough to warrant it’s use in every patient. Factors such as treatment toxicity, second-line sequencing, and patient goals and preferences must be considered when selecting the optimal therapy.

    “There are a lot of new data [being made available] and we need to offer patients the opportunity to get the best outcomes,” Ticiana Leal, MD, said. “[We need to] have discussions about combinations and have a shared decision-making approach with patients in order to get their perspective on it.”

    In an OncLive Peer Exchange filmed on-location in Barcelona, Spain, during the International Association for the Study of Lung Cancer 2025 World Conference on Lung Cancer (WCLC), a panel of lung cancer experts highlighted the clinical significance of updated data presented during the meeting, including final OS findings from FLAURA2. In light of the updated clinical trial results, they also discussed treatment selection approaches for single-agent vs combination regimens, risk-benefit considerations, and treatment sequencing strategies.

    How Should I Navigate the Choice Between Osimertinib Monotherapy and Combination Therapy?

    In February 2024, osimertinib combination therapy solidified its place in the EGFR-mutated NSCLC treatment space, earning FDA approval in combination with platinum-based chemotherapy in patients with locally advanced or metastatic disease whose tumors harbor EGFR exon 19 deletions or exon 21 L858R mutations, as detected by an FDA-approved test.1 During WCLC, investigators presented the final OS data from FLAURA2; prior data from this study supported the FDA approval of osimertinib plus chemotherapy.

    At a median follow-up of 51.2 months (range, 0.2-60.4) in the osimertinib plus chemotherapy arm (n = 279) and 51.3 months (range, 0.1-60.1) in the osimertinib monotherapy arm (n = 278), the median OS values were 47.5 months (95% CI, 41.0-not calculable) and 37.6 months (95% CI, 33.2-43.2), respectively (HR, 0.77; 95% CI, 0.61-0.96; P = .02).2 The 3-year OS rates were 63% and 51%, respectively, and the 4-year OS rates were 49% and 41%, respectively.

    “[These data] were the big news from this conference, [because] there was a real question where the [OS] HR would lie,” Helena Yu, MD, said. “Due to crossover, there was a possibility that the HR would be less significant, so I was pleasantly surprised. This was a measurable difference in outcomes for our patients, and I believe this will be practice changing.”

    “We were waiting for the OS [data]; we knew they were going to be positive, but I believe these data solidify this combination strategy as a frontline option for our patients. Importantly, this benefit was seen in the key subgroups that were predefined,” Leal added.

    Findings from a subgroup analysis of FLAURA2 showed that osimertinib plus chemotherapy showed a consistent OS benefit vs osimertinib monotherapy across patient subgroups. Notably, in patients with (HR, 0.72; 95% CI, 0.52-0.99) and without (HR, 0.77; 95% CI, 0.57-1.05) brain metastases as well as patients with disease harboring EGFR L858R mutations (HR, 0.76; 95% CI, 0.55-1.07) and EGFR exon 19 deletions (HR, 0.76; 95% CI, 0.56-1.02).

    The panelists continued their conversation by further unpacking how they choose between osimertinib monotherapy and osimertinib plus chemotherapy for the frontline treatment of patients with EGFR-mutated NSCLC. Leal noted that the clinical trial population and patients treated in the real-world setting are often different and that older patients, those with a poor performance status, and/or those with significant comorbidities such as baseline renal dysfunction would not be good candidates to receive the chemotherapy-containing combination.

    “It’s not a high-risk vs low-risk group. [We need to consider] all of these patient factors and patient preference together,” Zosia Piotrowska, MD, MHS, explained. “Different patients have different values, goals, and personal situations that affect [treatment]. Maybe they live farther away, and they don’t want to drive in or maybe they’ve had chemotherapy before. All these things are important in our decision-making. These are long and complicated discussions with patients. We have to provide them guidance, but we also want to hear what’s important to them.”

    Findings from a real-world study of 235 adult patients with stage IV NSCLC who started first treatment with osimertinib plus chemotherapy or osimertinib monotherapy between February 19, 2024, and December 31, 2024, revealed that patients who were younger and those with more advanced disease received the combination more often.3 Specifically, patients less than 65 years old (n = 71) received combination therapy 42% of the time compared with 23% among patients who were at least 65 years of age (n = 164). Patients with stage IVA (n = 94) and stage IVB (n = 127) disease were treated with the combination at respective rates of 20% and 34%.

    “[These data] are from a year after the initial results of FLAURA2 and there needs to be time to have a shift in practice patterns,” Leal said. “[We have] been very comfortable using osimertinib monotherapy and now having to shift to a higher intensity regimen takes a learning curve for many of us and for patients. In my community, I’m seeing quicker uptake of this combination than I was expecting. I’ve seen less uptake of the MARIPOSA regimen [amivantamab-vmjw (Rybrevant) plus lazertinib (Lazcluze)] and higher uptake of the FLAURA2 regimen.”

    Piotrowska noted that the fact that many patients do not make it to a second line of treatment in this setting could also influence the decision to choose between osimertinib plus chemotherapy or osimertinib monotherapy in the frontline setting. In FLAURA2, among patients who experienced progression on the combination (n = 127), 69% went on to receive a first subsequent treatment compared with 77% of those in the monotherapy arm who experienced disease progression (n = 185).2 In the combination group, subsequent treatment approaches included platinum-based chemotherapy (44%), non–platinum-based chemotherapy (30%), other EGFR-targeted therapy (8%), osimertinib plus a targeted or investigational agent (5%), and other approaches (14%). Comparatively, these subsequent therapies were given at respective rates of 72%, 3%, 7%, 3%, and 14% in the monotherapy group.

    “We’ve known for a long time that chemotherapy is an effective therapy for these patients,” Piotrowska explained. “[Because] there’s no guarantee that patients will get chemotherapy in the second line, there is some appeal to giving them multiple agents that target the cancer in different ways and try to give them the best outcome. A point that is critically important here is the idea of shared decision-making with patients and taking into account their preferences and goals of care.”

    Findings from a qualitative analysis of patient perspectives on osimertinib presented during WCLC showed that adult patients with advanced EGFR-mutated NSCLC were influenced by factors such as age, prior treatment experience, and life roles when considering treatment with the agent.4 Patients noted that they valued the convenience, tolerability, and ability to maintain independence provided by osimertinib.

    How Should I Weigh the Risks and Benefits in First-Line Treatment Selection?

    Beyond osimertinib plus chemotherapy, another regimen that is FDA approved for the frontline treatment of patients with EGFR-mutated NSCLC is the combination of the EGFR-MET bispecific antibody amivantamab plus the EGFR tyrosine kinase inhibitor lazertinib.5 In August 2024, the combination was approved in patients with untreated locally advanced or metastatic NSCLC with EGFR exon 19 deletions or exon 21 L858R substitution mutations, as detected by an FDA-approved test. The regulatory decision was supported by data from the phase 3 MARIPOSA trial (NCT04487080).

    At a median follow-up of 37.8 months (range, 0.0-48.1), updated data from MARIPOSA published in the New England Journal of Medicine showed that patients who received amivantamab plus lazertinib (n = 429) experienced a significant OS benefit vs osimertinib (n = 429; HR, 0.75; 95% CI, 0.61-0.92; P = .005).6 Specifically, the median OS values were not estimable (NE; 95% CI, 42.9 months-NE) and 36.7 months (95% CI, 33.4-41.0), respectively.

    “We all agree that [osimertinib plus chemotherapy and amivantamab plus lazertinib] are similar in terms of efficacy,” Piotrowska said. “Where things start to differentiate themselves is in terms of their toxicity profiles and the practical aspects [such as] administration and frequency of visits.”

    Data from a patient-level, head-to-head toxicity comparison presented during WCLC showed that patients who received amivantamab plus lazertinib were more likely to experience grade 3 or higher adverse effects (AEs; OR, 1.68; 95% CI, 1.21-2.34; P = .0022) and serious AEs (OR, 1.56; 95% CI, 1.15-2.13 P = .0052) vs osimertinib plus chemotherapy.7 The frequency of treatment discontinuation due to AEs was similar between the 2 arms (OR, 0.91; 95% CI, 0.56-1.50; P = .7064).

    “We have to take these cross-trial comparisons with a grain of salt, but in my experience, there are a group of patients who have quality of life decrements for a substantial period of time with amivantamab,” Edward Garon, MD, MS, said. “How much a subcutaneous formulation in the future may may help with that is a bit hard to know, but [toxicities] are a factor, and you need to talk to patients about the possibility of them.”

    Leal noted that the AE profile of the osimertinib plus chemotherapy is fairly well understood and toxicity management strategies are established. However, amivantamab plus lazertinib presents a unique toxicity profile, with AEs such as blood clots, infusion-related reactions, and rash that can be difficult to manage, she added.

    The phase 2 COCOON trial (NCT06120140) evaluated enhanced vs standard dermatologic management in patients with EGFR-mutated NSCLC who received amivantamab plus lazertinib; mitigation strategies for dermatologic AEs were not evaluated in MARIPOSA.8 In COCOON, patients were randomly assigned 1:1 to receive oral doxycycline or minocycline during weeks 1 through 12, followed by topical clindamycin scalp lotion during weeks 13 through 52, with chlorhexidine on the nails, and a ceramide-based moisturizer (n = 99) or standard dermatologic management (n = 102), which included general skin prophylaxis and reactive treatment.

    Findings from COCOON presented during WCLC demonstrated that patients in the investigational arm experienced a significantly lower incidence of grade 2 or higher dermatologic AEs of interest vs the control arm over the first 12 weeks, at 42% vs 75%, respectively (OR, 0.24; 95% CI, 0.13-0.45; P < .0001). Notably, the significant reduction of grade 2 or higher dermatologic AEs of interest was consistent across anatomic locations, excluding the incidence of paronychia which was comparable between the 2 arms during the first 12 weeks of treatment.

    “The skin toxicities with [the MARIPOSA regimen] occur at a higher rate than what we see with chemotherapy,” Piotrowska said. “These are [AEs] that we need to get used to managing, no matter what the regimen is. This is a place where our entire team, especially our nurses and nurse practitioners, need to have clear materials for patients to follow and be as systematic as possible in giving patients directions.”

    Renal dysfunction and a risk of cytopenias represent a risk of the FLAURA2 regimen due to the long-term administration of pemetrexed, Piotrowska noted. During FLAURA2, patients who received osimertinib plus chemotherapy experienced a median pemetrexed exposure of 8.3 months (range, 0.7-58.9).2

    “In my practice, there’s always a discussion about how long a patient needs to be on maintenance pemetrexed,” Leal explained. “As we monitor patients, they do seem to tire out over time and get more chronic fatigue, chronic anemia, lower extremity edema, and pseudo cellulitis that can bother some eye symptoms. Importantly, you will start to see their creatinine [levels] creep a little bit each time over time and there’s going to be a point where we need to reduce and [eventually] stop the pemetrexed dose because you want to make sure that you save that kidney function for later. It’s a real issue that we have to monitor and counsel patients for.”

    How Should I Sequence Treatments in the Second-Line Setting?

    The panelists shifted the focus of their conversation to the second-line setting, where they discussed which patients should receive a platinum-based doublet with osimertinib following disease progression on frontline osimertinib. Findings from the phase 3 COMPEL study (NCT04765059) presented during WCLC showed that patients who received osimertinib plus cisplatin or carboplatin with pemetrexed (n = 49) experienced a median progression-free survival (PFS) of 8.4 months (95% CI, 5.7-11.8) compared with 4.4 months (95% CI, 3.5-5.6) among those who received placebo with chemotherapy (n = 49; HR, 0.43; 95% CI, 0.27-0.70).9 The 6-month PFS rates were 64% and 32%, respectively.

    “A lot of us were waiting for these data and think they are relevant,” Yu commented. “Our practice patterns were changed based on the [phase 3] IMPRESS [NCT01544179] data of the earlier generation EGFR TKIs and the lack of benefit with continuing chemotherapy. [COMPEL] showed a benefit. I suspect a lot of that is [from] the maintenance of central nervous system [disease] control. [These findings] do complicate things moving forward. Should there be some targeted therapy that’s paired with platinum-based chemotherapy? Is it going to be better to continue osimertinib indefinitely [vs] novel therapies?”

    “I have not routinely incorporated osimertinib into my treatment plan after chemotherapy. There are some patients with brain metastases [for whom] I have done it, but it has not been my routine approach. The data were enough in that setting to give me confidence that this is not likely to be similar to IMPRESS, where the data looked worse by going to that,” Garon added.

    In terms of amivantamab-containing regimens in the second-line setting, findings from the phase 3 MARIPOSA-2 study (NCT04988295) showed that patients who received amivantamab plus chemotherapy (n = 131) following disease progression on osimertinib experienced a numerical OS benefit compared with those who received chemotherapy alone (n = 263; HR, 0.73; 95% CI, 0.54-0.99; P = .039).10 The 18-month OS rates were 50% (95% CI, 40%-59%) and 40% (95% CI, 33%-46%), respectively.

    “If I start with the FLAURA2 [regimen], I’m going to be less enthusiastic about using the COMPEL [regimen] in the second line,” Yu said. “As much as we say that amivantamab is a hard drug, when you’re adding it to chemotherapy, I find that it is somewhat better tolerated than with a TKI. The dexamethasone premedication can help with the infusion reaction and some of the toxicities. I am also comfortable with lowering the dose for toxicity. This regimen has surprised me in being reasonably well tolerated in the second line.”

    References

    1. FDA approves osimertinib with chemotherapy for EGFR-mutated non-small cell lung cancer. FDA. Updated February 20, 2024. Accessed September 11, 2025. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-osimertinib-chemotherapy-egfr-mutated-non-small-cell-lung-cancer
    2. Planchard D, Jänne PA, Kobayashi K, et al. First-line osimertinib + chemotherapy versus osimertinib monotherapy in EGFRm advanced NSCLC: FLAURA2 final overall survival. Presented at: International Association for the Study of Lung Cancer 2025 World Conference on Lung Cancer; September 6-9, 2025; Barcelona, Spain. Abstract PL02.06.
    3. Santos ES, Patel T, Divers S, et al. Real-world treatment of osimertinib monotherapy versus combination therapy in stage IV non-small cell lung cancer patients.Presented at: International Association for the Study of Lung Cancer 2025 World Conference on Lung Cancer; September 6-9, 2025; Barcelona, Spain. Abstract P3.12.24.
    4. Seeger R, Stacey D, Bossio E, Wheatley-Price P. Demographic influences on treatment preferences in advanced EGFR+ mNSCLC: a qualitative analysis of patient perspectives on osimertinib. Presented at: International Association for the Study of Lung Cancer 2025 World Conference on Lung Cancer; September 6-9, 2025; Barcelona, Spain. Abstract EP.12.25.
    5. FDA approves lazertinib with amivantamab-vmjw for non-small lung cancer. FDA. Updated August 20, 2024. Accessed September 12, 2025. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-lazertinib-amivantamab-vmjw-non-small-lung-cancer
    6. Yang JCH, Lu S, Hayashi H, et al. Overall survival with amivantamab-lazertinib in EGFR-mutated advanced NSCLC. N Engl J Med. Published online September 7, 2025. doi:10.1056/NEJMoa2503001
    7. Resuli B, Kauffmann-Guerrero D, Mertsch P, et al. Redefining tolerability: a head-to-head IPD toxicity comparison of amivantamab+lazertinib vs osimertinib+chemotherapy in EGFR-mutant NSCLC. Presented at: International Association for the Study of Lung Cancer 2025 World Conference on Lung Cancer; September 6-9, 2025; Barcelona, Spain. Abstract P3.12.67.
    8. Cho BC, Li W, Spira AI, et al. Enhanced vs standard dermatologic management with amivantamab-lazertinib in EGFRm advanced NSCLC: the COCOON global RCT. Presented at: International Association for the Study of Lung Cancer 2025 World Conference on Lung Cancer; September 6-9, 2025; Barcelona, Spain. Abstract P3.12.46.
    9. Pasello G, Zhao J, Tufman A, et al. COMPEL: osimertinib + platinum-based chemotherapy in patients with EGFRm advanced NSCLC and progression on 1L osimertinib. Presented at: International Association for the Study of Lung Cancer 2025 World Conference on Lung Cancer; September 6-9, 2025; Barcelona, Spain. Abstract OA08.03.
    10. Popat S, Reckamp KL, Califano R, et al. Amivantamab plus chemotherapy vs chemotherapy in EGFR-mutated, advanced non-small cell lung cancer after disease progression on osimertinib: second interim overall survival from MARIPOSA-2. Ann Oncol. 2024;35(suppl 2):S1244-S1245. doi:10.1016/j.annonc.2024.08.2296

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  • YouTube ramps up AI tools for video makers – France 24

    1. YouTube ramps up AI tools for video makers  France 24
    2. The next 20: Powering the future of entertainment together at Made on YouTube  YouTube Official Blog
    3. YouTube unveils new ways for creators to earn with brand deals, YouTube Shopping program  TechCrunch
    4. Cowherd, Smosh, Gladwell: YouTube’s AI Tools Get a Starry Podcast Test Drive  The Ankler.
    5. YouTube Music Gets Sweet New Features for Super Fans  Droid Life

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  • Healthy plant-based diet may lower type 2 diabetes risk while reducing greenhouse gas emissions

    Healthy plant-based diet may lower type 2 diabetes risk while reducing greenhouse gas emissions

    A diet focused on healthy plant-based foods may lower the risk of type 2 diabetes while reducing greenhouse gas emissions, according to a new study by Solomon Sowah and colleagues from the MRC Epidemiology Unit at the University of Cambridge, United Kingdom, published September 16th in the open-access journal PLOS Medicine.

    Growing research shows that unhealthy foods not only impact your health but are also detrimental to the environment. Diets such as the Planetary Health Diet (PHD) recommend high amounts of healthy plant-based foods and limited animal-derived foods and sugary drinks to improve both human and environmental health. Data on the impact of these types of diets show inconsistent findings, and there is little epidemiological data specifically examining the effect of the PHD on type 2 diabetes or environmental factors, such as greenhouse gas emissions.

    In this study, researchers analyzed dietary data from more than 23,000 people in the UK taken at three timepoints across 20 years. They found that higher adherence to the PHD was associated with lower incidence of type 2 diabetes-participants in the top fifth of adherence had a 32% lower incidence of type 2 diabetes compared to those in the bottom fifth. Higher adherence to the PHD was also associated with lower greenhouse emissions-among those in the top fifth of adherence, greenhouse gas emissions were 18% lower compared to those in the bottom fifth.

    The researchers recognize that while the study does not show a direct causal link between the PHD and type 2 diabetes, promoting healthier plant-based diets could be an important strategy to simultaneously prevent type 2 diabetes while reducing the negative impact of diet on the environment.

    Dr. Solomon Sowah says, “Our motivation for this study was to address the limited evidence regarding the association between the planetary health diet and both type 2 diabetes incidence and greenhouse gas emissions in a European population. We found that the planetary health diet containing higher amounts of wholegrains, fruits and vegetables, and lower amounts of red and processed meat and sugary drinks was associated with lower type 2 diabetes incidence and lower diet-related greenhouse gas emissions.”

    These findings provide support for the potential of the planetary health diet to make a meaningful contribution to help prevent type 2 diabetes. What’s more is that eating in line with the planetary health diet is also linked with a lower environmental impact. So, it offers a win-win to potentially help improve both human and planetary health. Action will be needed from all players, including individuals and policy makers to enable food consumption aligned with this dietary approach.”


    Prof. Nita Forouhi, senior author of the study

    Source:

    Journal reference:

    Sowah, S. A., et al. (2025) The association of the planetary health diet with type 2 diabetes incidence and greenhouse gas emissions: Findings from the EPIC-Norfolk prospective cohort study. PLoS Medicine. doi.org/10.1371/journal.pmed.1004633

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  • iFlow | Short Thoughts | Wednesday’s September FOMC, 25bp and what else?

    iFlow | Short Thoughts | Wednesday’s September FOMC, 25bp and what else?

    The Fed will cut rates 25bp on Wednesday, and the Summary of Economic Projections will add a third quarter-point rate cut for the end the year (up from the two cuts seen in June’s SEP). We don’t expect a 50bp cut, nor do we expect – despite the dots – the Fed to signal that an October cut is a fait accompli, adding some hawkish undertones to the meeting. As we pointed out in last week’s publication (see here), rate cuts this autumn, starting with this meeting, would have the Fed cutting rates even while inflation is running well over the 2% target. This doesn’t seem to concern the markets, which continue to price in a series of rate cuts well into next year.

    Let’s start with the dots. In the June SEP, the median 2025 projection envisioned two rate cuts this year (assuming 25bp for each). It wouldn’t take more than one or two contributors to move their dots lower for this quarter’s SEP to arrive at the three cuts we expect to be signaled. To mitigate against the market keying in on this anticipated change, we expect Chair Powell to point out – as he is wont to do at his press conferences – that the dots don’t represent a plan or a forecast but rather a representation of the collective view of the Committee given the outlook.

    We note that these cuts are largely fully priced in the market now, as Exhibit #1 shows. In addition, if the dots are indeed lower for 2025, we would expect that the projections for unemployment will have to rise from June’s 4.5%. Finally, we don’t have a high conviction view on 2026 and would not be surprised if the Committee as a whole feels the same way. In this regard, a wide dispersion of 2026 dots is not unlikely, and we don’t think the market will read too much into next year’s projections.

    Turning to the expected rate cut and how it is characterized, we first will look at the statement, which we expect to note the weakening in the labor market. At the July meeting, the statement was changed to assert that economic growth had moderated (from earlier statements asserting that the economy was expanding at a solid pace). How much alarm the Fed expresses about the economy and weakening jobs growth will be interesting, especially given the expected rate cut. However, if it also raises concerns about inflation, which is stubbornly high and potentially still grinding higher in coming months, it would highlight a degree of caution about a locked-in extended cycle. This is something we expect Powell to point out in his press conference, likely softening any overly dovish read of the meeting.

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  • British royal family holds first Catholic funeral in centuries for Duchess of Kent

    British royal family holds first Catholic funeral in centuries for Duchess of Kent

    By Tessa Gervasini

    Washington, D.C. Newsroom, Sep 16, 2025 /
    15:07 pm

    The British Royal family held its first Catholic funeral in modern history on Tuesday for the duchess of Kent, the first senior British royal to be received into the Church since the 17th century. 

    The duchess died on Sept. 4 at the age of 92 and asked that her funeral be held at Westminster Cathedral in London. She was raised Anglican but joined the Catholic Church in 1994. She described her conversion as a “long-pondered personal decision” but said she was attracted to the solace and clarity of the faith. 

    Her Royal Highness the Duchess of Kent holds a koala during a 1988 visit to Brisbane, Australia. Credit: Queensland State Archives, CC BY 3.0 AU, via Wikimedia Commons
    Her Royal Highness the Duchess of Kent holds a koala during a 1988 visit to Brisbane, Australia. Credit: Queensland State Archives, CC BY 3.0 AU, via Wikimedia Commons

    Born Katharine Lucy Mary Worsley, the duchess married Prince Edward, Duke of Kent, a first cousin of Queen Elizabeth II. Her family said she should be remembered for her “lifelong devotion to all the organizations with which she was associated, her passion for music, and her empathy for young people.”

    On Tuesday afternoon, hundreds gathered to honor the duchess’ life at the cathedral alongside the duke and their three children. King Charles III, Prince William, and Princess Kate Middleton were all in attendance; Queen Camilla was not present reportedly due to illness. 

    King Charles’ presence marked the first time a reigning British monarch has attended a Catholic funeral in a formal capacity on U.K. grounds since the Reformation.

    Britain’s King Charles III stands with Britain’s Princess Michael of Kent (left); Britain’s Prince Michael of Kent (second left); Britain’s Lord Frederick Windsor; Britain’s Prince William, Prince of Wales; Britain’s Catherine, Princess of Wales; Britain’s Sophie, Duchess of Edinburgh; and Britain’s Princess Anne, Princess Royal, following a Requiem Mass for the late Katharine, Duchess of Kent, at Westminster Cathedral in London on Sept. 16, 2025. Credit: JORDAN PETTITT/POOL/AFP via Getty Images
    Britain’s King Charles III stands with Britain’s Princess Michael of Kent (left); Britain’s Prince Michael of Kent (second left); Britain’s Lord Frederick Windsor; Britain’s Prince William, Prince of Wales; Britain’s Catherine, Princess of Wales; Britain’s Sophie, Duchess of Edinburgh; and Britain’s Princess Anne, Princess Royal, following a Requiem Mass for the late Katharine, Duchess of Kent, at Westminster Cathedral in London on Sept. 16, 2025. Credit: JORDAN PETTITT/POOL/AFP via Getty Images

    The Requiem Mass was celebrated by the archbishop of Westminster, Cardinal Vincent Nichols. The dean of Windsor joined the cathedral clergy during the Mass and presided over the burial of the duchess with the auxiliary bishop of Westminster. 

    In a Sept. 16 telegram to King Charles, Pope Leo XIV said he “was saddened to learn of the death of Her Royal Highness the Duchess of Kent.” The message was read by Archbishop Miguel Maury Buendia, apostolic nuncio to Great Britain, at the funeral Mass.

    “I send heartfelt condolences, together with the assurance of my prayerful closeness, to your majesty, the members of the royal family, and especially to her husband, the Duke of Kent, and their children and grandchildren at this time of sorrow,” Pope Leo wrote. 

    “Entrusting her noble soul to the mercy of our heavenly Father, I readily associate myself with all those offering thanksgiving to almighty God for the duchess’ legacy of Christian goodness, seen in her many years of dedication to official duties, patronage of charities, and devoted care for vulnerable people in society.”

    “To all who mourn her loss, in the sure hope of the Resurrection, I willingly impart my apostolic blessing as a pledge of consolation and peace in the risen Lord,” the pope said.

    Tessa Gervasini

    Tessa Gervasini is a staff reporter for Catholic News Agency.


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  • First-trimester cytomegalovirus screening found to be cost-effective

    First-trimester cytomegalovirus screening found to be cost-effective

    First-trimester cytomegalovirus screening found to be cost-effective | Image Credit: © jarun011 – © jarun011 – stock.adobe.com.

    Screening for primary cytomegalovirus (CMV) during the first trimester may be cost-effective by allowing treatment provision, according to a recent study published in the American Journal of Obstetrics & Gynecology.1

    Over 50% of US individuals are infected by CMV by the age of 40 years. In pregnancy, this can lead to congenital cytomegalovirus (cCMV), which is the primary infectious source of birth defects in US offspring.2 This has led to increased focus in managing this condition among clinicians and researchers.1

    “However, universal screening for CMV during pregnancy has long been opposed in the US, as screening is complex, given the need for differentiation between primary and secondary infections, and previously, no treatments were known to prevent vertical transmission of CMV,” wrote investigators.

    Screening and treatment pathways

    As new CMV treatments have emerged in recent years, investigators built a decision-analytic model to evaluate the cost-effectiveness of first-trimester primary CMV screening. Inputs for the model were found through searches of the PubMed database, with a theoretical cohort of 2,869,141 patients established.

    Study groups included patients receiving primary CMV in the first trimester and those without screening. Baseline primary CMV rates in US patients were used to determine true primary CMV cases. When undergoing screening, patients received testing with a serum IgG, followed by assessment with a serum IgM.

    In the model, valacyclovir treatment was only applied to patients identified with primary CMV. False negative screenings or cases of no screening in patients with primary CMV were assumed to have cCMV identified by abnormal ultrasound findings. It was also assumed that treatment would not be given to patients with no screening or without positive results.

    Cost considerations

    An analysis of a randomized controlled trial and 2 cohort studies were referenced to estimate CMV transmission rates to the fetus in patients with and without treatment. A branch was also included for women diagnosed with CMV but declining amniocentesis.

    Alongside vertical CMV transmission, stillbirths, abortions, neonatal deaths, neurodevelopmental disability, hearing loss, quality-adjusted life years (QALYs), and costs were reported as outcomes, with the latter based on a societal perspective. Costs and QALYs were both discounted at an annual rate of 3%.

    Relevant costs included excess cCMV management costs in the first year of life and costs of valacyclovir treatment and CMV screening, obtained from Centers for Medicare and Medicaid Services databases. Literature was assessed for all other costs.

    Findings on cost-effectiveness

    There were 2,869,141 pregnant patients included in the theoretical cohort, with CMV screening and treatment linked to 2898 less vertical transmissions, 94 fewer abortions, 19 fewer stillbirths, and 11 fewer neonatal deaths. Screening and treatment were also linked to reductions in hearing loss and neurodevelopmental disability of 460 and 263, respectively.

    Overall, universal screening was estimated to save 242.2 million dollars and lead to 3437 additional QALYs. Additionally, the willingness to pay threshold was never crossed, indicating no significant changes from an individual variable’s uncertainty. The model also highlighted a negative correlation between the efficacy of screening and the utility of hearing loss.

    Cost-effectiveness was even reported when reducing the specificity of the tests by over 60%. In a univariable sensitivity analysis, the cost-effectiveness of universal screening was increased up to 17-fold vs the current cost of screening tests. Finally, a multivariable analysis indicated cost-effectiveness from universal screening in 100% of samples.

    Implications

    The results indicated cost-effectiveness from primary CMV infection screening in the first trimester followed by treatment with valacyclovir. Investigators recommended further research to address contradictions between this data and prior cost-effectiveness studies.

    “To support that effort, further primary research, particularly with larger sample sizes, is needed to provide more evidence that valacyclovir or other CMV treatments are effective and safe in pregnancy,” wrote investigators.

    References

    1. Dzubay SK, Gagliuso AH, Arora M, et al. Universal screening and valacyclovir for first trimester primary cytomegalovirus: a cost-effectiveness analysis. Am J Obstet Gynecol. 2025;233:191.e1-9. doi:10.1016/j.ajog.2025.02.009
    2. Saldan A, Forner G, Mengoli C, Gussetti N, Palù G, Abate D. Testing for cytomegalovirus in pregnancy. J Clin Microbiol. 2017;55(3):693-702. doi:10.1128/JCM.01868-16

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  • Neurons play a key role in reducing lung inflammation in pulmonary fibrosis

    Neurons play a key role in reducing lung inflammation in pulmonary fibrosis

    Researchers at the University of Calgary studying a lethal lung disease called pulmonary fibrosis have found neurons, which were known to help detect pain, are also critical for reducing harmful lung inflammation that leads to the disease.

    Pulmonary fibrosis, also called lung scarring, is uncommon but it’s hard to treat and most people die within five years of diagnosis. Research to date has focused on how the lung lining gets damaged and the body’s attempts to repair the issue. The role of neurons – a complex network of cells within the nervous system that send messages between the brain, spinal cord and through the body – and the immune system has had less study.

    That is until a research team led by Cumming School of Medicine (CSM) physician-scientist Dr. Bryan Yipp, MD, found specific nerve cells that normally detect pain, also help control inflammation during lung fibrosis. An article – Nociceptor neurons suppress alveolar macrophage-induced Siglec-F+ neutrophil-mediated inflammation to protect against pulmonary fibrosis – detailing the discovery was published in the journal Immunity in August. 

    Our research into the role of the nervous system in lung diseases is new and our discovery opens up the possibility of using neurological therapies to treat lung diseases.”


    Dr. Bryan Yipp, MD,  physician-scientist, Cumming School of Medicine

    “Diseases such as seizures and mood disorders are currently being treated with electrical stimulation of nerves. Our findings show the same nerves being treated with electrical devices are the ones responsible for lung protection, so it is conceivable that boosting their function could improve the scarring,” says Yipp.

    Nerve cells in the lungs normally detect pain and foreign particles, inducing cough. Using mice, researchers found those cells also help protect the lungs by keeping potent inflammatory cells in check. When these nerve cells were removed – either through drugs or genetic manipulation – the inflammatory cells became dysregulated, and lung damage worsened. 

    Without the protective nerve cells, immune cells in the lungs (called alveolar macrophages) started producing a molecule involved in nerve communications called a neuropeptide, which they normally do not make. This unusual production of a nerve communication molecule drove inflammatory lung damage.

    “When we blocked the neuropeptide, named VIP, or removed the gene that makes it in the dysfunctional macrophages, the lung damage improved along with the harmful inflammation. But when VIP was added, the damage got worse again,” says first author Dr. Carlos Hiroki, PhD, whose doctoral thesis investigated the impact of nerve cells on pulmonary fibrosis for the past five years.

    Each year, about 2,500 people in Canada die from lung scarring and about 30,000 people live with the disease. The Yipp lab is working to better understand lung scarring so that new treatments can be developed. 

    This research received funding from the Canadian Institutes of Health Research (CIHR). The team will continue the study after receiving additional CIHR grant funding earlier this year. The research also benefited from use of the CSM’s Nicole Perkins Microbial Communities Core Labs flow cytometry core facility.

    September is Pulmonary Fibrosis awareness month, a global event designed to raise awareness and support those affected by the disease.

    Source:

    Journal reference:

    Hiroki, C. H., et al. (2025). Nociceptor neurons suppress alveolar macrophage-induced Siglec-F+ neutrophil-mediated inflammation to protect against pulmonary fibrosis. Immunity. doi.org/10.1016/j.immuni.2025.05.002

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  • GLP-1 Medications Force Food Industry Rethink – IFT.org

    1. GLP-1 Medications Force Food Industry Rethink  IFT.org
    2. The Ozempic movement: Can restaurants survive in the new age of weight-loss drugs?  The Caterer
    3. The Weight of Progress: A New Era Dawns for Anti-Obesity Drugs, Reshaping Markets and Health  FinancialContent
    4. America’s obsession with Ozempic  wng.org
    5. Ozempic Is The New Botox – And Novo, Eli Lilly Are Printing Billions – Novo Nordisk (NYSE:NVO), Eli Lilly (NYSE:LLY)  Benzinga

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