Day: July 22, 2025

Categories : CancerTags :

Radiotherapy Overcomes Resistance to Immunotherapy in Some Cancers

On By ModernMedia

By sparking the immune system into action, radiation therapy makes certain tumours that resist immunotherapy susceptible to the treatment, leading to positive outcomes for patients, according to new research published July 22 in Nature Cancer. Investigators dove deep into the molecular biology of non-small cell lung cancer to pinpoint what happens on a cellular and molecular level over time when the cancer is treated with either radiation therapy followed by immunotherapy or immunotherapy alone.

They found that radiation plus immunotherapy induced a systemic anti-tumour immune response in lung cancers that do not typically respond to immunotherapy. The combination therapy also yielded improved clinical response in patients whose tumours harbour features of immunotherapy resistance. 

Clinically, the results suggest that radiation therapy can help overcome immunotherapy resistance in certain patients. Researchers at the Johns Hopkins Kimmel Cancer Center Bloomberg~Kimmel Institute for Cancer Immunotherapy and the Netherlands Cancer Institute conducted the study, which was supported by the National Institutes of Health. 

“For a fraction of lung cancers where we aren’t expecting therapy responses, radiation may be particularly effective to help circumvent primary resistance to immunotherapy; this could potentially be applicable to acquired resistance, too,” says senior study author Valsamo “Elsa” Anagnostou, MD, PhD, co-director of the Upper Aerodigestive Malignancies Program, director of the Thoracic Oncology Biorepository, leader of Precision Oncology Analytics, co-leader of the Johns Hopkins Molecular Tumor Board and co-director of the Lung Cancer Precision Medicine Center of Excellence at Johns Hopkins. 

Researchers have long sought to better understand why some tumours grow resistant to immunotherapy and how to intercept that resistance. 

Radiation therapy has been proposed as one possible way to induce a systemic immune response because of a unique phenomenon called the abscopal effect. Radiation at the site of a primary tumour typically causes tumour cells to die and release their contents into the local microenvironment. Sometimes, the immune system discovers those contents, learns the tumour’s molecular footprint, then activates immune cells around the body to attack cancer cells at tumour sites that were not the targets of the radiation, including some far away from the primary cancer in the body. 

Because of this effect, radiation therapy could potentially improve how well an immunotherapy works against a cancer, even far from the original radiation site. Yet little has been known about the molecular biology behind the abscopal effect, or how to predict when and in which patients it will occur. 

To study this phenomenon, Anagnostou and colleagues obtained samples from patients with lung cancer at different times throughout their treatment journey and from various locations in the body, not just at the primary tumour site. They collaborated with Willemijn Theelen and Paul Baas at the Netherlands Cancer Institute, who were running a phase II clinical trial on the effect of radiation therapy followed by immunotherapy, specifically the PD-1 inhibitor pembrolizumab. 

With help from Theelen and Baas, Anagnostou’s team analysed 293 blood and tumour samples from 72 patients, obtained at baseline and after three to six weeks of treatment. Patients in the control group received immunotherapy alone, while the experimental group received radiation followed by immunotherapy. 

The team then performed multiomic analyses on the samples (combining different “omics” tools, including genomics, transcriptomics and various cell assays) to deeply characterise what was happening to the immune system systemically and in the local microenvironment at tumour sites that were not directly exposed to radiation. 

In particular, the team focused on immunologically “cold” tumours — those that typically do not respond to immunotherapy. These tumours can be recognised by particular biomarkers: a low mutation burden, no expression of a protein called PD-L1, or the presence of mutations in a signalling pathway called Wnt. 

Following radiation and immunotherapy, the team found that “cold” tumors far from the site of radiation experienced a prominent reshaping of the tumor microenvironment. Anagnostou describes this shift as the tumors “warming up,” transitioning from little or no immune activity to inflamed sites with strong immune activity, including the expansion of new and pre-existing T cells. 

“Our findings highlight how radiation can bolster the systemic anti-tumor immune response in lung cancers unlikely to respond to immunotherapy alone,” says lead study author Justin Huang, who led the multiomic analyses. “Our work underscores the value of international, interdisciplinary collaboration in translating cancer biology insights to clinical relevance.” Huang was awarded the 2025 Paul Ehrlich Research Award in recognition of groundbreaking discoveries by young investigators and their faculty mentors at the Johns Hopkins University School of Medicine.     

With Kellie Smith, PhD, an associate professor of oncology at the Johns Hopkins Kimmel Cancer Center and a Bloomberg~Kimmel Institute for Cancer Immunotherapy researcher, Anagnostou’s team focused on patients who attained long-term survival with combination radiotherapy and immunotherapy, and performed a functional test to find out what the patients’ own T cells were doing in the body. In cell cultures, they confirmed that the T cells expanding in patients who received radiation and immunotherapy were indeed recognizing specific mutation-associated neoantigens from the patients’ tumours. 

Finally, by tracking patient outcomes from the clinical trial, the team observed that patients with immunologically cold tumours that “warmed up” due to radiation therapy had better outcomes than those who did not receive radiation therapy. 

“It was super exciting, and truly made everything come full circle,” says Anagnostou. “We not only captured the abscopal effect, but we linked the immune response with clinical outcomes in tumours where one would not expect to see immunotherapy responses.” 

Using specimens from the same cohorts of patients, the team has recently been working to capture the body’s response to immunotherapy by detecting circulating tumour DNA (ctDNA) in the blood. That work was presented April 28 at the annual meeting of the American Association for Cancer Research in Chicago. 

Source: Johns Hopkins Medicine

Categories : Ethics and LawTags :

Carte Blanche “Gagging” Order Overturned

On By ModernMedia
Photo by Bill Oxford on Unsplash

A “gagging order” preventing Carte Blanche from broadcasting a programme about a Durban-based cardiologist accused of malpractice has been set aside.

Pietermaritzburg High Court Judge Siphokazi Jikela has ruled that the finalisation of the interdict, granted in early June by another judge, would “amount to an unjustified prior restraint and would undermine the essential role of the media in a democratic society”.

The matter came before Judge Jikela for determination on whether or not the interim order should be made final.

She has now dismissed the application and ordered cardiologist Dr Ntando Peaceman Duze to pay the costs.

Duze was accused by some of his patients of inserting stents unnecessarily, which resulted in them lodging complaints with the Health Professions Council of South Africa (HPCSA).

Carte Blanche interviewed them and got independent experts to corroborate their claims.

While Carte Blanche gave him multiple opportunities over two weeks to respond to questions, Duze turned to the courts, claiming “defamation” and preventing the airing of the segment. He wanted the interdict to be made final until the HPCSA had ruled on the complaints against him.

The matter was argued before Judge Jikela the following week. She handed down her ruling on Monday.

Read the judgment

Read GroundUp editorial: Judges should respect press freedom

Duze, in his initial application, also cited two other cardiologists as respondents but did not persist with his claims against them.

However, he said the complaints against him were instigated by them because of “professional jealousy”, a “conspiracy” and a “smear campaign”, because of the success of his practice at Westville Life Hospital.

He said he had elected not to respond to Carte Blanche because the questions were “defamatory” and sub judice as the issues were under consideration by the HPCSA.

Carte Blanche opposed the application.

Advocate Warren Shapiro argued that both the Constitutional Court and the Supreme Court of appeal had determined that a “prior restraint” was a drastic interference with freedom of expression, which was only granted in narrow circumstances.

Judge Jikela said that while Duze claimed the broadcast would infringe on his right to dignity and may cause reputational harm, she was mindful that “any restriction on media reporting warrants careful and cautious consideration”.

“Several defences may be raised in response to an allegation of defamation. In this matter, [Carte Blanche] sets out the defences that directly address the core grounds on which [Duze] has based his case.

“Notably they contend that the broadcast in question centres on the personal accounts of his former patients, which are supported by medical records and independent expert opinion. Duze himself states that he consults, on average, 50 patients a day and he treats nearly every heart patient at Westville Life Hospital.

“In these circumstances, there is a compelling public interest in the dissemination of information concerning the conduct of a medical professional whose actions may pose a risk to the health and safety of current and future patients,” Judge Jikela said.

Carte Blanche had also said the intended broadcast included comments made honestly and in good faith which fell within the ambit of protected fair comment.

“It is trite that media publications on matters of public interest enjoy protection, provided they are made reasonably, without malice, and after taking reasonable steps to verify the information prior to publication,” the judge said.

Judge Jikela said Duze’s right to protect his reputation and professional standing was not absolute and it did not trump Carte Blanche’s constitutionally protected right to freedom of expression which includes the freedom of the press.

“Importantly, the public also has a legitimate interest in being informed about matters that concern public health and potential risks to patient safety.”

She said Duze had only made “vague references” to pending hearings and investigations. Duze had to show a real and demonstrable risk of substantial prejudice “as opposed to a remote possibility”.

“The HPCSA is not a court of law. The sub judice rule does not apply automatically to its processes.

“I do not believe that the broadcast will improperly influence the panel of medical professionals tasked with adjudicating the complaints against him, particularly where those complaints are supported by scientific and clinical evidence.”

Turning to the issue of the balance of competing rights, Judge Jikela said Carte Blanche had sought external objective opinions and had given Duze the right to reply.

“Media reports are vital in ensuring transparency, accountability and the protection of the public, particularly in sectors as essential as health care,” she said.

Medical practitioners had a duty to act in the best interests of patients. Where there were breaches of these obligations, the public had a constitutionally protected right to be informed.

“While the right to dignity and reputation must be respected, it cannot be invoked to shield conduct that may endanger lives or compromise patient care,” Judge Jikela said.

She said prior restraint had a “chilling effect” on the right to freedom of expression.

If the broadcast was indeed unlawful or defamatory, Duze could claim damages from Carte Blanche.

“The inconvenience of pursuing a damages claim does not outweigh the importance of safeguarding freedom of expression, particularly where the applicant [Duze] has not demonstrated irreparable harm or the falsity of the statements,” she said.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Read the original article.

Categories : Surgeries & ProceduresTags :

Move Over Fillers: Why SA Patients Are Choosing PRF Anti-aging Treatments

On By ModernMedia

A major shift is underway in South Africa’s aesthetics industry, as cutting-edge platelet-rich fibrin (PRF) is quickly surpassing fillers or traditional platelet-rich plasma (PRP) therapy as the anti-ageing treatment of choice, delivering results that patients describe as “four times better” than its predecessor.

“Since introducing PRF into our practice, patients overwhelmingly choose it over PRP for skin rejuvenation and anti-ageing,” notes Dr Reza Mia, aesthetics expert at Anti-Aging Art in Johannesburg. “It means injecting a more potent concentrate with four times the cells to produce the results needed than previous alternatives, and subjectively, patients report it’s indeed four times better.”

A significant evolution from the once-popular “vampire facial”, PRF uses concentrated healing cells from the patient’s own blood to address an impressive range of concerns.

“When someone needs to improve their skin condition, stimulate hair growth, treat stretch marks and scarring, heal certain injuries or wounds, or even enhance intimate well-being with our P-shots and V-shots, PRF delivers some extraordinary results. For example, with our P-shots and V-shots, we’re seeing dramatic improvements in post-menopausal and post-pregnancy concerns among women, while men are achieving some enhancements in size, function, and performance,” he explains.

Turning platelets into a living filler

Through cutting-edge techniques, Dr Mia’s team turns the patient’s blood into a natural injectable filler with a blend of active cells and filler material, creating a gel-like substance. The filler is then injected back into the face or other areas where volume is needed, offering a compelling substitute for hyaluronic acid fillers, and a more powerful alternative to synthetic products. 

PRP’s shorter lifespan comes from the use of anticoagulants that prevent clotting and keep the platelets inactive until they are injected. These additives thin the solution, causing it to spread quickly in the body. As a result, the treatment has less time to work and build momentum.

Because anticoagulants can interfere with the regenerative properties of platelets, they aren’t used in PRF. Instead, PRF works with the body’s natural fibrin clotting process, creating a rich concentration of platelets, healing proteins, and repair signals that trigger tissue regeneration and collagen production – helping the skin recover and appear more youthful for longer.

“These platelets stay active for roughly three weeks, instead of the 12-hour window we see with PRP. The release is gradual and the platelets have more time to work in the body, so collagen and fibronectin production is stimulated for longer. This translates into thicker skin, steadier hair-growth cycles, and a noticeably longer glow. Our clinic further uses an advanced centrifuge protocol that can achieve more than four times the platelet count from a session with PRF, packing each vial with far greater regenerative potential.”

In practice, Anti-Aging Art uses PRF to revitalise and restore wherever the skin or hair needs a boost. It’s become a go-to for smoothing fine lines, strengthening hair follicles to fill in patchy beards and thinning crowns, and refreshing postpartum skin. “Many patients who switched from PRP to PRF report they healed faster and need fewer follow-up visits, making it a preferred option.”

The recovery time is also notably shorter. “With standard microneedling, patients remain red for two to three days. With PRF, they’re red for just a day – the platelets actually accelerate their healing.”

A non-surgical breast enhancement alternative

One of the most groundbreaking applications has been for non-surgical breast enhancement. “For patients who’ve removed their implants and now have tissue laxity, or those seeking natural enhancement without surgical implants, PRF filler is a game-changer. For breast enhancement, there really isn’t an alternative, with results lasting as long as six to 12 months.”

Because PRF is taken from the patient’s own blood and then allowed to thicken into a soft gel before injection, it acts like a natural cushion inside the breast. Once placed, the gel holds its shape for a few weeks, giving an immediate subtle lift. The platelets inside also continue to release growth signals that tell the body to lay down fresh collagen and create tiny new blood vessels, so the early fullness slowly turns into real, living tissue instead of fading away like normal swelling.

“Patients like that the injected material is completely theirs, with no risk of immune rejection, hard capsules or implant leaks, while routine mammograms remain easy for radiologists to read. Most women feel only mild bruising and heaviness for a day or two, and they’re back to normal within the week.

“There is some swelling over the first few days, so patients should plan treatments well before any special events. If you choose a top-up after a year, the new PRF simply layers onto existing tissue, giving a gentle, cumulative boost without stretching the skin unnaturally.”

Treatments start around the cost of a mid-range smartphone and vary based on the extent of the area treated. Results become visible quickly but continue to improve over time, developing over three to six months as collagen rebuilds, delivering significant value compared to multiple syringes of traditional fillers or surgical options.

However, Dr Mia cautions that PRF is powerful but not magical. “Regeneration has a biological ceiling. We can thicken skin, soften scars, and enhance breasts naturally, but PRF doesn’t replace surgical intervention for augmentation. PRF also isn’t appropriate for everyone – especially anyone with active cancer in the treatment area, since the growth factors could stimulate those cells.

“But for most patients seeking a rejuvenated, youthful appearance with that coveted ‘juicy’ glow, PRF delivers results that synthetic alternatives simply can’t match,” he concludes.

Categories : Implants and Prostheses NeurologyTags :

Building Better Cerebrospinal Fluid Shunts for the Brain

On By ModernMedia
Schematic of approach to simulating brain shunt fluid dynamics. Credit: Harvard SEAS

Millions of people worldwide suffer from hydrocephalus, a condition which recently received greater attention when Billy Joel announced his diagnosis. Treatment usually involves surgical placement of shunts to divert cerebrospinal fluid away, but this procedure often leads to complications, infections, and multiple re-treatments.  

Bioengineers in the Harvard John A. Paulson School of Engineering and Applied Sciences (SEAS) have now developed a new computational model to aid the creation of shunts tailored to individual patients’ anatomy and needs. The model combines brain anatomy, fluid flow, and biomolecular transport dynamics to simulate shunt performance with pinpoint accuracy.

The work was supported by federal funding from the National Science Foundation and published in Proceedings of the National Academy of Sciences. It was led by SEAS postdoctoral fellow Haritosh Patel, who works in the labs of Joanna Aizenberg, Professor of Materials Science at SEAS and Professor of Chemistry and Chemical Biology; and Venkatesh Murthy, Professor of Molecular and Cellular Biology and Director of the Center for Brain Science.

Repeat surgeries due to infection or obstruction

Tens of thousands of shunt procedures are performed annually in the U.S. — many of which are repeat surgeries due to the inserted devices becoming blocked or obstructed, or the patient suffering an infection.

“Some elderly patients told me they had had over 10 surgeries — one every two to three years,” Patel said. “We really wanted to understand why this was happening, and we realised that many of these obstructions and infections were tied to shunt designs that didn’t fully consider fluid dynamics as a fundamental part of their geometry. We noticed that the tubing geometry used in shunts closely resembles the kind of piping we rely on in household plumbing. While that simplicity has its advantages, we saw an opportunity to explore more creative, biomimetic solutions that better suit the complexity of the brain’s environment.”

Pursuing the problem from both a material and design perspective, the team quickly realized there was no universally accepted fluid flow model for the brain ventricle space to guide them. “Okay, well, we can’t test our devices in a model, so why don’t we first make a better model?” Patel said.

Computational tool simulates fluid flow in brain

The result is their computational tool, called BrainFlow, which combines detailed anatomical and physiological features of the brain to simulate the flow of cerebrospinal fluid flow in the presence of shunt implants.

 The model incorporates patient-specific medical imaging data along with pulse-induced flow to mimic a patient’s cerebrospinal fluid dynamics, all to offer insight into optimal shunt design, placement, and even choice of materials.

“We believe that our model, combined with novel geometries and materials improvements such as anti-biofouling coatings developed in my lab, could lead to smoother integration of optimized, patient-specific medical devices into patients’ brains, with less likelihood of complications, and a better quality of life,” Aizenberg said.

The Harvard team is currently conducting studies that use the model to test different designs of shunts and calculate their efficacy.

Source: Harvard John A. Paulson School of Engineering and Applied Sciences

Categories : NeurologyTags :

New Discovery Reveals Dopamine Operates with Surgical Precision

On By ModernMedia
Neurotransmitters at a synapse. Credit: Scientific Animations CC4.0

A new study from the University of Colorado Anschutz Medical Campus has upended decades of neuroscience dogma by revealing that the neurotransmitter dopamine communicates in the brain with extraordinary precision – not broad diffusion as previously believed. This groundbreaking research offers fresh hope for millions of people living with dopamine-related disorders, marking a significant advance in the quest for precision-based neuroscience and medicine.

For years, scientists thought of dopamine as a kind of chemical “broadcast system,” flooding large areas of the brain to influence behaviour. But new research, published in Science, found that dopamine acts more like a finely-tuned postal service, delivering highly localised messages to specific nerve cell branches at exact moments in time.

“Our current research found that dopamine signaling and transmission in the brain is much more complex than we thought,” said Christopher Ford, PhD, professor at the University of Colorado School of Medicine and lead author. “We knew that dopamine plays a role in many different behaviours, and our work gives the beginning of a framework for understanding how all those different behaviours could all be regulated by dopamine.”

‘We are really only at the tip of the iceberg in trying to understand how dysfunctions in dopamine contribute to diseases like Parkinson’s disease, schizophrenia or addiction.’

– Christopher Ford, PhD

Using advanced microscopy techniques, researchers found that dopamine is released in concentrated hotspots which enable targeted, rapid responses in nearby brain cells, while broader signals activate slower, widespread effects. This dual signaling system allows dopamine to simultaneously fine-tune individual neural connections and orchestrate complex behaviours like movement, decision-making, and learning.

The implications are far-reaching: dopamine system dysfunction plays a central role in a wide range of brain disorders, including Parkinson’s disease, addiction, schizophrenia, ADHD and depression. Current treatments largely focus on restoring overall dopamine levels – but this research suggests that the precision of dopamine signalling may be just as crucial.

“We are really only at the tip of the iceberg in trying to understand how dysfunctions in dopamine contribute to diseases like Parkinson’s disease, schizophrenia or addiction,” said Ford. “More work is needed to grasp how these specific changes in dopamine signalling are affected in these different neurological and psychiatric diseases. The goal, of course, would then be to build on those findings to come up with new and improved treatments for those disorders.”

Source: University of Colorado Anschutz Medical Campus