Haematuria, the presence of blood cells in urine, is a sign of bladder cancer. Because aspirin blocks platelets from forming harmful blood clots, the medication can cause mild bleeding or worsen existing bleeding in the urinary tract. Results from a study in the Journal of Internal Medicine suggest that this may prompt a clinician to run tests that uncover an asymptomatic bladder tumour.
For the study, investigators analysed information on 50 771 Danish adults who started taking aspirin in 2005–2023, as well as 156 191 who started non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs), which have less pronounced antiplatelet abilities than aspirin.
Compared with adults from the general population who have never used aspirin or NSAIDs, aspirin initiators received more cystoscopies – minimally invasive procedures that allow a doctor to view the inside of the bladder and urethra with a lighted tube equipped with a camera. Cytoscopy results showed that recent aspirin initiators had a similar bladder cancer prevalence, but a lower prevalence of invasive stage compared with never-users. This suggests that individuals initiating aspirin treatment represent a patient population with a higher incidence of bladder cancer, and that their higher cystoscopy rate reflects this and thus is clinically warranted. The combination of a larger proportion of relevant cystoscopies and a lower prevalence of invasive cancer stage at diagnosis may represent unmasking of otherwise asymptomatic bladder cancer.
NSAID initiators received more cystoscopies than never-users, but they had a lower bladder cancer prevalence after cystoscopy and a similar stage distribution as never-users. This suggests that the higher cystoscopy rate may not have been clinically warranted.
“We are very encouraged by these results. In the clinical setting, they underline the importance of acting on suspicious bladder cancer symptoms among aspirin initiators,” said lead author Malene Söth Hansen, MD, of Aarhus University. “The findings may further have implications for the question of whether aspirin can prevent bladder cancer, as detection in trials with short-term follow-up may appear as a higher incidence in the aspirin-exposed cohort.”
For a long time, the likelihood of surviving pancreatic cancer has been extremely low. For patients who were diagnosed with metastatic pancreatic cancer between 2015 and 2021, about 97% died within five years of their diagnosis.
Pancreatic cancer is so deadly in part because there are no effective screening tests, and it rarely causes noticeable symptoms in its earliest stages. By the time a patient experiences signs, such as jaundice – a yellowing of the skin – or abdominal pain, the cancer has often already spread to other organs.
As a gastrointestinal oncologist and researcher specialising in early-phase clinical trials, I have seen the critical need for more effective therapies for patients with pancreatic cancer. For decades, successfully targeting the central mechanism that causes the vast majority of pancreatic cancers was considered impossible.
However, that narrative is rapidly changing with a new drug that can shut down the key protein that drives pancreatic cancer, nearly doubling survival rates for patients with advanced stages of the disease.
‘Undruggable’ tumours
The standard treatment for advanced pancreatic cancer has historically relied on chemotherapy, potent drugs designed to kill rapidly dividing cells. While chemotherapy can slow the progression of the disease, its effectiveness is often limited by the ability of pancreatic cancer cells to develop resistance against these drugs.
Pancreatic cancer’s success lies in its genetics. More than 90% of pancreatic tumours are driven by mutations in a gene called KRAS. This gene codes for proteins that function as switches that turn cell growth on and off. When the KRAS gene is mutated, the switch becomes permanently stuck in the “on” position, commanding cancer cells to multiply endlessly.
For decades, scientists considered KRAS to be “undruggable.” The surface of the protein is exceptionally smooth, lacking the molecular pockets that standard drugs require to bind to and turn the switch off.
Because existing drugs haven’t been able to target this protein, treatment for pancreatic cancer has primarily relied on toxic drugs that act more like blunt instruments than precise tools. Chemotherapy attempts to control the disease through widespread cell destruction, causing significant collateral damage to healthy tissues that lead to side effects.
Daraxonrasib is taken daily by mouth. Instead of binding to KRAS directly, it attaches to a molecule called cyclophilin A in cells that helps fold proteins into their final 3D structures. This protein complex is then able to bind to the active KRAS protein and shut down its ability to signal cancer cells to multiply.
The company developing the drug, Revolution Medicines, presented results on May 31, 2026, from its Phase 3 clinical trial of 500 patients with metastatic pancreatic cancer who had received prior treatment. Compared to standard chemotherapy, daraxonrasib nearly doubled overall survival from 6.7 months to 13.2 months after diagnosis. Overall, daraxonrasib reduced the risk of death for metastatic pancreatic cancer patients by 60%. https://www.youtube.com/embed/sIspXSWQn1w?wmode=transparent&start=0 Daraxonrasib nearly doubled survival for patients with advanced pancreatic cancer compared to chemotherapy.
The most common side effect is a prominent skin rash, which affected more than 86% of patients in the study. Patients also frequently dealt with stomatitis – painful swelling and sores inside the mouth – as well as diarrhoea, nausea and vomiting. However, patients taking daraxonrasib were far less likely to stop treatment due to severe side effects compared to chemotherapy, and they had improved quality of life with reduced pain.
Next steps for daraxonrasib
By successfully targeting the specific genetic mutation that drives the vast majority of pancreatic cancers, researchers have demonstrated that this “undruggable” disease is treatable with targeted therapy.
The immediate next step is regulatory review of the drug’s readiness for the clinic. With data now officially published, Revolution Medicines will use these findings to seek formal approval from the Food and Drug Administration and other global regulatory bodies.
Because advanced pancreatic cancer is notoriously difficult to treat, breakthrough therapies that demonstrate this kind of significant survival benefit are often granted expedited or priority review. When daroxonrasib becomes available to patients will depend on the review timeline. Should the drug obtain approval, it could be available in clinics within months.
For the broader landscape of drug development, this milestone represents a likely shift in pancreatic cancer treatment. I expect more clinical trials exploring combination therapies pairing KRAS inhibitors with other drugs to prevent tumours from developing resistance to treatment.
Should daraxonrasib succeed, it could help set the stage for more precise, personalised and effective treatments for pancreatic cancer in the years to come.
3D structure of a melanoma cell derived by ion abrasion scanning electron microscopy. Credit: Sriram Subramaniam/ National Cancer Institute
The combination of a vaccine and a drug, which both harness the immune system to attack cancer cells, has proven successful in cutting the risk of skin cancer recurrence by 49% , a new study shows. This reduction, which was calculated five years after patients had their tumours surgically removed, remains unchanged.
Led by researchers at NYU Langone Health and its Perlmutter Cancer Center, the study tested the vaccine, called intismeran, in combination with the mainstay immunotherapy pembrolizumab (Keytruda) in 107 patients who had been randomly chosen after melanoma surgery to determine whether the combination therapy prevented their cancer from recurring. Intismeran is a personalized immunotherapy strategy that is developed with information from a patient’s individual tumour. These results were compared with those from a randomly selected group of 50 melanoma patients who had only received pembrolizumab postoperatively, a current standard of care.
Results of the phase 2b trial, known formally as KEYNOTE-942, are being presented at the 2026 annual meeting of the American Society of Clinical Oncology on June 1 in Chicago and simultaneously published in the society’s Journal of Clinical Oncology.
After five years of follow-up, 68.8% of patients who took the combination therapy remained cancer-free, while 49.1% of the patients in the pembrolizumab-alone group had no signs of cancer. This means that adding intismeran to pembrolizumab reduced the risk for recurrence or death by 49%. The combination therapy also reduced the risk of distant metastasis by 59%. Overall survival, meaning no death from cancer or any other cause, was 92.2%for the vaccine with immunotherapy group, while for the immunotherapy-alone group it was 71.3%.
“Our study offers strong evidence to melanoma patients that intismeran vaccine therapy, when used in combination with immunotherapy, can demonstrably reduce their risk of having their cancer return and improve clinical outcomes,” said study senior investigator Janice Mehnert, MD, a professor in the Department of Medicine at NYU Grossman School of Medicine.
“Our findings also serve as encouragement to cancer researchers globally that mRNA vaccines like intismeran could work well in combination with immunotherapy for other cancers whose high rates of mutations have proven difficult to target,” said Dr Mehnert, who also serves as director of the melanoma medical oncology program and associate director of clinical research at Perlmutter Cancer Center.
The study results highlight the role of T cells, which are capable of attacking viruses as well as cancers. To spare normal cells, the immune system uses checkpoint molecules on T cell surfaces to “turn off” their attack against viruses when they clear the infection. The body may recognide tumours as abnormal, but cancer cells hijack checkpoints to turn off and evade immune responses. Immunotherapies like pembrolizumab seek to block checkpoints, specifically the PD-1 protein receptor, making cancer cells more “visible” and vulnerable again to immune cells.
Immunotherapies, including PD-1 inhibitors like pembrolizumab, have become the mainstay for treating melanoma, although they do not work for all patients, because melanoma cells, known for their ability to evade the immune system, can become resistant to immunotherapy. For this reason, researchers have looked at adding vaccines.
The vaccine intismeran is based on messenger RNA, a chemical cousin of DNA that provides cells with instructions for making proteins. Intismeran and other mRNA cancer vaccines are meant to teach the immune system to recognize cancer cells as different from normal cells. In designing a vaccine against melanoma, researchers attempted to trigger an immune response to specific abnormal proteins, called neoantigens, made by cancer cells.
Because the study volunteers all had their tumours removed, researchers were able to analyse their cells for 34 neoantigens that were specific to each melanoma and create a personalised vaccine for each patient. As a result, T cells specific to the neoantigen proteins encoded by the mRNA were produced. Those T cells could then attack any melanoma cells trying to grow or spread.
Dr. Mehnert said that a phase 3, multicenter trial is already underway to determine if intismeran helps as a first-line therapy in combination with pembrolizumab for melanoma. Already, the vaccine is being tested to see if it also works to prevent recurrence of lung and other cancers.
For the KEYNOTE-942 trial, patients were enrolled at cancer centers in Australia and the United States from 2019 to 2021. All were men and women who had had surgery to remove their melanoma tumors. Seven patients in each treatment group died during follow-up, most from cancer. Side effects were considered manageable and included fatigue, pain at injection sites, and chills.
A plant long used in traditional medicine is now at the centre of research that could shape future cancer treatment options in South Africa and beyond.
Researchers at the North-West University(NWU) are investigating the anti-cancer potential of Lessertia frutescens, commonly known as cancer bush, after laboratory studies showed activity against several forms of cancer, including drug-resistant small cell lung cancer and colorectal cancer.
According to Prof Chrisna Gouws, a research professor in the Centre of Excellence for Pharmaceutical Sciences in the Faculty of Health Sciences, the research team tested extracts from the indigenous plant on cultured human cancer cells and more advanced laboratory-grown “mini-tumours” known as spheroids.
“Lessertia frutescens has shown significant anticancer activity against several different cancer types in our research,” she says.
Targeting cancers considered incurable
She says the findings became more important when the team observed activity in cancers that no longer respond to conventional treatment.
“What is very interesting and exciting is the apparent activity in drug-resistant cancers such as resistant small cell lung cancer where known chemotherapies have limited to no activity,” Prof. Gouws says.
“This provides us with new avenues to investigate for treatment options to treat cancers currently considered incurable.”
The research team said another factor attracting attention is the plant’s longstanding use in traditional medicine and its safety profile.
“An important consideration is that this plant has a long history of use and is considered non-toxic and safe for use,” Prof. Gouws says.
“It’s anticancer activity comes without the significant side-effects known to occur with most standard chemotherapies.”
Other systems in the body may benefit
Researchers also found that the plant may support other systems in the body during treatment.
“Lessertia has known boosting effects for the digestive and immune systems, and it can have mood-enhancing activities as well,” she says.
“It may therefore not only target the cancer but positively impact the patient as a whole at the same time.”
The team is now studying the plant’s phytochemicals to identify the molecules responsible for the anticancer activity and understand how they work.
“Although many molecules have been identified and shown to contribute to the anticancer activity of the plant, the mechanism of action remains mostly unclear,” says Prof. Gouws.
“We are therefore delving deeper now to try and understand how and why this plant works.”
The next phase of the study will include animal model testing later this year to confirm safety and efficacy before future clinical trials can be considered.
At the same time, the researchers are developing a complementary medicine product that may be available in pharmacies by 2027.
Prof. Gouws says the project could also create economic opportunities.
“Chemotherapy can be very expensive and inaccessible in rural areas. A new plant-based treatment will be much more cost-effective and may be more accessible because it can be manufactured locally,” she says. “An increase in demand for the plant material will also create economic opportunities through farming.”
More about Prof Chrisna Gouws
Prof Gouws leads the strategic project for Human-Based New Approach Methodologies for Biomedical Research. She holds a PhD in biochemistry and has more than 15 years’ experience in utilising cell culture-based models for human health and disease research, including developing new complex in vitro models for applications in drug research, including traditional medicinal remedies and plant materials for cancer treatment.
She is the founder and executive committee chair for the Society for Advanced Cell Culture Modelling for Africa, a board member of International Microphysiological Systems Society, and co-editor of the NAM Journal.
Patients with vitamin D deficiency may benefit from supplements before operations
Photo by Tima Miroshnichenko on Pexels
Vitamin D deficiency is associated with more moderate to severe pain following breast cancer surgery and an increased consumption of opioid drugs, finds research published online in the journal Regional Anesthesia & Pain Medicine. Breast cancer patients with low levels of vitamin D (below 30nmol/L) may benefit from taking supplements before undergoing a radical mastectomy, suggest researchers.
There is emerging evidence suggesting that vitamin D helps control how pain is felt and processed by the body. This is likely due to its anti-inflammatory effects and action on the immune system. Vitamin D deficiency is also commonly reported among patients with breast cancer. A team of researchers set out to examine the relationship between vitamin D deficiency and postoperative pain in patients undergoing breast cancer surgery.
Their prospective observational study, carried out at Fayoum University Hospital in Egypt between September 2024 and April 2025, included 184 breast cancer patients who were scheduled to undergo surgical removal of one entire breast.
Half of the patients were classified as vitamin D deficient (below 30 nmol/L) and half were classified as vitamin D sufficient (above 30nmol/L). Both groups had similar characteristics with an average age of 44 in the vitamin D deficient group and 42 in the vitamin D sufficient group.
Patients were managed according to the hospital’s routine protocol both during and after surgery. Clinical staff involved in their care were unaware of the patients’ vitamin D levels.
The opioid fentanyl was administered during the operation to manage acute pain. Following surgery, all patients were given paracetamol through a drip every 8 hours. In addition, patients could control how much tramadol (another opioid analgesic) they were given by directly pressing a button.
Patients reported their pain levels at zero, 6 hours, 12 hours, 18 hours and 24 hours after surgery. Nausea and vomiting, sedation score and days in hospital following surgery were also recorded.
Patients with vitamin D deficiency were three times more likely to report moderate to severe postoperative pain at any time point during the first 24 hours than those with sufficient vitamin D levels, the study found.
The researchers noted, however, that no patient in either group reported severe pain (7 or over on a scale of 0 to 10) so the difference was due entirely to a reduction in moderate pain (4-6 on the pain scale).
Vitamin D deficient patients received, on average, 8 μg more fentanyl during surgery, which the researchers described as a modest difference.
However, the study found those in the vitamin D deficient group used substantially more tramadol (112mg) after surgery than those who had sufficient vitamin D levels. This strong opioid was controlled directly by the patient up to a maximum dose of 50mg per hour.
Opioid drugs can cause a number of side effects including nausea, vomiting, drowsiness and confusion, while also carrying risks of dependency and addiction.
Postoperative nausea was more common in the vitamin D deficient group, and vomiting occurred only in that group, although the difference in vomiting was small and not statistically significant.
The study had some limitations. It was observational and conducted at a single centre, so no firm conclusion can be drawn about cause and effect. The researchers also did not assess inflammatory markers so could not explore the mechanisms underlying the relationship between vitamin D and pain. Data was also not collected on anxiety, depression, cancer stage, treatment or sleep disturbance before the surgery was carried out.
Nevertheless, the researchers conclude, “Vitamin D deficiency is associated with a higher occurrence of moderate to severe postoperative pain and increased opioid consumption in patients undergoing unilateral modified radical mastectomy.”
They suggest, “Preoperative vitamin D supplementation in breast cancer patients with vitamin D levels below 30 nmol/L may have a role in modulating postoperative pain.”
With colorectal cancer a growing concern among younger people, the American Cancer Society has endorsed two new types of stool tests to encourage people to get screened while also recommending a limited role for new blood tests many patients find appealing.
The recommendations are an update to the ACS’s screening guidelines – an update led by Andrew Wolf, MD, a cancer-prevention expert at UVA Health. He and a blue-ribbon panel of cancer experts conducted a systemic review of the available colorectal cancer tests to determine which are most effective. In addition to recommending a next-generation DNA stool test and a new type of RNA stool test, the group is advising doctors to recommend blood tests only to patients who decline all other options.
The recommendations come with a dose of pragmatism: “The most effective screening test,” the panel concludes, “is the one that the patient completes.”
“The new guidance adds a stool RNA test and an updated stool DNA test to the menu of preferred options for colorectal cancer screening, which currently include colonoscopy and stool tests that detect tiny amounts of blood, among other options,” said Wolf, a professor emeritus at the University of Virginia School of Medicine. “Although the idea of a blood test for colorectal cancer sounds very attractive, they aren’t yet as good as the other tests at detecting precancerous growths and early-stage cancer, so we don’t believe they are as effective as a screening test. That said, we’re very hopeful that broadening the array of options will get more folks screened and reduce the burden of suffering from colorectal cancer.”
About Colorectal Cancer
Colorectal cancer is the second-leading cause of cancer deaths in the United States, killing 55 000 people in 2026. Improvements in detection, screening and treatment have contributed to declining colorectal cancer death rates over the last several decades, but that decline has been accompanied since 2013 by an alarming increase in the cancer among people under the age of 50. Among that age group, colorectal cancer is now the leading cause of cancer death for men and the second-leading cause for women.
In response, the American Cancer Society in 2018 lowered the recommended age for initial colorectal cancer screening from 50 to 45 for people at average risk. It also affirmed the importance of screening tools such as stool-based tests as well as visual exams such as colonoscopies. Since then, however, new, multi-target stool tests and blood-based screening tests have become available. The new blood tests proved popular in a patient survey, with 53% of respondents saying they would prefer blood testing every three years to taking a stool test every year or receiving a colonoscopy every 10.
For the latest guideline update, Wolf and his colleagues examined the effectiveness of the new tests to provide doctors with guidance on if, how and when they should be used. The experts conclude that the DNA and RNA tests had high sensitivity for detecting colorectal cancer and moderate sensitivity for detecting advanced precancerous lesions that are about to turn into cancer. The blood tests, on the other hand, showed lower sensitivity for both advanced precancerous lesions and stage 1 cancers.
“While colorectal screening blood tests may not be as effective as other options, they are certainly better than not screening,” Wolf said. “So if a patient declines a stool test or a visual exam like a colonoscopy, a blood test would be the way to go, as long as the patient understands it is not as effective, and, if it is positive, they will still need to have a colonoscopy.”
Based on their results, the experts endorse the stool tests for patients at average risk but urge doctors to reserve the blood tests for patients who refuse other screening options. And they recommend that anyone who tests positive on any stool or blood test should receive a colonoscopy promptly.
It’s important, they note, that doctors explain to patients the strengths and weaknesses of the available tests so that patients can make informed decisions.
“Currently, almost a third of adults are not up to date with colorectal cancer screening, and among those ages 45 to 49, it’s twice that number,” Wolf said. “We hope these new options will help to close this gap. The most important message is that colorectal cancer is a disease you don’t have to die from, and there’s a screening test out there that’s right for you.”
Better preventing, detecting and treating cancer is the core mission of UVA Comprehensive Cancer Center, one of only 57 cancer centers in the nation to earn the prestigious “comprehensive” designation from the National Cancer Institute. That designation is awarded only to elite cancer centers with the most outstanding cancer care and research programs in the country.
A new study from Karolinska Institutet shows that gene analysis of breast cancer tumours can identify patients who do not benefit from chemotherapy given before surgery. The findings, published in the journal Nature Communications, could in the long term contribute to more personalised treatment.
The study included 179 patients with hormone dependent, HER2 negative breast cancer who took part in the Swedish PREDIX LumB trial. Before surgery, all patients received both treatments, but in different sequences. They were given either chemotherapy followed by hormone blocking therapy together with the drug palbociclib, which slows the division of cancer cells, or the reverse sequence.
When the researchers analysed the results, they found that the treatments led to similar reductions in tumour size overall. Survival was also similar regardless of whether treatment started with chemotherapy or with palbociclib and hormone blocking therapy.
Not all tumours responded
At the same time, the analyses showed that there was a subgroup of tumours with a poorer response to chemotherapy but a better response to palbociclib in combination with hormone‑blocking therapy.
To understand why some tumours did not respond to chemotherapy, the researchers analysed tumour gene expression, how active different genes are in the tumour, in tissue samples taken before treatment started. Based on these analyses, they developed a model called CDKPredX, which can identify tumours that respond poorly to chemotherapy but better to palbociclib combined with hormone blocking therapy.
“Today, we lack reliable ways to determine in advance which patients will actually benefit from chemotherapy before surgery. Our results show that tumour gene expression can provide important information in this respect,” says first author Alexios Matikas, docent at the Department of Oncology‑Pathology, Karolinska Institutet.
The model is based on patterns of gene expression in the tumour, including genes involved in cell division, hormone signalling and the immune system. When the researchers tested the model in other patient groups, they observed similar patterns.
Further studies are needed
“In the longer term, this type of analysis could help patients avoid treatments that do not benefit them, such as chemotherapy, and instead receive treatment that has a better chance of working. At the same time, further studies are needed before the method can be used in clinical practice,” says senior author Theodoros Foukakis, professor at the same department.
The researchers emphasise that the study is exploratory and that the genetic analysis is not yet ready for clinical use. Nevertheless, the results provide new insights into why different tumours respond differently to treatment.
New UK research has found that a one-week course of post-surgery radiotherapy is just as safe and effective as the traditional three-week course for people with early-stage breast cancer.
The FAST-Forward trial, led by Keele’s Professor Murray Brunt and sponsored by The Institute of Cancer Research, London, followed more than 4000 patients for a decade after their treatment.
The 10-year results of this phase III randomised trial, funded by the National Institute for Health and Care Research (NIHR) and published in the Lancet Oncology, show that a shorter, five-day radiotherapy schedule provides the same level of cancer control as the traditional three-week treatment.
These findings build on previous five-year results that have already driven a shift in clinical practice. Since 2020, it is estimated that tens of thousands of people in the UK have already benefited from the shorter course on the NHS. Researchers expect this approach will also reduce the burden on people undergoing treatment for breast cancer worldwide and expand access to life-saving radiotherapy.
Breast cancer is one of the most common cancers globally, and radiotherapy plays a critical role in reducing the risk of recurrence after surgery. A shorter treatment course is not only more convenient for patients – it also reduces hospital visits and eases pressure on radiotherapy services, making treatment more accessible.
The research team compared the traditional schedule of 15 treatments over three weeks with two shorter schedules that used five treatments over one week. The two shorter courses gave slightly different amounts of radiation to allow the research team to work out the best dose.
After 10 years, cancer coming back in the treated breast was very low in all three groups: 3.6% for the standard three-week treatment, 2.9% with the one-week treatment with a slightly higher dose, 2.1% with the one-week treatment with a slightly lower dose.
The lower dose one-week treatment had side effects that were very similar to the standard approach, with no increase in long-term breast or chest wall changes. Because of this, this dose and schedule are now the recommended option.
Professor Murray Brunt, chief investigator of the FAST-Forward study and Professor of Clinical Oncology at Keele University, said: “These 10-year results provide definitive long-term evidence that one-week radiotherapy given at an appropriate dose to the breast is a safe, effective, and more practical option for people with breast cancer.
“By reducing treatment from 15 sessions to just five, we can offer patients the same excellent cancer control with fewer hospital visits, less disruption to their daily life, and reduced pressure on healthcare services. This approach has already transformed practice in the UK and has the potential to improve access to life-saving treatment for people with cancer worldwide.
“Hearing patients talk about how much it helps to only need one week of radiotherapy has been really encouraging for everyone involved.”
Professor Judith Bliss, Professor of Clinical Trials at The Institute of Cancer Research, London, who co-led the trial, said: “The FAST-Forward trial is transforming cancer treatment by reducing standard breast radiotherapy from 3 weeks to just one week, without compromising effectiveness.
“The streamlined schedule has made radiotherapy more accessible, particularly for people who find it difficult to attend hospital and those in lower-income countries.”
“The FAST-Forward trial is part of a long-term programme of research into improving breast cancer radiotherapy at The Institute of Cancer Research (ICR).
“These final 10-year results mark a significant milestone in breast cancer treatment and reinforce the growing shift toward more efficient radiotherapy approaches. The success of FAST-Forward has led to the ongoing NIHR-funded FAST-Forward Boost trial, which is investigating whether more extensive radiotherapy – including an additional ‘boost’ dose for some patients – can also safely be delivered in five days.
Professor Anthony Gordon, Director for NIHR’s Health Technology Assessment (HTA) Programme, added: “The legacy of the FAST-Forward trial is clear to see, with thousands of women benefiting from shorter courses of radiotherapy and fewer hospital visits, helping the health and care sector to achieve more effective and efficient use of resources. The new 10-year results show the benefit of investing in high-quality, long-term research to improve the health and wealth of the nation.
“NIHR’s research aims to tackle the most urgent health and social care challenges, targeting the areas of greatest need and where the most significant impact can be made. The findings from the FAST-Forward trial have already made a considerable difference to the treatment regimens that breast cancer patients undergo, making them more efficient, while at the same time, easing pressure on NHS services.”
As a professional photographer and mother of two young children, Claire had always been busy, but the long hours and constant fatigue felt like an occupational hazard. She never imagined that exhaustion could signal something far more serious than a demanding schedule.
Then, in January 2024, it happened: Claire blacked out at her desk while editing videos. It was her body’s final, unmistakable warning. What followed was a hospital stay, a bone marrow biopsy, and a diagnosis that would change her life forever. Claire had been diagnosed with blood cancer, specifically Myelodysplastic Syndrome (MDS), a serious bone marrow condition that, without treatment, can be fatal.
She was just 30 years old. And she was far from alone. Blood cancer remains one of the top five causes of cancer death in South Africa. Despite being potentially curable, countless patients never find their matching donor in time. Claire was determined not to become another statistic.
A Road Full of Obstacles
Claire’s path to diagnosis was not straightforward. Doctors initially attributed her worsening symptoms to iron deficiency, leaving her untreated as her condition quietly progressed. By the time MDS was correctly identified, the only viable path forward was a stem cell transplant.
While awaiting a donor match, Claire endured bi-weekly injections to keep her body stable, a gruelling holding pattern as her family and medical team searched for hope. That hope came through DKMS Africa, which successfully identified a fully matched, unrelated donor for Claire.
The first transplant, using cells from that 100% unrelated matched donor, was performed with great hope. Unfortunately, it was not successful.
Claire’s medical team was not deterred. Turning to family, they proceeded with a haplo-identical transplant, a “half-match” procedure using stem cells donated by Claire’s brother. This second transplant was successful.
Why Every Match Still Matters
Claire’s outcome is cause for deep gratitude and genuine celebration. But her journey also carries an urgent message that must not be lost in the relief of her survival.
Haplo-identical transplants, where stem cells are donated by a family member who is only a partial genetic match rather than a full one, can offer a path forward when a fully matched donor cannot be found. However, this option is not available or ideal for everyone. Not all patients have a suitable family donor, and even when they do, the procedure carries greater medical complexity and risk than a fully matched stem cell transplant.
For most patients, a 100% match from an unrelated donor remains the gold standard: the safest and most effective option. Yet only around 30% of patients find a compatible donor within their own family, meaning the remaining 70% depend entirely on a stranger’s decision to join the registry. The more people who register as potential donors, the greater the chance that every patient in need will find their match.
The critical shortage of registered donors, particularly from diverse ethnic backgrounds, means that for many, the search ends without a match. Despite blood cancer being potentially curable, countless patients never find their matching donor in time.
Every name added to the registry is a potential lifeline for someone, somewhere, waiting for their match.
A Family Restored
Today, Claire is recovering. Her children have their mother. Her family, who stood beside her through diagnosis, uncertainty, and two transplants, now share in a renewed sense of hope and possibility.
Her story does not end with survival. It continues with a plea to every person who has considered registering as a stem cell donor and hasn’t yet done so. “Help save others like me. We need more people to register as potential stem cell donors. Your registration could mean the difference between life and death.”
Phase 2 randomised trial shows 38% reduction in risk of death with the drug when combined with chemotherapy
Kaplan–Meier estimates of OS in the mITT and ITT populations. Nature Medicine, 2026.
Pancreatic cancer is one of the deadliest cancers and among the hardest to treat, with most patients surviving less than a year after diagnosis. But a new drug developed at Northwestern University may soon help patients live longer.
In a randomised phase 2 clinical trial, patients who received the experimental drug elraglusib, alongside standard chemotherapy, were twice as likely to be alive after one year of treatment, compared to those receiving chemotherapy alone. The drug also reduced the risk of death by 38%.
The study is one of only a few successful randomised trials in the last decade to show a survival benefit that would be applicable to a broad population of pancreatic cancer patients, according to the authors.
“Pancreatic cancer remains one of the most challenging solid tumours to treat, but these findings provide cautious optimism for patients,” said study lead author Dr Devalingam Mahalingam, professor of medicine in the division of Hematology and Oncology at Northwestern University Feinberg School of Medicine.
“While these results will need to be confirmed in phase 3 trials, observing survival benefit in such a difficult-to-treat cancer is encouraging. Given the novel mechanism of this drug, these findings raise the possibility that it could have broader application across other tumour types,” added Mahalingam, who also is the associate director of clinical research at Robert H. Lurie Comprehensive Cancer Center of Northwestern University.
How the trial was conducted
The phase 2 trial enrolled 233 patients with metastatic pancreatic cancer across 60 sites in six countries in North America and Europe. Patients were randomly assigned to receive either standard chemotherapy or the same chemotherapy combined with elraglusib.
Those who received elraglusib lived a median of 10.1 months, compared to 7.2 months for those who only received chemotherapy. While that three-month difference may appear modest, it’s partly because the trial included patients whose cancer progressed too quickly to benefit from treatment.
Among patients who benefited from the drug, the impact was pronounced. Twice as many patients who received elraglusib were alive at one year (44% vs 22%) and about 13% of patients in the drug group were alive at two years, compared to none in the chemotherapy group.
Side effects were generally consistent with chemotherapy but slightly more common in the elraglusib group. The most frequent included low white blood cell counts, fatigue and temporary vision changes, which were reversible. Overall, the safety profile of the drug was considered manageable, the authors said in the study.
How elraglusib works
Elraglusib was developed nearly 15 years ago inside Northwestern University labs. It targets a protein known as GSK-3 beta, which plays a role in tumour growth and suppression of the immune system.
Unlike traditional chemotherapy, which aims to kill cancer cells, elraglusib seems to act on the tumour microenvironment – the mix of cancer cells, immune cells and surrounding tissue that can either support or weaken tumours.
Pancreatic tumours are hard to treat in part because of their microenvironment, which is particularly adept at suppressing immune response. In the study, patients who received elraglusib showed increases in cancer-fighting cells within their tumours, offering early evidence that the drug may help re-engage the immune system.
In addition, certain immune-related markers in the blood at the start of the trial were associated with longer survival among patients who received the drug. While these findings are preliminary, they suggest that elraglusib may be particularly effective in certain patients whose immune systems are already primed to respond.
Mahalingam and his colleagues are exploring a larger confirmatory phase 3 trial as funding and partnership allow. They are also interested in studying the drug in combination with other novel therapies to determine if broader clinical benefit can be achieved.
