Good morning. Today I recommend you go with cancer reporter Angus Chen into the world of patients put on waitlists for a scarce cell therapy and their doctors deciding who gets that chance. Read on.

How lessons from Covid will inform White House's response to monkeypox

Named four months ago to oversee the White House’s global health strategy, Raj Panjabi faces a new crisis in the monkeypox outbreak. Panjabi talked with STAT’s Rachel Cohrs about how the Covid has informed that response.

How are you revising the pandemic playbook?
A soon-to-be revised National Biodefense Strategy with a clear implementation plan about where measures and lines of efforts are — that’s one example. The other is actually putting money where our mouth is and asking Congress to fund biodefense at a historic level.

Do you have an example of how Covid-19 helped you get things up and running in response to monkeypox?
The Laboratory Response Network is a critical one. I wouldn’t underestimate just how important that has been. I’ve seen this in Liberia during the Ebola epidemic, and I was here on the Covid frontlines in a parking garage in Massachusetts a couple of years ago. If you don’t do enough testing, you are flying blind in a pandemic.

You can read the full interview here.

This ring turns body temp into a pregnancy detector

Wearable technology already tracks our health, with smartwatches warning of irregular heartbeats and smartphones gauging fall risk. New research adds another contender: The Oura ring, which picks up trends in body temperature that precede when someone might think about taking a pregnancy test. In the small PLOS Digital Health study, nightly high temps were much higher two to nine days after sex that led to conception. “If women know that they’re pregnant sooner, they can make choices about their life that they might not know to make otherwise,” study co-author Benjamin Smarr told STAT’s Katie Palmer. That could mean avoiding smoking and drinking early in pregnancy or evaluating options if the Supreme Court repeals Roe v. Wade, removing federal abortion protections. Katie has more, including whether continuous temperature data is that much better than what’s collected with a simple thermometer.

Experimental gene therapy shrank one patient's pancreatic cancer tumors

This is a study about one cancer patient’s win and another’s loss after receiving one particular kind of gene therapy aimed at one of the most lethal cancers. Pancreatic cancer, often diagnosed at an advanced stage, has few treatments able to control it. The new research, out yesterday in NEJM, details success after a single infusion of T cells genetically engineered to produce immune cells targeting the driver mutation KRAS G12D in a 71-year-old woman’s metastatic tumors. Her cancer receded and the new T cells persisted, circulating in her blood six months later. A second patient (whose age and gender were not given) also had T cells that persisted, but died six months after a similar treatment. The researchers are exploring why the therapy failed in that patient while they continue to watch how long the other patient continues to respond to her gene therapy.

Closer look: When CAR-T is scarce, cancer patients are dying on a wait list

(MD Anderson Cancer Center)

It’s a cliffhanger for cancer patients and their oncologists. CAR-T immunotherapy, in which patients’ own cells are taken from their bodies, trained in a lab to kill their cancers, and then reinfused, has been remarkably effective in some patients. But there is a shortage of materials to create this bespoke elixir — and of time. So doctors have to pick the patient whose disease is progressing enough to need the therapy but not so quickly that they're too sick in the next few months to get it. “About 20% of all our patients together are actually dying before they can get CAR-T,” Krina Patel of MD Anderson Cancer Center said. She put Shawn Goltzene (above) on her waitlist after he’d blasted through nearly all his options. STAT’s Angus Chen tells us what happened next and, in a companion story, what companies are doing about the CAR-T shortage.

Covid widened disparities in who filled prescriptions to treat opioid use disorder

Filled prescriptions for buprenorphine and naltrexone to treat opioid use disorder were growing until the pandemic flattened those rising numbers. A new study in JAMA Network Open looked into whether prescriptions dispensed during Covid-19 varied by a patient’s race or ethnicity, insurance status, or payer. The researchers note that people from racial or ethnic minority groups had lower rates of prescriptions for these medications than white people before the pandemic began, but they wanted to explore whether relaxed prescribing and dispensing policies that waived in-person evaluations had an impact. An analysis of pharmacy claims showed that while filled prescriptions fell among all groups after the pandemic began, the declines were sharper among Asian, Black, and Hispanic populations, across all insurance types. "Our results suggest the pressing need for research that more clearly defines use barriers,” the authors write.

Kavli Prize honors finding genes in brain disorders

Watching yesterday’s announcement of the Kavli Prize in neuroscience felt like a time warp as the four winners all recalled how challenging it was to discover the genes involved in serious brain disorders, long before the human genome was sequenced. The four neuroscientists who share this year’s $1 million prize — Jean-Louis Mandel of France, Harry Orr of the U.S., Christopher Walsh of the U.S., and Huda Zoghbi of Lebanon and the U.S. — collectively revealed the genetic underpinnings of Fragile X syndrome, spinocerebellar ataxia, Rett syndrome, and rare forms of epilepsy and autism spectrum disorder.

“We had to use what are now relatively archaic techniques of genetic linkage, isolating DNA from family members, looking for variation in this DNA, and which of these variations covariated with whether the individual was affected or unaffected,” Orr recalled. I have more on the prize, considered a Nobel predictor, here.

What to read around the web today

Pfizer asks FDA to authorize its Covid-19 vaccine for children under 5, Wall Street Journal
Liviah’s new liver: A family grapples with a girl’s puzzling hepatitis, New York Times
Justice Department says sweeping lab test fraud in Texas involved dozens of doctors and front companies, STAT
Tribal leaders sound the alarm after fentanyl overdoses spike at Blackfeet Nation, NPR
Italian authorities fine drugmaker for ‘excessive’ pricing of a rare disease drug, STAT