Closer Look
Experimental immunotherapy turns up the heat on brain tumors
Brain tumors are among the most difficult targets in cancer to reach and to treat. Even immunotherapies fall short, despite their promise in other cancer types. That's because brain tumors and surrounding tissues aren't "hot" enough, meaning they have too few immune cells to jump-start into attacking tumors. In a new approach to this problem, researchers writing in Science Translational Medicine report that combining immunotherapy with chemotherapy turned cold tumors hot in mice with glioblastoma, the most aggressive form of brain cancer.
In six patients enrolled in a Phase 1 trial based on the mouse results, the method also shrank recurring tumors. Researchers are now enrolling patients in a randomized Phase 2 trial that will compare the immunotherapy they used, one being developed by being the Swiss-Italian biotech Philogen, to standard of care. Scientists are also exploring combining it with other immunotherapies, such as CAR-T treatments. STAT's Andrew Joseph has more.
health insurance
How people pay for pregnancy and childbirth
Health coverage during pregnancy and childbirth is crucial. A new CDC report tells us who pays for it, based on national birth certificate data: 51.6% of births were covered by private insurance, 41% by Medicaid, 3.4% by other insurance, and 3.9% by patients' own funds. Those who self-pay are more likely to receive late or no prenatal care than those with coverage. Some other differences:
- Patients under 20 were nearly three times more likely to use Medicaid than those 35 and over.
- Patients with a bachelor's degree or higher were eight times more likely to have private insurance than mothers without a high school diploma.
- Among Black and Hispanic patients, 64% and 58.1% of deliveries, respectively, were covered by Medicaid, compared with 22.5% of Asian, 23.2% of American Indian or Alaska Native, 28.9% of Native Hawaiian or other Pacific Islander, and 28.1% of white patients.
guns
Opinion: Are active-shooter drills the best way to protect schoolchildren?
Listen to this third-grade teacher: "Sometimes we play games to help us learn. Sometimes we play games just for fun," Mira Taichman writes in NEJM. "And twice a year, we play a sick game where we imagine what would happen if someone walked through our hallway with an assault rifle, hunting children." The children aren't present in these scheduled active-shooter drills, but they still learn how to evacuate a building or block a door. "I would do anything — including take a bullet — to protect my kids. If that means rehearsing school shootings, so be it. But is that the best way?"
We don't know, Mary Beth Miotto and Robin Cogan write in another NEJM commentary. The ubiquitous programs, mandated in 40 states, lack evidence on their value. "It's time to reject school crisis simulations that rely on survival reactions in students and educators and which have not been rigorously studied," they say.
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