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Early hopes for a pancreatic cancer test, living with lupus, & how much Medicaid redetermination is costing community health centers

April 09, 2024
April 9, 2024
Reporter, Morning Rounds Writer
Good morning. Hope your eclipse viewing was rewarding, if you partook. Meanwhile, back beneath the skies we have more cool research emanating from conferences on cancer and heart disease.

cancer

Early data from a blood test for pancreatic cancer raise hopes

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Gillian Flaccus/AP

You can draw a direct line between the grim 3.2% five-year survival rate for pancreatic cancer and the dearth of cases discovered at an early enough stage for successful treatment. A cancer scientist presenting research yesterday at the American Association of Cancer Research annual meeting said his experimental blood test might be a better way to discover the cancer earlier. Results from 732 people from the U.S., Korea, and China, 359 of whom had early stage pancreatic cancer, and the rest who were healthy, showed promise but testing needs to be wider.

The test looks for bits of RNA discharged by tumors, in particular a certain microRNA signature found floating freely in the blood of patients or encapsulated in microscopic extracellular vesicles called exosomes, often abnormally expressed in many cancer cells. Early data suggest the test might be able to detect pancreatic cancer at stage 1 or 2 with a sensitivity of over 90%. STAT's Angus Chen brings us more from the conference.

medical devices

A device to ease angina works in an unexpected way, early trial says

This reminds me of that old sports saying about contests whose outcomes look certain but turn out not to be: "That's why they play the games." In biomedical research, tweak that to "that's why they do the studies." STAT's Lizzy Lawrence and Matthew Herper bring this to mind in their story about a small, fully independent clinical trial researchers thought would disprove a cardiac device's worth — but didn't.

The device, called a coronary sinus reducer, is meant to reduce chest pain by forcing blood backward through the heart's veins. It's made by Shockwave Medical, which Johnson & Johnson is buying for $13 billion. MRI imaging to detect this blood movement didn't see it, in patients who got it or who got a placebo procedure. But episodes of angina, chest pain caused by heart disease, fell by 40% in those who got the device, meaning the device had the intended effect, despite not working the way researchers expected.

What's next? Understanding why. Read more.

health care

Medicaid changes cost community health centers 

In further fallout from the end of Covid-19 emergency measures one year ago, community health centers are reckoning with an average loss of $600,000 through the process of Medicaid redetermination. New survey data from the National Association of Community Health Centers show centers lost almost one-quarter of their Medicaid patients. Medicaid enrollees make up about 40% of patients at these federally qualified centers, whose mission is to meet the health care needs of patients regardless of their ability to pay.

Much as individual disenrollment over the past year varied widely — from nearly 60% of Medicaid patients losing coverage in Utah to 12% in Maine — so did the impact on community health centers. The largest losses were felt by community centers in Colorado, Florida, Washington, and Texas — both at individual centers and cumulatively across the states. STAT's Annalisa Merelli has more.

closer look

After a lupus diagnosis came out of nowhere, she connects with others in her shoes

tiffanypeterson

Photo illustration: Casey Shenery for STAT 

Tiffany Peterson was attending college full-time, working full-time in Starbucks, and also tutoring grade-school kids in her free time. At home she'd always been "mom No. 2," taking care of her younger siblings. Then, when she could barely move, everything came to a halt. The pain she'd felt since childhood — and dismissed as arthritis she could treat with daily Aleve — caught up with her. Her diagnosis of lupus meant high-dose steroids and a series of rheumatologists.

"I fired a few, because I felt like they weren't letting me be a partner in my own care," she said. Shifting to patient advocacy, she started LupusChat, now with three co-hosts. "I wanted there to be a space where lupus patients and their caregivers or family can come to find community, and also have credible health information," she told STAT's Isabella Cueto. Read their conversation. 

covid

Study pinpoints biomarkers in people with long Covid who were hospitalized 

People with long Covid carry signs of inflammation in their blood that correspond to different patterns and levels of symptoms, a study in yesterday's Nature Immunology reports. The researchers tested blood samples from 659 adults in the U.K. who'd been hospitalized about six months previously for Covid-19, comparing proteins involved in inflammation and the immune system between those who had fully recovered and those who hadn't. 

Those who still had long Covid showed more inflammation of myeloid cells (precursors of white blood cells) and activation of immune system proteins in the complement system. Different markers were linked to cardiorespiratory, cognitive, or GI symptoms, among others. Because the participants had all been admitted to hospitals for their Covid-19 infections, it's possible their conditions could be related to their treatment, especially if they required intensive care. "These findings show the need to consider subphenotypes in managing patients" with long Covid, the authors conclude.

xenotransplantation

'Tense' rejection episode behind him, patient with transplanted pig kidney is enjoying home

We told you last week when the world's first recipient of a kidney transplant from a genetically modified pig left the hospital. In case you missed it, STAT's Megan Molteni has updated us on the rejection episode he went through before getting cleared to go home. First, the good news: 62-year-old Richard Slayman is able to live the life he'd been missing from more than a year: eating whatever he craved and taking a long, hot shower. But before he headed to Weymouth, Mass., from Massachusetts General Hospital, he had to weather a "tense" setback.

Eight days out from his transplant, his struggling kidney showed signs of the most common type of acute graft rejection, known as cellular rejection. It develops in about 1 in 5 patients receiving kidneys from human donors, and is treatable using high doses of steroids and a drug that depletes the body's ranks of T cells. For Slayman, after a tense three days, it worked. Read more on what's next, for him and the field.

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What we're reading

  • Survival of the nicest: Have we got evolution the wrong way round? Nature
  • Opinion: As a rule, rape exceptions for abortion don't work, STAT

  • The birthday effect: Why your big day might be your last, The Guardian

  • FDA agrees to review a rare disease drug that its developer was about to give up on, STAT

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