Samuel Hume: Top 5 advances in medicine in February
Samuel Hume, Fellow at The Foulkes Foundation and pursuing PhD in the University of Oxford’s Department of Oncology, shared a post on X:
“Top 5 advances in medicine in February.
1. The first large trial to show that oxygen can improve outcomes in stroke Patients in this trial had acute ischaemic stroke (caused by a large vessel blockage in the front part of the brain).
They received either 100% oxygen at 10 litres/minute (via a non-rebreather mask), or a sham treatment (roughly equivalent to breathing oxygen from air), for 4 hours.
All patients were treated with thrombectomy (mechanical clot removal), and that’s the key: it’s thought that oxygen ‘freezes’ the penumbra (the salvageable brain tissue) before blood flow is restored by thrombectomy.
That also explains why this hasn’t been found before: previous trials were done before thrombectomy was widely used.
This trial was done in only one country, in a select group of patients, so we’ll need broader trials: these are underway.
Normobaric hyperoxia combined with endovascular treatment for acute ischaemic stroke in China (OPENS-2 trial): a multicentre, randomised, single-blind, sham-controlled trial.
Authors: Weili Li, et al.
2. A vaccine to prevent recurrence of kidney cancer.
This is a small trial – 9 patients – all of whom had renal cell carcinoma removed by surgery.
Despite the surgery, there’s still a risk of cancer recurrence – about 50% over the next 3 years.
Here, tumours removed by surgery were sequenced, and personalised vaccines made based on the tumour’s mutations (its neoantigens).
There was no control group, but in these patients given a personalised vaccine, 0 had recurrence of their cancer.
A larger, randomised study is underway.
A neoantigen vaccine generates antitumour immunity in renal cell carcinoma.
Authors: David A. Braun, et al.
3. Gene therapy provided sight to children born blind.
The 4 children had a rare form of blindness, caused by mutations in the retina gene, AIPL1.
A functional copy of this gene was introduced, in one eye per patient, using the other eye as a control.
All of the children started to see (though imperfectly): they started to draw and write, moved around on their own, and played with others.
Normobaric hyperoxia combined with endovascular treatment for acute ischaemic stroke in China (OPENS-2 trial): a multicentre, randomised, single-blind, sham-controlled trial.
Authors: Weili Li, et al.
4. The GLP1 receptor agonist, Semaglutide, reduces cravings for alcohol and cigarettes.
Previous observational studies have shown a potential benefit of GLP1s on usage disorders, but this the first randomised (phase 2) trial.
The dose used was much lower than the dose for obesity, but still causes weight loss, so the trial was restricted to patients with BMI > 23.
There’s only 48 patients, and some of the effects are modest, so we’ll need to see this replicated in bigger trials.
Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial.
Authors: Christian S. Hendershot, et al.
5. Results from the first pig-to-living human kidney transplant.
To reduce the risk of rejection and to inactivate pig retroviruses, 69 edits to the pig’s genome were made, with CRISPR.
There was a challenging course post-surgery in this case, but this approach could massively broaden the supply of kidneys available for transplant.”
Xenotransplantation of a Porcine Kidney for End-Stage Kidney Disease.
Authors: Tatsuo Kawai, et al.
These findings are all from February.
Thank you for reading!”
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