BackgroundPostoperative delirium (POD) is a common complication following transcatheter aortic valve replacement (TAVR) and is associated with adverse outcomes in older patients. Frailty, a multidimensional geriatric syndrome, has been increasingly recognized as a potential risk factor for POD. However, existing evidence remains inconsistent. This meta-analysis aimed to evaluate the association between frailty and POD after TAVR.MethodsA systematic search of PubMed, Embase, and Web of Science was conducted from inception to January 22, 2026. Cohort studies evaluating the association between preprocedural frailty and POD after TAVR were included. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model accounting for the influence of potential heterogeneity.ResultsTen cohort studies involving 7,702 patients were included. Frailty was present in 2,062 (26.8%) patients, and 786 (10.2%) developed POD. Pooled analysis showed that frailty was significantly associated with an increased risk of POD after TAVR (OR: 2.17, 95% CI: 1.60–2.95; I2 = 55%). The association was stronger in studies with sample size ≥ 500 compared with < 500 (OR: 2.74 vs. 1.38; p for subgroup difference < 0.001). The effect estimates were consistent across subgroups stratified by study design, age, sex, frailty assessment methods, follow-up duration, analytic models, and study quality (all p for subgroup difference > 0.05). Notably, studies using CAM-ICU to diagnose POD showed a stronger association than those using DSM criteria or other methods (OR: 3.60 vs. 1.56 and 2.53; p = 0.006). Meta-regression identified sample size as a significant source of heterogeneity (p = 0.02).ConclusionsFrailty is associated with an increased risk of POD after TAVR. These findings highlight the importance of frailty assessment for perioperative risk stratification and support targeted strategies to prevent delirium in high-risk patients undergoing TAVR.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420261352173.
Robotic surgery tech to help cut West Hertfordshire waiting lists
West Hertfordshire Teaching Hospitals NHS Trust is using advanced robotic surgery technology to speed up recovery from cancer surgery.
Exploring the life stories of young adult men in prison with a history of dual harm
People who engage in both self-harm and violence (‘dual harm’) in prison cause widespread disruption to prison services. Whilst the behavioural profile of such individuals is gaining attention, there is very little research which explores their life histories and how these contextualise their dual harm. This study qualitatively explored how five young men in a medium secure prison in England with a history of dual harm (in the community, prison, or both) made sense of their life experiences and engagement in dual harm behaviours. Participants were interviewed using an in-depth life story interview protocol. A narrative analysis identified three themes: ‘Beginning: Making sense of a traumatic childhood’, ‘Middle: Exploring challenges during late adolescence’ and ‘End: Who I am now, and who I must be’. These themes, grounded in life experiences and associated meaning, offer valuable insights into the underpinnings of dual harm behaviours and direction for interventions addressing dual harm in prisons. The paper concludes with a discussion of key implications and directions for future research and practice in relation to the support and management of people who dual harm in custody.
Ultra-Short Radiotherapy Schedule for Prostate Cancer Supported by HERMES Trial
U.K. research has shown that condensing prostate cancer radiotherapy into two sessions, but with a higher dose per session, rather than the traditional five sessions does not lead to increased side effects when treatment is delivered using state-of-the-art magnetic resonance imaging (MRI)-guided technology.
Lead researcher Sian Cooper, clinical research fellow at The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research in London, told Inside Precision Medicine that the results of the HERMES trial “point toward a future where prostate radiotherapy is tailored to the disease, to the individual’s anatomy and symptom profile, whilst being mindful of the impact of treatment time on patients’ lives.”
Presenting at the 2026 Congress of the European Society for Radiotherapy and Oncology (ESTRO), Cooper said that the number of people diagnosed with prostate cancer is projected to double by 2040, meaning the demand for effective and efficient treatment has never been greater.
At present, localized prostate cancer is typically treated with stereotactic body radiotherapy over five sessions, but there has been increasing interest delivering the treatment in fewer sessions, with a larger dose each session.
“For patients, a two-session treatment course would be far less disruptive than the weeks of daily hospital visits that radiotherapy has traditionally required. This convenience comes with clear benefits for work, leisure, family life and travel. For clinicians and health systems, fewer fractions mean faster workflow throughput, and getting patients the right treatment, quicker,” said Cooper.
“We wanted to find out whether giving the equivalent dose in just two treatment sessions could be feasible and safe for patients, and to understand how it might affect the potential side effects patients can experience, such as problems with urinary and bowel function.”
The move toward giving higher radiotherapy doses in fewer sessions has been made possible by improvements in radiotherapy delivery technology over recent years.
“It has allowed us to harness the power of modern computing and discoveries in clinical physics, to create radiotherapy doses which conform very tightly to the edge of the prostate,” Cooper explained. “This results in vastly less dose to the normal, healthy tissues around the cancer.”
The HERMES trial used a Unity MR-Linac (Elekta AB, Sweden) machine, which Cooper describes as “the ultimate evolution of this progress,” to deliver radiotherapy to participants.
The device combines real-time MR scanning with a linear accelerator and is known as MRI-guided adaptive radiotherapy. It allows adaptation of the radiotherapy beam design to changes in patient anatomy on the treatment day as well as moment by moment motion management, meaning that if there are any changes in the target or healthy bystander organs, the radiation beam can be switched off.
“This level of precision was needed to safely deliver the high dose of radiation necessary to maintain the biologically equivalent dose in just two fractions,” Cooper noted.
In all, 46 participants (median age 74 years) with intermediate or lower high-risk prostate cancer were randomly assigned to receive radiotherapy at a dose of 24 Gy in two fractions over 8 days, with a 27 Gy integrated boost to the MRI defined tumor (n=22), or 36.25 Gy in five fractions over two weeks to the planning target volume, with 40 Gy to the prostate and proximal one cm seminal vesicles (n=24). All participants had androgen deprivation treatment for at least six months.
Cooper reported that, at two years, four (18%) participants in the two-fraction arm and six (25%) in the five-fraction arm experienced moderate (grade 2) urinary adverse events (AEs) such as increased frequency or urgency. Grade 2 gastrointestinal AEs occurred in one participant in each arm (5% and 4%, respectively).
There were no grade 3 or worse genitourinary or gastrointestinal events in either group.
The team also showed that quality of life, measured by the International Prostate Symptom Score and the International Index of Erectile Function, showed minimal change up to two years but will continue to be monitored up to five years.
Cooper said that the investigators will present efficacy data, a secondary endpoint, when it matures but she pointed out that as “the cancer control rate for prostate cancer is so high, it often takes many years for failures to appear, whereas trial data for ultra hypofractionation show that the genitourinary adverse event rate is the primary concern after treatment.”
ESTRO president, Matthias Guckenberger, MD, from University Hospital Zurich, Switzerland, who was not involved in the research said: “While the technology used in this trial is currently available in only a limited number of specialist centers worldwide, they are growing rapidly. These results can help guide how they are used and help us understand whether two-session radiotherapy should become a new standard of care.”
The post Ultra-Short Radiotherapy Schedule for Prostate Cancer Supported by HERMES Trial appeared first on Inside Precision Medicine.
Impact of Current Genetic Testing on Cancer Survivor Treatment
Genetic testing can provide useful information to guide treatment in breast and ovarian cancer patients not previously tested, according to a new U.K. study.
In this, the study’s pilot phase, 3,525 patients diagnosed between 2015 and 2018 were invited to take part using a simple, home‑based saliva test. By March 2026, 43.7% had accepted the invitation. Testing showed inherited cancer‑related gene variants in 8.6% of patients with breast cancer and 10.1% with ovarian cancer.
These findings were presented at the ESMO Breast Cancer 2026 congress by Clare Turnbull, PhD.
“A particularly important group are women who survived young‑onset breast cancer and may now be approaching the age at which, if they carry a germline pathogenic variant in BRCA1 or BRCA2, their risk of ovarian cancer becomes very high,” Turnbull told Inside Precision Medicine. She is professor of translational cancer genetics at the Institute of Cancer Research in London, and member of the ESMO Precision Oncology Task Force.
Hundreds of thousands of cancer survivors have never been genetically tested, either because testing was not available when they were diagnosed or it was not routinely offered then. But, these researchers say, such patients are just as likely as those diagnosed today to carry a germline pathogenic variant that increases cancer risk.
This pilot is part of the U.K.-only Retrospective Genetic Testing Programme, which uses National Health Service (NHS) records to identify patients with breast and ovarian cancer who hadn’t yet been offered genetic testing, but were eligible for it based on tumor characteristics.
“With widespread capacity issues in NHS clinical genetics services, the RGT Programme offers a unique solution to the task of offering genetic testing to this cohort. The RGT Programme offers testing via our previously trialed ‘BRCA-DIRECT’ pathway, a clinician-light, at-home genetic testing pathway,” Turnbull said.
The pilot focused on patient groups with a strong likelihood of hereditary cancer, including triple‑negative, bilateral and young‑onset breast cancer, as well as high‑grade serous ovarian cancer.
“Our program tests patients for either seven genes known to be associated with breast cancer (BRCA1, BRCA2, PALB2, CHEK2, ATM, RAD51C and RAD51D) or nine genes associated with ovarian cancer (BRCA1, BRCA2, BRIP1, MLH1, MSH2, MSH6. PALB2, RAD51C and RAD51D),” said Turnbull.
Cancer susceptibility genes are broadly separated into low-, moderate- and high-risk genes. Within the RGT program, only high-risk and some moderate-risk genes are included on testing panels.
The study also suggests that a simplified approach to genetic testing—the BRCA‑DIRECT pathway—is potentially feasible at scale, without increasing workload for healthcare professionals.
“This approach allows healthcare professionals to focus their time where it is most needed, particularly on individuals with positive or complex results,” said Antonio Marra, MD, medical oncologist at the European Institute of Oncology (IEO IRCCS) in Milan, Italy, in a press release. Marra was not involved in the study.
There are other potential benefits of this approach.
“This has important implications for the efficient use of healthcare resources,” said Marra. “Identifying patients at scale enables more targeted interventions and a more effective allocation of clinical expertise and infrastructure.”
“Based on the program’s early outcomes and the integration of the BRCA‑DIRECT pathway into routine care, the NHS is commissioning a broader range of direct‑to‑patient genetic tests, with potential expansion to prostate, pancreatic and colorectal cancer patients,” Turnbull said.
She added that, “While increasing the availability of genetic testing is important, automatic genetic testing is unlikely to be the solution. Genetic testing is a highly personal choice, and some individuals may not wish to pursue testing.”
The post Impact of Current Genetic Testing on Cancer Survivor Treatment appeared first on Inside Precision Medicine.
Anti-Inflammatory Drug Could Help Some People with Depression
Research led by the University of Bristol suggests treatment with an anti-inflammatory drug, already approved to treat arthritis, could help some people with depression.
The study, published in JAMA Psychiatry, was small but showed gradual improvement in the severity of depression and physical symptoms like fatigue, as well as a lowering of anxiety in those treated with tocilizumab versus placebo.
“Low-grade systemic inflammation is a putative causal factor in depression, present in approximately 30% of patients,” write co-lead author Golam Khandakar, MD, PhD, a professor and researcher at the University of Bristol, and colleagues.
“Individuals with difficult-to-treat depression have higher cytokine, e.g., interleukin 6 (IL-6) and C-reactive protein (CRP) levels, than treatment-responsive patients and controls.”
Tocilizumab is a humanized monoclonal antibody that blocks the IL‑6 receptor and is used as an immunosuppressive drug in several inflammatory and cytokine‑driven conditions. For example, it is approved by the FDA to treat rheumatoid arthritis and cytokine release syndrome in patients with severe COVID-19.
To test whether IL-6 inhibition could help people with depression, the authors carried out a small randomized controlled trial as a proof-of-concept study. Overall, 14 participants were given a tocilizumab infusion, and 16 participants were randomly assigned to receive a saline placebo infusion.
Adults were eligible to be in the study if they had moderate‑to‑severe, difficult‑to‑treat depression despite antidepressants, showed persistent low‑grade inflammation on repeat CRP tests, and had prominent physical depressive symptoms like fatigue.
After receiving a single infusion, the participants were followed up for four weeks with evaluations at one week, two weeks and four weeks. All were taking anti-depressants when enrolled and continued them during the trial.
The trial was not large enough or long enough to show a statistically significant improvement, but it did show a consistent pattern of greater, clinically sized improvement with tocilizumab by the end of the follow-up period, especially in patients with higher baseline CRP.
No real differences were seen at one or two weeks, but at four weeks people given tocilizumab showed bigger improvements in overall depression scores, fatigue, energy levels, anxiety and quality of life than those in the placebo group. Around 54% of participants in the tocilizumab went into remission at four weeks versus 31% of the placebo group.
“This work represents an important milestone in the development of new treatments for depression especially difficult-to-treat depression, which affects millions of people in the U.K. alone,” said Khandakar in a press statement.
“This is one of the first randomized controlled trials to test immunotherapy for depression, the first to test the IL-6 receptor as the treatment target, and the first to use a targeted approach to select patients most likely to benefit, and to show that it works.”
The researchers now want to carry out a larger randomized trial to assess if the effects they saw are significant in a bigger treatment population.
The post Anti-Inflammatory Drug Could Help Some People with Depression appeared first on Inside Precision Medicine.
Sleep quality and its associated factors among women of reproductive age in Ethiopia: a systematic review and meta-analysis
BackgroundQuality sleep is vital for women’s health during reproductive years, affecting both physical and mental well-being. In Ethiopia, socio-economic and cultural factors worsen sleep issues, but data on this demographic are scarce. This systematic review and meta-analysis assesses the prevalence of poor sleep quality among Ethiopian women and identifies contributing factors, aiming to inform interventions and policies to improve sleep health in low-resource settings.MethodThis systematic review followed PRISMA guidelines and searched PubMed, Scopus, and Web of Science for observational studies. We included studies utilizing the Pittsburgh Sleep Quality Index (PSQI), as it is the most widely validated tool for assessing subjective sleep quality across diverse populations. Reviewers independently screened articles using Rayyan and assessed study quality with the Joanna Briggs Institute tools. Data were analyzed using Stata version 17. To account for potential clinical and methodological variability across studies, a random-effects model was employed to pool results, with heterogeneity assessed using statistics and the Cochrane’s Q test. Publication bias and sensitivity analyses were also performed.ResultNine studies involving 4,376 women of reproductive age (15–49 years) in Ethiopia were included. The pooled prevalence of poor sleep quality was 49.17% (95% CI: 35.29, 63.08). Significant predictors of poor sleep quality included intimate partner violence (OR: 3.24), depression (OR: 3.37), unplanned pregnancy (OR: 2.71), multigravidity (OR: 2.61), and substance use (OR: 2.24).ConclusionA systematic review indicates that nearly half of Ethiopian women of reproductive age experience poor sleep quality. Key factors include unplanned pregnancies, substance use history, intimate partner violence, previous depression, stress, being in the third trimester, and comorbidities; these need urgent attention and the implementation of screening and preventive measures. Future research should focus on effective interventions to improve sleep quality in these populations.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023455867.
Royal Cornwall adopts digital tool to help identify liver disease risk
Royal Cornwall Hospitals NHS Trust is using a digital tool to identify those at risk of liver disease, potentially before symptoms appear.
Impact of a Novel Functional Snack on Perimenopausal Symptoms and Well-being
Conditions: Perimenopause; Perimenopause-Related Depression; Mood; Sleep; Quality of Life; Gut -Microbiota
Interventions: Dietary Supplement: Functional Snacks; Other: Placebo Snacks
Sponsors: King’s College London; Tulā Code Ltd
Recruiting
Interventions: Dietary Supplement: Functional Snacks; Other: Placebo Snacks
Sponsors: King’s College London; Tulā Code Ltd
Recruiting
Regeneron, Parabilis Ink Up-to-$2.3B Antibody-Peptide Conjugate Collaboration
Regeneron Pharmaceuticals will partner with Parabilis Medicines to discover and develop an initial five candidates encompassing a new form of antibody-drug conjugates aimed at challenging and historically undruggable targets, through a strategic research collaboration that could generate up to $2.3 billion-plus for the Cambridge, MA, biotech.
Regeneron will marry its antibody capabilities with Parabilis’ stabilized helical peptide or Helicon
platform, to develop both Antibody-Helicon Conjugates (AHCs) as well as stand-alone therapies based on Helicons—stabilized, cell-penetrant alpha-helical peptides designed to engage intracellular protein targets, including flat surfaces that are not well suited to traditional small molecule binding.
While ADCs traditionally use antibodies to selectively deliver drug payloads into target cells to induce their death from within, the AHCs envisioned by Regeneron and Parabilis would combine antibody-targeted cell access with Helicon payloads designed to selectively modulate specific intracellular proteins, including some long-undruggable proteins.
“In addition to the potential of Helicons to address previously undruggable targets, the collaboration’s intent to couple Helicons to our VelocImmune® derived-antibodies so as to precisely deliver them to cells of interest represents an exciting new approach with the potential to create an entirely new therapeutic class that can span multiple therapeutic areas,” George D. Yancopoulos, MD, PhD, Regeneron’s board co-chair, president, and CSO, said in a statement.
Regeneron has agreed to pay Parabilis $125 million, consisting of a $450 million upfront payment and commitment to invest $75 million in Parabilis’ next equity financing, subject to specified conditions. Regeneron also agreed to pay Parabilis payments tied to achieving development, regulatory, and commercial milestones, as well as tiered royalties up to the low double-digits on future net sales of any approved medicines resulting from the collaboration.
Five initial targets
With five initial targets, the collaboration agreement could generate up to approximately $2.2 billion in total milestone payments to Parabilis.
Under the terms of the agreement, additional targets may be pursued upon additional option payments from Regeneron.
Regeneron shares fell nearly 10% Monday, to $629.68, from Friday’s close of $698.25, and plateaued on Tuesday, inching up 0.1% to $630.30. The Monday drop reflected not the Parabilis deal but a clinical setback: Regeneron on Friday evening acknowledged the failure of a Phase III trial (NCT05352672) assessing two dose levels of the lymphocyte-activation gene-3 (LAG-3) inhibitor fianlimab in combination with a PD-1 inhibitor, Regeneron’s marketed drug Libtayo® (cemiplimab), as a first-line treatment for patients with previously-untreated, unresectable locally advanced or metastatic melanoma.
Fianlimab plus cemiplimab failed the trial by not reaching statistical significance for the primary endpoint of improvement in progression-free survival (PFS) compared to monotherapy with another PD-1 inhibitor, Merck & Co.’s Keytruda® (pembrolizumab), the multi-indication cancer immunotherapy, Regeneron said, in an announcement released more than four hours after the close of financial markets.
Parabilis, a privately held company which rebranded from FogPharma in 2024, rang in 2026 by announcing the closing of a $305 million Series F financing on January 8, with proceeds intended to support continued clinical development of its lead helicon peptide candidate zolucatetide (formerly FOG-001)—a first and only direct inhibitor of the elusive β-catenin:TCF interaction, according to the company—including progression toward a registrational trial in desmoid tumors and continued evaluation across genetically simple and more complex tumor types.
Positive preliminary data
In March, Parabilis presented preliminary clinical data at the 11th Biennial Meeting of the International Society for Gastrointestinal Hereditary Tumors (InSiGHT) showing significant improvement in duodenal polyposis at 60 weeks in a patient with familial adenomatous polyposis (FAP) treated with zolucatetide in the company’s ongoing Phase I/II trial (NCT05919264).
The patient showed a 52.2% reduction in desmoid tumor diameter, as well as “substantial” reductions in polyp number and size compared with a pre-treatment evaluation nearly two years prior, consistent with downstaging from Spigelman stage II to stage I.
The financing, Parabilis added, will also support advancement of its targeted discovery pipeline, including its prostate cancer franchise, and additional efforts to leverage the company’s Helicon platform to unlock long-undruggable disease targets.
In addition to zolucatetide, Parabilis’ pipeline includes:
- Two prostate cancer-fighting discovery phase programs, an ERG degrader Helicon program, and an androgen receptor degrader
- A beta-catenin degrader Helicon program targeting mutations in the Wnt/β-catenin pathway, linked to 80–90% of cases of colorectal cancer, that is also in discovery phase
- A Helicon-enabled alpha radioligand therapies (HEARTs) program against multiple cancer targets, a program partnered with ARTBIO, in hit identification phase.
“Through our own pipeline, we have demonstrated the potential of Helicon peptides to directly inhibit or degrade several disease-driving proteins in oncology that have long been considered out of reach,” stated Mathai Mammen, MD, PhD, Parabilis’ chairman, CEO, and president. “We are thrilled to enter into a collaboration with Regeneron that builds on this foundation, combining the intracellular access and binding capabilities of our Helicons against challenging targets with antibodies from Regeneron.”
The post Regeneron, Parabilis Ink Up-to-$2.3B Antibody-Peptide Conjugate Collaboration appeared first on GEN – Genetic Engineering and Biotechnology News.