Open medicine digest: smoking cessation, antimalarials, prostate cancer genomics, and more

Open medicine digest explores recent research published elsewhere across open access medicine. Here we take a look at the highlights from the past couple of weeks.

Ethnicity and prostate cancer genomics

Recent evidence suggests that prostate cancer can be split into several subtypes on the basis of genetic analysis. Men of African ancestry experience higher incidence of prostate cancer compared with Caucasian men, but the majority of genetic studies have so far focused on European men.

In a study published in EBioMedicine, researchers have identified a new genomic alteration – a deletion in the LSAMP locus – in prostate cancers from African American men. Additionally, the authors found that the presence of PTEN and ERG alterations was lower in prostate tumors from African American men compared with Caucasians.

Taken together, these findings highlight that prostate cancer genomic alterations differ by ethnicity, and emphasize the need for evaluating cancer genomes in different populations.

Petrovics et al., EBioMedicine

Optimizing antimalarials to overcome resistance

Artemisinin combination therapies (ACTs) are used worldwide for the treatment of malaria, but emerging resistance threatens the use of these drugs. Different strategies – including treatment cycling and using multiple first-line therapies (MFT) – are currently employed in an attempt to combat the development of resistance.

In a modeling study, a collaboration of authors from Asia and the UK assessed optimal strategies to maintain ACT effectiveness at the population level. The authors compared situations where different antimalarials would be cycled, used sequentially, or used as MFT.

The results suggested that use of MFT would reduce the number of treatment failures compared with the other strategies, and that including a non-ACT therapy in the treatment regimen would help to delay the emergence and spread of resistance.

Nguyen et al., The Lancet Global Health

Are smoking cessation interventions value for money?


Smoking during pregnancy is a major global health issue, and is associated with serious complications for the mother and baby. There are a number of interventions that have been reported to reduce smoking among pregnant women, but their cost-effectiveness is not completely understood.

Now, a systematic review has been conducted to assess whether smoking cessation interventions given during pregnancy offer value for money. While it was found that the majority of interventions are cost-effective, a number of studies included in the review were of poor quality. The authors concluded that better estimates for postpartum relapse are required before firm conclusions can be drawn.

Jones et al., BMJ Open

Predicting cardiac complications in patients undergoing chemotherapy

Anthracycline-based chemotherapy regimens are used to treat a variety of cancer types, but are associated with cardiac damage when given at high doses. It is important to be able to identify those at risk of cardiac complications, and researchers from the USA have investigated whether high-sensitivity cardiac troponin T (hscTnT) is associated with risk of cardiac damage.

The researchers measured hscTnT in patients with breast cancer or non-Hodgkin lymphoma who were receiving doxorubicin treatment. Those with elevated levels of hscTnT were more likely to suffer a decline in left ventricular ejection fraction whilst on treatment.

While these findings require further validation in a larger study, elevations in baseline levels of hscTnT could be indicative of increased risk of cardiac damage in this patient group.

Blaes et al., Vascular Health and Risk Management

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