Healthcare Watch October 2022

TeleMed Texts: AI Can Detect Mental Illness from Text Messages

A new study from the University of Washington School of Medicine has found AI algorithms to be just as effective as humans in identifying a potential illness by evaluating the language used in text messages. As texting becomes an increased medium of mental health treatment, it has become obvious that remote psychiatric interventions can lack the emotional reference points that therapists use to navigate conversations with patients. The UW research team used natural language processing to identify messages that reflect “cognitive distortions,” for the purpose of catching cues that might slip past an undertrained or overworked clinician.

Justin Tauscher, PhD, the paper’s lead author at the University of Washington School of Medicine stated, “We have visual cues, we have auditory cues, things that don’t come out in a text message. Those are things we’re trained to lean on. The hope here is that technology can provide an extra tool for clinicians to expand the information they lean on to make clinical decisions.”

Because the AI proves to work as accurately as humans do when grading language for cognitive distortions, clinicians can lean on this extra tool to help with their own training, when they cannot be fully present during patient interactions, or are simply overworked with too many cases.

Therapeutic Talk: Merck and Moderna Team Up for Cancer Vaccine

Merck and Moderna are jointly developing a cancer vaccine, mRNA-4157/V940. The vaccine, developed by Moderna, is designed to stimulate the immune system by generating T-cell responses based on the mutational signature of a patient’s tumor. It is currently in Phase II of clinical trials in combination with Merck’s anti-PD-1 therapy Keytruda (pembrolizumab) as adjunct treatment for patients with high-risk melanoma.

“We have been collaborating with Merck on PCVs since 2016, and together we have made significant progress in advancing mRNA-4157 as an investigational personalized cancer treatment used in combination with Keytruda,” said Stephen Hoge, MD, President of Moderna. “With data expected this quarter on PCV, we continue to be excited about the future and the impact mRNA can have as a new treatment paradigm in the management of cancer. Continuing our strategic alliance with Merck is an important milestone as we continue to grow our mRNA platform with promising clinical programs in multiple therapeutic areas.”

The companies shook hands on the agreement in 2016 and Merck agreed to pay Moderna $250 million to exercise its option for personalized cancer vaccines including mRNA-4157/V940 while collaborating on development and commercialization.

Discoveries & Innovations: Delivering Therapies to the Central Nervous System

Researchers are making progress on delivering gene therapies across the blood brain barrier, which has prevented molecules from entering the brain tissue.

The blood brain barrier (BBB) has long been an issue for treating diseases of the central nervous system. The BBB prevents molecules from entering the brain tissue, which is exactly where treatments targeted at the central nervous system need to be delivered. Developing different delivery systems that surpass the BBB has been an active area of research for years. One research team from Brigham and Women’s Hospital has made a new step forward in the space.

Adeno-associated viruses (AAVs) are small viruses that can cross the BBB and that scientists have been modifying to carry therapies for some time, though they remain largely inefficient. This team reports on a new AAV variant tested in preclinical models that is significantly more efficient than previously developed delivery vehicles, therefore improving their potential to deliver drugs to treat brain cancers such as glioblastoma and genetic diseases that affect the central nervous system.

“Our study is exciting because it shows that we are one step closer to being able to deliver gene therapy across the blood-brain barrier in humans,” said Fengfeng Bei, PhD, of the Brigham’s Department of Neurosurgery. “Our findings demonstrate that AAVs could provide a valuable tool for developing systemic gene therapies against glioblastoma and other diseases where CNS delivery is required.”

Dr. Bei and her team collected cell-penetrating peptides, a group of short peptides that can cross the BBB, and tested about 100 of them by inserting them into a variety of AAVs to find a combination that might be more efficient. Number AAV.CPP.16 turned out to be significantly more efficient at delivering gene therapy across the BBB than previously tested AAVs, according to pre-clinical models. This breakthrough represents a potential way to treat a broad spectrum of central nervous system disease by improving delivery of targeted therapies that already exist.

Doctor Docs: Oncologists Rate New Lung, Breast Cancer Data Most Exciting

After the European Society for Medical Oncology (ESMO) Congress 2022 in Paris, InCrowd, an Apollo Intelligence brand, released a report on medical oncologists and hematology-oncologists’ reactions to the proceedings, finding that lung cancer developments are the most exciting area to be discussed at the event, as reported by 19% of responses. These discussions include updates on the drug targeting molecules KRAS, EGFR, and PD-L1 for lung cancer treatment and novel targets and markers including RET+ and ROS1. Breast cancer was the second most enthusiastically discussed new area of data, with treatment advances around HER expression, immunotherapy in triple negatives, diverse sacituzumab usages, and cyclin inhibition, which oncologists named as demonstrating benefits.

The InCrowd ESMO 2022 Real-Time Roundup also included key insights such as enthusiasm around lymphomas and chronic lymphocytic leukemia treatment with encouraging data on non-chemo treatment via new therapies such as CAR-T and bispecifics and treatment management updates on optimizing first-line treatment. “Researchers have identified more than a dozen cancer types that have increased in incidence over the past 20 years among those under age 50. Physicians everywhere are eager for an expanded range of treatment options that help them improve disease control,” stated Colin Turner-Kerr, International Managing Director for Apollo Intelligence.

FDA Update

Drug Approvals

The FDA approved new treatment option, Relyvrio (sodium phenylbutyrate/taurursodiol), to treat patients with amyotrophic lateral sclerosis (ALS), commonly referred to as Lou Gehrig’s disease. ALS attacks the nerve cells of voluntary muscles, which are responsible for movements such as chewing, walking, breathing, and talking, leading to paralysis. The oral medication from Amylyx Pharmaceuticals can be dissolved in water or administered through a feeding tube.

The FDA has broadened the eligibility of COVID-19 booster vaccines targeting Omicron to be used in children as young as five years old. Pfizer/BioNTech’s modified vaccine can be given to children as young as five years old, while Moderna’s adapted shot can be given to children as young as six years old. The modified shots contain mRNA components that target the original SARS-CoV-2 strain as well as the BA.4 and BA.5 subvariants.

Regeneron and Sanofi’s Dupixent (dupilumab) received approval for a new indication as a treatment of adult patients with prurigo nodularis. It is the first and only medicine specifically indicated to treat prurigo nodularis in the U.S. Prurigo nodularis is a chronic, debilitating skin disease with underlying type 2 inflammation.

Med Device Approvals

The FDA cleared Vesalio’s NeVa VS, a self-expanding mesh stent intended to be used as an additional (adjunct) treatment when the brain’s blood vessels are narrowed (cerebral vasospasm). The stent is used to prevent bleeding into the cerebrospinal fluid around the brain following a brain aneurysm.


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