MAYO CLINIC

Dr. Jake Berchuck discusses a novel epigenomic liquid biopsy platform for determining PSMA expression in prostate cancer, showing strong correlation with PSMA PET scan results. The platform analyzes cell-free DNA to infer tumor PSMA expression, potentially guiding treatment decisions for cell surface-targeting therapies and offering genome-wide insights into gene regulation.

A phase 2 trial showed ¹⁷⁷Lu-Dotatate achieved a 6-month progression-free survival of 77.8% in refractory meningioma patients, surpassing the historical benchmark of 26%. Median PFS was 11.5 months, and median overall survival was 27.8 months. Common AEs included fatigue, lymphocyte count decrease, anemia, and nausea.

Rice University leads a multiuniversity team awarded $34.9 million by ARPA-H to develop ROGUE, a bioelectronic implant for obesity and type 2 diabetes treatment, aiming to reduce costs and improve adherence. ROGUE functions as a 'living pharmacy,' producing biologics on demand, and is rechargeable via a wearable device, designed for outpatient deployment. The project, backed by over $100 million from ARPA-H and DARPA, includes collaborations with Carnegie Mellon, Northwestern, and other institutions, focusing on clinical translation and commercialization.

Oliver Sartor and Ken Herrmann discuss PSMA ligand therapy advancements in prostate cancer, highlighting clinical trials like PSMAfore and ENZA-p, exploring lutetium-PSMA combinations with enzalutamide and earlier disease stages. They emphasize ongoing studies, dosing optimization challenges, and the potential of treating micrometastases, stressing multidisciplinary collaboration and the rapid progress in nuclear medicine.

Dr. Jeffrey Wong discusses theranostics, a precision medicine approach combining imaging and therapy for prostate cancer. It uses PET scans with specific agents targeting PSMA on prostate cancer cells, aiding in treatment decisions. Side effects are minimal, mainly temporary blood count depression.

Precision medicine must consider the exposome, cumulative environmental exposures, alongside the genome. Dr. Konstantinos Lazaridis advocates for a Human Exposome Project to integrate exposomics with genomics, enhancing personalized healthcare. Challenges include data management and analysis, where AI plays a crucial role. Future healthcare will assess multiple 'omics' to provide comprehensive, individualized care plans.

Mayo Clinic Health System in Fairmont will close its surgical unit and labor and delivery unit by March 2025 due to physician shortages, low birth rates, and an aging patient demographic. Expecting patients will be diverted to Mankato or other facilities. Outpatient services will continue, and affected staff will receive support.

Neeraj Agarwal presents a post-hoc analysis of TALAPRO-2 Phase III study, showing talazoparib and enzalutamide combination's efficacy in metastatic castrate-resistant prostate cancer patients previously treated with ARPI or docetaxel. The analysis highlights benefits for HRR-deficient tumors and suggests extending PARP inhibitor activity beyond BRCA1 and BRCA2 mutations. Agarwal emphasizes the importance of clinical evidence implementation and the need for further research.

Eight potential human bird flu cases reported in Missouri, with antibody tests pending. If confirmed, it could indicate the virus is spreading among humans, raising pandemic concerns.

Radiopharmaceutical therapy ¹⁷⁷Lu-Dotatate shows promise for refractory meningioma, with 78% of patients progression-free at 6 months, surpassing prior benchmarks. The trial, led by Dr. Kenneth W. Merrell, suggests radiopharmaceuticals could be a safe and effective treatment option for aggressive meningiomas.