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Combining antibody drug conjugates (ADCs) and tyrosine kinase inhibitors (TKIs) targeting HER2 has been shown to improve efficacy in patients with advanced HER2+ breast cancer. Here, the authors report a randomised phase 2b trial comparing neoadjuvant ARX788 (HER2 ADC) plus pyrotinib (HER1, HER2 and HER4 TKI) against neoadjuvant standard of care (docetaxel, carboplatin, trastuzumab, and pertuzumab) for the treatment of HER2+ breast cancer.

An expert-elicitation process identifies current methodological barriers for monitoring terrestrial biodiversity, and how technological and procedural development of robotic and autonomous systems may contribute to overcoming these challenges.

Qian et al. used cardiac magnetic resonance images and electrocardiograms from the UK Biobank and an ischemic heart disease cohort and developed more than 3,500 cardiac digital twins. They demonstrate that the myocardial anatomy causes differences in the QRS duration among sexes while age and body weight alter potassium conductance and myocardial conduction velocity.

An ultra-low-loss integrated photonic chip fabricated on a customized multilayer silicon nitride 300-mm wafer platform, coupled over fibre with high-efficiency photon number resolving detectors, is used to generate Gottesman–Kitaev–Preskill qubit states.

Geospatial estimates of the prevalence of anemia in women of reproductive age across 82 low-income and middle-income countries reveals considerable heterogeneity and inequality at national and subnational levels, with few countries on track to meet the WHO Global Nutrition Targets by 2030.

CXCR3 and CXCR7 are chemokine receptors involved in cellular migration in physiological and pathophysiological context. Here, the authors present cryo-EM structures of CXCR3 in complex with small molecule agonists and discover their dual-agonism at CXCR7.

A peripherally restricted CB1 agonist (VIP36) targeting a cryptic receptor pocket was developed, showing high efficacy in mouse pain models with minimal side effects and tolerance, potentially revolutionizing chronic pain treatment and GPCR drug design.

Immune lymphocyte estimation from nucleotide sequencing (ImmuneLENS) infers B cell and T cell fractions from whole-genome sequencing data. Applied to the 100,000 Genomes Project datasets, circulating T cell fraction provides sex-dependent and prognostic insights in patients.

A genome-wide study based on three-dimensional facial images identifies new loci associated with facial morphology in East Asian populations. Comparison with data from European populations identifies variants related to facial shape differences between these populations.

Single-cell Proliferation Rate Inference in Non-homogeneous Tumors through Evolutionary Routes (SPRINTER) allows users to infer proliferation rates of individual clones within a tumor from single-cell DNA sequencing data. Applying SPRINTER to human tumor datasets highlighted a link between proliferation and metastatic potential.

In a phase 1 trial, patients with pancreatic ductal adenocarcinoma who were treated with surgery and bespoke neoantigen mRNA vaccines combined with anti-PD-L1 and chemotherapy exhibited marked long-lived persistence of neoantigen-specific CD8⁺ T cell clones, which correlated with prolonged recurrence-free survival at a 3.2-year follow-up.

Swanton and colleagues present a clonal expression signature, ORACLE, which, in combination with clinicopathological and molecular risk factors, can predict survival of patients with lung adenocarcinoma, and they prospectively validate its prognostic value.

Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis involving evasion of immune control. Here, the authors perform a comprehensive analysis of single-cell multi-omic data revealing either a myeloid-enriched or adaptive-enriched tumour microenvironment, linked to distinct B and T cell clonal selection and differentiation, distinct overall survival, and potential therapeutic approaches.

Ibogaine is a natural substance that interrupts opioid addiction but has cardiac risks. This article introduces novel ibogaine analogs that show reduced cardiac risk and enhanced neuroplasticity and therapeutic-like effects in models of opioid use disorder.

Different processes are in place to facilitate RNA-Polymerase 2 (Pol2) binding to chromatin. Here the authors reveal that the fusion transcription factor PAX3-FOXO1 shapes RNA Pol2 enhancer loops by recruitment of the histone acetyltransferase p300 via a small alpha-helical hook in its activation ___domain. Degradation of PAX3-FOXO1 or p300 rapidly collapses Pol2 clusters.

A proof-of-principle study reports a complete photonic quantum computer architecture that can, once appropriate component performance is achieved, deliver a universal and fault-tolerant quantum computer.

At the Gates Foundation, the newly established Women’s Health Innovations team supports the research, development and increased access to innovative products, devices and platforms aimed at improving women’s health. Importantly, women should have a central role in the women’s health innovation ecosystem, leading research, shaping strategies and making funding decisions.

Bhattacharjee and Schaeffer et al. map exclusive breastfeeding (EBF) in 94 low- and middle-income countries (LMICs), finding increased EBF practice and reduced subnational variation across the majority of LMICs from 2000 to 2018. However, only six LMICs will meet WHO’s target of ≥70% EBF by 2030 nationally, and only three will achieve this in all districts.

Large scale sequencing study is of paramount importance to unravel the heterogeneity of colorectal cancer. Here, the authors sequenced 205 cancer genes in more than 2000 tumours and identified additional mutated driver genes, determined that mutational burden and specific mutations in TP53 are associated with survival odds.

A normative digital atlas of fetal brain maturation produced using 1,059 optimal quality, three-dimensional ultrasound brain volumes from 899 fetuses presents a unique spatiotemporal benchmark from a large cohort with normative postnatal growth and neurodevelopment at 2 years of age.

There is currently no licensed SARS-CoV-2 vaccine. Here, the authors generate an optimized DNA vaccine candidate encoding the SARS-CoV-2 spike antigen, demonstrating induction of specific T cells and neutralizing antibody responses in mice and guinea pigs. These initial results support further development of this vaccine candidate.

Peripheral macrophages located along motor axons react differently to neurodegeneration compared to CNS microglia in ALS mice. Modifying peripheral macrophages suppresses proinflammatory microglial responses, shifting them toward neuronal support.

Metastatic cells can mimic many of the phenotypic behaviors of embryonic cells. Here, the authors generate a melanoblast-specific transcriptome using a genetically engineered mouse model and identify KDELR3 as a pro-metastasis gene in melanoma.

Germline biallelic pathogenic MUTYH variants predispose patients to colorectal cancer (CRC); however, approaches to identify MUTYH variant carriers are lacking. Here, the authors evaluated mutational signatures that could distinguish MUTYH carriers in large CRC cohorts, and found MUTYH-associated somatic mutations.

Genome-wide association analyses based on whole-genome sequencing and imputation identify 40 new risk variants for colorectal cancer, including a strongly protective low-frequency variant at CHD1 and loci implicating signaling and immune function in disease etiology.

In this disease mapping study, the authors estimate disability-adjusted life year rates for three of the major causes of mortality for children under five 43 countries in sub-Saharan Africa. They identify significant heterogeneity at the subnational level, highlighting the need for a targeted intervention approach.

Two malaria vaccines comprising Plasmodium falciparum sporozoites and treatment with either pyrimethamine or chloroquine induced durable protective responses against both the African vaccine strain and a heterologous South American strain of P. falciparum.

Cancer vaccines that self-assemble into uniform nanoparticles improve tumor clearance.

Exome sequencing of 2,871 probands with congenital heart disease (CHD) provides new insights into the genetic architecture of these disorders. The results implicate new genes in CHD pathogenesis and highlight striking overlap between genes with damaging de novo mutations in individuals with CHD and autism.

Nationwide genomic biobank in Mexico unravels demographic history and complex trait architecture from 6,057 individuals.

Exposure to ultraviolet light is responsible for a large proportion of melanomas but the molecular mechanisms are unknown. In this study, melanoma is found to be induced in mice by UVA and UVB light in a pigment-dependent and -independent manner, respectively, resulting in different types of DNA damage.

The term 'athlete's heart' refers to the plethora of electrical, structural, and functional cardiac adaptations that occur in athletes undertaking vigorous training regimens. The manifestations of cardiac adaptation to exercise can resemble the signs of cardiac disease that precede sudden cardiac death. Differentiation between athlete's heart and cardiac pathology presents a challenge for physicians. In this Review, Sheikh and Sharma describe the impact of ethnicity on cardiac adaptation to exercise, with a focus on black athletes, and discuss the impact of ethnically mediated changes on preparticipation cardiovascular evaluation.

Ewing sarcoma (EWS) is a rare pediatric bone cancer typically involving the EWSR1-FLI1 fusion. Here the authors perform a genome-wide association study and report three new EWS risk loci that reside near GGAA repeat sequences, and identify candidate genes (RREB1 and KIZ) from eQTL analysis.

In an interim analysis of a phase 1/2 trial, a heterologous prime boost vaccine comprised of a chimpanzee adenovirus and self-amplifying mRNA that encodes neoantigens derived from common oncogenic driver mutations in combination with immune checkpoint blockade was safe and elicited neoantigen-specific T cell responses in patients with advanced solid tumors.

Inflammatory processes in atherosclerotic lesions promote disease progression and plaque rupture. Here the authors load the drug statin into nanoparticles made of recombinant high-density lipoprotein and show that these accumulate in atherosclerotic plaques and reduce plaque inflammation in mice.