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Tuesday, May 24, 2016

Morning Rounds by Megan Thielking

Good morning, everyone! Here's what you need to know to get ahead of the day's news in health and science. 

House grapples with how to handle Medicare and Medicaid fraud

Medicare and Medicaid spending are both rising dramatically — in part due to significant fraud within the system — and the House is holding a hearing to address the issue this morning. In 2015, HHS reported nearly $90 billion in improper payments made to Medicare, Medicaid, and other federal public health programs. Those improper payments can be due to billing errors, but they can also come when a health care provider uses federal funding in an “improper manner.” That finding comes after the news of high increases in Medicare and Medicaid payments in 2014; they rose 5.5 and 11 percent, respectively. Officials from HHS, the Government Accountability Office, and CMS will be witnesses during the hearing.

Major hurdles to cancer care and clinical trials

A concerning report out this morning finds that doctors aren't having tough talks with advanced cancer patients. Researchers surveyed 178 late-stage cancer patients before they underwent a scan to update the classification of their cancer stage. Only 10 percent of those patients reported having recent conversations with their oncologists about their prognosis, even though their average life expectancy was about six months. 

And a new poll from Memorial Sloan Kettering finds patients aren’t as open to participating in clinical trials as researchers would like. Only 35 percent of Americans say they’d be likely to enroll in a clinical trial. Approximately 55 percent said they were worried about the safety of the trials or side effects that might occur. Another half said the trial locations would make it too difficult for them to participate. That’s a big problem, MSK doctors say, because cancer research is quite dependent on getting more patients enrolled in trials to test new therapies. 

Harnessing the killer cells that could help fight cancer

Lymphocytes launch an attack on a cancer cell, seen here reacting in red. (Dr. Misty Jenkins, Walter and Eliza Hall Institute)
Your body’s “natural killer” cells are constantly patrolling for haywire cells that could turn into cancer. They’re a certain type of lymphocyte that are able to bind to the cells that create tumors and kill them. In a new discovery described in Nature Immunology, scientists outline a protein brake that flips on and off those natural killer cells. When the researchers removed the protein, they saw the NK cells were actually much better able to protect the body’s other cells from the spread of melanoma. They’re investigating whether there’s a way to release that brake to better target cancers inside the body. The next step: "We need to show that these chemicals are effective in human cells," paper author Sandra Nicholson of the Walter and Eliza Hall Institute of Medical Research told me. 

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Lab Chat: Delivering nanoparticles in a Trojan horse

Just because it looks like an immune cell and talks like an immune cell doesn’t mean it is one. Researchers at Houston Methodist have created nanoparticle drugs that could serve as a Trojan horse to carry drugs past the body’s immune system. Here’s what Ennio Tasciotti told me about the findings, published in Nature Materials.

What’s been the big challenge in delivering nanoparticle-packaged drugs?

Once injected into a patient, the nanoparticles are treated as a foreign body, just as a bacteria or a virus. The immune system of a patient tries to remove them from circulation as soon as they can. This problem has plagued the whole field of nanoparticle research, and is the reason why so many of these techs have failed in the clinic.

What did you do to get around that problem?

I thought, what if we make these nanoparticles look like an immune cell? In order for an object to look like a cell, the first thing to do is to make its surface look like a cell, because cells recognize each other first through surface contact. These particles are kind of Trojan horses that look like something benign, and they’re able to deliver a therapeutic. 

How do those nanoparticles know where to take the therapeutics?

Our technology focuses on inflammation as a target. It’s the common denominator among a number of pathologies that affect humans, like cancer, cardiovascular problems, trauma, and infection. We’ve developed a universal delivery system to target inflammation. It’s a universal shuttle system that always takes you to the problem, and according to the problem, you can drive there different types of drugs or molecules that are specific to the disease.

Inside STAT: Biotech is staring down a gender problem

(Molly Ferguson for STAT)

Back in January, an investor relations firm at the JP Morgan health care conference made headlines for hiring female models to balance out their party’s significantly male skew. “When you think about going to a party, when you don’t have any models, it’s going to be 90/10, or even greater, male-to-female. Adding in some females changes the dynamic quite a bit,” the organizers told Bloomberg News. The party was just the tip of the iceberg, though.

Annalisa Jenkins, CEO of Dimension Therapeutics, recounts another conference where she and two female colleagues were given men’s boxer shorts as an attendance gift. The organizer’s response to her request for a gift for women? “You can always give that to your boyfriend or your husband.” In the newest episode of our podcast Signal, Meg Tirrell and Luke Timmerman explore the deeply pervasive problem of sexism in the biotech industry.

How to minimize concussions in youth sports

The House Energy and Commerce committee is holding a hearing today on what needs to be done to minimize concussions in youth sports. The hearing was spurred by a National Academies report in 2013 that found some helmets aren't very effective in preventing concussions. The committee members will discuss what ought to be added to voluntary standards they’re hoping helmet manufacturers will adopt, and whether consumers need to be better informed about the efficacy of helmets in the first place.

Robert De Niro dives into vaccine debate, again

Brace yourselves for big drama over a forthcoming vaccine documentary from Robert De Niro and Harvey Weinstein. De Niro dropped a mention of it in a new interview with Vulture, but said he’s keeping hush-hush about the project given the recent scandal over Andrew Wakefield’s “Vaxxed” film, which was pulled from the Tribeca Film Festival schedule last month. De Niro recently defended the discredited idea that vaccines could be connected to autism in an interview on the Today Show

Fewer Americans are skipping medical care due to cost

The percentage of people who forgo medical treatment because of cost fell in 2015 4.5 percent of US adults, down from 5 percent the previous year The newest numbers out from the CDC push the rate down to a low last seen in 1999. Still, black and Hispanic individuals were more likely to avoid seeking treatment due to cost than were white Americans. 

What to read around the web today

  • Diet after divorce: Men vs. women. WSJ
  • Where dentists are scarce, American Indians forge a path to better care. New York Times

More reads from STAT

Thanks for reading! More tomorrow,

Megan

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