🗞️ Medical News Craving? Here’s Your Fix

There are many things in this world we never seem to have enough of.

Competent politicians.
Cheap pints.
Affordable housing.

The list goes on 💭 

But perhaps the greatest shortage of all?

Fresh, piping hot medical news.

Lucky for you, we’ve got the latest batch ready to serve 🧑‍🍳

👋 Happy Friday. Here’s what we got:

If you want to read any previous editions of The Handover, you can on our website.

Sometimes a paper is just so huge that the big boys of media get a whiff.
They skim over the abstract, while we’re elbow deep in forest plots.
So when the BBC, the Guardian, and The New York Times try to step on our patch,

We take it personally.

And we don’t put out Wordle puzzles, lifestyle columns or horoscopes (... yet).

But we can’t blame them for talking about this one.

Because pancreatic ductal adenocarcinoma is no trivial matter.
In fact, it’s one of the most lethal forms of cancer, with a 5 year survival rate of just 9%,

Often diagnosed late, treatment options are limited.
Or at least, they were.

Because there’s a new player in town.
Its name … Daraxonrasib.

Now don’t let this impossible to pronounce drug get you in a twist.
It’s not rocket science, just molecular oncology.

Let’s break it down:

When working properly, the RAS protein is a master conductor for cell growth. It sits patiently, waiting for signals from the rest of the body. 

When it gets the message, it activates, RAS(ON)✅, making cells divide and grow. Once the job is done, it deactivates, RAS(OFF)❌, stopping cells from growing uncontrollably (maybe you can see where this is going)

In over 90% of pancreatic cancer cases, the RAS gene is mutated, getting stuck in the RAS(ON) position. It just sits there, shouting like a drunk uncle at Christmas and inciting cell division on a deadly scale.

And Daraxonrasib tells it to shut the hell up.

But you don’t come to The Handover for a cellular biology lesson (I hope), it’s time for the trial ⚖️

The Phase 3 RASolute 302 trial, published in The New England Journal of Medicine is the star this week.
500 patients across the world were randomised to chemotherapy or daraxonrasib.

And how did daraxonrasib do? Pretty damn well:

In statistical terms, that’s known as an absolute thrashing.

But it gets even better:

Now the trial wasn’t blinded, so there may be some bias at play.
And for the 10% of patients whose cancer isn’t RAS related, the benefits were less clear.

But it is undeniable that this is a huge step forward in treating one of the most aggressive cancers.

Better survival, better side effects, better wellbeing…
Sometimes, news is just good.

That seems worth putting on the front page to me 🎉

Are you statinophobic?

Statins - the UK’s most commonly prescribed drug, are also the UK’s most controversial drugs. We could go into a whole deep dive on the philosophy of statin hate. Socrates and Plato would have had a field day with it. 

However, the standout aversion comes from:

You see, regulation works like this:
Product labels are not a list of proven harms. They are a catalogue of reported or suspected associations. Of which some are well established, and others far more uncertain.

And as a result of being such a mainstream drug, statins have been investigated to death.
Resulting in a large list of “potential” side effects of taking the medication.

Product labels side effects include: memory loss, depression, sleep disturbance, neuropathy, liver dysfunction… in fact, there is a listed 66 “undesirable effects” that statins have warnings against. 

And for many patients, that list alone is enough to decline a prescription that might otherwise reduce their risk of a life-threatening cardiovascular event.

So instead of arguing on X, a group of researchers did the unsexy thing and went back to the research:

Published in The Lancet, this meta-analysis asked this:

According only to high-quality evidence, are the side effects listed on statin drug labels actually caused by statins?

To be included in this study, strict inclusion criteria had to be met:

And after whittling down all the evidence, they landed on 19 statin vs placebo trials and 4 more‑intensive vs less‑intensive statin regimen, totalling 154,664 participants in this meta-analysis.

After doing their statistical magic, the headline finding was this:

Out of the 66 “undesirable effects” investigated, there was no convincing evidence of causality found in 62 of them. 

Those categories include:

In other words, across these categories and more, according to the highest-quality evidence, participants taking statins were no more likely to experience these conditions than those taking a placebo.

The four categories where statins did have an effect were:

So even in those where effects were found, they seem to be very marginal.

So yes, statins appear to slightly raise certain liver enzyme levels and cause you to retain more fluid than you normally would.

But they don’t quite cause widespread cognitive collapse, emotional ruin, kidney failure, lung disease, or sexual dysfunction - at least according to 150,000 patients. 

Which means if you're going to have a phobia, it probably doesn't need to be statins.
Make it something more sensible.
Like spiders or Michael Jackson.

🧬 Ovarian Cancer Breakthrough 

Another major cancer breakthrough this week, NICE has approved mirvetuximab soravtansine (Elahere), as the first new treatment in more than 20 years for women with a resistant type of ovarian cancer.

Developed by drug company AbbVie, it’s been designed for patients whose tumours express a specific receptor, folate receptor alpha (FRα), it’s been described as a biological Trojan horse, which attaches to tumour cells to destroy them. 

In clinical trials, the drug extended survival by around four months on average, delayed disease progression and even caused fewer side effects than standard chemotherapy.

In over a third of patients the tumour size was reduced by at least 30%, compared with 16% from chemotherapy.

The hope is that as many as 400 women per year could benefit.

It’s a W week for oncology and a reminder to us all that targeted treatments are changing the cancer game 🦀

🌳 Touch Grass, ICU Edition

Have you ever thought about what it’s like to be in ICU as a patient?

The constant beeping monitors. White walls. Fluorescent lights. No fresh air, no sunlight, no sense of time passing.

Sure, you’re getting proper medical care. But it’s not the most healing environment.

That’s why King’s College Hospital in London has opened a rooftop garden for critical care patients, giving those who are well enough the chance to have a break from the ward environment. 

The space can help reduce anxiety, improve wellbeing and remind the sickest patients that there’s a whole world waiting for them beyond the ICU curtains.

It’s a small space, but a huge mental break … 🧘

❌ Doc Suspended for Attendance Lie 

A cardiology trainee has been suspended for a year after falsely claiming she attended a training course when, in actuality, she was preparing for her wedding. 

Dr Preethi Suresh scanned the QR codes for both attendance and feedback, and then uploaded the subsequent certificate to her portfolio to claim the CPD hours. But the cardiologist consultant did not remember her attending, and once directly questioned, she confessed to the lie. 

The Medical Practitioners Tribunal Service concluded her conduct was dishonest and undermined trust in the profession. Dr Suresh was suspended from practice for 12 months and will face a review hearing before returning to work.

A costly reminder that CPD stands for Continuing Professional Development, and not Creative Portfolio Documentation. 😬

🦠 The First AI-Made Vaccine

Giving conspiracy theorists one more thing to rant about on Instagram Live, the University of Cambridge has developed what they claim is the world’s first vaccine, completely designed by AI.

The experimental jab is designed to protect against entire families of coronavirus. The vaccine has already entered human trials, with researchers using AI to create a "super-antigen" designed to train the immune system against both current and future coronavirus threats. Ebola and influenza are expected in the future.

📖 Handover Read of The Week

The Handover read of the week comes from this tweet, which speaks on the prevalence of medical errors.

A good read and a good write-up. Check it out 👉 here: Doctors Are Not Crashing Jumbo Jets

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