Daily Respiratory Research Analysis

Third-generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are standard first-line therapy for advanced, EGFR-mutated nonsmall cell lung cancer (NSCLC). However, their benefit is limited in patients who have co-existing tumor suppressor gene (TSG) mutations, highlighting a need for intensified strategies to improve outcomes. ACROSS2 (ClinicalTrials.gov identifier NCT04500717) is the first prospective, multicenter, randomized phase 3 study to compare the third-generation EGFR-TKI aumolertinib in combination with carboplatin-pemetrexed versus aumolertinib monotherapy in patients who had NSCLC with EGFR mutations and concomitant TSG mutations. In total, 126 patients were enrolled and randomly assigned to either combination therapy (n = 62) or monotherapy (n = 64). The primary end point was median progression-free survival (PFS). At a median follow-up of 25.3 months, combination therapy significantly prolonged median PFS compared with monotherapy (19.78 vs 16.53 months; hazard ratio, 0.58; 95% confidence interval, 0.34-0.97). Landmark PFS rates at 12, 18, and 24 months were 78.7% versus 65.3%, 67.2% versus 40.8%, and 41.0% versus 29.9%, respectively. Subgroup analyses demonstrated a clear PFS benefit in patients who had co-existing tumor protein p53 (TP53) mutations. Grade 3 or greater adverse events occurred in 25.9% of patients who received combination therapy versus 17.2% of those who received monotherapy; no drug-related deaths were observed. Overall survival data were immature (data maturity, 4%). The ACROSS2 trial provides the first prospective evidence supporting a genotype-directed, chemotherapy-targeted intensification approach favoring aumolertinib plus carboplatin-pemetrexed for this molecularly defined population.

BACKGROUND: In the United States, already-prevalent power outages are increasing in frequency and duration with climate change. Studies from New York State show that power outages may increase hospitalizations for cardiovascular disease (CVD) and respiratory disease in vulnerable populations such as older adults, but exposure data limitations have constrained nationwide studies of power outages and health. Here, we tested if power outages were associated with emergency CVD and respiratory disease-related hospitalizations among older adults in the United States. METHODS AND FINDINGS: We developed a national dataset of power outage exposure and identified county-days with ≥1% of customers exposed to 8+ hour power outages in 2018. We leveraged data on 23 million Medicare Fee-For-Service beneficiaries aged 65+ to estimate daily county-level rates of emergency CVD- and respiratory-related hospitalizations. We applied a case-crossover design with a conditional Poisson model to estimate the lagged association (up to 1 week) between daily county-level power outage exposure and cause-specific hospitalization rates. Models controlled for daily temperature, precipitation, and wind speed. RESULTS: Power outages were associated with increased emergency CVD and respiratory hospitalizations. The association between power outage and CVD hospitalizations was strongest the day after power outage exposure (rate ratio [RR]=1.02, 95% CI: 1.01, 1.03), while the association between outage and respiratory disease was strongest the day of power outage exposure (RR = 1.03, 95% CI: 1.01, 1.04). We estimated this association using county-level power outage data; future studies could use higher spatial resolution data. CONCLUSIONS: Power outages may increase the risk of CVD and respiratory hospitalizations among US older adults. Improving electricity reliability could support community health and protect older adults from CVD and respiratory disease exacerbations.

In the United States, annual influenza vaccination has been recommended for all persons aged ≥6 months, including during the 2025-26 season. Interim influenza vaccine effectiveness (VE) estimates were calculated for patients with acute respiratory illness-associated outpatient visits and hospitalizations from three U.S. respiratory virus VE networks during the 2025-26 influenza season, using a test-negative case-control design. Among children and adolescents aged <18 years, VE was 38%-41% against influenza outpatient visits and 41% against influenza-associated hospitalization. Among adults aged ≥18 years, VE was 22%-34% against influenza outpatient visits and 30% against influenza-associated hospitalization. Among children and adolescents, VE against influenza A ranged from 37% (against outpatient visits) to 42% (against hospitalization) across settings; among adults, VE against influenza A ranged from 30% (against hospitalization) to 34% (against outpatient visits) across settings. Among children and adolescents, VE against influenza A(H3N2)-associated outpatient visits was 35% and against influenza A(H3N2)-associated hospitalization was 38%. VE against influenza B outpatient visits ranged from 45%-71% among children and adolescents and was 63% among adults. Other estimates of VE were not statistically significant or were not reportable. Although interim influenza VE is lower during the 2025-26 influenza season than it was during recent influenza seasons, these findings demonstrate that influenza vaccination still provides protection against influenza. CDC recommends influenza vaccination; U.S. influenza vaccines remain available for persons aged ≥6 months.