Highlights of FDA Oncology Approvals in 2023: Bispecific T-cell Engagers, Pediatric Indications, and Inclusive Drug Development

SUMMARY

Cancer drug development remained robust in 2023. Highlights of U.S. drug approvals this year include new immunotherapies and targeted drug development in adult and pediatric patients as well as patients with rare diseases.

Design and development of masked therapeutic antibodies to limit off-target effects: application to anti-EGFR antibodies

Therapeutic antibodies frequently cause side effects by binding antigen in non-target tissues. Here we demonstrate a novel molecular design of antibodies that addresses this problem by reversibly "masking" antibody complementarity determining regions until they reach diseased tissues containing disease-associated proteases. Specifically, two distinct single-chain Fv (scFv) fragments derived from antibodies against the epidermal growth factor receptor (cetuximab and 425) were fused a protease susceptible linker to their epitopes, which were engineered to encourage intermolecular association. Surface plasmon resonance and flow cytometry were used to confirm that the masked complex poorly interacts with native antigen, whereas protease treatment restores antigen recognition. Minimally, the "masked" scFvs possesses an eight-fold lower association with the epitope compared with the individual scFvs unmasked by proteolytic cleavage. This molecular design may have general utility for targeted release of therapeutic antibodies at disease sites.

Loneliness in elderly people: an important area for nursing research

The phenomenon of loneliness occurs in people of all ages but may be a particular problem in the elderly. It is acknowledged that loneliness is not a necessary accompaniment to ageing and that ageing is not solely responsible for the development of loneliness in elderly people. However, there is a relationship between ageing and loneliness. Four major theories of loneliness are reviewed and their utility for application to research in the elderly is examined along with a consideration of the ways in which loneliness can be measured. While causal relationships are difficult to determine, there is evidence that loneliness is associated with a number of physical and psychological pathologies and the relevance of these to nursing is discussed. There is a growing awareness of the phenomenon of loneliness in elderly people in the nursing literature and some evidence that nursing intervention can be beneficial in this regard both at alleviating loneliness and reducing some of the adverse effects of loneliness. Finally some directions for nursing research are presented which are aimed at improving the assessment and nursing intervention for loneliness in elderly people.

A patient's view of asthma

A medical consultation is seen as a meeting between cultures which have developed from different standpoints. These cultures are described, as are the ways in which they may contribute to, or impede a full understanding between the doctor and the patient with asthma, or concerned parent.

Tuberculosis in San Antonio: 1960-1984

San Antonio, Tex, has a long history of having a high rate of tuberculosis, but from 1960 through 1984, the rate was reduced by 82.6%. In 1984 it had a lower case rate than all but one of the six major Texas cities. The rate reduction involved all ethnic groups. The City Chest Clinic treats most of the new active cases, either by providing all necessary services or by supplying medication in cooperation with local physicians. The use of chemotherapeutic drugs has greatly reduced the transmission of the disease. Preventive therapy may prevent infection or reduce the bacterial population in contacts of active cases. The city health department's nursing division provides follow-up of patients and contacts. To prevent premature discontinuation of medications, nurses observe selected patients as they take their medicines. High case rates among minority ethnic groups, although improved, still are observed. Furthermore, high rates of new active cases are still found in areas of the city with the lowest median family income, low median values of homes, and overcrowding.