Research Roundup: UTIs; C Difficile; Classic Hodgkin Lymphoma; Radiotherapy; Smoking And Tobacco

CIDRAP: Phase 3 Trial Shows Some Promise For Bacteriophages For UTI Treatment
The results of a randomized, controlled clinical trial show that intravesical bacteriophage treatment was non-inferior to standard-of-care antibiotic treatment and safe for treating urinary tract infection (UTI) patients, but it was not superior to placebo in terms of efficacy or safety, researchers reported yesterday in the Lancet Infectious Diseases. (9/17)

CIDRAP: Vaccine candidate fails to reduce C difficile infection in phase 3 trial
A phase 3 trial for a bivalent Clostridioides difficile toxoid vaccine was terminated because of futility, an international team of investigators led by scientists from Sanofi Pasteur reported yesterday in The Lancet Infectious Diseases. In the observer-blind, randomized controlled trial, which was conducted in 326 hospitals in the United States, Canada, Latin America, Europe, and the Asia-Pacific region, adults 50 years or older with increased risk of C difficile infection were randomized 2:1 to receive one dose of Sanofi Pasteur's C difficile vaccine candidate (containing toxoids A and B) or one dose of placebo. The primary outcome was the efficacy of the vaccine in preventing symptomatic C difficile infection. (9/16)

Journal Of Clinical Oncology: Cause-Specific Mortality Following Initial Chemotherapy In A Population-Based Cohort Of Patients With Classical Hodgkin Lymphoma, 2000-2016  
Mortality for patients with classical Hodgkin lymphoma (cHL) treated during an era characterized in the United States by widespread use of doxorubicin, bleomycin, vinblastine, and dacarbazine and diminishing use of radiotherapy is not well understood. We identified 20,007 individuals diagnosed with stage I/II (early) or III/IV (advanced) cHL between age 20 and 74 years treated with initial chemotherapy in US population-based cancer registries during 2000-2015 (follow-up through 2016). We used standardized mortality ratios (SMRs) to compare cause-specific relative mortality risk following cHL to that expected in the general population and estimated excess absolute risks (EARs; per 10,000 patient-years) to quantify disease-specific death burden. (Dores et al, 9/01)

Journal Of Clinical Oncology: Consolidation Radiotherapy Could Be Safely Omitted In Advanced Hodgkin Lymphoma With Large Nodal Mass In Complete Metabolic Response After ABVD: Final Analysis Of The Randomized GITIL/FIL HD0607 Trial 
To investigate the role of consolidation radiotherapy (cRT) in advanced-stage Hodgkin lymphoma (HL) presenting at baseline with a large nodal mass (LNM) in complete metabolic response after doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy. Advanced-stage (IIB-IVB) HL patients, enrolled in the HD 0607 trial (Clinicaltrial.gov identifier NCT00795613), with both a negative PET after two (PET-2) and six (PET-6) ABVD cycles, who presented at baseline with an LNM, defined as a nodal mass with the largest diameter ≥ 5 cm, were prospectively randomly assigned to receive cRT over the LNM or no further treatment (NFT). (Gallamini et al, 9/1)

JAMA Network: Efficacy Of Smartphone Applications For Smoking Cessation: A Randomized Clinical Trial
Is a smartphone application based on acceptance and commitment therapy (ACT) efficacious for smoking cessation? In this 2-group stratified, double-blind, individually randomized clinical trial of 2415 adult smokers with a 12-month follow-up and high retention, participants assigned to the smartphone application based on ACT had 1.49 times higher odds of quitting smoking compared with the participants assigned to the smartphone application based on US clinical practice guidelines. (Bricker et al, 9/21)

JAMA Network: Tobacco Dependence Treatment Is Critical To Excellence In Health Care
The treatment of tobacco dependence1 is critical to health and should be foundational to excellence in health care delivery. The Surgeon General’s 2020 report identified low-cost interventions that are effective in helping people quit smoking when used in both outpatient and inpatient clinical settings and indicated that the benefits of quitting for health and well-being are substantial.2 Almost 500 000 Americans die annually from tobacco use, and 16 million have serious tobacco-induced chronic diseases.2 This results in $170 billion in health care costs, including $110 billion from hospitalizations.3 People who use evidence-based cessation interventions are more likely to quit smoking than those who do not.2 Too few of the 34 million Americans who are addicted to nicotine receive assistance from health care professionals.2 Many more lives could be saved if universal treatment of tobacco dependence were implemented across all health care systems, both during hospitalization and after discharge.1 (Sarna, et al, 9/21)