'Landmark 20-Year Study Reshapes Understanding of PTSD'

 A large 20-year study — the longest and most detailed of its kind — shows that posttraumatic stress disorder (PTSD) symptoms can endure for decades, challenging conventional timelines for recovery and offering new insights to guide future treatment.

Researchers analyzed data from the World Trade Center Health Program (WTCHP), which is administered by the US CDC’s National Institute for Occupational Safety and Health (NIOSH), and found symptoms of PTSD persisted for as long as two decades in 10% of first responders involved in the World Trade Center disaster of September 2001.

Participation in the WTCHP is voluntary, but those who enroll receive free assessments, monitoring, and treatment, including psychiatric and behavioral healthcare. It is the longest and most detailed analysis of PTSD and includes 81,298 observations from 12,822 WTC responders.

Participants entered the WTCHP at different timepoints and were assessed annually. Not every enrollee was assessed every year, but the sheer number of participants and observations “just provides much greater density of data over that 20-year course than any previous study,” lead author Frank D. Mann, PhD, told Medscape Medical News.

The study was published online on May 27 in Nature Mental Health.

Filling the PTSD Knowledge Gap

Most PTSD research has focused on the short term, with limited insight into how symptoms evolve over the long haul. Without long-term data, it’s been difficult to understand whether PTSD resolves, persists, or worsens — hindering efforts to guide treatment and support. This study aimed to fill that gap by tracking symptom patterns over two decades.

Responders were assessed regularly using the PTSD Checklist for a Specific Stressor, a standardized tool that measures symptom severity on an 85-point scale. On average, each participant completed 6.3 assessments over the course of the study.

A score of ≥ 44 was considered indicative of clinically elevated PTSD symptoms. Between 2002 and 2022, the crude prevalence of elevated symptoms ranged from 8% to 15%. At the same time, 16%-34% of responders each year reported little to no symptoms, scoring at or near the minimum on the scale.

The researchers found that symptom trajectories varied widely. Nearly as many participants experienced worsening symptoms as those who improved. As a result, the overall population average remained relatively flat over the 20-year period.

Among responders who met the threshold for PTSD, the median time to symptom improvement was 8.9 years — and by year 20, about 76% had shown improvement.

New Insights

Mann, a senior research scientist at Stony Brook University Renaissance School of Medicine, Stony Brook, New York, said the study not only reinforced existing knowledge about PTSD in responders but also uncovered new insights.

Most notably, it showed that PTSD symptoms tended to peak around a decade after 9/11 — significantly later than delayed-onset patterns reported in previous trauma studies.

He also noted a surprising outcome — the top 10% of responders who experienced worsening symptoms over the long term accounted for the majority of mental health costs. These individuals, Mann said, represent a critical gap in care, with current interventions proving largely ineffective for them.

Mann suggested that ongoing trauma exposure — especially for responders still in high-risk jobs — and potential genetic susceptibility may contribute to late-emerging or persistent symptoms.

“These individuals are an urgent priority for health systems, as available resources have not been effective for them,” the study authors wrote.

Mann and his colleagues also found that occupation offered the strongest protection against developing PTSD. Police officers and firefighters benefit from training designed to help them cope with trauma, and repeated exposure may build a degree of resilience.

In contrast, responders without such training — like construction workers — faced a 50%-55% higher risk of developing PTSD symptoms. Mann emphasized that occupational status was a more powerful predictor of PTSD risk than the severity of the traumatic exposures themselves.

Commenting on the research for Medscape Medical News, Sandra Lowe, MD, medical director of the Mount Sinai WTCMH program, noted that while the study largely confirms what has been known about responders — such as the significant variability in symptom trajectories over time — it still makes a valuable contribution.

“Extending observations for up to 20 years is rare in any study, especially in a cohort this large,” said Lowe, an associate professor of psychiatry at the Icahn School of Medicine at Mount Sinai, New York City, who was not involved in the study.

Also commenting, James West, MD, chair of the American Psychiatric Association’s Committee on the Psychiatric Dimensions of Disaster, described the finding that 10% of responders continued to experience symptoms two decades after exposure as “sobering.”

However, he emphasized that it aligns with observations in the disaster recovery community, where the psychological impact “goes way beyond what most people see as the immediate aftermath and recovery.” West stressed the urgent need to develop effective treatments that enable those affected to live fuller, less impaired lives.

“We still need to be finding the effective treatments that can help these people live fuller lives without impairment from their trauma symptoms,” said West.

Lowe pointed out that the symptom peak around 10 years post-exposure is often linked to external factors. Some responders who had been managing symptoms might lose resilience due to major life changes such as retirement.

“One of the things that was able to keep them engaged is now lost,” she said. “They begin to spend more time reflecting on recollections, and symptoms can worsen.”

West agreed, adding that retirement or job loss often leads to symptom increases because it removes a primary coping mechanism. Both Lowe and Mann also highlighted that 9/11 memorial events can trigger new symptoms or exacerbate existing ones.

Lowe noted that responders with stronger coping skills tended to fare better over time. Effective coping strategies include maintaining regular schedules — especially for eating and sleeping — leading a structured life, and employing stress management techniques like meditation, yoga, or enjoyable hobbies. Social connection and being part of a community are also critical for resilience. She added that clinicians should always inquire about trauma history.

Lowe, West, and Mann all pointed out that PTSD is often accompanied by physical health issues, particularly cardiovascular problems, which tend to be worse in those with the disorder.

Responders with stronger coping skills tended to do better over time, said Lowe. Coping skills that can help make a difference include having a regular schedule, especially for eating and sleeping; having a structured life; and stress management tools, such as meditation or yoga or an enjoyable hobby. Social connection — being part of a community — is also critical, Lowe said.

Clinicians should always inquire about trauma, she said. Lowe, West, and Mann all noted that people with PTSD often have physical illness and that cardiovascular outcomes in particular are worse for those individuals.

WTCHP Future Uncertain

However, despite advances in understanding PTSD and the importance of ongoing care, the future of the program supporting World Trade Center responders remains uncertain.

Some 140,000 people are now enrolled in the WTCHP, which was established as a federal program in 2010. Congress has generally reauthorized the program whenever its funding came up for renewal.

However, earlier this year, the Trump administration dismissed two thirds of the NIOSH workforce, including John Howard, MD, the administrator of the WTCHP.

In response, members of Congress and advocates for 9/11 survivors urged the US Department of Health and Human Services (HHS) to reinstate Howard and the affected employees. Howard is listed as back on the job has since returned to his position, and HHS reportedly reinstated hundreds of NIOSH workers in May.

An HHS spokesperson told Medscape Medical News that the WTCHP continues to provide services and is actively “accepting, reviewing, and processing new enrollment applications and certification requests.”

Meanwhile, the Trump administration’s fiscal year 2026 budget proposal seeks to reduce CDC funding by $3.5 billion — approximately 40% — with a shift in focus toward infectious diseases. It remains unclear how the WTCHP will be affected by this new direction.

Mann said he is not involved in the program’s funding details but added, “Presumably, as long as some funding continues to keep the program alive, we will continue monitoring responders and providing free treatment until the very last World Trade Center responder passes.”

The study was partially funded through National Institutes of Health and CDC grants, the SUNY Research Foundation, and the CDC’s World Trade Center Health Program. Mann, Lowe, and West reported having no relevant financial relationships.

https://www.medscape.com/viewarticle/landmark-20-year-study-reshapes-understanding-ptsd-2025a1000fst

'Educational Video Game Enhances Physicians’ Trauma Triage Decisions in Emergency Departments'

 In a secondary analysis of a trial, exposure to an educational video game on trauma triage was associated with a moderate increase in emergency department (ED) physicians’ willingness to transfer injured patients to trauma centers and a smaller improvement in their ability to recognize severely injured patients.

METHODOLOGY:

• Researchers conducted a process evaluation of a randomized clinical trial that involved 800 physicians (mean age, 43.7 years) responsible for trauma triage at EDs in levels III-V trauma centers and nontrauma centers across the US.
• Participants were randomly assigned to receive either usual education (control group) or a customized video game intervention designed to recalibrate trauma triage heuristics. Those in the intervention group played the game for 2 hours, after which all participants completed a 36-case virtual simulation to assess decision-making.
• Researchers used the signal detection theory and analyzed: Perceptual sensitivity, defined as the ability to distinguish between patients who meet vs do not meet criteria for transfer; and decisional threshold, defined as tolerance for false-positive or false-negative decisions.

TAKEAWAY:

• Exposure to the video game was associated with a significant reduction in undertriage rates (22% vs 38%; P < .001) and a slight increase in overtriage (39% vs 34%; P < .001).
• Video game intervention led to a moderate increase in tolerance for false-positive decisions (intervention standard deviation [SD] units, 0.14; control SD units, 0.53) and a moderate (Cohen d = 0.60) increase in willingness to transfer.
• The intervention group was also associated with a higher perceptual sensitivity (1.00 SD units vs 0.87 SD units; P < .001), indicating a small improvement (Cohen d = 0.20) in recognizing severely injured patients.
• The intervention’s effect was more pronounced among physicians working ≥ 10 shifts per month, who showed a greater reduction in undertriage (40% in the control group vs 22% in the intervention group; P = .05).

IN PRACTICE:

“The results of this secondary analysis of a randomized clinical trial suggest that educational adventure video games have the potential to improve physician performance in time-sensitive conditions and appear to act by increasing physicians’ willingness to implement clinical practice guidelines,” the study authors wrote.

SOURCE:

This study was led by Deepika Mohan, MD, MPH, Department of Surgery, University of Pittsburgh School of Medicine in Pittsburgh. It was published online on June 4 in JAMA Network Open.

LIMITATIONS:

The use of simulation for process evaluation may not fully reflect real-world decision-making. Physicians exposed to the intervention may have had an advantage in completing the virtual simulation. Additionally, the differences in response rates between intervention and control groups, potentially due to perceived differences in honoraria value, could have introduced bias.

DISCLOSURES:

This study was supported by grants from the National Institutes of Health. Two authors reported receiving grants from various sources. One author reported receiving $250 to participate in a stakeholder meeting.

https://www.medscape.com/viewarticle/educational-video-game-enhances-physicians-trauma-triage-2025a1000fsw

'Obesity Linked to Earlier Disease, Higher Comorbidity Risk'

 Compared with individuals with normal BMI, those with obesity have earlier onset and higher rates of related comorbidities, with musculoskeletal pain as the most common.

METHODOLOGY:

• Obesity is associated with more than 200 comorbidities, yet limited data exist on their timing and sequence of onset.
• Researchers conducted a retrospective cohort study using US electronic health record data to compare the prevalence, incidence, and sequence of obesity-related comorbidities in adults with obesity (BMI ≥ 30) vs those with normal BMI (18.5 to < 25) between January 2011 and December 2014.
• The prevalence of 19 obesity-related comorbidities, including musculoskeletal pain and cardiometabolic and endocrine disorders, was assessed at baseline; the incidence of new-onset cases was analyzed over a median follow-up of 5 years.

TAKEAWAY:

• Researchers included 57,978 adults each (mean age, 52 years; 64.7% women) in the cohorts with obesity and normal BMI.
• At baseline, 61.1% of individuals with obesity and 49.6% of those with normal BMI had at least one obesity-related comorbidity.
• Multimorbidity (at least three comorbidities) was nearly twice as prevalent in the obesity group vs the normal BMI group (31.2% vs 16.6%).
• Individuals with obesity had a significantly higher risk of developing a new obesity-related comorbidity (adjusted hazard ratio, 1.35; P < .0001).
• Musculoskeletal pain was the most prevalent comorbidity at baseline and the most frequent new comorbidity in both cohorts, with a higher incidence among those with obesity (244.6 vs 197.9 per 1000 person-years).
• Those with obesity developed their first comorbidity at a median of 0.67 years earlier than those with normal BMI (P < .0001), with similarly significant accelerations in the onset of second and third comorbidities.

IN PRACTICE:

“Early identification and effective interventions to manage obesity should be the focus for preventing [obesity-related comorbidities], with the overall goal of reducing the burden of disease and simplifying treatment approaches,” the study authors wrote.

SOURCE:

This study was led by Firas Dabbous, Evidera Inc., Wilmington, North Carolina, and published online in Clinical Obesity.

LIMITATIONS:

Most participants were White, women, and from the US Midwest, limiting generalizability. The 5-year follow-up may not capture potential comorbidities with longer latent periods, such as cancer. Inclusion of patients taking antiobesity medications may also complicate interpretation of the results.

DISCLOSURES:

This study received funding from Novo Nordisk Inc. Six authors are employees and shareholders of the funding agency, and one is a consultant. Three authors are employees of Evidera Inc., which received funding from Novo Nordisk Inc.

https://www.medscape.com/viewarticle/obesity-linked-earlier-disease-higher-comorbidity-risk-2025a1000fsx

Can PSA Guide Metastatic Prostate Cancer Care?

 Prostate-specific antigen (PSA) levels could help guide treatment decisions for patients with metastatic hormone-sensitive prostate cancer, according to real-world findings from the IRONMAN study.

Specifically, an undetectable PSA nadir — defined as PSA level < 0.2 ng/mL — predicted a good prognosis and a PSA level ≥ 0.2 ng/mL predicted poor prognosis among patients receiving androgen deprivation therapy (ADT) or androgen receptor pathway inhibitor (ARPI) therapy for 6-12 months, according to Michael Ong, MD, who presented the findings at the 2025 American Society of Clinical Oncology annual meeting. 

In other words, this real-world study found that absolute PSA at 6 and 12 months is prognostic in this patient population, said Ong, a medical oncologist at Ottawa Hospital Research Institute, Canada.

Patients with a poor prognosis could then be considered for clinical trials offering therapy escalation, whereas those with a better prognosis — particularly those with PSA < 0.1 ng/mL — could be considered for de-escalation, said Ong.

Ong explained that prior phase 3 studies have demonstrated that PSA > 0.2 ng/mL is associated with poor prognosis in patients receiving ADT and ARPI. However, data in real-world settings remain limited. Some patients with rapid PSA decline never progress, whereas others develop early resistance despite intensive therapy, he explained. 

The IRONMAN study set out to answer two main questions: When should PSA cutoffs be interpreted for prognostic significance? And how may PSA cutoffs differ in real-world patients?

To this end, Ong and his colleagues included 1219 patients from the prospective IRONMAN cohort with metastatic hormone-sensitive prostate cancer who had received ADT and ARPI therapy, with or without docetaxel, and had PSA data available. PSA was stratified into three groups: ≥ 0.2 ng/mL, 0.10-0.19 ng/mL, and < 0.10 ng/mL. 

The research team constructed a 12-month landmark population to assess conditional overall survival (OS) and progression-free survival (PFS) at 6 and 12 months across each PSA level. The 12-month analysis was the primary study outcome. 

Patients were a median age of 70 years, 58% had Gleason score of 8-10, and 75% had de novo metastatic disease. Overall, most (74%) were White and just over half were enrolled from centers outside US or Canada. ARPI agents included abiraterone acetate (44%), apalutamide (21%), enzalutamide (22%), or darolutamide (13%), and 12% of patients received docetaxel in addition to doublet therapy with ADT plus ARPI. 

PSA levels shifted across the two time points. At 6 months, 52% of patients had a PSA < 0.2 ng/mL, whereas 48% had a PSA level ≥ 0.2 ng/mL. At 12 months, 68% had PSA levels < 0.2 ng/mL and 32% had levels ≥ 0.2 ng/mL.

Both the 6- and 12-month landmark analyses showed that PSA ≥ 0.2 ng/mL was associated with worse conditional OS and PFS compared with PSA < 0.2 ng/mL. 

Ong broke down conditional OS and PFS at 12 months — the primary study outcome —by absolute PSA levels. 

Absolute PSA	3-year overall survival	3-year progression-free survival	OS mortality risk (adjusted hazard ratio)
≥ 0.2 ng/mL	45%	41%	4.85 (3.36-7.01)
0.10-0.19 ng/mL	79%	62%	1.34 (0.82-2.20)
< 0.1 ng/mL	84%	80%	Reference

After adjustment for confounders, PSA ≥ 0.2 ng/mL was associated with an almost fivefold higher risk for death at 12 months (adjusted hazard ratio, 4.85). 

Ong noted that PSA was prognostic of overall survival regardless of ARPI class or whether patients received doublet or triplet therapy with docetaxel.

Invited discussant Rahul Aggarwal, MD, agreed that a PSA nadir between 6 and 12 months “is strongly prognostic for progression-free and overall survival.” 

However, Aggarwal cautioned, although “it is tempting to use PSA nadir to guide treatment decisions in clinical practice,” the approach has not been validated.

Plus, other factors and biomarkers may play a role in treatment decisions and help optimize outcomes, including quality of life, treatment and financial toxicity, and the role of the tumor suppressor gene PTEN, added Aggarwal, of the University of California, San Francisco.

“We await randomized trial data to know, in fact, whether we should use this to guide treatment decision-making,” said Aggarwal. 

Such trials are underway. Ong is co-chair of a phase 3 study assessing survival after treatment escalation for patients with PSA ≥ 0.2 ng/mL after 6-12 months of ADT and ARPI therapy. Another phase 3 study will assess treatment de-escalation in those with PSA ≤ 0.2 ng/mL at 6-12 months after treatment initiation. 

This study’s principal funder was the Movember Foundation; the Prostate Cancer Clinical Trials Consortium was a trial sponsor, plus Amgen, Astellas, AstraZeneca, Bayer, Janssen, Merck, Novartis and Sanofi provided funding support. Ong disclosed relationships with AstraZeneca, Bayer, Bristol-Myers Squibb, EMD Serono, Janssen, Merck, Novartis/AAA, Pfizer, Sanofi, and Ipsen. Aggarwal disclosed relationships with Alessa Therapeutics, Amgen, AstraZeneca, Bayer, BioXcel Therapeutics, Boxer Capital, Curio Science, and others. 

https://www.medscape.com/viewarticle/ironman-canpsa-guide-metastatic-prostate-cancer-care-2025a1000fte

Early FIT Screening Tied to Big Reduction in CRC Mortality

 A new analysis provided “strong” support for starting fecal immunochemical test (FIT) screening at ages 40-49 rather than at the currently recommended age of 50.

An exploratory initiative that offered FIT screening to residents aged 40-49 years in two Taiwan municipalities gave researchers an opportunity to test whether early screening made a real difference in colorectal cancer (CRC) mortality and incidence. They found that it did.

Both outcomes were “significantly lowered” with early screening compared with regular screening (starting at age 50), the authors found. Those who underwent early screening had lower CRC incidence (26.1 vs 42.6 per 100,000 person-years) and mortality (3.2 vs 7.4 per 100,000 person-years), with similar results after propensity score-matched analyses and in an extended nonadherence adjustment model.

The study was published online in JAMA Oncology.

Both Early, Regular Screening Best

Researchers analyzed a community-based FIT screening cohort of more than 500,000 Taiwanese residents aged 40-49 years between 2001 and 2009 who also then had an opportunity to undergo regular screening at age 50 or older.

Participants were categorized into four subcohorts based on early FIT screening at ages 40-49 and regular CRC screening at 50 years or older: Those who underwent both early and regular screening, those who underwent only early screening, those who underwent only regular screening, and those who refused regular screening.

Participants were followed up until 2019 to compare CRC incidence and mortality across subcohorts. To reduce self-selection bias, a delayed screening design and propensity score matching were used, restricting analyses to participants who underwent regular screening.

Of the 263,125 included participants, 55.8% were women. A total of 39,315 participated in early and regular screening, whereas 223,810 participated in only regular screening.

The early screening group had lower CRC incidence (26.1 vs 42.6 per 100,000 person-years) and mortality (3.2 vs 7.4 per 100,000 person-years).

In propensity score-matched analyses, early screening significantly reduced CRC incidence (adjusted relative risk [aRR], 0.79) and mortality (aRR, 0.61).

The findings persisted in an extended nonadherence adjustment model across all four subcohorts, showing a 25% reduction in incidence (aRR, 0.75) and a 34% reduction in mortality (aRR, 0.661).

The authors noted that CRC incidence and mortality were lower for the group participating in both early and regular screening than for the group participating in only regular screening. “This difference was particularly evident in the three key age groups — age 50-54 years, 55-59 years, and 60-64 years — who derived the greatest benefit from early-age screening during follow-up (approximately 10-15 years after recruitment at age 40-49 years),” the authors wrote.

Furthermore, the findings showed that FIT screening at ages 40-49 required fewer tests to prevent one CRC case than regular screening and was therefore cost-effective.

However, the authors concluded, “whether early screening policies are generalizable to other populations should be evaluated carefully.”

‘Essential’ to Inform Practice

In a related editorial, Thejus Jayakrishnan, MD, of the Dana-Farber Cancer Institute, Harvard Medical School, Boston, and colleagues noted that the authors had limited information on established CRC risk factors in the study population or on the proportion of individuals in each group who tested positive on FIT and who subsequently followed through with a colonoscopy, factors that could affect outcomes.

Nevertheless, they wrote, “This analysis adds to the current limited body of literature — comprised mainly of observational studies, colonoscopy registry studies, and modeling studies — that suggests that initiating screening at an age younger than 50 may lead to public health benefits. Until randomized clinical trials are conducted and results available, observational studies such as this will be essential to inform policy and practice,” although external validation of the findings in different countries is needed.

The study was supported by the Health Promotion Administration, Ministry of Health and Welfare of the Taiwanese government. Lead author Han-Mo Chiu, MD, PhD, National Taiwan University, Taipei, Taiwan, reported receiving grants from the Taiwanese government during the conduct of the study, as well as personal fees from Boston Scientific, Olympus Medical, and Fujifilm Medical System outside the submitted work. No other disclosures were reported.

Two coauthors of the editorial declared receiving personal fees and grants from commercial entities outside the submitted work.

https://www.medscape.com/viewarticle/early-fit-screening-tied-big-reduction-crc-mortality-2025a1000fs4

AI Meets Frailty: Rethinking Hematology in Older Patients

 Conditions like leukemia and myelodysplastic syndromes become more prevalent with age, but older patients often present with multiple comorbidities, greater physical and cognitive frailty, and diminished tolerance to intensive therapies. This creates complex challenges for the hematologist.

Matteo Giovanni Della Porta, MD

“It is not enough to focus solely on the disease; the patient must be assessed as a whole, balancing treatment efficacy with quality of life,” Matteo Giovanni Della Porta, MD, head of the Leukemia Unit at Humanitas Cancer Center and professor of hematology at Humanitas University, Milan, Italy, told Medscape Medical News. “This poses a significant clinical challenge that demands multidisciplinary expertise and increasingly personalized therapeutic strategies.”

Can artificial intelligence (AI) play a role in addressing this challenge? Experts discussed the pros and cons here on the opening day of the 2025 European Hematology Association (EHA 2025) Congress.

AI: Friend or Foe? 

Polypharmacy is common in older patients, and it is simply not feasible for a single physician to know and recall all possible interactions between medications and the therapies required to treat a hematologic condition. “Every clinical decision must be tailored to the patient’s age, comorbidities, and pharmacologic complexity, where efficacy meets vulnerability,” said Torsten Haferlach, MD, co-founder of the MLL Munich Leukemia Laboratory in Germany, speaking at the session titled “Aging and Hematology: Artificial Intelligence in Geriatric Hematology.” 

AI can help address these limitations, provided that human oversight is maintained, he said.

Torsten Haferlach, MD

“AI can integrate heterogeneous clinical, functional, and social data to develop personalized risk profiles, predict treatment tolerability, and recommend more appropriate care pathways. In the future, AI-driven predictive models may support complex clinical decision-making, helping ensure that treatments for older patients are better balanced, more effective, and more sustainable,” Della Porta explained to Medscape Medical News.

Large language models are now being used to support automatic diagnosis, often generating clinically usable results. But Della Porta cautioned that most AI tools are not yet optimized for older populations. A recent scoping review of FDA-approved AI-based devices found that only 0.4% focused exclusively on geriatric health.

Reshaping Doctor-Patient Relationship 

Still, as AI increasingly takes over administrative tasks, such as note taking and report generation, it might give clinicians more time for meaningful patient interaction.

“AI does not replace physicians, but it can make their work more effective and help foster a closer connection with the patient, also through building trust,” said Esther Lueje, MD, a geriatrician at Fundación Jiménez Díaz University Hospital, Madrid, Spain. She explained that AI can free up time, reduce diagnostic uncertainty, and support more transparent decision-making.

However, Della Porta cautioned while speaking with Medscape Medical News, that “[i]f patients feel that technology is replacing empathy or meaningful dialogue, there is a risk of emotional detachment. The key point is that AI should serve the doctor–patient relationship, not hinder it.”

Lueje also warned that integrating large language models into daily practice comes with challenges: hallucinations, clinical errors, the need for medical oversight, and limited digital literacy among physicians. 

“We have a stethoscope in one hand but no prompt — or the skill to write one — in the other,” Haferlach also noted.

Synthetic Patients, Virtual Trials 

Another realm for AI integration is synthetic data, which could become as revolutionary as telecommunications and biotechnology. “Data are the new oil,” said Alfonso Piciocchi, PhD, chief scientific officer and head of the Biostatistics Unit at Fondazione GIMEMA, Italy.

Alfonso Piciocchi, PhD

In his talk, Piciocchi explored the concept of synthetic patients: AI-generated models that mirror real patient populations, preserving key data correlations. 

These are not mere simulations, as they preserve the same multivariate structure, correlations, and observed distributions as real-world data. They are primarily used to train AI algorithms while safeguarding patient privacy. “The generation of synthetic patients is not without risks: if the initial database is not well-defined, the risk of failure can be significant," Piciocchi told Medscape Medical News.

However, current experiences indicate that these synthetic patient cohorts closely resemble actual human cohorts and can be effectively used to create control groups in so-called “virtual” clinical trials or to enhance the representation of under-recruited populations, such as elderly patients, who are often difficult to enroll.

In addition to synthetic patients, there is increasing discussion around digital twins: virtual representations of real patients created by integrating biological, clinical, and environmental data. "They allow clinicians to simulate disease progression or predict therapeutic responses before initiating treatment, thereby enhancing personalization of care," Della Porta said, emphasizing that both technologies are already in use in experimental settings and are expected to become integral components of precision medicine in hematology in the coming years.

Della Porta and Lueje reported no relevant financial relationships. Haferlach reported being part owner of MLL Munich Leukemia Laboratory. Piciocchi reported being a consultant, on the speaker bureau, or advisory board of Takeda, GSK, Janssen, Amgen, Gedeon Richter, and AbbVie.

https://www.medscape.com/viewarticle/ai-meets-frailty-rethinking-hematology-older-patients-2025a1000fu7

Nurix Therapeutics (NRIX) Shares Dip After Trial Update on Bexobrutide

 Nurix Therapeutics (NRIX) experienced a stock decline following the release of new data from its Phase 1a/b clinical trial for bexobrutideg (NX-5948), a treatment targeting B-cell malignancies. Despite this, the trial showcased impressive efficacy, with response rates of 80.9% in patients with chronic lymphocytic leukemia and 84.2% in those with Waldenström Macroglobulinemia. Building on these results, Nurix plans to proceed with pivotal trials within the year.

https://www.gurufocus.com/news/2924912/nurix-therapeutics-nrix-shares-dip-after-trial-update-on-bexobrutide