Johannesburg

Researchers are evaluating a new treatment called ifinatamab deruxtecan (I-DXd) for men with metastatic castration-resistant prostate cancer (mCRPC). This study compares I-DXd to chemotherapy to see if it helps people live longer overall and live longer without their cancer worsening. It is a Phase 3, open-label trial focused on patients who have progressed on prior therapies and have evidence of metastatic disease. Participants receive either I-DXd through an intravenous infusion every 3 weeks or docetaxel chemotherapy administered every 3 weeks. Prednisone tablets are also given daily as part of the treatment plan. Before each I-DXd dose, premedication is provided to help prevent nausea and vomiting using a combination of drugs such as corticosteroids and anti-nausea medicines. Treatment continues until disease progression, unacceptable side effects, or other reasons to stop. During the study, researchers monitor overall survival and how long patients live without their cancer progressing, for up to about 36 months. Participants undergo tumor tissue collection, scans, and assessments to track disease status and side effects. Safety is closely watched throughout treatment. The study includes men aged 18 and older with confirmed prostate cancer and metastatic disease who have previously received certain hormone therapies but no prior taxane chemotherapy for mCRPC.

Researchers are looking for new medicines to prevent HIV-1 (Human Immunodeficiency Virus Type 1) infection. The goals of this study are to learn: * If taking MK-8527 once a month works to prevent HIV-1 infection as well as or better than a standard (usual) pre-exposure prophylaxis (PrEP) taken once a day * About the safety of MK-8527 and if people tolerate it

Researchers are investigating new treatments for people with high-risk, early-stage breast cancer, specifically targeting triple-negative breast cancer (TNBC) and hormone receptor (HR)-low positive/HER2-negative breast cancer. These types have little or no HER2 protein and involve hormones like estrogen or progesterone. The study aims to evaluate if the addition of sacituzumab tirumotecan (sac-TMT), a targeted therapy, combined with pembrolizumab and chemotherapy can improve outcomes compared to pembrolizumab with chemotherapy alone. Participants receive treatments including sacituzumab tirumotecan, pembrolizumab, and chemotherapy drugs such as carboplatin and paclitaxel, all given by intravenous infusion. Rescue medications like antihistamines, acetaminophen, dexamethasone, or steroid mouthwash may be used as needed. The study is randomized and open-label, comparing sac-TMT followed by chemotherapy plus pembrolizumab to chemotherapy and pembrolizumab without sac-TMT. During the study, researchers will monitor participants up to about 30 weeks to assess the percentage of people with no remaining cancer cells at surgery. They will also follow participants for up to approximately 92 months to track event-free survival, meaning time without cancer growth, spread, or return. Participants will undergo imaging, clinical assessments, and laboratory tests to evaluate treatment effects and safety throughout the study.

This research aims to evaluate and improve how appendicitis, the most common emergency surgery, is managed worldwide. Appendicitis requires timely diagnosis and treatment to prevent complications and reduce healthcare costs. By using appendicitis as a "tracer condition," the study examines emergency care systems across different countries, focusing on access to care, treatment quality, and efficiency. The goal is to find gaps in emergency surgical care, especially in low- and middle-income countries, to guide future improvements. The study will collect data from about 500 hospitals globally between February 3 and May 25, 2025. Each hospital will gather information over 14 days on patients undergoing appendicectomy, which includes open, laparoscopic, and robotic surgeries, as well as cases converted from minimally invasive to open surgery. The study also includes two sub-studies: one exploring sustainability and waste management in operating rooms, and another examining the financial impact of appendicectomy on patients, particularly in lower-income settings. Participants include all patients having appendicectomy for suspected or confirmed appendicitis during the study period. Data will be collected from routine health records without additional follow-up. Researchers will measure key outcomes such as time to surgical assessment, rates of laparoscopic surgery, postoperative complications, length of hospital stay, and financial costs to patients. The study aims to capture data on about 14,000 patients to understand how differences in hospital resources affect care and outcomes worldwide.

Researchers are evaluating the safety and effectiveness of combining durvalumab and domvanalimab compared to durvalumab plus placebo in adults with locally advanced (Stage III), unresectable non-small cell lung cancer (NSCLC) whose disease has not worsened after definitive platinum-based concurrent chemoradiation therapy. This Phase III, randomized, double-blind, placebo-controlled, international study involves multiple centers. Participants receive intravenous infusions of durvalumab and domvanalimab or durvalumab and placebo. The treatments are given after patients have completed concurrent platinum-based chemotherapy and radiation therapy with a total radiation dose of approximately 60 Gy. The study monitors patients over time to assess treatment effects and safety. During the study, participants undergo evaluations including tumor tissue analysis for PD-L1 status, performance status assessments, and monitoring of organ and marrow function. The main outcome measured is progression-free survival up to 8 years after randomization. Researchers also monitor for any adverse effects and disease progression throughout the study period.

Researchers are comparing two methods of delivering brief interventions to people who may have unhealthy alcohol use based on their scores on the Alcohol Use Disorders Identification Test (AUDIT). The study aims to find out if an electronic brief intervention (eBI) delivered through an app on a handheld device is at least as effective as a traditional face-to-face brief intervention provided by a trained health educator. This non-inferiority trial focuses on reducing alcohol consumption and risky drinking behaviors in adults who score 8 or higher on the AUDIT. Participants will be assigned to receive either the electronic brief intervention via an app or the traditional in-person brief intervention during alternating weeks at participating hospitals and clinics in Zacatecas, Mexico, and Alexandra Township, South Africa. The brief intervention includes personal feedback on drinking risk levels and guidance to help participants develop a realistic plan to lower their alcohol use to safer levels. The study enrolls adults aged 18 and older who have not been screened in the last six months. During the study, participants first complete alcohol screening and a survey about their demographics and recent alcohol use. Follow-up surveys are conducted at 3 and 6 months to track changes in alcohol consumption and AUDIT scores. Researchers measure the average daily quantity and frequency of drinking over the past 30 days as the primary outcome. Participants receive incentives for completing surveys, and contact information is collected to support follow-up. The study monitors changes over time to evaluate the effectiveness of both intervention methods.

Researchers are evaluating the safety and effects of fosmanogepix, a study medicine, for treating candidemia and invasive candidiasis, which are serious fungal infections caused by Candida species. This Phase 3 clinical trial compares fosmanogepix to the standard treatment of caspofungin followed by fluconazole, aiming to show that fosmanogepix is not worse than the standard therapy by a margin of 15%. The study includes adult patients diagnosed with these infections. Participants will receive either fosmanogepix or caspofungin as an intravenous infusion daily at the study clinic. After the initial infusion phase, patients may switch to oral tablets of fosmanogepix or fluconazole capsules, which can be taken at the clinic or at home if discharged. Treatment duration varies by individual, lasting up to six weeks depending on infection clearance and symptom improvement. A follow-up visit will take place six weeks after stopping treatment. During the study, patients will undergo multiple visits to monitor their health and treatment response. Researchers will assess outcomes such as the proportion of patients alive at 30 days and the overall treatment success at the end of study treatment, up to day 42. Safety will be closely monitored throughout the study and during follow-up, ensuring comprehensive evaluation of the treatments over the entire participation period.

Researchers are evaluating the safety, tolerability, and immune response duration of a second dose of the RSVpreF vaccine given during later pregnancies. The study also examines how long immunity lasts from a single dose given during a previous pregnancy by analyzing blood samples from nonpregnant participants who had the vaccine before. This is a Phase 3 trial focused on pregnant women and their babies as well as nonpregnant women previously vaccinated. Pregnant participants are grouped into Cohort 1, who previously received RSVpreF in a Pfizer trial and will get a second dose, and Cohort 2, who received RSVpreF previously via commercial or trial means and will be randomly given either RSVpreF or placebo. Both groups will be monitored for safety and immune response. Cohort 3 includes nonpregnant women who had RSVpreF before and will provide blood samples to check how long protection lasts, without receiving further vaccination. Participants will undergo safety monitoring during pregnancy and after birth. Infants will be followed for six months to assess safety and antibody levels. Blood tests will measure immune response, including neutralizing antibodies at birth. The study tracks local and systemic reactions, adverse events, serious adverse events, and new medical conditions in both pregnant participants and their infants over various timeframes throughout the study.

Researchers are evaluating the safety and effectiveness of zodasiran injections in adolescents and adults aged 12 years and older who have genetically or clinically diagnosed Homozygous Familial Hypercholesterolemia (HoFH). This phase 3, randomized, placebo-controlled study aims to understand how the treatment affects levels of LDL cholesterol, a harmful type of cholesterol, in the blood over time. Participants receive either zodasiran or a placebo through subcutaneous injections during the double-blind treatment period. After completing this phase, those who wish can enter an optional open-label extension where all placebo participants have the chance to switch to the active drug. The study involves ongoing monitoring to compare the effects of zodasiran versus placebo. Throughout the study, participants will have their LDL cholesterol levels measured at the start and after 12 months to assess changes. Researchers will also monitor safety through regular clinical assessments and laboratory tests. The total duration includes the double-blind period plus the optional extension, providing detailed information on treatment impact and participant health over time.

Researchers are investigating the effectiveness, safety, and tolerability of combining baxdrostat with dapagliflozin compared to dapagliflozin alone in people with chronic kidney disease (CKD) and high blood pressure. This Phase III, international, multicenter, double-blind, placebo-controlled study aims to see if this combination reduces risks such as significant kidney function decline, kidney failure, heart failure events, or cardiovascular death. The study includes a 4-week run-in period where participants not previously treated with SGLT2 inhibitors receive dapagliflozin alone. After this, participants are randomly assigned to receive either baxdrostat plus dapagliflozin or placebo plus dapagliflozin in a double-blinded manner. Study visits occur frequently initially (at 2, 4, 8, 16, 34, and 52 weeks after randomization) and then approximately every 4 months. If participants stop the blinded treatment early, they continue dapagliflozin alone unless specific criteria require its discontinuation. Participants will undergo regular assessments including blood pressure monitoring and laboratory tests related to kidney function and cardiovascular health. The primary outcome measures the reduction in risk of major kidney and heart events over up to 37 months. Even if participants stop the study treatment, they will continue follow-up visits and data collection to ensure comprehensive safety and efficacy evaluation throughout the study duration.