Vasteras

Unhealthy lifestyle habits are major risk factors for cardiovascular disease (CVD), which is the leading cause of death worldwide and in Sweden. This research evaluates a digital lifestyle program developed within Swedish primary healthcare to see if it can improve important heart health outcomes and encourage healthier habits in adults aged 40 to 60. The study is a multi-center randomized trial comparing standard care alone to standard care plus the digital intervention. The main goal is to measure LDL-cholesterol levels six months after starting the study, along with other health and lifestyle factors. Participants receive standard care consisting of one structured health dialogue focused on lifestyle habits. Those in the intervention group also get access to the digital lifestyle program, which includes digital lectures, home assignments, and group meetings online. Healthcare providers can offer personalized digital support and feedback to help patients improve diet, physical activity, alcohol use, tobacco use, sleep, and stress management. The intervention is delivered entirely through digital means alongside regular primary care. During the study, participants will be monitored for changes in cholesterol levels, blood sugar, blood pressure, weight, body measurements, cardiovascular risk scores, diet, physical activity, sleep, stress, alcohol and tobacco use, and quality of life. These assessments happen six months after randomization to evaluate the effects of the intervention. The study uses these measures to understand how well the digital program supports healthier lifestyle changes and reduces cardiovascular risk.

Researchers are evaluating the safety and tolerability of a new advanced therapy medicinal product called pTTL in adults with stage IV colorectal cancer. This first-in-human, open-label, non-randomised Phase I/IIa trial focuses on pTTL, which uses the patient's own tumor-draining lymph node-derived T cells expanded in the lab with personalized cancer neoantigens. These neoantigens are unique mutations from the patient's tumor identified by next generation sequencing, allowing the therapy to target multiple specific tumor markers simultaneously. The treatment involves collecting tumor and lymph node samples from each patient to produce a personalized pTTL cell product. This process includes sequencing tumor mutations, selecting neoantigens, and expanding T cells stimulated by these patient-specific neoantigens. The pTTL product is administered as a single intravenous dose after a pre-conditioning chemotherapy regimen with cyclophosphamide and fludarabine. The trial includes three parts: tissue collection and pTTL production (about 8 to 12 weeks), pTTL treatment with 26 weeks of safety follow-up, and a long-term follow-up of up to 4.5 years. Participants will undergo tumor biopsies or surgery to provide samples for neoantigen evaluation and lymph node collection. Before treatment, patients receive supportive care and chemotherapy to prepare for pTTL infusion. Researchers will monitor safety by tracking adverse events, including those related to the immune system, for six months after therapy. Long-term monitoring will continue for several years to assess safety and treatment outcomes. The trial requires participants to have adequate organ function, performance status, and life expectancy to safely undergo treatment and follow-up.

Researchers are studying head and neck squamous cell carcinoma (HNSCC) patients with factors that increase the risk of treatment failure. The goal is to personalize treatment and improve outcomes for those receiving curative radiotherapy. This phase III trial compares the standard radiation dose to a higher dose given more frequently (hyperfractionated radiotherapy) to see if intensifying treatment benefits patients with advanced disease. The study also explores advanced imaging and genetic tests to better predict treatment response and cancer behavior. Participants will be randomly assigned to receive either the standard radiotherapy dose of 68.0 Gy in 34 fractions once daily or a higher hyperfractionated dose of 83.0 Gy in 68 fractions given twice daily over five days a week. Different radiation doses are targeted to the primary tumor and affected lymph nodes based on risk areas. The trial includes translational research using MRI, CT, and PET scans, as well as gene and protein analyses, to understand tumor characteristics and treatment effects. Patients with lower-risk tumors not eligible for randomization can still join the research parts that do not involve altered radiation schedules. During the study, participants will undergo regular monitoring including imaging and clinical assessments every three months for two years, then every six months up to five years to check local tumor control. Researchers will collect data from these visits along with tissue and blood samples for genetic and immune profiling. Safety, treatment adherence, and long-term outcomes will be closely followed to evaluate the impact of the different radiotherapy approaches and the predictive value of the biological tests.

Researchers are evaluating AZD0780, an oral PCSK9 inhibitor, in a phase 3, randomized, placebo-controlled study to see if it can reduce the risk of major adverse cardiovascular events (MACE-PLUS) in adults with established atherosclerotic cardiovascular disease (ASCVD) or those at high risk for a first ASCVD event. The study compares AZD0780 to a placebo and monitors participants from randomization until the primary analysis censoring date, followed by a final study closure visit. Participants will be randomly assigned to receive either oral AZD0780 or an oral placebo once daily. The treatment period lasts until the primary analysis censoring date, after which a study closure visit will occur. The study is event-driven and designed to assess the time to the first major cardiovascular event during treatment. During the study, participants will be closely monitored with various assessments to evaluate cardiovascular outcomes and safety over approximately 54 months. Researchers will track the time to first event of any component of MACE-PLUS and collect data to assess the effect of AZD0780 compared to placebo. The study includes regular visits and evaluations to ensure participant safety and adherence to treatment.

Researchers are investigating whether adding regular radiological scans during follow-up after surgery for high-risk malignant melanoma improves patient survival. This study focuses on patients who have undergone radical surgery for stage IIb-c and III cutaneous malignant melanoma. Since radiological exams can be costly, cause anxiety, and expose patients to radiation, the study aims to determine their value especially given the availability of effective medical treatments for melanoma. Participants are randomly assigned to one of two groups for a 3-year follow-up period. One group receives routine follow-up with regular doctor visits according to national guidelines. The other group receives the same follow-up plus whole body CT or PET scans and blood tests at baseline, 6, 12, 24, and 36 months. An interim analysis will be done after 1000 patients have enrolled. Throughout the study, researchers will monitor overall survival over a 5-year period. Participants will have scheduled assessments including scans and blood tests if assigned to the imaging group. The study also tracks adherence to follow-up visits and any health changes. This approach aims to provide clear evidence on the benefit and impact of imaging during follow-up after melanoma surgery.

Researchers are evaluating the effectiveness of adding LY3537982 (olomorasib) to standard anti-cancer drugs compared to standard treatment alone in participants with untreated advanced non-small cell lung cancer (NSCLC) that has a specific KRAS G12C gene mutation. This pivotal Phase 3 trial includes participants with locally advanced or metastatic NSCLC and considers their programmed death-ligand 1 (PD-L1) expression levels. The study includes multiple parts: Dose Optimization, Part A, and Part B are randomized, while Safety Lead-In for Part B and Part C are non-randomized. Treatments being assessed include LY3537982 taken orally, pembrolizumab administered intravenously, and standard chemotherapy drugs such as cisplatin, carboplatin, and pemetrexed given intravenously. Participants receive these treatments according to their assigned groups based on their PD-L1 expression and tumor histology. Participants will be monitored with regular assessments including measuring disease progression, safety evaluations, and treatment emergent adverse events for up to approximately one year, with overall study participation potentially lasting up to three years depending on individual response and health status. Outcome measures focus on progression-free survival and safety, capturing any adverse events from the start of treatment until disease progression or death.

Researchers are investigating whether a shorter duration of immunotherapy is as effective as the current standard for patients with high-risk malignant skin melanoma who have undergone radical surgery. This phase 3 international study focuses on patients aged 18 and older with stage IIb-c, III, or IV melanoma. The goal is to compare six months versus twelve months of immunotherapy to determine if the shorter treatment can prevent cancer recurrence as well as the longer one, potentially reducing side effects, hospital visits, and healthcare costs. The study treatment involves immunotherapy using drugs nivolumab or pembrolizumab given intravenously according to routine clinical practice. Patients are randomized to receive either six months (experimental group) or twelve months (standard group) of treatment. For those who received neoadjuvant immunotherapy before surgery, treatment durations are adjusted accordingly to total six or twelve months. Follow-up includes imaging scans at baseline, six months, and thirty-six months, along with medical examinations at multiple time points up to three years. If relapse occurs, further evaluations and treatment decisions are made by a multidisciplinary team. Participants will have regular visits for physical exams, imaging tests, and blood work to monitor their health and treatment response. The main outcomes measured are relapse-free survival and distant metastatic-free survival at two years. Overall survival and health economic effects will also be assessed. Patients are followed for up to five years to track survival and any disease recurrence, ensuring close monitoring of safety and effectiveness throughout the study period.

Researchers are investigating the use of superparamagnetic iron oxide (SPIO) nanoparticles as a tracer for delayed sentinel lymph node dissection (d-SLND) in women with ductal cancer in situ (DCIS), unclear breast lesions, or those planned for risk-reducing mastectomy where upfront axillary surgery is not needed. The study aims to evaluate the effectiveness and accuracy of delaying sentinel lymph node dissection until invasive cancer is confirmed by pathology, avoiding unnecessary upfront surgery. This is a phase 3 open-label randomized controlled trial designed to accommodate different surgical practices for mastectomy and breast-conserving surgery. Participants receive an injection of SPIO near the lesion either up to 24 hours before or during the primary breast surgery. The sentinel lymph node (SLN) is marked with SPIO but not removed during the initial operation. If final pathology shows invasive breast cancer, a second operation (d-SLND) is performed using either SPIO or radioactive isotope as the primary tracer, with randomization determining the order. The procedure involves measuring magnetic and isotope signals, incision, SLN identification, excision, and checking for residual signal. Blue dye use is optional but recommended, and all SLNs identified by any tracer are removed. A control group undergoing standard upfront SLND is also included. Participants undergo breast surgery with SPIO injection, potential second surgery for d-SLND if invasive cancer is found, and careful intraoperative monitoring of tracer signals. Researchers measure detection rates of delayed and late SLND and nodal concordance during operations. Data on technical success and procedure steps are collected. Patients are monitored for outcomes related to SLN detection and procedure success. The total participation duration depends on surgical findings and may include follow-up evaluations after both surgeries.

Researchers are evaluating Trastuzumab deruxtecan (T-DXd) in adult patients with unresectable or metastatic HER2-low expressing breast cancer. This non-interventional study aims to assess the effectiveness of T-DXd, patients' demographic and clinical characteristics, treatment patterns, tolerability, management of adverse drug reactions, and patient experience. The study also collects data on conventional chemotherapy treatments in a disease registry to better understand treatment outcomes in this population. Participants will receive treatment with Trastuzumab deruxtecan or conventional chemotherapy drugs such as capecitabine, eribulin, gemcitabine, paclitaxel, or nab-paclitaxel according to the Summary of Product Characteristics and routine clinical practice. No study drug will be administered by the researchers, as treatments follow physicians' standard care decisions. This approach allows observation of real-world treatment use and outcomes. During the study, patients' treatment timelines and responses will be followed, focusing on the time to next treatment up to 31 months. Researchers will monitor tolerability, adverse drug reactions, and patient-reported experiences. Data collection includes clinical and demographic information, treatment patterns, and outcomes to provide a comprehensive understanding of T-DXd and conventional chemotherapy use in this patient group.

Researchers are evaluating the effect of tozorakimab, added to standard care, in adults hospitalized with viral lung infection who need supplemental oxygen. The study focuses on preventing death or progression to invasive mechanical ventilation or extracorporeal membrane oxygenation by day 28. This is a Phase III, multicenter, randomized, double-blind trial comparing tozorakimab to placebo in patients with viral lung infection causing acute respiratory failure. Participants will receive a single intravenous dose of either tozorakimab or a matching placebo on the first day of the study. Both groups continue to receive standard care for their viral lung infection. The study is designed to assess the safety and efficacy of tozorakimab as an add-on therapy in this patient population. Throughout the study, researchers will monitor participants for survival and the need for invasive mechanical ventilation or ECMO up to 28 days after treatment. The main outcome measured is the proportion of patients who die or require mechanical ventilation or ECMO by day 28. Participants will be closely observed during hospitalization, with data collected on their respiratory status and treatment outcomes to evaluate the study drug's impact and safety.