Chene Bougeries

Researchers are evaluating treatments for patients with clinically node positive breast cancer who undergo upfront surgery. The study aims to compare tailored axillary surgery (TAS) combined with axillary radiotherapy (ART) against the standard axillary lymph node dissection (ALND) to see which approach results in better arm-related quality of life and fewer cases of lymphedema two years after treatment. This trial addresses the concern that ALND, while standard, can cause significant harm and morbidity, and seeks to determine if TAS plus ART can reduce this burden. Participants are randomly assigned to receive either ALND, which involves surgical removal of lymphatic tissue in the armpit area, or the combination of TAS and ART. TAS targets positive lymph nodes more selectively than ALND and removes fewer nodes, while ART involves radiation treatment to the axillary region. The trial is conducted in the upfront surgery setting, with prior clipping of the most suspicious axillary lymph node to aid in treatment precision. During the study, participants will complete quality of life questionnaires and be closely monitored for the development of lymphedema over two years following randomization. The main outcomes measured are changes in arm-related quality of life and the occurrence of lymphedema. Safety and treatment effects will be tracked through regular follow-up visits, with the overall goal of improving patient well-being and reducing treatment-related side effects.

Researchers are evaluating the addition of tirzepatide, a combined GIP/GLP-1 receptor agonist, to automated insulin delivery (AID) therapy in adults with type 1 diabetes (T1D). The study aims to test if this new treatment can improve blood glucose control, as only about 30% of adults with T1D currently meet recommended glucose targets. This prospective, randomized, open-label Phase 3 study hopes to provide important data on the efficacy and safety of tirzepatide as an add-on to insulin therapy in this population. Participants aged 18 to 65 with T1D diagnosed for at least 12 months, currently using AID therapy, and meeting certain glycemic and BMI criteria will be enrolled. They will be randomly assigned to receive either tirzepatide starting at 2.5 mg weekly for four weeks followed by 5 mg weekly for 12 weeks, or continue their standard care without tirzepatide. The study treatment period includes a titration phase and a total of 16 weeks of intervention. During the study, participants will wear a continuous glucose monitor (Dexcom G7) and share device data to track glucose levels. Researchers will assess the percentage of time glucose stays within the target range (3.9 to 10.0 mmol/L) after 12 weeks of treatment. Secondary measures include time spent above or below specific glucose thresholds and changes in body mass index (BMI). Safety and adherence will be monitored throughout the study.