Latest news with #Lugano
Yahoo
a day ago
- Business
- Yahoo
Blockstream Expands in Europe With Acquisition of Swiss Crypto Firm Elysium Labs
Adam Back's Bitcoin development firm, Blockstream, has acquired Swiss blockchain startup Elysium Labs. The acquisition will see the creation of a European incubator entity, Blockstream CH SAGL, according to an emailed announcement shared with CoinDesk on Monday. The deal terms weren't disclosed by the firms. Blockstream is building momentum around its European ventures, following the inception of its Lugano Research Center, which is focused on product development of Bitcoin layer-2 networks Lightning and Liquid. The firm has not disclosed financial details of the acquisition. Blockstream CH SAGL will serve as a hub for Blockstream's European operations alongside its Turin, Italy-based research and development team and the Lugano Research Center, according to Monday's announcement. An early proponent of the cypherpunk movement, Blockstream CEO and co-founder Adam Back is a notable figure in Bitcoin lore. Back developed Hashcash in 1997 to combat email spam, which was a direct influence on Satoshi Nakamoto in creating Bitcoin's proof-of-work mechanism, and was cited as such in the original whitepaper. 'Bringing Elysium Lab into Blockstream strengthens our Swiss presence and amplifies our commitment to nurturing innovation across Europe,' Back said in Monday's announcement. Read More: Adam Back's Bitcoin Treasury Firm to Go Public with 30K BTC and $1.5B in Buying Power
The Herald Scotland
2 days ago
- Sport
- The Herald Scotland
Manager to talk with Celtic target before making decision
Cluj are in Switzerland this week for a Europa League tie against Lugano. Munteanu has yet to start a game so far this season for Petrescu's side, as the transfer interest in him continues to intensify. And former Chelsea star Petrescu - now in his fourth spell as manager of the club - will make a decision as to whether to play his star man in the European tie after talks with him. Read more: He said: "I want to have a clarifying discussion with Louis. "It's possible he'll play from the start or he might start as a sub. "If he feels good, maybe he can start. You know how it is in football. "But I want to say if he leaves tomorrow or this week, I wouldn't be upset. "I understand the situation, the club understands, the player understands and I would be happy for him. "But at the same time, if he stays, I would be even happier."
Yahoo
16-07-2025
- Sport
- Yahoo
Report – Inter Milan Name Atalanta Europa League Hero Top Priority To Reinforce Frontline
Inter Milan have set their sights on Atalanta talisman Ademola Lookman as the final piece of their attacking jigsaw. According to Corriere dello Sport via FCInterNews, the Nigerian has climbed to the top of the Nerazzurri shortlist. Advertisement Despite only recently adding Ange-Yoan Bonny to Cristian Chivu's squad, Inter remain in the market for a new forward. Indeed, the Italian giants are keen to offload Mehdi Taremi after a dreadful first season in Serie A. However, they will not pursue another out-and-out striker. Inter Milan Make Ademola Lookman Top Attacking Priority LUGANO, SWITZERLAND – JULY 12: FC Internazionale Sportif Director Milano Piero Ausilio looks on before Pre-season Friendly between FC Lugano v FC Internazionale at Cornaredo Stadium on July 12, 2022 in Lugano, Switzerland. (Photo by) Instead of chasing another classic center-forward, Chivu's men are eager to sign a versatile attacker. Lookman ticks all the boxes for the type of player Piero Ausilio and Beppe Marotta are looking to recruit. Indeed, he can cover virtually every role in the final third. Advertisement Capable of playing on the wing, he's also adept at a center-forward position. Furthermore, he has a proven track record in Serie A. Over the past three years, he has been Atalanta's most consistent forward and one of the best in Italian football.
Medscape
09-07-2025
- Health
- Medscape
Launched: Early-Stage Hodgkin Lymphoma Prediction Tool
The first prediction model to be developed for early-stage classic Hodgkin lymphoma, focusing on just four key risk factors that are assessed via an easy-to-use online risk calculator, provides individualized prediction of patients' 2-year progression-free survival, using continuous variables that enable high precision in the risk assessments. 'Utilizing objective, continuous, and readily available variables in nearly 5400 early-stage classic Hodgkin lymphoma patients, we developed and validated a robust, dynamic, and modern prediction model,' co-author Andrew M. Evens, DO, of the Division of Blood Disorders, Rutgers Cancer Institute, New Brunswick, New Jersey, said in presenting the findings at the 18th International Conference on Malignant Lymphoma (ICML) 2025 in Lugano, Switzerland. 'Male sex, and continuous values of decreasing hemoglobin or albumin, and incrementally increasing maximum tumor diameter were associated with worse progression-free survival,' Evens said of the research, which was simultaneously published in NEJM Evidence . While the vast majority of patients with early-stage classic Hodgkin lymphoma do have favorable outcomes, the cure rate isn't 100%, and the prognostic models currently used, such as those from the European Organisation for Research and Treatment of Cancer (EORTC) or German Hodgkin Study Group (GHSG), have been used for decades, with general assessments as being either favorable or unfavorable, Evens explained. 'These original models were based on data from the early 1970s, when the majority of patients had staging laparotomies and radiation alone as treatment,' he explained. An update from the GHSG in 2013 was performed, but 'overall, it had poor specificity,' he said. 'With more sophistication available in modeling and in contemporary datasets, there has been an unmet need [for a modernized prediction tool] identified,' Evens noted. In response, the new model was developed by Evens and colleagues as part of the HoLISTIC (Hodgkin Lymphoma International Study for Individual Care) international consortium. Called the Early-Stage cHL International Prognostication Index (E-HIPI), the new model was developed with the use of data on 3000 patients with untreated, early-stage classic Hodgkin lymphoma from four seminal, phase 3 clinical trials, including the CCTG-ECOG, EORTC H9, RAPID, and EORTC H10 trials. Those patients, overall, had a median age of 31.2 years, and 77.4% had stage II disease. Their estimated 2-year progression-free survival was 93.7%. Four Key Risk Factors in Early-Stage Classic Hodgkin Lymphoma Based on the analysis, four key parameters that emerged as being significantly associated with progression-free survival were female sex, conveying a lower risk (hazard ratio [HR], 0.59); maximum tumor diameter (HR, 1.06 per 1 cm, ranging from 1.5 to 15.0, hence 'about a 10% increased risk with each centimeter increase,' Evens said); hemoglobin level (HR, 1.09; continuous, ranging from 5.0 to 16.5 g/dL); and albumin level (HR, 0.83; continuous, ranging from 2.5 to 6.0 g/dL), where increases from low levels to high levels were predictive factors for each. The data were validated externally using two separate cohorts of 2360 contemporaneously treated patients from five international cancer registries, including the BC Cancer, Princess Margaret, Iowa/Mayo SPORE, Stanford Registry, and Danish National Lymphoma Registry. In those external validation cohorts, the 2-year progression-free survival was slightly lower, at 90.3% in cohort 1 and 91.6% in cohort 2. After multivariate adjustment in a Cox regression model, the E-HIPI model was significantly associated with progression-free survival, whereas the EORTC measures of favorable or unfavorable status were not. The number of nodal groups was also considered as a potential predictor but was ultimately not found to be significantly associated with progression-free survival in the model. Continuous Variables Provide Greater Context The online risk calculator, in addition to providing a 2-year progression-free survival estimate, also helps to estimate risk according to adjustments based on differing potential disease trajectories. Notably, whereas many other models use basic cutoffs for factors, such as age being categorized as older or younger than 45 years, the model uses continuous variables to provide context for each input in relation to a full range, instead of just being under or over a specific level. 'We know that if you try to dichotomize a continuous factor, you lose a lot of statistical power, and you lose potential nonlinear effects,' Evens explained. With dichotomized values such as age categorized as older or younger than 45 years, 'how can you know, for instance, that outcomes with a 44-year-old are going to be similar to the 18-year-old?' he said. 'Likewise, with tumor diameters, as opposed to saying simply above or below 10 cm, this approach gives us more richness and more power in individualized prediction to base the risk on the exact tumor dimension.' The 2-year progression-free survival was seen as the most important primary outcome for the model because among the very small proportion of patients who do have a relapse, such events most commonly occur within 2 years, Evens noted. However, with ever-advancing therapies continuously affecting outcomes, and the known small risk for postacute late effects occurring years later, potentially due not to the disease itself but to exposure to treatments such as chemotherapy and radiation, the work on E-HIPI will continue. The current predictor was step 1, Evens told Medscape Medical News . Step 2 will be to look at different treatments and help predict outcomes based on the differing treatments, and step 3 will involve the estimation of postacute late effects, he explained. 'Our model provides more precise and individualized prediction [than existing methods], and in the near future with the second and third iterations of the model, we'll be able to take this to the bedside and help predict not just general outcomes for patients, but more exact treatment options,' he said. The E-HIPI is in fact the second prognostic tool developed by the international consortium. The team has also made available the Advanced-stage cHL International Prognostication Index. Commenting on the study, Alex Herrera, MD, chief of the Division of Lymphoma, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope Medical Center in Duarte, California, said the new model offers some important new insights. 'We rely heavily on early-stage prognostic indices, since patients with early-stage cHL are classified as 'favorable' or 'unfavorable' based on these risk factor indices, and that is what determines the treatment plan,' he told Medscape Medical News . 'Here we see that some of the traditional factors in the GHSG and EORTC risk stratification may not be as useful.' Herrera agreed that a key attribute of the new prediction model is the use of the continuous values. 'An important change [from previous models] is the use of the full range of values (continuous) as opposed to just binary thresholds,' Herrera said. He added that 'albumin and hemoglobin have always been a part of the advanced-stage IPI, but here they were key prognostic factors for early-stage disease.' While the previous indices will continue to determine how to treat patients, 'the online tool will allow this to become a key part of prognostic discussions with patients in the clinic,' Herrera said.
Medscape
09-07-2025
- Health
- Medscape
CLL: Hematologists Face Off on Best Long-Term Strategy
In the age of targeted therapy, what's the best long-term strategy to treat chronic lymphocytic leukemia (CLL), the most common leukemia in Western countries? Should treatment be continuous to achieve deep remissions or time-limited to allow patients to take breaks? At the 18th International Conference on Malignant Lymphoma (ICML) 2025 in Lugano, Switzerland, a pair of hematologists set aside their friendship for a few moments and took opposite sides in a debate over off-and-on BCL2 targeting vs continuous treatment with Bruton's tyrosine kinaseinhibitors (BTKis). Here's a summary of their discussion — and insight from another specialist who provided perspective to Medscape Medical News. Team Venetoclax: It's the 'Most Potent' Therapy Hematologist John F. Seymour, MBBS, PhD, of the Royal Melbourne Hospital, Parkville, and the Peter MacCallum Cancer Center, Melbourne, both in Australia, supported on-and-off BLC2 targeting via therapy with venetoclax, which he called 'the most potent known anti-CLL therapy.' He highlighted its early record of rapid improvement in patients and asked, 'Why would we not want to use a drug that potent?' He cited data from the 2023 CLL13 study, which he said showed that venetoclax combinations have 'an astonishing and unprecedented ability to achieve incredibly deep remissions, as measured by undetectable MRD [measurable or minimal residual disease] rates in the peripheral blood above 90% with short term time-limited treatment.' The study authors reported that 'venetoclax-obinutuzumab [VO] with or without ibrutinib was superior to chemoimmunotherapy as first-line treatment in fit patients with CLL.' Seymour also noted phase 3 data from several studies demonstrating that time-limited therapy of 12-14 months achieved 4-year progression-free survival (PFS) rates between 75% and 85%, similar to continuous BTKi therapy outcomes. 'So in terms of PFS, both are equivalent,' he said. Team BTKi: The Evidence Is in Hematologist Stephan Stilgenbauer, MD, of Ulm University, Ulm, Germany, countered by emphasizing the extensive evidence base supporting continuous BTKi therapy, noting data from 'almost 2000 patients on nine clinical trials' with nearly 5 years of aggregate follow-up. He added that 'we have a median follow-up time that is close to 50 years in aggregate, and even more importantly, seven of these nine trial arms involved the relevant CLL patient population — namely, patients of a median age of about 70 years.' He contrasted this with more limited data for venetoclax combinations, stating that VO had evidence from only two trials, the CLL13 and CLL14 trials, with 'only a single arm' addressing the relevant older patient population. And the aggregated median follow-up time, he said, is just over 10 years. Regarding efficacy, Stilgenbauer presented cross-trial comparisons showing 48-month PFS rates in older patients, with aggregate data showing 72% for BCL-2 inhibitors and 79% for '79% BTKis.' 'It is quite clear efficacy is better with [BTKis],' he said. Team Venetoclax: Listen to Guidelines and Patients Seymour highlighted European Society For Medical Oncology (ESMO) recommendations regarding therapy. ESMO's 2024 interim guideline update says that in front-line therapy, 'first-line treatment in patients with CLL regardless of IGHV [immunoglobulin heavy chain variable region status] but without a TP53 mutation or del(17p), preference should be given to time-limited therapies and to therapies and/or combinations with longer follow-up data, if efficacy is similar.' However, the 2021 ESMO guidelines offer these cautions about time-limited therapies: 'side-effect profile (renal impairment and risk of TLS [tumor lysis syndrome] vs atrial fibrillation and bleeding risk), application mode (intravenous [IV] application with combination therapy due to the antibody infusion vs oral medication only), intensity of controls (5-week ramp-up period with the combination), and shorter follow-up have to be taken into consideration.' Seymour also noted patient preference data showing that 'the most dominant factor for patients' preference with given equivalent efficacy was shorter duration of treatment.' As for adverse effects, Seymour argued that current protocols have minimized this risk for TLS. 'Interventions are very uncommonly needed. When analyzing aggregate data, TLS is in less than 1 in 200 patients,' he said. He contrasted this with the risks of continuous therapy, noting that 'continuous accumulation of risk of adverse events is seen, and some of those, and the most troublesome among those are cardiovascular. That can be atrial fibrillation or flutter. While second-generation drugs have a lower rate, they still occur, and they still increase with time.' Most devastatingly, 'the risk of sudden cardiac death is increased with ibrutinib across a number of these studies. And that risk continues to accumulate with time.' Team BTKi: Safety Matters Stilgenbauer challenged safety perceptions about BTKis, highlighting the CLL12 placebo-controlled trial. 'When you look at the adverse event table from this trial, you see that all of these so-called treatment-emergent adverse events that occurred with ibrutinib also occurred with placebo,' he said. 'These adverse events occur due to the disease and not due to the treatment.' He also noted safety data showing higher rates of severe neutropenia in venetoclax combinations. 'You have a high-grade neutropenia in more than 55% of patients. You have thrombocytopenia, anemia, you have febrile neutropenia and pneumonia,' Stilgenbauer said, comparing this to single-digit percentages with BTKis. The Outside Expert: Focus on Patient Characteristics Medscape Medical News contacted Hematologist Seema Ali Bhat, MD, of The Ohio State University in Columbus, Ohio, and asked her for her perspective. Here are excerpts from our conversation: What do you think regarding time-limited venetoclax-based therapy vs continuous BTKi therapy? Both regimens are highly effective options for CLL, and the choice between them should be individualized. Time-limited venetoclax combinations (with obinutuzumab or acalabrutinib +/- obinutuzumab) offer the advantage of finite therapy, with potential for deep remissions, MRD negativity, and treatment-free intervals. On the other hand, BTKis have shown sustained efficacy with long-term data, even in high-risk groups. In fact, a pooled analysis of three trials showed that first-line treatment with ibrutinib provides long-term overall survival benefits, with estimates similar to those of an age-matched adult population. What should hematologists be thinking about when they make decisions regarding treatment in these patients? Several factors should guide treatment selection: •Patient-specific factors: age, fitness, cardiovascular comorbidities (atrial fibrillation, hypertension, congestive heart failure, etc.), renal function, medication adherence, and treatment goals. BTKis are known to have cardiac adverse effects, so patients with underlying uncontrolled cardiac condition like atrial fibrillation or hypertension may not be suitable for this kind of therapy. On the other hand, patients with renal dysfunction may be prone to worsening renal function due to risk for TLS with venetoclax. •Patient preferences: If a patient does not want to come in for frequent laboratory monitoring during venetoclax ramp-up, a BTKi is preferred. Similarly, if coming for IV infusions for 6 months is burdensome, it is better to avoid a VO regimen. If there is a patient who wants fixed duration therapy but prefers not to have IV treatments, the acalabrutinib plus venetoclax (AV) regimen will be ideal in this case. The consideration of patient preferences is important. Some patients value time off treatment and the concept of deep remissions while others may prioritize fewer visits or simpler oral treatments. •Disease characteristics: We take disease biology into consideration, especially IGHV mutation status and TP53 disruption. In the CLL14 study, it was very clear that in patients with TP53 disruptions, the responses were not as durable as in patients without these abnormalities. Studies with BTKis have consistently shown similar outcomes in patients with or without TP53 disruption. •Drug interactions: Due to an increased risk for bleeding, it is advised to be cautious when combining BTKis with blood thinners. In a patient who is at an increased risk for bleeding, venetoclax-based therapy may be preferred. •Access and cost: Time-limited therapy may be more cost-effective, but access to obinutuzumab and logistical complexity of venetoclax ramp-up can be barriers. Shared decision-making is essential, especially as both options — time-limited or continuous offer excellent outcomes in many patients. Is there anything else you'd like to add about this topic? Head-to-head comparisons between these different types of treatments are ongoing — for example, trials like FLAIR and CLL17— so we are eagerly awaiting those results which may help further refine this field. Also, the oral doublets have so far been compared with chemoimmunotherapy, it will be important to see how AV compares to VO in the MAJIC trial or how zanubrutinib plus sonrotoclax, a new BCL2 inhibitor, compares to VO in the CELESTIAL trial. Until we have definitive long-term comparative data, clinicians should avoid rigid treatment algorithms.
