Leukaemia without chemotherapy at the start: what a phase 3 trial found

86% of adults were free of events at two years without chemotherapy, against 67% with it

In the 15 October 2026 issue of the New England Journal of Medicine, the Italian GIMEMA group reported a phase 3 trial in 236 adults newly diagnosed with Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph-positive ALL). They were randomly assigned in a 2:1 ratio to ponatinib, a targeted drug, followed by the immunotherapy blinatumomab, or to the older targeted drug imatinib plus chemotherapy. The median age was 55, with a range of 24 to 82. At a median follow-up of 23.7 months, estimated event-free survival at 24 months, the primary end point, was 86% with the chemotherapy-free regimen and 67% with imatinib plus chemotherapy. Relapse occurred in 5% and 13%. Overall survival, which was not the primary end point, was 90% and 85%.

For adults with this leukaemia, the trial tested whether first treatment can begin without chemotherapy at all, and on its main measure the chemotherapy-free arm came out ahead.

The comparison has limits. Patients in the chemotherapy group whose residual leukaemia persisted or came back were allowed to switch to the new regimen, which blurs any survival comparison. With a median follow-up of 23.7 months, the report does not establish long-term disease control or late side effects, and the abstract does not summarise side effects. So far, 19% of patients on the new regimen have gone on to a stem-cell transplant after a first complete haematologic response. This is a trial result, not a regulatory approval of the combination for first treatment.

Adding a glucose sensor lowered HbA1c by 0.9 points more than routine care in type 2 diabetes without insulin

The CONNECT trial, published online in the New England Journal of Medicine on 14 October 2026, randomly assigned 283 adults aged 21 to 84 with type 2 diabetes who were not using insulin, at 22 primary care practices in the United States, to continuous glucose monitoring (CGM) or to routine care for 26 weeks. HbA1c, the blood marker of average glucose over recent months, fell from 8.8% to 7.2% with CGM and from 8.7% to 8.0% with routine care. The adjusted difference was −0.9 percentage points (95% CI −1.1 to −0.6). Time with glucose in the 70–180 mg/dL range was 21 percentage points higher with CGM, time with low glucose was slightly lower, and no severe hypoglycaemia was reported.

Earlier evidence for these sensors came mainly from people with type 1 diabetes or people with type 2 diabetes using insulin. This trial tested them in people with type 2 diabetes who do not use insulin and are treated in primary care.

The randomised comparison lasted 26 weeks; the registered study continues with a 26-week extension in which both groups use CGM. Dexcom, the sensor maker, funded the trial, and several authors work for the company. It measured glucose, not complications such as heart, kidney or eye disease, and it does not show whether the difference lasts beyond 26 weeks.

Ablation left no measurable tumour on ultrasound in 258 small thyroid cancers after at least three years

Radiologists in South Korea reported in the journal Thyroid on 9 October 2026 the outcomes of 258 consecutive patients with a single low-risk papillary thyroid microcarcinoma, a papillary cancer up to 1 cm, treated with radiofrequency ablation. In this procedure a thin electrode is guided through the skin into the tumour under ultrasound and destroys it with heat. In 94 of the tumours there were calcifications, whose effect on ablation had been unclear. Mean follow-up was 53.5 months. The procedure was technically successful in every patient, the mean reduction in tumour volume exceeded 90% by 18 months, and every tumour reached a 100% volume reduction by the final follow-up of at least 36 months. Calcifications disappeared in 90 of 94 tumours. Cancer spread to lymph nodes in one patient (0.4%), 15 patients (5.8%) developed a new cancer elsewhere in the thyroid, and one had temporary hoarseness.

Calcified tumours responded in the same way as tumours without calcification, so in this series calcification did not stand in the way of ablation.

This is a retrospective series without a comparison group treated by surgery or monitored without treatment, so it cannot show that ablation matches surgery for recurrence or survival. The 15 new cancers arose elsewhere in the gland: the series describes what happened to the treated tumours and says nothing about an effect on the rest of the thyroid.

Raising one RNA-splicing protein in old mice slowed the growth of frailty by 44%

A team whose corresponding authors are Antonio del Sol and George M. Church reported in Nature Aging on 14 October 2026 a screen in human skin fibroblasts, connective-tissue cells, for genes that shift the activity pattern of aged cells toward that of young ones. The screen identified SRSF1, a protein that controls how RNA is spliced. In cultured cells, raising SRSF1 reduced signs of senescence, stress in the cell's protein quality control and inflammatory signalling without the cells losing their identity. In aged mice, switching on extra SRSF1 slowed the growth of a frailty score by 44% and was associated with a 14% longer median lifespan, with 9–10 mice per group.

Partial reprogramming with the so-called Yamanaka factors can make cells look younger, but concerns about toxicity and efficacy limit its use in living animals. This screen points to a single factor that produced a younger gene-activity pattern in cells while they kept their identity.

This is laboratory and mouse work. The lifespan groups had 9–10 mice, the lifespan finding is reported as an association, and nothing here tests SRSF1 in people or shows a safe way to raise it. Six authors are listed as inventors on a patent application covering SRSF1, and two are cofounders of and hold equity in a company developing therapies for age-related diseases.

This material is for information only and does not replace a consultation with a doctor. Nothing in it is a recommendation to start, stop or change treatment.

Sources

• Chiaretti S, et al. Ponatinib-Blinatumomab or Imatinib-Chemotherapy for Adult Ph-Positive ALL. N Engl J Med. 2026. PMID 42874102

• GIMEMA ALL2820: ponatinib and blinatumomab versus chemotherapy and imatinib in newly diagnosed adult Ph-positive ALL. ClinicalTrials.gov. NCT04722848

• Oser TK, et al. Continuous Glucose Monitoring in Non-Insulin-Treated Type 2 Diabetes. N Engl J Med. 2026. PMID 42878622

• CONNECT: continuous glucose monitoring in people with type 2 diabetes not on insulin. ClinicalTrials.gov. NCT06601166

• Jeong SY, et al. Radiofrequency Ablation of Calcified Papillary Thyroid Microcarcinoma: Long-Term Imaging Evolution and Clinical Outcomes. Thyroid. 2026. PMID 42853595

• Plesa AM, Jung S, et al. Transcriptomic reprogramming screen identifies SRSF1 as a regulator of aging. Nature Aging. 2026. DOI 10.1038/s43587-026-01234-8