Shorter radiotherapy after mastectomy held up in a phase 3 trial

After mastectomy for high-risk breast cancer, severe acute skin reactions occurred in 1.7% with 16 sessions against 12.2% with 25

On 19 October 2026 the Journal of Clinical Oncology published HypoMast-IMNI, a phase 3 trial led by Fudan University Shanghai Cancer Center in China. It enrolled 1,494 people with high-risk operable breast cancer who needed radiotherapy after mastectomy to the chest wall and the nearby lymph nodes, including the internal mammary nodes. They were randomly assigned to a shorter course of 42.56 Gy in 16 sessions or the conventional 50 Gy in 25. After a median follow-up of 58.1 months in the modified intention-to-treat population of 1,429 patients, the cancer had returned in the treated area within five years in 1.7% of the shorter-course group and 2.2% of the conventional group. The trial was designed to show that the shorter course is not worse, and it met that criterion. Distant metastasis-free, recurrence-free, disease-free and overall survival did not differ significantly, and grade 3 acute skin toxicity occurred in 1.7% against 12.2%.

When radiotherapy after mastectomy also has to cover the internal mammary nodes, it had not been established that a shorter course works as well and is as safe. For that situation the trial supports one specific regimen with nine fewer sessions and markedly fewer severe skin reactions.

Recurrences in the treated area were rare in both groups, so the estimate is imprecise: the hazard ratio was 0.69 with a 95% confidence interval from 0.32 to 1.51. Grade 2 or higher radiation pneumonitis and lung fibrosis were low and similar in both arms, and no ischaemic heart events were recorded, but this follow-up cannot establish heart effects that emerge later. The result applies to this regimen and to patients like those enrolled, aged 18 to 75 according to the trial registry.

In adults in China with biopsy-confirmed MASH and F2–F3 fibrosis, biopsy-defined improvement occurred in 30–37% against 10% on placebo

Investigators at 42 clinical sites in China reported in The Lancet Gastroenterology & Hepatology on 16 October 2026 a phase 2b trial of simedeutirom, an investigational selective agonist of the β form of the thyroid hormone receptor. It enrolled adults aged 18 to 74 with metabolic dysfunction-associated steatohepatitis (MASH), the inflammatory form of fatty liver disease, confirmed by biopsy and with moderate or advanced scarring (fibrosis stage F2 or F3). The 186 participants were randomly assigned to 80 mg or 160 mg of simedeutirom or placebo once a day for 52 weeks; in the 179 analysed, the median age was 42 and 65% were men. On repeat biopsy at week 52, MASH improved without worsening of fibrosis in 22 of 59 people (37%) on 80 mg, 18 of 60 (30%) on 160 mg and 6 of 60 (10%) on placebo. Grade 3 adverse events occurred in 5%, 8% and 5%, with no deaths and no one stopping treatment because of side effects.

The trial assessed the liver tissue itself, on biopsy after 52 weeks, in adults whose disease had already caused scarring.

It is a phase 2b trial run only in China, and its main measure was a change on biopsy, not cirrhosis, liver failure or survival. The observed response was 30% with 160 mg and 37% with 80 mg; the abstract does not report a direct statistical comparison between the doses. The trial was funded by the manufacturer, Haisco Pharmaceutical Group, and three authors are company employees. The drug is investigational, and the authors call for phase 3 trials.

In Swedish screening participants, higher detection of right-sided serrated polyps was associated with fewer cancers after colonoscopy

Researchers from Sweden and Japan reported in Endoscopy on 16 October 2026 an analysis of colonoscopies done in SCREESCO, a Swedish screening trial in which people around the age of 60 were invited either to colonoscopy or to a faecal immunochemical test (FIT). Among 9,982 people who had colonoscopy in the colonoscopy arm and 5,875 in the FIT arm, linkage with cancer registries found 20 and 17 bowel cancers diagnosed more than six months after a colonoscopy that had not found cancer. The researchers compared this with each endoscopist's proximal serrated polyp detection rate: the share of colonoscopies in which they find serrated polyps, a category of polyps, in the right-sided part of the colon. The five-year cumulative incidence of such cancers was 0.16% when the endoscopist's rate was below 10% and 0.06% when it was 10% or higher. Among endoscopists who already had a high adenoma detection rate, the figures were 0.13% and 0.06%, and over eight years the risk fell as the serrated polyp rate rose (hazard ratio 0.90 per percentage point).

Compared with cancers found at screening, cancers diagnosed after a colonoscopy more often involved the right side and an advanced stage, and the authors suggest that the serrated polyp rate adds information beyond the adenoma detection rate.

The analysis rests on only 37 such cancers. It shows an association at the level of the endoscopist, not proof that raising the detection rate prevents cancer. The participants were people invited to screening in Sweden around the age of 60, 59 to 62 according to the trial registry. The authors declared no conflicts of interest.

In older women with overweight, strength training in water improved bone measures at one hip site more than training on land

A group from the University of Valencia reported in Archives of Gerontology and Geriatrics on 13 October 2026 a randomised trial in 98 older women with overweight: mean age 67.5 years, body mass index 27.9 and body fat 42.6%. They were assigned to supervised resistance training in water, resistance training on land with elastic tubes, or a control group, twice a week for 32 weeks. Bone at the hip and lower spine was measured by dual-energy X-ray absorptiometry (DXA). Bone mineral density and T-score in Ward's triangle, a small region in the neck of the thigh bone, improved more in the water group than in both other groups (effect sizes 0.445 and 0.412). Total hip bone mineral content also changed differently between groups over time; the other hip and spine measures did not.

Exercise is recommended to preserve bone with age, but some older adults find conventional land-based programmes hard to take part in. Whether resistance training in water does anything for bone had been unclear; in this trial it changed bone at one site of the hip.

This is a secondary analysis of three arms of a six-arm trial, and the trial was registered retrospectively. The difference appeared in one small region of the hip, not across the hip and spine as a whole, and the study measured bone density, not fractures. The participants were older women with overweight.

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

• Wang X, et al. Hypofractionated Versus Conventionally Fractionated Postmastectomy Radiotherapy With Internal Mammary Node Irradiation for High-Risk Breast Cancer (HypoMast-IMNI): A Randomized Phase III Trial. J Clin Oncol. 2026. PMID 42896129

• Hypofractionated vs conventional fractionated postmastectomy radiotherapy for high risk breast cancer. ClinicalTrials.gov. NCT03856372

• Xue F, et al. Thyroid hormone receptor-β agonist simedeutirom (HSK31679) for Chinese patients with metabolic dysfunction-associated steatohepatitis: a 52-week, multicentre, randomised, double-blind, placebo-controlled, phase 2b trial. Lancet Gastroenterol Hepatol. 2026. PMID 42887516

• HSK31679 in Chinese patients with non-alcoholic steatohepatitis. ClinicalTrials.gov. NCT06168383

• Sekiguchi M, et al. Serrated polyp detection rates beyond adenoma detection rate for postcolonoscopy colorectal cancer: findings from the SCREESCO trial. Endoscopy. 2026. PMID 42887539

• SCREESCO: colonoscopy and FIT as colorectal cancer screening test in the average risk population. ClinicalTrials.gov. NCT02078804

• Juesas Á, et al. Effects of aquatic and land-based resistance training on hip bone health in overweight older women: A 32-week randomized controlled trial. Arch Gerontol Geriatr. 2026. PMID 42879863