PFAS are chemicals that were used in things like nonstick cookware or stain resistant fabrics, and they’ve been implicated in a number of deleterious health outcomes, including autism. A new study looks at PFAS exposures in mothers and changes in brain architecture in their infants, and finds a relationship. Autism expert Heather Volk at Johns Hopkins describes the study.
Volk: Thinking about how to best measure it and how to study the impact of PFAS on brain development is a great question. This particular paper seeks to try to do that, actually leveraging magnetic resonance imaging data. What is notable about this paper with PFAS is they're actually looking at maternal levels of PFAS measured in relationship to child brain measures. It's only 51 mother child pairs, I think it is an important first look at trying to connect actual measured chemical exposures during pregnancy to child brain development.   :31
Volk says much larger studies need to be done to establish a role for PFAS in autism risk. At Johns Hopkins, I’m Elizabeth Tracey.

Covid vaccines boosted the immune response in people being treated for cancer and improved their survival, a recent study concludes. mRNA expert Jeff Coller at Johns Hopkins says as more evidence mounts establishing the benefits of mRNA vaccines, we need to be mindful of how messaging around them creates expectation.
Coller: We originally were told that the vaccines would prevent you from getting COVID. That was a message that was oversold at the beginning and people did get COVID. They said well these vaccines didn't work. Did the vaccine work? Well you didn’t die did you? so yes it did work. It did exactly what it was supposed to do which is to prevent hospitalization and death. It's the same thing with the seasonal flu vaccine. It is very difficult to get a vaccine against a respiratory virus that is neutralizing, meaning that you do not contract it. I don't know of one that really does that.     :32
Coller says such messaging around vaccines for respiratory illnesses is critical. At Johns Hopkins, I’m Elizabeth Tracey.

mRNA vaccines can help the body fight cancer, a new study found, yet when we look at what has been called ‘vaccine hesitancy’ we see many people are suspicious of vaccines in general, let alone mRNA vaccines. Johns Hopkins mRNA expert Jeff Coller says history bears this out.
Coller: The efficacy of the vaccines was extremely high and the safety profile was extremely high but there has been a long history associated with vaccine hesitation and vaccine mis- and disinformation that goes way back, even to the very first vaccine from Jenner. You can read on the history of this and it's probably part of the human experience that there's a general distrust of you know what we call preventative medicine.  We could learn lessons from the past of how to deal with that sort of general distrust.    :29
Jenner used cowpox virus to vaccinate people against smallpox in 1796, and is credited with saving millions of lives by doing so, much the way Covid vaccines are credited with saving millions of people during the pandemic. Yet Jenner’s work took years to be accepted and adopted worldwide, just as mRNA technology is being closely scrutinized today. At Johns Hopkins, I’m Elizabeth Tracey.

People with lung cancer and melanoma who were receiving immunotherapies and got a Covid vaccine saw dramatically improved survival compared with folks who did not get the vaccine, a recent study shows. mRNA expert Jeff Coller at Johns Hopkins muses on why.
Coller: Why do we see it with mRNAs? Is it because the seasonal flu vaccine for example is not yet an mRNA and maybe there's something special about the mRNA platform that really does excite the immune system to recognize these tumors? And we need to understand that. This study doesn't provide that answer. mRNA is a natural product, the body knows how to read it and make the protein that's associated with it. That might be it, that it's just highly immunogenic. There's a big responsibility of scientists and our public health officials and our politicians to educate the public about technologies that are showing such amazing promise such as the mRNA platform.    :34
The clear take home is mRNA works, Coller says. At Johns Hopkins, I’m Elizabeth Tracey.

People undergoing immunotherapy treatment for cancer and who got a Covid vaccine survived longer than those who did not get the vaccine, a new study finds. Jeff Coller, an mRNA expert at Johns Hopkins, examines why this hasn’t been seen with other vaccines.
Coller: With other vaccines, the flu vaccine maybe you might have seen it because with other vaccines most of the time it's children and children hopefully are not necessarily the patients that are coming down with some of these devastating cancers so you're never going to be able to make that correlation. With seasonal flu of course there's also limited adoption of the seasonal flu that's a factor. with the mRNA vaccines we saw millions of Americans receive it that so it was a huge cohort that synchronized in time too, that also is a very important aspect of the study you have a large number of people synchronized in time that you could follow.   :31
Coller says this natural experiment clearly shows the benefits of mRNA vaccines as a platform for treating many different diseases and conditions where our innate immune response is a critical component. At Johns Hopkins, I’m Elizabeth Tracey.

If you were being treated for lung cancer or melanoma with immunotherapy and you received a Covid vaccine, you got a surprising benefit: you were twice as likely to survive your cancer as those who did not get a vaccine, a recent study found. Jeff Coller, an mRNA expert at Johns Hopkins, says the result suggests a nonspecific vaccine could be a game changer in cancer treatment.
Coller: This study basically is saying we could make a generic mRNA that's really going to excite the immune system to attack tumors. Because science builds upon itself we have technologies that are showing such promise. Because of politicalization of that technology and misunderstanding and mis- and disinformation around that technology we're seeing decisions being made which are potentially cutting off the American public from access to this type of medicine, which really could cure some of the most devastating cancers.  :29 
This study demonstrated the utility of the mRNA vaccine in lung cancer and melanoma, both associated with poor prognoses in more advanced stages. At Johns Hopkins, I’m Elizabeth Tracey.  

People with lung cancer or melanoma who were receiving immunotherapy and got a Covid vaccine within 100 days of initiating treatment saw dramatically improved survival compared to those folks who did not receive a vaccine, a new study shows. mRNA expert Jeff Coller at Johns Hopkins says there is a history here.
Coller: This study is just one of a number of things that have come out in the last few years. So back in 2022 researchers had shown that you could go into a pancreatic tumor and then identify specific aspects in that tumor that were different from the rest of the body. And then you could take that information and put it into an mRNA and then inject that mRNA into the tumor. And in that case they had 50% of the patients in that small clinical trial survived and a follow up study that came out just a few months ago shows that those patients are still alive.  :34
Coller notes that mRNAs are made by our bodies all the time. At Johns Hopkins, I’m Elizabeth Tracey.

Combating cancer may soon include immunization with an mRNA vaccine, as studies accumulate demonstrating their benefit in revving up the immune system against the disease. mRNA expert Jeff Coller at Johns Hopkins says this is one way to engage your innate abilities to target cancer.
Coller: Your body knows how to respond to it. It's been evolved to do this over millions of years and so what we're doing is taking 2 great principles: the idea of using the immune system to fight cancer, so again this is something that your body knows how to do. Your body knows how to fight foreign things and your body also knows how to respond to an mRNA and by taking an mRNA and now helping train the immune system to attack a tumor it's really chocolate and peanut butter. They're 2 great tastes that go great together.  :32
The most recent study showed dramatic survival benefits in both lung cancer and melanoma three years after the vaccine was administered, also raising the prospect that an off the shelf vaccine might do the trick rather than a personalized shot. At Johns Hopkins, I’m Elizabeth Tracey.

Receipt of an mRNA vaccine for Covid within 100 days of beginning immunotherapy for lung cancer or melanoma increased a person’s survival likelihood by a factor of two or greater, a new study shows. Johns Hopkins mRNA expert Jeff Coller says the implications are huge.
Coller: The real dream here is that we could have an mRNA based treatment that could be used to put into the body and then would allow the immune system, the natural fighting capacity of your body to go after those tumors and attack it in a way that is much more safe and effective than normal traditional chemotherapy. mRNA is a natural product. Your body makes millions of mRNAs every single day and so when we introduce an mRNA we're simply taking advantage of a normal system that exists in your body.    :33
The study also showed benefits even in those whose tumors weren’t normally responsive to immunotherapy, with an almost fivefold survival benefit at three years. At Johns Hopkins, I’m Elizabeth Tracey.

mRNA vaccines saved millions of lives during the Covid-19 pandemic. Now a new study points to their effectiveness in helping people survive cancer. The study looked at people who received a Covid vaccine within 100 days of starting immunotherapy for lung cancer or melanoma, and demonstrated a huge survival benefit. Jeff Coller, an mRNA expert at Johns Hopkins, comments.
Coller: In addition to what we observed during the pandemic where they were so highly effective at preventing and treating infectious disease we're also seeing that they have an incredible ability to help the body fight cancer, and this study builds upon a growing set of data that really demonstrates that mRNA technology can help us cure and treat some of the most difficult cancers that human beings face, like melanoma and pancreatic cancer and glioblastoma.             :27
People who had received the vaccine were more than twice as likely to be alive three years later than those who hadn’t. At Johns Hopkins, I’m Elizabeth Tracey.

Testing a fluid known as cerebrospinal fluid, or CSF, found surrounding the brain and spinal cord, reveals a lot about brain tumors and the immune response to them. Johns Hopkins neurosurgery department director Chetan Bettegowda and test developer says this is just the first place this test may help.
Bettegowda: We view this truly as a platform to continue to iterate and add on. While the focus of the study today was on brain cancers we know that there are a number of inflammatory and autoimmune conditions, those are much more common thankfully than the brain cancers that we deal with. When we think about things like multiple sclerosis or neuroinflammatory conditions, neurodegenerative conditions, we know that there are components there that are very tightly linked to inflammation and the immune system. We are very enthusiastic that these sorts of approaches can be modified and further optimized to help patients with that.   :34
At Johns Hopkins, I’m Elizabeth Tracey.

Tumor components and immune response indicators can be found in cerebrospinal fluid, or CSF, when someone has a brain tumor, in a new test developed by Chetan Bettagowda, director of neurosurgery at Johns Hopkins and one of the test’s developers. 
Bettegowda: What we did was develop a test that utilizes a technology called next generation sequencing which allows us to sequence hundreds, thousands, millions of regions of the genome in a very rapid fashion. So what we did was to take a cohort of individuals with and without cancers of the central nervous system, we identified CSF from these patients. We developed ways to really look at two or three key factors associated for the tumor cell and a couple of factors associated with the immune cells.   :33
Bettegowda says the assessments are helpful in assessing both the cancer and how the body is responding to it, important for treatment. At Johns Hopkins, I’m Elizabeth Tracey.

Your immune system has everything to do with how your body responds to cancer, and brain tumors are no exception. A new test aims to assess that along with characterizing the tumor itself. Chetan Bettegowda, director of neurosurgery at Johns Hopkins and one of the test’s developers, explains.
Bettegowda: We know that cancers and tumors elicit a response from the immune system. We have treatments that use the immune system to attack cancer cells and we know the responsiveness of tumors is in part based on these complex interactions. This is one of the earliest if not the first integrated test that allows the simultaneous understanding of what's happening to tumor material by looking at DNA as well as looking at the immune cells that are in that compartment, and we were excited to be able to marry these two very important items.                  :34
Bettegowda says the test will also be able to monitor the impact of treatment. At Johns Hopkins, I’m Elizabeth Tracey.

Your brain and spinal cord are floating in something called cerebrospinal fluid, or CSF, and when brain tumors develop they shed cells and cellular components into this fluid. A new test developed by director of neurosurgery Chetan Bettegowda at Johns Hopkins and colleagues helps assess such tumors without the need for surgery.
Bettegowda: We know that the brain and spinal cord are bathed in cerebrospinal fluid. It's fluid that's naturally produced by the body, several hundred mls every day. And because it's in proximity to the brain and spinal cord we thought this would be a natural medium for us to be able to detect materials being shed by tumors or tumor associated cells. One of the cool advances of this study was that we've been able to now not only interrogate what's happening to the tumor without doing a biopsy but also understand what the microenvironment is doing.     :33
Bettegowda says using this test clinically is on the horizon. At Johns Hopkins, I’m Elizabeth Tracey.

When someone is thought to have a brain tumor procedures to make the diagnosis may be risky or invasive, so a new test developed by Chetan Bettegowda, director of the department of neurosurgery at Johns Hopkins and colleagues is a welcome addition to tests used for diagnosis and monitoring.
Bettegowda: The work that we published is an attempt to understand what's happening in the brain without the need to perform invasive brain biopsies. Accessing the brain and spinal cord is more challenging than almost any other part of the body because it's housed in these structures of the skull or the spinal column and even the simplest of biopsies ends up actually being a neurosurgical procedure done in the operating room, with real risks. How do we follow treatment, how do we establish a diagnosis without the need to do surgery?                      :31
The test samples cerebrospinal fluid, or CSF, which surrounds the brain and spinal cord, looking for DNA from the tumor in addition to assessing immune response. At Johns Hopkins, I’m Elizabeth Tracey.

AI assisted colonoscopy, where a computer helped interpret images seen during the procedure, resulted in endoscopists being less adept at recognizing precancerous lesions known as polyps, a recent study finds. Kimmel Cancer Center director William Nelson at Johns Hopkins comments.
Nelson: They've got pretty used to using it in this group, and so what the study was was they looked at a cohort of about 1400 subjects who underwent colonoscopy that wasn't computer aided, both before and after the introduction of the AI tool, tried to look at what the polyp detection rate was. What they saw was that it fell from 38.4% to 22.4%. Before they were using the AI tool they detected polyps more readily than after.  :30
Nelson says he isn’t concerned about this outcome since when AI assistance is available it is utilized to achieve the best result, and if it isn’t available endoscopists won’t learn to rely on it, and notes that technologies are increasingly ubiquitous and largely beneficial. At Johns Hopkins, I’m Elizabeth Tracey.

If you’ve been treated for early breast cancer your overall risk for recurrence is small, a new large, long term study finds. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says these risks can be pinned to how the primary cancer was treated.
Nelson: If they receive radiotherapy there was a greater chance of breast cancer and lung cancer, these are known risks. If they had the hormonal treatment there was a little bit of increased risk of uterine cancer but it also reduce the risk of the contralateral breast cancer. Again that's already known and that chemotherapy probably had a little bit of an increased risk of leukemia. All those things are already known what was interesting was that the additional risk was not very much so these women can likely focus not on other cancers, they're at the same risk as everybody else, but focus on the rest of their lives.  :34
So overall this study provides reassurance, Nelson concludes. At Johns Hopkins, I’m Elizabeth Tracey.

Women who’ve had early breast cancer and been treated can likely lay their worries about recurrence to rest, a new study concludes. Johns Hopkins Kimmel Cancer Center director William Nelson says that’s the conclusion of this very large, long term study.
Nelson: They did this monstrous cohort study and they found 476,000 women from 1993 to 2016 who had had breast cancer and they recognized the second primary cancer in about 65,000 of them by 20 years. 13.6% had developed a non breast cancer which is only about 2% greater than what you would have expected otherwise, 5.6% had developed a breast cancer in the other breast and that was only about 3.1% greater than expected.   :33
Nelson says women should still be vigilant about follow up after being treated since just as with primary breast cancers catching recurrence early is the best strategy. At Johns Hopkins, I’m Elizabeth Tracey.

People who’ve had colorectal cancer and have a known mutation should likely take aspirin to help prevent disease recurrence, according to a new study. The benefit of aspirin in preventing cancers has been shown before in the skin cancer melanoma, although Kimmel Cancer Center director William Nelson at Johns Hopkins says the mechanism is probably different.
Nelson: One of the things that looms large in the pathogenesis of melanoma is, particularly that related to sun exposure is sunburns. And so remember what happens with the sunburn is the UV light is absorbed by the skin does some kind of damage. The burn itself is the redness and all this stuff is an inflammatory response. It's not just sun exposure but in fact it looms large in melanoma, particularly skin melanoma whether you've had significant sunburns and one wonders if that doesn't attenuate the inflammatory response to any damage you might get.     :32
Consult your doctor before beginning aspirin, Nelson says. At Johns Hopkins, I’m Elizabeth Tracey.

People who’ve had colorectal cancer and who have a mutation known as  PI3 kinase benefit from taking asprin to prevent recurrence, a new study shows. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the findings.
Nelson:  There were recurrences in each group that got aspirin. In about 7.7% but if you had the hotspot mutation the recurrences were 14.1% with placebo if you had the other ones and it was 16.8% so there's a significant benefit or reduction in the chance for colorectal cancer to come back if you took aspirin. There were some adverse events 16.8% on aspirin and 11.6% on placebo bleeding or bruising. It does look like the science behind it seems reasonable, aspirin did the trick.    :33
Nelson advocates for everyone with cancer to get a genetic analysis of their malignancy to determine the best treatments and long term prevention strategies. At Johns Hopkins, I’m Elizabeth Tracey.