Jefferson Investigates: Diabetes and Prostate Cancer Treatment, Weight Loss and Sleep Apnea, Vaccine for Bird Flu in Cattle

When postdoctoral researcher Amy Shaver’s father was diagnosed with prostate cancer, all his other concerns went out the window — even his diabetes. He was fortunate to treat his cancer without medication, because drugs commonly prescribed for advanced prostate cancer can worsen metabolic problems, a major concern for people with diabetes.

Clinical trials often exclude people with significant health conditions like diabetes to avoid complicating results, leaving doctors with little guidance.

Now, Dr. Shaver and cancer researcher Grace Lu-Yao, PhD, MPH, are working to fill those knowledge gaps. Their new study, published in JNCI Cancer Spectrum, evaluates outcomes for men with diabetes who took two common prostate cancer drugs: abiraterone and enzalutamide.

Using SEER-Medicare, a national cancer database, the team examined unplanned hospitalizations — a potential indicator of both medication- and cancer-related issues — among three groups of patients taking either abiraterone or enzalutamide: men without diabetes, men with diabetes but no complications and men with diabetes and complications.

They found that advanced prostate cancer patients faced more unexpected hospital stays after starting treatment with one of these drugs, regardless of diabetes status, possibly due to cancer progression that made them a candidate for the medications. But hospitalizations after beginning medication were more likely for those with diabetes, especially those with complications from their diabetes. Among patients with diabetes but no complications, hospitalizations more than doubled in patients taking abiraterone, compared with a smaller increase in patients taking enzalutamide. This suggests that patients with diabetes may respond differently to each of these drugs.

Drs. Shaver and Lu-Yao, both members of Sidney Kimmel Medical College and Sidney Kimmel Comprehensive Cancer Center, say the findings highlight the need to tailor cancer treatment strategies, treat patients holistically and supplement clinical trial data with real-world evidence, especially for those underrepresented in clinical trials

“This study generated new evidence demonstrating that diabetes indeed does matter, and that's something for patients and doctors to consider when they decide which treatment to use,” says Dr. Lu-Yao.

The researchers plan to continue studying how other conditions, such as cardiovascular or kidney disease, can impact outcomes for cancer patients.

By Marilyn Perkins

Overweight and obese adults are at increased risk of obstructive sleep apnea, which causes unintended obstruction in breathing and frequent brief nighttime awakenings due to a blocked airway. Continuous positive airway pressure (CPAP) therapy is an effective treatment, but many people can’t tolerate it or don’t use CPAP long-term.

Hypoglossal nerve stimulation (HGNS) is an alternative for those who can’t tolerate CPAP. Prior research found that HGNS was successful in patients with a lower body mass index (BMI). A new study from Jefferson Health researchers showed that patients reap the greatest effects from HGNS if they lose weight during the 12 months after the procedure.

During HGNS surgery, surgeons implant a remote-controlled device that’s linked to the tongue’s hypoglossal nerve. During sleep the device monitors respiration and stimulates the tongue in sync with breathing, which stops the tongue from blocking the airway.

Researchers looked at sleep-study results and BMI data from 2,171 patients who had the Inspire HGNS device implanted at Jefferson Health and other locations.

Patients who lost at least 2 BMI points experienced fewer nighttime respiratory events, compared to those who gained at least 2 BMI points or whose weight remained within 2 BMI points of their starting weight. For people with a BMI between 25 and 35, 2 BMI points is equivalent to 5% to 10% of their body weight, or 8 to 20 pounds.

Because weight loss improved the effectiveness of HGNS, doctors should talk to patients about a multimodal approach to treating sleep apnea.

“It’s worth discussing HGNS plus weight loss, whether it’s surgery, GLP-1 medications or other interventions,” says sleep surgeon Colin Huntley, MD, the study’s senior author. “Weight loss alone is probably unlikely to cure the sleep apnea, but it will improve the effectiveness of the treatments.”

Former Thomas Jefferson University Hospital resident Chihun “Jim” Han spearheaded the study. Jefferson medical students Praneet Kaki and Jennifer Goldfarb; former sleep medicine/sleep surgery fellows Thomas Kaffenberger and Nicole Molin; and sleep surgeon Maurits Boon, MD, also contributed to the research.

By Lisa Fields

A highly pathogenic subtype of bird flu has increasingly infected dairy cows across the U.S., affecting over 900 farms in 16 states since early 2024. The virus has led to high morbidity and a sharp decline in milk production, threatening both animal health and farm survival.

Researchers at Thomas Jefferson University, led by Matthias Schnell, PhD, in collaboration with the USDA and the University of Texas Medical Branch, have developed a new vaccine for bird flu using a rabies virus platform. They published their findings in npj Vaccines.

The vaccine was tested on 12 beef calves in Texas using different dosing strategies. The researchers found that two doses with an adjuvant, which enhances the vaccine's efficacy, produced the strongest and longest-lasting immune response, with antibodies detectable for up to 200 days. Even a single dose with an adjuvant elicited a measurable response.

“It may be just a single-shot vaccine, but two are even better,” says Dr. Schnell. “Furthermore, the vaccine is deactivated, so it can’t spread through the cow’s milk.”

First author, Nir Paran, PhD, a visiting scientist from the Israel Institute for Biological Research, then worked to assess the vaccine immune response in the lab by comparing it to the serum taken from previously infected cows. The team, which included senior research associate Chris Wirblich, PhD, found a similar result. “We got neutralizing antibodies against viruses similar to cows that were naturally infected and cleared the infection, which is a good sign,” says Dr. Schnell.

However, the study has limitations. It only had a small number of beef cattle and measured only immune response, not whether the vaccine prevents infection or reduces virus shedding in milk, which are key concerns for dairy farms.

The team is now seeking funding from the NIH and USDA to expand testing to include more cows and to focus on dairy cows. Future studies will explore whether the vaccine can prevent disease, stop transmission and safeguard both livestock and public health.

By Deborah Balthazar