Replacing registered nurses in high stakes hospital care is dangerous to patients

UNIVERSITY OF PENNSYLVANIA SCHOOL OF NURSING

 

IMAGE: 

PENN NURSING'S Karen Lasater, PhD, RN, ASSOCIATE PROFESSOR AND THE JESSIE M. SCOTT TERM CHAIR IN NURSING AND HEALTH POLICY.

view more 

CREDIT: PENN NURSING

Philadelphia (June 10, 2024) – A new study published in Medical Care today showed that substituting registered nurses (RN) with lower-wage staff (e.g. licensed practical nurses, unlicensed assistive personnel) in hospital care is linked with more deaths, readmissions, longer hospital stays, poorer patient satisfaction, and higher costs of care.

The study, by the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing (Penn Nursing), comes at a time when hospitals are struggling to recruit and retain RNs in hospital care because of poor working conditions. “Nurses in hospitals provide care for the sickest patients. It’s high stakes care. The findings show that replacing RNs with non-RN staff is dangerous to patients,” said lead-author, Karen Lasater, PhD, RN, Associate Professor and the Jessie M. Scott Term Chair in Nursing and Health Policy.

Though hospitals often cite a low supply of RNs as the reason they cannot hire enough, the latest research shows there is no evidence of an RN shortage in the US. Thus, there is no justification for substituting less qualified staff for RNs.

The researchers studied the outcomes of over 6.5 million Medicare patients in 2,676 general acute care hospitals across the U.S. They found that:

• Even a modest substitution in RN care is associated with poorer patient outcomes. A 10-percentage point reduction in the proportion of RNs was associated with 7% higher odds of dying in the hospital; as well as higher odds of readmission, experiencing a longer length of stay, and poorer patient satisfaction.
• Substituting RN care is associated with avoidable patient deaths. Researchers estimated that if every U.S. hospital reduced RN care by 10 percentage points, nearly 11,000 avoidable deaths among Medicare patients could occur annually.
• Alternative hospital staffing models yield a poor return on investment for hospitals. Hospitals substituting lower-wage staff for RNs will not save money because longer lengths of stay will erase their labor savings. 
• Medicare risks spending millions of dollars annually on avoidable, preventable hospital readmissions. The thousands of preventable readmissions associated with a 10-percentage point reduction in RNs translates to $68.5 million in avoidable costs paid by Medicare.

“The public has no way of assessing the adequacy of hospital RN staffing, and in all but two states (California and Oregon) there are no regulations establishing minimum safe RN staffing requirements in hospitals to protect the safety of patients,” said senior author Linda Aiken, PhD, RN, Professor of Nursing and Founding Director of CHOPR. “Rather than replacing RNs with less qualified staff, hospital leaders should focus on improving their work environments to retain RNs.”

“With roughly half of hospital RNs reporting high levels of burnout, hospitals should focus on fixing the root causes of their burnout – chronic understaffing and poor work environments – not replacing RNs with lesser trained nursing staff that the evidence shows is likely dangerous to patients,” said Lasater.

Other recent publications by the Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing shows that:

• Establishing minimum hospital nurse staffing standards in are in the public’s interest:

Lasater, K. B., Aiken, L. H., Sloane, D. M., French, R., Anusiewicz, C. V., Martin, B., ... & McHugh, M. D. (2021). Is hospital nurse staffing legislation in the public’s interest?: an observational study in New York State. Medical care, 59(5), 444. Open Access

Lasater, K. B., Aiken, L. H., Sloane, D., French, R., Martin, B., Alexander, M., & McHugh, M. D. (2021). Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: an observational study. BMJ Open, 11(12). Open Access

• Poor hospital nurse work environments pre-dated the pandemic and were strongly associated with nurse burnout and intent to leave their employer.

Aiken, L. H., Sloane, D. M., McHugh, M. D., Pogue, C. A., & Lasater, K. B. (2023). A repeated cross-sectional study of nurses immediately before and during the Covid-19 pandemic: Implications for action. Nursing Outlook, 71(1), 101903. Open Access

The study was carried out by the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing. Funding and support for the study was from the National Institute of Nursing Research/NIH (R01NR014855; T32NR007104).

# # #

Study Citation (available Open Access):

Lasater, K.B., Muir, K.J., Sloane, D.M., McHugh, M.D., Aiken, L.H. (2024). Alternative models of nurse staffing may be dangerous in high stakes hospital care. Medical Care.

About the University of Pennsylvania School of Nursing

The University of Pennsylvania School of Nursing is one of the world’s leading schools of nursing. For the ninth year in a row, it is ranked the #1 nursing school in the world by QS University. For the third year in a row, our Bachelor of Science in Nursing (BSN) program is ranked # 1 in the 2023 U.S. News & World Report’s Best Colleges rankings. Penn Nursing is also consistently ranked highly in the U.S. News & World Report annual list of best graduate schools and is ranked as one of the top schools of nursing in funding from the National Institutes of Health. Penn Nursing prepares nurse scientists and nurse leaders to meet the health needs of a global society through innovation in research, education, and practice. Follow Penn Nursing on: Facebook, X, LinkedIn, YouTube, & Instagram.

About the Center for Health Outcomes and Policy Research

The Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing is dedicated to building the actionable evidence base needed to advance effective policy, practice, and health system reforms that improve health outcomes, cultivate clinician well-being, and promote health equity across communities.

---

JOURNAL

Medical Care

ARTICLE TITLE

Alternative Models of Nurse Staffing May Be Dangerous in High-Stakes Hospital Care

ARTICLE PUBLICATION DATE

7-Jun-2024

 

UC San Diego develops first-in-kind protocol for creating ‘wired miniature brains’

The development paves the way for more advanced research regarding autism, schizophrenia and other neurological disorders

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - SAN DIEGO

 

IMAGE: 

ALYSSON MUOTRI, DIRECTOR OF THE SANFORD STEM CELL INSTITUTE (SSCI) INTEGRATED SPACE STEM CELL ORBITAL RESEARCH CENTER AT UC SAN DIEGO. RESEARCHERS WORLDWIDE CAN NOW CREATE HIGHLY REALISTIC MINIATURE BRAINS WITH FUNCTIONING NEURAL NETWORKS, THANKS TO THE PUBLICATION OF HIS PROPRIETARY PROTOCOL.

view more 

CREDIT: UC SAN DIEGO HEALTH SCIENCES

Researchers worldwide can now create highly realistic brain cortical organoids — essentially miniature artificial brains with functioning neural networks — thanks to a proprietary protocol released this month by researchers at the University of California San Diego.

The new technique, published in Nature Protocols, paves the way for scientists to perform more advanced research regarding autism, schizophrenia and other neurological disorders in which the brain’s structure is usually typical, but electrical activity is altered. That’s according to Alysson Muotri, Ph.D., corresponding author and director of the UC San Diego Sanford Stem Cell Institute (SSCI) Integrated Space Stem Cell Orbital Research Center. The SSCI is directed by Dr. Catriona Jamieson, a leading physician-scientist in cancer stem cell biology whose research explores the fundamental question of how space alters cancer progression.

The newly detailed method allows for the creation of tiny replicas of the human brain so realistic that they rival “the complexity of the fetal brain’s neural network,” according to Muotri, who is also a professor in the UC San Diego School of Medicine’s Departments of Pediatrics and Cellular and Molecular Medicine. His brain replicas have already traveled to the International Space Station (ISS), where their activity was studied under conditions of microgravity.

Two other protocols for creating brain organoids are publicly accessible, but neither allow researchers to study the brain’s electrical activity. Muotri’s method, however, allows researchers to study neural networks created from the stem cells of patients with various neurodevelopmental conditions. 

“You no longer need to create different regions and assemble them together,” said Muotri, adding that his protocol allows different brain areas — like the cortex and midbrain — “to co-develop, as naturally observed in human development.”

“I believe we will see many derivations of this protocol in the future for the study of different brain circuits,” he added.

Such “mini brains” can be used to test potentially therapeutic drugs and even gene therapies before patient use, as well as to screen for efficacy and side effects, according to Muotri.

A plan to do so is already in the works. Muotri and researchers at the Federal University of Amazonas in Manaus, Amazonas, Brazil, are teaming up to record and investigate Amazonian tribal remedies for Alzheimer’s disease — not on Earth-based mouse models, but on diseased human brain organoids in space.

A recent Humans in Space grant — awarded by Boryung, a leading health care investment company based in South Korea — will help fuel the research project, which spans multiple continents and habitats, from the depths of the Amazon rainforest to Muotri’s lab on the coast of California — and, eventually, to the International Space Station.

Other research possibilities for the brain organoids include disease modeling, understanding human consciousness and additional space-based experiments. In March, Muotri — in partnership with NASA — sent to space a number of brain organoids made from the stem cells of patients with Alzheimer’s disease and ALS (amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease). The payload returned in May and results, which will eventually be published, are being reviewed. 

Because microgravity mimics an accelerated version of Earth-based aging, Muotri should be able to witness the effects of several years of disease progression while studying the month-long mission’s payload, including potential changes in protein production, signaling pathways, oxidative stress and epigenetics.

“We’re hoping for novel findings — things researchers haven’t discovered before,” he said. “Nobody has sent such a model into space, until now.”

Co-authors of the study include Michael Q. Fitzgerald, Tiffany Chu, Francesca Puppo, Rebeca Blanch and Shankar Subramaniam, all of UC San Diego, and Miguel Chillón, of the Universitat Autònoma de Barcelona and the Institució Catalana de Recerca i Estudis Avançats, both in Barcelona, Spain. Blanch is also affiliated with the Universitat Autònoma de Barcelona.

This work was supported by the National Institutes of Health R01MH100175, R01NS105969, MH123828, R01NS123642, R01MH127077, R01ES033636, R21MH128827, R01AG078959, R01DA056908, R01HD107788, R01HG012351, R21HD109616, R01MH107367, California Institute for Regenerative Medicine (CIRM) DISC2-13515 and a grant from the Department of Defense W81XWH2110306.

About the Sanford Stem Cell Institute
The UC San Diego Sanford Stem Cell Institute (SSCI) is a global leader in regenerative medicine and a hub for stem cell science and innovation in space. SSCI aims to catalyze critical basic research discoveries, translational advances and clinical progress — terrestrially and in space — to develop and deliver novel therapy.

 

Brain cortical organoids are examined under an electronic microscope. Muotri recently published his method for making such organoids, which he says are so realistic that they "rival the complexity of the fetal brain's neural network."

CREDIT

UC San Diego Health Sciencespeutics to patients.

JOURNAL

Nature Protocols

DOI

10.1038/s41596-024-00994-0 

COI STATEMENT

Muotri is a cofounder and has equity interest in TISMOO, a company dedicated to genetic analysis and brain organoid modeling focusing on therapeutic applications customized for autism spectrum disorder (ASD) and other neurological disorders with genetic origins. He is also the inventor of several patents related to human functional brain organogenesis, including the protocol described in the new publication.

 

Engagement key to eliminating prejudice: Uncovering the process of feeling understood

OSAKA UNIVERSITY

 

IMAGE: 

IMAGE OF A SITUATION WHERE A FRIEND DOES NOT UNDERSTAND YOU.

view more 

CREDIT: TOMOHIRO IOKU

Osaka, Japan - A research group at Osaka University has uncovered how the view of other people and groups changes when individuals feel that they are understood by others by conducting an experimental study on the relationship between Japanese and Chinese people. The study shows that the role of felt understanding largely derives from a reduction in prejudice toward the other person.

Feeling understood by other people is a crucial determinant for positive interpersonal and intergroup relationships; however, the psychology behind this determinant was not well understood.

In this study, Drs. Tomohiro Ioku and Eiichiro Watanabe at Osaka University manipulated psychological processes of felt understanding in the context of East Asia, more specifically between Japanese and Chinese people.

The results showed for the first time that in intergroup relationships, people are more willing to engage with their counterparts when they feel understood, primarily because it reduces their prejudice.

The issue of discrimination against foreigners is often discussed in media. Based on the results of this study, such discrimination problems could be reduced if foreigners learn the local language and communicate their understanding of the country. For example, the Centre for International Education and Exchange at Osaka University runs J-ShIP programs for learning Japanese (https://ciee.osaka-u.ac.jp/en/short-term_programs/new-short-term-programs/). More media features on similar programs and initiatives could help reduce discrimination issues in the long term.

###
The article, “An experimental study of the process of felt understanding in intergroup relations: Japanese and Chinese relations in Japan,” was published in Scientific Reports at DOI: https://doi.org/10.1038/s41598-024-63227-0

About Osaka University
Osaka University was founded in 1931 as one of the seven imperial universities of Japan and is now one of Japan's leading comprehensive universities with a broad disciplinary spectrum. This strength is coupled with a singular drive for innovation that extends throughout the scientific process, from fundamental research to the creation of applied technology with positive economic impacts. Its commitment to innovation has been recognized in Japan and around the world. Now, Osaka University is leveraging its role as a Designated National University Corporation selected by the Ministry of Education, Culture, Sports, Science and Technology to contribute to innovation for human welfare, sustainable development of society, and social transformation.
Website: https://resou.osaka-u.ac.jp/en

  

The extent to which Japanese people want to approach Chinese people when they read an article describing Chinese understandings about Japan (vs. misunderstandings). The higher the dots, the stronger the intention to approach Chinese people.

Estimated indirect effects via felt positive regard, intergroup overlap, and stereotypes. The further to the right, the larger the indirect effect.

CREDIT

Tomohiro Ioku

---

JOURNAL

Scientific Reports

DOI

10.1038/s41598-024-63227-0 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

An experimental study of the process of felt understanding in intergroup relations: Japanese and Chinese relations in Japan

ARTICLE PUBLICATION DATE

7-Jun-2024

 

Income inequality and carbon dioxide emissions have a complex relationship

New Drexel University study is the first to use a multidimensional framework – finding domestic income inequality unevenly impacts different emission components in wealthy nations

DREXEL UNIVERSITY

 

IMAGE: 

FIGURE 1. CONCEPTUAL DIAGRAM OF THE 4 EMISSION COMPONENTS THAT CONSTITUTE THE MULTIDIMENSIONAL EMISSIONS PROFILE (MEP) FRAMEWORK, AND THEIR RELATIONSHIPS WITH PRODUCTION-BASED ACCOUNT (PBA) AND CONSUMPTION-BASED ACCOUNT (CBA), IN A SIMPLIFIED 2-NATION MODEL THAT EXCLUDES RE-IMPORTS AND RE-EXPORTS.

view more 

CREDIT: THE FIGURE IS ADAPTED FROM FIGURE 3.1 IN HUANG (2022) AND IS ORIGINALLY INSPIRED BY STEININGER ET AL. (2014).

Income inequality and carbon dioxide emissions for high-income nations such as the United States, Denmark and Canada are intrinsically linked – but a new study from Drexel University has taken a deeper look at the connection and found this relationship is less fixed, can change over time, and differ across emission components. The findings could help countries set a course toward reducing emissions of the harmful greenhouse gas and alleviating domestic income inequality at the same time.

The study, conducted by Xiaorui Huang, PhD, an assistant professor in the College of Arts and Sciences, applies a multidimensional emissions profile (MEP) framework to examine how the relationship between income inequality and emissions can differ by category of human activity.  

The study, published in Social Forces, considers four emission components — carbon dioxide-emitting activities — with distinct implications for climate change mitigation, using data from 34 wealthy nations between 2004-2015:

• emissions generated by domestic-oriented supply chain activities
• emissions embodied in exports
• direct emissions of end-user activities
• emissions embodied in imports

These components are identified as distinct points of intervention for climate change mitigation, and they are interconnected via domestic and global supply chains. Huang applied MEP framework to investigate how these four emission components may be heterogeneously related to nations’ income inequality. The multidimensional analysis identifies emission components that may be mitigated by inequality-reducing policies — synergy— and emission components that may grow due to such policies — trade-offs.

The research employed statistical models to examine the link between carbon dioxide emissions and the income share of the top 10% of a country’s population – a measure capturing the concentration of income at the top of the distribution. Huang found that the income share of the top 10% is negatively related to direct end-user emissions from 2009 to 2011 following the Great Recession, and positively related to emissions embodied in exports from 2011 to 2015.

“I theorize that direct end-user emissions and emissions embodied in exports are related to the top 10% income share via different mechanisms,” Huang said.

Prior research establishes three co-existing theoretical mechanisms: power and political economy, how income inequality shapes consumption patterns or the ‘Veblen effect’, and households’ marginal propensity to emit.

“The political economy mechanism focuses on how income concentration at the top of the distribution empowers the wealthy to undermine regulations on carbon emissions from general production activities including export-oriented industries,” said Huang. “Income share of the top 10% is related to emissions embodied in exports via the political economy mechanism, which became more pronounced from 2011 to 2015.”

“In contrast, the ‘Veblen effect’ and the marginal propensity mechanisms are more closely linked to consumption activities: the former concerns how domestic income inequality spurs competitive and emulative consumption, while the latter concerns the societal distribution of households at different income levels with varying marginal propensity to spend additional income and emit CO2 as a result,” said Huang. “Income inequality is related to direct end-user emissions through these two mechanisms—the strength of which changed due to the Great Recession of 2008, resulting in the negative relationship from 2009 to 2011.”

The paper suggests that reducing income concentration at the top end of the distribution could synergistically reduce emissions embodied in exports, but might increase direct end-user emissions at times, such as during and immediately after a recession.

“To mitigate the dual crises of climate change and growing economic inequality, it is vital to enhance the synergy between CO2 emissions abatement and inequality reduction,” said Huang.

Huang suggests that these insights can guide policy efforts to improve the synergy while minimizing the trade-offs. Inequality-reducing policies – one example currently being considered is a global tax on billionaires – should be implemented along with measures that improve the well-being of lower-income populations without causing inadvertent growth in their direct fossil fuel consumption.

Read the full paper here: https://academic.oup.com/sf/advance-article-abstract/doi/10.1093/sf/soae074/7681807?redirectedFrom=fulltext

---

JOURNAL

Social Forces

DOI

10.1093/sf/soae074 

METHOD OF RESEARCH

Meta-analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Harness the Co-Benefit and Avoid the Trade-off: The Complex Relationship between Income Inequality and Carbon Dioxide Emissions

 

Revealed: tricks used by opioid giant to mold doctors’ minds

Experts find “smorgasbord of tactics” used to boost sales during opioid addiction epidemic

BMJ

Opioid giant Mallinckrodt, selling more than Purdue Pharma in the US, was forced by the courts to publish more than 1.3 million internal documents.

In The BMJ today, researchers Sergio Sismondo and Maud Bernisson sift through nearly 900 contracts which together reveal a carefully coordinated effort to shape medical attitudes toward pain medicine.

Pharmaceutical companies have a long history of managing physician and public opinion, explain the authors. For example, by recruiting physicians to serve as influencers, planting articles in scientific journals, coordinating conference presentations, and developing continuing medical education (CME) courses.

Amid surging concerns over an addiction crisis, Mallinckrodt faced growing hesitancy among frontline prescribers. But the contracts show how the painkiller manufacturer employed each of these tactics as it sought to reframe concerns about addiction as a phobia and muddle the very concept of dependence as “pseudoaddiction.” It even went so far as casting opioids as preventive medicine for chronic pain. 

“It’s like they used every trick in the book,” says Robert Steinbrook, director of the Health Research Group of the advocacy organization Public Citizen.

To many busy physicians, these messages would have appeared as trustworthy scholarship and evidence-based guidance, Sismondo and Bernisson explain.

The documents include a Mallinckrodt regulatory expert describing how its CME program “underscores Mallinckrodt’s credibility with the FDA as a company that cares about … safe opioid prescribing,” while a sales manager’s exhortation in a 2013 email to the reps under him states: “You have only 1 responsibility, SELL BABY SELL!”

Adriane Fugh-Berman, professor of pharmacology & physiology at Georgetown University, who has been researching the marketing tactics of the pharmaceutical industry for thirty years, adds that “creating the term pseudoaddiction and distorting the terms tolerance and dependence were strategies that distracted physicians from noticing their patients were addicted.” 

In spite of settling with the US government for lax handling of its opioid supply and later being ordered to pay $1.7 billion over accusations of misleading and deceptive marketing practices to boost opioid sales, Mallinckrodt continues to sell opioids today, with sales of some $262 million in 2023, up 25% from the year before.

[Ends]

---

JOURNAL

The BMJ

DOI

10.1136/bmj.q1208 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

How an opioid giant deployed a playbook for moulding doctors’ minds

ARTICLE PUBLICATION DATE

10-Jun-2024

COI STATEMENT

The authors declare that financial support was received for the research and authorship of this article. MB was part of the NanoBubbles project, which has received Synergy grant funding from the European Research Council, within the European Union’s H2020 programme, grant agreement no 951393. SS’s collaboration with MB was supported by a Radboud Excellence professorship and Social Sciences and Humanities Research Council of Canada grant 435-2022-0182

New pathways for treating never-smoker lung cancer revealed

Precision medicine characterization through integration of genomic, transcriptomic, proteomic, and clinical data

NATIONAL RESEARCH COUNCIL OF SCIENCE & TECHNOLOGY

 

IMAGE: 

(LEFT) DISTRIBUTION OF GENDER AMONG NEVER-SMOKING LUNG CANCER PATIENTS ANALYZED IN THIS STUDY WITH PREDOMINANCE OF FEMALES.
(MIDDLE) SCREENING RESULTS FOR GENETIC MUTATIONS IN NEVER-SMOKING LUNG CANCER PATIENTS, SHOWING 15% OF PATIENTS WITH UNIDENTIFIED MUTATIONS IN LUNG TISSUE. A TOTAL OF 101 TISSUE SAMPLES UNDERWENT GENOMIC AND PROTEOMIC ANALYSIS.
(RIGHT) MOLECULAR CHARACTERIZATION OF KOREAN NEVER-SMOKING LUNG ADENOCARCINOMA USING MULTI-OMICS ANALYSIS.

view more 

CREDIT: KOREA INSTITUTE OF SCIENCE AND TECHNOLOGY(KIST)

The primary cause of lung cancer is smoking. However, the incidence of lung cancer among never-smokers has been steadily increasing, especially among women. While approximately 80% of never-smoking lung cancer patients are prescribed targeted therapies that focus on mutations in proteins such as EGFR and ALK, the remaining patients often receive cytotoxic chemotherapy with high side effects and relatively low response rates, highlighting the urgent need for targeted therapies.

Dr. Lee Cheolju's team at the Chemical Life Convergence Research Center at the Korea Institute of Science and Technology (KIST), along with Dr. Kim Seon-Young's team at the Korea Research Institute of Bioscience and Biotechnology and Dr. Han Ji-Youn's team at the National Cancer Center, have elucidated the overexpression of estrogen signaling pathways in specific Korean never-smoking lung cancer cases using multi-omics analysis and proposed the anti-cancer drug saracatinib as a targeted therapeutic agent. Multi-omics integrates various molecular information, with proteomics presenting a particular challenge due to the need to analyze small amounts of proteins without loss, typically microgram-scale.

The research team obtained tissue samples from 101 Korean never-smoking lung cancer patients without identified treatment targets among 1,597 patients who visited the National Cancer Center over the past decade and distributed clinical information, genomic, transcriptomic, proteomic, and phosphoproteomic data to each omics analysis method for mutual referencing. Particularly, proteomic analysis measured an average of over 9,000 proteins and 5,000 phosphorylated proteins per sample using only 100 μg of protein, which is 10% of the amount required for conventional protein analysis, using isotopic labeling techniques.

Analysis of genetic mutations and cellular signaling pathways revealed that driver mutations of genes known to be associated with cancer, such as STK11 and ERBB2, were observed in the tissues of never-smoking lung cancer patients. Additionally, while the estrogen signaling pathway was found to be overexpressed, there were no significant changes in estrogen hormone receptors. Based on this, saracatinib, a sub estrogen signaling transduction protein inhibitor, showed statistically significant (p<0.01) cell death effects when applied to cells with mutations in STK11 and ERBB2 compared to the control group without such mutations.

Building on this, the research team is developing a molecular diagnostic technique for discriminating patients with specific expression of estrogen signaling pathways among never-smoking lung cancer patients. Additionally, they plan to conduct preclinical trials of saracatinib's therapeutic effects on never-smoking lung cancer animal models in collaboration with the National Cancer Center.

Dr. Lee Cheolju of KIST stated, "This successful case of discovering new therapeutic targets for refractory cancer through multi-omics analysis is based on purely domestic research and the collaborative efforts of hospitals and research institutions, which holds significant meaning. Building on this experience, we will lead the expansion of multi-omics research on human diseases."

Representative Features and Identification of Mutant Genes in Patients with Unidentified Mutations 

(Left) Increased expression of genes associated with estrogen hormone response observed in tissues from patients with unidentified mutations in both genetic and protein analyses.
(Right) Patients with driver mutations in STK11 and ERBB2 show significant differences in smoking history, and high estrogen response shows similar results to known KRAS mutations.

(Left) Validation of proteins associated with estrogen response using tissue immunostaining, identifying Saracatinib as the most effective drug in inhibiting the expression of related proteins using public bio big data and cross-analyzing its mechanism with genetic expression in Korean never-smoking lung cancer patients to predict positive anticancer effects.
(Right) Selection of cell lines with mutations identical to those found in patients among lung cancer cell lines, treated with Saracatinib alongside a control group without these mutations, demonstrating excellent anticancer effects from low to high concentrations and confirming the anticancer effects of Saracatinib.

CREDIT

Korea Institute of Science and Technology(KIST)

KIST was established in 1966 as the first government-funded research institute in Korea. KIST now strives to solve national and social challenges and secure growth engines through leading and innovative research. For more information, please visit KIST’s website at https://eng.kist.re.kr/

This research was supported by the Ministry of Science and ICT, Korea, under the KIST's main projects and the Bio-Medical Technology Development Program (2022M3H9A2096187). The research results have been published online in the latest issue of the international journal Cancer Research (IF 11.2, JCR field 10.6%).

---

JOURNAL

Cancer Research

DOI

10.1158/0008-5472.CAN-23-1551 

ARTICLE TITLE

Proteogenomic Characterization Reveals Estrogen Signaling as a Target for Never-Smoker Lung Adenocarcinoma Patients without EGFR or ALK Alterations