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BACKGROUND: Granulocyte-macrophage colony-stimulating factor (GM-CSF) and dysregulated myeloid cell responses are implicated in the pathophysiology and severity of COVID-19. METHODS: In this randomised, sequential, multicentre, placebo-controlled, double-blind study, adults aged 18-79 years (Part 1) or ≥70 years (Part 2) with severe COVID-19, respiratory failure and systemic inflammation (elevated C-reactive protein/ferritin) received a single intravenous infusion of otilimab 90 mg (human anti-GM-CSF monoclonal antibody) plus standard care (NCT04376684). The primary outcome was the proportion of patients alive and free of respiratory failure at Day 28. RESULTS: In Part 1 (n=806 randomised 1:1 otilimab:placebo), 71% of otilimab-treated patients were alive and free of respiratory failure at Day 28 versus 67% who received placebo; the model-adjusted difference of 5.3% was not statistically significant (95% CI -0.8-11.4%, p=0.09). A nominally significant model-adjusted difference of 19.1% (95% CI 5.2-33.1%, p=0.009) was observed in the predefined 70-79 years subgroup, but this was not confirmed in Part 2 (n=350 randomised) where the model-adjusted difference was 0.9% (95% CI -9.3-11.2%, p=0.86). Compared with placebo, otilimab resulted in lower serum concentrations of key inflammatory markers, including the putative pharmacodynamic biomarker CC chemokine ligand 17, indicative of GM-CSF pathway blockade. Adverse events were comparable between groups and consistent with severe COVID-19. CONCLUSIONS: There was no significant difference in the proportion of patients alive and free of respiratory failure at Day 28. However, despite the lack of clinical benefit, a reduction in inflammatory markers was observed with otilimab, in addition to an acceptable safety profile.

By 2040, there will be an estimated 26 million cancer survivors in the United States. The essential components of survivorship care are (1) surveillance for cancer recurrence, (2) surveillance for new primary cancers, (3) management of physical and psychological long-term effects of treatment, (4) prevention or mitigation of late treatment effects, and (5) coordination of care between the oncology team and primary care clinicians. Recommendations for surveillance to detect recurrence vary with cancer type and stage at diagnosis. Screening for new primary cancers is the same as for the general population. Although many cancer survivors do not undergo recommended surveillance or screening, family physicians can encourage and facilitate adherence. Family physicians should also monitor and manage the physical and psychological effects of cancer diagnosis and treatment, such as depression, lymphedema, pain, and sexual dysfunction. Cardiovascular disease is a leading cause of death for cancer survivors, often as a long-term effect of cancer treatments. Clinicians should counsel patients on cessation of tobacco and alcohol use, participation in recommended levels of physical activity, and adherence to optimal nutrition recommendations. Finally, family physicians should work with the cancer care team to coordinate the care plan and assure that all recommended components are achieved. Written survivorship care plans should be provided to cancer survivors to help them transition from active treatment to posttreatment monitoring. By 2040, there will be an estimated 26 million cancer survivors in the United States. The essential components of survivorship care are (1) surveillance for cancer recurrence, (2) surveillance for new primary cancers, (3) management of physical and psychological long-term effects of treatment, (4) prevention or mitigation of late treatment effects, and (5) coordination of care between the oncology team and primary care clinicians. Recommendations for surveillance to detect recurrence vary with cancer type and stage at diagnosis. Screening for new primary cancers is the same as for the general population. Although many cancer survivors do not undergo recommended surveillance or screening, family physicians can encourage and facilitate adherence. Family physicians should also monitor and manage the physical and psychological effects of cancer diagnosis and treatment, such as depression, lymphedema, pain, and sexual dysfunction. Cardiovascular disease is a leading cause of death for cancer survivors, often as a long-term effect of cancer treatments. Clinicians should counsel patients on cessation of tobacco and alcohol use, participation in recommended levels of physical activity, and adherence to optimal nutrition recommendations. Finally, family physicians should work with the cancer care team to coordinate the care plan and assure that all recommended components are achieved. Written survivorship care plans should be provided to cancer survivors to help them transition from active treatment to posttreatment monitoring.. [ABSTRACT FROM AUTHOR]

A 42GHz-500kW ECRH system [1-6] is used to carry out various experiments related to plasma breakdown and ECR heating on tokamaks SST-1 and Aditya-U. The system has been upgraded with new anode modulator power supply to launch two ECRH pulses to carry out breakdown and heating simultaneously. In SST-1, ECRH system is used routinely for plasma breakdown at fundamental harmonic, approximately 150kW power is launched for 70ms to 150ms duration and consistent plasma start-up is achieved in SST-1. In the recent experiments, second EC pulse is also launched at the plasma flat-top to heat the plasma, some heating signatures are seen but more experiments will be carried out to confirm the plasma heating with ECRH. In Aditya-U tokamak, simultaneous plasma breakdown and heating experiments are carried out successfully [2]. In the first pulse around 100kW power in fundamental O-mode is launched for 70ms duration for the breakdown at low-loop voltage and around 150kW ECRH power for 50ms duration is launched in second EC pulse to heat the plasma. In case of Aditya-U, plasma heating is observed clearly as soft X-ray signal increases sharply with ECRH. In AdityaU tokamak, deuterium plasma experiments have been carried out and ECRH launched at the flat-top of deuterium plasma current. In deuterium plasma also ECR heating is observed as soft X-ray signal increases with ECH power. For SST-1, ECRH system is being upgraded with another 82.6GHz system, this system would be used to carry out plasma heating and start-up at second harmonic. The 82.6GHz system is already connected with the SST-1 tokamak, the old 82.6GHz-200kW Gyrotron will be upgraded to 400kW system to carry out effective heating experiments on SST-1 at higher ECRH power. The paper discusses the recent results of ECRH experiments carried out on tokamaks SST-1 & Aditya-U and presents the upgradation plan of EC system for SST-1.