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[Editorial] The next decade in AMR: getting the basics right

Nov 18–24, 2025, marks the 10th edition of World AMR Awareness Week, an annual campaign led by WHO with the goal to increase awareness of global antimicrobial resistance (AMR) and to encourage best practices. Much has happened over this past decade—a pandemic, a seminal paper directly attributing over 1 million deaths each year to bacterial AMR, and a shift to One Health thinking—but the next decade will be pivotal in translating awareness into sustained action, innovative solutions, and global leadership to truly curb the threat of AMR.

[Articles] Management and survival of patients with cancer of unknown primary discussed by a French national multidisciplinary tumour board: a retrospective analysis

Integration of clinical, pathological and molecular data within an expert MTB is feasible in a real-life setting, enables access to molecularly guided treatments and improves survival for a large proportion of CUP patients. Our findings highlight the benefits of dedicated MTB and reference centres to improve the management of CUP.

[Comment] Ending HIV transmission in Europe

Many European countries have managed to reduce HIV incidence tremendously over the past decades, yet declines have stalled, or even reversed, in many countries.1 By combining data from national HIV surveillance and population statistics, Jongen et al. provide a unique insight into the structural risk factors for HIV diagnosis in The Netherlands.2 HIV diagnoses were disproportionally found among individuals with a migrant background, and people with economic and mental health vulnerabilities. These data can help design tailored HIV treatment and prevention strategies to reach those at highest risk and ensure trends in incidence revert back to their downward trajectory.

[Comment] Oil spill in Esmeraldas: a public health emergency in the context of environmental racism

Esmeraldas, a coastal province in northern Ecuador, is among the country's most vulnerable and marginalized regions. With more than 70% of its population self-identified as Afro-descendant and high levels of multidimensional poverty, it faces historical exclusion from essential public services such as health care, potable water, and sanitation. This configuration of vulnerability is key to understanding the impact of the oil spill that occurred on March 13, 2025,1 not only as an environmental disaster but also as a public health emergency and a human rights crisis.

Fish Oil for Patients Receiving Hemodialysis — Red Herring or Great Catch?

More than 470,000 patients with kidney failure receive hemodialysis in the United States alone, with worldwide estimates approaching 3 million patients. Mortality from kidney failure remains unacceptably high, with recent U.S. estimates of approximately 18% per year — higher than the mortality observed among patients with heart failure, diabetes, or…

A-E-I-O-U and Sometimes Why—Dialysis in Acute Kidney Injury

Students memorize the indications for dialysis in acute kidney injury (AKI) as the vowels of the alphabet, A-E-I-O-U: acidosis, electrolytes, ingestions, overload, and uremia. In a study published in JAMA, Liu and colleagues ask clinicians to consider the last vowel, sometimes Y (“why”), in their report of the LIBERATE-D trial testing a conservative vs conventional thrice-weekly strategy for dialysis for patients with AKI. A brief historical review of the evolution of strategies for kidney replacement therapy (KRT) will help put LIBERATE-D into context.

[Series] Anti-cytokine biologics for asthma in adults

An estimated 3–10% of patients with asthma are unable to reach full control with currently available inhaled therapies. In a large proportion of these patients, asthma can be driven in whole or in part by type 2 (T2) inflammation, which is usually initiated by an immunological response to stimulation at mucosal surfaces. The introduction of monoclonal antibodies, which target T2 inflammatory processes, provides important options for this population. In the past decade, five anticytokine biologics (ACBs) that block specific T2 inflammatory cytokines have been introduced.

[Seminar] Alcohol use disorders

Alcohol use disorders consist of conditions characterised by compulsive heavy alcohol use and loss of control over alcohol intake. Alcohol use disorders are some of the most prevalent mental disorders globally, with higher prevalence in high-income countries and lower prevalence in low-income countries. The recent COVID-19 pandemic was associated with an increase in fully alcohol-attributable mortality, in part triggered by alcohol-specific interactions with stress. Despite their high prevalence, alcohol use disorders remain undertreated, even though there are scientifically established and cost-effective psychosocial, community, and pharmacological interventions available.

[Articles] Durvalumab in combination with BCG for BCG-naive, high-risk, non-muscle-invasive bladder cancer (POTOMAC): final analysis of a randomised, open-label, phase 3 trial

Among patients with BCG-naive, high-risk NMIBC, 1 year of durvalumab combined with BCG induction and maintenance therapy showed a statistically significant and clinically meaningful improvement in disease-free survival versus BCG induction and maintenance alone. The combination had a manageable safety profile, consistent with that of the individual therapies. These results support 1 year of durvalumab in combination with BCG induction and maintenance therapy as a potential new treatment for this patient population.

[Department of Error] Department of Error

Chang AY, Bolongaita S, Cao B, et al. Epidemiological and demographic trends and projections in global health from 1970 to 2050: a descriptive analysis from the third Lancet Commission on Investing in Health, Global Health 2050. Lancet 2025; 406: 940–49—In the Acknowledgments section of this Article, the funding information for author OK should have read “OK was funded by a Wallander Scholarship (Stockholm, Sweden: W19-0015) from the Jan Wallanders och Tom Hedelius stiftelse samt Tore Browaldhs stiftelse.” This correction has been made to the online version as of Nov 6, 2025.

[Department of Error] Department of Error

Ziegler A-G, Cengiz E, Kay TWH. The future of type 1 diabetes therapy. Lancet 2025; 406: 1520–34—In this Review, the second sentence of the Adjunctive treatments section should read “Adjunctive therapies include the amylin analogue pramlintide, metformin, GLP-1 receptor agonists, and SGLT2 and dual SGLT1 and SGLT2 inhibitors.” This correction has been made to the online version as of Nov 6, 2025.

[Correspondence] CheckMate 8HW and the future of dual immunotherapy – Authors' reply

We appreciate the comments in response to the CheckMate 8HW trial. In CheckMate 8HW, central confirmation of microsatellite instability-high or mismatch repair-deficient status of metastatic colorectal cancer was defined as one central test result of either an immunohistochemistry-based deficient microsatellite mismatch repair test or a PCR-based microsatellite instability test.1 The use of both testing methodologies can maximise sensitivity but we recognise, as Ghanem and Pérez-Wert highlight, that this is not always feasible in clinical practice.

[Correspondence] CheckMate 8HW and the future of dual immunotherapy

The phase 3 CheckMate 8HW trial, in patients with microsatellite instability-high or mismatch repair-deficient metastatic colorectal cancer, showed superior progression-free survival with nivolumab–ipilimumab versus nivolumab monotherapy across all treatment lines (hazard ratio [HR] 0·62, 95% CI 0·48–0·81, p=0·0003).1 However, it is unclear if patients with PD-L1-positive tumours benefit from the addition of ipilimumab. Figure 3 suggests lower benefit in the PD-L1 expression of 1% or higher subgroup (HR 0·77) compared with the PD-L1 expression of less than 1% subgroup (HR 0·57).

[Correspondence] Community-controlled research for disruption-resilient partnerships

In the USA, the termination of over 1500 research grants totalling approximately US$7·5 billion revealed the vulnerabilities in traditional academic–community research partnerships.1 These abrupt terminations targeted research focused on marginalised populations and showed how political shifts can destroy decades of trust-building between researchers and vulnerable communities while creating immediate disruptions in health care access and services.

[Correspondence] Africa leads, multilateral health organisations support

At birth, parents must do everything to support their child, but as children mature, the parental role shifts from providing full care to providing guidance, support, and resources when asked.1 Africa's public health institutions have undergone a similar journey. Yet, the multilateral health organisations that surround them too often behave as if African institutions were still in their infancy.