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[Editorial] International funding for cancer care: a shared responsibility

A side event held by the Bloomberg New Economy International Cancer Coalition and American Society of Clinical Oncology at the 2025 UN General Assembly in New York, New York, USA, saw the launch of the Global Cancer Financing Platform, marking a pivotal step in reshaping how the world funds cancer care. This gathering brought together international stakeholders from across governments, industry, philanthropy, and civil societies to explore innovative financing models for cancer care. One highlight was the potential for diaspora remittances.

[Seminar] Large-vessel vasculitis

Primary large-vessel vasculitis encompasses conditions that, despite sharing many common features, constitute distinct entities that have their own prognostic implications. These conditions include giant cell arteritis and Takayasu arteritis, with isolated aortitis being increasingly recognised in the literature and studied within this disease spectrum. Epidemiological studies have evidenced a worldwide distribution of Takayasu arteritis. In giant cell arteritis, distinct clinical phenotypes with specific outcomes (ie, cranial and large vessel forms) have been recognised.

[Seminar] Osteoporosis

Osteoporotic fractures are one of the most common and consequential diseases of advanced ageing and many antifracture therapies are widely available but largely underused. This Seminar presents an updated approach to osteoporosis consultation, drawing upon published evidence and collaborative expert opinion to place the data in a pragmatic and useful context for clinicians. New evidence on osteoporosis screening recommendations, fracture-risk assessment, intervention decisions, nutrition-based therapies, and antiresorptive and anabolic therapies are discussed, along with practical approaches to treatment in the oldest old, those with chronic kidney disease, and patients who continue to fracture despite therapy.

[Department of Error] Department of Error

Ye C, Ebeling PR, Kline G. Osteoporosis. Lancet 2025; 406: 2003–16—In this Seminar, the middle initial of author Peter R Ebeling was not included and their affiliation should have been Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, VIC, Australia. These corrections have been made to the online version as of Oct 23, 2025, and the printed version is correct.

[Correspondence] Drug-coated balloon angioplasty and stenting for coronary artery lesions – Authors' reply

We deeply appreciate the feedback provided by Tingquan Zhou, Pitt O Lim, Christian Spaulding and colleagues, Filippo Luca Gurgoglione and Bernardo Cortese, and Tuomas T Rissanen and colleagues. Introduced by Scheller and colleagues1 in 2004, drug-coated balloon (DCB) angioplasty has emerged as an attractive alternative to stent-based interventions. Studies and consensus documents have supported the application of DCBs in de novo small-vessel disease;2,3 nevertheless, a pertinent question remains regarding the applicability of DCB in de novo lesions across all vessel diameters.

[Correspondence] Drug-coated balloon angioplasty and stenting for coronary artery lesions

In the REC-CAGEFREE I trial by Chao Gao and colleagues,1 an open-label, randomised, non-inferiority trial comparing a drug-coated balloon (DCB) with a drug-eluting stent (DES) in patients with de novo, non-complex coronary lesions, the DCB group did not reach non-inferiority; however, event rates at 2 years were low. The study shows the safety of DCB-only angioplasty: the number of acute occlusions (0 in the DCB group vs 1 in the DES group) and the rate of vessel thrombosis (0·4% vs 0·3%) were very low in both groups.

[Correspondence] Drug-coated balloon angioplasty and stenting for coronary artery lesions

The REC-CAGEFREE I trial1 by Chao Gao and colleagues describes the results of a multicentre trial in which a paclitaxel drug-coated balloon (DCB) did not reach expected non-inferiority compared with a drug-eluting stent (DES) in terms of the device-oriented composite endpoint (DoCE) assessed at 2 years. Gao and colleagues concluded that DES should remain the preferred treatment for patients with de novo coronary artery disease.

[Correspondence] Drug-coated balloon angioplasty and stenting for coronary artery lesions

We read with great interest the Article by Chao Gao and colleagues1 and compliment the authors for a large, well designed trial that is the first to compare drug-coated balloon (DCB) angioplasty with drug-eluting stent (DES) deployment in patients with de novo, non-complex coronary artery lesions. The results are somewhat disappointing, as a strategy of DCB angioplasty with rescue stenting did not reach non-inferiority compared with DES implantation in terms of the trial's device-oriented composite endpoint at 2 years.

[Correspondence] Drug-coated balloon angioplasty and stenting for coronary artery lesions

The conclusion in the REC-CAGEFREE-I trial by Chao Gao and colleagues1 that drug-coated balloon (DCB) angioplasty is inferior to drug-eluting stent (DES) deployment in patients with non-complex, de novo coronary artery disease is such a sweeping statement that the linked Comment by Margaret B McEntegart and Ajay J Kirtane2 attempted to rebalance it.

[Correspondence] Integrating preconception health into CVD prevention

The Lancet Commission on rethinking coronary artery disease: moving from ischaemia to atheroma1 compellingly reframes coronary artery disease as a lifelong continuum, advocating for early prevention strategies rooted in atheroma detection. The Commission's thoughtful and forward-looking reframing of atherosclerotic coronary artery disease (ACAD) as a systemic, lifelong condition marks a major and much-needed shift in cardiovascular care. The emphasis on early detection, risk factor modification, and the life-course approach is commendable and timely.

[Correspondence] Rethinking atherosclerotic disease prevention

The Lancet Commission on rethinking coronary artery disease1 offers important advances in cardiovascular disease (CVD) prevention. The Commission argues, correctly in our opinion, that identification of adequate management of people with high blood pressure is more important than finding the optimal CVD risk threshold for its pharmacological treatment. A large (n=3 337 314) cross-sectional study of people aged 45–74 years in Australia2 showed that 41% of individuals with low CVD risk and blood pressure of more than 140/90 mm Hg were not managed with antihypertensive medications.

[Correspondence] Plant-based diets for coronary artery disease prevention

We read with interest the Lancet Commission1 on rethinking coronary artery disease, which shifts focus from ischaemia to atherosclerosis. The prominence of diet as a risk factor for atherosclerotic coronary artery disease (ACAD) is rightfully highlighted in the Commission. However, we believe greater emphasis could have been placed on the importance of plant-based diets given their great potential in atherosclerosis prevention.

[Correspondence] Loans dominated COVID-19 funding: it's time to adjust

As the US foreign assistance architecture faces unprecedented dismantling, lessons from past crises take on urgent significance. Our new analysis of COVID-19 donor funding1 reveals a profound disconnect between the rhetoric of global solidarity and the reality: most official development assistance was issued as loans, and direct support to partner governments was minimal.

[Correspondence] Naegleria fowleri in Kerala, India: prevention over panic

Kerala, India, is confronting a rare but deadly cluster of primary amoebic meningoencephalitis caused by Naegleria fowleri, with about 69 confirmed cases and 19 deaths reported in 2025.1 Although uncommon, the disease is almost uniformly fatal and can progress over days. Because primary amoebic meningoencephalitis frequently mimics bacterial meningitis or viral encephalitis, diagnosis and treatment are often delayed. In some instances, it has also been mistaken for cerebral toxoplasmosis, cryptococcal meningitis, or tuberculous meningitis.

[Perspectives] Cinematic portrayals of euthanasia and ageing across the decades

Cinema can be enormously instructive in reflecting and informing public consciousness on societal issues. It is especially illuminating for exploring perceptions of ageing, a complex, diverse, and heterogeneous social experience. An early scene in Michael Anderson's 1976 film Logan's Run depicts a ceremony in which people at the age of 30 years ascend to a crystal maze where only those “strong enough” are “renewed”. Little do citizens of the underground utopia in Logan's Run realise that they will all perish upon ascension, irrespective of perceived strength.