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Researchers uncover ‘on/off switch’ for breast cancer metastasis

The research could help clinicians better predict patient response to existing medicines

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Songnan Wang, MD-PhD student in biochemistry and Arc researcher and Lingyin Li, associate professor of biochemistry at Stanford and Arc Core investigator

Researchers from Stanford University have discovered an “on/off switch” for breast cancer metastasis, in a move that could redefine treatment.

Despite their promise, immunotherapies fail to treat many cancers, including over 80 per cent of some of the most advanced breast cancers and many of those patients who do respond still experience metastases eventually.

Researchers from Stanford University and the Arc Institute has revealed a better way to predict and improve patient responses.

A team led by Lingyin Li, associate professor of biochemistry at Stanford and Arc Core investigator, found that a protein called ENPP1 acts as an “on/off switch” that controls breast cancer’s ability to both resist immunotherapy and metastasise.

The study, published in December in the Proceedings of the National Academy of Sciences, showed that ENPP1 is produced by cancer cells and by healthy cells in and around the tumour, and that high patient ENPP1 levels are linked to immunotherapy resistance and subsequent metastases.

The research could lead to new, more effective immunotherapies and help clinicians better predict patient response to existing medicines.

“Our study should offer hope for everyone,” said Li, who is also an institute scholar at Sarafan ChEM-H.

Thawing cold tumours

Immunotherapies, like pembrolizumab (Keytruda), work by blocking an immune-dampening interaction between a cancer cell and a T cell, a kind of immune cell. For this to be effective, though, T cells need to permeate the tumour. So-called “hot” tumours, like those in melanoma and a subset of lung cancer, are treatable through immunotherapies, but many others, like breast and pancreatic cancers, are “cold,” devoid of T cell infiltration.

In her quest to turn cold tumours hot, Li started with cGAMP, a molecule that cells produce when their DNA is damaged, which happens when a cell becomes cancerous. If left intact, cGAMP activates an immune response through what is known as the STING pathway, which can help make a tumour hot.

Li previously discovered that cGAMP is exported outside the cells but often, before it can trigger a response, a protein called ENPP1 chews up these molecular “danger” signals. ENPP1, she proposed, helped keep cold tumours cold.

High levels of ENPP1 correlate with poor prognosis in many cancers, but the protein can perform many actions in the body, so Li set out to determine if its cGAMP-chewing ability is behind its clinical significance.

An on/off switch

Li began collaborating with two professors at the University of California, San Francisco: Hani Goodarzi, also an incoming Arc Institute Core investigator, and Laura Van’t Veer, a clinician who leads the I-SPY 2 trial, a groundbreaking breast cancer trial.

ENPP1 levels naturally vary across individuals, so the team looked at data from patients in the I-SPY 2 trial to see how responses to pembrolizumab varied with ENPP1 levels at the time of diagnosis.

Patients with high ENPP1 levels had low response to pembrolizumab and high chance of metastases. Those with low ENPP1 levels had a high response to pembrolizumab and no metastases. ENPP1 predicted both response to immunotherapy and likelihood of relapse.

Two things were suddenly clear: that ENPP1 was critical in metastases, not just in primary tumours and that they should be looking at ENPP1 in healthy cells, not only in cancer cells.

Songnan Wang, an MD-PhD student in biochemistry, Arc researcher and first author on the paper, said: “Using the finest molecular scalpels developed in our lab, I was excited to dig deeper and figure out exactly how ENPP1 has such a dramatic influence on clinical outcomes.”

In a series of mouse studies, Wang proved that removing ENPP1 entirely or eliminating only its cGAMP-chewing ability in normal and cancer cells yielded exactly the same result: decreased tumour growth and decreased metastases. And the team proved that it resulted directly from suppressing the STING pathway. They found an on/off switch.

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Vipoglanstat trial reaches recruitment halfway point

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Vipoglanstat has reached the halfway point for patient recruitment in a phase 2 endometriosis trial.

Gesynta Pharma said 50 per cent of the target of 190 patients have been randomised in the NOVA trial.

The study is evaluating vipoglanstat, described by the company as a novel, non-hormonal, non-opioid drug candidate for the treatment of endometriosis.

Endometriosis is a chronic inflammatory condition where tissue similar to the lining of the womb grows outside the uterus, often causing severe pain and, in some cases, infertility.

The condition affects more than 10 per cent of women of reproductive age.

Top-line results from the study are expected in 2027.

The NOVA trial is a randomised, double-blind, placebo-controlled phase 2 proof-of-concept study evaluating vipoglanstat in women with endometriosis across Europe.

This means patients are assigned to treatment groups by chance, neither participants nor researchers know who receives the drug or placebo during the study, and the results are intended to show whether the treatment has enough evidence to move into later testing.

The trial is assessing the efficacy and safety of two dose levels of vipoglanstat and will provide information for the design of a subsequent phase 3 programme.

Eva Johnsson, chief medical officer and vice president of clinical development at Gesynta Pharma, said:

“Reaching the halfway point in patient recruitment marks a major milestone for our Phase 2 clinical trial in endometriosis. Achieved well ahead of schedule, the rapid progress reflects strong participation from clinical sites and great interest among eligible participants. This momentum highlights the urgent need for better treatments.

“We are now eager to complete enrolment and proceed to the next phase of evaluation.”

Patric Stenberg, chief executive of Gesynta Pharma, said:

“The NOVA trial is a significant advancement in a field with few ongoing clinical trials, and a key step toward establishing a strong foundation for a future Phase 3 programme for vipoglanstat.

“Given the immense medical need, our focus remains on delivering a treatment that is highly effective, safe, and well-tolerated.”

Vipoglanstat is an orally active drug candidate designed to reduce pain and inflammation by targeting mPGES-1, an enzyme that produces prostaglandin E2, a substance linked to inflammation in endometriotic lesions.

A preclinical proof-of-concept study in an advanced endometriosis model found that vipoglanstat significantly reduced pain-related behaviours and endometriotic lesion burden.

Gesynta said previous clinical studies have supported the drug candidate’s safety, tolerability and pharmacodynamic effects in humans. Pharmacodynamic effects refer to how a drug acts in the body.

NOVA stands for the Non-hormonal Option, a Vipoglanstat Assessment trial.

Endometriosis commonly presents with severe period pain, known as dysmenorrhoea, pain between periods, pain during sexual intercourse, gastrointestinal symptoms and infertility.

Current management is typically limited to painkillers, hormonal therapies and surgery.

Despite its prevalence, Gesynta said endometriosis remains a critically underserved area of women’s health.

The company said the disease is significantly underdiagnosed and undertreated, with few new treatment options available to patients.

Approximately 190 patients aged 18 to 45 will receive vipoglanstat or placebo over four menstrual cycles.

The primary objective is to evaluate the effect of vipoglanstat on endometriosis-related pain during non-menstrual days.

Secondary objectives include assessing the effect on menstrual pain, known as dysmenorrhoea, pain during sexual intercourse, known as dyspareunia, use of opioid rescue medication and quality-of-life measures.

Changes in endometriotic lesions, areas of tissue linked to the condition, will also be explored using MRI scans.

Gesynta Pharma said its research on targeting mPGES-1 began at Karolinska Institutet in Sweden.

The company said a second drug candidate, GS-073, is ready to enter clinical phase 1 for the treatment of chronic inflammatory pain.

Gesynta Pharma’s shareholders include Hadean Ventures, Industrifonden, Innovestor Life Science, Linc, HealthCap, XGen Venture and other specialist investors.

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Femtech World Awards 2026: Celebrating initiatives that move women’s health forward

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By Wolfgang Hackl, CEO, OncoGenomX Inc., Allschwil, Switzerland

As the FemTech World Awards 2026 winners are revealed, it is a privilege to reflect on the Research Award 2026 sponsored by OncoGenomX Inc., and on the exceptional standard set by this year’s finalists.

On behalf of OncoGenomX Inc., sincere thanks to every applicant and congratulations go to the nominees whose work continues to push women’s health innovation forward.

Research Awards matter because they do more than recognize excellence in a single moment; they help elevate the science, courage, and systems thinking needed to transform women’s health at scale.

This year’s three finalists represented three different but equally important forms of progress. Natural Cycles brought forward one of the largest studies ever conducted on menstrual and ovulatory patterns in perimenopause, analysing nearly one million cycles from more than 197,000 women across over 140 countries.

That project stood out for both its dataset scale and its ability to translate new evidence into a regulated product designed to support women navigating a historically under-researched life stage.

IVI RMA stood out for scientific rigor and clinical precision. Its multicenter, double-blinded, non-selection study on non-mosaic segmental aneuploid embryos offered high-quality evidence on implantation and live birth outcomes, helping move fertility care away from assumption and toward a more evidence-based approach to embryo management and patient counseling.

UN ESCAP’s ‘Femtech in South-East Asia: Unlocking innovation for women’s health’ stood out for a different reason.

Rather than focusing on one product area or one clinical question, it mapped an entire emerging ecosystem.

The report examined the state of femtech across key South-East Asian markets, documented barriers such as financing gaps, stigma, weak ecosystem support, and data challenges, and then translated that research into practical recommendations for governments, investors, founders, and ecosystem builders.

In many ways, all three finalists are winners.

Each project excelled on core evaluation criteria including originality, relevance, coherence, effectiveness, efficiency, impact, and sustainability.

Each also offered something genuinely valuable to the future of women’s health: stronger evidence, clearer decision-making, more informed product development, and greater visibility for unmet needs that have gone too long without sufficient attention.

The final decision was therefore a genuine head-to-head race.

The jury supported its discussion with a numerical scoring approach, but it also looked carefully at systems impact: the extent to which a project not only advances one intervention, but improves the wider conditions under which innovation can emerge, scale, and endure.

That perspective mattered in this category, because the strongest research is not always only the most technically impressive; sometimes it is the research that opens doors for many future innovations to follow.

On that basis, the OncoGenomX Jury selected UN ESCAP as the winner of the Research Award.

The decisive factor was not simply that the report was comprehensive, though it was.

It was that the project helps change the environment around innovation itself.

It provides a practical roadmap for strengthening research, improving data governance, expanding founder support, addressing gender bias in investment, scaling innovative finance, and integrating women’s health more fully into policy and development agendas.

That broader enabling effect is what distinguished the UN ESCAP project. Natural Cycles demonstrated outstanding research translation, and IVI RMA demonstrated exceptional clinical rigor.

UN ESCAP, however, showed how research can influence the structures that determine whether many other femtech solutions will ever be funded, adopted, trusted, and scaled. In that sense, its impact reaches beyond one company, one product, or one clinical pathway, and toward a healthier innovation landscape overall.

Warm congratulations again to all finalists and nominees.

And special congratulations to UN ESCAP on receiving the OncoGenomX Research Award at the Femtech World Awards 2026.

The jury’s decision reflects deep respect for all three projects and a shared belief that women’s health advances fastest when excellent science is paired with the power to reshape the systems around it.

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WEC Chair calls out Health Minister’s delay on banning BBLs and other harmful cosmetic procedures

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WEC chair Sarah Owen has criticised delays over a ban on high harm cosmetic procedures, including liquid BBLs.

The Women and Equalities Committee has published a letter from health minister Karin Smyth after the government missed the 18 April deadline to respond to the committee’s report on cosmetic procedures.

The report, published on 18 February, recommended that high harm procedures such as liquid Brazilian butt lifts, known as BBLs, should be banned immediately without further consultation.

MPs said the government is “not moving quickly enough” in introducing a licensing system for non-surgical cosmetic procedures and “should accelerate regulatory action”.

They also warned that “this lack of timely action is fostering complacency in self-regulation” within the industry.

In her letter, Smyth said the Department of Health and Social Care had “taken the decision to first of all focus on introducing legal safeguards for the cosmetic procedures posing the highest risks and I can confirm that we plan to consult on draft regulations in June”.

The letter added:

“Our intention is to issue a formal government response to the WEC report, once our consultation setting out our proposed approach and underpinning legislation is published.

“I acknowledge the concerns around the government’s pace of delivery in this area but, as you will appreciate, this is a complex area of policy and striking the balance between increased patient safety, placing new requirements on businesses and introducing proportionate and enforceable regulation is challenging.

“I recognise that regulation has not kept pace with the expansion of the aesthetics industry and, on that basis, I can assure you that we are committed to implementing licensing in the current parliament.”

Owen, chair of the Women and Equalities Committee and Labour MP, said:

“Further consultation and delay on clamping down on high harm procedures such as liquid BBLs is unacceptable. It allows unscrupulous people to continue to put women at risk and lets down those who have lost loved ones following these practices or who have come to serious harm themselves.

“As WEC’s report warned back in February, procedures that are deemed high risk such as liquid BBLs and liquid breast augmentations, which have already been shown to pose a serious threat to patient safety, should be banned immediately.

“While it is positive to hear a licensing system for non-surgical cosmetic procedures will be introduced within this Parliament, this issue requires faster regulatory progress, particularly in high harm areas, and the Government is not moving quickly enough.

“The Committee previously heard a powerful and shocking testimony from a woman who developed sepsis after having a liquid BBL. Her experience and those of many others provides clear evidence of the need to tackle this evolving wild west.”

A liquid BBL is a non-surgical procedure intended to alter the shape of the buttocks.

Sepsis is a potentially life-threatening response to infection that can lead to organ damage if not treated quickly.

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