The death of UnitedHealthcare CEO Brian Thompson triggered a deluge of painful stories about health care denials on social media.

Photo by Bilal Kamoon via flickr In late 2021, editors at Laboratory Investigation noticed something strange. The journal was receiving far more emails than usual asking to withdraw manuscripts tha…

Mycobacterium bovis Bacillus Calmette-Guerin (BCG), the first line treatment for non-muscle invasive bladder cancer (NMIBC), promotes production of type I interferons, particularly interferon (IFN)-γ. Prolonged inflammation and IFN-γ exposure are known to cause an adaptive immune response, enabling immune escape and proliferation by tumor cells. We investigated HLA-E and NKG2A, a novel T and NK cell checkpoint pathway, as a driver of adaptive resistance in BCG unresponsive NMIBC. We observed ubiquitous inflammation in all patients after BCG immunotherapy, regardless of recurrence status. IFN-γ was shown to drive tumor expression of HLA-E and PD-L1. Further, NKG2A-expressing NK and CD8 T cells were enriched in BCG unresponsive tumors and with enhanced capacity for cytolytic functions. Strikingly, in situ spatial analyses revealed that HLA-EBRIGHT tumors are activated to recruit NK and T cells via chemokine production potentially sparing HLA-EDIM/NEG tumors that would otherwise be susceptible to lysis. Finally, blood-derived NK cells retained antitumor functions at time of tumor recurrence. These data support combined NKG2A and PD-L1 blockade for BCG unresponsive disease. ### Competing Interest Statement The authors have declared no competing interest.

I am an anatomic pathologist with a particular interest in gynaecological cancer. I am Indian but was born in Washington, DC, USA. My father was a diplomat and after I was born we lived in Kathmandu, Khartoum, Delhi, London, Madrid and Rangoon. I am the middle child of 5 siblings and every few years we would leave our friends and life behind and start again! I have married to an English artist for 27 years and we have 3 children. These factors have all been constant and enduring lessons in diplomacy, team-working and survival!

Intrinsic molecular subtypes may explain marked variation between bladder cancer patients in prognosis and response to therapy. Complex testing algorithms and little attention to more prevalent, earl...

Dr. Jeannie Callum is a new member of SEAMO, cross-appointed to the Departments of Pathology and Molecular Medicine and Medicine.

As the founding editor of the Canadian Oxford Dictionary, she turned to “trashy novels” and parliamentary debates to find Canada’s version of the language.