Interventions: Behavioral: Be Specific; Behavioral: Be Kind; Behavioral: Be Present; Behavioral: Break Habit; Behavioral: Psychoeducation
Sponsors: University of California, Los Angeles; University of Exeter
Not yet recruiting
enGene (NASDAQ: ENGN) stock suffered an 83% plunge this past week that reflects just how competitive the field is among drug candidates for nonmuscle invasive bladder cancer (NMIBC)—and how questions over clinical data are enough to send investors scurrying to sell their shares.
enGene shares cratered 81% Thursday from $8.85 to $1.72, then fell another 13% Friday, reaching a 52-week low as it finished the week at $1.50.
The sharp falloff followed enGene reporting updated data from its Phase II LEGEND trial (NCT04752722) assessing its nonviral gene therapy candidate detalimogene voraplasmid in high-risk, Bacillus Calmette-Guérin (BCG)-unresponsive NMIBC patients with carcinoma in situ (CIS) with or without concomitant papillary disease (CIS±papillary). The data showed a drop in response rates from a November 2025 readout, falling short of company and Wall Street expectations.
As of the April 21 data cutoff, 67 of 124 evaluable patients treated with detalimogene (formerly EG-70) achieved a 54% complete response (CR) at any time, a rate that fell to 43% (52 of 121 evaluable patients) CR rate at six months. That compares with the 63% CR at any time and 62% CR rate at six months shown for the first 62 patients assessed, as announced by enGene in November 2025.
Also, detalimogene showed a nine-month CR rate of 32.7%, which fell to 13.3% at 12 months after treatment. Engene said it will present its data at the American Urological Association Annual Meeting (AUA 2026), set for May 15–18 in Washington, DC.
“While durability outcomes to date are not what we hoped, these data are preliminary,” enGene president and CEO Ron Cooper stressed in a statement. “We are focused on evaluating the totality of the data as it evolves and plan to continue to engage with the FDA and the medical community.”
Speaking to analysts, Cooper added: “The data are not yet fully mature, and the durability picture is incomplete. We plan to await longer-term durability data for all of Cohort 1 in the second half of the year and continue our ongoing discussion with the FDA regarding both our statistical analysis plans and plans for potential BLA filing.”
At least two analysts warned that the updated data will make it harder for enGene to compete with other developers of NMIBC treatments now in the clinic.
“Durability now screens below key benchmarks in the setting, which makes it hard for us to underwrite meaningful commercial upside for detalimogene in what will be a crowded mkt, where ~40% 12‑mo CR is the bar to clear,” cautioned Maury Raycroft, PhD, equity analyst with Jefferies, in a research note.
Raycroft slashed enGene’s 12-month price target 82% from $28 to $5. More ominously, Raycroft chopped Jefferies’ peak sales forecasts for detalimogene by 79%—from the $1.7 billion forecasted for the gene therapy across CIS±papillary, papillary‑only, and BCG‑naïve NMIBC, to $350 million for CIS±papillary alone.
The NMIBC treatment space has expanded in recent years as established drugs like the cancer immunotherapy blockbuster Keytruda® (pembrolizumab), marketed by Merck & Co. (NYSE: MRK), have been joined on the market by newer therapies.
One is Johnson & Johnson (NYSE: JNJ)’s Inlexzo
(gemcitabine), an intravesical drug releasing system (iDRS) designed to provide sustained local delivery of a cancer treatment into the bladder. Two other newer therapies are Adstiladrin® (nadofaragene firadenovec-vncg), a nonreplicating adenoviral vector-based gene therapy indicated for high-risk BCG-unresponsive NMIBC with CIS±papillary and marketed by privately held Ferring Pharmaceuticals (which licensed the drug from another private company, FKD Therapies, in 2018); and ImmunityBio (NASDAQ: IBRX)’s interleukin-15 (IL-15) receptor agonist Anktiva® (nogapendekin alfa inbakicept-pmln), indicated with BCG. ImmunityBio is part of the privately held NantWorks portfolio of companies.
Those marketed drugs are expected to be joined over the next couple of years by candidates being developed by:
Mani Foroohar, MD, senior managing director, genetic medicines, and a senior research analyst with Leerink Partners, noted that enGene’s 54% any time and 43% six-month updated CR rates lagged behind those of three competitors: Anktiva (71% and 56%), cretostimogene (75.5% and 64%), and Inlexzo (82% and 59%). However, he added that Adstiladrin was more comparable to detalimogene, which showed rates of 51% and 41%.
“Weaker data in recent patient cohorts and lower-than-expected durability trends undermine our confidence in [detalimogene]’s competitive position and essentially foreclose the possibility of closing the efficacy gap with CGON, JNJ, etc., in a later LEGEND update,” Foroohar wrote in a research note.
“With shares trading at a level pricing in program failure, investor focus will center on cohort consistency, data evolution with longer follow-up, and FDA interpretation of the totality of the dataset (questions that will take time to address and will not be resolved prior to full LEGEND data/subsequent regulatory engagement,” Foroohar added.
Like Raycroft, Foroohar also now projects $350 million in unadjusted peak year sales for detalimogene, shredding his firm’s projection by 65% from $1 billion.
“From here, investor discussion will center on whether longer follow-up and additional cohort maturation can stabilize efficacy trends ahead of further FDA engagement in 2H26.”
enGene and Cooper insist that detalimogene is more than up to the challenge of competing with other NMIBC treatments. Of the 52 patients who responded at six months, 37 of 44 patients who had a nine-month assessment were in CR (an additional eight patients are pending evaluation), while 13 of 22 patients who had a 12-month assessment were in CR (an additional 11 patients are pending evaluation).
Among patients who showed the 43% six-month CR rate, 14% (6 of 43) successfully converted from non-CR to CR post re-induction.
The company cited other data from the LEGEND trial showing that the progression rate to muscle-invasive or advanced disease was 3.2%, a figure enGene calls low. Detalimogene was generally well tolerated, the company added, with 55% of patients having experienced a treatment-related adverse event (TRAE), mostly mild (Grade 1 and 2), though six patients (4.8%) reported a Grade 3 TRAE.
“These updated data continue to reinforce the favorable safety and tolerability profile of detalimogene and its clinical activity in a heavily pretreated, high-risk NMIBC patient population with limited therapeutic options,” enGene’s Cooper stated. “Importantly, the low rate of progression to muscle-invasive disease leaves patients eligible for other bladder-sparing therapies.”
Detalimogene’s favorable safety profile was also acknowledged by Jefferies’ Raycroft: “We continue to view this administrability/safety profile as a core differentiator vs other intravesical gene/immune constructs (and a key adoption lever), even as durability to date is tracking below expectations.”
Odyssey Therapeutics (NASDAQ: ODTX) raised $304 million in gross proceeds through an upsized initial public offering (IPO) by selling 15.5 million shares priced Thursday at $18 a share, the top of its $16–$18 range, and well above the 13.2 million shares it disclosed in its prospectus just before the offering. Concurrently, an affiliate of TPG Life Sciences Innovations purchased 1.39 million shares at the IPO price, raising another $25 million for Odyssey.
But on their first full day of trading on Friday, Odyssey’s shares fell 9%, closing at $16.42, as investors deemed the upsizing to be aggressive.
Odyssey, a developer of targeted therapies for autoimmune and inflammatory diseases, said it would use approximately $135 million in IPO proceeds to advance its lead candidate, the oral small molecule RIPK2 scaffolding inhibitor OD-001, through 12-week induction readouts from its planned Phase IIa combination trial and Phase IIb monotherapy trial in ulcerative colitis.
Plans also call for using approximately $50.0 million of proceeds to advance Odyssey’s oral small molecule SLC15A4 inhibitor OD-002 through IND-enabling activities and a planned Phase I/IIa trial; and the rest for additional discovery, preclinical, and clinical activities for disclosed or future programs, enabling capabilities, as well as general corporate purposes, working capital, and other capital expenditures.
An option to purchase up to an additional 2.325 million shares at the IPO price is held by Odyssey’s IPO underwriters: J.P. Morgan, TD Cowen, and Cantor are joint book-running managers, while Wedbush PacGrow and Oppenheimer are co-lead managers.
The Odyssey IPO is one of four biotech IPOs emerging in recent weeks:
The post StockWatch: enGene Shares Crater on Declines in Complete Response Rates to Bladder Cancer Therapy appeared first on GEN – Genetic Engineering and Biotechnology News.
For decades, physicians and scientists have thought that metformin, a biguanide drug that is prescribed for millions of people worldwide for type 2 diabetes (T2D), mainly targets the liver to suppress glucose production. A Northwestern University-led study in mice has now found that this “wonder drug” instead acts primarily on the gut, and prevents glucose levels from rising in the blood by driving glucose utilization inside cells lining the intestine.
The research found that metformin slows mitochondrial energy production in gut cells by inhibiting mitochondrial complex I in the intestinal epithelium. This then “co-opts” the intestines to function as a glucose sink, forcing the intestine to metabolize extra sugar. The study also found that another biguanide drug, phenformin, and the structurally unrelated supplement berberine, which is known as “nature’s Ozempic,” appear to engage the same pathway in the gut as does metformin.
The preclinical findings could help to explain several gut-related clinical effects in people who take metformin and suggest that modulating mitochondrial metabolism in the gut may represent an effective strategy for controlling blood sugar. “Metformin essentially helps the intestine suck the glucose out of the bloodstream, which further highlights that the gut plays a major role in regulating blood sugar levels,” said corresponding author Navdeep Chandel, PhD, professor of biochemistry and molecular genetics at Northwestern University Feinberg School of Medicine.
Chandel is senior and co-corresponding author of the researchers’ published paper in Nature Metabolism, titled “Metformin inhibits mitochondrial complex I in intestinal epithelium to promote glycaemic control.” Chandel is also the David W. Cugell, MD, Professor of Medicine (Pulmonology and Critical Care), Biochemistry and Molecular Genetics, and an investigator with the Chan Zuckerberg Initiative. The study’s first author is Zach Sebo, PhD, a postdoctoral fellow in the Chandel lab who will soon start his own research group at the University of Kansas School of Medicine.
Metformin is the most widely prescribed medication for type 2 diabetes and the biguanide class drug approved by the FDA, the authors wrote. However, they noted, “Despite its extensive use, the mechanisms underlying its clinical effects, including attenuated postprandial glucose excursions and elevated intestinal glucose uptake, remain unclear.”
The body relies on glucose as a fast and versatile fuel, but too much glucose can lead to insulin resistance and ultimately damage blood vessels and organs. The newly reported study builds on findings from previous work in Chandel’s lab, which found that metformin lowers blood sugar by blocking a specific part of the cell’s energy-making machinery, mitochondrial complex I, a key enzyme in cellular respiration. The research reported in Nature Metabolism extends that work by pinpointing the specific tissue targeted by metformin.
The study used a mouse model genetically engineered to express a yeast enzyme (NDI1) that mimics mitochondrial complex I but is resistant to inhibition by metformin. By expressing NDI1 specifically in intestinal cells, those gut cells resisted metformin’s effects. In these mice, the drug’s ability to lower blood glucose was significantly reduced, demonstrating that inhibition of mitochondrial complex I in the gut is a key driver of its therapeutic action. “In this study, we show how metformin exerts multiple clinical effects through selective inhibition of mitochondrial complex I in the intestinal epithelium,” they wrote.
![Corresponding author Navdeep Chandel in his lab in Chicago. [Kristin Samuelson, Northwestern University]](https://www.genengnews.com/wp-content/uploads/2026/05/Low-Res_Navdeep-Chandel-1-225x300.jpeg)
Metformin is currently the only FDA-approved biguanide drug, but the team found that another biguanide, phenformin, which had previously been used to control blood glucose but was then withdrawn, also lowered blood glucose through the same mechanism. The findings suggest that directing drugs or supplements to the gut could be an effective strategy for controlling blood sugar, Chandel said. Sebo added, “Our study suggests that revisiting assumptions about metformin’s mechanism may offer a more detailed understanding of how it works.”
The study revealed unexpected parallels with berberine, a popular plant-derived OTC supplement that is often used to control blood sugar. Berberine has recently gained attention on social media as “nature’s Ozempic,” though experts caution that evidence is still limited, and it should not be used as a substitute for approved medications. The study by Chanel and colleagues has now found that berberine appears to engage the same pathway as metformin in the intestine. “Thus, we identify mitochondrial complex I in intestinal epithelium as a shared and essential therapeutic target for metformin, phenformin, and berberine,” the authors stated.
“Metformin has decades of clinical evidence behind it, whereas supplements like berberine are far less rigorously tested,” Chandel said. “If you’re going to use berberine, you may as well use the real deal.”
The study results may help to explain clinical observations among people who take metformin. According to Chandel, individuals who take metformin tend to have lower blood sugar after meals, and the study suggests that metformin turns the gut into a “sponge” that soaks up extra sugar. Individuals taking metformin also tend to have lower levels of circulating citrulline, which is made only by mitochondria in small intestine cells. If metformin inhibits mitochondria, citrulline production drops. Taking metformin also increases levels of GDF15, a hormone linked to reduced appetite and weight loss. The gut senses energy stress and sends out GDF15, which tells the brain to eat less and adjust metabolism.
“In addition to enhanced intestinal glucose utilization and blood glucose clearance, this mechanism accounts for metformin-induced citrulline depletion, improved postprandial glycaemia, and elevated lactoyl-phenylalanine (Lac-Phe) and growth differentiation factor 15 (GDF15) levels—all of which are definitive clinical outcomes caused by metformin treatment,” the authors wrote in summary.
“People have always wondered how one drug can do 10 things,” Chandel said. “Well, it can do that if the drug is hitting a big node in a cell, and hitting mitochondria in a cell is a big node. So, if you can get into those cells and inhibit mitochondria, it’s going to have huge effects.”
The post Diabetes Drug Metformin’s Blood Glucose-Lowering Effects Tied to Action on Gut Cells appeared first on GEN – Genetic Engineering and Biotechnology News.
Nature Medicine, Published online: 10 May 2026; doi:10.1038/s41591-026-04406-6
As presented at the 2026 ESC Heart Failure Congress, in a large randomized controlled trial in patients with heart failure with reduced or mildly reduced ejection fraction, treatment with low-dose digoxin was generally safe and well tolerated, but did not significantly reduce the composite endpoint of total worsening heart failure events or cardiovascular mortality.
Nature Medicine, Published online: 10 May 2026; doi:10.1038/s41591-026-04408-4
As presented at the 2026 ESC Heart Failure Congress, in a phase 2 randomized trial in patients with heart failure with reduced left ventricular ejection fraction after myocardial infarction, treatment with CDR132L, an antisense oligonucleotide inhibitor of miR-132, was well tolerated but did not have a significant effect on measures of left ventricular structure or function.
NEW YORK — No quick dispatching of disease investigators. No televised news conference to inform the public. No timely health alerts to doctors.
In the midst of a hantavirus outbreak that involves Americans and is making headlines around the world, the U.S. government’s top public health agency, the Centers for Disease Control and Prevention, has been uncharacteristically missing in action, according to a number of experts.
In the second week of the landmark trial between Elon Musk and OpenAI, Musk’s motivations for bringing the suit were under scrutiny.
Last week, Musk took the stand, alleging that OpenAI CEO Sam Altman and president Greg Brockman had deceived him into donating $38 million to the company. He claimed that they’d promised to maintain it as a nonprofit dedicated to developing AI for the benefit of humanity, only to later accept billions of dollars of investment from Microsoft and restructure the company to operate a for-profit subsidiary.
This week, Brockman fired back with his side of the story, arguing that Musk had actually pushed for OpenAI to create a for-profit arm and fought a bitter battle to have “absolute control” over it. OpenAI has argued that Musk is suing because he didn’t get his way and is now trying to undermine a competitor to his own AI company, xAI.
Shivon Zilis, a former OpenAI board member and the mother of four of Musk’s children, also testified, revealing that Musk tried to recruit OpenAI CEO Sam Altman to lead a new AI lab at his electric-car company, Tesla.
Musk cofounded OpenAI in 2015 with Altman, Brockman, and others but left in 2018. Now, he’s asking the court to remove Altman and Brockman from their roles and to unwind the restructuring OpenAI undertook last year, which converted its for-profit subsidiary into a public benefit corporation. He is also seeking as much as $134 billion in damages from OpenAI and Microsoft, OpenAI’s investor.
The outcome of the trial could upend OpenAI’s race toward an IPO at a valuation approaching $1 trillion. Meanwhile, xAI, which Musk founded in 2023, is now a division of his rocket company, SpaceX; the combined companies are also expected to go public as early as June, at a target valuation of $1.75 trillion.
On Monday, Brockman walked into the courtroom in a blue suit and tie, holding hands with his wife, Anna Brockman. On the stand, he was serene, even chipper, as he recalled OpenAI’s early days. But he grew agitated under impassioned questioning from Elon Musk’s lawyer, Steven Molo. Altman listened in silence, while Anna Brockman sat behind him, fidgeting. Outside the courthouse, protesters rallying against the AI race sang hymns over the voices of lawyers giving press conferences.
Two days before trial began, according to Brockman, Musk messaged him to ask if he would be interested in settling. When Brockman suggested that both sides drop their claims, Musk texted back: “By the end of this week, you and Sam will be the most hated men in America. If you insist, so it will be.”
Last week, Musk testified that he’s suing to save OpenAI’s nonprofit mission to develop AI safely, but he said he was open to seeing OpenAI become a capped-profit company with moderate investments from Microsoft.
This week, Brockman told the jury that Musk was never truly committed to keeping OpenAI a nonprofit. In the summer of 2017, when an AI model that OpenAI built beat the world’s best players in a video game called Dota 2, Musk hosted a gathering at his “Haunted Mansion” near San Francisco. The house was splattered with confetti and cups, Brockman recalled, and the actress Amber Heard, who was Musk’s girlfriend at the time, served whiskey.
“Time to make the next step for OpenAI. This is the triggering event,” Musk wrote in an email—having said weeks earlier that if OpenAI made a major public achievement, it would be “time to create a for-profit,” Brockman told the jury.
Over the next six weeks, Brockman said, Musk and the other cofounders had intense discussions about creating a for-profit entity to raise enough capital to build artificial general intelligence—powerful AI that can compete with humans on most cognitive tasks. Musk wanted to have majority equity in the entity and the right to choose a majority of the board members. He also wanted to be its CEO, said Brockman.
Brockman testified that in August 2017, he and other cofounders gathered to hash out the terms of the for-profit structure. Ilya Sutskever, OpenAI’s chief scientist at the time, arrived bearing a painting of a Tesla as a “token of goodwill” in return for the actual Teslas Musk had given them days earlier. “It felt a little bit like [Musk] was buttering us up, right,that he wanted us to feel indebted to him,” Brockman told the jury.
When Brockman and Sutskever proposed that they all have equal shares of equity, said Brockman, Musk fell silent and finally said, “I decline.” Musk then stood up and “stormed around the table,” he said. “I actually thought he was going to hit me.” Musk grabbed the painting and walked out.
Brockman said that afterwards he struggled to decide whether to continue building OpenAI with Musk or break away. “There was a fork in the road,” he said. “Do we accept Elon’s terms? Or do we reject the terms, he quits to create his own, and then we create our own?”
“The one thing we could not accept was to hand him unilateral, absolute control, potentially, over the AGI,” Brockman told the jury.
In his theatrical baritone, Molo argued that Brockman was motivated by greed rather than a commitment to OpenAI’s nonprofit mission to develop AI that benefits humanity. He noted that while Brockman never invested money in the company, he now owns a stake worth close to $30 billion.
“Solving for the mission has always been my primary motivation,” Brockman said, pushing back on Molo’s characterization of him. “It remains so today.”
Molo pulled up Brockman’s electronic journal on a screen in the courtroom, trying to show the jury what Brockman was really thinking behind the scenes. In 2017, while negotiating with Musk about the future of OpenAI, Brockman wrote about wanting to become a billionaire: “Financially what will take me to $1B?”
“Why didn’t you take the $29 billion and donate it to the nonprofit that you had a fiduciary duty to, for the good of humanity?” Molo asked Brockman, raising his voice to dramatize moral indignation.
Molo then pulled up a journal entry Brockman had written in November 2017, while he was torn over whether to turn OpenAI into a for-profit without Musk: “it’d be wrong to steal the nonprofit from him. to convert to a b-corp without him. that’d be pretty morally bankrupt.” Brockman and Musk had previously considered creating a b-corp, which is a for-profit company that pursues a social mission.
Brockman explained, “I meant it would actually serve the mission, but it’d be hard to look at yourself in the mirror.”
Molo also tried to undermine Brockman’s credibility by revealing that he holds a stake in multiple companies with business ties to OpenAI, including the AI company Cerebras, the cloud provider CoreWeave, and the nuclear fusion startup Helion Energy. Altman has tried to steer OpenAI into deals with companies that he invests in, including Helion and the rocket maker Stoke Space, drawing scrutiny over potential conflicts of interest.
Former OpenAI chief technology officer Mira Murati and former OpenAI board member Helen Toner both appeared in video depositions. They addressed the brief firing of Altman in 2023, saying that they could not trust him because of his alleged history of lying. Murati’s text messages with Altman from that time, which were introduced as evidence, revealed his desperate attempts to understand what was happening and regain control.
After Brockman’s two days of testimony, Shivon Zilis, who left OpenAI’s board in 2023, took the stand in a black jacket and black jeans, appearing composed but with a flicker of nerves. OpenAI’s lawyer Sarah Eddy asked her in a deceptively soothing voice whether she acted as a conduit for Musk as he tried to poach OpenAI’s cofounders to work at a new AI lab within Tesla. Eddy argued that Musk is suing OpenAI only to undermine a competitor in the AI race.
Zilis said she met Musk while working at OpenAI as an informal advisor in 2016, and that they had a “one-off” romantic encounter. In 2017, she joined Tesla and Musk’s brain-implant company, Neuralink. In 2020, she joined OpenAI’s board of directors. She became pregnant with Musk’s children through IVF but did not disclose her ties with Musk to OpenAI until Business Insider reported them in 2022.
By late 2017, Musk had concluded that OpenAI was unlikely to build AGI and pivoted to building an AI lab at Tesla, according to an email sent to Zilis.
Eddy pulled up a draft of an FAQ document that Zilis emailed a colleague at Tesla in 2017 about an event the company was organizing at the NeurIPS AI conference: “The purpose of this event is to share that Tesla is building a world leading AI lab(?) which will rival the likes of Google/DeepMind and Facebook AI Research.”
Zilis told the jury that when Musk was still on OpenAI’s board, he tried to recruit Altman to lead that prospective AI lab. Musk had asked Andrej Karpathy, an OpenAI research scientist he’d recruited to work at Tesla, “to send a list of top OpenAI people to poach,” according to a text message by Zilis.
“There is little chance of OpenAI being a serious force if I focus on TeslaAI,” Musk texted Zilis in 2018, just before he left OpenAI. Tesla’s AI lab never came to fruition.
Eddy pressed Zilis about whom she was loyal to when she was working for OpenAI and Musk at the same time. “I had an allegiance to the best outcome for AI for humanity,” Zilis told the jury.
Next week, Ilya Sutskever will testify, as will Microsoft CEO Satya Nadella. The lawyers for both Musk and OpenAI will deliver their closing arguments. The jury will begin deliberating the week after and deliver an advisory verdict guiding the judge to decide the case.
This story is part of MIT Technology Review’s ongoing coverage of the Musk v. Altman trial. Follow @techreview or @michelletomkim on X for up-to-the-minute reporting.
Below is a lightly edited, AI-generated transcript of the “First Opinion Podcast” interview with Will Flanary, aka Dr. Glaucomflecken. Be sure to sign up for the weekly “First Opinion Podcast” on Apple Podcasts, Spotify, or wherever you get your podcasts. Get alerts about each new episode by signing up for the “First Opinion Podcast” newsletter. And don’t forget to sign up for the First Opinion newsletter, delivered every Sunday.
Torie Bosch: Will Flanary is better known as Dr. Glaucomflecken. He is social media’s most famous comedian slash doctor, and he’s not afraid of punching up.
During one of health secretary Robert F. Kennedy Jr.’s recent appearances on Capitol Hill, Rep. Adelita Grijalva (D-Ariz.) brought up an unusual allegation: that in 2001, he collected a dead raccoon’s penis. The incident was first described in the new book “RFK Jr.: The Fall and Rise” by Isabel Vincent, which quotes from a journal of Kennedy’s: “I was standing in front of my parked car on I-684 cutting the penis out of a road killed raccoon, thinking about how weird some of my family members have turned out to be.” According to Vincent, Kennedy cut off the penis “to study [it] later.”
While Kennedy did not respond to Grijalva about the raccoon incident, focusing instead on the National Institutes of Health budget and DEI, it has been widely treated as sensational news. But the jokes about it obscure an important question: whether his described actions meet fundamental standards of bioethical judgment.
We read with great interest the recent article by Shin et al. (1). The authors leveraged the substantial Australian Genetics of Depression Study (AGDS) cohort to provide compelling evidence for the clinical and biological validity of the atypical depression subtype. Their integrative analysis of clinical features, polygenic scores (PGSs) for mental, metabolic, and circadian traits, and self-reported treatment outcomes is a significant contribution to the field. The particularly robust finding of an association between a genetic predisposition for eveningness (lower-chronotype PGS) and atypical depression, which persisted after adjustment for body mass index (BMI), is noteworthy and points to a potentially core, BMI-independent pathway.