Citations

AbstractBackgroundUniversal skin cancer screening for the Latino population is impractical.ObjectivesWe focused on melanoma education by conducting an online education campaign and collected baseline, postintervention, and 3‐month follow‐up surveys to assess sun‐protective behaviors.MethodsParticipants were recruited through (1) social media ads and (2) emails sent to Mayo Clinic Latino patients.ResultsTotal social media impressions were 508,442 and 413,007 in Spanish and English, respectively. There were 18,790 and 11,731 clicks for the Spanish and English ads, respectively, resulting in 175 baseline survey responses. From email distribution, 4151 emails translated to 219 baseline participants. Of the 394 patients who participated in the baseline survey, 89 completed the postintervention survey, and 57 completed the 3‐month follow‐up survey (28 from social media and 29 Mayo Clinic patients). Social media provides a unique opportunity for the medical community to promote melanoma education, distribute content quickly, and provide medical education in disparate healthcare areas. Our Spanish ad click‐through rate was 3.70% compared to 2.84% for English. The click‐to‐action rate was 0.57%, and the baseline‐to‐completion rate was 16.00%.ConclusionsOur study suggests social media could be a unique tool for distributing melanoma educational materials to Latino populations. The click‐through rates for this study were several‐fold higher than other studies' reported click‐through rates (0.4%–0.93%). It is important to develop melanoma educational materials that are culturally relevant and focused on Latino populations that can provide persistent improvements in mitigating melanoma risk behaviors such as sunscreen application and self‐skin examinations.

Chronic myeloid leukemia (CML) is defined by the presence of Philadelphia chromosome resulting from a reciprocal translocation between chromosomes 9 and 22 [t9;22] that gives rise to a BCR::ABL1 fusion gene. CML occurs in 3 different phases (chronic, accelerated, and blast phase) and is usually diagnosed in the chronic phase in developed countries. Tyrosine kinase inhibitor (TKI) therapy is a highly effective treatment option for patients with chronic phase–CML. The primary goal of TKI therapy in patients with chronic phase–CML is to prevent disease progression to accelerated phase–CML or blast phase–CML. Discontinuation of TKI therapy with careful monitoring is feasible in selected patients. This manuscript discusses the recommendations outlined in the NCCN Guidelines for the diagnosis and management of patients with chronic phase–CML.

TPS587 Background: Biliary tract cancer (BTC) is characterized by generally poor prognoses with limited treatment options. Systemic chemotherapy usually begins with gemcitabine, platinum agents, and a checkpoint inhibitor followed by 5-FU and oxaliplatin, irinotecan or a taxane. Presently, there is no consensus second-line therapy for patients with BTC. The DLL/Notch signaling pathway has been described to be a major driver of cholangiocarcinogenesis and VEGF-A overexpression has been reported in BTC tumors, correlating with stage, metastasis, and prognosis of the disease. CTX-009 is a recombinant bispecific antibody that binds both delta-like ligand-4 (DLL4) and vascular endothelial growth factor A (VEGF-A). The antibody simultaneously inhibits the DLL4-Notch 1 and VEGF A-VEGF receptor signaling pathways. Methods: COMPANION-002 (CTX-009 -002) is an open-label, randomized, controlled study in patients in second line advanced or metastatic BTC. To be eligible, patients must have radiologically documented progression after a prior gemcitabine and platinum containing chemotherapy regimen as first line therapy for locally advanced unresectable or metastatic disease. 150 patients will be randomized in a 2:1 ratio to receive either CTX-009 plus paclitaxel or paclitaxel alone. The stratification factors to be used at randomization include stage (locally advanced vs. metastatic), anatomic subsite of primary tumor (intrahepatic cholangiocarcinoma vs. other, i.e. extrahepatic cholangiocarcinoma, gallbladder, or ampullary), and Eastern Cooperative Oncology Group (ECOG) Performance status (0 vs. 1). Patients will be treated in 28-day cycles, with CTX-009 administered at 10 mg/kg IV on Day 1 and 15, and paclitaxel administered at 80 mg/m2 on days 1, 8, and 15. The patients randomized to paclitaxel arm can crossover after disease progression if selection criteria continue to be met. The primary objective of the study is to assess the efficacy of CTX-009 in combination with paclitaxel vs. paclitaxel alone, as measured by Overall Response Rate (ORR) assessed by an Independent Central Radiology (ICR) review. Key secondary objectives include overall survival, progression-free survival, and duration of response. Clinical trial information: 251040.

AbstractBackgroundDiagnosing gastroesophageal reflux disease (GERD) can be challenging given varying symptom presentations, and complex multifactorial pathophysiology. The gold standard for GERD diagnosis is esophageal acid exposure time (AET) measured by pH‐metry. A variety of additional diagnostic tools are available. The goal of this consensus was to assess the individual merits of GERD diagnostic tools based on current evidence, and provide consensus recommendations following discussion and voting by experts.MethodsThis consensus was developed by 15 experts from nine countries, based on a systematic search of the literature, using GRADE (grading of recommendations, assessment, development and evaluation) methodology to assess the quality and strength of the evidence, and provide recommendations regarding the diagnostic utility of different GERD diagnosis tools, using AET as the reference standard.Key ResultsA proton pump inhibitor (PPI) trial is appropriate for patients with heartburn and no alarm symptoms, but nor for patients with regurgitation, chest pain, or extraesophageal presentations. Severe erosive esophagitis and abnormal reflux monitoring off PPI are clearly indicative of GERD. Esophagram, esophageal biopsies, laryngoscopy, and pharyngeal pH monitoring are not recommended to diagnose GERD. Patients with PPI‐refractory symptoms and normal endoscopy require reflux monitoring by pH or pH‐impedance to confirm or exclude GERD, and identify treatment failure mechanisms. GERD confounders need to be considered in some patients, pH‐impedance can identify supragrastric belching, impedance‐manometry can diagnose rumination.ConclusionsErosive esophagitis on endoscopy and abnormal pH or pH‐impedance monitoring are the most appropriate methods to establish a diagnosis of GERD. Other tools may add useful complementary information.

This case report describes a conjunctival biopsy of a patient with mpox infection.

Abstract Mpox, caused by infection with Monkeypox virus, usually presents as a mild, self-limited illness in immunocompetent persons that resolves within 2–4 weeks. Serious complications have been reported when mpox lesions involve vulnerable anatomic sites, such as the eye, and in those with substantial immunosuppression. We describe a patient with advanced human immunodeficiency virus infection and sustained viral shedding of mpox with ocular involvement, which resulted in vision loss.