Immune checkpoint inhibitors (ICIs) have dramatically changed the treatment landscape for advanced melanoma, but their use in older patients remains understudied. An age-related decline in immune function is of concern when treating older patients because host immune factors can influence clinical outcomes with immunotherapy. Therefore, we aimed to evaluate the effectiveness of ICIs in patients 65years and older.

Using the SEER-Medicare data, we evaluated survival by first systemic treatment type in a retrospective cohort study of patients aged 65years and older who were diagnosed with stage IV cutaneous melanoma between 2012 and 2015. Cox proportional hazards regression was used to estimate hazard ratios (HR) and their corresponding 95% confidence intervals.

A total of 541 patients were included in this study. Median survival differed significantly between groups (p<0.0001) and was longest in patients treated with PD-1 inhibitors (34.0months), followed by CTLA-4 inhibitors (16.8months), targeted therapy (9.7months), chemotherapy (7.1months), and no systemic therapy (3.6months). The ICI survival benefit persisted after adjusting for age, sex, comorbidities, M stage, the presence of brain metastases, and evaluation at an NCI-designated cancer center. Hazard ratios comparing ICIs to no systemic therapy were 0.35 (95% CI 0.24-0.52) for PD-1 inhibitors and 0.48 (95% CI 0.37-0.63) for CTLA-4 inhibitors. We did not observe a difference in ICI effectiveness by age group (65-74 vs ≥75).

In a nationally representative cohort of patients with advanced melanoma, ICI therapy delivered in a real world setting significantly improved survival in patients aged 65years and older.

In a nationally representative cohort of patients with advanced melanoma, ICI therapy delivered in a real world setting significantly improved survival in patients aged 65 years and older.

Black Americans are at increased risk of chronic pancreatitis (CP) compared to their White counterparts. We aimed to describe the race-specific smoking history and lifetime drinking in patients diagnosed with CP.

We analyzed data on 334 Black and White CP participants of the North American Pancreatitis Study 2 Continuation and Validation Study and Ancillary Study. Lifetime drinking history and lifetime smoking history were collected through in-person interviews. Intensity, frequency, duration and current status of drinking and smoking were compared between Black and White CP participants, stratified by physician-defined alcohol etiology. In addition, drinking levels at each successive decades in life (20s, 30s, 40s) were compared by race and graphically portrayed as heat diagrams.

Among patients with alcoholic CP, current smoking levels were not different by race (67-70%), but a smaller proportion of Black patients reported having smoked 1 or more packs per day in the past (32%) as compared to White patients (58%, p<0.0001). Black patients were more likely to report current consumption of alcohol (31%), as opposed to White patients (17%, p=0.016). Black patients also reported more intense drinking at age 35 and 45 years as compared to White patients, while age at CP onset were similar between the two groups.

We found more intense drinking but less intense smoking history in Black CP patients as compared to White CP patients. Effective alcohol abstinence and smoking cessation program with sustained impact are needed in CP patients.

We found more intense drinking but less intense smoking history in Black CP patients as compared to White CP patients. Effective alcohol abstinence and smoking cessation program with sustained impact are needed in CP patients.

There has been renewed interest in HBV-associated ICC, because it could share a common carcinogenesis disease process with HCC. We investigated whether there is a difference in clinical outcome between ICC patients with HBV infection and those without any major risk factors for HCC.

A total of 253 curatively resected, surgically diagnosed ICC patientswere analyzed and divided into two groups according to the presence or absence of major risk factors for HCC an HBV group (n=45) and a non-HCC-risk (NHR) group (n=208).

Lymph node metastasis was more frequently observed in the NHR group (HBV vs. NHR 8.89% vs. 24.52%, P= 0.027). Patients in the HBV group demonstrated more favorable survival than those in the NHR group. However, this difference was not statistically significant (5-year survival rate, 54.7% vs. 42.3%, P= 0.128). Cumulative recurrence rate in the HBV group was 62.2%, which was not significantly different from 63.0% in the NHR group (P= 1.000).

This study found that while ICC patients with HBV infection showed some favorable tumor characteristics, patients’ stage-specific survival and recurrence rates were not significantly different compared to those without any major risk factors for HCC.

This study found that while ICC patients with HBV infection showed some favorable tumor characteristics, patients’ stage-specific survival and recurrence rates were not significantly different compared to those without any major risk factors for HCC.Cystoisospora belli infection is regarded as an indicator disease of AIDS in Japan; however, only a few case reports showing this association are present. Our case study involved a 49-year-old Thai woman living in Japan since her marriage to a Japanese man. Methotrexate concentration She was repeatedly hospitalized owing to persistent diarrhea. Considering her native country, she was suggested of having AIDS. Serological examination for HIV-1 tested positive, and C. belli infection was diagnosed on detection of oocysts in her stool samples. She was treated successfully for the parasitic infection with oral trimethoprim-sulphamethoxazole therapy for 10 days. No AIDS-associated opportunistic infections other than cystoisosporiasis were detected. Thus, this study suggests that an immunocompromised individual with persistent and recurrent diarrhea should be examined to confirm for C. belli infection. Moreover, it is possible that a person in a high-latitude region will develop a parasitic infection common in tropical areas because of globalization.