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Dermatology Journal Club proslijedio/la je Tweet
@DrStevenTChen is at@ucsf giving a comprehensive and accessible grand rounds on ICI induced cutaneous AE’s. Managed to put in a plug for@DermatologyJC along the way!pic.twitter.com/zWUsBcOR7U
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Dermatology Journal Club proslijedio/la je Tweet
However, even relatively short (for dermatologists) durations of antibiotics can result in notable changes to microbiome. I often think treating fewer patients may be more important to using shorter courses.
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Dermatology Journal Club proslijedio/la je Tweet
Another interesting step towards understanding the interplay b/t microbiome and immune recognition/cancer control. Needs much more investigation but will give me pause when gearing up for ICI Rx for my pts.
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Dermatology Journal Club proslijedio/la je Tweet
We know from inpatient data that a single day of antibiotics (anti-pseudomonals in particular) have an impact on the potential for abx resistance, hard not to imagine similarly fast impact on microbiome.
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Dermatology Journal Club proslijedio/la je Tweet
My take away - Using abx is very different than abx for inflammatory conditions (like we use in
#dermatology). We can definitely find other options (hopefully non-immunosuppressive ones) in derm for non-infectious issues.#dermjcHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Dermatology Journal Club proslijedio/la je Tweet
Also every practice that treats patients with immunotherapy should have a multidisciplinary team of specialist - ID, derm, endo, GI , cardio etc dedicated to the myriad of IO toxicity - clinical and research
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Dermatology Journal Club proslijedio/la je Tweet
Thanks for the interesting discussion and new colleagues!
#dermjc#hojournalclubhttps://twitter.com/DermatologyJC/status/1217641370241785857 …Hvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Also thank you to
@HOJournalClub for coordinating with us and for everyone’s participation!! Feel free to keep discussing!#dermjcHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Dermatology Journal Club proslijedio/la je Tweet
Outpatient duration of abx is a very difficult frontier for antimicrobial stewardship programs to tap into. Wonder if some of the presumed modulation could be minimized with shorter durations.
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Q4: Final thoughts? Lingering questions?
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Dermatology Journal Club proslijedio/la je Tweet
Agreed ! A clinically relevant ? would be if manipulation of the intestinal microbiome could turn nonresponsive tumors (immune checkpoint blockade) into responder
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Dermatology Journal Club proslijedio/la je Tweet
https://www.ncbi.nlm.nih.gov/m/pubmed/29302014/ … prospective studies are coming to study bifidobacterium longhum in this context
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Dermatology Journal Club proslijedio/la je Tweet
Taking this one step further--is the effect same in cancers involving different microbiomes? Bladder? Colon?
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Dermatology Journal Club proslijedio/la je Tweet
Yes, I think the implications for future microbiome research are a major takeaway from this study
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Dermatology Journal Club proslijedio/la je Tweet
The other concept I’m trying to wrap my head around and maybe plausible is “inflammation”- it has been reported that older patients respond well due to the concept of immunesenescene, maybe antibiotics reduce this inflammation and hence downregulate IO action
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Dermatology Journal Club proslijedio/la je Tweet
A3 At the least I would like to see more controlling for confounders. An RCT isn't really an option for this case, but perhaps a prospective cohort study might be?
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Dermatology Journal Club proslijedio/la je Tweet
Interesting perspective. I would say most of the ICI use is currently in malignancies that track in older populations. But they're moving into so many settings that this will likely shift more over time.
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Dermatology Journal Club proslijedio/la je Tweet
https://www.ncbi.nlm.nih.gov/m/pubmed/29097494/ … would like to see more robust prospective gut Microbiome research on patients being treated with ICI
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Dermatology Journal Club proslijedio/la je Tweet
A2 Just a signal of association,Not evidence for causation (yet)Several patients with
#lcsm have concomitant COPD ( on chronic abx) but respond to ICI. Does open opportunities for more Microbiome research and antibiotic stewardship#dermjc#hojournalclubHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi
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