Dermatology Journal Club

@DermatologyJC

1st Twitter dermatology journal club | Meets on 9PM EST 3rd Wed of the month | tweeting as

Vrijeme pridruživanja: travanj 2018.

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  1. Prikvačeni tweet
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  2. proslijedio/la je Tweet
    22. sij

    is at giving a comprehensive and accessible grand rounds on ICI induced cutaneous AE’s. Managed to put in a plug for along the way!

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  3. proslijedio/la je Tweet
    16. sij
    Odgovor korisnicima

    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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  4. proslijedio/la je Tweet
    16. sij
    Odgovor korisniku/ci

    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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  5. proslijedio/la je Tweet
    Odgovor korisnicima

    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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  6. proslijedio/la je Tweet
    16. sij
    Odgovor korisniku/ci

    My take away - Using abx is very different than abx for inflammatory conditions (like we use in ). We can definitely find other options (hopefully non-immunosuppressive ones) in derm for non-infectious issues.

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  7. proslijedio/la je Tweet
    16. sij

    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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  8. proslijedio/la je Tweet
    16. sij

    Thanks for the interesting discussion and new colleagues!

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  9. 16. sij

    Also thank you to for coordinating with us and for everyone’s participation!! Feel free to keep discussing!

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  10. proslijedio/la je Tweet
    Odgovor korisnicima

    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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  11. 16. sij

    Q4: Final thoughts? Lingering questions?

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  12. proslijedio/la je Tweet
    16. sij
    Odgovor korisnicima i sljedećem broju korisnika:

    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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  13. proslijedio/la je Tweet
    16. sij
    Odgovor korisnicima i sljedećem broju korisnika:

    prospective studies are coming to study bifidobacterium longhum in this context

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  14. proslijedio/la je Tweet
    16. sij
    Odgovor korisnicima i sljedećem broju korisnika:

    Taking this one step further--is the effect same in cancers involving different microbiomes? Bladder? Colon?

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  15. proslijedio/la je Tweet
    16. sij
    Odgovor korisnicima

    Yes, I think the implications for future microbiome research are a major takeaway from this study

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  16. proslijedio/la je Tweet
    16. sij
    Odgovor korisnicima i sljedećem broju korisnika:

    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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  17. proslijedio/la je Tweet
    16. sij

    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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  18. proslijedio/la je Tweet
    16. sij
    Odgovor korisnicima

    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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  19. proslijedio/la je Tweet
    16. sij
    Odgovor korisnicima

    would like to see more robust prospective gut Microbiome research on patients being treated with ICI

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  20. 16. sij
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  21. proslijedio/la je Tweet
    16. sij
    Odgovor korisniku/ci

    A2 Just a signal of association,Not evidence for causation (yet)Several patients with have concomitant COPD ( on chronic abx) but respond to ICI. Does open opportunities for more Microbiome research and antibiotic stewardship

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