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Ruxolitinib Cream As-Needed Monotherapy Demonstrates Sustained Disease and Symptom Control in Patients with Mild to Moderate Atopic Dermatitis: Pooled Analysis from Two Phase 3 Studies
(Springer, 2026) Blauvelt, Andrew; Kircik, Leon; Simpson, Eric L.; Lio, Peter; Eichenfield, Lawrence F.; Prajapati, Vimal H.; Grewal, Parbeer; Lynde, Charles; Hong, H. Chih-Ho; Sturm, Daniel; Kallender, Howard; Ren, Haobo; Paranagama, Dilan; Wong, Grace K. W.; Geng, Bob; Dermatology, School of Medicine
Introduction: Long-term disease and symptom control is a goal of atopic dermatitis (AD) therapy. This study assessed the long-term maintenance of disease and symptom control with as-needed application of ruxolitinib cream.
Methods: Patients aged ≥ 12 years with AD, an Investigator's Global Assessment (IGA) score of 2/3, and 3-20% affected body surface area were included in the phase 3 TRuE-AD1 and TRuE-AD2 studies. This analysis included patients randomized to twice-daily (BID) 1.5% ruxolitinib cream for 8 weeks and then as-needed (IGA ≥ 1) BID for up to 44 weeks (long-term safety [LTS] period).
Results: Among patients evaluated for disease control in the as-needed period (N = 428), IGA 0/1 (skin/almost clear skin) was achieved by 67.1% of patients at week 8. From week 8, 80-90% of patients with IGA 0/1 at a given visit maintained or improved their response at the next visit. Median time to worsening disease (IGA ≥ 2) was 36.1 weeks during the as-needed period, and IGA 0/1 was quickly recaptured. Patients spent a median 43.9% of the as-needed period off treatment due to lesion clearance. No itch/no sleep disturbance (Patient-Oriented Eczema Measure questions 1 and 2) was reported in 32.7%/71.8% of patients at week 8 and 36.2%/74.5% of patients at week 52. No new safety concerns emerged in the LTS period.
Conclusion: Continued disease and symptom control with substantial time off treatment makes 1.5% ruxolitinib cream an effective long-term option for patients with mild to moderate AD.
Prevention and Management of Infectious Complications in Pediatric Patients With Cancer: A Survey Assessment of Current Practices Across Children's Oncology Group Institutions
(Wiley, 2025) Slatnick, Leonora R.; Hoogstra, David; Fisher, Brian T.; Wolf, Joshua; Orgel, Etan; Nessle, C. Nathan; Patel, Pratik A.; Miller, Tamara P.; Wilkes, Jennifer; Dupuis, L. Lee; Goode, Erin; Jackson, Kasey; Willis, Daniel N.; Elgarten, Caitlin; Aftandilian, Catherine; Thompson, Joel; Alexander, Sarah; Beauchemin, Melissa P.; Belsky, Jennifer A.; Hess, Jennifer; Prudowsky, Zachary D.; Guinipero, Terri; Rossoff, Jenna; Demedis, Jenna; Walsh, Alexandra M.; Richards, Rebecca; Choi, Daniel K.; Dvorak, Christopher C.; Esbenshade, Adam J.; Pediatrics, School of Medicine
Introduction: While clinical practice guidelines (CPGs) for pediatric oncology infection prophylaxis and management exist, few data describe actual management occurring at pediatric oncology centers.
Methods: An electronic survey querying infection management practices in nontransplant pediatric oncology patients was iteratively created by the Children's Oncology Group (COG) Cancer Control and Supportive Care Infectious Diseases Subcommittee and sent to leaders at all COG institutions, limiting each site to one response to represent their institution.
Results: The response rate was 57% (129/227 institutions). Many sites reported utilizing COG-endorsed CPGs for antibacterial (76%) and antifungal prophylaxis (74%), and fever and neutropenia (FN, 64%). Most institutions reported using antimicrobial prophylaxis for patients with acute myeloid leukemia (88% antibacterial, 100% antifungal) and relapsed acute lymphoblastic leukemia (82% antibacterial, 95% antifungal). Definitions of fever, phagocyte recovery, and antibiotic duration in febrile patients varied. Most institutions administer empiric broad-spectrum antibiotics for nonneutropenic fever, although 14% reported withholding antibiotics based on initial clinical status or risk stratification tools. Most respondents reported (70%) admitting FN patients for at least 48 h, however 15% have low-risk FN protocols allowing outpatient management. FN patients remain admitted on antibiotics through count recovery in 50% of institutions, whereas the others employed various early discharge/early antibiotic discontinuation strategies.
Conclusions: There is often consistency but also substantial variability in reported antimicrobial prophylaxis strategies and management of patients with fever and represents an opportunity for implementation studies to standardize application of CPG recommendations and randomized trials to advance evidence where knowledge gaps exist.
Thymic epithelial tumors at the crossroads of immunity, autoimmunity, and immunotherapy
(Springer, 2026-03-17) Canaslan, Kübra; Moeini Nia, Fatemeh; Baez, Maria; Abolhassani, Hassan; Ridge, Natalie; Zerdan, Maroun Bou; Marks, Jennifer; Rangoonwala, Hussain; Jahanbin, Behnaz; Emami, Amir Hossein; O'Reilly, Katie; Gökmen-Polar, Yesim; Badve, Sunil S.; Xu, Chunwei; Hao, Yue; Sharma, Aparna; Upadhya, Swasthik; Salle, Francoise Galateau; Pan, Kelsey; El Olsta, Badi; Shin, Dong M.; Ardeshir-Larijani, Fatemeh; Medicine, School of Medicine
Thymic epithelial tumors (TETs) sit at a unique intersection of cancer, central tolerance, and autoimmunity. These tumors arise in the thymus, an immune-rich organ responsible for T-cell education, and despite their low tumor mutational burden (TMB) and microsatellite stability, they display paradoxical behavior under immune checkpoint inhibition. This review synthesizes data on thymic biology, paraneoplastic autoimmunity, molecular profiling, and clinical trials of immune checkpoint inhibitors (ICIs) in thymoma and thymic carcinoma. We describe how disruption of autoimmune regulator (AIRE)/Fez family zinc finger 2 (FEZF2)-driven tissue-restricted antigen expression and impaired regulatory T-cell generation collectively permit the escape of autoreactive T cells and foster classic paraneoplastic syndromes such as myasthenia gravis, pure red cell aplasia, and Good syndrome. We then link these baseline defects to the high frequency and severity of immune-related adverse events observed in TET patients treated with ICIs, despite only modest response rates. Emerging "harm axis" biomarkers, including autoantibody profiles and composite T- and B-cell perturbations, may help stratify risk and guide treatment selection. Finally, we review rational therapeutic strategies such as vascular endothelial growth factor-tyrosine kinase inhibitors-ICI combinations, radiotherapy-ICI approaches, perioperative immunotherapy, and emphasize the need for biomarker-enriched trial design. TETs provide a powerful model to understand how failure of central tolerance can simultaneously sensitize tumors to immune attack and prime patients for catastrophic toxicity, with implications that extend to other low-TMB, immune-infiltrated malignancies.
Advances in male sex separation for the support of mosquito control programs
(Frontiers Media, 2026-03-10) Duman-Scheel, Molly; Medical and Molecular Genetics, School of Medicine
Several mosquito control technologies, including the sterile insect technique (SIT), the incompatible insect technique (IIT), and a variety of genetic technologies are emerging as promising solutions for combatting insecticide resistance and the spread of vector-borne diseases. These approaches involve mass releases of male mosquitoes in an effort to suppress mosquito populations in an eco-friendly manner. At small scale, male mosquito selection can be achieved through the use of mechanical separation techniques, but such methods are not sufficient for scaled implementation of emerging mosquito population control technologies. This review discusses mechanical, genetic, and automated mosquito sex sorting techniques that have emerged to address the need for scaled male mosquito production, as well as the potential contributions of RNA interference (RNAi) to facilitate this process. One RNAi method utilizes the oral delivery of yeast expressing interfering RNA targeting genes required for female larval survival. The yeast, which can be incorporated into normal insect larval diets, enables male sex selection during larval rearing in mosquitoes and could easily be extended to other insects. RNAi-mediated sex-sorting technologies, in combination with mechanical, genetic, and automated sorting technologies, could facilitate the scaled production of adult males in support of global insect population suppression efforts.
Do we agree on seizure reduction after vagus nerve stimulation? Interrater reliability of retrospective and prospective seizure frequency ratings from the CONNECTiVOS database
(Wiley, 2026) Dinger, Thiemo F.; Mithani, Karim; Al-Hasan, Hosni Abu; Yefet, Leeor; Niazi, Farbod; Suresh, Hrishikesh; Wong, Simeon M.; Danthine, Venethia; Berger, Alexandre; Yau, Ivanna; McRae, Lyndsey; Rutka, James T.; Christian, Eisha A.; Weiss, Shelly; Sham, Lauren; Donner, Elizabeth; Chau, Vann; Al-Johani, Hanan; Lima, Flavio Leao; Chandran, Arjun; Jabbarli, Ramazan; Sure, Ulrich; Hadjinicolaou, Aristides; Major, Philippe; Weil, Alexander G.; Tailor, Jignesh; Abel, Taylor J.; Remick, Madison; Akwayena, Emefa; Schrader, Dewi; Bollo, Robert J.; Smyth, Matthew D.; Aum, Diane; Lew, Sean; Wang, Shelly; Niazi, Toba; Raskin, Jeffrey S.; Widjaja, Elysa; Weiner, Howard L.; Gadgil, Nisha; LoPresti, Melissa A.; Fallah, Aria; Kerr, Elizabeth; Jain, Puneet; Ibrahim, George M.; Neurological Surgery, School of Medicine
Objective: Although vagus nerve stimulation (VNS) is a well-established neuromodulation therapy for drug-resistant epilepsy, treatment outcomes remain heterogeneous. One possible source of variability lies in differing interpretations of seizure frequency ratings (SFRs). This study examined interrater reliability (IRR) in SFRs between (1) retrospective clinician-clinician chart reviews and (2) prospective caregiver-clinician reports, and explored sources of disagreement.
Methods: Data were collected from the CONNECTiVOS database. In the retrospective cohort (n = 254), two clinicians independently reviewed medical records and rated seizure frequency across multiple timepoints. In the prospective cohort (n = 214), caregivers and clinicians independently reported SFR in children treated with VNS. IRR was assessed across different measurement thresholds, and potential causes of disagreement were analyzed.
Results: Clinician-clinician agreement in retrospective chart reviews was excellent (intraclass correlation coefficient [ICC] > .90, Cohen κ > .80), with 18.8% divergent ratings and 4.8% exceeding the reliable change index. Disagreement was significantly associated with higher mean seizure frequency at baseline (p = .004) and at postoperative timepoints (p < .001). In the prospective caregiver-clinician comparison, agreement for absolute seizure frequency was poor (ICC < .50), with discrepancies in 86.5% of cases, although only 1.8% were statistically significant. When rating pairs diverged, clinicians more often reported lower absolute seizure frequencies (p = .002) and greater relative seizure reductions (p = .023) and were more likely to classify patients as achieving a 90% reduction (p = .043).
Significance: This study highlights interrater variability in both retrospective and prospective SFR assessments, a finding systematically related to baseline seizure frequency. Coarser classifications (e.g., 50% or 90% seizure reduction) may improve agreement but reduce clinical nuance. Future efforts should focus on structured, patient-centered documentation and the development of objective outcome measures in VNS evaluation, particularly for children with high seizure burden.