Purpose-The clinical utility of plasma cell-free DNA (cfDNA) has not been assessed prospectively in patients with glioblastoma (GBM). We aimed to determine the prognostic impact

Alopecia areata (AA) is a clinically heterogeneous disease that is characterized by nonscarring hair loss, nail changes, and increased risk of other autoimmune disease. During clinical visits, children with AA often report bullying. We report survey results that highlight the prevalence of bullying and surrounding emotional impact of AA in pediatric patients. We found that bullying was common overall and additional psychological impact, including impairment of social and home life, was even more common. Children of all ages experienced bullying. Boys reported increased physical bullying. Interestingly, those with more severe disease and longer duration of disease experienced less bullying than those with less severe disease.

Purpose: To determine whether a multi-analyte liquid biopsy can improve the detection and staging of pancreatic adenocarcinoma (PDAC).

Purpose: The role of plasma-based tumor mutation burden (pTMB) in predicting response to pembrolizumab-based first-line standard of care therapy for metastatic non-small cell lung cancer (mNSCLC) has not been explored. Experimental Design: A 500-gene next-generation sequencing (NGS) panel was used to assess pTMB. Sixty-six patients with newly diagnosed mNSCLC starting first-line pembrolizumab-based therapy, either alone or in combination with chemotherapy, were enrolled (Clinicaltrial.gov identifier: NCT03047616). Response was assessed using RECIST 1.1. Associations were made for patient characteristics, 6-month durable clinical benefit (DCB), progression free survival (PFS), and overall survival (OS).Results: Of 66 patients, 52 (78.8%) were pTMB-evaluable. Median pTMB was 16.8 mutations per megabase (mut/Mb; range 1.9-52.5) and was significantly higher for patients achieving DCB compared to no durable benefit: 21.3 mut/Mb vs. 12.4 mut/Mb, P=0.003. For patients with pTMB >16 mut/Mb, median PFS was 14.1 vs. 4.7 months for patients with pTMB<16 mut/Mb (HR 0.30 [0.16-0.60]) P<0.001. Median OS for patients with pTMB>16 was not reached vs. 8.8 months for patients with pTMB<16 mut/Mb (HR 0.48 [0.22-1.03]) P=0.061. Mutations in ERBB2 exon 20, STK11, KEAP1, or PTEN were more common in patients with no DCB. A combination of pTMB>16 and absence of negative predictor mutations was associated with PFS (HR 0.24 [0.11-0.49]) P<0.001 and OS (HR 0.31 [0.13-0.74]) P=0.009. Conclusions: pTMB>16 mut/Mb is associated with improved PFS after first-line standard of care pembrolizumab-based therapy in mNSCLC. STK11/KEAP1/PTEN and ERBB2 mutations may help identify pTMB-high patients unlikely to respond. These results should be validated in larger prospective studies.

Postmortem CT might provide valuable information in determining the cause of death and understanding disease processes, particularly when combined with traditional autopsy. Pediatric applications of postmortem imaging represent a new and rapidly growing field. We describe our experience in establishing a pediatric postmortem CT program and present a discussion of the distinct challenges in developing this type of program in the United States of America, where forensic practice varies from other countries. We give a brief overview of recent literature along with the common imaging findings on postmortem CT that can simulate antemortem pathology.