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Drug survival of guselkumab for psoriasis in a real-world setting: a single-center retrospective chart review. J Dermatol Treat 2019; 1-2. 2 Blauvelt A, Papp KA, Griffiths CE et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: Results from the phase III, double-blinded, placebo-and active comparator-controlled VOYAGE 1 trial. J Am Acad Dermatol 2017; 76: 405-417. 3 Reich K, Armstrong AW, Foley P et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the treatment of patients with moderate to severe psoriasis with randomized withdrawal and retreatment: Results from the phase III, doubleblind, placebo-and active comparator-controlled VOYAGE 2 trial. J Am Acad Dermatol 2017; 76: 418-431. 4 Van Voorhees AS, Mason MA, Harrold LR et al. Characterization of insufficient responders to anti-tumor necrosis factor therapies in patients with moderate to severe psoriasis: real-world data from the US Corrona Psoriasis Registry. J Dermatolog Treat 2019; 1-8. 5 Langley RG, Tsai TF, Flavin S et al. Efficacy and safety of guselkumab in patients with psoriasis who have an inadequate response to ustekinumab: results of the randomized, double-blind, phase III NAVIGATE trial.

Objective: By reviewing the literature on post-operative radiotherapy, pre-operative therapy, radiotherapy for procedure-site metastases, and radiotherapy for non-operative management of malignant pleural mesothelioma (MPM), we hope to provide guidance for the role of radiotherapy in the treatment of this cancer.Background: MPM is an aggressive rare cancer associated with high rates of morbidity and mortality.Trimodality treatment consisting of surgery, chemotherapy, and radiotherapy has shown promise for mesothelioma, as these tumors have been demonstrated to be radiosensitive.Methods: Works of interest were identified using MEDLINE/PubMed and Cochrane Library searches.Eligible studies included those done on patients who received curative intent therapy for histologically confirmed mesothelioma.Conclusions: Post-operative radiotherapy following either extrapleural pneumonectomy or pleurectomydecortication has shown to reduce local recurrence with increased median survival. There is limited but promising results for pre-operative radiotherapy; further research is warranted. There does not appear to be a role for prophylactic radiotherapy in procedure-site metastases. Radiotherapy may provide benefit for nonoperative management in patients that are poor surgical candidates. Based on the current body of literature, radiotherapy is especially well-suited for those with epithelioid tumors. Special attention must be paid to reduce mean lung dosages and the volume of lung receiving high radiation doses in order to lower the risk of adverse effects and pulmonary toxicity.

Alopecia areata (AA) is a common nonscarring hair loss disorder with a lifetime risk of 2%. Although AA is characterized by Th1/IFN-skewing, with additional Th2 and IL-23 activation in scalp tissues, little is known about its systemic profile in blood. To evaluate the blood proteomic signature of AA and determine serum biomarkers associated with increased disease severity, we assessed w350 inflammatory and cardiovascular proteins using OLINK high-throughput proteomics in 35 moderate-to-severe AA patients (>30% scalp involvement, mean age¼43.17 years; mean SALT¼74.98), in comparison with age-matched healthy individuals, and as a point of reference also to moderate-to-severe psoriasis (n¼19, mean PASI¼20.43), and atopic dermatitis/AD patients (n¼36, mean SCORAD¼61.35). 74 proteins were significantly differentially expressed between AA and controls (FCH>1.3, FDR<.05) including innate immunity (IL-6, IL-8), Th1 (CXCL9/CXCL10/CXCL11/IFNG), Th2 (CCL13/ CCL17/CCL7), and Th17 markers (CCL20/PI3/S100A12). 86 biomarkers were correlated with clinical severity in AA patients (P<.05) including Th1 (CCL3), Th2 (CCL11/CCL13), innate (IL8) and Th17 markers (S100A12). Many cardiovascular/atherosclerosis-related proteins were significantly higher in AA compared to controls, and also correlated with severity, including SELP, SRC, AXIN1, MPO, IL18, and OSM (P<.05). Pathway analysis showed significant increases in cardiovascular/atherosclerosis, and immune pathways compared to controls (FCH>4.0, FDR<.001), which also correlated with clinical severity (P<.05). This study defined the abnormalities of moderate-to-severe AA and associated circulatory biomarkers. It shows that AA is a systemic disease with immune, cardiovascular and atherosclerosis dysregulation, highlighting the need for systemic treatment approaches.