Background In response to the COVID-19 pandemic and the associated rise in anti-Asian hate crimes, we developed the Compassionate Home, Action Together program, (CHATogether) to support the mental health of the Asian American and Pacific Islander (AAPI) community. CHATogether is a culturally informed and virtually delivered support program that harnesses the talents of AAPI teens, young adults, parents, and mental health professionals who share a commitment to serve their local communities. Methods Our objective was to identify the active components, optimal utilization, potential benefits, and pertinent limitations of the CHATogether program during the 3 years since its inception in 2019. By that time, the program had developed six distinct component arms: interactive theater, mental health education, research, peer support and community outreach, collaboration, and AAPI mentorship. To work towards this objective, we conducted a qualitative study using thematic analysis and an inductive approach based on grounded theory (GT), in which we analyzed anonymized transcripts of four focus groups, comprised of 20 program participants (11 females; 9 males). Results We developed a model of two overarching domains, each with three underlying themes: I. Individual stressors: (1) Family conflict; (2) Cultural identity; and (3) Pandemic impact; and II. Collective stressors: (1) Stigma related to mental health and illness; (2) Pandemic uncertainty; and (3) Xenophobia and societal polarization. Strengths of the CHATogether program include its role as a conduit toward AAPI connectedness and pride as well as purpose in building community. Through support and mentorship, the program cultivates a unique platform that promotes healing and resiliency in response to pandemic stressors and beyond. Conclusions CHATogether creates a safe space for the AAPI community. Through its methods of storytelling and encouraging creativity, CHATogether facilitates the discussion of challenging topics specific to the AAPI community. Given the national mental health crisis that is further being exacerbated by the COVID-19 pandemic, a digital prevention program such as CHATogether holds promise towards providing access to mental health resources and supporting early help-seeking behaviors for individuals in the AAPI community.

Ovarian cancer affects one in 72 female patients in America, and nearly half of the females who carry a BRCA1/2 mutation will be diagnosed in their lifetime. At present, treatment options such as immune checkpoint inhibitors (ICI) and poly (ADP-ribose) polymerase inhibitors (PARPi) are effective against ovarian cancer in a subset of the population. In this article, we review important combination therapeutics that maximize the benefits of these agents in as many patients as possible. PARPi targets deoxyribonucleic acid (DNA) repair mechanisms inside malignant cells, inducing cell death through synthetic lethality. ICIs target immunogenic antigens expressed on the surface of malignant cells so that the immune system can eliminate cancer cells. There is a direct relationship between the degree of DNA damage, also known as the tumor mutational burden and the effectiveness of ICIs. This principle suggests that treatments combining PARPi and ICI may allow DNA damage to accumulate by interrupting repair mechanisms, which may result in newly expressed antigens that could be targeted by the bolstered immune system. In addition, heat-shock proteins (Hsps) are upregulated during cellular stress, such as the stress elicited by the immense metabolic demand of cancer cells. Hsp has potential as prognostic biomarkers, and further, study is required to see how they interact with treatment options. More specifically, both Hsp60 and Hsp10 may represent a prognostic biomarker for ovarian cancer, and further, research into their mechanisms is important. ICI and PARPi combinatorial therapies for ovarian cancer may extend the benefits of each drug to a larger population, and Hsp represents an opportunity for predicting outcomes and tracking responses in cancer patients.

Pancreatic ductile adenocarcinoma (PDAC) has a dismal prognosis, with an overall 5-year survival of <10%. At present, PDAC is treated using systemic chemotherapeutic regiments, which have shown survival benefit in clinical trials. Unfortunately, the survival benefit offered by the current standards do not greatly impact the 5-year overall survival statistics with the disease and are associated with toxicity. The large majority of PDACs are associated with a mutation in Kirsten Ras (KRAS), which results in constative activation of downstream signaling resulting in oncogenesis, tumor progression, cellular survival, and metastasis. Due to the lack of druggable sites, designing direct KRAS inhibitors have proven difficult and extensive effort has been placed in finding upstream or downstream targets as potential therapeutic avenues. The epidermal growth factor receptor (EGFR), hedgehog (HH), and mTOR signaling pathways have all gained recent attention as potential candidates for targeted PDAC therapies. Erlotinib, an EGFR small-molecule inhibitor, has shown promise in preclinical studies against PDAC. It is currently the only Food and Drug Administration (FDA) approved targeted therapy for PDAC when used in conjunction with gemcitabine. However, clinical trials comparing erlotinib plus gemcitabine to gemcitabine alone have demonstrated only modest statistical significance in overall survival. Due to the unique hypovascular microenvironment in PDAC, designated by the term desmoplasia, the HH signaling pathway has also gained recent research interest. Recent studies have shown lithium, a divalent cation originally FDA approved for bipolar disorder, to inhibit PDAC progression through its mechanism of glycogen synthase 3 inhibition in the HH pathway. Metformin, a biguanide medication used in type II diabetes mellitus, has been shown to inhibit mammalian target of rapamycin complex 1 (mTORC1) signaling indirectly through its activation of AMPK. Preclinical studies have demonstrated tumor regression, induction of apoptosis, and effects on the microenvironment in PDAC through the inhibition of mTORC1 by metformin. We present compelling scientific rationale, based on unique signal transduction pathways, tumor pathophysiology, and therapeutics potential for the combination of erlotinib, lithium, and metformin for the treatment of PDAC.