Key clinical point: Adjuvant endocrine therapy (ET) significantly reduces the incidence of distant metastasis in patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) T1a/bN0M0 breast cancer (BC).

Major finding: The 9-year cumulative incidence of distant metastasis was significantly lower in patients who did vs did not receive adjuvant ET (1.5% vs 2.6%; adjusted subdistribution hazard ratio 0.54; P = .027), with the risk factors for distant metastasis being mastectomy (P = .022), no prior receipt of ET (P = .027), lymphatic invasion (P = .004), and higher nuclear grade (P = .047).

Study details: Findings are from a multicenter cohort study including 4758 patients with ER+ /HER2− T1a/bN0M0 BC who underwent surgery, of whom 3991 patients were administered adjuvant ET.

Disclosures: This study was partly supported by the National Cancer Center Research and Development Fund and the Practical Research for Innovative Cancer Control, Japan. The authors declared no conflicts of interest.

Source: Sasada S et al. Prognostic impact of adjuvant endocrine therapy for estrogen receptor-positive and HER2-negative T1a/bN0M0 breast cancer. Breast Cancer Res Treat. 2023 (Sep 9). doi: 10.1007/s10549-023-07097-6

Key clinical point: Adjuvant endocrine therapy (ET) significantly reduces the incidence of distant metastasis in patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) T1a/bN0M0 breast cancer (BC).

Major finding: The 9-year cumulative incidence of distant metastasis was significantly lower in patients who did vs did not receive adjuvant ET (1.5% vs 2.6%; adjusted subdistribution hazard ratio 0.54; P = .027), with the risk factors for distant metastasis being mastectomy (P = .022), no prior receipt of ET (P = .027), lymphatic invasion (P = .004), and higher nuclear grade (P = .047).

Study details: Findings are from a multicenter cohort study including 4758 patients with ER+ /HER2− T1a/bN0M0 BC who underwent surgery, of whom 3991 patients were administered adjuvant ET.

Disclosures: This study was partly supported by the National Cancer Center Research and Development Fund and the Practical Research for Innovative Cancer Control, Japan. The authors declared no conflicts of interest.

Source: Sasada S et al. Prognostic impact of adjuvant endocrine therapy for estrogen receptor-positive and HER2-negative T1a/bN0M0 breast cancer. Breast Cancer Res Treat. 2023 (Sep 9). doi: 10.1007/s10549-023-07097-6

Key clinical point: Adjuvant endocrine therapy (ET) significantly reduces the incidence of distant metastasis in patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) T1a/bN0M0 breast cancer (BC).

Major finding: The 9-year cumulative incidence of distant metastasis was significantly lower in patients who did vs did not receive adjuvant ET (1.5% vs 2.6%; adjusted subdistribution hazard ratio 0.54; P = .027), with the risk factors for distant metastasis being mastectomy (P = .022), no prior receipt of ET (P = .027), lymphatic invasion (P = .004), and higher nuclear grade (P = .047).

Study details: Findings are from a multicenter cohort study including 4758 patients with ER+ /HER2− T1a/bN0M0 BC who underwent surgery, of whom 3991 patients were administered adjuvant ET.

Disclosures: This study was partly supported by the National Cancer Center Research and Development Fund and the Practical Research for Innovative Cancer Control, Japan. The authors declared no conflicts of interest.

Source: Sasada S et al. Prognostic impact of adjuvant endocrine therapy for estrogen receptor-positive and HER2-negative T1a/bN0M0 breast cancer. Breast Cancer Res Treat. 2023 (Sep 9). doi: 10.1007/s10549-023-07097-6

Key clinical point: Neoadjuvant high-dose alkylating chemotherapy did not improve the Neoadjuvant Response Index (NRI) scores in patients with BRCA1- or BRCA2-pathway-altered (BRCA-altered) triple-negative breast cancer (TNBC).

Major finding: The NRI scores were comparable between the conventional and high-dose chemotherapy treatment groups (0.72 vs 0.78; P = .41). Adverse events, such as fatigue, infections, nausea, oral mucositis, and diarrhea, were more prevalent in the high-dose vs conventional chemotherapy group, although no treatment-related deaths occurred in either group.

Study details: Findings are from the phase 3 neo-TN study that included 122 patients with BRCA-altered TNBC who were randomly assigned to receive either conventional or high-dose chemotherapy.

Disclosures: This study was supported by The Dutch Cancer Foundation and the Schumacher Kramer Foundation, Amsterdam. The authors declared no conflicts of interest.

Source: Vliek S et al. High-dose alkylating chemotherapy in BRCA-altered triple-negative breast cancer: The randomized phase III NeoTN trial. NPJ Breast Cancer. 2023;9:75 (Sep 9). doi: 10.1038/s41523-023-00580-9

Key clinical point: Neoadjuvant high-dose alkylating chemotherapy did not improve the Neoadjuvant Response Index (NRI) scores in patients with BRCA1- or BRCA2-pathway-altered (BRCA-altered) triple-negative breast cancer (TNBC).

Major finding: The NRI scores were comparable between the conventional and high-dose chemotherapy treatment groups (0.72 vs 0.78; P = .41). Adverse events, such as fatigue, infections, nausea, oral mucositis, and diarrhea, were more prevalent in the high-dose vs conventional chemotherapy group, although no treatment-related deaths occurred in either group.

Study details: Findings are from the phase 3 neo-TN study that included 122 patients with BRCA-altered TNBC who were randomly assigned to receive either conventional or high-dose chemotherapy.

Disclosures: This study was supported by The Dutch Cancer Foundation and the Schumacher Kramer Foundation, Amsterdam. The authors declared no conflicts of interest.

Source: Vliek S et al. High-dose alkylating chemotherapy in BRCA-altered triple-negative breast cancer: The randomized phase III NeoTN trial. NPJ Breast Cancer. 2023;9:75 (Sep 9). doi: 10.1038/s41523-023-00580-9

Key clinical point: Neoadjuvant high-dose alkylating chemotherapy did not improve the Neoadjuvant Response Index (NRI) scores in patients with BRCA1- or BRCA2-pathway-altered (BRCA-altered) triple-negative breast cancer (TNBC).

Major finding: The NRI scores were comparable between the conventional and high-dose chemotherapy treatment groups (0.72 vs 0.78; P = .41). Adverse events, such as fatigue, infections, nausea, oral mucositis, and diarrhea, were more prevalent in the high-dose vs conventional chemotherapy group, although no treatment-related deaths occurred in either group.

Study details: Findings are from the phase 3 neo-TN study that included 122 patients with BRCA-altered TNBC who were randomly assigned to receive either conventional or high-dose chemotherapy.

Disclosures: This study was supported by The Dutch Cancer Foundation and the Schumacher Kramer Foundation, Amsterdam. The authors declared no conflicts of interest.

Source: Vliek S et al. High-dose alkylating chemotherapy in BRCA-altered triple-negative breast cancer: The randomized phase III NeoTN trial. NPJ Breast Cancer. 2023;9:75 (Sep 9). doi: 10.1038/s41523-023-00580-9

Key clinical point: In women with high levels of background parenchymal enhancement (BPE), a simultaneous high-temporal/high-spatial resolution (HTHS) magnetic resonance imaging (MRI) protocol detected an additional 15.7 cases of breast cancer (BC) per 1000 patients than the standard high-spatial resolution MRI protocol while concomitantly decreasing the rate of unnecessary biopsies by ~10%.

Major finding: HTHS vs standard protocol improved the BC detection rate per 1000 patients (23.6 vs 7.9; P = .021), increased the positive predictive value of biopsy (16.0% vs 6.3%; P = .014), and decreased the rate of unnecessary biopsies by 9.8%.

Study details: This retrospective study included 1414 women with 1481 high-BPE examinations.

Disclosures: This study was supported partly by the US National Cancer Institute. JS Sung, K Feigin, and K Pinker declared serving in leadership roles and consulting roles or as members of speakers’ bureaus of or receiving research funding from various sources.

Source: Eskreis-Winkler S et al. High-temporal/high-spatial resolution breast magnetic resonance imaging improves diagnostic accuracy compared with standard breast magnetic resonance imaging in patients with high background parenchymal enhancement. J Clin Oncol. 2023 (Aug 10). doi: 10.1200/JCO.22.00635

Key clinical point: In women with high levels of background parenchymal enhancement (BPE), a simultaneous high-temporal/high-spatial resolution (HTHS) magnetic resonance imaging (MRI) protocol detected an additional 15.7 cases of breast cancer (BC) per 1000 patients than the standard high-spatial resolution MRI protocol while concomitantly decreasing the rate of unnecessary biopsies by ~10%.

Major finding: HTHS vs standard protocol improved the BC detection rate per 1000 patients (23.6 vs 7.9; P = .021), increased the positive predictive value of biopsy (16.0% vs 6.3%; P = .014), and decreased the rate of unnecessary biopsies by 9.8%.

Study details: This retrospective study included 1414 women with 1481 high-BPE examinations.

Disclosures: This study was supported partly by the US National Cancer Institute. JS Sung, K Feigin, and K Pinker declared serving in leadership roles and consulting roles or as members of speakers’ bureaus of or receiving research funding from various sources.

Source: Eskreis-Winkler S et al. High-temporal/high-spatial resolution breast magnetic resonance imaging improves diagnostic accuracy compared with standard breast magnetic resonance imaging in patients with high background parenchymal enhancement. J Clin Oncol. 2023 (Aug 10). doi: 10.1200/JCO.22.00635

Key clinical point: In women with high levels of background parenchymal enhancement (BPE), a simultaneous high-temporal/high-spatial resolution (HTHS) magnetic resonance imaging (MRI) protocol detected an additional 15.7 cases of breast cancer (BC) per 1000 patients than the standard high-spatial resolution MRI protocol while concomitantly decreasing the rate of unnecessary biopsies by ~10%.

Major finding: HTHS vs standard protocol improved the BC detection rate per 1000 patients (23.6 vs 7.9; P = .021), increased the positive predictive value of biopsy (16.0% vs 6.3%; P = .014), and decreased the rate of unnecessary biopsies by 9.8%.

Study details: This retrospective study included 1414 women with 1481 high-BPE examinations.

Disclosures: This study was supported partly by the US National Cancer Institute. JS Sung, K Feigin, and K Pinker declared serving in leadership roles and consulting roles or as members of speakers’ bureaus of or receiving research funding from various sources.

Source: Eskreis-Winkler S et al. High-temporal/high-spatial resolution breast magnetic resonance imaging improves diagnostic accuracy compared with standard breast magnetic resonance imaging in patients with high background parenchymal enhancement. J Clin Oncol. 2023 (Aug 10). doi: 10.1200/JCO.22.00635

It is difficult to go through any publication or website these days without finding an article about artificial intelligence (AI). Many discuss its current status, while others speculate on potential future applications. Often, AI is described as an “existential threat to human health” by commentators who aren’t even aware of the definition of that term as Kierkegaard conceived it, the role of the individual to breathe meaning into life. Others characterize such cataclysmic predictions as “overblown and misdirected”.

The long-term potential for abuse of AI requires discussion, and should be addressed by policy makers, but that is beyond the scope of this column.

Meanwhile, there are many near-term opportunities for AI to improve health care and reduce tedious and time consuming tasks. Specifically, some AI-based tools are available to use in your office right now, with no “existential” threat to anybody.

The most popular current AI-based medical applications are automated scribes. They transcribe live consultations between physician and patient automatically and create a searchable report, plus notes for charts and billing.

I’ve written about AI scribes before, but the quality and user-friendliness of these products have improved dramatically in recent years. Language processing capabilities now permit you to speak naturally, without having to memorize specific commands. Some scribes can mimic your writing style based on sample notes that you enter into the system. Others allow you to integrate your own knowledge base, or a bibliography of research studies. With some systems, you can dictate notes directly into most EHR software, ask questions regarding medication dosages, or access a patient’s medical history from hospitals or other offices.

Current popular medical scribe products include DeepCura, DeepScribe, Nuance, Suki, Augmedix, Tali AI, Iodine Software, and ScribeLink. Amazon Web Services recently launched its own product, HealthScribe, as well. (As always, I have no financial interest in any product or service mentioned in this column.)

AI scribes aren’t entirely autonomous, of course; you need to read the output and check for potential inaccuracies. Still, users claim that they substantially reduce documentation and charting time, permitting more patient visits and less after-hours work.

AI can also be used to provide useful content for your patients. If you are not particularly good at writing, or don’t have the time for it, generative algorithms like the much-vaunted ChatGPT can generate posts, FAQs, and other informational content for your website, blog, or social media pages. You can ask for ideas about timely health topics and write general information articles, or create content specific to your location or specialty. You can use it to write emails informing your patients about upcoming office events or educate them on a range of topics, from getting their annual flu shots to scheduling regular screening skin exams.

With some of the same techniques and additional software, you can create entire videos for your website at a fraction of the cost of hiring a video production team. After using ChatGPT to write the content – for example, a 5-minute script on the importance of sunscreen in preventing skin cancer – you can employ a text-to-speech algorithm such as Revoicer to transform the script into audio content, and then a preproduction algorithm like Yepic or Synthesia to generate a video with a synthetic human. 

If you are unhappy with your current online presence, you can use AI to create an entire website. Through a series of questions, AI website builders such as Wix ADI, Jimdo, Hostinger, and 10Web gather all the information needed to set up a website draft that is already personalized with medical-specific content. Most offer the option to connect to Instagram, Facebook, Google My Business, and similar sites, to which they can import your office’s logo, images, and descriptive texts.

Some of them are capable of pulling up responsive site pages that automatically adjust to the device – mobile or computer – that the visitor is using. This is important, as I’ve written before, because more than half of all searches for doctors are now made on smartphones, so the more “mobile friendly” your site is, the higher it will be ranked. You can test how easily a visitor can use your website on a mobile device with Google’s free Mobile-Friendly Test.

If you give talks at medical meetings, you know how cumbersome and time-consuming it can be to create Powerpoint presentations. Once again, AI can save you time and trouble. Presentation designers such as Presentations.AI, Deck Robot, iA Presenter, and Beautiful.AI can assemble very acceptable presentations from your primary inputs. You typically choose a template, input your basic data, and AI will format the slides and offer you visuals, animations, voice-overs, and other fancy features. You will also have flexibility in changing segments or images or sizes you don’t like.

Dr. Eastern practices dermatology and dermatologic surgery in Belleville, N.J. He is the author of numerous articles and textbook chapters, and is a longtime monthly columnist for Dermatology News. Write to him at [email protected].

It is difficult to go through any publication or website these days without finding an article about artificial intelligence (AI). Many discuss its current status, while others speculate on potential future applications. Often, AI is described as an “existential threat to human health” by commentators who aren’t even aware of the definition of that term as Kierkegaard conceived it, the role of the individual to breathe meaning into life. Others characterize such cataclysmic predictions as “overblown and misdirected”.

The long-term potential for abuse of AI requires discussion, and should be addressed by policy makers, but that is beyond the scope of this column.

Meanwhile, there are many near-term opportunities for AI to improve health care and reduce tedious and time consuming tasks. Specifically, some AI-based tools are available to use in your office right now, with no “existential” threat to anybody.

The most popular current AI-based medical applications are automated scribes. They transcribe live consultations between physician and patient automatically and create a searchable report, plus notes for charts and billing.

I’ve written about AI scribes before, but the quality and user-friendliness of these products have improved dramatically in recent years. Language processing capabilities now permit you to speak naturally, without having to memorize specific commands. Some scribes can mimic your writing style based on sample notes that you enter into the system. Others allow you to integrate your own knowledge base, or a bibliography of research studies. With some systems, you can dictate notes directly into most EHR software, ask questions regarding medication dosages, or access a patient’s medical history from hospitals or other offices.

Current popular medical scribe products include DeepCura, DeepScribe, Nuance, Suki, Augmedix, Tali AI, Iodine Software, and ScribeLink. Amazon Web Services recently launched its own product, HealthScribe, as well. (As always, I have no financial interest in any product or service mentioned in this column.)

AI scribes aren’t entirely autonomous, of course; you need to read the output and check for potential inaccuracies. Still, users claim that they substantially reduce documentation and charting time, permitting more patient visits and less after-hours work.

AI can also be used to provide useful content for your patients. If you are not particularly good at writing, or don’t have the time for it, generative algorithms like the much-vaunted ChatGPT can generate posts, FAQs, and other informational content for your website, blog, or social media pages. You can ask for ideas about timely health topics and write general information articles, or create content specific to your location or specialty. You can use it to write emails informing your patients about upcoming office events or educate them on a range of topics, from getting their annual flu shots to scheduling regular screening skin exams.

With some of the same techniques and additional software, you can create entire videos for your website at a fraction of the cost of hiring a video production team. After using ChatGPT to write the content – for example, a 5-minute script on the importance of sunscreen in preventing skin cancer – you can employ a text-to-speech algorithm such as Revoicer to transform the script into audio content, and then a preproduction algorithm like Yepic or Synthesia to generate a video with a synthetic human. 

If you are unhappy with your current online presence, you can use AI to create an entire website. Through a series of questions, AI website builders such as Wix ADI, Jimdo, Hostinger, and 10Web gather all the information needed to set up a website draft that is already personalized with medical-specific content. Most offer the option to connect to Instagram, Facebook, Google My Business, and similar sites, to which they can import your office’s logo, images, and descriptive texts.

Some of them are capable of pulling up responsive site pages that automatically adjust to the device – mobile or computer – that the visitor is using. This is important, as I’ve written before, because more than half of all searches for doctors are now made on smartphones, so the more “mobile friendly” your site is, the higher it will be ranked. You can test how easily a visitor can use your website on a mobile device with Google’s free Mobile-Friendly Test.

If you give talks at medical meetings, you know how cumbersome and time-consuming it can be to create Powerpoint presentations. Once again, AI can save you time and trouble. Presentation designers such as Presentations.AI, Deck Robot, iA Presenter, and Beautiful.AI can assemble very acceptable presentations from your primary inputs. You typically choose a template, input your basic data, and AI will format the slides and offer you visuals, animations, voice-overs, and other fancy features. You will also have flexibility in changing segments or images or sizes you don’t like.

Dr. Eastern practices dermatology and dermatologic surgery in Belleville, N.J. He is the author of numerous articles and textbook chapters, and is a longtime monthly columnist for Dermatology News. Write to him at [email protected].

It is difficult to go through any publication or website these days without finding an article about artificial intelligence (AI). Many discuss its current status, while others speculate on potential future applications. Often, AI is described as an “existential threat to human health” by commentators who aren’t even aware of the definition of that term as Kierkegaard conceived it, the role of the individual to breathe meaning into life. Others characterize such cataclysmic predictions as “overblown and misdirected”.

The long-term potential for abuse of AI requires discussion, and should be addressed by policy makers, but that is beyond the scope of this column.

Meanwhile, there are many near-term opportunities for AI to improve health care and reduce tedious and time consuming tasks. Specifically, some AI-based tools are available to use in your office right now, with no “existential” threat to anybody.

The most popular current AI-based medical applications are automated scribes. They transcribe live consultations between physician and patient automatically and create a searchable report, plus notes for charts and billing.

I’ve written about AI scribes before, but the quality and user-friendliness of these products have improved dramatically in recent years. Language processing capabilities now permit you to speak naturally, without having to memorize specific commands. Some scribes can mimic your writing style based on sample notes that you enter into the system. Others allow you to integrate your own knowledge base, or a bibliography of research studies. With some systems, you can dictate notes directly into most EHR software, ask questions regarding medication dosages, or access a patient’s medical history from hospitals or other offices.

Current popular medical scribe products include DeepCura, DeepScribe, Nuance, Suki, Augmedix, Tali AI, Iodine Software, and ScribeLink. Amazon Web Services recently launched its own product, HealthScribe, as well. (As always, I have no financial interest in any product or service mentioned in this column.)

AI scribes aren’t entirely autonomous, of course; you need to read the output and check for potential inaccuracies. Still, users claim that they substantially reduce documentation and charting time, permitting more patient visits and less after-hours work.

AI can also be used to provide useful content for your patients. If you are not particularly good at writing, or don’t have the time for it, generative algorithms like the much-vaunted ChatGPT can generate posts, FAQs, and other informational content for your website, blog, or social media pages. You can ask for ideas about timely health topics and write general information articles, or create content specific to your location or specialty. You can use it to write emails informing your patients about upcoming office events or educate them on a range of topics, from getting their annual flu shots to scheduling regular screening skin exams.

With some of the same techniques and additional software, you can create entire videos for your website at a fraction of the cost of hiring a video production team. After using ChatGPT to write the content – for example, a 5-minute script on the importance of sunscreen in preventing skin cancer – you can employ a text-to-speech algorithm such as Revoicer to transform the script into audio content, and then a preproduction algorithm like Yepic or Synthesia to generate a video with a synthetic human. 

If you are unhappy with your current online presence, you can use AI to create an entire website. Through a series of questions, AI website builders such as Wix ADI, Jimdo, Hostinger, and 10Web gather all the information needed to set up a website draft that is already personalized with medical-specific content. Most offer the option to connect to Instagram, Facebook, Google My Business, and similar sites, to which they can import your office’s logo, images, and descriptive texts.

Some of them are capable of pulling up responsive site pages that automatically adjust to the device – mobile or computer – that the visitor is using. This is important, as I’ve written before, because more than half of all searches for doctors are now made on smartphones, so the more “mobile friendly” your site is, the higher it will be ranked. You can test how easily a visitor can use your website on a mobile device with Google’s free Mobile-Friendly Test.

If you give talks at medical meetings, you know how cumbersome and time-consuming it can be to create Powerpoint presentations. Once again, AI can save you time and trouble. Presentation designers such as Presentations.AI, Deck Robot, iA Presenter, and Beautiful.AI can assemble very acceptable presentations from your primary inputs. You typically choose a template, input your basic data, and AI will format the slides and offer you visuals, animations, voice-overs, and other fancy features. You will also have flexibility in changing segments or images or sizes you don’t like.

Dr. Eastern practices dermatology and dermatologic surgery in Belleville, N.J. He is the author of numerous articles and textbook chapters, and is a longtime monthly columnist for Dermatology News. Write to him at [email protected].

Key clinical point: In patients with locally advanced triple-negative breast cancer (TNBC), neoadjuvant apatinib (Apa) plus dose-dense paclitaxel and carboplatin (ddTCb) was more effective in improving clinical outcomes than ddTCb alone and showed an acceptable safety profile.

Major finding: A significantly higher proportion of patients in the Apa + ddTCb vs ddTCb treatment group achieved pathological complete response (60.9% vs 30.4%; P = .009) and underwent breast-conserving surgery (47.8% vs 21.7%; P = .016). The incidence of adverse events was higher in the Apa + ddTCb treatment arm, but they were generally acceptable.

Study details: This prospective cohort study included 23 patients with stages I-IIIC TNBC who received neoadjuvant Apa + ddTCb therapy matched with 69 patients with stages I-IIIC TNBC who received neoadjuvant ddTCb therapy only.

Disclosures: This study was supported by CAMS Innovation Fund for Medical Sciences and the Translational research project of Medical Oncology Key Foundation of Cancer Hospital, Chinese Academy of Medical Sciences. The authors declared no conflicts of interest.

Source: Liu J, Xu B, Zhang P, et al. Efficacy and safety of apatinib combined with dose-dense paclitaxel and carboplatin in neoadjuvant therapy for locally advanced triple-negative breast cancer: A prospective cohort study with propensity-matched analysis. Int J Cancer. 2023 (Sep 7). doi: 10.1002/ijc.34717

Key clinical point: In patients with locally advanced triple-negative breast cancer (TNBC), neoadjuvant apatinib (Apa) plus dose-dense paclitaxel and carboplatin (ddTCb) was more effective in improving clinical outcomes than ddTCb alone and showed an acceptable safety profile.

Major finding: A significantly higher proportion of patients in the Apa + ddTCb vs ddTCb treatment group achieved pathological complete response (60.9% vs 30.4%; P = .009) and underwent breast-conserving surgery (47.8% vs 21.7%; P = .016). The incidence of adverse events was higher in the Apa + ddTCb treatment arm, but they were generally acceptable.

Study details: This prospective cohort study included 23 patients with stages I-IIIC TNBC who received neoadjuvant Apa + ddTCb therapy matched with 69 patients with stages I-IIIC TNBC who received neoadjuvant ddTCb therapy only.

Disclosures: This study was supported by CAMS Innovation Fund for Medical Sciences and the Translational research project of Medical Oncology Key Foundation of Cancer Hospital, Chinese Academy of Medical Sciences. The authors declared no conflicts of interest.

Source: Liu J, Xu B, Zhang P, et al. Efficacy and safety of apatinib combined with dose-dense paclitaxel and carboplatin in neoadjuvant therapy for locally advanced triple-negative breast cancer: A prospective cohort study with propensity-matched analysis. Int J Cancer. 2023 (Sep 7). doi: 10.1002/ijc.34717

Key clinical point: In patients with locally advanced triple-negative breast cancer (TNBC), neoadjuvant apatinib (Apa) plus dose-dense paclitaxel and carboplatin (ddTCb) was more effective in improving clinical outcomes than ddTCb alone and showed an acceptable safety profile.

Major finding: A significantly higher proportion of patients in the Apa + ddTCb vs ddTCb treatment group achieved pathological complete response (60.9% vs 30.4%; P = .009) and underwent breast-conserving surgery (47.8% vs 21.7%; P = .016). The incidence of adverse events was higher in the Apa + ddTCb treatment arm, but they were generally acceptable.

Study details: This prospective cohort study included 23 patients with stages I-IIIC TNBC who received neoadjuvant Apa + ddTCb therapy matched with 69 patients with stages I-IIIC TNBC who received neoadjuvant ddTCb therapy only.

Disclosures: This study was supported by CAMS Innovation Fund for Medical Sciences and the Translational research project of Medical Oncology Key Foundation of Cancer Hospital, Chinese Academy of Medical Sciences. The authors declared no conflicts of interest.

Source: Liu J, Xu B, Zhang P, et al. Efficacy and safety of apatinib combined with dose-dense paclitaxel and carboplatin in neoadjuvant therapy for locally advanced triple-negative breast cancer: A prospective cohort study with propensity-matched analysis. Int J Cancer. 2023 (Sep 7). doi: 10.1002/ijc.34717

Key clinical point: Trifluridine/tipiracil (FTD/TPI) showed promising anti-tumor activity with a manageable safety profile regardless of prior exposure to fluoropyrimidine therapy in patients with metastatic breast cancer (BC).

Major finding: The median durations of progression-free survival were 5.7 months and 9.4 months in patients with and without prior exposure to fluoropyrimidine therapy, respectively. Neutropenia (81.8%), fatigue (29.7%), anorexia (25.7%), and nausea (25.7%) were the most common all-grade treatment-related adverse events.

Study details: Findings are from a phase 2 study including 74 patients with metastatic BC with or without prior exposure to fluoropyrimidine therapy who received FTD/TPI.

Disclosures: This study was funded by a grant from the National Medical Research Council, Singapore. Some authors declared receiving research funding, honoraria, consulting fees, or travel support from or having other ties with various sources.

Source: Lim JSJ et al. Phase II study of trifluridine/tipiracil (FTD/TPI) in metastatic breast cancers with or without prior exposure to fluoropyrimidines. Eur J Cancer. 2023;113311 (Aug 25). doi: 10.1016/j.ejca.2023.113311

Key clinical point: Trifluridine/tipiracil (FTD/TPI) showed promising anti-tumor activity with a manageable safety profile regardless of prior exposure to fluoropyrimidine therapy in patients with metastatic breast cancer (BC).

Major finding: The median durations of progression-free survival were 5.7 months and 9.4 months in patients with and without prior exposure to fluoropyrimidine therapy, respectively. Neutropenia (81.8%), fatigue (29.7%), anorexia (25.7%), and nausea (25.7%) were the most common all-grade treatment-related adverse events.

Study details: Findings are from a phase 2 study including 74 patients with metastatic BC with or without prior exposure to fluoropyrimidine therapy who received FTD/TPI.

Disclosures: This study was funded by a grant from the National Medical Research Council, Singapore. Some authors declared receiving research funding, honoraria, consulting fees, or travel support from or having other ties with various sources.

Source: Lim JSJ et al. Phase II study of trifluridine/tipiracil (FTD/TPI) in metastatic breast cancers with or without prior exposure to fluoropyrimidines. Eur J Cancer. 2023;113311 (Aug 25). doi: 10.1016/j.ejca.2023.113311

Key clinical point: Trifluridine/tipiracil (FTD/TPI) showed promising anti-tumor activity with a manageable safety profile regardless of prior exposure to fluoropyrimidine therapy in patients with metastatic breast cancer (BC).

Major finding: The median durations of progression-free survival were 5.7 months and 9.4 months in patients with and without prior exposure to fluoropyrimidine therapy, respectively. Neutropenia (81.8%), fatigue (29.7%), anorexia (25.7%), and nausea (25.7%) were the most common all-grade treatment-related adverse events.

Study details: Findings are from a phase 2 study including 74 patients with metastatic BC with or without prior exposure to fluoropyrimidine therapy who received FTD/TPI.

Disclosures: This study was funded by a grant from the National Medical Research Council, Singapore. Some authors declared receiving research funding, honoraria, consulting fees, or travel support from or having other ties with various sources.

Source: Lim JSJ et al. Phase II study of trifluridine/tipiracil (FTD/TPI) in metastatic breast cancers with or without prior exposure to fluoropyrimidines. Eur J Cancer. 2023;113311 (Aug 25). doi: 10.1016/j.ejca.2023.113311

Key clinical point: Giredestrant demonstrated stronger anti-proliferative activity than anastrozole and was well-tolerated in patients with estrogen receptor-positive (ER+ ), human epidermal growth factor receptor 2-negative (HER2−), untreated early breast cancer (BC).

Major finding: At week 2, giredestrant vs anastrozole had a stronger anti-proliferative effect as indicated by greater relative geometric mean reduction of Ki67 scores (−75% vs −67%; P = .043). Neutropenia (26% and 27%, respectively) and decreased neutrophil count (15% and 15%, respectively) were the most common grade 3-4 adverse events observed in the giredestrant + palbociclib and anastrozole + palbociclib treatment arms.

Study details: Findings are from the phase 2 coopERA Breast Cancer trial including 221 postmenopausal patients with clinical T stage (cT)1c to cT4a-c, ER+ /HER2− early BC who were randomly assigned to receive giredestrant or anastrozole in combination with palbociclib.

Disclosures: This study was funded by F Hoffmann-La Roche. Seven authors declared being employees or stockholders of F Hoffmann-La Roche, and the other authors declared ties with various sources.

Source: Hurvitz SA et al on behalf of thecoopERA Breast Cancer study group. Neoadjuvant palbociclib plus either giredestrant or anastrozole in oestrogen receptor-positive, HER2-negative, early breast cancer (coopERA Breast Cancer): An open-label, randomised, controlled, phase 2 study. Lancet Oncol. 2023;24(9):1029-1041 (Aug 29). doi: 10.1016/S1470-2045(23)00268-1

Key clinical point: Giredestrant demonstrated stronger anti-proliferative activity than anastrozole and was well-tolerated in patients with estrogen receptor-positive (ER+ ), human epidermal growth factor receptor 2-negative (HER2−), untreated early breast cancer (BC).

Major finding: At week 2, giredestrant vs anastrozole had a stronger anti-proliferative effect as indicated by greater relative geometric mean reduction of Ki67 scores (−75% vs −67%; P = .043). Neutropenia (26% and 27%, respectively) and decreased neutrophil count (15% and 15%, respectively) were the most common grade 3-4 adverse events observed in the giredestrant + palbociclib and anastrozole + palbociclib treatment arms.

Study details: Findings are from the phase 2 coopERA Breast Cancer trial including 221 postmenopausal patients with clinical T stage (cT)1c to cT4a-c, ER+ /HER2− early BC who were randomly assigned to receive giredestrant or anastrozole in combination with palbociclib.

Disclosures: This study was funded by F Hoffmann-La Roche. Seven authors declared being employees or stockholders of F Hoffmann-La Roche, and the other authors declared ties with various sources.

Source: Hurvitz SA et al on behalf of thecoopERA Breast Cancer study group. Neoadjuvant palbociclib plus either giredestrant or anastrozole in oestrogen receptor-positive, HER2-negative, early breast cancer (coopERA Breast Cancer): An open-label, randomised, controlled, phase 2 study. Lancet Oncol. 2023;24(9):1029-1041 (Aug 29). doi: 10.1016/S1470-2045(23)00268-1

Key clinical point: Giredestrant demonstrated stronger anti-proliferative activity than anastrozole and was well-tolerated in patients with estrogen receptor-positive (ER+ ), human epidermal growth factor receptor 2-negative (HER2−), untreated early breast cancer (BC).

Major finding: At week 2, giredestrant vs anastrozole had a stronger anti-proliferative effect as indicated by greater relative geometric mean reduction of Ki67 scores (−75% vs −67%; P = .043). Neutropenia (26% and 27%, respectively) and decreased neutrophil count (15% and 15%, respectively) were the most common grade 3-4 adverse events observed in the giredestrant + palbociclib and anastrozole + palbociclib treatment arms.

Study details: Findings are from the phase 2 coopERA Breast Cancer trial including 221 postmenopausal patients with clinical T stage (cT)1c to cT4a-c, ER+ /HER2− early BC who were randomly assigned to receive giredestrant or anastrozole in combination with palbociclib.

Disclosures: This study was funded by F Hoffmann-La Roche. Seven authors declared being employees or stockholders of F Hoffmann-La Roche, and the other authors declared ties with various sources.

Source: Hurvitz SA et al on behalf of thecoopERA Breast Cancer study group. Neoadjuvant palbociclib plus either giredestrant or anastrozole in oestrogen receptor-positive, HER2-negative, early breast cancer (coopERA Breast Cancer): An open-label, randomised, controlled, phase 2 study. Lancet Oncol. 2023;24(9):1029-1041 (Aug 29). doi: 10.1016/S1470-2045(23)00268-1

Key clinical point: The incidence rate of local recurrence was low even after omitting radiotherapy in women with luminal A breast cancer (BC) age ≥55 years who underwent breast-conserving surgery (BCS) followed by endocrine therapy.

Major finding: At 5 years, the cumulative incidence of local recurrence was low (2.3%; 95% CI 1.2%-4.1%), with 1.9% of patients (90% CI 1.1%-3.2%) reporting contralateral BC recurrences and 2.7% of patients (90% CI 1.6%-4.1%) reporting recurrences of any type.

Study details: This prospective cohort study included 500 women with T1N0 (tumor size < 2 cm and node negative) luminal A BC age ≥ 55 years who had undergone BCS followed by adjuvant endocrine therapy.

Disclosures: This study was supported by the Canadian Cancer Society and Canadian Breast Cancer Foundation. Some authors declared serving as consultants or members of data safety and monitoring boards or having ties with various sources.

Source: Whelan TJ et al for the LUMINA Study Investigators. Omitting radiotherapy after breast-conserving surgery in luminal A breast cancer. N Engl J Med. 2023;389(7):612-619 (Aug 17). doi: 10.1056/NEJMoa2302344

Key clinical point: The incidence rate of local recurrence was low even after omitting radiotherapy in women with luminal A breast cancer (BC) age ≥55 years who underwent breast-conserving surgery (BCS) followed by endocrine therapy.

Major finding: At 5 years, the cumulative incidence of local recurrence was low (2.3%; 95% CI 1.2%-4.1%), with 1.9% of patients (90% CI 1.1%-3.2%) reporting contralateral BC recurrences and 2.7% of patients (90% CI 1.6%-4.1%) reporting recurrences of any type.

Study details: This prospective cohort study included 500 women with T1N0 (tumor size < 2 cm and node negative) luminal A BC age ≥ 55 years who had undergone BCS followed by adjuvant endocrine therapy.

Disclosures: This study was supported by the Canadian Cancer Society and Canadian Breast Cancer Foundation. Some authors declared serving as consultants or members of data safety and monitoring boards or having ties with various sources.

Source: Whelan TJ et al for the LUMINA Study Investigators. Omitting radiotherapy after breast-conserving surgery in luminal A breast cancer. N Engl J Med. 2023;389(7):612-619 (Aug 17). doi: 10.1056/NEJMoa2302344

Key clinical point: The incidence rate of local recurrence was low even after omitting radiotherapy in women with luminal A breast cancer (BC) age ≥55 years who underwent breast-conserving surgery (BCS) followed by endocrine therapy.

Major finding: At 5 years, the cumulative incidence of local recurrence was low (2.3%; 95% CI 1.2%-4.1%), with 1.9% of patients (90% CI 1.1%-3.2%) reporting contralateral BC recurrences and 2.7% of patients (90% CI 1.6%-4.1%) reporting recurrences of any type.

Study details: This prospective cohort study included 500 women with T1N0 (tumor size < 2 cm and node negative) luminal A BC age ≥ 55 years who had undergone BCS followed by adjuvant endocrine therapy.

Disclosures: This study was supported by the Canadian Cancer Society and Canadian Breast Cancer Foundation. Some authors declared serving as consultants or members of data safety and monitoring boards or having ties with various sources.

Source: Whelan TJ et al for the LUMINA Study Investigators. Omitting radiotherapy after breast-conserving surgery in luminal A breast cancer. N Engl J Med. 2023;389(7):612-619 (Aug 17). doi: 10.1056/NEJMoa2302344

The RNA interference therapeutic patisiran (Onpattro) is one step closer to being approved in the United States for treatment of transthyretin-mediated (ATTR) amyloidosis with cardiomyopathy.

The Cardiovascular and Renal Drugs Advisory Committee of the Food and Drug Administration has voted 9 to 3 that the benefits of patisiran outweigh the risks for the treatment of ATTR amyloidosis cardiomyopathy – although many panel members questioned whether the benefits are clinically meaningful.

ATTR amyloidosis is an underdiagnosed, rapidly progressive, debilitating, and fatal disease caused by misfolded TTR proteins, which accumulate as amyloid deposits in various parts of the body, including the heart.

Intravenously administered patisiran is already approved in the United States and Canada for the treatment of the polyneuropathy of hereditary ATTR amyloidosis in adults.

In the APOLLO-B trial, patisiran showed a statistically significant and clinically meaningful benefit on functional capacity, as measured by the 6-minute walk test, compared with placebo, in patients with ATTR amyloidosis with cardiomyopathy.

The study also met its first secondary endpoint, demonstrating a statistically significant and clinically meaningful benefit on health status and quality of life.

But in explaining her “no” vote, committee member C. Noel Bairey Merz, MD, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, said she “did not feel like there was benefit” using existing clinically relevant thresholds typically used in cardiology.

Committee chair Javed Butler, MD, MPH, Baylor Scott & White Research Institute, Dallas, who also voted no, said he “struggled” with this vote and emphasized that it “absolutely does not reflect that there is not a potential with the therapy.”

Dr. Butler said he voted no largely because he wasn’t sure whether the benefits are clinically meaningful in the context of the study design and how it was conducted. He did not have any safety concerns, which was the general feeling of the committee.

Edward Kasper, MD, Johns Hopkins University, Baltimore, who voted in favor of patisiran for ATTR amyloidosis with cardiomyopathy, said there is a “light wind for benefit and no wind for risk. So, if you’re asking do benefits outweigh the risks, the answer is yes.”

But Dr. Kasper also noted: “It would have been a more difficult question to answer: Is there clinically meaningful benefit versus risk? But that’s not what the question asked.”

In explaining his “yes” vote, Ravi Thadhani, MD, MPH, Emory University, Atlanta, said: “We’re dealing with a rare disease with few options and devastating consequences. We heard from clinicians loud and clear, and from patients for that matter, that options and alternatives are critical, and that there is a continuous decline of cardiac function and worsening of disease in a number of patients that have received the current standard of care. For me, the benefits outweigh the risks.”

Dr. Thadhani also noted that from the data provided, no benefit was shown – ”disappointingly” he lamented – for women, for Black persons, and among individuals who were receiving tafamidis, and he urged the FDA and sponsor to consider this.

The FDA has set a target action date for patisiran for ATTR amyloidosis cardiomyopathy of Oct. 8.

A version of this article first appeared on Medscape.com.

The RNA interference therapeutic patisiran (Onpattro) is one step closer to being approved in the United States for treatment of transthyretin-mediated (ATTR) amyloidosis with cardiomyopathy.

The Cardiovascular and Renal Drugs Advisory Committee of the Food and Drug Administration has voted 9 to 3 that the benefits of patisiran outweigh the risks for the treatment of ATTR amyloidosis cardiomyopathy – although many panel members questioned whether the benefits are clinically meaningful.

ATTR amyloidosis is an underdiagnosed, rapidly progressive, debilitating, and fatal disease caused by misfolded TTR proteins, which accumulate as amyloid deposits in various parts of the body, including the heart.

Intravenously administered patisiran is already approved in the United States and Canada for the treatment of the polyneuropathy of hereditary ATTR amyloidosis in adults.

In the APOLLO-B trial, patisiran showed a statistically significant and clinically meaningful benefit on functional capacity, as measured by the 6-minute walk test, compared with placebo, in patients with ATTR amyloidosis with cardiomyopathy.

The study also met its first secondary endpoint, demonstrating a statistically significant and clinically meaningful benefit on health status and quality of life.

But in explaining her “no” vote, committee member C. Noel Bairey Merz, MD, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, said she “did not feel like there was benefit” using existing clinically relevant thresholds typically used in cardiology.

Committee chair Javed Butler, MD, MPH, Baylor Scott & White Research Institute, Dallas, who also voted no, said he “struggled” with this vote and emphasized that it “absolutely does not reflect that there is not a potential with the therapy.”

Dr. Butler said he voted no largely because he wasn’t sure whether the benefits are clinically meaningful in the context of the study design and how it was conducted. He did not have any safety concerns, which was the general feeling of the committee.

Edward Kasper, MD, Johns Hopkins University, Baltimore, who voted in favor of patisiran for ATTR amyloidosis with cardiomyopathy, said there is a “light wind for benefit and no wind for risk. So, if you’re asking do benefits outweigh the risks, the answer is yes.”

But Dr. Kasper also noted: “It would have been a more difficult question to answer: Is there clinically meaningful benefit versus risk? But that’s not what the question asked.”

In explaining his “yes” vote, Ravi Thadhani, MD, MPH, Emory University, Atlanta, said: “We’re dealing with a rare disease with few options and devastating consequences. We heard from clinicians loud and clear, and from patients for that matter, that options and alternatives are critical, and that there is a continuous decline of cardiac function and worsening of disease in a number of patients that have received the current standard of care. For me, the benefits outweigh the risks.”

Dr. Thadhani also noted that from the data provided, no benefit was shown – ”disappointingly” he lamented – for women, for Black persons, and among individuals who were receiving tafamidis, and he urged the FDA and sponsor to consider this.

The FDA has set a target action date for patisiran for ATTR amyloidosis cardiomyopathy of Oct. 8.

A version of this article first appeared on Medscape.com.

The RNA interference therapeutic patisiran (Onpattro) is one step closer to being approved in the United States for treatment of transthyretin-mediated (ATTR) amyloidosis with cardiomyopathy.

The Cardiovascular and Renal Drugs Advisory Committee of the Food and Drug Administration has voted 9 to 3 that the benefits of patisiran outweigh the risks for the treatment of ATTR amyloidosis cardiomyopathy – although many panel members questioned whether the benefits are clinically meaningful.

ATTR amyloidosis is an underdiagnosed, rapidly progressive, debilitating, and fatal disease caused by misfolded TTR proteins, which accumulate as amyloid deposits in various parts of the body, including the heart.

Intravenously administered patisiran is already approved in the United States and Canada for the treatment of the polyneuropathy of hereditary ATTR amyloidosis in adults.

In the APOLLO-B trial, patisiran showed a statistically significant and clinically meaningful benefit on functional capacity, as measured by the 6-minute walk test, compared with placebo, in patients with ATTR amyloidosis with cardiomyopathy.

The study also met its first secondary endpoint, demonstrating a statistically significant and clinically meaningful benefit on health status and quality of life.

But in explaining her “no” vote, committee member C. Noel Bairey Merz, MD, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, said she “did not feel like there was benefit” using existing clinically relevant thresholds typically used in cardiology.

Committee chair Javed Butler, MD, MPH, Baylor Scott & White Research Institute, Dallas, who also voted no, said he “struggled” with this vote and emphasized that it “absolutely does not reflect that there is not a potential with the therapy.”

Dr. Butler said he voted no largely because he wasn’t sure whether the benefits are clinically meaningful in the context of the study design and how it was conducted. He did not have any safety concerns, which was the general feeling of the committee.

Edward Kasper, MD, Johns Hopkins University, Baltimore, who voted in favor of patisiran for ATTR amyloidosis with cardiomyopathy, said there is a “light wind for benefit and no wind for risk. So, if you’re asking do benefits outweigh the risks, the answer is yes.”

But Dr. Kasper also noted: “It would have been a more difficult question to answer: Is there clinically meaningful benefit versus risk? But that’s not what the question asked.”

In explaining his “yes” vote, Ravi Thadhani, MD, MPH, Emory University, Atlanta, said: “We’re dealing with a rare disease with few options and devastating consequences. We heard from clinicians loud and clear, and from patients for that matter, that options and alternatives are critical, and that there is a continuous decline of cardiac function and worsening of disease in a number of patients that have received the current standard of care. For me, the benefits outweigh the risks.”

Dr. Thadhani also noted that from the data provided, no benefit was shown – ”disappointingly” he lamented – for women, for Black persons, and among individuals who were receiving tafamidis, and he urged the FDA and sponsor to consider this.

The FDA has set a target action date for patisiran for ATTR amyloidosis cardiomyopathy of Oct. 8.

A version of this article first appeared on Medscape.com.

Recently, my office received several phone calls from patients asking if I perform “trap tox.” Having not been on social media around that time, I assumed the term had something to do with botulinum toxin and the trapezius muscle, but I had never heard it before. Not too long afterwards, patients were asking me about it in the office, using the same terminology, and I had several calls about it in one day. When I asked one trusted patient where she’d heard this term, which seemed to be trending, she told me that she had seen it on Instagram, as an ad or a “suggested for you” post.

Whether it’s a different name or term for a cosmetic procedure or laser we use that I’ve never heard before – such as “lip flip” or trap tox (also known as “Barbie Botox”) – many of these trendy terms spread like wildfire on social media. Some of the terms may be marketing tools started and spread by doctors who perform aesthetic procedures, something I don’t recommend as it only creates confusion for patients and practitioners, similar to the confusion consumers face regarding the plethora of over-the-counter skin care options and the marketing terms used for them. Other terms and trends are also started by nonphysician or non–professionally trained providers, sometimes leading to an unsafe or misleading term for an aesthetic procedure.

Over the past few years, several articles about the impact of social media in aesthetics have been published. In one recent paper, published in 2022, Boen and Jerdan noted that 72% of people in the United States use social media, up from 5% of American adults in 2005. In the United States, they note, “YouTube is the most popular platform with 73% of adult users, followed by Facebook (69%), Instagram (37%), SnapChat (24%), and Twitter (22%). Of the sites used daily, Facebook has the most activity (74%), followed by Instagram (64%), SnapChat (63%), YouTube (51%), and Twitter (42%).” They argue that the pros of social media in aesthetic medicine include its use as an educational tool by medical professionals to educate and provide accurate information about cosmetic procedures, and that “providing factual and evidence-based medical information to the public can help to counteract the abundant misinformation that is out there.” The cons include misinformation, no credentialing verification of the provider of the information – essentially anyone can be an “influencer” – as well as the addictive nature of social media for the consumer.

Along the same lines, younger patients tend to rely more on social media in choosing treatments and providers, further perpetuating any anxiety created from misinformation and unrealistic expectations from nonmedical influencers regarding procedures, filters used on photographs, photo editing, etc., in achieving an aesthetic result.

Physicians, particularly fellowship-trained aesthetic and surgical dermatologists, plastic and reconstructive surgeons, oculoplastic surgeons, and ENT facial plastic surgeons, who have the most training, knowledge, and expertise about aesthetic procedures, often have the least amount of time to devote to education via social media, compared with nonmedical influencers. Unless sponsored, they are also not being compensated for using it as an educational tool, except for potential indirect compensation from using it as a marketing tool for themselves and their practices. In contrast, nonmedical influencers often have many followers and time to create content, and in some cases, this is their full-time job.

All in all, most authors agree that social media has been associated with an increased acceptance of cosmetic surgery and procedures. Whether it be a trend seen on social media, or viewing one’s appearance in a filtered or photoediting app, or seeing an image of how another person looks (similar to how people in magazines, films and on television, were viewed in the past), social media has piqued people’s interest in aesthetics. It remains a balance for interested physicians to help keep information about cosmetic procedures presented in a healthy, interesting, professional, and accurate manner, and in a non–time-consuming way.

Dr. Wesley practices dermatology in Beverly Hills, Calif. Write to her at [email protected]. She had no relevant disclosures.
 

References

Boen M and Jerdan K. Clin Dermatol. 2022 Jan-Feb;40(1):45-8.

Chen J et al. JAMA Facial Plast Surg. 2019 Sep 1;21(5):361-7.

Chopan M et al. Plast Reconstr Surg. 2019 Apr;143(4):1259-65.

Recently, my office received several phone calls from patients asking if I perform “trap tox.” Having not been on social media around that time, I assumed the term had something to do with botulinum toxin and the trapezius muscle, but I had never heard it before. Not too long afterwards, patients were asking me about it in the office, using the same terminology, and I had several calls about it in one day. When I asked one trusted patient where she’d heard this term, which seemed to be trending, she told me that she had seen it on Instagram, as an ad or a “suggested for you” post.

Whether it’s a different name or term for a cosmetic procedure or laser we use that I’ve never heard before – such as “lip flip” or trap tox (also known as “Barbie Botox”) – many of these trendy terms spread like wildfire on social media. Some of the terms may be marketing tools started and spread by doctors who perform aesthetic procedures, something I don’t recommend as it only creates confusion for patients and practitioners, similar to the confusion consumers face regarding the plethora of over-the-counter skin care options and the marketing terms used for them. Other terms and trends are also started by nonphysician or non–professionally trained providers, sometimes leading to an unsafe or misleading term for an aesthetic procedure.

Over the past few years, several articles about the impact of social media in aesthetics have been published. In one recent paper, published in 2022, Boen and Jerdan noted that 72% of people in the United States use social media, up from 5% of American adults in 2005. In the United States, they note, “YouTube is the most popular platform with 73% of adult users, followed by Facebook (69%), Instagram (37%), SnapChat (24%), and Twitter (22%). Of the sites used daily, Facebook has the most activity (74%), followed by Instagram (64%), SnapChat (63%), YouTube (51%), and Twitter (42%).” They argue that the pros of social media in aesthetic medicine include its use as an educational tool by medical professionals to educate and provide accurate information about cosmetic procedures, and that “providing factual and evidence-based medical information to the public can help to counteract the abundant misinformation that is out there.” The cons include misinformation, no credentialing verification of the provider of the information – essentially anyone can be an “influencer” – as well as the addictive nature of social media for the consumer.

Along the same lines, younger patients tend to rely more on social media in choosing treatments and providers, further perpetuating any anxiety created from misinformation and unrealistic expectations from nonmedical influencers regarding procedures, filters used on photographs, photo editing, etc., in achieving an aesthetic result.

Physicians, particularly fellowship-trained aesthetic and surgical dermatologists, plastic and reconstructive surgeons, oculoplastic surgeons, and ENT facial plastic surgeons, who have the most training, knowledge, and expertise about aesthetic procedures, often have the least amount of time to devote to education via social media, compared with nonmedical influencers. Unless sponsored, they are also not being compensated for using it as an educational tool, except for potential indirect compensation from using it as a marketing tool for themselves and their practices. In contrast, nonmedical influencers often have many followers and time to create content, and in some cases, this is their full-time job.

All in all, most authors agree that social media has been associated with an increased acceptance of cosmetic surgery and procedures. Whether it be a trend seen on social media, or viewing one’s appearance in a filtered or photoediting app, or seeing an image of how another person looks (similar to how people in magazines, films and on television, were viewed in the past), social media has piqued people’s interest in aesthetics. It remains a balance for interested physicians to help keep information about cosmetic procedures presented in a healthy, interesting, professional, and accurate manner, and in a non–time-consuming way.

Dr. Wesley practices dermatology in Beverly Hills, Calif. Write to her at [email protected]. She had no relevant disclosures.
 

References

Boen M and Jerdan K. Clin Dermatol. 2022 Jan-Feb;40(1):45-8.

Chen J et al. JAMA Facial Plast Surg. 2019 Sep 1;21(5):361-7.

Chopan M et al. Plast Reconstr Surg. 2019 Apr;143(4):1259-65.

Recently, my office received several phone calls from patients asking if I perform “trap tox.” Having not been on social media around that time, I assumed the term had something to do with botulinum toxin and the trapezius muscle, but I had never heard it before. Not too long afterwards, patients were asking me about it in the office, using the same terminology, and I had several calls about it in one day. When I asked one trusted patient where she’d heard this term, which seemed to be trending, she told me that she had seen it on Instagram, as an ad or a “suggested for you” post.

Whether it’s a different name or term for a cosmetic procedure or laser we use that I’ve never heard before – such as “lip flip” or trap tox (also known as “Barbie Botox”) – many of these trendy terms spread like wildfire on social media. Some of the terms may be marketing tools started and spread by doctors who perform aesthetic procedures, something I don’t recommend as it only creates confusion for patients and practitioners, similar to the confusion consumers face regarding the plethora of over-the-counter skin care options and the marketing terms used for them. Other terms and trends are also started by nonphysician or non–professionally trained providers, sometimes leading to an unsafe or misleading term for an aesthetic procedure.

Over the past few years, several articles about the impact of social media in aesthetics have been published. In one recent paper, published in 2022, Boen and Jerdan noted that 72% of people in the United States use social media, up from 5% of American adults in 2005. In the United States, they note, “YouTube is the most popular platform with 73% of adult users, followed by Facebook (69%), Instagram (37%), SnapChat (24%), and Twitter (22%). Of the sites used daily, Facebook has the most activity (74%), followed by Instagram (64%), SnapChat (63%), YouTube (51%), and Twitter (42%).” They argue that the pros of social media in aesthetic medicine include its use as an educational tool by medical professionals to educate and provide accurate information about cosmetic procedures, and that “providing factual and evidence-based medical information to the public can help to counteract the abundant misinformation that is out there.” The cons include misinformation, no credentialing verification of the provider of the information – essentially anyone can be an “influencer” – as well as the addictive nature of social media for the consumer.

Along the same lines, younger patients tend to rely more on social media in choosing treatments and providers, further perpetuating any anxiety created from misinformation and unrealistic expectations from nonmedical influencers regarding procedures, filters used on photographs, photo editing, etc., in achieving an aesthetic result.

Physicians, particularly fellowship-trained aesthetic and surgical dermatologists, plastic and reconstructive surgeons, oculoplastic surgeons, and ENT facial plastic surgeons, who have the most training, knowledge, and expertise about aesthetic procedures, often have the least amount of time to devote to education via social media, compared with nonmedical influencers. Unless sponsored, they are also not being compensated for using it as an educational tool, except for potential indirect compensation from using it as a marketing tool for themselves and their practices. In contrast, nonmedical influencers often have many followers and time to create content, and in some cases, this is their full-time job.

All in all, most authors agree that social media has been associated with an increased acceptance of cosmetic surgery and procedures. Whether it be a trend seen on social media, or viewing one’s appearance in a filtered or photoediting app, or seeing an image of how another person looks (similar to how people in magazines, films and on television, were viewed in the past), social media has piqued people’s interest in aesthetics. It remains a balance for interested physicians to help keep information about cosmetic procedures presented in a healthy, interesting, professional, and accurate manner, and in a non–time-consuming way.

Dr. Wesley practices dermatology in Beverly Hills, Calif. Write to her at [email protected]. She had no relevant disclosures.
 

References

Boen M and Jerdan K. Clin Dermatol. 2022 Jan-Feb;40(1):45-8.

Chen J et al. JAMA Facial Plast Surg. 2019 Sep 1;21(5):361-7.

Chopan M et al. Plast Reconstr Surg. 2019 Apr;143(4):1259-65.