Sunpasitthiprasong Hospital

INTRODUCTION:TIGIT and PD-1 trigger distinct but interconnected immunosuppressive pathways. We investigated first-line domvanalimab (Fc-silent anti-TIGIT) plus zimberelimab (anti-PD-1) in PD-L1-high (≥50%), stage IIIB-IV NSCLC. MATERIALS AND METHODS:This phase 2, multicenter, randomized, open-label study (ARC-10, Part 1) randomized (2:2:1) patients to intravenous domvanalimab 15 mg/kg plus zimberelimab 360 mg (DZ), zimberelimab 360 mg (Z), or platinum-doublet chemotherapy every 3 weeks. The primary endpoint was progression-free survival (PFS). Secondary endpoints were overall survival (OS), confirmed objective response rate (ORR), and safety. RESULTS:Of 98 randomized patients, 95 received treatment (DZ, n = 38; Z, n = 40; chemotherapy, n = 17). As of May 17, 2024, median follow-up was 24.5 months; 22patients remained on first-line treatment (DZ, n = 11; Z, n = 10; chemotherapy, n = 1). Median (95% CI) PFS was 11.5 (4.0-26.2) months for DZ, 6.2 (2.5-12.3) months for Z, and 9.6 (2.6-16.4) months for chemotherapy. Median (95% CI) OS was not reached (13.7-not evaluable [NE]) for DZ, 24.4(7.8-NE) months for Z, and 11.9(2.7-NE) months for chemotherapy. DZ vs Z hazard ratio (95% CI) was 0.69 (0.40-1.18) for PFS and 0.64 (0.32-1.25) for OS. ORR (95% CI) was 44.7% (28.6-61.7) for DZ, 35.0% (20.6-51.7) for Z, and 35.3% (14.2-61.7) for chemotherapy. Grade ≥ 3 treatment-related adverse events (AEs) were lower for DZ (21.1%) and Z (15.0%) vs chemotherapy (47.1%). Immune-mediated AEs were similar between DZ (23.7%) and Z (20.0%). Infusion-related reactions were low (0%-7.9% across arms). CONCLUSIONS:Adding Fc-silent anti-TIGIT (domvanalimab) to anti-PD-1 (zimberelimab) led to encouraging efficacy and showed no new safety concerns in patients with previously untreated stage IIIB-IV NSCLC.

Cannabis is the most widely used illicit drug globally, with an increasing use for both medicinal and non-medical purposes. Despite evolving policies and regulations, knowledge gaps persist among the youth, particularly regarding cannabis use, its integration into food products, and associated health risks. Many adolescents rely on unverified sources such as social media and peer networks for cannabis-related information, thereby increasing the risk of misinformation and unsafe consumption. This cross-sectional descriptive study assessed knowledge levels with respect to medical cannabis use, cannabis in food, and health literacy among late adolescent students in educational institutions. Additionally, it examined factors influencing knowledge, experience, and willingness to try cannabis while exploring opinions on medical cannabis use and cannabis in food. Data were collected from 252 students aged 15 - 18 years, using self-administered questionnaires. Descriptive statistics were used to analyze participant characteristics, while the chi-square test was applied to assess relationships between demographic factors, knowledge, and health literacy. The Decision Tree method (CART Algorithm) identified key determinants, classified participants based on significant factors, and predicted cannabis use and abstinence. The findings revealed that 49.2% of the participants had low cannabis-related knowledge, whereas 62.3% demonstrated moderate health literacy. Gender and field of study significantly influenced knowledge and health literacy. Most of the participants acknowledged the benefits and risks of cannabis use. These results highlight the need for targeted educational interventions to enhance cannabis-related knowledge and health literacy among late adolescents, considering their unique contexts and experiences.

Thailand’s decriminalization of cannabis in June 2022 substantially increased adolescent exposure. Cannabis knowledge and health literacy among vocational students remain poorly characterized. A cross-sectional online survey was conducted from January to March 2024 among vocational secondary students at one vocational institution in a province in northeastern Thailand. Of 2,656 eligible students, 555 provided valid responses (response rate 20.9

Current data on the genetic and lifestyle factors associated with Epstein-Barr virus (EBV) reactivation in the oral cavity are limited for the Thai population. Furthermore, comprehensive data linking EBV reactivation to head and neck cancers in Thailand remains scarce. The present study aimed to detect EBV reactivation using quantitative PCR in normal oral buccal cells and to examine the associated risk factors. A total of 982 oral buccal cell samples collected across Thailand were analyzed. EBV was detected in 36% (350/974) of samples when targeting the Epstein-Barr nuclear antigen-1 gene, 52% (458/885) of samples when targeting latent membrane protein-1 (LMP-1) and 20% (196/981) of samples when both genes were investigated. The highest prevalence of LMP-1 and dual gene positivity was observed in individuals aged 11-20 years. Several SNPs in the TNF-α promoter region, including rs1452146766, rs1799964, rs1554283139, rs924800313, rs1799724 and rs1771099055, were more frequently observed in EBV-positive samples than in EBV-negative samples. Notably, the TNF-α mutation rs1799964 (-1031 TC and CC) was present in 17.3% vs. 9.3% of EBV-positive cases, respectively. Multivariate analysis identified sex, smoking, alcohol consumption, soft drink intake, age of 21-30 years and having four children as significant factors associated with EBV reactivation. In the 21-30-year-old age group, LMP-1 positivity was elevated, and higher rates of alcohol use, sexual activity and oral ulcers were observed. Furthermore, in individuals with mouth ulcers, the TNF-α mutation (TC; n=81) was more common than wild-type TNF-α (CC; n=16).

OBJECTIVES:Global information on the costs of the autism spectrum disorder (ASD) diagnostic process is limited. No previous research has been conducted in Thailand. This study aimed to determine the societal costs of the ASD diagnostic process after the patients visited 7 tertiary hospitals in the Northern, Central, Northeast, and Southern regions of Thailand. METHODS:A total of 155 children diagnosed with ASD were included from January to December 2022. The societal costs consisted of the patient costs, and service provider costs. Government reimbursement and labor costs were also evaluated. The patient perspective costs were calculated from direct nonmedical costs plus nonreimbursable direct medical costs. Direct nonmedical costs were collected by parent questionnaires. Nonreimbursable direct medical costs and the government reimbursement were acquired from each hospital's financial database. Service provider perspective costs were gathered from the Human Resources Unit hospital database. RESULTS:The median of societal, service provider, patient, labor costs, and government reimbursement for the ASD diagnostic process were 3578.6 (2433.7-5412.8), 259.5 (259.5-314.7), 3319.0 (2169.0-5138.1), 559.6 (488.8-795.6), and 200 (0-300) Thai Bahts (THB)/child, respectively. The caregiver productivity loss was the largest proportion among the total patient perspective costs. The median societal costs by region sorted by descending order were Northeast, Central, North, and South, which were 5197.6 (3248.5-6802.3), 3578.6 (2688.8-5412.8), 3028.6 (2286.7-4905.7), and 2198.9 (1686.8-3483.9) THB/child, respectively. CONCLUSION:The societal costs of the ASD diagnostic process were 3578.6 THB/child. The Northeast region demonstrated the highest costs. The caregiver productivity loss was the largest proportion of the total societal costs.