Introduction: Anxiety and depression can affect immune function, yet little is known about their impact on immune checkpoint inhibitor (ICI) therapy outcomes. We investigated associations between an existing anxiety or depression diagnosis and ICI outcomes. Methods: In this secondary analysis, multicenter retrospective real‐world data were abstracted from medical charts. Patients included received ≥ 1 dose of anti‐PD‐1 or anti‐PD‐L1 monotherapy. Key variables abstracted were anxiety/depression diagnosis at treatment initiation, ICI therapy outcomes (immune‐related adverse events, irAEs; overall survival, OS; time to treatment failure, TTF), and other sociodemographic and clinical factors. Results: Of the 913 patients, 11% and 12% had an existing anxiety or depression diagnosis, respectively. Rates of any grade irAEs were 32% overall, and 44% and 37% among those with anxiety or depression history, respectively. In the multivariable analysis, patients with an anxiety diagnosis had a greater likelihood of experiencing irAEs (OR = 1.80; 95% CI = 1.16–2.79, p = 0.009) and better OS (HR = 0.74; 95% CI = 0.54–1.00, p = 0.048) compared to those without an anxiety diagnosis. Depression diagnosis was not significantly associated with irAEs, OS, or TTF. In multivariable sensitivity analyses restricted to patients with non‐small cell lung cancer (NSCLC, n = 417), those with an anxiety diagnosis had a trend toward better OS (HR = 0.66; 95% CI = 0.43–1.01; p = 0.056) and longer TTF (HR = 0.71; 95% CI = 0.50–1.02; p = 0.063) than those without an anxiety diagnosis, while irAEs did not vary significantly by anxiety. Conclusion: Pre‐existing anxiety diagnosis may impact clinical outcomes for patients receiving anti‐PD‐1 or anti‐PD‐L1 treatments. Links between psychosocial factors and ICI outcomes should be further examined in translational and prospective studies.

Primary clear cell adenocarcinoma (CCA) of the urinary bladder is a rare and aggressive malignancy. Few reports in the literature describe this presentation, as associated with malignant transformation of endometriosis. This case highlights the complex etiology of this variant of CCA, initially diagnosed using comprehensive imaging and genetic analysis, and subsequently confirmed through extensive surgical intervention and chemotherapy.

Background/Objectives: Allogeneic hematopoietic stem cell transplantation (alloSCT) is a curative treatment for myeloid diseases, yet relapse remains the major cause of post-transplant mortality. To reduce the risk of recurrence, we evaluated the addition of 400 cGy total body irradiation (TBI) to conditioning with fludarabine-busulfan (Flu/Bu4). Methods: In this prospective study, 46 patients with myeloid diseases were randomized to Flu/Bu4 or Flu/Bu4/TBI conditioning group. The Flu/Bu4 conditioning regimen consisted of fludarabine 40 mg/m² on days -6 to -3 followed by busulfan 130 mg/m² on days -6 to -3. Flu/Bu4/TBI conditioning regimen added 400 cGy TBI on day -1 to the FluBu4 regimen. Results: Among 34 acute myeloid leukemia (AML) patients, relapse was numerically lower in those who received Flu/Bu4/TBI (25%) versus Flu/Bu4 (44.4%) at three years (HR = 0.58, 95% CI 0.19 to 1.81, p = 0.35). Flu/Bu4/TBI appeared to increase the risk of non-relapse mortality (NRM) vs. Flu/Bu4 in AML patients at three years (25.0% versus 11.1%; HR = 2.11, 95% CI 0.51 to 8.83, p = 0.65). Overall survival (OS) was similar in AML patients undergoing conditioning with Flu/Bu4 (72.2%) versus Flu/Bu4/TBI (62.5%) at one year (p = 0.4). Conclusions: In conclusion, the addition of 400 cGy TBI to Flu/Bu4 reduced the risk of relapse but did not improve OS as a consequence of higher regimen-related mortality. Clinicaltrials.gov identifier: NCT01366612.

Caval thrombus with intracardiac involvement is a rare condition that is associated with renal cell carcinoma. Few reports in literature describe this presentation with metastatic melanoma. Metastatic melanoma is known to involve the adrenal gland, although associated tumor thrombus extension into the renal vein and inferior vena cava is extremely rare. In this case report, we describe radical nephrectomy and adrenalectomy for metastatic melanoma.