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BACKGROUND Using smartphone technology and text messaging for health is a growing field. This type of technology is well integrated into the lives of young adults. However, few studies have tested the effect of this type of technology to promote weight loss in young adults OBJECTIVE:: The purpose of this study is to test the effectiveness of a behaviorally based smartphone application for weight loss combined with text messaging from a health coach on weight, body mass index (BMI), and waist circumference in young adults as compared with a control condition. METHODS Sixty-two young adults, aged 18 to 25 years, were randomized to receive (1) a smartphone application + health coach intervention and counseling sessions or (2) control condition with a counseling session. All outcome measures were tested at baseline and 3 months. These included weight, BMI, waist circumference, dietary habits, physical activity habits, and self-efficacy for healthy eating and physical activity. RESULTS The sample was 71% female and 39% white, with an average age of 20 years and average BMI of 28.5 kg/m. Participants in the smartphone + health coach group lost significantly more weight (P = .026) and had a significant reduction in both BMI (P = .024) and waist circumference (P < .01) compared with controls. CONCLUSIONS The results of this weight loss trial support the use of smartphone technology and feedback from a health coach on improving weight in a group of diverse young adults.

A major obstacle to the development of immunotherapy for pancreatic ductal adenocarcinoma (PDA) has been identifying immune relevant antigens that are not expressed by normal cells. DNA sequencing technologies that allow for the genome-wide identification of tumor mutations have shown that human PDAs harbor an average of 63 mutations (called the “mutome”). Since these mutations are not present prior to the onset of tumorigenesis, each mutation generates a novel and essentially foreign antigen (termed “epitope”). Unlike most classical tumor epitopes, mutome-derived epitopes are uniquely specific to each patient’s tumor. Furthermore, T cells recognizing them may avoid immunological tolerance mechanisms that inhibit or deplete T cells that recognize classical tumor epitopes that are also expressed by normal cells. Vaccines designed to activate mutome-specific T cells have the potential to induce robust and specific antitumor responses and provide a new approach for personalized tumor immunotherapy. We are using the Panc02 murine PDA model to develop and explore the potential of this approach. Sequence analysis identified 596 point mutations in Panc02 cells, significantly more than the number found in human PDAs. The NetMHC prediction server was used to screen for epitopes predicted to bind H2-Db and H2-Kb. In total, 15 strong candidates (NetMHC scores 100 spots per 1x105 T cells). Antitumor efficacy was evaluated by immunizing mice 3 days following subcutaneous Panc02 challenge. Only immunization against the 5 robust peptides was capable of preventing tumor outgrowth, and was significantly more effective than treatment with GM-CSF-secreting whole-cell vaccination (GVAX), another approach currently being investigated in the clinic by our group. We are currently testing the efficacy of this approach against larger established tumors and metastatic liver lesions. We are also working to optimize this approach by testing additional adjuvants and vaccine vectors, including recombinant Listeria monocytogenes that express the mutant gene sequences. Exact epitopes are being mapped in order to evaluate the utility of MHC-binding predictions. Ultimately, we intend to translate our optimized approach into the clinic.