JAMA Oncology最新文献

{"title":"Minimally Invasive Surgery, Intraoperative Capsule Rupture, and Survival in Early Ovarian Cancer.","authors":"Koji Matsuo,Alice J Lee,Matthew W Lee,Emmeline L Friedman,Hadi Erfani,Sawa Keymeulen,Kimberly M Juarez,Jennifer A Yao,Shinya Matsuzaki,Michiko Kodama,Lynda D Roman","doi":"10.1001/jamaoncol.2026.0711","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0711","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"45 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147733313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Treatment Intent Beyond the Curative/Palliative Binary in Modern Oncology.","authors":"Hanneke W M van Laarhoven,Inge Henselmans,Peter S N van Rossum","doi":"10.1001/jamaoncol.2026.0493","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0493","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"29 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147733312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing Treatment Outcomes Following Immune-Related Adverse Events-Reply.","authors":"Joseph M Unger,Dawn L Hershman","doi":"10.1001/jamaoncol.2026.0785","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0785","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"82 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147733522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing Treatment Outcomes Following Immune-Related Adverse Events.","authors":"Koichiro Yuji,Wakako Yuji","doi":"10.1001/jamaoncol.2026.0782","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0782","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"24 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147733318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying High-Risk Smoldering Multiple Myeloma for Early Intervention.","authors":"Cecilie V Maeng,Sæmundur Rögnvaldsson,Christian Brieghel,Morten N Andersen,Ida B Kristensen,Agoston Szabo,Kirsten Grønbæk,Carsten U Niemann,Sigurdur Y Kristinsson,Sigrún Thorsteinsdóttir","doi":"10.1001/jamaoncol.2026.0831","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0831","url":null,"abstract":"ImportanceEarly treatment may benefit patients with high-risk smoldering multiple myeloma (SMM), a precursor of active multiple myeloma, but inconsistent high-risk definitions may capture different disease subsets.ObjectiveTo compare 2 high-risk SMM risk definitions: the AQUILA trial inclusion criteria and the 2/20/20 risk stratification model.Design, Setting, and ParticipantsThis cohort study included data from 2 separate SMM cohorts and a retrospective analysis assessing progression risk. The Iceland Screens, Treats, and Prevents Multiple Myeloma (iStopMM) is a large population-based screening study in Iceland, conducted from 2016 to 2021, while the Danish Lymphoid Cancer Resource (DALY-CARE) is a nationwide clinical data collection from Denmark from 2002 to 2025. From the iStopMM cohort, individuals with SMM were detected by screening. In DALY-CARE, individuals with SMM were identified in a clinical setting. Data were analyzed from March 2025 to January 2026.ExposureHigh-risk SMM by the AQUILA criteria, defined by presence of immunoparesis, monoclonal protein (M-protein) greater than 3.0 g/dL, immunoglobin A isotype, bone marrow plasma cell infiltration greater than 50%, or free light chain ratio 8 or greater. High risk by the 2/20/20 model was defined by presence of more than 1 of: M-protein greater than 2.0 g/dL, bone marrow plasma cell infiltration greater than 20%, or free light chain ratio greater than 20.Main Outcomes and MeasuresProportion of high-risk SMM in the 2 cohorts by both models and risk of progression as defined by initiation of treatment.ResultsA total of 193 individuals (median [IQR] age, 70 [63-72] years; 116 [60%] female) from the iStopMM cohort and 1147 individuals (median [IQR] age, 72 [64-79] years; 598 [52%] female) from the DALY-CARE cohort were included. In the screened cohort (iStopMM), 65 participants (34%) had high-risk SMM according to the AQUILA criteria, and 15 participants (8%) had high-risk SMM according to the 2/20/20 model. In the clinical cohort (DALY-CARE), 607 participants (55%) met high-risk criteria according to AQUILA, and 219 participants (19%) had high-risk SMM according to the 2/20/20 model. For individuals with AQUILA-defined high-risk disease in the clinical cohort, the 2-year progression risk was 27.0% (95% CI, 23.3%-30.7%), with an annual progression rate of 14.5%. For individuals with high risk defined by 2/20/20, the 2-year progression risk was 44.1% (95% CI, 37.1%-51.1%), with an annual progression rate of 27.3%.Conclusions and RelevanceThis cohort study found that the AQUILA trial criteria classified approximately 3 times more patients with SMM as having high risk compared with the 2/20/20 model and captured a group with substantially lower progression risk. These results suggest that the 2/20/20 model more accurately identifies a truly high-risk group with SMM, for whom early treatment is more likely to be beneficial.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"71 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147733314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young-Onset Colorectal Cancer Mortality by Education.","authors":"Ahmedin Jemal,Dongjun Lee,Rebecca L Siegel,Elizabeth J Schafer,Hyuna Sung,Farhad Islami","doi":"10.1001/jamaoncol.2026.0581","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0581","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"66 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Care For Young Adult Patients With Cancer at the End of Life.","authors":"Eduardo Bruera","doi":"10.1001/jamaoncol.2026.0489","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0489","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"109 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"18F-Fluorodeoxyglucose Positron Emission Tomography for Estimating Outcomes After Initial Treatment for Metastatic Breast Cancer: A Nonrandomized Clinical Cohort Trial.","authors":"Jasper J L van Geel,Bertha Eisses,Sjoerd G Elias,Adrienne H Brouwers,Frederike Bensch,Sophie L Gerritse,Lindsay Angus,Andor W J M Glaudemans,Evelien J M Kuip,Agnes Jager,Daniela E Oprea-Lager,Daniëlle J Vugts,Jasper Emmering,Anne I J Arens,Wim J G Oyen,Bert van der Vegt,Marjolijn N Lub-de Hooge,C Willemien Menke-van der Houven van Oord,Elisabeth G E de Vries,Carolina P Schröder, ","doi":"10.1001/jamaoncol.2026.0767","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0767","url":null,"abstract":"ImportanceOptimizing treatment decisions in metastatic breast cancer (MBC) can alleviate patients' burden and improve quality of life. Whether 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) can be used to better estimate outcomes is unknown.ObjectiveTo evaluate clinical utility of early metabolic change on FDG-PET for improving outcome estimation compared with standard diagnostic evaluation in patients with newly diagnosed MBC.Design, Setting, and ParticipantsThe multicenter IMPACT-MBC clinical cohort trial enrolled patients with nonrapidly progressive, newly diagnosed MBC from August 2013 to May 2018, before initiation of first-line systemic therapy. Baseline assessment included metastasis biopsy procedure and FDG-PET and CT imaging. Early FDG-PET was performed after 2 weeks of treatment, and CT response evaluation after 8 weeks. Clinical utility was defined as the ability of early FDG-PET to estimate progressive disease (PD) on CT, progression-free survival (PFS), and overall survival (OS). Data were analyzed from October 19, 2025, to February 13, 2026.InterventionEarly FDG-PET or standard-of-care (SOC) biopsy-based treatment.Main Outcomes and MeasuresClinical utility of molecular imaging to improve outcome estimation of standard diagnostics defined as the capacity to identify poor patient outcomes. Measures were PD at 8 weeks, PFS, and OS.ResultsThe analysis included 200 patients (median [range] age, 61 [32-84] years; 198 females [99%] and 2 males [1%]). Non-PD on early FDG-PET had a negative predictive value (NPV) of 94.7% (95% CI, 89.5%-97.4%) for non-PD on 8-week CT. This was similar in all MBC subtypes and bone-only disease. Patients with SOC treatment and non-PD on early FDG-PET (n = 133) had a median PFS of 19.4 (95% CI, 15.2-22.8) months and OS of 39.4 (95% CI, 33.7-48.3) months compared to 4.1 (95% CI, 3.3-15.5) months and 18.5 (95% 3 CI, 7.0-33.0) months, respectively (P < .001 for both). Patients with non-PD on 8-week CT but with PD on early FDG-PET had a median (IQR) PFS and OS of 9.5 (4.1-18.1) and 19.4 (8.7-33.0) months compared to 22.3 (15.3-96.1) months and 40.1 (23.4-72.7) months without PD.Conclusions and RelevanceIn this clinical cohort trial of patients with nonrapidly progressive, newly diagnosed MBC before initiation of first-line systemic therapy, early FDG-PET after only 2 weeks of treatment identified patients with MBC with distinct long-term outcomes. Incorporating early FDG-PET can improve outcome estimation of standard CT assessment.Trial RegistrationClinicalTrials.gov Identifier: NCT01957332.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"19 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unadjusted Confounding in the Association Between Clonal Hematopoiesis and Heart Failure After Cancer Therapy-Reply.","authors":"Derek Shyr,Yash Pershad,Alexander G Bick","doi":"10.1001/jamaoncol.2026.0779","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0779","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"4 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Assistance in Dying Use Among Adolescent and Young Adult Patients With Cancer.","authors":"Emilie Muth,Nicole Maseja,Andrew Harper,Siwei Qi,Linda Watson,Claire Link,Janet Vandale,Kathleen Reynolds,Ursula M Sansom-Daly,James Silvius,Miranda M Fidler-Benaoudia","doi":"10.1001/jamaoncol.2026.0700","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0700","url":null,"abstract":"ImportanceAdolescents and young adults are a unique cancer population that require tailored cancer care. Although literature suggests insufficient palliative care for these individuals, the utilization and context surrounding medical assistance in dying (MAID) in adolescent and young adult patients with cancer is unexplored.ObjectiveTo describe MAID utilization and experiences among adolescent and young adult patients with cancer.Design, Setting, and ParticipantsThis mixed-methods, retrospective cohort study included all patients in Alberta, Canada, diagnosed with a first primary cancer between age 15 and 39 years who received MAID for cancer before age 45 years from 2016 to 2022. The analysis was performed from May 2024 to February 2026.Main Outcomes and MeasuresDescriptive statistics summarized patient, cancer, supportive care, and MAID characteristics. Symptom complexity and burden in the year before death, using the Edmonton Symptom Assessment System-revised (ESAS-r) were modelled. Qualitative thematic analysis of long-hand medical charting of health care professionals was conducted to understand the context leading to MAID. Integration of quantitative and qualitative findings was undertaken using a joint display.ResultsOverall, 34 adolescent and young adult patients (median [range] age, 33.44 [15.79-39.10] years) with cancer received MAID, with provisions peaking in 2020. Eighteen were female individuals (52.9%), 31 (91.2%) lived in an urban zone, 10 (29.4%) had children, and more than half received at least 3 types of cancer treatment. The median (range) time from advanced cancer diagnosis to provision was 1.1 (0.1-14.5) years, yet half of individuals received specialist palliative care less than 3 months prior to death. Symptom burden significantly increased over the year before death for all domains, with rapid rises visually observed beginning around month 5 prior to MAID. Overall, 10 of 14 (71.4%) reported high symptom complexity in the last month of life, with symptom scores highest for tiredness, poor well-being, pain, and drowsiness. Twenty-four of 30 (80%) reported a loss of ability to engage in activities making life meaningful at MAID provision. Qualitative themes offered context into the patient experience and included social isolation, previous experience with cancer death, wanting control, and achieving death acceptance. Finally, the joint display showed points of convergence between quantitative and qualitative results.Conclusions and RelevanceThis cohort study suggests that health care professionals may use advanced disease diagnosis or patient-reported symptom scores to trigger timely specialist palliative care referrals, which may reduce suffering and improve experiences at end of life for adolescent and young adult patients with cancer.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"22 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}