JAMA Oncology最新文献

{"title":"Challenges in Shared Care Research in Hematopoietic Cell Transplant.","authors":"Kwok Ying Chan,Harinder Gill,Chi Yan Wong","doi":"10.1001/jamaoncol.2025.1132","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.1132","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"25 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992024","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":"Patient-Reported Outcomes With Stereotactic Intensity Modulated Radiotherapy After Radical Prostatectomy: A Nonrandomized Clinical Trial.","authors":"John Nikitas,Leslie K Ballas,Tahmineh Romero,Connor Lynch,Ting Martin Ma,Luca F Valle,Ankush Sachdeva,Natalie Chong,Vince Basehart,Antonio Franco,Robert Reiter,Christopher Saigal,Karim Chamie,Mark S Litwin,Nicholas M Donin,Matthew Rettig,Nicholas G Nickols,Minsong Cao,Stanley L Liauw,Michael L Steinberg,Amar U Kishan","doi":"10.1001/jamaoncol.2025.1059","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.1059","url":null,"abstract":"ImportancePostoperative radiotherapy remains underused for men with biochemical recurrence or adverse pathological features after radical prostatectomy (RP). Stereotactic body radiotherapy (SBRT) may improve utilization and poses potential radiobiological advantages.ObjectiveTo evaluate physician-reported late toxic effects and 2-year patient-reported outcomes (PROs) following post-RP SBRT.Design, Setting, and ParticipantsThis phase 2, single-arm trial was conducted in 2 academic centers in the US and included a comparator cohort. Men with post-RP prostate-specific antigen greater than 0.03 ng/mL or adverse pathologic features were included. Data were collected from February 2018 to March 2021, and data were analyzed from January to October 2024.InterventionsSBRT delivered at 30 to 34 Gy in 5 fractions to the prostate bed. Nodal irradiation, boost to gross disease, and/or hormonal therapy were delivered per physician discretion.Main Outcomes and MeasuresLate toxic effects (more than 90 days after treatment) were graded according to Common Terminology Criteria for Adverse Events version 4.03. PROs were measured using Expanded Prostate Cancer Index-26. The proportion of men whose PROs had decrements greater than twice the threshold for minimal clinically important difference (MCID) at any point during the first 2 years were evaluated. The longitudinal PROs for men receiving SBRT was compared with a cohort of 200 men receiving postoperative conventionally fractionated radiotherapy (CFRT) using logistic regression, while adjusting for baseline scores, age, and receipt of nodal irradiation.ResultsOf 100 patients treated with post-RP SBRT, the median (IQR) age was 68.5 (63.9-71.4) years, and the median (IQR) follow-up was 43 (37-53) months. Cumulative incidence of late grade 2 and 3 genitourinary toxic effects was 25% and 4%, respectively, and of late grade 2 and 3 gastrointestinal tract toxic effects was 3% and 3%, respectively. The proportion of patients with decrements more than 2-fold the MCID in PROs was 38.9% (37 of 95) for urinary incontinence, 17.9% (17 of 95) for urinary irritation, and 34.1% (31 of 91) for bowel function. Compared with the CFRT cohort, the adjusted odds ratio for patients receiving SBRT experiencing decrements more than 2-fold the MCID was 1.55 (95% CI, 0.87-2.76; P = .14) for urinary incontinence, 0.94 (95% CI, 0.46-1.94; P = .87) for urinary irritation, and 1.03 (95% CI, 0.57-1.84; P = .93) for bowel function.Conclusions and RelevanceIn this nonrandomized clinical trial, post-RP SBRT was well-tolerated, with no measurably different decline in urinary or bowel PROs through 2 years compared with CFRT. Randomized studies and longer follow-up will better define the toxic effects and efficacy profile of post-RP SBRT.Trial RegistrationClinicalTrials.gov Identifier: NCT03541850.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"5 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992026","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":"Can Ultra-Hypofractionated Stereotactic Radiation After Radical Prostatectomy Cut Time on Treatment or Are the Data Not Sharp Enough?","authors":"Sean M McBride,Howard I Scher","doi":"10.1001/jamaoncol.2025.0572","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0572","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"121 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992033","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":"Barriers to Chimeric Antigen Receptor T-Cell Therapy.","authors":"Yannis K Valtis,Kuo-Kai Chin,David Nemirovsky,Sean M Devlin,Meira Yisraeli Salman,Leora Boussi,Briana Cadzin,Carina McLoughlin,Elizabeth Cathcart,Paul Davis,Chelsea Brooklyn,Todd Goldstein,Chris Famulare,Gunjan L Shah,Moneeza Walji,Michael Scordo,Alexander P Boardman,Roni Shouval,Eytan M Stein,Mark B Geyer,Sham Mailankody,M Lia Palomba,Saad Z Usmani,Gilles Salles,Sergio A Giralt,Miguel-Angel Perales,Jae H Park","doi":"10.1001/jamaoncol.2025.1127","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.1127","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"53 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992027","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":"Challenges in Shared Care Research in Hematopoietic Cell Transplantation-Reply.","authors":"Gregory A Abel,Haesook T Kim,Robert J Soiffer","doi":"10.1001/jamaoncol.2025.1135","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.1135","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"25 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992023","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":"Reconsidering the Cancer Center Accreditation Model.","authors":"Alison S Baskin,Samantha K Hendren,Lesly A Dossett","doi":"10.1001/jamaoncol.2025.0620","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0620","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"20 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921037","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":"Harm-Benefit Balance of Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer.","authors":"James Heyward,Catherine R Lesko,Joseph C Murray,Hemalkumar B Mehta,Jodi B Segal","doi":"10.1001/jamaoncol.2025.0985","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0985","url":null,"abstract":"ImportanceThe benefits and harms of immune checkpoint inhibitor (ICI) therapy for lung cancer vary across groups, including those typically underrepresented in randomized clinical trials.ObjectiveTo quantify the harms and benefits of ICI-containing regimens in individuals with non-small cell lung cancer and assess heterogeneity across priority subgroups.Design, Setting, and ParticipantsThis retrospective cohort study conducted in 2024 used 2013 to 2019 Surveillance, Epidemiology, and End Results (SEER) Medicare data of individuals 66 years or older with non-small cell lung cancer who were exposed to any ICI.ExposuresICI + chemotherapy, single ICI (reference group).Main OutcomesSevere immune-related adverse events (irAE; harm) and mortality (when delayed mortality was the benefit). Severe irAEs were defined using validated diagnosis and medication codes. Mortality was ascertained from Medicare data. Hazard ratios (HRs) were estimated and 95% CIs were stratified by whether an ICI was used as the first or second or later systemic anticancer treatment (SACT) and in subgroups defined by preexisting autoimmune disease, sex, and age. The harm-benefit tradeoff was described as excess severe irAEs per year of life gained in which the gain in survival time was assessed using restricted mean survival time.ResultsOf 17 681 Medicare beneficiaries, 8797 (49.5%) were female, and the mean (SD) age was 74 (6.0) years. Compared with a single ICI (14 249 [80.6%]), individuals treated with ICI + chemotherapy (3432 [19.4%]) had an elevated risk of severe irAE in the first SACT setting (hazard ratio [HR], 1.18; 95% CI, 1.06-1.30) but not in the second or later SACT setting (HR, 1.04; 95% CI, 0.92-1.19); there was a decreased risk of mortality in the first SACT setting (HR, 0.66; 95% CI, 0.62-0.72) but not in the second or later SACT setting (HR, 0.94; 95% CI, 0.68-1.03). In the first SACT setting, ICI + chemotherapy delayed mortality more among patients with (vs without) autoimmune disease at baseline. For each 1 year of life gained, the risk of severe irAEs was 0.31 (95% CI, 0.09-0.53) and the tradeoff was also statistically significant in men and patients without autoimmune disease.ConclusionsThe results of this cohort study suggest that given both treatment-related harms and benefits, ICI + chemotherapy use in the first SACT setting requires informed decision-making; the potential benefits of ICI + chemotherapy vs single ICI in high-risk subgroups is encouraging.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"23 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921034","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":"Prophylactic Irradiation of the Contralateral Breast for BRCA Carriers With Early Breast Cancer: A Nonrandomized Clinical Trial.","authors":"Ella Evron,Benjamin W Corn,Hadassah Goldberg,Roxolyana Abdah-Bortnyak,Ora Rosengarten,Diana Matceyevsky,David B Geffen,Raphael Catane,M Raphael Pfeffer,Orit Kaidar-Person,Merav A Ben David","doi":"10.1001/jamaoncol.2025.0901","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0901","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"48 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921035","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":"Immunotherapy With or Without Chemotherapy in Advanced NSCLC-A Delicate Balance of Harm and Benefit.","authors":"Giannis Mountzios","doi":"10.1001/jamaoncol.2025.0897","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0897","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"183 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921036","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":"Management of Adult Acute Lymphoblastic Leukemia: A Review.","authors":"Hagop Kantarjian,Ibrahim Aldoss,Elias Jabbour","doi":"10.1001/jamaoncol.2025.0613","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0613","url":null,"abstract":"ImportanceResearch in acute lymphoblastic leukemia (ALL) is translating into rapid changes in therapy and outcomes. Historically, adult ALL was treated with intensive chemotherapy extending over 2.5 to 3 years. This established tradition, accepted because of the high cure rates in childhood ALL, has been challenged by the development of highly active targeted therapies.ObservationTreatment modalities, combined with less and shorter chemotherapy durations, have produced better results than chemotherapy. The novel therapies include using the more potent BCR::ABL1 tyrosine kinase inhibitors (eg, ponatinib, dasatinib) with the bispecific CD3-CD19 T-cell engager antibody blinatumomab in Philadelphia chromosome-positive ALL and combining blinatumomab and/or inotuzumab (CD22 antibody drug conjugate) with standard chemotherapy in B-cell ALL. These have been associated with improved 4-year survival rates of 85% to 90% in Philadelphia chromosome-positive ALL and 80% to 85% in B-cell ALL.Conclusions and RelevanceThe management of ALL is changing rapidly. Investigators have evaluated frontline and later-line regimens with combinations of tyrosine kinase inhibitors and immunotherapies with less or no chemotherapy. Future research will evaluate CD19, CD20, and CD22 multitargeting antibodies and chimeric antigen receptor T-cell therapies, new antibody formulations, and less intensive/shorter regimens.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"8 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897460","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}