JAMA Oncology最新文献

{"title":"Eligibility for Cochlear Implant Candidacy Evaluation in Childhood Cancer Survivors.","authors":"Johnnie K Bass,Sarah E Warren,Sydney G Dillard,Anna Lawrence Peeples,Kendrick Li,Skye Jones,Chia-Ho Hua,Lu Xie,Siyao Liu,Kirsten K Ness,Melissa M Hudson,Gregory T Armstrong,Celine Richard,Kevin R Krull","doi":"10.1001/jamaoncol.2025.0856","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0856","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"38 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897426","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":"Modeling Population-Level Impacts of Cell-Free DNA Screening for Colorectal Cancer in Canada.","authors":"John M Hutchinson,Yibing Ruan,Brendan J Chia,Carl J Brown,Robert J Hilsden,Jonathan M Loree,Darren R Brenner","doi":"10.1001/jamaoncol.2025.0908","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0908","url":null,"abstract":"ImportanceCell-free DNA (cfDNA) testing is an emerging approach for colorectal cancer screening that has been approved in the US. The impact of cfDNA testing in the Canadian setting, assuming adherence mirroring prior real-world cfDNA work and assay performance from a Guardant Health study, is unknown.ObjectiveTo estimate how cfDNA screening impacts clinical and economic outcomes in Canada compared with existing screening approaches (fecal immunochemical testing [FIT] or colonoscopies).Design, Setting, and ParticipantsThe OncoSim-Colorectal model (version 3.6.5.7) was used to simulate participation, relative effectiveness, and cost of introduction of cfDNA tests every 3 years. A population of 32 million Canadians were simulated and examined for outcomes and costs between 2024 and 2092.ExposuresScreening with colonoscopy, FIT, or cfDNA.Main Outcomes and MeasuresScreen-detected colorectal cancer cases, deaths, health-adjusted person-years, potential years of life lost, and cost of cancer screening and management were examined.ResultsUnder higher participation, cfDNA detected 393 087 cases of colorectal cancer between 2024 and 2092 compared with 156 009 cases in the FIT scenario, and cfDNA reduced overall mortality by 121 383 deaths compared with current predictions with FIT. Linear regression models indicated that approximately 78% participation with 80% adherence or 69% participation with 100% adherence to cfDNA screening would be required to reduce deaths below the levels achieved by colonoscopy testing. Higher costs were associated with cfDNA testing, where each health-adjusted person-year had a cost of CAD $234.80 (US $164.06), and 0.025 deaths were averted per CAD $100 000 (US $69 874) additional dollars spent compared with FIT testing. When cfDNA testing was modeled with the same participation as FIT testing (43%), there was worse overall population impact (eg, greater number of deaths), emphasizing the importance of high participation for cfDNA testing to improve outcomes.Conclusions and RelevanceThis study suggests that cfDNA testing could result in increased detection of colorectal cancer and reduced mortality if higher participation than reported in previous studies is achieved at the population level. Patient input on acceptance of blood-based vs stool-based screening may help inform real-world implementation.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"13 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897425","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":"There Is Nothing Benign About Reducing the Cancer Research Budget.","authors":"Richard J Boxer","doi":"10.1001/jamaoncol.2025.1550","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.1550","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"52 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889322","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":"Trends in Surgical Overtreatment of Prostate Cancer","authors":"Steven M. Monda, Timothy Demus, Salvador Jaime-Casas, Sabir Meah, Arnav Srivastava, Richard Sarle, Corinne Labardee, Khurshid R. Ghani, Kevin M. Ginsburg, Todd M. Morgan, Tudor Borza","doi":"10.1001/jamaoncol.2025.0963","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0963","url":null,"abstract":"ImportanceOvertreatment of prostate cancer is a public health concern that undermines prostate cancer screening efforts.ObjectiveTo assess trends in pathologic grade on prostatectomy during the past 2 decades as a surrogate for overtreatment.Design, Setting, and ParticipantsThis retrospective cohort study examined the grade of prostate cancer on final pathology reports among patients undergoing prostatectomy between January 1, 2010, and September 1, 2024, in 2 parallel cohorts: Surveillance, Epidemiology, and End Results (SEER), a nationwide cancer registry, and Michigan Urological Surgery Improvement Collaborative (MUSIC), a statewide clinical registry. The presence of higher-risk features among patients who underwent grade group 1 prostatectomy during this period was also assessed.ExposuresThe primary exposure of interest was year of radical prostatectomy.Main Outcomes and MeasuresThe primary outcome was the proportion of all prostatectomies that were pathologic grade group 1 (pGG1) on final pathology reports. The secondary outcome was the proportion of pGG1 prostatectomies with a higher-risk preoperative feature, assessed as a binary variable and including at least 1 of the following: more than 50% of biopsy cores positive, prostate-specific antigen of 10 ng/mL or higher, or grade group 2 on biopsy.ResultsA total of 162 558 male patients in SEER (median [IQR] age, 63 [57-67] years) and 23 370 in MUSIC (median [IQR] age, 64 [59-69] years) underwent prostatectomy. The proportion of radical prostatectomies resulting in pGG1 on final pathology reports decreased from 32.4% (5852 of 18 071) to 7.8% (978 of 12 500) between 2010 and 2020 in SEER and from 20.7% (83 of 401) to 2.7% (32 of 1192) between 2012 and 2024 in MUSIC. A more recent prostatectomy was associated with a lower likelihood of a pGG1 prostatectomy while controlling for age and race within SEER (odds ratio [OR] per 5 years, 0.41; 95% CI, 0.40-0.42; <jats:italic>P</jats:italic> < .001) and MUSIC (OR per 5 years, 0.39; 95% CI, 0.36-0.43; <jats:italic>P</jats:italic> < .001). Within a subset analysis of those prostatectomies that were final pGG1, a more recent prostatectomy was associated with the presence of a higher-risk preoperative feature, including more than 50% of biopsy cores positive, prostate-specific antigen of 10 ng/mL or higher, and grade group 2 on prior biopsy within SEER (OR per 5 years, 1.60; 95% CI, 1.54-1.67; <jats:italic>P</jats:italic> < .001) and MUSIC (OR per 5 years, 1.60; 95% CI, 1.34-1.90; <jats:italic>P</jats:italic> < .001)Conclusions and RelevanceThis cohort study found that since 2010, the frequency of pGG1 prostatectomies markedly decreased, and those few that were performed were more likely to have a higher-risk feature. This reduction in the proportion of prostatectomies that are pGG1 likely reflects improved diagnostic pathways, adherence to active surveillance protocols for low-risk cases, and ongoing efforts at","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"27 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884650","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":"Representation of the Middle East and North African Region in Oncology Clinical Trials.","authors":"Tarek Taha,Tomer Meirson,Ithai Waldhorn","doi":"10.1001/jamaoncol.2025.0764","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0764","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"24 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871974","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":"The Role of Social Media in Fueling Bias in Oncology","authors":"Raffaele Giusti, Gennaro Daniele, Fotios Loupakis","doi":"10.1001/jamaoncol.2025.0617","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0617","url":null,"abstract":"This Viewpoint explores the role of social media in the dissemination of medical research findings and discusses how oversight, education, and media literacy can help prevent the spread of misinformation.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"6 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866770","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":"Intravenous Magnesium and Cisplatin-Associated Acute Kidney Injury","authors":"Shruti Gupta, Ilya G. Glezerman, Jamie S. Hirsch, Api Chewcharat, Sophia L. Wells, Jessica L. Ortega, Marta Pirovano, Raphael Kim, Kevin L. Chen, Kenar D. Jhaveri, Valda D. Page, Matthew H. Abramson, Anip Bansal, Avisek Ghimire, Melanie S. Joy, Ala Abudayyeh, David E. Leaf","doi":"10.1001/jamaoncol.2025.0756","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0756","url":null,"abstract":"ImportanceCisplatin-associated acute kidney injury (CP-AKI) is a frequent complication of cisplatin chemotherapy and is associated with considerable morbidity and mortality. Prophylactic administration of intravenous (IV) magnesium attenuates CP-AKI in animal models; however, its association with CP-AKI in humans has not been rigorously evaluated.ObjectiveTo evaluate the association of prophylactic IV magnesium administration with CP-AKI in patients with cancer undergoing cisplatin chemotherapy.Design, Settings, and ParticipantsThis multicenter study was conducted at 5 major cancer centers across the US and included adult patients with cancer who were treated with a first dose of IV cisplatin between 2006 to 2022. Data analyses were performed from February to December 2024.ExposureIV magnesium vs no IV magnesium receipt on the first day of cisplatin treatment.Main Outcomes and MeasuresComposite outcome of CP-AKI or death, with CP-AKI defined as a 2-fold or greater increase in serum creatinine levels from baseline or receipt of kidney replacement therapy within 14 days after first dose of IV cisplatin. Secondary outcomes were CP-AKI or death, defined using alternative definitions, as well as major adverse kidney events at 90 days. Inverse probability treatment weighting was used to estimate the association between IV magnesium receipt and CP-AKI. Models were adjusted for demographics, comorbidities, laboratory values, receipt of concurrent nephrotoxic anticancer therapies, site, year of cisplatin administration, and cisplatin dose.ResultsA total of 13 719 patients were included (median [IQR] age, 59 [49-67] years; 7817 male [57%]), of whom 3893 (28.4%) received IV magnesium on the first day of cisplatin chemotherapy. The median (IQR) dose of IV magnesium was 2 (1-2) g. CP-AKI or death occurred in 104 of 3893 patients (2.7%) who received IV magnesium, and in 520 of 9826 (5.3%) who did not (adjusted odds ratio, 0.80; 95% CI, 0.66-0.97). Results were similar across a number of sensitivity analyses and secondary outcomes, including major adverse kidney events at 90 days.Conclusions and RelevanceThis multicenter cohort study found that patients with cancer who received prophylactic IV magnesium before initiating treatment with IV cisplatin had a lower risk of CP-AKI compared to those who did not receive magnesium. Randomized clinical trials are needed to confirm these findings.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"42 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866819","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-Centered Research Through Artificial Intelligence to Identify Priorities in Cancer Care","authors":"Jiyeong Kim, Michael L. Chen, Shawheen J. Rezaei, Mariana Ramirez-Posada, Jennifer L. Caswell-Jin, Allison W. Kurian, Fauzia Riaz, Kavita Y. Sarin, Jean Y. Tang, Steven M. Asch, Eleni Linos","doi":"10.1001/jamaoncol.2025.0694","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0694","url":null,"abstract":"ImportancePatient-centered research is essential for bridging the gap between research and patient care, yet patient perspectives are often inadequately represented in health research.ObjectiveTo leverage artificial intelligence (AI) and natural language processing (NLP) to analyze a large dataset of patient messages, defining patient concerns and generating relevant research topics, and to quantify the quality of these AI-generated topics.Design, Setting, and ParticipantsThis case series was conducted using an automated framework involving a 2-staged unsupervised NLP topic model and AI-generated research topic suggestions. The study was based on deidentified patient portal message data from individuals with breast or skin cancer at Stanford Health Care and 22 affiliated centers over July 2013 to April 2024.ExposuresA widely used large language model (ChatGPT-4o [OpenAI]; April 2024) was used and guided through multiple prompt-engineering strategies to perform multilevel tasks, including knowledge interpretation and summarization (eg, interpreting and summarizing the NLP-defined topics), knowledge generation (eg, generating research ideas corresponding to patients’ issues), self-reflection and correction (eg, ensuring and revising the research ideas after searching for scientific articles), and self-reassurance (eg, confirming and finalizing the research ideas).Main Outcomes and MeasuresThree breast oncologists (J.L.C., A.W.K., F.R) and 3 dermatologists (K.Y.S, J.Y.T., E.L.) evaluated the meaningfulness and novelty of the AI-generated research topics using a 5-point Likert scale (1 representing exceptional to 5 representing poor). Mean (SD) scores for meaningfulness and novelty were computed for each topic.ResultsA total of 614 464 patient messages were analyzed from 25 549 individuals, 10 665 with breast cancer (98.6% female) and 14 884 had skin cancer (49.0% female). The overall mean (SD) scores for meaningfulness and novelty were 3.00 (0.50) and 3.29 (0.74), respectively, for breast cancer topics and 2.67 (0.45) and 3.09 (0.68), respectively, for skin cancer topics. One-third of the AI-suggested research topics were highly meaningful and novel when both scores were lower than the average (5 of 15 for breast cancer and 6 of 15 for skin cancer). Notably, two-thirds of the AI-suggested topics were novel (10 of 15 for breast cancer and 11 of 15 for skin cancer).Conclusions and RelevanceThis case series demonstrates that AI/NLP-driven analysis of large volumes of patient messages can generate quality research topics in cancer care that reflect patient perspectives, providing valuable guidance for future patient-centered health research endeavors.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"68 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866769","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":"Comments on a Modified Classification for Immunotherapy in Progressive Diseases-Reply.","authors":"Jonas Saal,Niklas Klümper","doi":"10.1001/jamaoncol.2025.0729","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0729","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"8 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872038","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":"Comments on a Modified Classification for Immunotherapy in Progressive Diseases.","authors":"Xin Li,Hu Ma,Jian-Guo Zhou","doi":"10.1001/jamaoncol.2025.0726","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0726","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"114 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872039","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}