JAMA Oncology最新文献

{"title":"Tomosynthesis vs Digital Mammography Screening in Women with a Family History of Breast Cancer.","authors":"Tong Li,Yu-Ru Su,Janie M Lee,Ellen S O'Meara,Diana L Miglioretti,Karla Kerlikowske,Louise Henderson,Nehmat Houssami","doi":"10.1001/jamaoncol.2025.1209","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.1209","url":null,"abstract":"ImportanceEvidence on screening outcomes with digital breast tomosynthesis (DBT) vs digital mammography (DM) in women with a family history of breast cancer is limited.ObjectiveTo compare the performance of DBT and DM screening in women with a family history of breast cancer overall and subdivided by breast cancer family history category, breast density, age group, screening interval, and screening round, and to describe characteristics of cancers detected on screening vs interval cancers.Design, Setting, and ParticipantsIn this comparative cohort study at imaging facilities affiliated with the Breast Cancer Surveillance Consortium, adult women 18 years and older with a self-reported family history of breast cancer who underwent DBT or DM from 2011 to 2018 were included, with a 1-year follow-up for breast carcinoma. Data analysis was performed between November 2023 and August 2024.ExposuresDBT or DM.Main Outcomes and MeasuresThe main outcomes were absolute risk difference (ARD) between DBT and DM for recall rate, cancer detection rate, interval cancer rate, advanced cancer rate, biopsy rate, positive predictive values, sensitivity, and specificity, with inverse probability of treatment weighting.ResultsA total of 208 945 women with a family history of breast cancer undergoing 502 357 screening examinations were included in the sample. Median (IQR) age was 58 (50-66) and 57 (49-66) years for the DBT and DM groups, respectively. Adjusted ARDs (DBT vs DM) were significant for recall rate (-1.51%; 95% CI, -2.42% to -0.59%) and specificity (1.56%; 95% CI, 0.65%-2.46%) in the overall cohort of 121 698 DBT and 380 561 DM examinations and among women with 1 first-degree relative (recall rate ARD, -1.72%; 95% CI, -2.70% to -0.74%; specificity ARD, 1.75%; 95% CI, 0.81%-2.69%). Among those with only second-degree relatives, the biopsy rate for DBT was significantly higher (ARD, 0.39%; 95% CI, 0.18%-0.61%). Significant ARDs were observed for the ductal carcinoma in situ detection rate (-0.71 per 1000 examinations; 95% CI, -1.03 to -0.38 per 1000 examinations) in women with almost entirely fatty breasts; recall rate (-1.90%; 95% CI, -2.88% to -0.92%) and specificity (1.93%; 95% CI, 0.97%-2.89%) in women with scattered fibroglandular densities. Significant ARDs were also observed for the positive predictive value for recall (1.75%; 95% CI, 0.84%-2.67%) in heterogeneously dense breasts, as well as the biopsy rate (0.48%; 95% CI, 0.16%-0.80%) and advanced cancer rate (-0.61 per 1000 examinations; 95% CI, -1.02 to -0.20 per 1000 examinations) in extremely dense breasts. DBT screening had a higher proportion than DM of screen-detected early-stage, invasive cancers with favorable prognostic characteristics.Conclusions and RelevanceIn this cohort study of women with a family history of breast cancer, DBT screening reduced recall rates and increased specificity compared to DM, particularly in women with 1 first-degree relative with breast cancer and those with scatte","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"17 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114159","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":"Skimming the Median and the Problem of Exaggerated Survival Gains.","authors":"Tito Fojo,Susan Bates","doi":"10.1001/jamaoncol.2025.0035","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0035","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"3 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114157","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 Next Wave After Immunotherapy in Cancer Drug Development-Back to the Future.","authors":"Satya Das","doi":"10.1001/jamaoncol.2025.0720","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0720","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"9 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114154","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":"Disparities in Trends of Gastroenteropancreatic Neuroendocrine Tumor Incidence-Reply.","authors":"Yazan Abboud,Kaveh Hajifathalian","doi":"10.1001/jamaoncol.2025.1334","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.1334","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"34 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114158","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 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}