JAMA Oncology最新文献

{"title":"Childhood Cancer Survivor Risk Estimates and Age, Overdispersion, and Social Context.","authors":"Jian Huang","doi":"10.1001/jamaoncol.2025.2421","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2421","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"17 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144792020","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":"Bacterial Decolonization With Mupirocin Ointment for Acute Radiation Oral Mucositis Prevention: A Phase 3 Randomized Clinical Trial.","authors":"Zhaohui Liao,Xiaopeng Xiong,Li Zhao,Zipeng Zhang,Chunhong Guan,Lin Zhang,Fangyan Zhong,Jun Rao,Xunsong Wang,Yun Xiao,Xiaochang Gong,Shao Hui Huang,Jingao Li,Tianzhu Lu","doi":"10.1001/jamaoncol.2025.2361","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2361","url":null,"abstract":"ImportanceAcute radiation oral mucositis (AROM) is a major dose-limiting toxic effect in patients with nasopharyngeal cancer undergoing radiotherapy. Reduction of severe (grade ≥3) AROM by bacterial decolonization (BD) could improve treatment tolerance and quality of life.ObjectiveTo evaluate the efficacy of BD with mupirocin nasal ointment in alleviating severe AROM compared with standard of care (SoC) by reducing Staphylococcus aureus colonization in nasal and oral mucosal during radiotherapy for nasopharyngeal cancer.Design, Setting, and ParticipantsThis was a single-center, open-label, phase 3 randomized clinical trial in China that enrolled patients with nasopharyngeal carcinoma (NPC) undergoing definitive chemoradiotherapy between July 2023 and February 2024. Data were analyzed from June 2024 to September 2024.InterventionsThe BD group received mupirocin nasal ointment twice daily for 3 days before radiotherapy for 5 consecutive days followed by a 1-week break, which was repeated throughout radiotherapy. Patients in the SoC group received routine nasal and oral care.Main Outcomes and MeasuresThe primary outcome was the incidence of severe (grade ≥3) AROM. Oral mucositis assessments were performed by independent evaluators who were blinded to group assignments. Secondary end points included quality of life assessed using the Quality-of-Life Questionnaire-Head and Neck 43 [QLQ-H&N43]), and the colonization levels of S aureus in nasal and oral mucosa.ResultsA total of 176 patients (mean [SD] age, 52.1 [10.1] years; 42 female [23.9%] individuals) were randomly assigned to the BD intervention group (n = 88) or the SoC control group (n = 88). In the BD group, severe AROM occurred in 20 of 88 patients (22.7%) compared with 42 (47.7%) in the SoC group (relative risk, 0.48; 95% CI, 0.31-0.74; P < .001). Multivariable logistic analysis confirmed the effect of BD (odds ratio, 0.27, 95% CI, 0.13-0.54; P < .001) on severe AROM risk reduction. The QLQ-H&N43 assessment showed BD significantly reduced symptom severity compared to SoC during radiotherapy, with lower median (IQR) pain scores (25.0 [25.0-50.0] vs 50.0 [25.0-50.0]) and fewer swallowing difficulties (8.3 [8.3-33.3] vs 33.3 [8.3-33.3]). Colonization rates of S aureus at the end of radiotherapy were lower in the BD than in the SoC group: nasal, 9.4% (8 of 85) vs 22.9 % (19 of 83) and oral, 5.9% (5 of 85) vs 20.5% (17 of 83).Conclusions and RelevanceThis phase 3 randomized clinical trial demonstrated that BD with mupirocin nasal ointment effectively reduced severe AROM, improved quality of life by alleviating oral pain and swallowing difficulties, and significantly reduced both nasal and oral S aureus colonization during radiotherapy. This approach offers a cost-effective strategy for AROM management, and although further studies are required to validate the findings, these results highlight the potential of microbial management to reduce radiation-related complications in patients with nasopharyn","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"31 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791837","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":"Childhood Cancer Survivor Risk Estimates and Age, Overdispersion, and Social Context-Reply.","authors":"Jennifer M Yeh,Zachary J Ward,Wendy Leisenring","doi":"10.1001/jamaoncol.2025.2424","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2424","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"732 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144792140","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":"Proportional Sedation for Persistent Agitated Delirium in Palliative Care","authors":"David Hui, Allison De La Rosa, Jaw-Shiun Tsai, Shao-Yi Cheng, Egidio Del Fabbro, Anita Thankam Thomas Kuzhiyil, Kendra Rowe, Ahsan Azhar, Thuc Nguyen, Michael Tang, Chien-An Yao, Hsien-Liang Huang, Jen-Kuei Peng, Wen-Yu Hu, Sonal Admane, Rony Dev, Minxing Chen, Patricia Bramati, Sanjay Shete, Eduardo Bruera","doi":"10.1001/jamaoncol.2025.2212","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2212","url":null,"abstract":"ImportanceNeuroleptic and benzodiazepine medications are often considered for patients with persistent agitated delirium in the last days of life; however, the risk-to-benefit ratio of these medications is ill-defined and benzodiazepine medications have not been compared to placebo.ObjectiveTo compare the effect of scheduled haloperidol, lorazepam, haloperidol plus lorazepam, and placebo on patients with advanced cancer and delirium and experiencing restlessness and/or agitation in the palliative care setting.Design, Settings, and ParticipantsThis multicenter randomized clinical trial was conducted at 3 acute palliative care units in Taiwan and the US with patients with advanced cancer experiencing persistent restlessness and/or agitation despite nonpharmacologic therapies and standard-dose haloperidol. Among 245 eligible patients, 111 were enrolled, and 75 received blinded treatments. Participants were randomized in a 1:1:1:1 ratio (stratified by site and Richmond Agitation-Sedation Scale [RASS] score). The study period was from July 16, 2019, to June 8, 2023, with a 30-day follow-up after medication administration. Data analysis was performed from October 10, 2023, to April 11, 2025.InterventionsScheduled intravenous haloperidol, lorazepam, haloperidol plus lorazepam, or placebo every 4 hours until discharge, death, or withdrawal from study. Medications in all 4 groups had identical volume and appearance.Main Outcomes and MeasuresChange in RASS scores during the first 24 hours. Secondary outcomes included the use of rescue neuroleptics or benzodiazepines for breakthrough restlessness or agitation during the first 24 hours, delirium severity, perceived patient comfort, and adverse events.ResultsThe primary outcome was assessed in 72 patients (mean [SD] age, 64 [12] years, 42 male [58%]) with a median (IQR) MDAS score of 24 (18-29). The lorazepam group had significantly lower RASS scores than the haloperidol group (mean difference, −2.1; 95% CI, −3.4 to −0.9; <jats:italic>P</jats:italic> < .001) and the combination group had significantly lower RASS scores than the haloperidol group (−2.0; 95% CI, −3.2 to −0.8; <jats:italic>P</jats:italic> = .002); however, there was no difference observed between haloperidol and placebo groups (−0.5; 95% CI, −1.7 to 0.7; <jats:italic>P</jats:italic> = .42) nor between the combination and lorazepam groups (0.2; 95% CI, −1.1 to 1.4; <jats:italic>P</jats:italic> = .79). The combination and lorazepam groups required fewer rescue medications for breakthrough restlessness or agitation compared to the haloperidol and placebo groups (32%, 37%, 56%, 83%, respectively; <jats:italic>P</jats:italic> = .006). Adverse events or survival did not differ between groups.Conclusions and RelevanceThe results of this randomized clinical trial indicate that proactive use of scheduled sedatives, particularly lorazepam-based regimens, may reduce persistent restlessness and/or agitation in patients with advanced cancer and de","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"39 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747753","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":"Tibremciclib or Placebo Plus Fulvestrant in Hormone Receptor–Positive and ERBB2-Negative Advanced Breast Cancer After Endocrine Therapy","authors":"Zhonghua Tao, Jian Zhang, Qiufan Zheng, Yongsheng Wang, Li Cai, Hongyan Xu, Xinhua Xu, Xiangshun Kong, Sijuan Ding, Chunfang Hao, Hao Wang, Hong Zong, Xin Jin, Xinshuai Wang, Yang Li, Xiuli Yang, Weijie Li, Xiaoya Du, Hui Chen, Pengxiang Wu, Peiqi Li, Li Mao, Lieming Ding, Xichun Hu, Shusen Wang","doi":"10.1001/jamaoncol.2025.2092","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2092","url":null,"abstract":"ImportanceCyclin-dependent kinase (CDK) 4/6 inhibitors combined with endocrine therapy (ET) are now considered the standard treatment regimen for hormone receptor–positive (HR<jats:sup>+</jats:sup>) and <jats:italic>ERBB2 </jats:italic>(formerly <jats:italic>HER2</jats:italic>)–negative (<jats:italic>ERBB2</jats:italic><jats:sup>−</jats:sup>) advanced breast cancer (ABC). Tibremciclib (BPI-16350), a novel CDK4/6 inhibitor, has demonstrated favorable tolerability and promising antitumor activity as a monotherapy or combined with fulvestrant among patients with HR<jats:sup>+</jats:sup>/<jats:italic>ERBB2</jats:italic><jats:sup>−</jats:sup> ABC in a phase 1 trial. Further investigations are necessary to assess the efficacy and safety of tibremciclib.ObjectiveTo compare tibremciclib plus fulvestrant and placebo plus fulvestrant in terms of efficacy and safety among patients with HR<jats:sup>+</jats:sup>/<jats:italic>ERBB2</jats:italic><jats:sup>−</jats:sup> ABC who exhibited disease progression after ET.Design, Setting, and ParticipantsThe TIFFANY trial was a double-blind, placebo-controlled, phase 3 randomized clinical trial of patients with HR<jats:sup>+</jats:sup>/<jats:italic>ERBB2</jats:italic><jats:sup>−</jats:sup> ABC who had experienced progression while receiving prior ET and had received no more than 1 line of chemotherapy. This trial was conducted at 69 Chinese centers between May 25, 2022, and April 25, 2023. The data cutoff date for this analysis was March 31, 2024.InterventionsPatients were randomly assigned to receive tibremciclib (400 mg, orally, once daily) plus fulvestrant or placebo plus fulvestrant at a 2:1 ratio until disease progression, death, or treatment discontinuation for various reasons.Main Outcomes and MeasuresThe primary end point was investigator-assessed progression-free survival (PFS), and the secondary end points included the objective response rate, overall survival, and safety.ResultsA total of 274 female patients (median [IQR] age, 53.0 [46.0-60.0] years) were randomly assigned to receive tibremciclib plus fulvestrant (184 [67.2%]) or placebo plus fulvestrant (90 [32.8%]). Among these patients, 144 PFS events occurred (80 in the tibremciclib arm and 64 in the placebo arm), with a median follow-up of 12.9 months for both arms. Tibremciclib plus fulvestrant significantly improved PFS compared with placebo plus fulvestrant (median, 16.5 months [95% CI, 12.8-16.6] vs 5.6 months [95% CI, 4.5-9.2]; hazard ratio, 0.37; 95% CI, 0.27-0.52; <jats:italic>P</jats:italic> &amp;amp;lt; .001). In patients with measurable disease, tibremciclib plus fulvestrant achieved an objective response rate of 45.6% (95% CI, 37.6%-53.7%) compared with 12.9% (95% CI, 6.1%-23.0%) in the placebo arm (<jats:italic>P</jats:italic> &amp;amp;lt; .001). The most common grade 3 or higher treatment-emergent adverse events in the tibremciclib vs placebo arm were neutropenia (15.2% vs 5.6%, respectively), anemia (12.0% vs 4.4%, respectively), and hypok","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"65 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747749","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":"Grade Group 1 Prostate Cancer Outcome by Biopsy Grade and Risk Group","authors":"Neal A. Patel, Daniel A. Barocas, Daniel W. Lin, Xian Wu, David Green, Kevin H. Kensler, Jonathan Shoag, Bashir Al Hussein Al Awamlh","doi":"10.1001/jamaoncol.2025.2304","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2304","url":null,"abstract":"ImportanceAdvocates for removing the cancer label from grade group 1 (GG1) prostate cancer detected on biopsy primarily base their argument on the observation that when only GG1 is detected on prostatectomy, rates of metastasis are rare. However, the frequency with which GG1 prostate cancer on biopsy is associated with adverse clinical features and the long-term cancer outcomes in this context are poorly defined.ObjectiveTo assess cancer-specific outcomes of localized GG1 prostate cancer stratified by risk category.Design, Setting, and ParticipantsA population-based cohort study using Surveillance, Epidemiology, and End Results data was performed to assess cancer-specific outcomes in 117 162 men with localized GG1 prostate cancer stratified by National Comprehensive Cancer Network risk groups between January 1, 2010, and December 31, 2020. Competing risk analyses and multivariable regression determined rates of prostate cancer–specific mortality and associations with prostatectomy adverse pathology. Data were analyzed from July 1, 2024, to October 1, 2024.Main OutcomesProstate cancer–specific mortality and risk of adverse pathology at surgery in GG1 prostate cancer.ResultsAmong 117 162 men with biopsy GG1 prostate cancer, 10 440 (9%) had favorable intermediate-risk disease, 3145 (3%) had unfavorable intermediate-risk disease, and 4539 (4%) had high-risk disease. Median age was 64 years (IQR, 58-69 years). A total of 867 men with high-risk GG1 prostate cancer (60%) had adverse pathology at prostatectomy. The prostate cancer–specific mortality rates for unfavorable intermediate-risk GG1 and for high-risk GG1 were 2.4% and 4.7%, respectively, comparable to the prostate cancer–specific mortality rates for favorable intermediate-risk GG2 and unfavorable intermediate-risk greater than or equal to GG2, which were 2.1% and 4.0%, respectively. In adjusted analyses, favorable intermediate-risk GG1 (adjusted hazard ratio [AHR], 1.60; 95% CI, 1.30-1.96), unfavorable intermediate-risk GG1 (AHR, 2.10; 95% CI, 1.53-2.89), and high-risk GG1 (AHR, 3.58; 95% CI, 2.93-4.38) were associated with increased risk of prostate cancer–specific mortality compared with low-risk GG1.Conclusions and RelevanceThis cohort study found that approximately 1 in 6 men with GG1 prostate cancer has intermediate-risk or high-risk disease. Biopsy GG1 prostate cancer has heterogeneous long-term outcomes that are reflected in adverse pathology and prostate cancer–specific mortality. These data indicate that not all GG1 prostate cancer follows an indolent course. A subset of men with biopsy GG1 prostate cancer have outcomes comparable to those of men with higher-grade intermediate-risk prostate cancer, a group that often undergoes treatment. These findings should be considered in the reclassification debate.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"14 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747827","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 and Opportunities for the US Oncology Workforce","authors":"Lawrence N. Shulman, Hedvig Hricak, S. Gail Eckhardt","doi":"10.1001/jamaoncol.2025.2331","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2331","url":null,"abstract":"This Viewpoint discusses potential challenges facing the US oncology workforce in light of growing gaps between patients with cancer and the number of oncology clinicians.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"75 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747747","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":"Concerns About Conclusions of the POLAR Trial.","authors":"Lise Ventzel,Jordi Bruna,Guido Cavaletti","doi":"10.1001/jamaoncol.2025.2355","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2355","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"8 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747752","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":"Five Years After Pathologic Complete Response Without Surgery.","authors":"Zemin Tian,Yinde Huang,Yuan Qiu","doi":"10.1001/jamaoncol.2025.2123","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2123","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"32 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693273","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":"Defining Lifetime Risk Thresholds for Breast Cancer Surgical Prevention.","authors":"Xia Wei,Lea Mansour,Samuel Oxley,Caitlin T Fierheller,Ashwin Kalra,Jacqueline Sia,Subhasheenee Ganesan,Michail Sideris,Li Sun,Adam Brentnall,Stephen Duffy,D Gareth Evans,Li Yang,Rosa Legood,Ranjit Manchanda","doi":"10.1001/jamaoncol.2025.2203","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2203","url":null,"abstract":"ImportanceExpanding access to genetic testing and availability of validated breast cancer (BC) risk prediction models are increasingly identifying women at elevated BC risk who do not carry high-penetrance BRCA1/BRCA2/PALB2 pathogenic variants. The precise BC risk threshold for offering risk-reducing mastectomy (RRM) for BC prevention is unknown.ObjectiveTo define the lifetime BC risk thresholds for RRM to be cost-effective compared with nonsurgical alternatives for BC prevention.Design, Setting, and ParticipantsThis economic evaluation used a decision-analytic Markov model to compare the cost-effectiveness of RRM with BC screening and medical prevention in a simulated cohort. Extensive sensitivity analyses were performed. The study setting was from a UK payer perspective over a lifetime horizon until age 80 years. The simulated cohort included women aged 30 to 60 years at varying lifetime BC risks from 17% to 50%. The study was conducted between September 2022 and September 2024.ExposuresUndergoing RRM or receiving risk-stratified BC screening with medical prevention (tamoxifen or anastrozole).Main Outcomes and MeasuresThe incremental cost-effectiveness ratio was calculated as incremental cost per quality-adjusted life-year (QALY) gained and compared with the UK willingness-to-pay (WTP) threshold of £20 000 (US $27 037) to £30 000 (US $40 555) per QALY. BC cases prevented were estimated at the population level.ResultsIn the simulated cohort of 100 000 thirty-year-old women in the UK, undergoing RRM became cost-effective at a 34% lifetime BC risk using the £30 000 (US $40 555) per QALY WTP threshold. This increased to a 42% lifetime BC risk using the £20 000 (US $27 037) per QALY WTP threshold. The identified lifetime BC risk thresholds for RRM to be cost-effective among women aged 35, 40, 45, 50, 55, and 60 years were 31%, 29%, 29%, 32%, 36%, and 42%, respectively, using the £30 000 (US $40 555) per QALY WTP threshold. Overall, undergoing RRM was deemed cost-effective for women aged 30 to 55 years with a lifetime BC risk of at least 35%, with more than 50% of simulations being cost-effective in probabilistic sensitivity analysis. Offering RRM for women with a lifetime BC risk of 35% or higher could potentially prevent approximately 6538 (95% CI, 4454-7041), or approximately 11% (95% CI, 8%-12%), of the 58 756 BC cases occurring annually in women in the UK. In the probabilistic sensitivity analysis, 20.71% to 59.96%, 44.04% to 81.29%, and 97.26% to 99.35% of simulations were cost-effective for women with 35%, 40%, and 50% lifetime BC-risk undergoing RRM at age 30 under the £20 000 to £30 000 per QALY WTP threshold, respectively.Conclusions and RelevanceIn this economic evaluation, undergoing RRM appears cost-effective for women aged 30 to 55 years with a lifetime BC risk of 35% or higher. These results could have significant clinical implications to expand access to RRM beyond BRCA1/BRCA2/PALB2 pathogenic variant carriers. Future studies evaluati","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"143 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693269","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}