JAMA Oncology最新文献

{"title":"Five Years After Pathologic Complete Response Without Surgery-Reply.","authors":"Henry M Kuerer","doi":"10.1001/jamaoncol.2025.2126","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2126","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"14 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693272","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":"Sequential vs Induction Plus Concurrent Chemoradiotherapy in Nasopharyngeal Carcinoma: A Randomized Clinical Trial.","authors":"Fen Xue,Dan Ou,Congying Xie,Shaojun Lin,Jingao Li,Xiaozhong Chen,Fuzheng Zhang,Hongmei Ying,Xueguan Lu,Chunying Shen,Tingting Xu,Xiaomin Ou,Weiwei Li,Xin Zhou,Chengrun Du,Changming Zhou,Chaosu Hu,Xiayun He","doi":"10.1001/jamaoncol.2025.2191","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2191","url":null,"abstract":"ImportanceInduction chemotherapy (IC) plus concurrent chemoradiotherapy (CCRT) has been a standard treatment for locoregionally advanced nasopharyngeal carcinoma (LA-NPC) but with high acute toxic effects in CCRT phase. Whether CCRT can be safely replaced by radiation therapy with adjuvant chemotherapy (AC) is unknown.ObjectiveTo assess if sequential chemoradiotherapy (SCRT; IC, followed by radiotherapy alone, followed by AC) is noninferior to IC plus CCRT for LA-NPC in terms of efficacy, with less acute toxic effects.Design, Setting, and ParticipantsThis multicenter, open-label, phase 3 noninferiority randomized clinical trial was conducted from January 2018 to September 2021 in 6 centers in China. Patients aged 18 to 65 years with newly diagnosed stage III/IVA NPC were enrolled. The data cutoff date was June 30, 2024.InterventionsPatients were randomly assigned 1:1 to receive 2 cycles of IC with a gemcitabine and cisplatin (GP) regimen (gemcitabine, 1000 mg/m2, on days 1 and 8 plus cisplatin, 25 mg/m2, on days 1, 2, and 3, repeated every 3 weeks) plus radiotherapy alone, followed by 2 cycles of AC with a GP regimen (SCRT group) or 2 cycles IC (GP regimen) followed by radiotherapy concurrent with weekly cisplatin, 30 mg/m2 (IC plus CCRT group).Main Outcomes and MeasuresThe primary end points were 3-year failure-free survival (FFS) with a noninferiority margin of 10% (hazard ratio [HR] less than 1.6) and the incidence of grade 3 or higher acute mucositis during radiotherapy. The secondary end points included overall survival, locoregional FFS, distant FFS, response rate, and toxic effects.ResultsOf 420 enrolled patients, 107 (25.5%) were women, and the median (IQR) age was 48 (41-54) years. A total of 210 patients were randomized to the SCRT group and 210 to the IC plus CCRT group. The median (IQR) follow-up time was 50 (40-61) months. In the intention-to-treat population, 3-year FFS was 83.7% (95% CI, 78.6-88.8) vs 79.5% (95% CI, 74.0-85.0) in the SCRT group vs the IC plus CCRT group, respectively (HR, 0.77; 95% CI, 0.50-1.19; P = .24), with the upper bound of the 95% CI less than 1.6. Identical outcomes were reported in the per-protocol population. Compared with the IC plus CCRT group, the SCRT group had significantly lower incidences of grade 3 or higher acute nonhematological toxic effects (acute mucositis, 61 [29.0%] vs 88 [41.9%], respectively; P < .001; nausea, 20 [9.5%] vs 38[18.1%], respectively; P = .01; vomiting, 8 [3.8%] vs 20 [9.5%], respectively; P = .02). No differences were observed in late toxic effects.Conclusions and RelevanceResults from this noninferiority randomized clinical trial suggest that SCRT is noninferior to IC plus CCRT in terms of 3-year FFS in LA-NPC, with less severe acute nonhematological toxic effects.Trial RegistrationClinicalTrials.gov Identifier: NCT03366415.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"12 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693271","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":"Redefining Systemic Therapy Timing in Nasopharyngeal Cancer-Before, During, or After Radiation.","authors":"Alisa Rybkin,Aarti Bhatia,Henry S Park","doi":"10.1001/jamaoncol.2025.2171","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2171","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"17 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693270","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":"COVID-19 Vaccine Booster Uptake and Effectiveness Among US Adults With Cancer.","authors":"Jacek Skarbinski,Eric P Elkin,Yonah C Ziemba,Elham Kazemian,Brigid M Wilson,Hinnah Siddiqui,Cheryl B Schleicher,Crystal A Hsiao,Joshua R Nugent,Karen L Reckamp,Akil Merchant,James M Crawford,David A Zidar,Lawrence H Kushi,Jane C Figueiredo","doi":"10.1001/jamaoncol.2025.2020","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2020","url":null,"abstract":"ImportancePersons with cancer are at increased risk of severe COVID-19 infection, but the additional benefit of COVID-19 boosters is unclear.ObjectiveTo assess COVID-19 vaccine effectiveness (VE) and number needed to vaccinate (NNV) among persons with cancer of an additional dose of the monovalent COVID-19 vaccine.Design, Setting, and ParticipantsRetrospective cohort study conducted in 4 health care systems in the US among persons with cancer receiving chemotherapy or immunotherapy. Statistical analysis was conducted between March 2023 and August 2024.ExposuresReceipt of an additional dose of the monovalent COVID-19 vaccine before January 1, 2022, with follow-up until August 31, 2022, and the bivalent COVID-19 vaccine from September 1, 2022, to August 31, 2023.Main Outcomes and MeasuresCOVID-19 hospitalization, diagnosed COVID-19, and COVID-19-related intensive care unit (ICU) admission.ResultsAmong 72 831 persons with cancer (17 922 female individuals [24.6%]), 69% received a monovalent booster by January 1, 2022. During 34 006 person-years of follow-up, the COVID-19 hospitalization rate was 30.5 per 1000 person-years among patients who received a monovalent booster vs 41.9 per 1000 person-years among patients who received the primary series alone, with an adjusted VE of 29.2% (95% CI, 19.9%-37.3%) and NNV to prevent 1 COVID-19 hospitalization of 166 (95% CI, 130-244). There was also significant VE to prevent diagnosed COVID-19 (8.5% [95% CI, 3.7%-13.0%]) and COVID-19-related ICU admission (35.6% [95% CI, 20.0%-48.3%]). Among 88 417 persons with cancer (24 589 female individuals [27.8%]) with 81 027 person-years of follow-up during the bivalent period, patients who received this booster (38%) had a COVID-19 hospitalization rate of 13.4 per 1000 person-years vs 21.7 per 1000 person-years among persons who did not receive a bivalent vaccine, with an adjusted VE of 29.9% (95% CI, 19.4%-39.1%) and NNV to prevent 1 COVID-19 hospitalization of 451 (95% CI, 345-697); the adjusted VE was 30.1% (95% CI, 7.7%-47.0%) to prevent COVID-19-related ICU admission.Conclusions and RelevanceIn this retrospective cohort study, COVID-19 booster vaccinations were associated with significant protection against severe COVID-19, with a favorable NNV among persons with cancer. However, uptake of COVID-19 vaccine boosters was low, and interventions are therefore justified to increase COVID-19 uptake in this high-risk population.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"24 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645809","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":"Risk Factors for COVID-19-Related Hospitalization and Death in Patients With Cancer: The National Cancer Institute COVID-19 in Cancer Patients Study (NCCAPS).","authors":"Brian I Rini,Ana F Best,Mel D Bowman,Grace E Mishkin,Andrea M Denicoff,Larry V Rubinstein,Lyndsay Harris,Ann M Geiger,Nicholas M Mark,Steven A Pergam,Jeremy L Warner,Alok A Khorana,Sacha Gnjatic,Tina W F Yen,Darla K Liles,Christine M Bestvina,Neil J Shah,Jacqueline T Norrell,Dawn L Hershman,Jennifer L Holter-Chakrabarty,Andrew S Poklepovic,Stephen J Chanock,Hari Sankaran,Larissa A Korde","doi":"10.1001/jamaoncol.2025.2010","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2010","url":null,"abstract":"ImportanceRetrospective case series have identified having cancer and receiving treatment for cancer as risk factors for inferior COVID-19 outcomes.ObjectiveTo determine risk factors for hospitalization and death in patients with cancer with COVID-19 infection.Design, Setting, and ParticipantsThe National Cancer Institute COVID-19 in Cancer Patients Study (NCCAPS) is a prospective longitudinal natural history cohort study examining the impact of COVID-19 on patients with cancer. Adults were eligible within 14 days of an initial positive SARS-CoV-2 test result if they were receiving active treatment for cancer or had prior stem cell/bone marrow transplant or CAR T-cell treatment. The statistical analysis took place between September 2024 and April 2025.Main Outcomes and MeasuresThe primary objective of the study was to determine patient factors, therapy types, and cancer types associated with COVID-19 severity, defined as hospitalization for or death from COVID-19 within 30 and 90 days after the first positive SARS-CoV-2 test result. Multivariable regressions were performed for COVID-19-specific hospitalization and mortality (proportional hazard and cause-specific hazard models).ResultsOf 1572 eligible adult patients (median [range] age, 60 [18-93] years; 840 female [53.4%]), 1066 (67.8%) had a solid tumor, with 683 (64.0%) having metastatic disease; breast (252 [23.6%]) and lung cancer (148 [13.9%]) were most common. At enrollment, 1013 patients (64.4%) were unvaccinated for SARS-CoV-2. COVID-19-related mortality at 90 days was 3.0% and did not increase at subsequent time points. The cumulative incidence of COVID-19-specific death in the first 90 days was highest in patients with lymphoma, intermediate in patients with acute leukemia and lung cancer, and lowest in patients with other solid tumors and other hematologic cancers. In multivariable analysis, receipt of chemotherapy (hazard ratio [HR], 1.97; 95% CI, 1.52-2.54) and baseline history of stroke, atrial fibrillation, or pulmonary embolism (HR, 1.78; 95% CI, 1.33-2.38) were associated with a higher risk of hospitalization. Vaccination prior to SARS-CoV-2 infection was associated with a lower risk of hospitalization (HR, 0.52; 95% CI, 0.38-0.70). Over 2 years of follow-up, there were 1739 cancer treatment disruptions, of which 881 (50.7%) were attributed to COVID-19, with most disruptions occurring within the first 30 days.Conclusions and RelevanceThe results of this prospective cohort study showed that COVID-19 had a significant impact on patients with cancer, including hospitalization, treatment disruptions, and death.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"6 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645806","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":"Proper Definition of Postprostatectomy Prostate-Specific Antigen Persistence.","authors":"Brian R Lane,Kevin B Ginsburg,Tudor Borza","doi":"10.1001/jamaoncol.2025.2117","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2117","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"24 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645747","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":"Considerations for Using Clinical Practice Data to Study COVID-19 Vaccines in Patients With Cancer.","authors":"Larry Han","doi":"10.1001/jamaoncol.2025.1937","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.1937","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"109 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645748","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":"COVID-19 Pandemic and Posttreatment Breast Cancer Surveillance and Outcomes.","authors":"Erin E Hahn,Sarah Eng,Aiyu Chen,Eric C Haupt,Shannon Goodall,Corrine E Munoz-Plaza,Huong Q Nguyen,Michael K Gould,Patricia A Ganz,Ernest Shen","doi":"10.1001/jamaoncol.2025.1991","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.1991","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"52 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645746","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":"Proper Definition of Postprostatectomy Prostate-Specific Antigen Persistence-Reply.","authors":"Derya Tilki,Ming-Hui Chen,Anthony V D'Amico","doi":"10.1001/jamaoncol.2025.2120","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.2120","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"27 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645749","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":"Adjuvant Chemoradiation and Immunotherapy for Extrahepatic Cholangiocarcinoma and Gallbladder Cancer: A Randomized Clinical Trial.","authors":"Han Xiao,Jiansong Ji,Shaoqiang Li,Jiaming Lai,Guangyan Wei,Jian Wu,Wei Chen,Wenxuan Xie,Shutong Wang,Liangliang Qiao,Jianfei Tu,Shunli Shen,Zhenwei Peng","doi":"10.1001/jamaoncol.2025.1926","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.1926","url":null,"abstract":"ImportanceExtrahepatic cholangiocarcinoma (EHC) and gallbladder cancer (GBC), which make up most biliary tract cancers, have distinct molecular and clinical features compared with intrahepatic cholangiocarcinoma. However, effective adjuvant treatments specifically for patients with resectable EHC and GBC are scarce.ObjectiveTo evaluate the safety and efficacy of immunotherapy combining with chemoradiotherapy.Design, Setting, and ParticipantsIn the ACCORD randomized clinical trial, from April 2020 to June 2022, patients with EHC and GBC after curative resection were assessed for eligibility. Patients were randomized 1:1 into to the combination camrelizumab plus concurrent capecitabine and radiotherapy group or the observation group. Data were analyzed from June to August 2024.InterventionsThe intervention group received camrelizumab every 3 weeks after surgery. After 2 courses of camrelizumab treatment, patients received capecitabine with concurrent radiotherapy. Patients in the observation group received no anticancer treatment unless relapse was detected.Main Outcomes and MeasuresThe primary end point was overall survival (OS) and the secondary end points included recurrence-free survival (RFS) and safety.ResultsOf 93 included patients, 48 (52%) were female, and the median (range) age was 62 (31-70) years. Patients' baseline characteristics were comparable in the 2 groups. With a median (IQR) follow up of 36 (32-39) months, patients in the combination treatment group significantly better OS and RFS. The 1-year, 2-year and 3-year OS rates were 95.7% (95% CI, 83.7-98.9), 71.4% (95% CI, 56.4-82.5), and 58.2% (95% CI, 40.4-72.4), respectively, in the combination treatment group and 80.9% (95% CI, 66.4-89.5), 52.9% (95% CI, 37.7-65.9), and 30.5% (95% CI, 16.5-45.7), respectively, in the observation group (hazard ratio, 0.43; 95% CI, 0.24-0.79; P = .004). The 1-year, 2-year and 3-year RFS rates were 78.3% (95% CI, 63.4-87.7), 54.0% (95% CI, 38.6-67.1), and 40.3% (95% CI, 25.3-54.8), respectively, in the combination treatment group and 55.3% (95% CI, 40.1-68.1), 27.0% (95% CI, 15.2-40.3), and 17.2% (95% CI, 7.7-29.8), respectively, in the observation group (hazard ratio, 0.46; 95% CI, 0.28-0.76; P < .001). In the combination treatment group, only 6 patients (13%) experienced treatment delay for camrelizumab, and all patients completed the chemoradiation treatment, with no treatment-related deaths.Conclusions and RelevanceIn this randomized clinical trial, camrelizumab plus concurrent capecitabine and radiotherapy as an adjuvant therapy demonstrated superior survival outcomes over observation in patients with resectable EHC/GBC with a well-tolerable safety profile. The observed camrelizumab plus concurrent capecitabine and radiotherapy efficacy warrants further study with active treatment (chemotherapy or chemoradiation therapy) as the control group.Trial RegistrationClinicalTrials.gov Identifier: NCT04333927.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"34 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593978","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}