Journal of Clinical Oncology最新文献

{"title":"Treatment Intensification With Either Fludarabine, AraC, G-CSF and Idarubicin, or Cladribine Plus Daunorubicin and AraC on the Basis of Residual Disease Status in Older Patients With AML: Results From the NCRI AML18 Trial.","authors":"Nigel H Russell, Abin Thomas, Robert K Hills, Ian Thomas, Amanda Gilkes, Nuria Marquez Almuina, Sarah Burns, Lucy Marsh, Paresh Vyas, Marlen Metzner, Nicholas McCarthy, Georgia Andrew, Jennifer Byrne, Rob S Sellar, Richard Kelly, Paul Cahalin, Ulrik Malthe Overgaard, Priyanka Mehta, Mike Dennis, Steven Knapper, Sylvie D Freeman","doi":"10.1200/JCO.24.00259","DOIUrl":"https://doi.org/10.1200/JCO.24.00259","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the survival benefit of chemotherapy intensification in older patients with AML who have not achieved a measurable residual disease (MRD)-negative remission.</p><p><strong>Methods: </strong>Five hundred twenty-three patients with AML (median age, 67 years; range, 51-79) without a flow cytometric MRD-negative remission response after a first course of daunorubicin and AraC (DA; including 165 not in remission) were randomly assigned between up to two further courses of DA or intensified chemotherapy-either fludarabine, cytarabine, granulocyte colony-stimulating factor and idarubicin (FLAG-Ida) or DA with cladribine (DAC).</p><p><strong>Results: </strong>Overall survival (OS) was not improved in the intensification arms (DAC <i>v</i> DA: hazard ratio [HR], 0.74 [95% CI, 0.55 to 1.01]; <i>P</i> = .054; FLAG-Ida <i>v</i> DA: HR, 0.86 [95% CI, 0.66 to 1.12]; <i>P</i> = .270); OS at 3 years was 34%, 46%, and 42% for DA, DAC, and FLAG-Ida, respectively. Early deaths and other adverse events were more frequent with FLAG-Ida (9% day 60 deaths <i>v</i> 4% after DA or DAC; <i>P</i> = .032). Of patients entering random assignment, 131 had MRD unknown status. In this subgroup of patients lacking evidence of residual leukemia by flow cytometry, there was no detectable survival advantage from intensification. A planned sensitivity analysis excluding these patients demonstrated a survival benefit for both DAC (HR, 0.66 [95% CI, 0.46 to 0.93]; <i>P</i> = .018) and FLAG-Ida (HR, 0.72 [95% CI, 0.53 to 0.98]; <i>P</i> = .035); OS at 3 years was 30%, 46%, and 46% for DA, DAC, and FLAG-Ida, respectively. There was a concordant reduction in relapse (DAC <i>v</i> DA: HR, 0.66 [95% CI, 0.45 to 0.98]; <i>P</i> = .039; FLAG-Ida <i>v</i> DA: HR, 0.70 [95% CI, 0.49 to 0.99]; <i>P</i> = .042). DAC benefit was maintained when survival was censored for transplant (<i>P</i> = .042).</p><p><strong>Conclusion: </strong>In this study of older patients with AML considered fit and with evidence of residual disease after first induction, chemotherapy intensification improved survival. DAC intensification was better tolerated than FLAG-Ida.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2400259"},"PeriodicalIF":42.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667852","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":"Optimizing DeepHRD Interpretability for Enhanced Clinical Decision Making.","authors":"Hui Li, Qin Guo, Chengshan Guo","doi":"10.1200/JCO-24-01870","DOIUrl":"https://doi.org/10.1200/JCO-24-01870","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2401870"},"PeriodicalIF":42.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667662","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":"Reply to: Optimizing DeepHRD Interpretability for Enhanced Clinical Decision Making.","authors":"Erik N Bergstrom, Scott M Lippman, Ludmil B Alexandrov","doi":"10.1200/JCO-24-02279","DOIUrl":"https://doi.org/10.1200/JCO-24-02279","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2402279"},"PeriodicalIF":42.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667818","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":"Reply to: Peak Corticosteroid Dose for Immune-Related Adverse Events and Survival: Not the Whole Story.","authors":"Rik J Verheijden, Jolien S de Groot, Babs O Fabriek, Miki N Hew, Anne M May, Karijn P M Suijkerbuijk","doi":"10.1200/JCO-24-02234","DOIUrl":"https://doi.org/10.1200/JCO-24-02234","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2402234"},"PeriodicalIF":42.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638816","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":"Reply to: Significance of Up-Front Stereotactic Radiosurgery for Non-Small Cell Lung Cancer Patients With Brain Metastases in the Era of New Generation Tyrosine Kinase Inhibitors.","authors":"Chad G Rusthoven, Emily Miao, Lillian A Boe, Luke R G Pike","doi":"10.1200/JCO-24-02129","DOIUrl":"https://doi.org/10.1200/JCO-24-02129","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2402129"},"PeriodicalIF":42.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638818","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":"Peak Corticosteroid Dose for Immune-Related Adverse Events and Survival: Not the Whole Story.","authors":"Deniz Can Guven","doi":"10.1200/JCO-24-01878","DOIUrl":"https://doi.org/10.1200/JCO-24-01878","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2401878"},"PeriodicalIF":42.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638806","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":"Significance of Up-Front Stereotactic Radiosurgery for Non-Small Cell Lung Cancer Patients With Brain Metastases in the Era of New Generation Tyrosine Kinase Inhibitors.","authors":"Masamune Noguchi, Yurika Shindo, Kohei Wakabayashi, Yutaro Koide","doi":"10.1200/JCO-24-01876","DOIUrl":"https://doi.org/10.1200/JCO-24-01876","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2401876"},"PeriodicalIF":42.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638830","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":"Efficacy, Toxicity, and Cosmesis of Partial Breast Irradiation: Honing in on Dose and Patient Selection.","authors":"Rachel A Rabinovitch","doi":"10.1200/JCO-24-01625","DOIUrl":"https://doi.org/10.1200/JCO-24-01625","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2401625"},"PeriodicalIF":42.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621275","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":"Therapy for Stage IV Non-Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2024.2.","authors":"Lyudmila Bazhenova, Nofisat Ismaila, Fawzi Abu Rous, Krishna Alluri, Janet Freeman-Daily, Balazs Halmos, Narinder Malhotra, Kristen A Marrone, Sonam Puri, Angel Qin, Natasha B Leighl","doi":"10.1200/JCO-24-02133","DOIUrl":"https://doi.org/10.1200/JCO-24-02133","url":null,"abstract":"<p><p><i>Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in the</i> <i>ASCO Guidelines Methodology Manual</i>. <i>ASCO Living Guidelines follow the</i> <i>ASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines</i>. <i>Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating clinician and do not account for individual variation among patients. See the Appendix for disclaimers and other important information (Appendix 1 and Appendix 2</i>, <i>online only). Updates are published regularly and can be found at</i> <i>https://ascopubs.org/nsclc-da-living-guideline</i>.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2402133"},"PeriodicalIF":42.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621295","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":"Axillary Surgery for Patients With Residual Isolated Tumor Cells (ypN0i+) After Neoadjuvant Systemic Therapy for Early Breast Cancer.","authors":"Elisa Agostinetto, Carmela Caballero, Michail Ignatiadis, C Florin Pop","doi":"10.1200/JCO-24-01711","DOIUrl":"https://doi.org/10.1200/JCO-24-01711","url":null,"abstract":"<p><p><i>The Oncology Grand Rounds series is designed to place original reports published in the</i> Journal <i>into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in</i> Journal of Clinical Oncology<i>, to patients seen in their own clinical practice</i>.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2401711"},"PeriodicalIF":42.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621272","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}