Jama Oncology最新文献

{"title":"Reassessing Treatment Outcomes Following Immune-Related Adverse Events-Reply.","authors":"Brandon R Block, Thomas U Marron, Nicholas Gulati","doi":"10.1001/jamaoncol.2026.1209","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.1209","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":20.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844769","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":"Rates of Systemic Treatment for Metastatic Non-Small Cell Lung Cancer Among Older Adults.","authors":"Adam H Fox, Ralph C Ward, Mariam Alexander, Raymond U Osarogiagbon, Robert A Smith, Jamie L Studts, Gerard A Silvestri","doi":"10.1001/jamaoncol.2026.1080","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.1080","url":null,"abstract":"<p><strong>Importance: </strong>Metastatic non-small cell lung cancer (mNSCLC) has very high mortality rates, and comprises approximately half of new cases of lung cancer; however, highly effective and better tolerated treatments have become available in recent decades. Nevertheless, population-level treatment of mNSCLC is poorly characterized in the era of rapid treatment advances.</p><p><strong>Objective: </strong>To characterize treatment rates, trends, and factors associated with treatment of mNSCLC.</p><p><strong>Design, setting, and participants: </strong>This population-based study used linked Surveillance Epidemiology and End Results (SEER) and Medicare claims data and the analysis included patients 65 years and older diagnosed with mNSCLC from January 2006 to December 2021. Data were analyzed from October 2025 to February 2026.</p><p><strong>Exposures: </strong>Sociodemographic variables, comorbidity burden, histologic type, referral to subspecialist, enrollment in Medicare Part D, and biomarker testing.</p><p><strong>Main outcomes: </strong>The primary outcome was receipt of systemic treatment. Statistical analyses included summary statistics and a competing risk proportional hazards model for receipt of systemic treatment.</p><p><strong>Results: </strong>Of 254 611 patients with mNSCLC, the cohort median (IQR) age was 73 (68-80) years, with 133 635 (52.5%) male individuals; a total of 9512 (3.7%) were Asian, 26 546 (10.4%) were Black, 4553 (1.8%) were Hispanic, 205 381 (80.7%) were White, and 8619 (3.4%) were another or unknown race. A total of 119 197 patients (46.8%) ever received systemic treatment. Of the 100 367 (39.8%) who died within 90 days of diagnosis, 13.2% were treated compared with 69% of those surviving more than 90 days. The treated proportion increased only slightly between 2006 and 2021. In a competing risk model, referral to oncology specialists was associated with treatment (hazard ratio [HR], 2.5; 95% CI, 2.41-2.67; P < .001) which corresponded to a 30.3% greater cumulative incidence of treatment at 180 days (CIF180) compared with those without a referral. Similarly, those with biomarker testing had a 17.8% greater CIF180, whereas those older than 80 years had a 15.4% lower CIF180 compared to those aged 65 to 69 years. Patients with NSCLC not otherwise specified histologic findings had a 12.8% lower CIF180 compared with those with adenocarcinoma histologic findings. Other factors associated with significant but smaller differences in receipt of treatment included comorbidity burden, marital status, Medicare Part C or Part D coverage, rurality, and race and ethnicity.</p><p><strong>Conclusions and relevance: </strong>In this cohort study of older adults with mNSCLC, despite advances in therapy in recent decades, almost half of patients never received systemic therapy, and the proportion treated only minimally improved over time. Approximately one-fifth of those with the most favorable clinical profiles did not receiv","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":20.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844756","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":"Clarification for Gleason Pattern.","authors":"","doi":"10.1001/jamaoncol.2026.1415","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.1415","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":20.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844810","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":"Prostate-Specific Membrane Antigen Imaging and Initial Treatment for Prostate Cancer.","authors":"Michael S Leapman, John Rothen, Jessica B Long, Isaac E Kim, Aaron E Mitchell, James B Yu, Michaela A Dinan, Cary P Gross, Xiaomei Ma","doi":"10.1001/jamaoncol.2026.0893","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0893","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":20.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844771","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":"Reassessing Treatment Outcomes Following Immune-Related Adverse Events.","authors":"Stephen Rhodes, Jonathan Shoag","doi":"10.1001/jamaoncol.2026.1206","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.1206","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":20.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844803","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":"Tumor-Infiltrating Clonal Hematopoiesis and Pan-Cancer Prognosis in Patients With Solid Tumors.","authors":"Dabin Yun, Cheng Chen, Na Qin, Zhaoming Wang, Nan Song","doi":"10.1001/jamaoncol.2026.1036","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.1036","url":null,"abstract":"<p><strong>Importance: </strong>Tumor-infiltrating clonal hematopoiesis (TI-CH) indicates the infiltration of somatically mutated hematopoietic cells into the tumor microenvironment. While clonal hematopoiesis is a known prognostic factor in hematologic malignant neoplasms, the clinical relevance of TI-CH in solid tumors remains poorly understood.</p><p><strong>Objective: </strong>To characterize the prevalence of TI-CH in solid tumors and evaluate its association with clinical factors and overall survival (OS).</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study analyzed whole-genome sequencing data of a large cohort of patients with solid tumors from the Genomics England 100 000 Genomes Project between 2015 and 2019. The data analysis was conducted from June to November 2025.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the prevalence of TI-CH, defined by somatic variants in 74 driver genes (variant allele frequency 2% to 30%) in tumor tissue. Secondary outcomes included associations of TI-CH with clinical factors (age, cytotoxic chemotherapy) and OS, assessed using Cox proportional hazards models.</p><p><strong>Results: </strong>Among 10 571 patients with solid tumors (mean [SD] age, 64.68 [12.18] years; 6430 [60.83%] female), TI-CH was detected in 1943 patients (18.38%), with the highest frequency observed in patients with TET2 variants (212 patients [10.91%]) and in patients with endometrial cancer (251 patients [32%]). TI-CH was more common with older age (odds ratio [OR], 1.15 [95% CI, 1.10-1.19]) and cytotoxic chemotherapy (OR, 1.24 [95% CI, 1.06-1.44]). TI-CH was significantly associated with worse pan-cancer OS (hazard ratio [HR], 1.13 [95% CI, 1.02-1.25]), particularly breast cancer OS (HR, 1.95 [95% CI, 1.54-2.48]). At the gene level, worse pan-cancer OS was significantly associated with GATA2 variants (HR, 3.00 [95% CI, 1.61-5.59]), and worse breast cancer OS was significantly associated with TET2 variants (HR, 2.92 [95% CI, 1.59-5.37]).</p><p><strong>Conclusions and relevance: </strong>In this cohort study, older age and cytotoxic chemotherapy were associated with higher odds of TI-CH. TI-CH was associated with worse survival in patients with solid tumors, specifically implicating GATA2 (pan-cancers) and TET2 (breast cancer) variants. These findings suggest TI-CH may serve as a prognostic biomarker in patients with solid tumors.</p>","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":20.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844842","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":"Healthy Lifestyle Advice and Practice Among Cancer Survivors in the US.","authors":"Chao Cao, Kathryn H Schmitz, Edward L Giovannucci, I-Min Lee, Ann H Partridge, Jennifer A Ligibel","doi":"10.1001/jamaoncol.2026.0879","DOIUrl":"10.1001/jamaoncol.2026.0879","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":20.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tiragolumab Plus Atezolizumab and Chemotherapy for Advanced Nonsquamous Non-Small Cell Lung Cancer: The Phase 3 SKYSCRAPER-06 Randomized Clinical Trial.","authors":"Mark A Socinski, Rolf Stahel, Dae Ho Lee, Federico Cappuzzo, Makoto Nishio, Christine M Lovly, Ozgur Ozyilkan, Qingshan Li, Melissa Johnson, Edward B Garon, Saadettin Kilickap, Flavio Augusto Ferreira da Silva, Jorge Alatorre-Alexander, Raymond Meng, Reena Amin, Christina Matheny, Sarah Troutman, Xiaohui Wen, Namrata S Patil, Wei Zou, Delvys Rodriguez-Abreu","doi":"10.1001/jamaoncol.2026.0818","DOIUrl":"10.1001/jamaoncol.2026.0818","url":null,"abstract":"<p><strong>Importance: </strong>Programmed cell death 1 ligand 1/programmed cell death protein 1 inhibitors, with or without chemotherapy, are standard first-line treatment for patients with advanced non-small cell lung cancer (NSCLC); however, survival benefit is limited, and many patients experience disease progression.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of tiragolumab plus atezolizumab plus chemotherapy vs placebo plus pembrolizumab plus chemotherapy in patients with advanced nonsquamous NSCLC.</p><p><strong>Design, setting, and participants: </strong>SKYSCRAPER-06 was a phase 3 randomized clinical trial that recruited patients with previously untreated, locally advanced unresectable or metastatic NSCLC at 129 sites in 21 countries between December 15, 2020, and September 14, 2023 (data cutoff, April 19, 2024).</p><p><strong>Intervention: </strong>Patients were randomized 1:1 to receive either tiragolumab, 600 mg, plus atezolizumab, 1200 mg, plus chemotherapy (pemetrexed, 500 mg/m2, and carboplatin [area under the curve 5], or cisplatin, 75 mg/m2) or placebo plus pembrolizumab, 200 mg, plus chemotherapy via intravenous infusion on day 1 of each 21-day cycle until disease progression, loss of clinical benefit, unacceptable toxic effect, or withdrawal of consent.</p><p><strong>Main outcomes and measures: </strong>Primary end points were investigator-assessed progression-free survival and overall survival. The safety and tolerability of the study drugs were also evaluated.</p><p><strong>Results: </strong>Of 542 patients in the full analysis set (mean [SD] age, 63.6 [9.3] years; 353 [65.1%] male), 269 were randomized to tiragolumab plus atezolizumab plus chemotherapy and 273 to placebo plus pembrolizumab plus chemotherapy. Overall, baseline demographics were similar between treatment groups. At data cutoff (median follow-up, 11.8 months), median investigator-assessed progression-free survival was 8.3 months (95% CI, 7.1-9.6 months) with tiragolumab plus atezolizumab plus chemotherapy vs 9.9 months (95% CI, 8.7-11.9 months) with placebo plus pembrolizumab plus chemotherapy (hazard ratio, 1.27; 95% CI, 1.02-1.57; P = .99); median overall survival was 18.9 months (95% CI, 15.2-23.8 months) vs 23.1 months (95% CI, 20.7-33.0 months) in each treatment group, respectively (hazard ratio, 1.33; 95% CI, 1.02-1.73; P = .98). Grade 3 to 4 adverse events occurred in 164 of 267 patients (61.4%) in the tiragolumab plus atezolizumab plus chemotherapy group and 165 of 272 patients (60.7%) in the placebo plus pembrolizumab plus chemotherapy group, with grade 5 AEs occurring in 27 of 267 patients (10.1%) and 16 of 272 patients (5.9%) in each group, respectively.</p><p><strong>Conclusions and relevance: </strong>In the phase 3 SKYSCRAPER-06 randomized clinical trial, the primary end points were not met and the study has been terminated.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04619797.</p>","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":20.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Entropy and the Block Universe-A Physicist's Goodbye.","authors":"Yang Yang","doi":"10.1001/jamaoncol.2026.0266","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0266","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":20.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786340","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":"Multiple Spinal Intradural Tumors and a Pigmented Skin Lesion.","authors":"Asad M Lak, Shruthi Kondaboina, Satoshi Yamaguchi","doi":"10.1001/jamaoncol.2026.0386","DOIUrl":"https://doi.org/10.1001/jamaoncol.2026.0386","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":20.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786325","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}