Jama Oncology最新文献

{"title":"Changes in Oncology Medication Use After Withdrawal of Accelerated Approval.","authors":"Catherine S Hwang, Aaron S Kesselheim, Amar H Kelkar, Edward R Scheffer Cliff, Benjamin N Rome","doi":"10.1001/jamaoncol.2025.0359","DOIUrl":"10.1001/jamaoncol.2025.0359","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774539","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":"Error in Byline.","authors":"","doi":"10.1001/jamaoncol.2025.0822","DOIUrl":"10.1001/jamaoncol.2025.0822","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774602","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":"Prognostic and Predictive Insights From Genomic Assays for Breast Cancer in Diverse Populations: A Review.","authors":"Yara Abdou, Olga Kantor, Jennifer Racz, Lisa Newman, Lori J Pierce, Eric P Winer","doi":"10.1001/jamaoncol.2025.0178","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0178","url":null,"abstract":"<p><strong>Importance: </strong>Despite recent declines in breast cancer mortality rates, substantial disparities persist among race and ethnicity groups. Genomic assays are crucial for understanding the biological characteristics of tumors, providing valuable insights into prognosis and treatment response. Their integration into personalized clinical decision-making has notably enhanced outcomes, making these assays particularly valuable for underrepresented populations, which often face disproportionately poorer prognoses. Expanding research to evaluate the performance and predictive value of these assays across diverse groups is essential to ensure equitable benefits for all patients.</p><p><strong>Observations: </strong>This review evaluated the distribution of risk estimates from multigene assays, primarily focusing on 21-, 70-, and 50-gene signature assays, their predictive capabilities and impact on breast cancer recurrence and survival outcomes across race and ethnicity groups. Findings indicate that racial and ethnic disparities in breast cancer outcomes were influenced by a complex interplay of biological, social, and systemic factors. Black women were more likely to have aggressive tumor phenotypes, such as luminal B and basal-like subtypes, which contributed to poorer outcomes. These disparities persist even after adjusting for genomic assay results and molecular subtypes, suggesting that genomic factors alone cannot fully explain differences in clinical outcomes. Although subgroup analyses from 2 randomized clinical trials showed no apparent differences in the 21-gene signature's predictive value across racial groups, further research is needed to ensure that genomic assays are equitably calibrated for diverse populations.</p><p><strong>Conclusions and relevance: </strong>This review supports genomic assays as valuable tools for informing prognosis and treatment decisions in breast cancer; however, they do not fully capture factors associated with racial and ethnic disparities in outcomes. A comprehensive approach that integrates genomic data with a deeper understanding of social determinants and systemic inequities is essential to ensure all patients benefit equitably from advancements in personalized medicine.</p>","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774615","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":"Chromosome 1p Loss and 1q Gain for Grading of Meningioma.","authors":"Alexander P Landry, Justin Z Wang, Vikas Patil, Jeff Liu, Chloe Gui, Yosef Ellenbogen, Andrew Ajisebutu, Leeor Yefet, Qingxia Wei, Olivia Singh, Julio Sosa, Sheila Mansouri, Aaron A Cohen-Gadol, Ghazaleh Tabatabai, Marcos Tatagiba, Felix Behling, Jill S Barnholtz-Sloan, Andrew E Sloan, Silky Chotai, Lola B Chambless, Alireza Mansouri, Serge Makarenko, Stephen Yip, Felix Ehret, David Capper, Derek S Tsang, Jennifer Moliterno, Murat Gunel, Pieter Wesseling, Felix Sahm, Kenneth Aldape, Andrew Gao, Gelareh Zadeh, Farshad Nassiri","doi":"10.1001/jamaoncol.2025.0329","DOIUrl":"10.1001/jamaoncol.2025.0329","url":null,"abstract":"<p><strong>Importance: </strong>The World Health Organization (WHO) classification of central nervous system tumors (CNS) grading for meningioma was updated in 2021 to include rare molecular features, namely homozygous deletions of CDKN2A or CDKN2B and TERT promotor alterations. Previous work, including the cIMPACT-NOW statement, has discussed the potential value of including chromosomal copy number alterations to help refine the current grading system.</p><p><strong>Objective: </strong>To identify chromosomal copy number alterations that could be used to improve the current CNS WHO grading of meningioma.</p><p><strong>Design, setting, and participants: </strong>In this cohort study, patients with surgically treated meningioma were followed-up until recurrence or progression of disease or death. Chromosomal copy number alterations were then correlated with progression-free survival (PFS) to identify new outcome biomarkers. This study included patients with a histopathological diagnosis of meningioma from multiple institutions in Canada, the US, and Germany, with molecular data collection starting in 2016. Data were analyzed from January to September 2024.</p><p><strong>Exposures: </strong>All patients underwent surgery for meningioma and a subset underwent radiation therapy.</p><p><strong>Main outcomes and measures: </strong>The main outcome was PFS. Cox regression analysis was used to identify copy number alterations associated with outcomes in the context of WHO grading.</p><p><strong>Results: </strong>Among 1964 patients with meningioma (1256 female; median [IQR] age, 58 [48-69] years) assessed, loss of chromosome 1p in WHO grade 1 meningiomas was associated with significantly worse outcomes compared with tumors without loss of 1p (median PFS, 5.83 [95% CI, 4.36-∞] years vs 34.54 [95% CI, 16.01-∞] years; log-rank P < .001). Outcomes of patients with WHO grade 1 tumors with loss of chromosome 1p were comparable to those of patients with WHO grade 2 tumors (median PFS, 4.48 [95% CI, 4.09-5.18] years). Combined loss of chromosome 1p and gain of chromosome 1q were associated with outcomes that were highly concordant with WHO grade 3 tumors, regardless of initial grade (median PFS: grade 1, 2.23 [95% CI, 1.28-∞] years; grade 2, 1.90 [95% CI, 1.23-2.25] years; grade 3, 2.27 [95% CI, 1.68-3.05] years).</p><p><strong>Conclusions and relevance: </strong>These findings highlight a role for cytogenetic profiling in the next iteration of CNS WHO grading, with a specific focus on chromosome 1p loss and 1q gain, suggesting that chromosome 1p loss, in addition to 22q loss, should be added as a criterion for a CNS WHO grade of 2 and addition of 1q gain as a criterion for a CNS WHO grade of 3.</p>","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774595","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":"Formulation-Based Cost Savings with Cabozantinib Capsules.","authors":"Austin Wesevich, Walter M Stadler, Mark J Ratain","doi":"10.1001/jamaoncol.2025.0175","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0175","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774605","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":"Management of EGFR-Variant and ALK-Positive Non-Small Cell Lung Cancer Brain Metastasis.","authors":"Luke R G Pike, Helena Yu, Chad G Rusthoven","doi":"10.1001/jamaoncol.2025.0188","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0188","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774610","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":"Selective Elimination of Breast Surgery for Invasive Breast Cancer: A Nonrandomized Clinical Trial.","authors":"Henry M Kuerer, Vicente Valero, Benjamin D Smith, Savitri Krishnamurthy, Emilia J Diego, Helen M Johnson, Heather Lin, Yu Shen, Anthony Lucci, Simona F Shaitelman, Melissa P Mitchell, Judy C Boughey, Richard L White, Kelly K Hunt, Wei T Yang, Gaiane M Rauch","doi":"10.1001/jamaoncol.2025.0207","DOIUrl":"10.1001/jamaoncol.2025.0207","url":null,"abstract":"<p><strong>Importance: </strong>Neoadjuvant systemic therapy (NST) has been associated with pathologic complete response (pCR) in up to 60% of breast cancers (BCs). The findings of this trial question the necessity of surgery.</p><p><strong>Objective: </strong>To report preplanned 5-year efficacy outcomes evaluating radiotherapy alone without breast surgery in patients selected with image-guided vacuum assisted biopsy (VAB).</p><p><strong>Design, setting, and participants: </strong>This single-arm, prospective, phase 2 nonrandomized clinical trial was conducted at 7 US medical centers and included women 40 years or older with cT1-2N0-1M0 ERBB2-positive (formerly HER2-positive) or triple-negative invasive BC who showed residual breast lesions after NST of less than 2 cm on imaging. Enrollment was from March 6, 2017, to November 9, 2021. Data analysis was from October to December 2024.</p><p><strong>Intervention: </strong>Image-guided VAB of the tumor bed (9G with a minimum of 12 cores) was performed after standard NST. Patients with clinically node-negative disease at diagnosis and no residual cancer in the breast on post-NST VAB underwent whole-breast radiotherapy with a boost without breast or axillary surgery. Patients with initial documented nodal disease and a breast pCR on VAB underwent targeted axillary dissection, while those with residual cancer when undergoing VAB had standard breast and axillary surgery. Patients were monitored with physical examinations and mammography every 6 months.</p><p><strong>Main outcome measures: </strong>The primary outcome was ipsilateral breast tumor recurrence.</p><p><strong>Results: </strong>Fifty patients (median [IQR] age, 62 [55-77] years) were enrolled and underwent post-NST VAB. Twenty-nine (58%) and 21 (42%) patients had ERBB2-positive and triple-negative invasive BC, respectively. Breast pCR on VAB was identified in 31 patients (62%; 95% CI, 47.2%-75.34%), and axillary pCR was identified among all 8 patients with initial nodal metastases and breast pCR on VAB who underwent targeted axillary dissection. At a median follow-up of 55.4 (IQR, 44.0-63.5) months, the ipsilateral breast tumor recurrence rate was 0%, and disease-free and overall survival rates were 100% for patients without breast surgery.</p><p><strong>Conclusions and relevance: </strong>The results of this nonrandomized clinical trial that reported preplanned 5-year outcomes suggest that omission of breast surgery in select patients after NST may be feasible, with no recurrences seen. More confirmatory studies are necessary before this new approach alters surgical practice.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02945579.</p>","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732694","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":"Smoking Status of the US Cancer Population and a New Perspective From the National Cancer Database.","authors":"Giorgio Caturegli, Xuan Zhu, Bryan Palis, Timothy W Mullett, Benjamin J Resio, Daniel J Boffa","doi":"10.1001/jamaoncol.2025.0247","DOIUrl":"10.1001/jamaoncol.2025.0247","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722088","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":"Immunotherapy Strategies After Immune Checkpoint Inhibitor Exposure in Renal Cell Carcinoma: A Review.","authors":"Giulia Claire Giudice, Kathryn E Beckermann, Paulo Siqueira Do Amaral, Brian I Rini","doi":"10.1001/jamaoncol.2025.0017","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0017","url":null,"abstract":"<p><strong>Importance: </strong>Immune checkpoint inhibitors have transformed the treatment landscape for metastatic renal cell carcinoma; however, the failure of first-line therapeutic strategies remains a considerable challenge. Currently, clinicians face various issues, such as managing cases in patients who progress during treatment or relapse after adjuvant immunotherapy.</p><p><strong>Observations: </strong>This review evaluates different strategies for treating patients with advanced kidney cancer previously exposed to immunotherapy. Evidence from other malignant neoplasms suggests potential effectiveness for rechallenging with immune checkpoint inhibitors. The most important available data are presented, including retrospective, prospective, and randomized clinical trials, to explore the role of immunotherapy in patients with renal cell carcinoma who have experienced prior failure of immune checkpoint inhibitors.</p><p><strong>Conclusions and relevance: </strong>Although retrospective data suggest modest effectiveness of an immunotherapy rechallenge treatment, larger phase 3 trials failed to demonstrate substantial benefit in progression-free survival and overall survival. Currently, no randomized evidence supports the use of agents targeting conventional immune checkpoints in patients with renal cell carcinoma who have previously received immunotherapy.</p>","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722086","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":"Identifying Who Is at Risk of Interval Breast Cancers.","authors":"Christoph I Lee, Kathryn P Lowry","doi":"10.1001/jamaoncol.2025.0101","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.0101","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722084","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}