Jama Oncology最新文献

{"title":"Neoadjuvant Exercise Therapy in Prostate Cancer: A Phase 1, Decentralized Nonrandomized ControlledTrial.","authors":"Lee W Jones, Chaya S Moskowitz, Catherine P Lee, Gina A Fickera, Su S Chun, Meghan G Michalski, Kurtis Stoeckel, Whitney P Underwood, Jessica A Lavery, Umeshkumar Bhanot, Irina Linkov, Chau T Dang, Behfar Ehdaie, Vincent P Laudone, James A Eastham, Anne Collins, Patricia T Sheerin, Lydia Y Liu, Stefan E Eng, Paul C Boutros","doi":"10.1001/jamaoncol.2024.2156","DOIUrl":"10.1001/jamaoncol.2024.2156","url":null,"abstract":"<p><strong>Importance: </strong>Observational data have shown that postdiagnosis exercise is associated with reduced risk of prostate cancer death. The feasibility and tumor biological activity of exercise therapy is not known.</p><p><strong>Objective: </strong>To identify recommended phase 2 dose of exercise therapy for patients with prostate cancer.</p><p><strong>Design, setting, and participants: </strong>This single-center, phase 1a dose-finding trial was conducted at a tertiary cancer center using a patientcentric, decentralized platform and included 53 inactive men with treatment-naive localized prostate cancer scheduled to undergo surgical resection between June 2019 and January 2023. Data were analyzed in June 2024.</p><p><strong>Intervention: </strong>Six escalated exercise therapy dose levels ranging from 90 to 450 minutes per week of individualized, moderate-intensity treadmill walking, allocated using adaptive continual reassessment. All exercise therapy sessions were conducted remotely with real-time monitoring.</p><p><strong>Main outcomes and measures: </strong>Feasibility was evaluated by relative exercise dose intensity (REDI). A dose level was considered feasible if 70% or more of patients achieved an REDI of 75% or greater. Activity end points were changes in tumor cell proliferation (Ki67) and plasma prostate-specific antigen levels between pretreatment and postintervention. Safety and changes in patient physiology were also assessed.</p><p><strong>Results: </strong>A total of 53 men were enrolled (median [IQR] age, 61 [56-66] years). All dose levels were feasible (≥75% REDI). The mean (95% CI) changes in Ki67 were 5.0% (-4.3% to 14.0%) for 90 minutes per week, 2.4% (-1.3% to 6.2%) for 150 minutes per week, -1.3% (-5.8% to 3.3%) for 225 minutes per week, -0.2% (-4.0% to 3.7%) for 300 minutes per week, -2.6% (-9.2% to 4.1%) for 375 minutes per week, and 2.2% (-0.8% to 5.1%) for 450 minutes per week. Changes in prostate-specific antigen levels were 1.0 ng/mL (-1.8 to 3.8) for 90 minutes per week, 0.2 ng/mL (-1.1 to 1.5) for 150 minutes per week, -0.5 ng/mL (-1.2 to 0.3) for 225 minutes per week, -0.2 (-1.7 to 1.3) for 300 minutes per week, -0.7 ng/mL (-1.7 to 0.4) for 375 minutes per week, and -0.9 ng/mL (-2.4 to 0.7) for 450 minutes per week. No serious adverse events were observed. Overall, 225 minutes per week (approximately 45 minutes per treatment at 5 times weekly) was selected as the recommended phase 2 dose.</p><p><strong>Conclusions and relevance: </strong>The results of this nonrandomized clinical trial suggest that neoadjuvant exercise therapy is feasible and safe with promising activity in localized prostate cancer.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03813615.</p>","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1187-1194"},"PeriodicalIF":28.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11258635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635055","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":"Bilateral Mastectomy and Breast Cancer Mortality.","authors":"Vasily Giannakeas, David W Lim, Steven A Narod","doi":"10.1001/jamaoncol.2024.2212","DOIUrl":"10.1001/jamaoncol.2024.2212","url":null,"abstract":"<p><strong>Importance: </strong>The benefit of bilateral mastectomy for women with unilateral breast cancer in terms of deaths from breast cancer has not been shown.</p><p><strong>Objectives: </strong>To estimate the 20-year cumulative risk of breast cancer mortality among women with stage 0 to stage III unilateral breast cancer according to the type of initial surgery performed.</p><p><strong>Design, settings, and participants: </strong>This cohort study used the Surveillance, Epidemiology, and End Results (SEER) Program registry database to identify women with unilateral breast cancer (invasive and ductal carcinoma in situ) who were diagnosed from 2000 to 2019. Three closely matched cohorts of equal size were generated using 1:1:1 matching according to surgical approach. The cohorts were followed up for 20 years for contralateral breast cancer and for breast cancer mortality. The analysis compared the 20-year cumulative risk of breast cancer mortality for women treated with lumpectomy vs unilateral mastectomy vs bilateral mastectomy. Data were analyzed from October 2023 to February 2024.</p><p><strong>Exposures: </strong>Type of breast surgery performed (lumpectomy, unilateral mastectomy, or bilateral mastectomy).</p><p><strong>Main outcomes and measures: </strong>Contralateral breast cancer or breast cancer mortality during the 20-year follow-up period among the groups treated with lumpectomy vs unilateral mastectomy vs bilateral mastectomy.</p><p><strong>Results: </strong>The study sample included 661 270 women with unilateral breast cancer (mean [SD] age, 58.7 [11.3] years). After matching, there were 36 028 women in each of the 3 treatment groups. During the 20-year follow-up, there were 766 contralateral breast cancers observed in the lumpectomy group, 728 contralateral breast cancers in the unilateral mastectomy group, and 97 contralateral cancers in the bilateral mastectomy group. The 20-year risk of contralateral breast cancer was 6.9% (95% CI, 6.1%-7.9%) in the lumpectomy-unilateral mastectomy group. The cumulative breast cancer mortality was 32.1% at 15 years after developing a contralateral cancer and was 14.5% for those who did not develop a contralateral cancer (hazard ratio, 4.00; 95% CI, 3.52-4.54, using contralateral breast cancer as a time-dependent covariate). Deaths from breast cancer totaled 3077 women (8.54%) in the lumpectomy group, 3269 women (9.07%) in the unilateral mastectomy group, and 3062 women (8.50%) in the bilateral mastectomy group.</p><p><strong>Conclusions and relevance: </strong>This cohort study indicates that the risk of dying of breast cancer increases substantially after experiencing a contralateral breast cancer. Women with breast cancer treated with bilateral mastectomy had a greatly diminished risk of contralateral breast cancer; however, they experienced similar mortality rates as patients treated with lumpectomy or unilateral mastectomy.</p>","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1228-1236"},"PeriodicalIF":28.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761827","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 Abstract.","authors":"","doi":"10.1001/jamaoncol.2024.4464","DOIUrl":"10.1001/jamaoncol.2024.4464","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":"10 9","pages":"1294"},"PeriodicalIF":28.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299009","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":"JAMA Oncology.","authors":"","doi":"10.1001/jamaoncol.2023.4660","DOIUrl":"https://doi.org/10.1001/jamaoncol.2023.4660","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":"10 9","pages":"1161"},"PeriodicalIF":28.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299011","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":"More Benefits of Tai Chi Than Aerobic Exercise in Patients With Advanced Lung Cancer.","authors":"Chieh-Hsuan Tsai, Ping-Hao Chiang","doi":"10.1001/jamaoncol.2024.2453","DOIUrl":"10.1001/jamaoncol.2024.2453","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1290-1291"},"PeriodicalIF":28.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493946","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":"Chemotherapy, Radiation Therapy, and Nasopharyngeal Carcinoma.","authors":"Cho-Yin Lee, Ti-Hao Wang, Yung-Shuo Kao","doi":"10.1001/jamaoncol.2024.2522","DOIUrl":"10.1001/jamaoncol.2024.2522","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1292-1293"},"PeriodicalIF":28.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581255","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":"Population-Based Incidence of Cervical Intraepithelial Neoplasia Across 14 Years of HPV Vaccination.","authors":"Rachael Adcock, Huining Kang, Philip E Castle, Walter Kinney, Rebecca T Emeny, Charles Wiggins, Cosette M Wheeler","doi":"10.1001/jamaoncol.2024.2673","DOIUrl":"10.1001/jamaoncol.2024.2673","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1287-1290"},"PeriodicalIF":28.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761834","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":"B-Cell Maturation Antigen/CD19 Dual-Targeting Immunotherapy in Newly Diagnosed Multiple Myeloma.","authors":"Wanting Qiang, Jing Lu, Yanchun Jia, Jia Liu, Jin Liu, Haiyan He, Xiaoxiang Wang, Xiaoqiang Fan, Lina Jin, Qianqi Ruan, Qi Zhang, Lianjun Shen, Lihong Weng, Wei Cao, Wenling Li, Juan Du","doi":"10.1001/jamaoncol.2024.2172","DOIUrl":"10.1001/jamaoncol.2024.2172","url":null,"abstract":"<p><strong>Importance: </strong>Patients with high-risk newly diagnosed multiple myeloma (NDMM) often have poor outcomes with standard treatments, necessitating novel effective frontline therapies to enhance clinical outcomes. GC012F, a B-cell maturation antigen/CD19 dual-targeting chimeric antigen receptor (CAR) T-cell therapy, has been developed on the novel FasTCAR platform. Notably, its use as a frontline therapy for patients with high-risk NDMM who are eligible for transplant has not been thoroughly explored.</p><p><strong>Objective: </strong>To examine the safety, pharmacokinetics, and patient health and survival outcomes associated with GC012F in individuals with NDMM.</p><p><strong>Design, setting, and participants: </strong>Patients were enrolled in this single-arm, open-label phase 1 cohort study between June 28, 2021, and June 1, 2023 (the data cutoff date). All patients included in this study were treated at a single center, Shanghai Changzheng Hospital. The patients in the efficacy evaluation were followed up for a minimum period of 3 months.</p><p><strong>Intervention: </strong>Patients underwent 2 cycles of induction therapy, followed by GC012F infusion (at 1 × 105 cells/kg, 2 × 105 cells/kg, or 3 × 105 cells/kg).</p><p><strong>Main outcomes and measures: </strong>The primary goals were to assess the safety, efficacy, and pharmacokinetics of GC012F at various dose levels.</p><p><strong>Results: </strong>Of 22 patients receiving GC012F treatment, 6 experienced mild to moderate cytokine release syndrome (grade 1-2) and none experienced neurotoxic effects. Nineteen patients were included in the efficacy evaluation, and all 19 patients showed stringent complete responses and achieved minimal residual disease negativity. The treatment's effectiveness was consistent across different dose levels. GC012F demonstrated a rapid response, with a median time to first stringent complete response of 84 days (range, 26-267 days) and achieving minimal residual disease negativity within 28 days (range, 23-135 days). The CAR T-cell expansion was robust, with a median peak copy number of 60 652 copies/μg genomic DNA (range, 8754-331 159 copies/μg genomic DNA), and the median time to median peak copy number was 10 days (range, 9-14 days).</p><p><strong>Conclusions and relevance: </strong>The findings of this single-arm, open-label phase 1 cohort study suggest that GC012F may be a safe treatment associated with positive health and survival outcomes for patients with high-risk NDMM eligible for transplant. Owing to the small sample size, further studies with larger cohorts and longer follow-up durations are needed.</p>","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1259-1263"},"PeriodicalIF":28.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761826","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":"Chemotherapy, Radiation Therapy, and Nasopharyngeal Carcinoma.","authors":"Pantea Bayatfard, Sezin Yuce Sari, Gozde Yazici","doi":"10.1001/jamaoncol.2024.2519","DOIUrl":"10.1001/jamaoncol.2024.2519","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1292"},"PeriodicalIF":28.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581254","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":"Exercise for Prostate Cancer-Worthy Goals but Suboptimal Trial Designs.","authors":"Marian L Neuhouser, Jeannette M Schenk, Jonathan L Wright","doi":"10.1001/jamaoncol.2024.2057","DOIUrl":"10.1001/jamaoncol.2024.2057","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1177-1178"},"PeriodicalIF":28.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635053","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}