Jama Oncology最新文献_第2页

Adult T-Cell Leukemia/Lymphoma and Targeted Maternal Screening. 成人t细胞白血病/淋巴瘤与母体靶向筛查。

IF 20.1 1区医学

Jama Oncology Pub Date : 2026-04-30 DOI: 10.1001/jamaoncol.2026.0859

Paulo S Pinheiro, Tabassum Z Insaf, Amber N Balda, Baozhen Qiao, Sophia H L George, Ayako Okuyama, Juan C Ramos

{"title":"Adult T-Cell Leukemia/Lymphoma and Targeted Maternal Screening.","authors":"Paulo S Pinheiro, Tabassum Z Insaf, Amber N Balda, Baozhen Qiao, Sophia H L George, Ayako Okuyama, Juan C Ramos","doi":"10.1001/jamaoncol.2026.0859","DOIUrl":"10.1001/jamaoncol.2026.0859","url":null,"abstract":"Importance: Adult T-cell leukemia/lymphoma (ATLL) is a rare but highly aggressive malignant disease caused by lifelong infection with human T-cell leukemia virus type 1 (HTLV-1), typically acquired through mother-to-child transmission. In southwestern Japan, the world's highly documented HTLV-1 endemic region, maternal HTLV-1 screening and breastfeeding counseling have reduced vertical transmission. Because of the long latency between infection and disease, reductions in ATLL burden are expected to occur over time. In the US, HTLV-1 screening is limited to blood donors, while mother-to-child transmission remains unaddressed, despite growing immigrant populations from HTLV-1-endemic regions.Objective: To estimate ATLL incidence in the US by race, ethnicity, and birthplace, and to assess whether incidence in specific populations approaches levels observed in historically endemic regions with established maternal HTLV-1 screening programs.Design, setting, and participants: A population-based incidence and survival analysis was performed using cancer registries from all 50 US states. Individuals 15 years or older diagnosed with ATLL between 2005 and 2022 were included. Data analysis was conducted from December 2024 to November 2025.Exposures: Race, ethnicity, and country of birth, with focused analyses of non-Hispanic Caribbean-born US residents originating from HTLV-1-endemic regions, were examined.Main outcomes and measures: The main outcomes were age-adjusted incidence rates, incidence rate ratios, temporal trends, sensitivity analyses accounting for misclassification with peripheral T-cell lymphoma not otherwise specified (PTCL-NOS), and cause-specific survival.Results: A total of 3228 individuals with ATLL were identified. Among these individuals diagnosed with ATLL between 2005 and 2022, 1662 (51.5%) were male and 1566 (48.5%) were female, with a mean (SD) age at diagnosis of 61.1 (17.3) years, estimated from 5-year age group data. A total of 126 (3.9%) were non-Hispanic Asian or Pacific Islander, 1300 (40.3%) were non-Hispanic Black, 364 (11.3%) were Hispanic, 1394 (43.2%) were non-Hispanic White, and 44 (1.4%) were another race (including American Indian or Alaska Native, other or multiple race, and unknown race). Incidence varied by birthplace. Among non-Hispanic Caribbean-born US residents, the ATLL incidence rate was 14.1 per million, compared with 0.4 per million among US- or Canada-born populations (incidence rate ratio [IRR], 32.0; 95% CI, 27.9-36.8). Rates reached 33.7 per million among individuals born in Grenada. Sensitivity analyses redistributing excess PTCL-NOS incidence under a misclassification framework increased ATLL incidence among Caribbean-born populations to levels approaching or exceeding those reported in HTLV-1 endemic regions. Five-year survival was poor (23.8%; 95% CI, 21.1%-26.5%","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/PMC13133722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786299","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}

引用次数: 0

Local Salvage Therapy Alone for Local Recurrence of Prostate Cancer After Radiotherapy: A Systematic Review and Meta-Analysis. 局部保留治疗单独治疗前列腺癌放疗后局部复发：一项系统综述和荟萃分析。

IF 20.1 1区医学

Jama Oncology Pub Date : 2026-04-30 DOI: 10.1001/jamaoncol.2026.1023

Marcin Miszczyk, Federico Mastroleo, Anna Kujawska, Adam Gurwin, Giulia Marvaso, Tamás Kói, Giorgio Calleris, Marnix Rasing, Joseph Chin, Donald Fuller, Arjun Nathan, Max Peters, Jochem van der Voort van Zyp, Pocharapong Jenjitranant, George Hruby, Timo F W Soeterik, Giulio Francolini, Leonie Exterkate, Christiaan G Overduin, Giancarlo Marra, Paolo Gontero, Ahmed R Alfarhan, Pawel Rajwa, Amar U Kishan, Barbara Alicja Jereczek-Fossa, Shahrokh F Shariat

{"title":"Local Salvage Therapy Alone for Local Recurrence of Prostate Cancer After Radiotherapy: A Systematic Review and Meta-Analysis.","authors":"Marcin Miszczyk, Federico Mastroleo, Anna Kujawska, Adam Gurwin, Giulia Marvaso, Tamás Kói, Giorgio Calleris, Marnix Rasing, Joseph Chin, Donald Fuller, Arjun Nathan, Max Peters, Jochem van der Voort van Zyp, Pocharapong Jenjitranant, George Hruby, Timo F W Soeterik, Giulio Francolini, Leonie Exterkate, Christiaan G Overduin, Giancarlo Marra, Paolo Gontero, Ahmed R Alfarhan, Pawel Rajwa, Amar U Kishan, Barbara Alicja Jereczek-Fossa, Shahrokh F Shariat","doi":"10.1001/jamaoncol.2026.1023","DOIUrl":"10.1001/jamaoncol.2026.1023","url":null,"abstract":"Importance: Standard-of-care management of radiorecurrent prostate cancer (PCa) involves systemic therapy; however, some patients seek to avoid the adverse events (AEs) that are associated with androgen-deprivation therapy (ADT).Objective: To determine outcomes of local therapy without systemic therapy for radiorecurrent PCa.Data sources: MEDLINE, Embase, Web of Science Core Collection, and Google Scholar were searched from inception up to May 2025. No date or language filters were used. Data were analyzed from June to November 2025.Study selection: Prospective and retrospective studies were selected that investigated local salvage therapies without concomitant systemic treatment for locally recurrent PCa after definitive radiotherapy. Eligible studies provided ADT-free survival (ADT-FS) and/or metastasis-free survival (MFS). Authors were contacted for additional data.Data extraction and synthesis: This study was prospectively registered and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias was assessed using Risk of Bias Assessment Tool for Nonrandomized Studies, version 2. Individual patient data were reconstructed from Kaplan-Meier curves or retrieved from authors. ADT-FS, MFS, and rates of AEs were pooled in a random-effects models.Main outcomes and measures: Main outcomes were ADT-FS and MFS, which were modeled as pooled summary Kaplan-Meier curves, and rates of severe or worse AEs, which were modeled as proportions. Outcomes were stratified by treatment method.Results: Thirty-one studies (4525 patients) were identified that assessed salvage high-dose-rate brachytherapy (HDR-BT; 336 patients), low-dose-rate brachytherapy (LDR-BT; 92 patients), stereotactic body radiotherapy (SBRT; 213 patients), radical prostatectomy (sRP; 1476 patients), cryotherapy (1621 patients), high-intensity focused ultrasonography (HIFU; 677 patients), or mixed methods (110 patients). Prospective studies comprised approximately one-fourth of the evidence (1055 patients); however, none were identified for sRP. Pooled 2-year and 5-year ADT-FS (2887 patients) were 76.8% and 55.2%, respectively. Pooled 2-year and 5-year MFS (3425 patients) were 90.4% and 75.2%, respectively. Rates of severe or worse AEs (2308 patients) ranged from 14% for LDR-BT, 13% for sRP, 5% for HDR-BT, 5% for HIFU, 4% for SBRT, and 2% for cryotherapy. Risk of bias concerns primarily regarded patient selection. Limitations included a lack of randomized clinical trials.Conclusions and relevance: The findings of this systematic review and meta-analysis suggest that local therapies alone have reasonable efficacy in well-selected patients with locally radiorecurrent PCa. ADT-free survival was maintained for more than three-quarters of patients at 2 years and more than","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/PMC13133724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786343","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}

引用次数: 0

Long-Term Outcomes of Patients With BRCA+ or PALB2+ Pancreatic Cancer Treated With Maintenance Rucaparib: A Secondary Analysis of a Nonrandomized Clinical Trial. 维持性鲁卡帕尼治疗BRCA+或PALB2+胰腺癌患者的长期预后：一项非随机临床试验的二次分析

IF 20.1 1区医学

Jama Oncology Pub Date : 2026-04-30 DOI: 10.1001/jamaoncol.2026.0870

Kim A Reiss, Mingyi Xia, Mwangala Akamandisa, Kurt D'Andrea, Brad Wubbenhorst, Christopher J Lord, Stephen J Pettitt, Andrew N J Tutt, Timothy J Brown, Mark H O'Hara, Charles Schneider, Ursina Teitelbaum, Zain Hannan, Ryan Hood, Rashmi Tondon, Robert H Vonderheide, Susan M Domchek, Katherine L Nathanson

引用次数: 0

Competing Risk of Death in Heart Failure or Cardiomyopathy Prediction After Breast Cancer-Reply. 乳腺癌后心衰或心肌病预测的竞争死亡风险

IF 20.1 1区医学

Jama Oncology Pub Date : 2026-04-01 DOI: 10.1001/jamaoncol.2025.6474

Jiling Chou, Reina Haque, Arnold L Potosky