Jama OncologyPub Date : 2024-10-03DOI: 10.1001/jamaoncol.2024.4330
Jonathan M Loree, David Chan, Jennifer Lim, Heather Stuart, Nicolas Fidelman, Jonathan Koea, Jason Posavad, Meredith Cummins, Sarah Doucette, Sten Myrehaug, Boris Naraev, Dale L Bailey, Andrew Bellizzi, David Laidley, Veronica Boyle, Rachel Goodwin, Jaydi Del Rivero, Michael Michael, Janice Pasieka, Simron Singh
{"title":"Biomarkers to Inform Prognosis and Treatment for Unresectable or Metastatic GEP-NENs.","authors":"Jonathan M Loree, David Chan, Jennifer Lim, Heather Stuart, Nicolas Fidelman, Jonathan Koea, Jason Posavad, Meredith Cummins, Sarah Doucette, Sten Myrehaug, Boris Naraev, Dale L Bailey, Andrew Bellizzi, David Laidley, Veronica Boyle, Rachel Goodwin, Jaydi Del Rivero, Michael Michael, Janice Pasieka, Simron Singh","doi":"10.1001/jamaoncol.2024.4330","DOIUrl":"https://doi.org/10.1001/jamaoncol.2024.4330","url":null,"abstract":"<p><strong>Importance: </strong>Evidence-based treatment decisions for advanced gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) require individualized patient-centered decision-making that accounts for patient and cancer characteristics.</p><p><strong>Objective: </strong>To create an accessible guidance document to educate clinicians and patients on biomarkers informing prognosis and treatment in unresectable or metastatic GEP-NENs.</p><p><strong>Methods: </strong>A multidisciplinary panel in-person workshop was convened to define methods. English language articles published from January 2016 to January 2023 in PubMed (MEDLINE) and relevant conference abstracts were reviewed to investigate prognostic and treatment-informing features in unresectable or metastatic GEP-NENs. Data from included studies were used to form evidence-based recommendations. Quality of evidence and strength of recommendations were determined using the Grading of Recommendations, Assessment, Development and Evaluations framework. Consensus was reached via electronic survey following a modified Delphi method.</p><p><strong>Findings: </strong>A total of 131 publications were identified, including 8 systematic reviews and meta-analyses, 6 randomized clinical trials, 29 prospective studies, and 88 retrospective cohort studies. After 2 rounds of surveys, 24 recommendations and 5 good clinical practice statements were developed, with full consensus among panelists. Recommendations focused on tumor and functional imaging characteristics, blood-based biomarkers, and carcinoid heart disease. A single strong recommendation was made for symptomatic carcinoid syndrome informing treatment in midgut neuroendocrine tumors. Conditional recommendations were made to use grade, morphology, primary site, and urinary 5-hydroxyindoleacetic levels to inform treatment. The guidance document was endorsed by the Commonwealth Neuroendocrine Tumour Collaboration and the North American Neuroendocrine Tumor Society.</p><p><strong>Conclusions and relevance: </strong>The study results suggest that select factors have sufficient evidence to inform care in GEP-NENs, but the evidence for most biomarkers is weak. This article may help guide management and identify gaps for future research to advance personalized medicine and improve outcomes for patients with GEP-NENs.</p>","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367078","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}
Jama OncologyPub Date : 2024-10-03DOI: 10.1001/jamaoncol.2024.4335
Celeste Manfredi, Antonio Franco, Francesco Ditonno, Eugenio Bologna, Leslie Claire Licari, Costantino Leonardo, Alessandro Antonelli, Cosimo De Nunzio, Edward E Cherullo, Marco De Sio, Riccardo Autorino
{"title":"Prevalence and Factors Associated With Prostate Cancer Among Transgender Women.","authors":"Celeste Manfredi, Antonio Franco, Francesco Ditonno, Eugenio Bologna, Leslie Claire Licari, Costantino Leonardo, Alessandro Antonelli, Cosimo De Nunzio, Edward E Cherullo, Marco De Sio, Riccardo Autorino","doi":"10.1001/jamaoncol.2024.4335","DOIUrl":"10.1001/jamaoncol.2024.4335","url":null,"abstract":"<p><strong>Importance: </strong>Evidence on prostate cancer (PCa) in transgender women is very limited; data are needed to reduce gender disparities in both PCa knowledge and health care.</p><p><strong>Objective: </strong>To evaluate the prevalence of PCa among transgender women in the US and assess the factors associated with PCa, and factors associated with biochemical recurrence (BCR) and bone metastases (BM) secondary to PCa in the transgender population.</p><p><strong>Design, setting, and participants: </strong>A retrospective cohort study was conducted in October 2023, covering the period between 2011 and 2022 (12-year analysis). The study was based on a large, all-payer claims, deidentified, US database (PearlDiver Mariner). Transgender women who were identified as male before assignment of transsexual status codes were included. Patients with PCa were detected in the transgender women population.</p><p><strong>Main outcomes and measures: </strong>PCa diagnosis was selected as primary outcome; BCR and BM were chosen as secondary outcomes.</p><p><strong>Results: </strong>A total of 95 460 transgender women with a mean (SD) age of 52.5 (9.4) years were included. PCa was diagnosed in 589 individuals with a mean (SD) age of 66.8 (10.0) years (estimated prevalence, 0.62%; 95% CI, 0.54%-0.77%). Age (adjusted odds ratio [OR], 1.10; 95% CI, 1.08-1.12; P < .001) and family history (adjusted OR, 2.27; 95% CI, 1.60-4.92; P < .001) were positively associated with PCa in transgender women. Gender-affirming hormone therapy (GAHT) was negatively associated with PCa in transgender women (OR, 0.60; 95% CI, 0.56-0.89; P < .001) but positively associated with BCR (OR, 1.83; 95% CI, 1.21-2.86; P < .001) and BM (OR, 3.96; 95% CI, 1.50-9.99; P < .001) in the transgender population with PCa.</p><p><strong>Conclusions and relevance: </strong>This cohort study found that PCa appeared to be relatively uncommon in transgender women. GAHT may reduce the risk of PCa in transgender patients, but it may also increase the risk of BCR and BM in transgender women with PCa. Further studies are needed to confirm our findings.</p>","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367085","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}
Jama OncologyPub Date : 2024-10-03DOI: 10.1001/jamaoncol.2024.3927
Deborah C Marshall
{"title":"Moving the Needle on Equity in Prostate Cancer.","authors":"Deborah C Marshall","doi":"10.1001/jamaoncol.2024.3927","DOIUrl":"https://doi.org/10.1001/jamaoncol.2024.3927","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":""},"PeriodicalIF":28.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367084","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}
Jama OncologyPub Date : 2024-10-01DOI: 10.1001/jamaoncol.2024.2640
Min Hee Hong, Yoon Ji Choi, Hee Kyung Ahn, Sun Min Lim, Bhumsuk Keam, Dong-Wan Kim, Tae Min Kim, Jeonghwan Youk, Yu Jung Kim, Shinwon Hwang, Sangwoo Kim, Ju Won Kim, Hye Ryun Kim, Jin Hyoung Kang
{"title":"Lazertinib in EGFR-Variant Non-Small Cell Lung Cancer With CNS Failure to Prior EGFR Tyrosine Kinase Inhibitors: A Nonrandomized Controlled Trial.","authors":"Min Hee Hong, Yoon Ji Choi, Hee Kyung Ahn, Sun Min Lim, Bhumsuk Keam, Dong-Wan Kim, Tae Min Kim, Jeonghwan Youk, Yu Jung Kim, Shinwon Hwang, Sangwoo Kim, Ju Won Kim, Hye Ryun Kim, Jin Hyoung Kang","doi":"10.1001/jamaoncol.2024.2640","DOIUrl":"10.1001/jamaoncol.2024.2640","url":null,"abstract":"<p><strong>Importance: </strong>EGFR-variant non-small cell lung cancer (NSCLC) is associated with a high rate of central nervous system (CNS) metastases, even with treatment with first-generation or second-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs).</p><p><strong>Objective: </strong>To investigate CNS activity with lazertinib, a third-generation EGFR TKI.</p><p><strong>Design, setting, and participants: </strong>This multicenter single-arm, phase 2 nonrandomized controlled trial was conducted in South Korea and included patients with EGFR-variant NSCLC who had asymptomatic or mildly symptomatic brain metastases after unsuccessful treatment with first-generation or second-generation EGFR TKIs. Data were collected from June 2021 to April 2022, with a data cutoff date of December 15, 2022.</p><p><strong>Exposure: </strong>Lazertinib, 240 mg, once daily.</p><p><strong>Main outcomes and measures: </strong>The primary end point was intracranial objective response rate (iORR) in the evaluable population according to the Response Evaluation Criteria in Solid Tumours version 1.1 assessed by the investigators. Secondary end points included intracranial progression-free survival (iPFS) and iORR in patients with T790M-negative disease and isolated CNS progression as well as overall ORR, duration of response, intracranial duration of response, disease control rate, overall survival, cerebrospinal fluid penetration of lazertinib, and safety.</p><p><strong>Results: </strong>Among 40 included patients, 25 (63%) were women, and the median (range) age was 63 (29-85) years. A total of 38 patients were evaluable for tumor response, including 12 patients with leptomeningeal metastases. At data cutoff, the median (range) follow-up was 13.6 (2.9-17.7) months. The iORR for the evaluable population was 55% (21 of 38; 95% CI, 38.3-71.4); for patients with T790M-positive disease, 80% (4 of 5; 95% CI, 28.4-99.5); for patients with T790M-negative disease, 43% (9 of 21; 95% CI, 21.8-66.0); and for patients with T790M-unknown disease, 67% (8 of 12; 95% CI, 34.9-90.1). The median iPFS was 15.8 months (95% CI, 15.2-not reached) for the evaluable population, 15.2 months (95% CI, 4.2-not reached) for the T790M-positive subgroup, 15.4 months (95% CI, 7.9-not reached) for the T790M-negative subgroup, and 18.0 months (95% CI, 3.9-not reached) for the T790M-unknown subgroup. The cerebrospinal fluid penetration rate of lazertinib was 46.2% (95% CI, 10.0-49.6), providing further support for its mechanism of intracranial response. Most adverse events were grade 1 or 2.</p><p><strong>Conclusions and relevance: </strong>In this study, lazertinib had substantial CNS activity, regardless of T790M status, against the progression of intracranial metastases with or without leptomeningeal metastases after unsuccessful treatment with first-generation or second-generation EGFR TKIs in patients with metastatic EGFR-variant NSCLC. These results suggest that","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1342-1351"},"PeriodicalIF":28.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11327907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983648","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}
Jama OncologyPub Date : 2024-10-01DOI: 10.1001/jamaoncol.2024.2903
Casey Crump, Weiva Sieh
{"title":"Hidden Morbidity in Cancer Care-Mental Health in Spouses.","authors":"Casey Crump, Weiva Sieh","doi":"10.1001/jamaoncol.2024.2903","DOIUrl":"10.1001/jamaoncol.2024.2903","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1317-1318"},"PeriodicalIF":28.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983647","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}
Jama OncologyPub Date : 2024-10-01DOI: 10.1001/jamaoncol.2024.2924
Elizabeth A Mittendorf, Sara M Tolaney
{"title":"Neoadjuvant Immunotherapy-From Trials to Practice.","authors":"Elizabeth A Mittendorf, Sara M Tolaney","doi":"10.1001/jamaoncol.2024.2924","DOIUrl":"10.1001/jamaoncol.2024.2924","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1319-1321"},"PeriodicalIF":28.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113723","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}
Jama OncologyPub Date : 2024-10-01DOI: 10.1001/jamaoncol.2024.2652
Julia S Wong, Hajime Uno, Angela C Tramontano, Lauren Fisher, Catherine V Pellegrini, Gregory A Abel, Harold J Burstein, Yoon S Chun, Tari A King, Deborah Schrag, Eric Winer, Jennifer R Bellon, Matthew D Cheney, Patricia Hardenbergh, Alice Ho, Kathleen C Horst, Janice N Kim, Kara-Lynne Leonard, Meena S Moran, Catherine C Park, Abram Recht, Daniel E Soto, Ron Y Shiloh, Susan F Stinson, Kurt M Snyder, Alphonse G Taghian, Laura E Warren, Jean L Wright, Rinaa S Punglia
{"title":"Hypofractionated vs Conventionally Fractionated Postmastectomy Radiation After Implant-Based Reconstruction: A Randomized Clinical Trial.","authors":"Julia S Wong, Hajime Uno, Angela C Tramontano, Lauren Fisher, Catherine V Pellegrini, Gregory A Abel, Harold J Burstein, Yoon S Chun, Tari A King, Deborah Schrag, Eric Winer, Jennifer R Bellon, Matthew D Cheney, Patricia Hardenbergh, Alice Ho, Kathleen C Horst, Janice N Kim, Kara-Lynne Leonard, Meena S Moran, Catherine C Park, Abram Recht, Daniel E Soto, Ron Y Shiloh, Susan F Stinson, Kurt M Snyder, Alphonse G Taghian, Laura E Warren, Jean L Wright, Rinaa S Punglia","doi":"10.1001/jamaoncol.2024.2652","DOIUrl":"10.1001/jamaoncol.2024.2652","url":null,"abstract":"<p><strong>Importance: </strong>Postmastectomy radiation therapy (PMRT) improves local-regional disease control and patient survival. Hypofractionation (HF) regimens have comparable efficacy and complication rates with improved quality of life compared with conventional fractionation (CF) schedules. However, the use of HF after mastectomy in patients undergoing breast reconstruction has not been prospectively examined.</p><p><strong>Objective: </strong>To compare HF and CF PMRT outcomes after implant-based reconstruction.</p><p><strong>Design, setting, and participants: </strong>This randomized clinical trial assessed patients 18 years or older undergoing mastectomy and immediate expander or implant reconstruction for breast cancer (Tis, TX, or T1-3) and unilateral PMRT from March 8, 2018, to November 3, 2021 (median [range] follow-up, 40.4 [15.4-63.0] months), at 16 US cancer centers or hospitals. Analyses were conducted between September and December 2023.</p><p><strong>Interventions: </strong>Patients were randomized 1:1 to HF or CF PMRT. Chest wall doses were 4256 cGy for 16 fractions for HF and 5000 cGy for 25 fractions for CF. Chest wall toxic effects were defined as a grade 3 or higher adverse event.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the change in physical well-being (PWB) domain of the Functional Assessment of Cancer Therapy-Breast (FACT-B) quality-of-life assessment tool at 6 months after starting PMRT, controlling for age. Secondary outcomes included toxic effects and cancer recurrence.</p><p><strong>Results: </strong>Of 400 women (201 in the CF arm and 199 in the HF arm; median [range] age, 47 [23-79] years), 330 patients had PWB scores at baseline and at 6 months. There was no difference in the change in PWB between the study arms (estimate, 0.13; 95% CI, -0.86 to 1.11; P = .80), but there was a significant interaction between age group and study arm (P = .03 for interaction). Patients younger than 45 years had higher 6-month absolute PWB scores if treated with HF rather than CF regimens (23.6 [95% CI, 22.7-24.6] vs 22.0 [95% CI, 20.7-23.3]; P = .047) and reported being less bothered by adverse effects (mean [SD], 3.0 [0.9] in the HF arm and 2.6 [1.2] in the CF arm; P = .02) or nausea (mean [SD], 3.8 [0.4] in the HF arm and 3.6 [0.8] in the CF arm; P = .04). In the as-treated cohort, there were 23 distant (11 in the HF arm and 12 in the CF arm) and 2 local-regional (1 in the HF arm and 1 in the CF arm) recurrences. Chest wall toxic effects occurred in 39 patients (20 in the HF arm and 19 in the CF arm) at a median (IQR) of 7.2 (1.8-12.9) months. Fractionation was not associated with chest wall toxic effects on multivariate analysis (HF arm: hazard ratio, 1.02; 95% CI, 0.52-2.00; P = .95). Fewer patients undergoing HF vs CF regimens had a treatment break (5 [2.7%] vs 15 [7.7%]; P = .03) or required unpaid time off from work (17 [8.5%] vs 34 [16.9%]; P = .02).</p><p><strong>Conclusions and releva","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1370-1378"},"PeriodicalIF":28.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908056","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}
Jama OncologyPub Date : 2024-10-01DOI: 10.1001/jamaoncol.2024.3044
Ruth M O'Regan, Yi Zhang, Gini F Fleming, Prudence A Francis, Roswitha Kammler, Giuseppe Viale, Patrizia Dell'Orto, Istvan Lang, Meritxell Bellet, Herve R Bonnefoi, Carlo Tondini, Federica Villa, Antonio Bernardo, Eva M Ciruelos, Patrick Neven, Per Karlsson, Bettina Müller, Wolfram Jochum, Khalil Zaman, Silvana Martino, Charles E Geyer, Katarzyna J Jerzak, Nancy E Davidson, Robert E Coleman, James N Ingle, Marion T van Mackelenbergh, Sherene Loi, Marco Colleoni, Catherine A Schnabel, Kai Treuner, Meredith M Regan
{"title":"Breast Cancer Index in Premenopausal Women With Early-Stage Hormone Receptor-Positive Breast Cancer.","authors":"Ruth M O'Regan, Yi Zhang, Gini F Fleming, Prudence A Francis, Roswitha Kammler, Giuseppe Viale, Patrizia Dell'Orto, Istvan Lang, Meritxell Bellet, Herve R Bonnefoi, Carlo Tondini, Federica Villa, Antonio Bernardo, Eva M Ciruelos, Patrick Neven, Per Karlsson, Bettina Müller, Wolfram Jochum, Khalil Zaman, Silvana Martino, Charles E Geyer, Katarzyna J Jerzak, Nancy E Davidson, Robert E Coleman, James N Ingle, Marion T van Mackelenbergh, Sherene Loi, Marco Colleoni, Catherine A Schnabel, Kai Treuner, Meredith M Regan","doi":"10.1001/jamaoncol.2024.3044","DOIUrl":"10.1001/jamaoncol.2024.3044","url":null,"abstract":"<p><strong>Importance: </strong>Adjuvant ovarian function suppression (OFS) with oral endocrine therapy improves outcomes for premenopausal patients with hormone receptor-positive (HR+) breast cancer but adds adverse effects. A genomic biomarker for selecting patients most likely to benefit from OFS-based treatment is lacking.</p><p><strong>Objective: </strong>To assess the predictive and prognostic performance of the Breast Cancer Index (BCI) for OFS benefit in premenopausal women with HR+ breast cancer.</p><p><strong>Design, setting, and participants: </strong>This prospective-retrospective translational study used all available tumor tissue samples from female patients from the Suppression of Ovarian Function Trial (SOFT). These individuals were randomized to receive 5 years of adjuvant tamoxifen alone, tamoxifen plus OFS, or exemestane plus OFS. BCI testing was performed blinded to clinical data and outcome. The a priori hypothesis was that BCI HOXB13/IL17BR ratio (BCI[H/I])-high tumors would benefit more from OFS and high BCI portended poorer prognosis in this population. Settings spanned multiple centers internationally. Participants included premenopausal female patients with HR+ early breast cancer with specimens in the International Breast Cancer Study Group tumor repository available for RNA extraction. Data were collected from December 2003 to April 2021 and were analyzed from May 2022 to October 2022.</p><p><strong>Main outcomes and measures: </strong>Primary end points were breast cancer-free interval (BCFI) for the predictive analysis and distant recurrence-free interval (DRFI) for the prognostic analyses.</p><p><strong>Results: </strong>Tumor specimens were available for 1718 of the 3047 female patients in the SOFT intention-to-treat population. The 1687 patients (98.2%) who had specimens that yielded sufficient RNA for BCI testing represented the parent trial population. The median (IQR) follow-up time was 12 (10.5-13.4) years, and 512 patients (30.3%) were younger than 40 years. Tumors were BCI(H/I)-low for 972 patients (57.6%) and BCI(H/I)-high for 715 patients (42.4%). Patients with tumors classified as BCI(H/I)-low exhibited a 12-year absolute benefit in BCFI of 11.6% from exemestane plus OFS (hazard ratio [HR], 0.48 [95% CI, 0.33-0.71]) and an absolute benefit of 7.3% from tamoxifen plus OFS (HR, 0.69 [95% CI, 0.48-0.97]) relative to tamoxifen alone. In contrast, patients with BCI(H/I)-high tumors did not benefit from either exemestane plus OFS (absolute benefit, -0.4%; HR, 1.03 [95% CI, 0.70-1.53]; P for interaction = .006) or tamoxifen plus OFS (absolute benefit, -1.2%; HR, 1.05 [95% CI, 0.72-1.54]; P for interaction = .11) compared with tamoxifen alone. BCI continuous index was significantly prognostic in the N0 subgroup for DRFI (n = 1110; P = .004), with 12-year DRFI of 95.9%, 90.8%, and 86.3% in BCI low-risk, intermediate-risk, and high-risk N0 cancers, respectively.</p><p><strong>Conclusions and relevance: </strong>In ","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1379-1389"},"PeriodicalIF":28.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11327904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983646","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}
Jama OncologyPub Date : 2024-10-01DOI: 10.1001/jamaoncol.2024.3239
Giorgio Bogani, Francesco Raspagliesi
{"title":"Relapse Patterns in Early-Stage Endometrial Cancer Based on Molecular Classification.","authors":"Giorgio Bogani, Francesco Raspagliesi","doi":"10.1001/jamaoncol.2024.3239","DOIUrl":"10.1001/jamaoncol.2024.3239","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"1439-1440"},"PeriodicalIF":28.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903310","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}