{"title":"Three Years Is Enough-Reforming Medical Education Amid Rising Debt.","authors":"Mia Wells, Devdutta Sangvai","doi":"10.1001/jama.2025.13386","DOIUrl":"10.1001/jama.2025.13386","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1053-1054"},"PeriodicalIF":55.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979476","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":"Partial Heart Transplants-Growing Data for Growing Valves.","authors":"Kevin P Daly","doi":"10.1001/jama.2025.14668","DOIUrl":"10.1001/jama.2025.14668","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1065-1067"},"PeriodicalIF":55.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979423","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":"Integrated Fall Prevention in Primary Care-It Takes a Village.","authors":"Manuel Montero-Odasso, Maw Pin Tan, David B Hogan","doi":"10.1001/jama.2025.14386","DOIUrl":"10.1001/jama.2025.14386","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1063-1064"},"PeriodicalIF":55.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979437","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":"Treatment of Atopic Dermatitis.","authors":"Aaron M Drucker","doi":"10.1001/jama.2025.11589","DOIUrl":"10.1001/jama.2025.11589","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1103-1104"},"PeriodicalIF":55.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979461","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":"Non-Risk-Based Lung Cancer Screening-Reply.","authors":"Wenhua Liang, Caichen Li, Jianxing He","doi":"10.1001/jama.2025.10963","DOIUrl":"10.1001/jama.2025.10963","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1113"},"PeriodicalIF":55.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979369","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":"Follow-Up of Extracranial-Intracranial Bypass Surgery for Symptomatic Cerebral Artery Occlusion.","authors":"Jing Li, Xiaowen Mao, Yongmei Li","doi":"10.1001/jama.2025.13216","DOIUrl":"https://doi.org/10.1001/jama.2025.13216","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":""},"PeriodicalIF":55.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114991","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":"Bedtime.","authors":"Charlene Fix","doi":"10.1001/jama.2025.8316","DOIUrl":"10.1001/jama.2025.8316","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1028"},"PeriodicalIF":55.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979222","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":"Toripalimab Combination Therapy Without Concurrent Cisplatin for Nasopharyngeal Carcinoma: The DIAMOND Randomized Clinical Trial.","authors":"Cheng Xu, Xiao-Yu Liang, Xin-Qiong Huang, Feng Jin, Kun-Yu Yang, Guang-Yuan Hu, Xiao-Dong Zhu, Ying Wang, Ying Huang, Ning Zhang, De-Sheng Hu, Ling Guo, Guo-Rong Zou, Xiao-Zhong Chen, Shao-Wen Xiao, Jin-Gao Li, Liang-Fang Shen, Yuan-Yuan Li, Jing Huang, Guo-Xian Long, Ling Li, Luo Huang, Long-Jiang She, Yuan Wu, Wei-Hua Zeng, Meng-Yun Qiang, Wei-Xin Liu, Yong Su, Ling-Long Tang, Fang-Yun Xie, Fei Han, Li-Xia Lu, Yan-Qun Xiang, Yan-Ping Mao, Wen-Fei Li, Xu Liu, Qi Yang, Guan-Qun Zhou, Rui Guo, Pu-Yun Ouyang, Xiao-Hui Wang, Lei Chen, Li-Ting Liu, Li Lin, Ji-Bin Li, Ai-Hua Lin, Hong-Yun Zhao, Shu-Bin Hong, Yu-Sheng Jie, Hui-Ling Huang, Xu-Hua Tang, Yue-Can Zeng, Jing-Ping Yun, Sheng-Bing Zang, Zi-Ming Du, Zu-Lu Ye, Li-Zhi Liu, Li Tian, Hao-Jiang Li, Ying-Lin Peng, Na Liu, Ying-Qin Li, Ye-Lin Liang, Han-Miao Wei, Yu-Pei Chen, Yuan Zhang, Xiao-Jing Du, Jia-Wei Lv, Ying Sun, Jun Ma","doi":"10.1001/jama.2025.13205","DOIUrl":"10.1001/jama.2025.13205","url":null,"abstract":"<p><strong>Importance: </strong>With the programmed cell death protein 1 (PD-1) blockade toripalimab, omitting highly toxic concurrent cisplatin may be feasible for nasopharyngeal carcinoma (NPC) without compromising survival.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of toripalimab incorporated into induction chemotherapy and radiotherapy, without concurrent cisplatin, for locoregionally advanced NPC.</p><p><strong>Design, setting, and participants: </strong>Open-label, multicenter, randomized phase 3 clinical trial conducted from August 2021 to July 2022 at 13 hospitals in China, enrolling 532 patients with T4N1M0 or T1-4N2-3M0 NPC; 400 (75.2%) completed the trial per protocol. The final date of follow-up was March 21, 2025.</p><p><strong>Interventions: </strong>Patients were randomly assigned to either the standard therapy group (n = 266), receiving toripalimab with gemcitabine-cisplatin induction chemotherapy and concurrent cisplatin-radiotherapy (100 mg/m2 triweekly for 2 cycles), or the concurrent cisplatin-sparing group (n = 266), receiving the same regimen without concurrent cisplatin. The 17 cycles of toripalimab (240 mg triweekly) were distributed across the induction, radiotherapy, and adjuvant phases as 3, 3, and 11 cycles, respectively.</p><p><strong>Main outcomes and measures: </strong>Coprimary end points were failure-free survival (noninferiority margin, 8%) and incidence of all-grade vomiting (superiority design). Secondary end points included overall survival, locoregional recurrence-free survival, distant metastasis-free survival, safety, tumor response, quality of life, and tolerability.</p><p><strong>Results: </strong>In the 532 patients in the intention-to-treat population (median [IQR] age, 47 [39-54] years; 25.2% women), after a median follow-up of 37.0 (range, 4.0-50.0) months, the concurrent cisplatin-sparing group had a 3-year failure-free survival rate of 88.3% vs 87.6% in the standard therapy group, a difference of 0.7% (lower limit of the 1-sided 95% CI, -3.9%; P = .002 for noninferiority; stratified hazard ratio, 0.92 [95% CI, 0.66-1.79]; log-rank P = .73). In the safety analysis, the incidence of all-grade vomiting was significantly lower in the concurrent cisplatin-sparing group vs the standard therapy group (26.2% [68/260] vs 59.8% [156/261]; difference, 33.6% [1-sided 95% CI, 26.9%-∞]; P < .001). Patient-reported quality of life (participation rate, 87.5%) and tolerability (participation rate, 94.7%) were better in the concurrent cisplatin-sparing group, primarily in gastrointestinal, functional, and global health status.</p><p><strong>Conclusions and relevance: </strong>In this phase 3 randomized clinical trial, among patients with locoregionally advanced NPC, toripalimab combination therapy without concurrent cisplatin was a feasible treatment with high efficacy in failure-free survival and low toxicity.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"973-983"},"PeriodicalIF":55.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979485","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":"What Constitutes a Satisfactory Drug?","authors":"","doi":"10.1001/jama.2024.18935","DOIUrl":"10.1001/jama.2024.18935","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"1029"},"PeriodicalIF":55.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979542","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":"Inclusive Cancer Registries for Gender-Diverse Patients.","authors":"Julian Gendreau, Arjit Singh, Saarang Patel","doi":"10.1001/jama.2025.12616","DOIUrl":"10.1001/jama.2025.12616","url":null,"abstract":"","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":"947-948"},"PeriodicalIF":55.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979313","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}
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