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  • Delayed Adjacent Chemotherapy and Survival After Lung Cancer Surgery—Reply
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-21
    Daniel Joseph Boffa

    In Reply We agree that observational comparison of outcomes across populations is dependent on the distribution of all attributes with the potential to affect the outcome of interest. For attributes that are captured by the database (eg, age, comorbidity, stage), a number of strategies were used to create balance (propensity matching) or adjust for imbalances (Cox proportional hazards). For attributes that are not captured by the database (eg, performance status [PS], smoking status), one must first hypothesize as to whether an imbalance is likely. First, we identified populations by a common event that tends to create balance in unmeasured attributes. All patients had undergone and survived lung cancer surgery. This would suggest that all patients had a reasonable PS (in the study by Kawaguchi et al,1 75% of patients who underwent surgery had a PS of 0). Whereas PS and smoking have not been examined in relationship to the timing of adjuvant chemotherapy in lung cancer per se, neither has been associated with delays for other tumor types.2,3 Therefore, we believe that imbalances, should they exist for smoking and PS, would likely be subtle.

    更新日期:2017-09-21
  • Delayed Adjacent Chemotherapy and Survival After Lung Cancer Surgery
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-21
    Samer Al Hadidi

    To the Editor In their recent article in JAMA Oncology, Salazar et al1 found that patients with non–small cell lung cancer treated with delayed chemotherapy, defined as chemotherapy administered after 56 days, had better outcomes, with hazard ratio of 0.664 (95% CI, 0.623-0.707; P < .001) compared with patients who received surgery alone. The authors listed multiple valid limitations to their study, including the retrospective nature of the National Cancer Database data that they used.

    更新日期:2017-09-21
  • Association of HIV Status With Outcomes of Anal Squamous Cell Carcinoma in the Era of Highly Active Antiretroviral Therapy
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-21
    Alex K. Bryant, Minh-Phuong Huynh-Le, Daniel R. Simpson, Samir Gupta, Andrew B. Sharabi, James D. Murphy
    更新日期:2017-09-21
  • Adjuvant Chemotherapy Following Neoadjuvant Chemotherapy Plus Surgery for Patients With Gastroesophageal Cancer—Is There Room for Improvement?
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-21
    Elizabeth C. Smyth, David Cunningham

    Optimal multimodality treatment followed by surgical resection results in cure for less than half of patients with operable adenocarcinoma of the lower esophagus or gastroesophageal junction. This is true whether the adjunctive therapy is neoadjuvant chemotherapy, perioperative chemotherapy, or neoadjuvant chemoradiotherapy. Therefore, it is reasonable to question whether additional treatment beyond current standards of care might increase the proportion of patients cured. In this issue of JAMA Oncology, Mokdad and colleagues,1 in a propensity score–matched analysis based on a large National Cancer Database cohort, examine the effects of adjuvant chemotherapy following chemoradiotherapy and surgery for resectable gastroesophageal adenocarcinoma. They found that patients treated with adjuvant chemotherapy had improved overall survival compared with those who did not receive adjuvant treatment (median overall survival, 40 vs 34 months; hazard ratio, 0.79; 95% CI, 0.72-0.88; P < .001). Based on these findings, a randomized clinical trial of adjuvant chemotherapy vs observation following neoadjuvant chemoradiotherapy and surgical resection is proposed to provide a definitive answer to this question.

    更新日期:2017-09-21
  • Association of Immune-Related Adverse Events With Nivolumab Efficacy in Non–Small-Cell Lung Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-21
    Koji Haratani, Hidetoshi Hayashi, Yasutaka Chiba, Keita Kudo, Kimio Yonesaka, Ryoji Kato, Hiroyasu Kaneda, Yoshikazu Hasegawa, Kaoru Tanaka, Masayuki Takeda, Kazuhiko Nakagawa
    更新日期:2017-09-21
  • Adjuvant Chemotherapy vs Postoperative Observation Following Preoperative Chemoradiotherapy and Resection in Gastroesophageal CancerA Propensity Score–Matched Analysis
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-21
    Ali A. Mokdad, Adam C. Yopp, Patricio M. Polanco, John C. Mansour, Scott I. Reznik, Daniel F. Heitjan, Michael A. Choti, Rebecca R. Minter, Sam C. Wang, Matthew R. Porembka
    更新日期:2017-09-21
  • Interpretability of Cancer Clinical Trial Results Using Restricted Mean Survival Time as an Alternative to the Hazard Ratio
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-21
    Kyongsun Pak, Hajime Uno, Dae Hyun Kim, Lu Tian, Robert C. Kane, Masahiro Takeuchi, Haoda Fu, Brian Claggett, Lee-Jen Wei
    更新日期:2017-09-21
  • Highlights
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01

    Testing for genetic predisposition for breast cancer has expanded from BRCA1 and BRCA2 mutation analysis to panel testing of many germline alterations. Couch et al questioned what levels of risk are associated with genes identified by hereditary cancer multigene panel testing. In a case-control study of 65 057 patients with breast cancer receiving germline testing, several genes were identified with high or moderately increased risk of breast cancer such as ATM and PALB2. Other variants were not associated with breast cancer risk. These data can be informative for counseling patients. Obeid et al provide an Editorial.

    更新日期:2017-09-14
  • JAMA Oncology
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01

    JAMA Oncology is committed to publishing influential original research, opinions, and reviews that advance the science of oncology and improve the clinical care of patients with cancer. Mission Statement: JAMA Oncology is the definitive journal for scientists, clinicians, and trainees in the field of oncology worldwide. Our original, innovative, and timely scientific and educational content provides a deeper understanding of cancer pathogenesis and recent treatment advances for our readers. JAMA Oncology aims to effectively convey the findings of important clinical research, major scientific breakthroughs, actionable discoveries, and state-of-the-art treatment pathways to the oncology community. Our goal is that successful communication of new knowledge will ultimately translate to clinical benefit for people living with and surviving cancer.

    更新日期:2017-09-14
  • Sickness
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Daniel Shalev

    更新日期:2017-09-14
  • Error in Figure
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01

    In the Original Investigation titled “Proton Beam Radiotherapy and Concurrent Chemotherapy for Unresectable Stage III Non–Small Cell Lung Cancer: Final Results of a Phase 2 Study,”1 published online July 20, 2017, there were errors in Figure 2a in the numbers at risk at 24, 48, 72, and 96 months. The correct numbers at risk are as follows: for overall survival, 36, 17, 11, and 2, and for progression-free survival, 21, 13, 8, and 1, respectively. This article was corrected online.

    更新日期:2017-09-14
  • Error in Author Degree
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01

    In the article “Association of Interactive Reminders and Automated Messages With Persistent Adherence to Colorectal Cancer Screening: A Randomized Clinical Trial,”1 published online on May 18, 2017, there was an error in one of the author’s degrees. Where it previously read Francis K. L. Chan, MD, PhD, the degree now correctly reads Francis K. L. Chan, MD, DSc. This article was corrected online.

    更新日期:2017-09-14
  • Erroneous Sentence Removed From Article
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01

    In the article titled “From Muslim Registries to Radical Health Care Reform—Caring for Patients in an Era of Political Anxiety,”1 an erroneous sentence has been removed. Previously, the article reported that a student wearing a hijab was threatened with being set on fire, a statement based on a campus crime alert that was subsequently cancelled. The erroneous sentence has been removed, and the article was corrected online.

    更新日期:2017-09-14
  • Mutation in BRAF V600E—Reply
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Frank A. Sinicrope, Qian Shi, Steven R. Alberts

    In Reply In reply to the comments of Emambux et al, we emphasize that our study population was restricted to patients with stage III colon carcinoma from 2 phase 3 FOLFOX-based adjuvant chemotherapy trials who experienced tumor recurrence. In patients with recurrence (n = 1395), we found that those whose cancers showed deficient mismatch repair (dMMR) and harbored BRAF V600E mutations had significantly worse survival after recurrence (SAR) compared with patients with dMMR tumors with nonmutated BRAF.1 This analysis was performed as a secondary aim, and we acknowledged that data for treatment after recurrence were not available and that patient numbers for these tumor subsets reflect their relatively low frequency despite 4979 participants in both trials. Our findings are supported by data in metastatic dMMR colorectal cancers in which mutated vs nonmutated BRAF was associated with significantly worse overall survival in a multivariable analysis.2 Furthermore, patients with stage III dMMR colon cancers and mutated BRAF had an increased rate of peritoneal recurrence that was associated with shorter time-to-recurrence and worse disease-free survival in the NCCTG N0147 trial.3

    更新日期:2017-09-14
  • Current Challenges Associated With Next-Generation Sequencing of Breast Cancer—Reply
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Polly Niravath, Burcu Cakar, Matthew Ellis

    In Reply Regarding the deficiency in cell-free DNA (cfDNA) reports not reporting germ-line abnormalities, we1 certainly agree with Dr Sorscher. The current approach of ordering both a cfDNA test from one laboratory and a germ-line analysis from another is both inefficient and expensive. Indeed, patients with advanced disease can find themselves in a situation where the germ-line testing is reimbursed and the cfDNA is not, or vice versa. A combined germ-line and cfDNA somatic test makes particular sense in the setting of PARP inhibition, where a BRCA1/2 mutation may identify a patient with sensitive disease irrespective of whether the mutation is germ-line or somatic. A test that does not do both risks missing patients who could benefit.

    更新日期:2017-09-14
  • Mutation in BRAF V600EA Poor Prognostic Marker in Stage III Colon Cancers With Deficient MMR?
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Sheik Emambux, Guillaume Mouillet, David Tougeron

    To the Editor Based on 2 oxaliplatin-based adjuvant trials, Sinicrope and colleagues1 recently reported an association between survival after recurrence (SAR) and both DNA mismatch repair (MMR) status and BRAF mutation in patients with stage III colon carcinomas (CC). Given that MMR status and BRAF mutation are strongly associated, they analyzed MMR and BRAF as a combined variable. Among dMMR CC, BRAF-mutated tumors had significantly poorer SAR compared with BRAF wild-type tumors (adjusted hazard ratio [HR], 2.70; 95% CI, 1.23-5.93; P = .01). Some caution is warranted when analyzing these results. When using SAR as an end point, patient treatment at recurrence has an effect on survival but these data were not available. Also, patient numbers were relatively small in the different groups resulting in low statistical power: 33 BRAF-mutated dMMR and 40 BRAF wild-type dMMR. Adjusted median SAR were incalculable owing to small sample size and lack of robustness of the model. In addition, results were adjusted on variables collected at CC diagnosis and not at relapse (ie, performance score), which is not relevant.

    更新日期:2017-09-14
  • Erroneous Sentence in Cancer Care Chronicles Article
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Reshma Jagsi

    To the Editor I write to correct an erroneous statement that was included in my Cancer Care Chronicles article, “From Muslim Registries to Radical Health Care Reform-Caring for Patients in an Era of Political Anxiety,” that was published online on February 3, 2017, and in the March issue of JAMA Oncology.1 In the course of explaining that I understood why one of my patients was concerned about the inclusion of her religious background in her electronic medical record due to the current sociopolitical climate, I included a sentence about a student at my institution having been threatened with being set afire by a stranger for wearing a hijab. The source of this information came from a University of Michigan institutional crime alert that was sent via campus-wide email on November 12, 2016,2 and subsequent email to the campus community from President Mark Schlissel and other leaders on November 13, 2016.3 The institution’s message stated, “In the days since last Tuesday’s election, people in our community have experienced hateful attacks, both on an individual level and as members of groups…We saw a threatening message painted on the rock near our campus; a student walking near campus was threatened with being lighted on fire because she wore a hijab; another student left his apartment to go to class and found a swastika with a message telling him to go home. Some students have also been shouted at and accused of being racist because of their political views.” Relying on this information, I submitted my manuscript to JAMA Oncology on December 2, 2016. On December 21, the University of Michigan cancelled the crime alert regarding the incident with the student wearing the hijab because, upon investigation, detectives had determined the incident in question did not occur.2 The online copy of the November 13, 2016, email from campus leaders that was posted on the internet was thus amended by adding a parenthetical hyperlink to the cancellation notice, “(this crime alert has been canceled),” after the word “hijab.” Unlike the original alert and institutional announcement, however, notification of the cancellation and amendment were not emailed to the community, and so I was unaware of the subsequent developments until an astute reader contacted the editors of JAMA Oncology.

    更新日期:2017-09-14
  • Current Challenges Associated With Next-Generation Sequencing of Breast Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Steven Sorscher

    To the Editor I appreciated the nice review of the current status and promise for the use of next-generation sequencing (NGS) in identifying actionable somatic and germline molecular abnormalities as breast cancer therapeutic targets. The authors1(p262) conclude that “circulating tumor DNA analysis, once sensitive and broad enough” will enable the identification of these actionable abnormalities.

    更新日期:2017-09-14
  • Association of Interactive Reminders and Automated Messages With Persistent Adherence to Colorectal Cancer ScreeningA Randomized Clinical Trial
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Martin C. S. Wong, Jessica Y. L. Ching, Thomas Y. T. Lam, Simpson K. C. Ng, John C. T. Wong, Justin C. Y. Wu, Francis K. L. Chan
    更新日期:2017-09-14
  • Lung Cancer Screening With Low-Dose Computed Tomography in the United States—2010 to 2015
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Ahmedin Jemal, Stacey A. Fedewa
    更新日期:2017-09-14
  • 更新日期:2017-09-14
  • Expanding Purpura in a Neutropenic Patient
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Zoe O. Brown-Joel, Nahid Y. Vidal, Karolyn A. Wanat
    更新日期:2017-09-14
  • Androgen Receptor Function and Androgen Receptor–Targeted Therapies in Breast CancerA Review
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Miho Kono, Takeo Fujii, Bora Lim, Meghan Sri Karuturi, Debasish Tripathy, Naoto T. Ueno
    更新日期:2017-09-14
  • Diagnosis and Management of Waldenström MacroglobulinemiaMayo Stratification of Macroglobulinemia and Risk-Adapted Therapy (mSMART) Guidelines 2016
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Prashant Kapoor, Stephen M. Ansell, Rafael Fonseca, Asher Chanan-Khan, Robert A. Kyle, Shaji K. Kumar, Joseph R. Mikhael, Thomas E. Witzig, Michelle Mauermann, Angela Dispenzieri, Sikander Ailawadhi, A. Keith Stewart, Martha Q. Lacy, Carrie A. Thompson, Francis K. Buadi, David Dingli, William G. Morice, Ronald S. Go, Dragan Jevremovic, Taimur Sher, Rebecca L. King, Esteban Braggio, Ann Novak, Vivek Roy, Rhett P. Ketterling, Patricia T. Greipp, Martha Grogan, Ivana N. Micallef, P. Leif Bergsagel, Joseph P. Colgan, Nelson Leung, Wilson I. Gonsalves, Yi Lin, David J. Inwards, Suzanne R. Hayman, Grzegorz S. Nowakowski, Patrick B. Johnston, Steven J. Russell, Svetomir N. Markovic, Steven R. Zeldenrust, Yi L. Hwa, John A. Lust, Luis F. Porrata, Thomas M. Habermann, S. Vincent Rajkumar, Morie A. Gertz, Craig B. Reeder
    更新日期:2017-09-14
  • Pediatric Palliative Care—A Shared Priority
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Jennifer W. Mack

    Seventeen years ago, Wolfe and colleagues1 demonstrated pervasive symptoms and suffering among children with cancer at the end of life. In this issue of JAMA Oncology, Levine and colleagues2 have extended this work by evaluating experiences of children with cancer and their parents in the first year after diagnosis. This work demonstrates that children with cancer report significant symptoms in their first month of cancer treatment, with a majority suffering from nausea, anorexia, pain, anxiety, and constipation and half suffering from depression. These data suggest that pediatric oncologists such as myself do not sufficiently meet one of our fundamental obligations to these children—we are not adequately treating their suffering. We must think about how best to respond and remedy this gap.

    更新日期:2017-09-14
  • Pheochromocytoma and Paraganglioma Susceptibility GenesEstimating the Associated Risk of Disease
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Lauren Fishbein, Katherine L. Nathanson

    Approximately 40% of the tumors of the autonomic nervous system, pheochromocytomas and paragangliomas (PCC/PGL), are associated with an underlying inherited mutation, more than any other tumor type. Thus, germline mutation testing is recommended for all patients with PCC/PGL. Strong evidence supports an association of susceptibility for PCC/PGL with germline mutations in 10 genes (FH, MAX, NF1, RET, SDHA, SDHB, SDHC, SDHD, TMEM127, and VHL); mutations in an additional 5 genes also have been associated with disease susceptibility but with lower levels of evidence (EGLN1 [PHD2], EPAS1 [HIF2A], KIF1B, MET, and SDHAF2).1 Even for genes in which an association between mutation and disease has been well established, the frequency of mutations is quite rare; thus, a paucity of data exist on which to base clinical recommendations for patients regarding the risk for developing the first PCC/PGL (eg, if they are identified though familial mutation testing), additional primary PCC/PGLs, metastatic disease, and other tumor types.

    更新日期:2017-09-14
  • Clinical and Radiologic Responses to Cladribine for the Treatment of Erdheim-Chester Disease
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Gaurav Goyal, Mithun V. Shah, Timothy G. Call, Mark R. Litzow, William J. Hogan, Ronald S. Go
    更新日期:2017-09-14
  • Adjuvant Treatment for High-Risk Clear Cell Renal CancerUpdated Results of a High-Risk Subset of the ASSURE Randomized Trial
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Naomi B. Haas, Judith Manola, Janice P. Dutcher, Keith T. Flaherty, Robert G. Uzzo, Michael B. Atkins, Robert S. DiPaola, Toni K. Choueiri
    更新日期:2017-09-14
  • Association Between Loss-of-Function Mutations Within the FANCM Gene and Early-Onset Familial Breast Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Guido Neidhardt, Jan Hauke, Juliane Ramser, Eva Groß, Andrea Gehrig, Clemens R. Müller, Anne-Karin Kahlert, Karl Hackmann, Ellen Honisch, Dieter Niederacher, Stefanie Heilmann-Heimbach, André Franke, Wolfgang Lieb, Holger Thiele, Janine Altmüller, Peter Nürnberg, Kristina Klaschik, Corinna Ernst, Nina Ditsch, Frank Jessen, Alfredo Ramirez, Barbara Wappenschmidt, Christoph Engel, Kerstin Rhiem, Alfons Meindl, Rita K. Schmutzler, Eric Hahnen
    更新日期:2017-09-14
  • Use of Bayesian Decision Analysis to Minimize Harm in Patient-Centered Randomized Clinical Trials in Oncology
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Vahid Montazerhodjat, Shomesh E. Chaudhuri, Daniel J. Sargent, Andrew W. Lo
    更新日期:2017-09-14
  • Effect of Neoadjuvant Chemotherapy Followed by Surgical Resection on Survival in Patients With Limited Metastatic Gastric or Gastroesophageal Junction CancerThe AIO-FLOT3 Trial
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Salah-Eddin Al-Batran, Nils Homann, Claudia Pauligk, Gerald Illerhaus, Uwe M. Martens, Jan Stoehlmacher, Harald Schmalenberg, Kim B. Luley, Nicole Prasnikar, Matthias Egger, Stephan Probst, Helmut Messmann, Markus Moehler, Wolfgang Fischbach, Jörg T. Hartmann, Frank Mayer, Heinz-Gert Höffkes, Michael Koenigsmann, Dirk Arnold, Thomas W. Kraus, Kersten Grimm, Stefan Berkhoff, Stefan Post, Elke Jäger, Wolf Bechstein, Ulrich Ronellenfitsch, Stefan Mönig, Ralf D. Hofheinz
    更新日期:2017-09-14
  • Population-Attributable Risk Proportion of Clinical Risk Factors for Breast Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Natalie J. Engmann, Marzieh K. Golmakani, Diana L. Miglioretti, Brian L. Sprague, Karla Kerlikowske
    更新日期:2017-09-14
  • Metronomic Chemotherapy vs Best Supportive Care in Progressive Pediatric Solid Malignant TumorsA Randomized Clinical Trial
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Raja Pramanik, Sandeep Agarwala, Yogendra Kumar Gupta, Sanjay Thulkar, Sreenivas Vishnubhatla, Atul Batra, Deepa Dhawan, Sameer Bakhshi
    更新日期:2017-09-14
  • Patients’ and Parents’ Needs, Attitudes, and Perceptions About Early Palliative Care Integration in Pediatric Oncology
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Deena R. Levine, Belinda N. Mandrell, April Sykes, Michele Pritchard, Deborah Gibson, Heather J. Symons, David Wendler, Justin N. Baker
    更新日期:2017-09-14
  • Clinical Characterization of the Pheochromocytoma and Paraganglioma Susceptibility Genes SDHA, TMEM127, MAX, and SDHAF2 for Gene-Informed Prevention
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Birke Bausch, Francesca Schiavi, Ying Ni, Jenny Welander, Attila Patocs, Joanne Ngeow, Ulrich Wellner, Angelica Malinoc, Elisa Taschin, Giovanni Barbon, Virginia Lanza, Peter Söderkvist, Adam Stenman, Catharina Larsson, Fredrika Svahn, Jin-Lian Chen, Jessica Marquard, Merav Fraenkel, Martin A. Walter, Mariola Peczkowska, Aleksander Prejbisz, Barbara Jarzab, Kornelia Hasse-Lazar, Stephan Petersenn, Lars C. Moeller, Almuth Meyer, Nicole Reisch, Arnold Trupka, Christoph Brase, Matthias Galiano, Simon F. Preuss, Pingling Kwok, Nikoletta Lendvai, Gani Berisha, Özer Makay, Carsten C. Boedeker, Georges Weryha, Karoly Racz, Andrzej Januszewicz, Martin K. Walz, Oliver Gimm, Giuseppe Opocher, Charis Eng, Hartmut P. H. Neumann
    更新日期:2017-09-14
  • Mismatch Repair Deficiency, Microsatellite Instability, and SurvivalAn Exploratory Analysis of the Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) Trial
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Elizabeth C. Smyth, Andrew Wotherspoon, Clare Peckitt, David Gonzalez, Sanna Hulkki-Wilson, Zakaria Eltahir, Matteo Fassan, Massimo Rugge, Nicola Valeri, Alicia Okines, Madeleine Hewish, William Allum, Sally Stenning, Matthew Nankivell, Ruth Langley, David Cunningham
    更新日期:2017-09-14
  • Associations Between Cancer Predisposition Testing Panel Genes and Breast Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Fergus J. Couch, Hermela Shimelis, Chunling Hu, Steven N. Hart, Eric C. Polley, Jie Na, Emily Hallberg, Raymond Moore, Abigail Thomas, Jenna Lilyquist, Bingjian Feng, Rachel McFarland, Tina Pesaran, Robert Huether, Holly LaDuca, Elizabeth C. Chao, David E. Goldgar, Jill S. Dolinsky
    更新日期:2017-09-14
  • Planning Adjuvant Trials When Regimens Effective for Patients With Advanced Disease Don’t Work in the Adjuvant Setting—Paradigms Lost
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Bhupinder Mann, James Zwiebel

    Clinical benefit of a treatment demonstrated in patients with metastatic cancer leads to an optimistic and, understandably, logical belief that the same treatment is likely to be active against those apparently quiescent malignant cells that lead to disease recurrences after removal of the primary cancer. Thus, a simple paradigm has directed the development of adjuvant systemic therapy of solid tumors: administration of the systemic treatment regimen found to be active in the metastatic disease to a subset of patients at high risk of disease recurrence. Delaying of events (ie, fewer relapses or fewer deaths at a selected time point, in those receiving the adjuvant treatment) indicates the benefit derived from the adjuvant treatment. Successes using this classic paradigm have been many, but most often they are modest in effect and at times have required meta-analyses to extract a convincing evidence of treatment efficacy. Unfortunately, though quite understandably, the apparent simplicity and a promise of success of the process, confounded by the limits of available technology, has curtailed motivation to a deeper inquiry into the likely critical differences in the complexities of 2 related but distinct phenomena—the biology of established and visible growing metastatic tumors, and the biology of the apparently quiescent malignant cells in transition.

    更新日期:2017-09-14
  • Multigene Panel Testing and Breast Cancer RiskIs It Time to Scale Down?
    JAMA Oncol. (IF 16.559) Pub Date : 
    Elias I. Obeid, Michael J. Hall, Mary B. Daly

    Genetic predisposition testing for breast cancer and other cancers has become a cornerstone in the evaluation of women with breast cancer, particularly if their disease is diagnosed at an earlier age or there is a significant family history of cancer.1,2 The Supreme Court ruling in 2013 that human genes cannot be patented because DNA is a “product of nature” cleared the way for companies with next-generation sequencing capabilities to develop diverse tests and panels that include multiple genes associated with hereditary cancer risk.3 Although multigene panel testing has evolved into the standard for evaluating women who meet criteria for genetic testing in the past few years, concerns about the inclusion of moderate-risk genes on some multigene panels and the uncertain clinical utility of this information have tempered the enthusiasm for panel testing among health care professionals and patients alike. In this issue of JAMA Oncology, Couch et al4 address an important question regarding the association of several moderate-risk genes included on multigene panels and breast cancer risk.

    更新日期:2017-09-14
  • Escalation of Commitment in Treatment Decisions Near the End of Life
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Laurent Knoops, Philippe Bastin

    As a dual board–certified hematologist and palliative care physician, I am convinced that numerous patients with advanced hematologic malignant neoplasms would benefit from early palliative care intervention, given that many of them will not be cured, and suffer from several distressing symptoms. However, for this patient population, early palliative care access is still uncommon, and far less common than for patients with solid tumors. Many patients with advanced hematologic malignant neoplasms receive aggressive treatments or chemotherapy while nearing the end of life and often die in the intensive care unit, even though it is not consistent with their expressed wishes.1

    更新日期:2017-09-14
  • Treatment of Gastric and Gastroesophageal Cancers—Do We Really Need Anthracyclines?
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Noman Ashraf, Richard Kim

    Combination chemotherapy has been shown to be superior to single-agent therapy in gastric and gastroesophageal cancers. However, there is no consensus regarding the optimal regimen. Epirubicin-containing regimens are considered standard in parts of Europe, but the role of anthracyclines remains debatable. In this Viewpoint, we question the continued use of anthracyclines in the treatment of gastroesophageal cancers and discuss why we feel that it is time to move on. Anthracyclines are associated with serious toxic effects including alopecia, myelosuppression, febrile neutropenia, stomatitis, arrhythmias, and congestive heart failure. These toxic effects must be carefully weighed against expected treatment benefits. Although epirubicin-containing regimens have shown improvement in survival for both resectable and advanced gastroesophageal cancers, the exact contribution of epirubicin has never been demonstrated in a head-to-head comparison with a comparable nonanthracycline-containing arm in any phase III randomized trial. Evidence supporting anthracycline use is mostly derived from small uncontrolled phase II studies, comparisons against no chemotherapy,1 trials comparing widely dissimilar regimens where the exact contribution of the anthracycline cannot be established,2 or a meta-analysis with its own limitations.3

    更新日期:2017-09-14
  • Is There Room for Second-Line Treatment of Pleural Malignant Mesothelioma?
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Alfredo Addeo, Lucio Buffoni, Massimo Di Maio

    Malignant pleural mesothelioma (MPM) is characterized by a bad prognosis and modest activity of systemic treatment. Currently, there is no clear agreement on the clinical role of second-line chemotherapy in patients with MPM; nevertheless, early case study reports including some pretreated patients had provided evidence that additional responses are possible with the use of further chemotherapy1 after the failure of first-line treatment.

    更新日期:2017-09-14
  • The High Cost of New Cancer Therapies—A Challenge of Inequality for All Countries
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-01
    Oluf Dimitri Røe

    When people or governments cannot afford effective and potentially life-saving or life-prolonging treatments, we usually think of this situation affecting low-resource countries in the Third World. When antiretroviral HIV medications increased life expectancy almost to normal throughout much of the world, hundreds of thousands died in African countries, in part due to the high cost of medications. Ford et al1 in 2011 stated, “Early concerns about the cost and complexity of treatment were overcome thanks to the efforts of a global coalition of health providers, activists, academics, and people living with HIV/AIDS, who argued that every effort must be made to ensure access to essential care when millions of lives depended on it.” The authors also referred to an important court case in Thailand in 2002, in which 2 patients with HIV won the case against Bristol-Myers-Squibb to override the patent of an antiretroviral drug; thus, much cheaper generics could be produced. Patents can lead to high prices and limit access to medications; consequently, patients are “injured” by high prices, which can challenge the legality of high prices. The ruling had great international implications both for health care and human rights.2

    更新日期:2017-09-14
  • Faith Healer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-14
    Roger Sippl

    更新日期:2017-09-14
  • Error in Figure and Methods Section
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-14

    In the article by Esserman et al1 titled “Use of Molecular Tools to Identify Patients With Indolent Breast Cancers With Ultralow Risk Over 2 Decades,” there are errors in Figure 1 and in the Methods section. The boxes at the bottom of Figure 1 (CONSORT diagram) should read from left to right: “313 Received no endocrine treatment” and “339 Received tamoxifen treatment.” The last line of the second paragraph of the Methods section should read “RNA was extracted, and 652 patients had 70-gene signature classification passing the quality check (Figure 1): 339 had received tamoxifen, and 313 had not received adjuvant systemic therapy.” The article has been corrected online.

    更新日期:2017-09-14
  • Is There Merit for MET-Targeted Therapies in Gastroesophageal Cancer?
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-14
    Massimiliano Mazzone, Veronica Finisguerra, Hans Prenen

    To the Editor A recent study published in JAMA Oncology evaluated the effect of the MET inhibitor onartuzumab in combination with standard first-line chemotherapy in patients with advanced human epidermal growth factor receptor 2–negative, mesenchymal-epithelial transition (MET)–positive gastroesophageal carcinoma.1 MET positivity was defined as at least 50% of cells staining positive with intensity of 1+ or greater. This randomized phase 3 trial was stopped early because no improvement in progression-free survival, overall survival, or overall response rate was seen in the arm treated with chemotherapy and onartuzumab, irrespective of MET expression status. These negative results are in line with previously published phase 2/3 trials showing disappointing results with MET-inhibiting drugs.2 In their Discussion, Shah et al1 describe several hypotheses to explain the failure of MET inhibitors, more specifically MET overexpression not being the appropriate target or MET signaling being a consequence rather than the cause of tumor growth, concluding that better predictive biomarkers are needed.

    更新日期:2017-09-14
  • Sudden Flank Pain in a Patient Receiving Ibrutinib for Mantle Cell Lymphoma
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-14
    Yu Xi Terence Law, Lui Shiong Lee
    更新日期:2017-09-14
  • Identification of ALK Rearrangements in Malignant Peritoneal Mesothelioma
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-14
    Yin P. Hung, Fei Dong, Jaclyn C. Watkins, Valentina Nardi, Raphael Bueno, Paola Dal Cin, John J. Godleski, Christopher P. Crum, Lucian R. Chirieac
    更新日期:2017-09-14
  • HLA-Mismatched Microtransplant in Older Patients Newly Diagnosed With Acute Myeloid LeukemiaResults From the Microtransplantation Interest Group
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-14
    Mei Guo, Nelson J. Chao, Jian-Yong Li, David A. Rizzieri, Qi-Yun Sun, Ann Mohrbacher, Elizabeth F. Krakow, Wan-Jun Sun, Xu-Liang Shen, Xin-Rong Zhan, De-Pei Wu, Li Liu, Juan Wang, Min Zhou, Lin-Hua Yang, Yang-Yi Bao, Zheng Dong, Bo Cai, Kai-Xun Hu, Chang-Lin Yu, Jian-Hui Qiao, Hong-Li Zuo, Ya-Jing Huang, Anthony D. Sung, Jun-Xiao Qiao, Zhi-Qing Liu, Tie-Qiang Liu, Bo Yao, Hong-Xia Zhao, Si-Xuan Qian, Wei-Wei Liu, Rafael Forés, Rafael F. Duarte, Hui-Sheng Ai
    更新日期:2017-09-14
  • The Difficult Transition
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-14
    Marni B. Siegel

    In our family, 48-hour infusions were planned around tennis matches, surgical procedures strategically scheduled to not interfere with vacations, and general treatment strategies constantly balanced between likelihood of helping and not interfering with quality of life: 2 months after a left lower lung resection, my mom went skiing in Vermont; 2 weeks after a right breast mastectomy, she flew to Colorado; 7 days after brain radiation, she was doing the StairMaster in Aspen. We watched home infusion pumps go from large, laptop-sized bags to something as small as an iPhone, at least 4 cycles of “hair today, gone tomorrow,” and new combinatorial therapies tried, which had extended the average “life expectancy” from 4 months to 6 months when we were 10 years from diagnosis. Although we were unsure if our mom would make it to my bat mitzvah 8 months after her Whipple surgery in 2001, she beamed as she watched all 3 of us graduate college over the next decade. Mom’s vivaciousness surpasses any words worth writing: she was a beautiful and strong woman who just happened to have pancreatic cancer.

    更新日期:2017-09-14
  • Chimeric Antigen Receptor (CAR) T-Cell Therapy
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-07
    John M. Pagel, Howard (Jack) West
    更新日期:2017-09-07
  • The Waiting Room
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-07
    Roger Sippl

    更新日期:2017-09-07
  • Timing of Pregnancy and Survival in Women With Breast Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-07
    Samer Al Hadidi

    To the Editor Iqbal et al1 reported no survival difference in pregnant compared with nonpregnant women with a breast cancer diagnosis in a recent JAMA Oncology article. The 5-year actuarial survival rate was 97% for women who had pregnancy 6 months or more after diagnosis of breast cancer vs 88% for women with no pregnancy, with age-adjusted hazard ratio of 0.22.1 According to eTable 6 in their study, 53% of the analyzed patients are labeled with unknown tumor size. Moreover, 55% of the patients’ lymph node status was unknown. Such a degree of missing data can affect the authors’ conclusion given the survival relationship with both tumor size and nodal status.2 Despite correlation between tumor size and nodal involvement, the prognostic value of the 2 factors is independent. On the other hand, unknown receptor status may affect the results.

    更新日期:2017-09-07
  • A New Monoclonal Protein Detected in a Patient With Myeloma Undergoing Elotuzumab Therapy
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-07
    Felicia Tang, Christine Schmotzer, Rose C. Beck
    更新日期:2017-09-07
  • Effect of Modified Vaccinia Ankara–5T4 and Low-Dose Cyclophosphamide on Antitumor Immunity in Metastatic Colorectal CancerA Randomized Clinical Trial
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-07
    Martin Scurr, Tom Pembroke, Anja Bloom, David Roberts, Amanda Thomson, Kathryn Smart, Hayley Bridgeman, Richard Adams, Alison Brewster, Robert Jones, Sarah Gwynne, Daniel Blount, Richard Harrop, Melissa Wright, Robert Hills, Awen Gallimore, Andrew Godkin
    更新日期:2017-09-07
  • Development and Validation of a Novel Acute Myeloid Leukemia–Composite Model to Estimate Risks of Mortality
    JAMA Oncol. (IF 16.559) Pub Date : 2017-09-07
    Mohamed L. Sorror, Barry E. Storer, Amir T. Fathi, Aaron T. Gerds, Bruno C. Medeiros, Paul Shami, Andrew M. Brunner, Mikkael A. Sekeres, Sudipto Mukherjee, Esteban Peña, Mahmoud Elsawy, Shylo Wardyn, Jennifer Whitten, Rachelle Moore, Pamela S. Becker, Jeannine S. McCune, Frederick R. Appelbaum, Elihu H. Estey
    更新日期:2017-09-07
  • Mise en Place
    JAMA Oncol. (IF 16.559) Pub Date : 2017-08-31
    Carlos A. Rodriguez-Russo

    更新日期:2017-08-31
  • Validity of Surrogate End Points for Prostate Cancer—Reply
    JAMA Oncol. (IF 16.559) Pub Date : 2017-08-31
    Trevor J. Royce, Ming-Hui Chen, Anthony V. D’Amico

    In Reply We thank Dr Baker for his Letter and agree that an optimal way to select men at highest risk for death, as well as for entry onto randomized clinical trials assessing the impact on survival of adding androgen deprivation therapy to novel agents shown to overcome castration resistance, is by combining prostate-specific antigen (PSA) nadir greater than 0.5 ng/mL with other important prostate cancer prognostic factors shown to have independent prognostic significance on multivariable analysis in which the end point is time to death. In our multivariable model that included age and known prostate cancer prognostic factors as covariates, which was appended in the Supplement (available online only), we reported adjusted hazard ratios (AHRs) and showed that increasing age (AHR, 1.08; 95% CI, 1.04-1.66; P < .001) in addition to PSA nadir greater than 0.5 ng/mL (AHR, 1.72; 95% CI, 1.17-2.52; P = .01) was significantly associated with the risk of death.1 The established prostate cancer prognostic factor2 Gleason score 7 and 8 to 10 as compared with 6 was not significant, with P values of .05 and .08, respectively, in the multivariable model; other established prognostic factors such as PSA level and clinical stage were also not significant (P = .24 and .50, respectively). Therefore, when selecting men at the highest risk for death it appears that PSA nadir greater than 0.5 ng/mL identified the most at-risk population and that established prognostic factors such as PSA level, clinical stage, and Gleason score do not add significantly to this risk assessment in men. Regarding age, it is expected that with increasing age survival would shorten but adding a drug that is aimed at killing prostate cancer is unlikely to change the impact of increasing age on the risk of death because the association of increasing age and increased risk of death is likely driven by competing risks.3 The reason we added additional covariates in our model was stated in the Methods section of our study: “because men were not stratified by comorbidity prior to randomization, we also included age and known PC [prostate cancer] prognostic factors—specifically PSA, Gleason score, and T stage—in the adjusted model because we only evaluated the subset of 157 men with no or minimal comorbidity, given that PSA failure has been shown to be associated with an increased risk of ACM [all-cause mortality] only in men with no or minimal comorbidity.4”5(p654) As a result, our conclusion was that PSA nadir greater than 0.5 ng/mL “appears” to be a surrogate. This is the reason why we suggested the use of PSA greater than 0.5 ng/mL only as a patient selection factor to identify men for future randomized clinical trials who are at high risk for death if they are treated in accordance with current standards of practice, and not for immediate use as a surrogate end point for death without further validation.

    更新日期:2017-08-31
  • Validity of Surrogate End Points for Prostate Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-08-31
    Stuart G. Baker

    To the Editor A valid surrogate end point is a substitute for a true end point that allows conclusions about the effect of treatment on the true end point to be drawn sooner than with a true end point. Royce et al1 argued that a prostate-specific antigen nadir value greater than 0.5 ng/mL is a good surrogate end point for all-cause mortality in men with prostate cancer. They base their claim on the proportion of treatment effect explained (PTE) of 103.86%. However, PTE is not a reliable measure of surrogacy. First, the confidence intervals, which were not reported, are typically too large to be useful,2 particularly if the effect of treatment on the true end point (not adjusted for the surrogate end point) is small.3 Second, PTE is based on an assumption, which may not hold, that treatment and surrogate end point have an additive effect, with no interaction, on the hazard function for all-cause mortality.3

    更新日期:2017-08-31
  • Salvage Chemoimmunotherapy With Inotuzumab Ozogamicin Combined With Mini–Hyper-CVD for Patients With Relapsed or Refractory Philadelphia Chromosome–Negative Acute Lymphoblastic LeukemiaA Phase 2 Clinical Trial
    JAMA Oncol. (IF 16.559) Pub Date : 2017-08-31
    Elias Jabbour, Farhad Ravandi, Partow Kebriaei, Xuelin Huang, Nicholas J. Short, Deborah Thomas, Koji Sasaki, Michael Rytting, Nitin Jain, Marina Konopleva, Guillermo Garcia-Manero, Richard Champlin, David Marin, Tapan Kadia, Jorge Cortes, Zeev Estrov, Koichi Takahashi, Yogin Patel, Maria R. Khouri, Jovitta Jacob, Rebecca Garris, Susan O’Brien, Hagop Kantarjian
    更新日期:2017-08-31
Some contents have been Reproduced with permission of the American Chemical Society.
Some contents have been Reproduced by permission of The Royal Society of Chemistry.
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