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  • Incorrect Percentages in the Abstract
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-16

    In the article titled “Association of Proton Pump Inhibitors and Capecitabine Efficacy in Advanced Gastroesophageal Cancer: Secondary Analysis of the TRIO-013/LOGiC Randomized Clinical Trial,”1 the percentages corresponding with disease control rate in the Results section of the Abstract were reversed. The sentence should read “…and disease control rate (72% vs 83%; P = .02)…”. This article was corrected online.

    更新日期:2017-11-17
  • Association of First-in-Class Immune Checkpoint Inhibition and Targeted Therapy With Survival in Patients With Stage IV Melanoma
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-16
    Andrew J. Sinnamon, Madalyn G. Neuwirth, Phyllis A. Gimotty, Tara C. Gangadhar, Ravi K. Amaravadi, Lynn M. Schuchter, Giorgos C. Karakousis
    更新日期:2017-11-17
  • Gradually Worsening Pruritic Plaques
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-16
    Hoda Daher, Basim Towfiq, Samer Al Hadidi
    更新日期:2017-11-17
  • Strategies to Achieve High-Value Oncology Care—A Beginning
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-16
    Harold C. Sox, Ethan M. Basch, Donald Berwick

    Cancer care is costly for individuals and in the aggregate. In one study, insured patients with advanced cancer reported median monthly out-of-pocket treatment expenditures of $592.1 In the aggregate, US expenditures for cancer care were $127 billion in 2013, which was 7% of total health care expenditures.2 These costs are projected to be at least $158 billion in 2020.3 Cancer care contributed 6.5% of the growth in health expenditures from 2000 to 2013. Circulatory diseases provide an informative contrast: disability-adjusted life-years have shrunk nearly 20% from 2005 to 2010 while annual expenditures have increased 7%. For cancer, the same figures are 12% and 26%, respectively.2

    更新日期:2017-11-17
  • Association of Ipilimumab With Safety and Antitumor Activity in Women With Metastatic or Recurrent Human Papillomavirus–Related Cervical Carcinoma
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-16
    Stephanie Lheureux, Marcus O. Butler, Blaise Clarke, Mihaela C. Cristea, Lainie P. Martin, Katia Tonkin, Gini F. Fleming, Anna V. Tinker, Hal W. Hirte, Daliah Tsoref, Helen Mackay, Neesha C. Dhani, Prafull Ghatage, Johanne Weberpals, Stephen Welch, Nhu-An Pham, Vinicius Motta, Valentin Sotov, Lisa Wang, Katherine Karakasis, Smitha Udagani, Suzanne Kamel-Reid, Howard Z. Streicher, Patricia Shaw, Amit M. Oza
    更新日期:2017-11-17
  • Critical Lessons From High-Value Oncology Practices
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-16
    Douglas W. Blayney, Melora K. Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
    更新日期:2017-11-17
  • Rethinking Extended Adjuvant Antiestrogen Therapy to Increase Survivorship in Breast Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-16
    Balkees Abderrahman, V. Craig Jordan
    更新日期:2017-11-17
  • Incorrect Trial Database Number
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01

    In the Original Investigation titled “Effect of the addition of cetuximab to paclitaxel, cisplatin, and radiation therapy for patients with esophageal cancer: the NRG Oncology RTOG 0436 phase 3 randomized clinical trial,”1 published online July 6, 2017, there was an incorrect NCT trial number in the Abstract. The correct number is NCT00655876. This article was corrected online.

    更新日期:2017-11-10
  • Highlights
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01

    Many patients with head and neck squamous cell carcinoma experience recurrence, but little is known about outcome patterns. Leeman et al reviewed 1000 consecutive patients with stage III to IVB oropharyngeal, oral cavity (OCC), laryngeal, or hypopharyngeal cancers who had been definitively treated. By 5 years, local treatment failure was highest among patients with OCC. Overall survival following local regional failure did not differ between groups, but time from distant metastasis to death was significantly shorter among patients with OCC. Treatment failure and survival after recurrence of head and neck cancer are influenced by site of disease.

    更新日期:2017-11-10
  • JAMA Oncology
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01

    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:2017-11-10
  • Chimeric Antigen Receptor (CAR) T-Cell Therapy
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    John M. Pagel, Howard (Jack) West
    更新日期:2017-11-10
  • Small Cell, Large Impact
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Amishi Bajaj

    更新日期:2017-11-10
  • Error in Figure and Methods Section
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01

    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:2017-11-10
  • Is “Do Everything!” Always Appropriate?—Reply
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Tomasz M. Beer, Vinay Prasad

    In Reply We are grateful that Dr Mangalik has taken an interest in our article,1 which was a response to a chapter in Dr Vincent DeVita’s book The Death of Cancer, in which Dr DeVita guides the management of a friend with prostate cancer. In our article, we highlighted deviations from the best clinical evidence, as well as missed opportunities in the management provided.

    更新日期:2017-11-10
  • Is “Do Everything!” Always Appropriate?
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Aroop Mangalik

    To the Editor I read with interest the Viewpoint by Beer and Prasad.1 I agree with the points they raised regarding the book by DeVita and DeVita-Raeburn, The Death of Cancer.2 Their book is a good historical perspective of the development of modern multidrug chemotherapy and has a fascinating account of DeVita’s team’s success in achieving high rates of complete remissions and even cures in advanced Hodgkin disease and other hematological malignant neoplasms. However, that approach has had limited success in the treatment of most other cancers. The attitude of “never give up” causes more harm than good. Unregulated, unsupervised clinical trials have caused severe harm to many patients, as illustrated by the Jesse Gelsinger case.3

    更新日期:2017-11-10
  • Mutation Frequencies in Patients With Early-Onset Colorectal Cancer—Reply
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Rachel Pearlman, Albert de la Chapelle, Heather Hampel

    In Reply We appreciate the opportunity to respond to the letters received regarding our article. We have made every effort to thoroughly address the raised questions and comments. We agree with Beggs that there is no proof that genes such as BRCA1/2, PALB2, CHEK2, and CDKN2A were the driver for these patients’ early-onset colorectal cancers (CRC). The article stated that it was unclear what impact, if any, these mutations had in CRC development, so as to not imply that they were a relevant driver. However, we believe that the findings are important clinically to the patients and their relatives at high risk for the cancers associated with pathogenic germline mutations in these genes. All mutation-positive individuals will need to follow intensive surveillance and prevention options as recommended by the National Comprehensive Cancer Network.1

    更新日期:2017-11-10
  • The Bitter, Expensive Pill at the End of Life
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Marc De Hert, Wim Distelmans

    To the Editor With initial amazement we read the recent Viewpoint of Shankaran et al.1 The practice of “Big Pharma” to scam patients at one of the most vulnerable moments of their lives with excessive drug cost is far from dignified. Over the years, the practice of euthanasia and/or physician-assisted death has been confronted with fierce opposition. But even the most creative critics using different formats of the “slippery slope” argument would never have come up with the intolerable practices of pharmaceutical firms.2,3

    更新日期:2017-11-10
  • Mutation Frequencies in Patients With Early-Onset Colorectal Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Steven A. Narod, Mohammad Akbari

    To the Editor Pearlman et al1 show what can be achieved through the cooperation of cancer registries with pathologists and other clinicians. The study participants were 450 newly identified young men and women with colon cancer who were treated at one of 51 Ohio hospitals. Both blood and paraffin-embedded tumor samples were submitted to the core molecular and pathology laboratories. Using a panel of 25 cancer susceptibility genes as a genetic screening test, 72 patients were found to carry a pathogenic mutation; of these, 59 mutations were in genes associated with colon cancer and 13 mutations were in genes associated with breast or pancreatic cancer but not (classically) with colon cancer.

    更新日期:2017-11-10
  • Mutation Frequencies in Patients With Early-Onset Colorectal Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Florentia Fostira, Ioannis Papaconstantinou

    To the Editor The article by Pearlman et al1 broaches a matter of high importance; 1 in 6 patients with a diagnosis of early-onset colorectal cancer (CRC) carries a germline defect in a known cancer susceptibility gene. Of these, 1 in 8 carries a CRC-predisposing allele while 3% of the individuals tested carried mutations in breast cancer genes with high or moderate penetrance. These might be simply incidental findings and although they can be clinically actionable for the individuals themselves and their families, a direct association with CRC predisposition has not been established.

    更新日期:2017-11-10
  • Mutation Frequencies in Patients With Early-Onset Colorectal Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Steven Sorscher

    To the Editor Pearlman et al reported that in screening patients with colorectal cancer (CRC) for inherited germline mutated genes predisposing to CRC, 13 of 72 (18%) “had mutations in genes not traditionally associated with CRC risk.”1(p464) They note that “all patients found to have pathogenic mutations received genetic counseling and current evidence-based guidelines for intensive cancer surveillance based on their mutation status.”1(p469) However, these guidelines are not based on any known relevance of incidentally discovered germline mutations.

    更新日期:2017-11-10
  • Mutation Frequencies in Patients With Early-Onset Colorectal Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Andrew D. Beggs

    To the Editor The recent study by Pearlman et al1 raises concerns. The hypothesis of the article is laudable, that is, genetic susceptibility forms a significant part of the risk in patients with early-onset (defined as younger than 50 years) colorectal cancer (CRC). However, the data reported in the article do not correlate with what is known as being relevant in the disease mechanism of CRC.2 The authors report mutations in “nontraditional” CRC genes such as BRCA1/2, CDKN2A, PALB2, and CHEK2 in 32 of 72 patients, all of which are associated with hereditary breast cancer.3 In fact, given that CRC is a phenomenon driven primarily by dysfunctional Wnt signaling, it is difficult to understand how these germline drivers in cell cycle and DNA repair genes (which have been extensively investigated previously, in vitro and in vivo, as potential driver genes in CRC) have any relevance to this topic; they merely inflate the relevant germline variation rate reported in this study. What the article should in fact report is that a detection rate of 10% for patients with Lynch syndrome was observed, which is above what has previously been reported in other population studies and is likely to be enriched by the selection for early-onset cancer. The observed APC mutation (APC c.3920T>A, p.I1307K mutation) is almost uniquely associated with Ashkenazi Jewish ancestry,4 being associated with a multiple-tumor phenotype; it is not low penetrance and unlikely to be common outside the group of patients. In conclusion, this type of study is useful in that it highlights the role of genetic testing in early onset-cancer cases, but it should not be used to argue that there is a hidden pool of patients with relevant germline drivers. It is likely that further information from population-based whole-genome sequencing studies (eg, the UK 100 000 Genomes project) will reveal the complex landscape of rare, highly penetrant CRC driver genes.

    更新日期:2017-11-10
  • Out-of-Pocket Costs, Financial Distress, and Underinsurance in Cancer Care
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Fumiko Chino, Jeffrey M. Peppercorn, Christel Rushing, Arif H. Kamal, Ivy Altomare, Greg Samsa, S. Yousuf Zafar
    更新日期:2017-11-10
  • Hospital-Based End-of-Life Care and Costs for Older Patients With Malignant Brain Tumors
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Laura L. Dover, Caleb R. Dulaney, John B. Fiveash, Courtney P. Williams, Bradford E. Jackson, Paula Warren, Gabrielle B. Rocque
    更新日期:2017-11-10
  • An Erysipeloid Cutaneous Eruption in a Woman With Advanced Breast Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Christina E. Alexander, Melody Maarouf, Drew J. B. Kurtzman
    更新日期:2017-11-10
  • 更新日期:2017-11-10
  • Association of Previous Clinical Breast Examination With Reduced Delays and Earlier-Stage Breast Cancer Diagnosis Among Women in Peru
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Anya Romanoff, Tara Hayes Constant, Kay M. Johnson, Manuel Cedano Guadiamos, Ana María Burga Vega, Joseph Zunt, Benjamin O. Anderson
    更新日期:2017-11-10
  • Association Between SLC16A5 Genetic Variation and Cisplatin-Induced Ototoxic Effects in Adult Patients With Testicular Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Britt I. Drögemöller, Jose G. Monzon, Amit P. Bhavsar, Adrienne E. Borrie, Beth Brooks, Galen E. B. Wright, Geoffrey Liu, Daniel J. Renouf, Christian K. Kollmannsberger, Philippe L. Bedard, Folefac Aminkeng, Ursula Amstutz, Claudette A. Hildebrand, Erandika P. Gunaretnam, Carol Critchley, Zhuo Chen, Liam R. Brunham, Michael R. Hayden, Colin J. D. Ross, Karen A. Gelmon, Bruce C. Carleton
    更新日期:2017-11-10
  • Second Primary Malignant Neoplasms and Survival in Adolescent and Young Adult Cancer Survivors
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Theresa H. M. Keegan, Archie Bleyer, Aaron S. Rosenberg, Qian Li, Melanie Goldfarb
    更新日期:2017-11-10
  • Role of Cytotoxic Tumor-Infiltrating Lymphocytes in Predicting Outcomes in Metastatic HER2-Positive Breast CancerA Secondary Analysis of a Randomized Clinical Trial
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Shuzhen Liu, Bingshu Chen, Samantha Burugu, Samuel Leung, Dongxia Gao, Shakeel Virk, Zuzana Kos, Wendy R. Parulekar, Lois Shepherd, Karen A. Gelmon, Torsten O. Nielsen
    更新日期:2017-11-10
  • Abiraterone Acetate for Metastatic Prostate Cancer in Patients With Suboptimal Biochemical Response to Hormone Induction
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Thomas W. Flaig, Melissa Plets, Maha H. A. Hussain, Neeraj Agarwal, Nicholas Mitsiades, Hari A. Deshpande, Ulka N. Vaishampayan, Ian M. Thompson
    更新日期:2017-11-10
  • Genomic Profiling of Small-Bowel Adenocarcinoma
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Alexa B. Schrock, Craig E. Devoe, Robert McWilliams, James Sun, Thomas Aparicio, Philip J. Stephens, Jeffrey S. Ross, Richard Wilson, Vincent A. Miller, Siraj M. Ali, Michael J. Overman
    更新日期:2017-11-10
  • Predictors of Hand-Foot Syndrome and Pyridoxine for Prevention of Capecitabine–Induced Hand-Foot SyndromeA Randomized Clinical Trial
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Yoon-Sim Yap, Li-Lian Kwok, Nicholas Syn, Wen Yee Chay, John Whay Kuang Chia, Chee Kian Tham, Nan Soon Wong, Soo Kien Lo, Rebecca Alexandra Dent, Sili Tan, Zuan Yu Mok, King Xin Koh, Han Chong Toh, Wen Hsin Koo, Marie Loh, Raymond Chee Hui Ng, Su Pin Choo, Richie Chuan Teck Soong
    更新日期:2017-11-10
  • Development and Validation of an Individualized Immune Prognostic Signature in Early-Stage Nonsquamous Non–Small Cell Lung Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Bailiang Li, Yi Cui, Maximilian Diehn, Ruijiang Li
    更新日期:2017-11-10
  • Effect of the Addition of Cetuximab to Paclitaxel, Cisplatin, and Radiation Therapy for Patients With Esophageal CancerThe NRG Oncology RTOG 0436 Phase 3 Randomized Clinical Trial
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Mohan Suntharalingam, Kathryn Winter, David Ilson, Adam P. Dicker, Lisa Kachnic, André Konski, A. Bapsi Chakravarthy, Christopher J. Anker, Harish Thakrar, Naomi Horiba, Ajay Dubey, Joel S. Greenberger, Adam Raben, Jeffrey Giguere, Kevin Roof, Gregory Videtic, Jondavid Pollock, Howard Safran, Christopher H. Crane
    更新日期:2017-11-10
  • Nivolumab for Patients With Advanced Melanoma Treated Beyond ProgressionAnalysis of 2 Phase 3 Clinical Trials
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Georgina V. Long, Jeffrey S. Weber, James Larkin, Victoria Atkinson, Jean-Jacques Grob, Dirk Schadendorf, Reinhard Dummer, Caroline Robert, Ivan Márquez-Rodas, Catriona McNeil, Henrik Schmidt, Karen Briscoe, Jean-François Baurain, F. Stephen Hodi, Jedd D. Wolchok
    更新日期:2017-11-10
  • Use of Molecular Tools to Identify Patients With Indolent Breast Cancers With Ultralow Risk Over 2 Decades
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Laura J. Esserman, Christina Yau, Carlie K. Thompson, Laura J. van 't Veer, Alexander D. Borowsky, Katherine A. Hoadley, Nicholas P. Tobin, Bo Nordenskjöld, Tommy Fornander, Olle Stål, Christopher C. Benz, Linda S. Lindström
    更新日期:2017-11-10
  • Breast Cancer Screening With Mammography Plus Ultrasonography or Magnetic Resonance Imaging in Women 50 Years or Younger at Diagnosis and Treated With Breast Conservation Therapy
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Nariya Cho, Wonshik Han, Boo-Kyung Han, Min Sun Bae, Eun Sook Ko, Seok Jin Nam, Eun Young Chae, Jong Won Lee, Sung Hun Kim, Bong Joo Kang, Byung Joo Song, Eun-Kyung Kim, Hee Jung Moon, Seung Il Kim, Sun Mi Kim, Eunyoung Kang, Yunhee Choi, Hak Hee Kim, Woo Kyung Moon
    更新日期:2017-11-10
  • Patterns of Treatment Failure and Postrecurrence Outcomes Among Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma After Chemoradiotherapy Using Modern Radiation Techniques
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Jonathan E. Leeman, Jin-gao Li, Xin Pei, Praveen Venigalla, Zachary S. Zumsteg, Evangelia Katsoulakis, Eitan Lupovitch, Sean M. McBride, Chiaojung J. Tsai, Jay O. Boyle, Benjamin R. Roman, Luc G. T. Morris, Lara A. Dunn, Eric J. Sherman, Nancy Y. Lee, Nadeem Riaz
    更新日期:2017-11-10
  • Treatment Beyond Progression With Immune Checkpoint Inhibitors—Known Unknowns
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Gideon M. Blumenthal, Marc R. Theoret, Richard Pazdur
    更新日期:2017-11-10
  • Mother Tongue
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Charu Agrawal, Daniel Epner

    “It is a part of who we are. You will appreciate it later,” my mother repeatedly told me as a child the many times I refused to respond to her in Hindi. Although I was born in the United States, I always felt slightly foreign. For one thing, my name, Charu Agrawal, sounds foreign. My mother would pack foods like aloo gobi and parathas in my lunch box. I constantly found myself trying to fit in with my classmates, who spoke English at home, had American-sounding names like Brittany, and brought turkey sandwiches for lunch. However, as immigrants to this country, my parents were determined to assimilate into American culture while retaining their Indian identity. Speaking Hindi was central to their identity. In contrast, I was desperately trying to fit in, so speaking English, sometimes with a Texas twang, was mandatory among my schoolmates. Nonetheless, I soon learned that I had better speak Hindi in our household if I expected any consideration from my parents, such as permission to attend birthday parties and sleepovers, and later, to borrow the family car. So, I spoke Hindi purely as a survival tactic, not as a nod to my cultural heritage. While I spent the majority of my childhood thinking that Hindi would not have any practical use outside our home, my perspective changed one day on hospital rounds.

    更新日期:2017-11-10
  • Afraid That I’ll Not Be Afraid—A Paradox of Care
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Chiara Catania

    Mark, a 49-year-old nonsmoker, was diagnosed 2 years ago with metastatic adenocarcinoma of the lung. When he was given the diagnosis, he fell into despair, his mind befogged, no future, in total darkness, total solitude. He wanted to be left alone but was also afraid that his friends and loved ones would abandon him. He cried; he cried a great deal. He became depressed; he began saying good-bye to friends because he was convinced he had only a few months to live. He withdrew into himself and stopped wanting to see anyone. He also became aggressive toward his wife and children. He was beginning a process of separation from the world, from life. This was how he was when he came to my clinic accompanied by his wife. He was suffering from dyspnea, pain, and a deep feeling of desperation. He had chosen not to speak, letting his wife explain what he was suffering from. He averted his eyes, staring into space as if he were not there or just passing through by chance. It was if his wife and I were not talking about him, sharing his story. Initially, I let his wife speak but then began to ask him questions directly. But his wife answered promptly, always stepping in for him.

    更新日期:2017-11-10
  • Biosimilars—Curb Your Enthusiasm
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Y. Tony Yang, Brian Chen, Charles L. Bennett

    Biosimilars are nonpatented biologic products that are similar to reference biologic agents in structure, function, activity, safety, and efficacy. In 2014, investigators from the RAND Corporation, a prominent policy think tank, predicted that the introduction of biosimilars could result in up to $44.2 billion worth of savings from 2014 to 2024 in the United States.1 Thus, they envisioned that the emergence of biosimilar drugs has the potential to create substantial savings for the nation’s health care system. This estimate was derived from a model identifying potential price savings based on 4 factors: safety and effectiveness of a biosimilar in comparison with the branded biologic; payers’ willingness to pay for biosimilars relative to the branded biologic; the extent to which patients, physicians, and payers will adopt biosimilars; and barriers to entry faced by biosimilar makers.1

    更新日期:2017-11-10
  • The Trade-off Between Speed and Safety in Drug Approvals
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Anupam B. Jena, Jie Zhang, Darius N. Lakdawalla

    The US Food and Drug Administration (FDA) is tasked with determining whether investigational drugs are safe and effective, and with approving new drugs quickly enough for patients in need. To meet both objectives, the FDA must strike a balance between speed and safety. An excessively slow approval process may lead to lives lost among those who could have benefited from safe and effective drugs brought to market sooner. However, rapid approvals risk adverse events, including deaths. To strike a balance between inherent trade-offs in drug approval, the FDA ought to be managing risk, not minimizing it.

    更新日期:2017-11-10
  • Will Machine Learning Tip the Balance in Breast Cancer Screening?
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Andrew D. Trister, Diana S. M. Buist, Christoph I. Lee

    Although multiple randomized clinical trials have demonstrated mortality benefit from routine mammography, population-based breast cancer screening continues to be a highly contentious issue. Digital mammography is the most prevalent breast cancer screening tool, but it is imperfect, with a sensitivity of 84% for detecting breast cancers present at the time of screening. The other 16% are not detected owing to a combination of factors, most notably the human limitation of what radiologists are visually able to identify on mammographic images.1 One in 10 women who undergo mammography screening experience screening failures including false-positive examination results that may lead to unnecessary anxiety, biopsies, surgical excision, and treatment. More recently, critics of screening have suggested that a considerable proportion of screen-detected breast cancers constitute overdiagnosis or cases that would not have become clinically relevant during women’s lifetimes.2 These collective harms are felt to outweigh mortality benefits among certain subpopulations of women, especially younger women.

    更新日期:2017-11-10
  • To ProtecT Our Patients With Prostate Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Daniel E. Spratt
    更新日期:2017-11-10
  • Toward Palliative Care for All Patients With Advanced Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-01
    Yael Schenker, Robert Arnold

    A recently updated clinical practice guideline from the American Society of Clinical Oncology (ASCO) strongly recommends that all patients with advanced cancer receive palliative care early in the disease course, concurrent with active treatment.1 We applaud this recognition that the pillars of palliative care—including assessment and treatment of distressing symptoms, exploration of illness understanding and prognostic awareness, clarification of treatment goals, and assistance with decision making—should be the standard of care. Over the past 10 years, a growing evidence base has demonstrated the value of these services in promoting quality of life for patients with advanced cancer.2 The most recent ASCO guidelines build on reports from the Institute of Medicine and previous ASCO consensus statements defining palliative care as an integral part of oncology.

    更新日期:2017-11-10
  • Issues of Awareness Related to Human Papillomavirus Infection Positivity Among US Adult Men—Reply
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-09
    Jasmine J. Han, Thomas Beltran, John Song

    In Reply Dr Castellanos and colleagues inquire whether men who tested positive for genital human papillomavirus (HPV) infection were counseled regarding their status and educated on HPV in our study.1 Currently, there is no clinically approved HPV test for men.2 Therefore, HPV testing for men was for research purposes only, and the decision was made by the National Health and Nutrition Examination Survey (NHANES) Physician Advisory Group not to report the results to the participants. The reporting protocols were reviewed and approved by the National Center for Health Statistics Research Ethics Review Board. The advisory group decided that it would be inappropriate to provide positive HPV results to participants because clinically approved HPV test and result–based recommendations are not available for men. In contrast, women were provided with the HPV results because HPV testing is completed with an approved test in a Clinical Laboratory Improvement Amendments–certified laboratory. Although NHANES does not provide any treatments for participants, women were informed of their results with recommendation to follow up with their clinician. In addition, NHANES provides health education with trained sexually transmitted infection (STI) health educators to women should they have any questions or concerns.3

    更新日期:2017-11-10
  • Issues of Awareness Related to Human Papillomavirus Infection Positivity Among US Adult Men
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-09
    Mario R. Castellanos, Maria A. Farberov, Alia Kozlova

    To the Editor The study by Han and collaborators1 provides important data on genital human papillomavirus (HPV) infection, on a national level. There is a serious knowledge gap about HPV infection in males compared with females. The data presented in the article highlight that 1 in 4 men aged 18 to 59 years harbors a cancer-causing HPV type, thus serving as an important reservoir for oncogenic HPV infection. The risk of HPV-induced cancer of the penis is low, with the Centers for Disease Control and Prevention (CDC) reporting 1168 new cases a year.2 This suggests that while HPV infection in males is common, most cases do not progress to cancer. This is not the case for cervical HPV infection in females, as 10% of infected women will progress to a high-grade cervical lesion within 2 years.3

    更新日期:2017-11-10
  • A Young Man With Disseminated Intra-abdominal Masses
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-09
    Aung Myint Tun, Philip Xiao, Elizabeth Guevara
    更新日期:2017-11-10
  • Status of Testing for High-Level Microsatellite Instability/ Deficient Mismatch Repair in Colorectal Carcinoma
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-09
    Stanley R. Hamilton

    Determining the microsatellite instability (MSI) status of colorectal carcinoma (CRC) and other tumor types has recently increased in importance for patient management and prevention strategies.1,2 High-level MSI (MSI-H)/deficient mismatch repair (dMMR) (widely used alternative terminologies) has long been known to be a hallmark of Lynch syndrome. The identification of this small subset of patients (approximately 3% of patients with CRC) has major implications for prevention in blood relatives and for avoiding metachronous tumors in patients who have a first Lynch-associated tumor. Preoperative decisions can be made about prophylactic surgery at the initial treatment, including abdominal colectomy and hysterectomy with bilateral salpingo-oophorectomy after childbearing is completed.

    更新日期:2017-11-10
  • Out-of-Pocket and Health Care Spending Changes for Patients Using Orally Administered Anticancer Therapy After Adoption of State Parity Laws
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-09
    Stacie B. Dusetzina, Haiden A. Huskamp, Aaron N. Winn, Ethan Basch, Nancy L. Keating
    更新日期:2017-11-10
  • Positron Emission Tomography/Computed Tomography–Based Assessments of Androgen Receptor Expression and Glycolytic Activity as a Prognostic Biomarker for Metastatic Castration-Resistant Prostate Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-09
    Josef J. Fox, Somali C. Gavane, Estelle Blanc-Autran, Sadek Nehmeh, Mithat Gönen, Brad Beattie, Hebert A. Vargas, Heiko Schöder, John L. Humm, Samson W. Fine, Jason S. Lewis, Stephen B. Solomon, Joseph R. Osborne, Darren Veach, Charles L. Sawyers, Wolfgang A. Weber, Howard I. Scher, Michael J. Morris, Steven M. Larson
    更新日期:2017-11-10
  • Mismatch Repair Deficiency Testing in Patients With Colorectal Cancer and Nonadherence to Testing Guidelines in Young Adults
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-09
    Talha Shaikh, Elizabeth A. Handorf, Joshua E. Meyer, Michael J. Hall, Nestor F. Esnaola
    更新日期:2017-11-10
  • Close Call
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-09
    Jane deLima Thomas

    I was working in my office when I learned that my friend Meg had been critically injured in a car crash. I called Meg’s husband, Mike, and learned that she had been cycling home from the YMCA when she was hit by a car from behind, pulled under, and dragged. The physicians were not sure that she would survive. I moved both quickly and slowly, as if in a dream. The practical part of my brain arranged coverage at work and child care for my son. I flew from Boston to San Francisco that afternoon.

    更新日期:2017-11-10
  • Error in Title of Letter to the Editor
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-02

    In the Letter to the Editor titled “Delayed Adjacent Chemotherapy and Survival After Lung Cancer Surgery”1 and its Letter in Reply2 published online September 21, 2017, there was an error in the title. The title should read “Delayed Adjuvant Chemotherapy and Survival After Lung Cancer Surgery.” These articles were corrected online.

    更新日期:2017-11-02
  • Factors Affecting the Association of Proton Pump Inhibitors and Capecitabine Efficacy in Advanced Gastroesophageal Cancer—Reply
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-02
    Michael P. Chu, Michael B. Sawyer

    In Reply We thank these authors for their interest in our article. It is true that this definition of 20% or more concurrent overlap might have led to an apparent decrease in capecitabine-proton pump inhibitor (PPI) effect, but we were more willing to accept finding a PPI effect and underestimating the interaction than to miss the interaction entirely, for 2 reasons. First, we do not believe that taking a PPI for 3 days (<20%) out of 14 days of capecitabine administration would have clinically meaningful effects. Furthermore, for brevity in the original article, we did not specify that almost all patients identified as having less than 20% concurrent PPI and capecitabine exposure had in fact never taken a PPI. Second, we have successfully used this definition of concurrent use for other PPI-focused oncology studies1- 3—for continuity, we continued this definition in this study. We found similar concerning results with patients receiving concurrent PPIs and adjuvant capecitabine in patients with colon cancer, for whom 5-year recurrence-free survival was 74% vs 83% in those not receiving a PPI (P = .03).3

    更新日期:2017-11-02
  • Factors Affecting the Association of Proton Pump Inhibitors and Capecitabine Efficacy in Advanced Gastroesophageal Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-02
    Guo-Fu Li, Guo Yu, Yan Gong

    To the Editor Based on a secondary analysis of the TRIO-013/LOGiC trial, Chu and colleagues1 recently reported an association between concomitant use of proton pump inhibitors (PPIs) and capecitabine efficacy in patients with advanced gastroesophageal cancer. In patients with gastroesophageal cancer receiving capecitabine and oxaliplatin, PPI users had significantly poorer median progression-free survival, 4.2 vs 5.7 months (hazard ratio, 1.55; 95% CI, 1.29-1.81; P < .001); median overall survival, 9.2 vs 11.3 months (hazard ratio, 1.34; 95% CI, 1.06-1.62; P = .04), and disease control rate (71.2% vs 82.5%; P = .02) vs PPI nonusers.1 The PPI users were defined as patients whose PPI prescription overlapped with capecitabine plus oxaliplatin treatment duration by at least 20% of the time.1 However, the authors did not provide any information about the definition of the PPI nonusers, which warrants further consideration. The PPI nonusers may be defined either as patients whose PPI prescription overlapped with capecitabine plus oxaliplatin treatment duration by less than 20% of the time or as patients who did not take PPI at baseline and during the trial, like the previous analyses.2,3 If the first definition was used, a proportion of patients who took PPI at baseline and during the trial with a duration less than 20% of study time would be identified as the PPI nonusers, which is irrational and inappropriate. As such, the effect of concomitant use of PPIs on the anticancer efficacy of capecitabine may have been underestimated.

    更新日期:2017-11-02
  • Factors Affecting the Association of Proton Pump Inhibitors and Capecitabine Efficacy in Advanced Gastroesophageal Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-02
    Koen G. A. M. Hussaarts, Roelof W. F. van Leeuwen, Ron H. J. Mathijssen

    To the Editor With interest, we read the report by Chu and colleagues1 investigating the association of proton pump inhibitors (PPIs) with capecitabine efficacy in patients with advanced gastroesophageal cancer. This retrospective analysis revealed a significant difference in treatment efficacy in patients treated with capecitabine and oxaliplatin with and without concomitant PPI use, probably due to an increased intragastric pH and subsequent impaired capecitabine absorption.

    更新日期:2017-11-02
  • Factors Affecting the Association of Proton Pump Inhibitors and Capecitabine Efficacy in Advanced Gastroesophageal Cancer
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-02
    Lishi Wang, Boern Shan, Weikuan Gu

    To the Editor We read with great interest the article by Chu et al1 that describes the association of proton pump inhibitors and capecitabine efficacy in advanced gastroesophageal cancer. We agree with the authors that there are limitations to the study. Furthermore, together in viewing the previous publication regarding the same population,2 we believe that the study raised an issue regarding the difference in response to treatment with anti–human epidermal growth factor receptor 2 (HER2) drugs among cancer patients of different ethnic groups.

    更新日期:2017-11-02
  • Trends in Breast, Colorectal, and Cervical Cancer Incidence Following the Affordable Care ActImplications for Cancer Screening
    JAMA Oncol. (IF 16.559) Pub Date : 2017-11-02
    Maxine Sun, Alexander P. Cole, Stuart L. Lipsitz, Quoc-Dien Trinh
    更新日期:2017-11-02
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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