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  • Targeting Immune Checkpoints in Cancer Therapy

    Abstract Full Text
    JAMA. 2017; 318(17):1647-1648. doi: 10.1001/jama.2017.14155

    This Viewpoint reviews the development of immune checkpoint inhibitors as a new drug class for treating cancer, and discusses future directions including development of commercial assays for identifying response-to-treatment biomarkers and the use of combination regimens to improve response.

  • JAMA October 3, 2017

    Figure: Analysis of ctDNA and Clinical Applications

    A variety of tumor-derived genomic alterations may be detected in cfDNA (see text for description of methods for cfDNA analysis). Current clinical applications include treatment selection and identification of resistance mutations; future applications include monitoring of treatment response, detection of recurrence, and screening.
  • JAMA September 5, 2017

    Figure: Clinical Actionability, Concordance With Family History and Phenotype, Penetrance, and Founder Mutations in 1040 Patients Undergoing Sequencing of Germline and Tumor DNA

    Representation of the 1040 cases that carried clinically actionable pathogenic or presumed pathogenic variants, comprising 182 cases broken into subsets of nonincremental cases (in which mutations would have been detected using genetic testing guidelines based on phenotype and family history) and incremental cases (in which mutations would not have been detected using guideline-based approaches). The incremental cases are categorized by high-, moderate-, or low-penetrance mutations. Numbers in parentheses indicate the numbers of patients in that category without Ashkenazi Jewish or European founder mutations.
  • The Potential and Challenges of Expanded Germline Testing in Clinical Oncology

    Abstract Full Text
    JAMA. 2017; 318(9):801-803. doi: 10.1001/jama.2017.11022
  • Trials and Tribulations

    Abstract Full Text
    JAMA. 2017; 318(7):612-613. doi: 10.1001/jama.2017.7106
  • JAMA June 20, 2017

    Figure 1: Flow of Patients Through Cancer and Leukemia B Group and Southwest Oncology Group 80405 Trial

    aThe reasons patients with wild-type (wt), indeterminate, or unknown KRAS status were excluded were not captured at the time of exclusion.bAmendment 5 limited trial eligibility to only patients with KRAS wild-type colorectal cancer in November 2008. cThis double-biologic treatment group was dropped from the trial and primary analysis based on amendment 6, which was established September 2009.dThe primary cohort comprises patients whose KRAS wt colorectal cancer was centrally confirmed by the Southwest Oncology Group and who had consented for the use of their specimens.eReasons for ineligibility in the primary cohort were not captured. fForty-nine tumor samples lacked sufficient DNA or analyses were incomplete.
  • JAMA June 20, 2017

    Figure 2: Kaplan-Meier Estimates of Overall Survival Among Patients Randomized to Bevacizumab or Cetuximab

    Tick marks on the curves denote the last known follow-up time for patients with no death date reported. The hazard ratio and P value are adjusted for prior adjuvant therapy, prior radiotherapy, protocol chemotherapy, and randomization before and after the amendment restricting eligibility to the KRAS wild-type tumor. Hazard ratio and P value for the RAS analysis are adjusted for prior adjuvant therapy, prior radiotherapy, protocol chemotherapy, and randomization before or after the amendment restricting eligibility to KRAS wild type tumor (KRAS is defined as exon 2 codons 12, 13; exon 4, codons 117, 146; exon 3 codons 59, 61 or NRAS: exon 2 codons 12, 13; exon 3 codons 59, 61; exon 4 codons 117, 146).
  • JAMA May 9, 2017

    Figure 1: Flow of Patients Through Randomization and Treatment

    KRAS indicates v-Ki-ras2 Kirsten Rat Sarcoma Viral Oncogene Homologue. To convert creatinine clearance to mL/s/m2, multiply by 0.0167. The full analysis set included all randomized patients; the safety analysis set included all patients who received at least 1 dose of randomized investigational product (selumetinib or placebo).aPatients could be prescreened if the investigator considered it appropriate for the patient to consent to central KRAS mutation status screening of archival tumor material prior to consenting to the main study. bSpecific reasons for exclusion of 2457 prescreened patients are not available. cAn individual patient could have had more than 1 reason for exclusion.dSevere noncompliance was based on the Case Report Form categories. The choices were patient decision, adverse event, severe noncompliance to protocol, condition under investigation worsened, and other.eIneligible due to cardiac conditions as specified in the protocol and World Health Organization performance status higher than 1.fAt the time of data cutoff (June 7, 2016).
  • Farewell to a Cancer That Never Was

    Abstract Full Text
    JAMA. 2017; 317(18):1824-1825. doi: 10.1001/jama.2017.3969

    This Medical News story follows up on the recent downgrading of a form of thyroid cancer to a noncancerous neoplasm.

  • Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013

    Abstract Full Text
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    JAMA. 2017; 317(13):1338-1348. doi: 10.1001/jama.2017.2719

    This study uses SEER database data to compare thyroid cancer incidence and mortality rates in the United States by cancer type and stage between 1974 and 2013.

  • JAMA January 24, 2017

    Figure 1: County-Level Mortality From Neoplasms

    A, Age-standardized mortality rate for both sexes combined in 2014. B, Relative percent change in the age-standardized mortality rate for both sexes combined between 1980 and 2014. In panels A, and B, the color scale is truncated at approximately the first and 99th percentiles as indicated by the range given in the color scale. C, Age-standardized mortality rate in 1980, 1990, 2000, and 2014. The bottom border, middle line, and top border of the boxes indicate the 25th, 50th, and 75th percentiles, respectively, across all counties; whiskers, the full range across counties; and circles, the national-level rate.
  • Little White Lies

    Abstract Full Text
    JAMA. 2017; 317(1):27-28. doi: 10.1001/jama.2016.11872
  • JAMA December 13, 2016

    Figure 1: County-Level Mortality From Neoplasms

    A, Age-standardized mortality rate for both sexes combined in 2014. B, Percent change in the age-standardized mortality rate for both sexes combined between 1980 and 2014. A and B, The color scale is truncated at approximately the first and 99th percentiles as indicated by the range given in the color scale. C, Age-standardized mortality rate in 1980, 1990, 2000, and 2014. The bottom border, middle line, and top border of the boxes indicate the 25th, 50th, and 75th percentiles, respectively, across all counties; whiskers, the full range across counties; and circles, the national-level rate.
  • A Precision Medicine Approach to Clinical Trials

    Abstract Full Text
    JAMA. 2016; 316(19):1953-1955. doi: 10.1001/jama.2016.12137

    This Medical News feature discusses the advances in clinical trial design and implementation that have grown out of the precision medicine approach.

  • Effect of Tailored Dose-Dense Chemotherapy vs Standard 3-Weekly Adjuvant Chemotherapy on Recurrence-Free Survival Among Women With High-Risk Early Breast Cancer: A Randomized Clinical Trial

    Abstract Full Text
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    JAMA. 2016; 316(18):1888-1896. doi: 10.1001/jama.2016.15865

    This randomized clinical trial compares the effects of tailored dose-dense adjuvant chemotherapy vs standard adjuvant chemotherapy on recurrence-free survival in women with high-risk early breast cancer.

  • JAMA October 25, 2016

    Figure: Tumor Gene Testing May Help Guide Breast Cancer Treatment Decisions

    Genetic profiling of breast cancer tumors could help determine whether chemotherapy is required.
  • Tumor Environment Contributes to Brain Tumor Resistance

    Abstract Full Text
    JAMA. 2016; 316(1):23-23. doi: 10.1001/jama.2016.8448
  • JAMA June 7, 2016

    Figure: Targeted Therapy Blocks Growth of Triple-Negative Breast Cancer in Mice

    Preclinical research suggests inhibiting JAK2, a protein involved in cell growth and division, may help shrink triple negative breast cancer tumors.
  • JAMA May 3, 2016

    Figure 4: Proposed Strategy for the Evaluation and Management of a Pancreatic Cyst

    BD-IPMN indicates branch duct intraductal papillary mucinous neoplasm; CEA, carcinoembryonic antigen; CT, computed tomography; EUS-FNA, endoscopic ultrasound–guided fine needle aspiration; IPMN, intraductal papillary mucinous neoplasm; MCN, mucinous cystic neoplasm; MD-IPMN, main duct intraductal papillary mucinous neoplasm; MPD, main pancreatic duct; MRI, magnetic resonance imaging; SCA, serous cystadenoma.
  • JAMA May 3, 2016

    Figure 3: Examples of Pancreatic Cysts Associated With Low Risk for Malignancy

    A, Mid-abdominal axial contrast-enhanced axial computed tomographic image. Classic computed tomographic appearance of microcystic serous cystadenoma with innumerable septations and a central stellate scar. B, Oblique coronal abdominal magnetic resonance cholangiopancreatography demonstrating multifocal branch duct intraductal papillary mucinous neoplasm. The caliber of the main pancreatic duct is normal throughout the pancreas. No single lesion measures greater than 1.5 cm in diameter.