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In This Issue of JAMA Oncology
May 2017


JAMA Oncol. 2017;3(5):579. doi:10.1001/jamaoncol.2016.4433


In this exploratory analysis of a clinical trial, Joensuu and colleagues investigated the effect of KIT and PDGFRA mutations on recurrence-free survival (RFS) in patients with gastrointestinal stromal tumors treated with surgery and adjuvant imatinib. Patients were randomized to receive adjuvant imatinib for 1 or 3 years; those with a deletion in KIT exon 11 had better RFS when receiving 3 years of adjuvant imatinib, and those with other genotypes had little or no benefit. The authors conclude that mutation analysis can help aid in patient selection for adjuvant imatinib treatment.


This retrospective observational study assessed whether delaying the initiation of adjuvant chemotherapy after resection would affect survival rates in patients with non–small-cell lung cancer (NSCLC). Salazar and colleagues found that the lowest mortality risk occurred when chemotherapy was started 50 days postoperatively, while initiation of chemotherapy after this interval did not increase mortality. Patients who received adjuvant chemotherapy later had a significantly better survival than those treated with surgery alone. The authors conclude that patients with a delayed recovery from NSCLC resection may benefit from adjuvant chemotherapy started up to 4 months after surgery.

Editor’s Note

Audio Author’s Interview

In a randomized clinical trial of 2259 participants diagnosed as having colorectal adenomas, Barry and colleagues investigated whether common variants in 7 vitamin D and calcium pathway genes modify the effects of vitamin D3 or calcium supplementation on the risk of recurrence. Patients were randomized to receive a daily oral supplementation with vitamin D3 (1000 IU), calcium carbonate (1200 mg elemental calcium), both, or neither. The effect of vitamin D3 supplementation on advanced adenomas (but not adenoma risk overall) significantly varied according to vitamin D receptor genotypes. The authors conclude that analysis of vitamin D receptor type can help clarity which patients may benefit from vitamin D3 supplementation for preventing advanced colorectal adenomas.

This Mendelian randomization study appraised the relevance of telomere length for risk of cancer and non-neoplastic diseases. The Telomeres Mendelian Randomization Collaboration sourced summary data from genomewide association studies (GWASs) published up to January 15, 2015. The authors found that genetically longer telomeres were associated with higher odds of disease for 9 of 22 primary cancers tested but were associated with reduced odds for 6 of 32 primary non-neoplastic diseases. The authors conclude that telomere length may a useful predictor of risk and could be used to guide therapeutic interventions.

In a population-based, retrospective cohort study, Iqbal and colleagues compared the overall survival of women diagnosed as having breast cancer during pregnancy or in the postpartum period with that of women who had breast cancer but did not become pregnant. The difference in survival between the pregnancy vs nonpregnancy groups was not statistically significant. The authors conclude that pregnancy around the time of, or after, the diagnosis of breast cancer did not adversely affect patient survival.