Customize your JAMA Network experience by selecting one or more topics from the list below.
The best neoadjuvant regimen for locally advanced breast cancer is elusive. Gianni et al questioned whether nab-paclitaxel was more effective than paclitaxel in achieving pathological complete remission (pCR) in patients with human epidermal growth factor receptor 2 (ERBB2/HER2)-negative breast cancer. In this randomized clinical trial, 695 patients received paclitaxel or nab-paclitaxel. Intention-to-treat analysis revealed a nonsignificantly improved pCR rate after nab-paclitaxel vs paclitaxel. The data do not support the substitution of nab-paclitaxel for paclitaxel. Sparano provides an Editorial.
Konishi et al assessed whether preoperative or postoperative carcinoembryonic antigen (CEA) is more prognostic for patients with colorectal cancer. The retrospective cohort analysis evaluated 1027 patients with colon cancer who underwent curative resection for stage I to III colon adenocarcinoma from 2007 to 2014. Elevated postoperative CEA, but not normalized postoperative CEA, was independently associated with shorter relapse-free survival. Elevated preoperative CEA that normalizes after resection was not an indicator of poor prognosis. The authors conclude that routine measurement of postoperative, rather than preoperative, CEA is warranted. Miksad and Meropol provide an Invited Commentary.
Breast implants are a common cosmetic surgery with a few known long-term toxicity outcomes. De Boer et al questioned whether potential extended immune stimulation from this foreign body could increase lymphoma risk. They identified all Dutch patients with a diagnosis of primary breast non-Hodgkin lymphoma between 1990 and 2016. Of 43 patients with breast anaplastic large-cell lymphoma (ALCL), 32 had ipsilateral breast implants, vs 1 of 146 women with other primary breast lymphomas. There is a significantly increased risk of breast ALCL with breast implants, but the incidence is low. McCarthy and Horwitz provide an Invited Commentary.
Immune-related adverse events (irAEs) have been associated with the efficacy of PD-1 (programmed cell death protein 1) inhibitors in patients with melanoma. Haratani et al studied 134 patients with advanced or recurrent non–small cell lung cancer who were treated with second-line or later nivolumab for an association of these toxic effects with clinical outcome. They found that irAEs were positively associated with progression-free and overall survival. These data increase the evidence that irAEs may be a marker of clinical response with immune checkpoint inhibitor use.
Erdheim-Chester disease (ECD) and Langerhans cell histiocytosis (LCH) are rare related hematologic neoplasms that frequently express the BRAF V600 mutation. Diamond et al report the final efficacy analysis for a cohort of 22 patients with ECD and 4 with LCH included in the VE-BASKET study that led to the recent approval of vemurafenib for these indications. The overall response rate was 61.5% in the overall cohort and 54.5% in patients with ECD. All evaluable patients achieved stable disease or better. Median progression-free and overall survival was not reached. The authors propose vemurafenib as the new standard of care for these disorders.
Highlights. JAMA Oncol. 2018;4(3):275. doi:10.1001/jamaoncol.2017.3209