Pub Date : 2026-02-05DOI: 10.1001/jamaoncol.2025.6327
Justin Ferdinandus, Horst Müller, Janina Jablonski, Andrea Kerkhoff, Sebastian Scholl, Yon-Dschun Ko, Max S. Topp, Vladan Vucinic, Wolfram Jung, Roland Schroers, Andreas Rank, Michael Fuchs, Gundolf Schneider, Volker Diehl, Peter Borchmann, Karolin Behringer
This secondary analysis of the GHSG HD21 randomized clinical trial evaluates the tolerability and impact of BrECADD vs escalated BEACOPP on health-related quality of life for patients with Hodgkin lymphoma.
{"title":"BrECADD vs BEACOPP and Health-Related Quality of Life in Advanced-Stage Hodgkin Lymphoma","authors":"Justin Ferdinandus, Horst Müller, Janina Jablonski, Andrea Kerkhoff, Sebastian Scholl, Yon-Dschun Ko, Max S. Topp, Vladan Vucinic, Wolfram Jung, Roland Schroers, Andreas Rank, Michael Fuchs, Gundolf Schneider, Volker Diehl, Peter Borchmann, Karolin Behringer","doi":"10.1001/jamaoncol.2025.6327","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.6327","url":null,"abstract":"This secondary analysis of the GHSG HD21 randomized clinical trial evaluates the tolerability and impact of BrECADD vs escalated BEACOPP on health-related quality of life for patients with Hodgkin lymphoma.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"58 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-05DOI: 10.1001/jamaoncol.2025.6332
Todd Burus, Haluk Damgacioglu, Bin Huang, Thomas C. Tucker, Ashish A. Deshmukh, Krystle A. Lang Kuhs
Importance The effects of COVID-19 pandemic–related disruptions on cancer diagnosis in the US have been widely observed, but their impact on short-term survival has not been assessed. Objective To examine 1-year cause-specific survival (CSS) rates among patients diagnosed with cancer during 2020 and 2021 using high-quality cancer registry data. Design, Setting, and Participants This population-based cohort study of cancer survival between 2015 and 2021 used the Surveillance, Epidemiology, and End Results 21 Registries (SEER-21) database. The population included individuals with an invasive cancer diagnosis and complete follow-up reported to registries included in SEER-21 between January 1, 2015, and December 31, 2021. Data were analyzed from May 13 to May 27, 2025. Exposure COVID-19 pandemic. Main Outcomes and Measures The primary outcome was 1-year CSS rates by stage at diagnosis for patients diagnosed with cancer in 2020 and 2021 compared with trends in 1-year CSS rates among patients diagnosed between 2015 and 2019. Additional site-specific analyses were performed on common cancer sites identified as having low survival (5-year relative survival <33%) or high incidence and high survival (incidence >20.0 per 100 000 and 5-year relative survival ≥66%). Results A total of 1 008 012 individuals were diagnosed with cancer during the first 2 years of the COVID-19 pandemic, including 473 781 in 2020 (50.1% female; 51.0% diagnosed at ≥65 years; 11.5% Black, 15.8% Hispanic, 64.1% White, and 7.4% other race) and 534 231 in 2021 (50.3% female; 51.9% diagnosed at ≥65 years; 51.9% diagnosed at ≥65 years; 11.7% Black, 16.2% Hispanic, 62.9% White, and 7.9% other race). Compared with prepandemic trends, significant absolute reductions in 1-year CSS rates occurred for early-stage diagnoses in 2020 (−0.44 [95% CI, −0.54 to −0.34] percentage points) and 2021 (−0.27 [95% CI, −0.37 to −0.16] percentage points) and late-stage diagnoses in 2020 (−1.34 [95% CI, −1.75 to −0.93] percentage points) and 2021 (−1.20 [95% CI, −1.69 to −0.71] percentage points). Survival reductions resulted in an estimated 17 390 more cancer-related deaths (13.1%) within 1 year of diagnosis than expected during the first 2 years of the COVID-19 pandemic. Absolute survival reductions greater than 1.00 percentage point occurred in both years for late-stage diagnoses among individuals of other non-Hispanic race and ethnicity (ie, American Indian and Alaska Native, Asian or Pacific Islander, or unknown race) and individuals aged 65 years or older. Significant site-specific survival reductions also existed in both 2020 and 2021, respectively, for early-stage diagnoses of esophageal cancer (−3.89 and −3.67 percentage points) and colorectal cancer (−1.08 and −0.78 percentage points) and late-stage diagnoses of prostate cancer (−0.64 and −0.77 percentage points). Conclusions and Relevance This cohort study found that individuals diagnosed with cancer in 2020 and 2021 experienc
{"title":"Survival of Patients Diagnosed With Cancer During the COVID-19 Pandemic","authors":"Todd Burus, Haluk Damgacioglu, Bin Huang, Thomas C. Tucker, Ashish A. Deshmukh, Krystle A. Lang Kuhs","doi":"10.1001/jamaoncol.2025.6332","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.6332","url":null,"abstract":"Importance The effects of COVID-19 pandemic–related disruptions on cancer diagnosis in the US have been widely observed, but their impact on short-term survival has not been assessed. Objective To examine 1-year cause-specific survival (CSS) rates among patients diagnosed with cancer during 2020 and 2021 using high-quality cancer registry data. Design, Setting, and Participants This population-based cohort study of cancer survival between 2015 and 2021 used the Surveillance, Epidemiology, and End Results 21 Registries (SEER-21) database. The population included individuals with an invasive cancer diagnosis and complete follow-up reported to registries included in SEER-21 between January 1, 2015, and December 31, 2021. Data were analyzed from May 13 to May 27, 2025. Exposure COVID-19 pandemic. Main Outcomes and Measures The primary outcome was 1-year CSS rates by stage at diagnosis for patients diagnosed with cancer in 2020 and 2021 compared with trends in 1-year CSS rates among patients diagnosed between 2015 and 2019. Additional site-specific analyses were performed on common cancer sites identified as having low survival (5-year relative survival <33%) or high incidence and high survival (incidence >20.0 per 100 000 and 5-year relative survival ≥66%). Results A total of 1 008 012 individuals were diagnosed with cancer during the first 2 years of the COVID-19 pandemic, including 473 781 in 2020 (50.1% female; 51.0% diagnosed at ≥65 years; 11.5% Black, 15.8% Hispanic, 64.1% White, and 7.4% other race) and 534 231 in 2021 (50.3% female; 51.9% diagnosed at ≥65 years; 51.9% diagnosed at ≥65 years; 11.7% Black, 16.2% Hispanic, 62.9% White, and 7.9% other race). Compared with prepandemic trends, significant absolute reductions in 1-year CSS rates occurred for early-stage diagnoses in 2020 (−0.44 [95% CI, −0.54 to −0.34] percentage points) and 2021 (−0.27 [95% CI, −0.37 to −0.16] percentage points) and late-stage diagnoses in 2020 (−1.34 [95% CI, −1.75 to −0.93] percentage points) and 2021 (−1.20 [95% CI, −1.69 to −0.71] percentage points). Survival reductions resulted in an estimated 17 390 more cancer-related deaths (13.1%) within 1 year of diagnosis than expected during the first 2 years of the COVID-19 pandemic. Absolute survival reductions greater than 1.00 percentage point occurred in both years for late-stage diagnoses among individuals of other non-Hispanic race and ethnicity (ie, American Indian and Alaska Native, Asian or Pacific Islander, or unknown race) and individuals aged 65 years or older. Significant site-specific survival reductions also existed in both 2020 and 2021, respectively, for early-stage diagnoses of esophageal cancer (−3.89 and −3.67 percentage points) and colorectal cancer (−1.08 and −0.78 percentage points) and late-stage diagnoses of prostate cancer (−0.64 and −0.77 percentage points). Conclusions and Relevance This cohort study found that individuals diagnosed with cancer in 2020 and 2021 experienc","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"301 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-29DOI: 10.1001/jamaoncol.2025.6100
Fawad A. Khan, Mohammed S. Khan, Ryan Pferdehirt
This Viewpoint discusses discordance in code status decisions between clinicians and patients with end-stage cancer and provides ethical frameworks for its resolution.
本观点讨论了临床医生和终末期癌症患者之间的编码状态决策的不一致，并为其解决提供了伦理框架。
{"title":"Code Status Decisions for End-Stage Cancer—Resolving the Ethical Dissonance","authors":"Fawad A. Khan, Mohammed S. Khan, Ryan Pferdehirt","doi":"10.1001/jamaoncol.2025.6100","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.6100","url":null,"abstract":"This Viewpoint discusses discordance in code status decisions between clinicians and patients with end-stage cancer and provides ethical frameworks for its resolution.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"7 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146071764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-29DOI: 10.1001/jamaoncol.2025.6196
Suzanne G. Orchard, Galina Polekhina, John Zalcberg, Wendy Bernstein, Finlay Macrae, Jeanne Tie, Lucy Gately, Victoria Mar, Jeremy Millar, Luz Maria Rodriguez, G. J. van Londen, Aaron Kent, Emma Hiscutt, Wee Loon Ong, Erica T. Warner, Leslie Ford, Asad Umar, John J. McNeil, Mark Nelson, Nigel Stocks, Raj C. Shah, Brenda Kirpach, Anne Murray, Robyn L. Woods, Joanne Ryan, Rory Wolfe, Peter Gibbs, Andrew T. Chan
Importance Prior studies, largely among middle-aged adults, reported aspirin reduces cancer risk after 10 years, particularly for colorectal cancer (CRC). In contrast, the Aspirin in Reducing Events in the Elderly (ASPREE) randomized clinical trial (RCT) reported that low-dose aspirin (LDA) treatment for a median of 4.7 years had no effect on overall cancer incidence but increased risk of incident late-stage cancer and cancer-related mortality. Objective To assess whether LDA is associated with cancer incidence and mortality in 10 years of follow-up in older adults (aged ≥70 years) and to assess the association with cancer after prior LDA exposure (legacy effects). Design, Setting, and Participants This community-based binational (Australian and US) cohort study included community-dwelling older adults (aged ≥70 years for Australian participants and ≥65 years for US minority group participants) free from overt cardiovascular disease, dementia, or independence-limiting physical disability. The cohort was derived from the ASPREE randomized clinical trial conducted from 2010 to 2017, with the observational extension study (ASPREE-XT) following up participants from 2018 to 2024. This study reports data from 2010 through 2022 (long-term outcomes) as well as reports analyses confined to the observation phase only (legacy analyses). Data were analyzed from May to November 2025. Intervention Daily 100-mg aspirin or placebo from randomization until cessation of study drug. Main Outcomes and Measures Outcomes were physician-adjudicated incident cancer, type, stage at diagnosis, and cancer mortality. Results In 19 114 community-dwelling older adults (mean [SD] age, 75.1 [4.5] years; 56.4% female), a total of 3448 incident cancers and 1173 cancer-related deaths occurred over 10 years of follow-up (median, 8.6 [IQR, 7.4-10.0] years) during ASPREE and ASPREE-XT. LDA was not associated with overall cancer incidence over the long term (hazard ratio [HR] = 0.98; 95% CI, 0.92-1.05), by stage at diagnosis or cancer type, including colorectal cancer (HR = 1.01; 95% CI, 0.84-1.21). However, LDA was associated with increased cancer-related mortality (HR = 1.15; 95% CI, 1.03-1.29). Among 14 907 participants without cancer during the RCT and consented into ASPREE-XT (median age, 78.6 years [IQR, 76.2-82.1]; 57.5% female), 1451 incident cancers and 376 cancer deaths occurred in the post-RCT period, during which original aspirin assignment during the RCT was not associated with differences in cancer incidence (HR = 0.91; 95% CI, 0.82-1.01) or cancer-related mortality (HR = 1.02; 95% CI, 0.83-1.25) compared with original placebo assignment. Conclusions and Relevance In this study, over a median of 8.6 years, LDA was not associated with incident cancer among older adults, but cancer mortality risk was significantly elevated. However, the elevated cancer mortality risk seen with aspirin for participants in the RCT period did not persist into the post-RCT observation period,
{"title":"Cancer Incidence and Mortality With Aspirin in Older Adults","authors":"Suzanne G. Orchard, Galina Polekhina, John Zalcberg, Wendy Bernstein, Finlay Macrae, Jeanne Tie, Lucy Gately, Victoria Mar, Jeremy Millar, Luz Maria Rodriguez, G. J. van Londen, Aaron Kent, Emma Hiscutt, Wee Loon Ong, Erica T. Warner, Leslie Ford, Asad Umar, John J. McNeil, Mark Nelson, Nigel Stocks, Raj C. Shah, Brenda Kirpach, Anne Murray, Robyn L. Woods, Joanne Ryan, Rory Wolfe, Peter Gibbs, Andrew T. Chan","doi":"10.1001/jamaoncol.2025.6196","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.6196","url":null,"abstract":"Importance Prior studies, largely among middle-aged adults, reported aspirin reduces cancer risk after 10 years, particularly for colorectal cancer (CRC). In contrast, the Aspirin in Reducing Events in the Elderly (ASPREE) randomized clinical trial (RCT) reported that low-dose aspirin (LDA) treatment for a median of 4.7 years had no effect on overall cancer incidence but increased risk of incident late-stage cancer and cancer-related mortality. Objective To assess whether LDA is associated with cancer incidence and mortality in 10 years of follow-up in older adults (aged ≥70 years) and to assess the association with cancer after prior LDA exposure (legacy effects). Design, Setting, and Participants This community-based binational (Australian and US) cohort study included community-dwelling older adults (aged ≥70 years for Australian participants and ≥65 years for US minority group participants) free from overt cardiovascular disease, dementia, or independence-limiting physical disability. The cohort was derived from the ASPREE randomized clinical trial conducted from 2010 to 2017, with the observational extension study (ASPREE-XT) following up participants from 2018 to 2024. This study reports data from 2010 through 2022 (long-term outcomes) as well as reports analyses confined to the observation phase only (legacy analyses). Data were analyzed from May to November 2025. Intervention Daily 100-mg aspirin or placebo from randomization until cessation of study drug. Main Outcomes and Measures Outcomes were physician-adjudicated incident cancer, type, stage at diagnosis, and cancer mortality. Results In 19 114 community-dwelling older adults (mean [SD] age, 75.1 [4.5] years; 56.4% female), a total of 3448 incident cancers and 1173 cancer-related deaths occurred over 10 years of follow-up (median, 8.6 [IQR, 7.4-10.0] years) during ASPREE and ASPREE-XT. LDA was not associated with overall cancer incidence over the long term (hazard ratio [HR] = 0.98; 95% CI, 0.92-1.05), by stage at diagnosis or cancer type, including colorectal cancer (HR = 1.01; 95% CI, 0.84-1.21). However, LDA was associated with increased cancer-related mortality (HR = 1.15; 95% CI, 1.03-1.29). Among 14 907 participants without cancer during the RCT and consented into ASPREE-XT (median age, 78.6 years [IQR, 76.2-82.1]; 57.5% female), 1451 incident cancers and 376 cancer deaths occurred in the post-RCT period, during which original aspirin assignment during the RCT was not associated with differences in cancer incidence (HR = 0.91; 95% CI, 0.82-1.01) or cancer-related mortality (HR = 1.02; 95% CI, 0.83-1.25) compared with original placebo assignment. Conclusions and Relevance In this study, over a median of 8.6 years, LDA was not associated with incident cancer among older adults, but cancer mortality risk was significantly elevated. However, the elevated cancer mortality risk seen with aspirin for participants in the RCT period did not persist into the post-RCT observation period, ","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"4 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146071493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IMPORTANCE Programmed cell death 1 protein (PD-1) or programmed cell death 1 ligand 1 inhibitors plus chemotherapy is the current standard first-line treatment of recurrent or metastatic nasopharyngeal carcinoma (RM-NPC). However, the long-term survival benefits at the 5-year benchmark remain uncertain. OBJECTIVE To determine whether adding camrelizumab to chemotherapy significantly improved 5-year overall survival (OS) as first-line treatment for RM-NPC, compared with chemotherapy alone. DESIGN, SETTING, AND PARTICIPANTS The CAPTAIN-1st trial was a randomized, double-blind, phase 3 trial conducted at 28 hospitals in China. Between November 13, 2018, and November 29, 2019, patients with treatment-naive RM-NPC were enrolled. This secondary analysis of the CAPTAIN-1st trial was prespecified. Data analysis was conducted on June 1, 2025. INTERVENTIONS Patients were randomized (1:1) to receive camrelizumab or placebo in combination with gemcitabine and cisplatin for 4 to 6 cycles, followed by maintenance therapy with camrelizumab or placebo until disease progression, unacceptable toxic effects, or completion of 2 years of treatment. MAIN OUTCOME The primary end point, progression-free survival per independent review committee, has been reported previously. Herein, the secondary end point of OS is reported as prespecified in the protocol. RESULTS Among 263 randomized patients (134 in randomized to camrelizumab, 129 to placebo), baseline characteristics were generally balanced between groups, except for age. The mean (SD) age was 49 (11.25) years, and 218 patients (82.9%) were male individuals, 45 (17.1%) were female individuals. With a median survival follow-up of 63.5 (95% CI, 61.2-64.6) months for the camrelizumab group and 63.0 (95% CI, 60.8-64.6) months for the placebo group, 85 (63.4%) and 95 (73.6%) deaths occurred, respectively. Median OS was 34.5 months (95% CI, 29.4-45.7) with camrelizumab vs 26.6 months (95% CI, 19.8-33.5) with placebo (hazard ratio [HR], 0.74; 95% CI, 0.55-0.99; 2-sided <jats:italic>P</jats:italic> = .047). After adjusting for age imbalance, the HR was 0.65 (95% CI, 0.48-0.89; <jats:italic>P</jats:italic> = .01). The 5-year OS rates were 37.8% vs 24.2%, reflecting an absolute difference of 13.6% (95% CI, 2.4%-24.8%; <jats:italic>P</jats:italic> = .02) in favor of camrelizumab. The OS benefits were generally consistent across subgroups. In the camrelizumab group, patients who achieved rapid clearance of Epstein-Barr virus (EBV) DNA had significantly longer OS compared with those without EBV DNA clearance (HR, 0.32; 95% CI, 0.18-0.58; <jats:italic>P</jats:italic> &lt; .001). CONCLUSIONS AND RELEVANCE In this secondary analysis of a randomized clinical trial, the addition of camrelizumab to chemotherapy produced statistically significant and clinically meaningful 5-year OS benefits compared with chemotherapy alone in the first-line treatment of RM-NPC. These findings provided the first 5-year evidence supporting the ben
{"title":"Five-Year Outcome of Camrelizumab Plus Chemotherapy in Recurrent or Metastatic Nasopharyngeal Carcinoma","authors":"Yan Huang, Dongchen Sun, Huaqiang Zhou, Ting Zhou, Song Qu, Jingao Li, Chaosu Hu, Mingjun Xu, Weidong Li, Liangfang Shen, Hui Wu, Jinyi Lang, Guangyuan Hu, Zhanxiong Luo, Zhichao Fu, Shenhong Qu, Weineng Feng, Xiaozhong Chen, Shaojun Lin, Bo Xie, Xiaojiang Li, Yan Sun, Zhixiong Lin, Qin Lin, Feng Lei, Jianting Long, Jinsheng Hong, Xiaoming Huang, Lingzhi Zeng, Peiguo Wang, Xiaohui He, Shen Zhao, Gang Chen, Yaxiong Zhang, Yuanyuan Zhao, Wenfeng Fang, Chuanpei Huang, Xiaotong Li, Shaodong Hong, Li Zhang, Yunpeng Yang","doi":"10.1001/jamaoncol.2025.6245","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.6245","url":null,"abstract":"IMPORTANCE Programmed cell death 1 protein (PD-1) or programmed cell death 1 ligand 1 inhibitors plus chemotherapy is the current standard first-line treatment of recurrent or metastatic nasopharyngeal carcinoma (RM-NPC). However, the long-term survival benefits at the 5-year benchmark remain uncertain. OBJECTIVE To determine whether adding camrelizumab to chemotherapy significantly improved 5-year overall survival (OS) as first-line treatment for RM-NPC, compared with chemotherapy alone. DESIGN, SETTING, AND PARTICIPANTS The CAPTAIN-1st trial was a randomized, double-blind, phase 3 trial conducted at 28 hospitals in China. Between November 13, 2018, and November 29, 2019, patients with treatment-naive RM-NPC were enrolled. This secondary analysis of the CAPTAIN-1st trial was prespecified. Data analysis was conducted on June 1, 2025. INTERVENTIONS Patients were randomized (1:1) to receive camrelizumab or placebo in combination with gemcitabine and cisplatin for 4 to 6 cycles, followed by maintenance therapy with camrelizumab or placebo until disease progression, unacceptable toxic effects, or completion of 2 years of treatment. MAIN OUTCOME The primary end point, progression-free survival per independent review committee, has been reported previously. Herein, the secondary end point of OS is reported as prespecified in the protocol. RESULTS Among 263 randomized patients (134 in randomized to camrelizumab, 129 to placebo), baseline characteristics were generally balanced between groups, except for age. The mean (SD) age was 49 (11.25) years, and 218 patients (82.9%) were male individuals, 45 (17.1%) were female individuals. With a median survival follow-up of 63.5 (95% CI, 61.2-64.6) months for the camrelizumab group and 63.0 (95% CI, 60.8-64.6) months for the placebo group, 85 (63.4%) and 95 (73.6%) deaths occurred, respectively. Median OS was 34.5 months (95% CI, 29.4-45.7) with camrelizumab vs 26.6 months (95% CI, 19.8-33.5) with placebo (hazard ratio [HR], 0.74; 95% CI, 0.55-0.99; 2-sided <jats:italic>P</jats:italic> = .047). After adjusting for age imbalance, the HR was 0.65 (95% CI, 0.48-0.89; <jats:italic>P</jats:italic> = .01). The 5-year OS rates were 37.8% vs 24.2%, reflecting an absolute difference of 13.6% (95% CI, 2.4%-24.8%; <jats:italic>P</jats:italic> = .02) in favor of camrelizumab. The OS benefits were generally consistent across subgroups. In the camrelizumab group, patients who achieved rapid clearance of Epstein-Barr virus (EBV) DNA had significantly longer OS compared with those without EBV DNA clearance (HR, 0.32; 95% CI, 0.18-0.58; <jats:italic>P</jats:italic> &amp;lt; .001). CONCLUSIONS AND RELEVANCE In this secondary analysis of a randomized clinical trial, the addition of camrelizumab to chemotherapy produced statistically significant and clinically meaningful 5-year OS benefits compared with chemotherapy alone in the first-line treatment of RM-NPC. These findings provided the first 5-year evidence supporting the ben","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"279 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146071471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1001/jamaoncol.2025.6092
Brandon R Block,Jaanvi Mehta,Shayan Owji,Dan Feng,Thomas U Marron,Nicholas Gulati
{"title":"Morbidity and Mortality Outcomes of Dupilumab for Cutaneous Immune-Related Adverse Events.","authors":"Brandon R Block,Jaanvi Mehta,Shayan Owji,Dan Feng,Thomas U Marron,Nicholas Gulati","doi":"10.1001/jamaoncol.2025.6092","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.6092","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"20 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1001/jamaoncol.2025.6080
Rashidul Alam Mahumud,Yifu Chen,Md Shahjalal,Padam Kanta Dahal,Khorshed Alam
ImportanceAdjuvant immunotherapy is increasingly integrated into cancer care to reduce recurrence and improve survival. However, its high cost raises critical concerns regarding affordability and economic value across diverse health system contexts.ObjectiveTo synthesize published economic evaluations of adjuvant immunotherapy and assess cost-effectiveness outcomes, quality-adjusted life-year (QALY)/life-year (LY) gains, and methodologic approaches.Evidence ReviewA systematic search was conducted of PubMed, Scopus, Embase, and Web of Science for full economic evaluations published between January 1, 2015, and January 31, 2025. Eligible studies included cost-effectiveness or cost-utility analyses of adjuvant immunotherapy across any cancer type. Data were extracted on cancer type, treatment strategy (single vs combination therapy), treatment line, model structure, health utility instruments, funding sources, and cost-effectiveness outcomes. Methodologic quality was appraised using the Criteria for Health Economic Quality Evaluation 2023. Due to heterogeneity of health systems, findings were narratively synthesized.FindingsThe analysis included 69 studies covering a range of cancer types, most frequently non-small cell lung cancer and melanoma. Of these, 46 (67%) evaluated first-line therapy with single-agent checkpoint inhibitors. Higher QALY/LY gains were consistently reported among the adjuvant immunotherapy group (63 [91%]), particularly for non-small cell lung cancer, industry-funded studies, and combination regimens. More than half of the evaluations (40 [58%]) concluded that adjuvant immunotherapy was cost-effective, although results varied by cancer type, model assumptions, drug pricing, funding organizations, and country-specific thresholds. Markov modeling was the dominant analytic approach (46 [67%]) and EuroQol 5 Dimensions was the most commonly used health utility instrument (56 [81%]).Conclusions and RelevanceThis systematic review found that adjuvant immunotherapy was frequently associated with meaningful QALY/LY improvements and was often considered cost-effective in high-risk or first-line settings. However, economic value remains context-specific, shaped by treatment strategy, drug costs, and modeling assumptions. These findings support the selective, value-based adoption of adjuvant immunotherapy and underscore the need for transparent, standardized economic evaluations to guide reimbursement and policy decisions.
辅助免疫治疗越来越多地融入到癌症治疗中，以减少复发和提高生存率。然而，它的高成本引起了人们对不同卫生系统背景下可负担性和经济价值的严重关切。目的综合已发表的辅助免疫治疗的经济评价，评估成本-效果、质量调整生命年(QALY)/生命年（LY）收益和方法学方法。对PubMed、Scopus、Embase和Web of Science进行系统检索，获取2015年1月1日至2025年1月31日之间发表的完整经济评估。符合条件的研究包括任何癌症类型的辅助免疫治疗的成本-效果或成本-效用分析。数据包括癌症类型、治疗策略（单一与联合治疗）、治疗线、模式结构、卫生实用工具、资金来源和成本-效果结果。采用《卫生经济质量评价标准2023》对方法学质量进行评价。由于卫生系统的异质性，研究结果是叙述性综合的。该分析包括69项研究，涵盖了一系列癌症类型，最常见的是非小细胞肺癌和黑色素瘤。其中，46个（67%）评估了单药检查点抑制剂的一线治疗。在辅助免疫治疗组（63[91%]），特别是对于非小细胞肺癌、行业资助的研究和联合治疗方案，有更高的QALY/LY增益的报道。超过一半的评估（40项[58%]）得出结论认为辅助免疫治疗具有成本效益，尽管结果因癌症类型、模型假设、药物定价、资助组织和国家特定阈值而异。马尔可夫模型是主要的分析方法（46例[67%]），EuroQol 5 Dimensions是最常用的健康效用工具（56例[81%]）。结论和相关性本系统综述发现，辅助免疫治疗通常与有意义的QALY/LY改善相关，并且通常被认为在高风险或一线环境中具有成本效益。然而，经济价值仍然取决于具体情况，受治疗策略、药物成本和建模假设的影响。这些发现支持选择性的、基于价值的辅助免疫治疗的采用，并强调需要透明、标准化的经济评估来指导报销和政策决策。
{"title":"Cost-Effectiveness of Adjuvant Immunotherapy in Cancer Treatments: A Systematic Review.","authors":"Rashidul Alam Mahumud,Yifu Chen,Md Shahjalal,Padam Kanta Dahal,Khorshed Alam","doi":"10.1001/jamaoncol.2025.6080","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.6080","url":null,"abstract":"ImportanceAdjuvant immunotherapy is increasingly integrated into cancer care to reduce recurrence and improve survival. However, its high cost raises critical concerns regarding affordability and economic value across diverse health system contexts.ObjectiveTo synthesize published economic evaluations of adjuvant immunotherapy and assess cost-effectiveness outcomes, quality-adjusted life-year (QALY)/life-year (LY) gains, and methodologic approaches.Evidence ReviewA systematic search was conducted of PubMed, Scopus, Embase, and Web of Science for full economic evaluations published between January 1, 2015, and January 31, 2025. Eligible studies included cost-effectiveness or cost-utility analyses of adjuvant immunotherapy across any cancer type. Data were extracted on cancer type, treatment strategy (single vs combination therapy), treatment line, model structure, health utility instruments, funding sources, and cost-effectiveness outcomes. Methodologic quality was appraised using the Criteria for Health Economic Quality Evaluation 2023. Due to heterogeneity of health systems, findings were narratively synthesized.FindingsThe analysis included 69 studies covering a range of cancer types, most frequently non-small cell lung cancer and melanoma. Of these, 46 (67%) evaluated first-line therapy with single-agent checkpoint inhibitors. Higher QALY/LY gains were consistently reported among the adjuvant immunotherapy group (63 [91%]), particularly for non-small cell lung cancer, industry-funded studies, and combination regimens. More than half of the evaluations (40 [58%]) concluded that adjuvant immunotherapy was cost-effective, although results varied by cancer type, model assumptions, drug pricing, funding organizations, and country-specific thresholds. Markov modeling was the dominant analytic approach (46 [67%]) and EuroQol 5 Dimensions was the most commonly used health utility instrument (56 [81%]).Conclusions and RelevanceThis systematic review found that adjuvant immunotherapy was frequently associated with meaningful QALY/LY improvements and was often considered cost-effective in high-risk or first-line settings. However, economic value remains context-specific, shaped by treatment strategy, drug costs, and modeling assumptions. These findings support the selective, value-based adoption of adjuvant immunotherapy and underscore the need for transparent, standardized economic evaluations to guide reimbursement and policy decisions.","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"396 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1001/jamaoncol.2025.5941
Bibek Aryal
{"title":"Make Every Cancer Case Count-A Call From the Mountains.","authors":"Bibek Aryal","doi":"10.1001/jamaoncol.2025.5941","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.5941","url":null,"abstract":"","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"180 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-15DOI: 10.1001/jamaoncol.2025.5934
Anne Rudbeck Juhl, Andreas Glenthøj, Børge Grønne Nordestgaard, Jesper Petersen, Michael Huy Cuong Pham, Klaus Fuglsang Kofoed, Jørgen Tobias Kühl, Andreas Fuchs, Per Ejlstrup Sigvardsen, Thomas Skårup Kristensen, Stig Egil Bojesen, Rasmus Rønnemoes, Jens Helby
Importance Splenomegaly is often detected incidentally, but it is unknown at which spleen length or volume risk of hematologic cancer or liver disease is substantially increased, and evidence lacks on when it is beneficial to evaluate individuals with splenomegaly for underlying disease. Objective To evaluate relative and absolute risks of hematologic cancers, cirrhosis, and liver cancer according to spleen length and volume in individuals with incidentally detected splenomegaly. Design, Setting, and Participants This prospective cohort study used data from 2 independent general population cohorts from Denmark and the UK. Participants had computed tomography or magnetic resonance imaging scans performed as part of study procedures from January 2012 to February 2020 for Danish individuals and from April 2014 to October 2021 for UK individuals. Data were analyzed from April 2024 to November 2025. Exposures Spleen volume and spleen length. Main Outcomes and Measures Hematologic cancers, cirrhosis, and liver cancer during a median follow-up of 5 years after the computed tomography or magnetic resonance imaging scans. Results Among 8459 included Danish individuals, 4821 (57.0%) were female, and the median (IQR) age at scan date was 61 (54-69) years; among 38 607 included UK individuals, 20 048 (51.9%) were female, and the median (IQR) age at scan date was 65 (58-70) years. Spleen length was measured in 8440 Danish individuals, and spleen volume was measured in 8226 Danish and 38 607 UK individuals. Relative risk of any hematologic cancer was increased for Danish individuals with spleen lengths above the 99th percentile (greater than 134 mm) compared with spleen lengths in the 26th to 74th percentile (hazard ratio, 5.11; 95% CI, 2.00-13.06) and more pronounced for spleen volume above the 99th percentile (greater than 433 mL for Danish individuals; hazard ratio, 11.08; 95% CI, 5.44-22.59; greater than 386 mL for UK individuals; hazard ratio, 11.82; 95% CI, 6.98-20.02). When studying absolute risks using clinically applicable cutoffs, 5-year risks of any hematologic cancer were moderately increased for spleen length of 130 to 139 mm or spleen volume of 400 to 499 mL. Individuals with spleen length of 140 mm or greater had even higher risk, as 5-year risks reached 23% in Danish men and 12% in Danish women 70 years and older. Individuals with spleen volume of 500 mL or greater had particularly high risk, with absolute 5-year risks for any hematologic cancer of 46% and 27% in Danish men and women 70 years and older, respectively, while 5-year risks were 21% and 18% in UK men and women 70 years and older, respectively. Furthermore, absolute 5-year risks of cirrhosis and liver cancer were substantially increased in UK individuals with spleen volume of 400 mL or greater, with 5-year risks for cirrhosis reaching 10.8% in men and 9.3% in women 70 years and older with spleen volume of 500 mL or greater. Five-year risks for liver cancer were 3.2% in men and 1.2% i
{"title":"Incidentally Detected Splenomegaly and Risk of Hematologic Cancer and Liver Disease","authors":"Anne Rudbeck Juhl, Andreas Glenthøj, Børge Grønne Nordestgaard, Jesper Petersen, Michael Huy Cuong Pham, Klaus Fuglsang Kofoed, Jørgen Tobias Kühl, Andreas Fuchs, Per Ejlstrup Sigvardsen, Thomas Skårup Kristensen, Stig Egil Bojesen, Rasmus Rønnemoes, Jens Helby","doi":"10.1001/jamaoncol.2025.5934","DOIUrl":"https://doi.org/10.1001/jamaoncol.2025.5934","url":null,"abstract":"Importance Splenomegaly is often detected incidentally, but it is unknown at which spleen length or volume risk of hematologic cancer or liver disease is substantially increased, and evidence lacks on when it is beneficial to evaluate individuals with splenomegaly for underlying disease. Objective To evaluate relative and absolute risks of hematologic cancers, cirrhosis, and liver cancer according to spleen length and volume in individuals with incidentally detected splenomegaly. Design, Setting, and Participants This prospective cohort study used data from 2 independent general population cohorts from Denmark and the UK. Participants had computed tomography or magnetic resonance imaging scans performed as part of study procedures from January 2012 to February 2020 for Danish individuals and from April 2014 to October 2021 for UK individuals. Data were analyzed from April 2024 to November 2025. Exposures Spleen volume and spleen length. Main Outcomes and Measures Hematologic cancers, cirrhosis, and liver cancer during a median follow-up of 5 years after the computed tomography or magnetic resonance imaging scans. Results Among 8459 included Danish individuals, 4821 (57.0%) were female, and the median (IQR) age at scan date was 61 (54-69) years; among 38 607 included UK individuals, 20 048 (51.9%) were female, and the median (IQR) age at scan date was 65 (58-70) years. Spleen length was measured in 8440 Danish individuals, and spleen volume was measured in 8226 Danish and 38 607 UK individuals. Relative risk of any hematologic cancer was increased for Danish individuals with spleen lengths above the 99th percentile (greater than 134 mm) compared with spleen lengths in the 26th to 74th percentile (hazard ratio, 5.11; 95% CI, 2.00-13.06) and more pronounced for spleen volume above the 99th percentile (greater than 433 mL for Danish individuals; hazard ratio, 11.08; 95% CI, 5.44-22.59; greater than 386 mL for UK individuals; hazard ratio, 11.82; 95% CI, 6.98-20.02). When studying absolute risks using clinically applicable cutoffs, 5-year risks of any hematologic cancer were moderately increased for spleen length of 130 to 139 mm or spleen volume of 400 to 499 mL. Individuals with spleen length of 140 mm or greater had even higher risk, as 5-year risks reached 23% in Danish men and 12% in Danish women 70 years and older. Individuals with spleen volume of 500 mL or greater had particularly high risk, with absolute 5-year risks for any hematologic cancer of 46% and 27% in Danish men and women 70 years and older, respectively, while 5-year risks were 21% and 18% in UK men and women 70 years and older, respectively. Furthermore, absolute 5-year risks of cirrhosis and liver cancer were substantially increased in UK individuals with spleen volume of 400 mL or greater, with 5-year risks for cirrhosis reaching 10.8% in men and 9.3% in women 70 years and older with spleen volume of 500 mL or greater. Five-year risks for liver cancer were 3.2% in men and 1.2% i","PeriodicalId":14850,"journal":{"name":"JAMA Oncology","volume":"81 1","pages":""},"PeriodicalIF":28.4,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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