Rokhzan, Ramin; Meier, Katharina
doi: 10.1056/NEJMicm2111765pmid: 35687046
Targeted Therapy in MelanomaA 51-year-old man presented with metastatic melanoma. Initiation of treatment with targeted therapy elicited a dramatic response.
Evans, John P.; Qu, Panke; Zeng, Cong; Zheng, Yi-Min; Carlin, Claire; Bednash, Joseph S.; Lozanski, Gerard; Mallampalli, Rama K.; Saif, Linda J.; Oltz, Eugene M.; Mohler, Peter J.; Gumina, Richard J.; Liu, Shan-Lu
doi: 10.1056/NEJMc2205019pmid: 35584183
Neutralization of Deltacron and BA.3 SARS-CoV-2 VariantsA small study assessed the neutralization of pseudoviruses composed of the recombinant deltacron and omicron BA.3 variants. BA.3 did not show broad cross-resistance, but deltacron was largely resistant to immune response elicited either by three doses of mRNA vaccines or by previous infection.
doi: 10.1056/NEJMc2205309pmid: 35704496
To the Editor: In the DESTINY-Breast03 trial, Cortés et al. (Mar. 24 issue)1 found that trastuzumab deruxtecan therapy prolonged progression-free survival to a greater extent than trastuzumab emtansine therapy among patients with human epidermal growth factor receptor 2 (HER2)–positive metastatic breast cancer previously treated with trastuzumab and a taxane. The percentage of patients with an overall response (complete or partial response) increased from 60.9% in an earlier, phase 2, single-group study2 to 79.7% in the phase 3 trial. Furthermore, in the trial, 58.2% of the patients in the trastuzumab deruxtecan group were Asian and 27.2% were White; in the trastuzumab . . .
Rubin, Eric J.; Baden, Lindsey R.; Abraham, Jonathan; Morrissey, Stephen
doi: 10.1056/NEJMe2207933pmid: 35704488
Viral Evolution and the Future of Monoclonal AntibodiesIn this audio interview conducted on June 14, 2022, the editors are joined by structural biologist Jonathan Abraham to discuss the effects of viral evolution on the use of monoclonal antibodies to prevent and treat SARS-CoV-2 infection.
doi: 10.1056/NEJMp2201800pmid: 35544378
Climate Change in the Supreme CourtThe U.S. Supreme Court’s reasoning in two Covid-19 cases threatens the power of Congress to legislate against risks in advance. Now, West Virginia v. EPA could have broad implications for protecting public health.
Pollock, Jordan R.; Moore, M. Lane; McQuivey, Kade S.; Makovicka, Justin L.; Economopoulos, Kostas; Bingham, Joshua S.
doi: 10.1056/NEJMvcm2000815pmid: 35704483
Clinical Examination of the HipHip pain is common, and the hip joint is complex. Obtaining a relevant patient history and conducting a proper physical examination can be challenging. This video demonstrates how to assess a patient with hip pain.
doi: 10.1056/NEJMp2119103pmid: 35687048
“It’s Hardly Credible”Reading Camus’ The Plague, a physician wonders why the hero doesn’t prescribe sulfa drugs. If there’s such a thing as “literary malpractice,” she asks, is it the questionable prescribing of a fictional character or the heavy-footed perseverations of a too-literal reader?
Blanco, Carlos; Kato, Elisabeth U.; Aklin, Will M.; Tong, Sebastian T.; Bierman, Arlene; Meyers, David; Volkow, Nora D.
doi: 10.1056/NEJMp2202740pmid: 35687034
Research to Move PolicyAddressing the overdose epidemic requires eliminating racial and ethnic disparities — along with socioeconomic, gender-based, and geographic disparities — in substance use disorder prevention and care. Prioritizing research that informs policy could help advance equity.
Palefsky, Joel M.; Lee, Jeannette Y.; Jay, Naomi; Goldstone, Stephen E.; Darragh, Teresa M.; Dunlevy, Hillary A.; Rosa-Cunha, Isabella; Arons, Abigail; Pugliese, Julia C.; Vena, Don; Sparano, Joseph A.; Wilkin, Timothy J.; Bucher, Gary; Stier, Elizabeth A.; Tirado Gomez, Maribel;
Showing 1 to 10 of 25 Articles
doi: 10.1056/NEJMoa2201048pmid: 35704479
AbstractBackgroundThe incidence of anal cancer is substantially higher among persons living with the human immunodeficiency virus (HIV) than in the general population. Similar to cervical cancer, anal cancer is preceded by high-grade squamous intraepithelial lesions (HSILs). Treatment for cervical HSIL reduces progression to cervical cancer; however, data from prospective studies of treatment for anal HSIL to prevent anal cancer are lacking.MethodsWe conducted a phase 3 trial at 25 U.S. sites. Persons living with HIV who were 35 years of age or older and who had biopsy-proven anal HSIL were randomly assigned, in a 1:1 ratio, to receive either HSIL treatment or active monitoring without treatment. Treatment included office-based ablative procedures, ablation or excision under anesthesia, or the administration of topical fluorouracil or imiquimod. The primary outcome was progression to anal cancer in a time-to-event analysis. Participants in the treatment group were treated until HSIL was completely resolved. All the participants underwent high-resolution anoscopy at least every 6 months; biopsy was also performed for suspected ongoing HSIL in the treatment group, annually in the active-monitoring group, or any time there was concern for cancer.ResultsOf 4459 participants who underwent randomization, 4446 (99.7%) were included in the analysis of the time to progression to cancer. With a median follow-up of 25.8 months, 9 cases were diagnosed in the treatment group (173 per 100,000 person-years; 95% confidence interval [CI], 90 to 332) and 21 cases in the active-monitoring group (402 per 100,000 person-years; 95% CI, 262 to 616). The rate of progression to anal cancer was lower in the treatment group than in the active-monitoring group by 57% (95% CI, 6 to 80; P=0.03 by log-rank test).ConclusionsAmong participants with biopsy-proven anal HSIL, the risk of anal cancer was significantly lower with treatment for anal HSIL than with active monitoring. (Funded by the National Cancer Institute; ClinicalTrials.gov number, NCT02135419.)