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This Week in JAMA: Feb 23, 2011


In JAMA this week, an international group of researchers present their findings on the accuracy and outcomes of screening mammography in women with a personal history of early-stage breast cancer. The researchers studied 58,870 screening mammograms from 19,078 women with a history of early-stage breast cancer and 58,870 matched screening mammograms from 55,315 women without a history of breast cancer. The team found that within one year after screening, 655 cancers were observed in women with a personal history of breast cancer, compared to 342 cancers in women with no personal history of breast cancer. "Mammography screening in women [with a personal history of breast cancer] detects early-stage second breast cancers but has lower sensitivity and higher interval cancer rate, despite more evaluation and higher underlying cancer rate, relative to that in women [without a history of breast cancer]," they conclude.

Also in JAMA this week, researchers in Maryland present their study on targeting immune dysregulation in myelodysplastic syndromes. In some patients, laboratory and clinical evidence suggests the immune system plays a role in the pathogenesis of early myelodysplastic syndromes, the authors write. "Many younger patients who respond to immunosuppressive therapy with drugs such as antithymocyte globulin and cyclosporine have clonal expansions of cytotoxic CD8+ T cells that suppress normal hematopoiesis, as well as expansion of CD4+ helper T-cell subsets that promote and sustain autoimmunity," they add. Immunosuppressive therapy could improve survival rates and halt leukemic progression, the researcher conclude.

And finally in JAMA this week, Rebecca Voelker writes about trial results some found disappointing, but which could provide "hope" for older women with breast cancer. The AZURE trial — a large Phase III trial of adjuvant biphosphonate therapy in women with breast cancer — disappointed researchers when it showed that zoledronic acid doesn't improve overall survival or prevent cancer recurrence. But the study generated a new hypothesis, Voelker says, "adjuvant therapy with the bone-building drug may improve survival odds and reduce the risk of disease progression in women with low estrogen levels from natural menopause or medication-induced ovarian suppression."

The Scan

Researchers Compare WGS, Exome Sequencing-Based Mendelian Disease Diagnosis

Investigators find a diagnostic edge for whole-genome sequencing, while highlighting the cost advantages and improving diagnostic rate of exome sequencing in EJHG.

Researchers Retrace Key Mutations in Reassorted H1N1 Swine Flu Virus With Avian-Like Features

Mutations in the acidic polymerase-coding gene boost the pathogenicity and transmissibility of Eurasian avian-like H1N1 swine influenza viruses, a PNAS paper finds.

Genome Sequences Reveal Evolutionary History of South America's Canids

An analysis in PNAS of South American canid species' genomes offers a look at their evolutionary history, as well as their relationships and adaptations.

Lung Cancer Response to Checkpoint Inhibitors Reflected in Circulating Tumor DNA

In non-small cell lung cancer patients, researchers find in JCO Precision Oncology that survival benefits after immune checkpoint blockade coincide with a dip in ctDNA levels.