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This Week in NEJM: Nov 3, 2011


A number of chemotherapy drugs are in short supply in the US, and according to this opinion article in NEJM , the main reason for the shortage is economic. "If manufacturers don't make enough profit, they won't make generic drugs," like many of these chemotherapy agents and, further, oncologists don't have much of an incentive to prescribe generic drugs since they themselves buy and sell chemotherapy agents, write Mandy Gatesman and Thomas Smith. The authors add that "to ensure a predictable supply of generic cancer drugs, manufacturers need reasonable markets and profits, and oncologists need incentives to use generics."

Another opinion piece in NEJM discusses the recent draft report from the US Preventive Services Task Force that recommends against prostate specific antigen screening for prostate cancer. Fritz Schröder points out that the report is limited due to its reliance on meta-analyses that included high- and low-quality data. He instead says risk stratification is important and that "PSA screening should not be dismissed as uniformly non-beneficial. Rather, decisions about screening should be made on an individual basis, by an informed patient and his clinician, after weighing that patient's particular risk factors."

The Scan

Genetic Risk Factors for Hypertension Can Help Identify Those at Risk for Cardiovascular Disease

Genetically predicted high blood pressure risk is also associated with increased cardiovascular disease risk, a new JAMA Cardiology study says.

Circulating Tumor DNA Linked to Post-Treatment Relapse in Breast Cancer

Post-treatment detection of circulating tumor DNA may identify breast cancer patients who are more likely to relapse, a new JCO Precision Oncology study finds.

Genetics Influence Level of Depression Tied to Trauma Exposure, Study Finds

Researchers examine the interplay of trauma, genetics, and major depressive disorder in JAMA Psychiatry.

UCLA Team Reports Cost-Effective Liquid Biopsy Approach for Cancer Detection

The researchers report in Nature Communications that their liquid biopsy approach has high specificity in detecting all- and early-stage cancers.