- N Engl J Med 2022; 387:356-365
A 49-year-old man with a family history of diabetes was evaluated because of hypoglycemia. Two hours earlier, he had been found on the floor, obtunded and making nonpurposeful movements. A diagnostic test was performed.
- N Engl J Med 2022; 387:355-355
A 59-year-old woman with a history of smoking tobacco presented with a 5-month history of darkening of the skin on her palms. Velvety thickening on the palms and fingers was observed on physical examination.
- N Engl J Med 2022; 386:2413-2423
A 29-year-old woman was evaluated for a soft-tissue mass in the pancreatic head, discovered after diarrhea and jaundice occurred. Diagnostic procedures were performed, and management decisions were made.
- N Engl J Med 2022; 386:2363-2376
Sixteen patients with mismatch repair–deficient, locally advanced rectal cancer were enrolled in a pilot study in which 6 months of neoadjuvant anti–PD-1 therapy was to be followed by surgical resection. Twelve patients have completed treatment and have had at least 6 months of follow-up; all 12 had a clinical complete...
- N Engl J Med 2022; 386:2425-2426
The cure rate for nonmetastatic rectal cancer has been improving for decades. Treatment for stage II and III rectal adenocarcinomas now routinely includes surgery, radiation therapy, and chemotherapy. The results of recent phase 3 trials have led to an increase in the intensity of treatment to include multiagent chemotherapy in...
- N Engl J Med 2022; 386:2261-2272
In a randomized, controlled trial, a ctDNA-guided approach to the postsurgical treatment of stage II colon cancer reduced adjuvant chemotherapy use without compromising recurrence-free survival.
- N Engl J Med 2022; 386:2330-2331
Liquid biopsy, the detection of tumor-related DNA in the peripheral blood, is currently the best available technological tool to improve clinical decision making in precision oncology.1 Liquid biopsy currently has enough analytic and clinical validity to be implemented in routine practice for advanced disease genotyping to predict the...
- N Engl J Med 2022; 386:2273-2282
Like cervical cancer, anal cancer is often caused by a human papillomavirus and has a premalignant stage called high-grade squamous intraepithelial lesion or anal intraepithelial neoplasia. A randomized trial showed that treating HSIL led to a 57% reduction in progression to anal cancer as compared with active surveillance.
- N Engl J Med 2022; 386:2145-2148
This explanatory editorial elucidates the components and concepts behind a study, described in this issue of the Journal, that involves therapeutic targeting of pancreatic cancer with an autologous T cell engineered to have exquisite specificity for targeting the cancer cell.
- N Engl J Med 2022; 386:2143-2144
Pancreatic ductal adenocarcinoma is the deadliest of all common cancers. The reasons for this are the advanced cancer stage by the time symptoms are noted and the occult presence of micrometastases in the liver and elsewhere at the time of initial surgical treatment. In addition, systemic therapy with chemotherapy rarely...
- N Engl J Med 2022; 386:2112-2119
A 71-year-old woman with progressive pancreatic adenocarcinoma containing a mutated KRAS oncogene was given adoptive cellular therapy of her own T cells that had been altered to express two different T-cell receptors specific for her HLA type and the mutated KRAS in the tumor. Six months...
- N Engl J Med 2022; 386:1969-1971
A case that would otherwise have set off an avalanche of investigations and therapeutics, family meetings, and consultations was quietly referred for charity hospice care, though Ms. M.’s immigration status made acceptance even by a hospice agency precarious.
- N Engl J Med 2022; 386:e56
A 67-year-old man presented with a 1-month history of dyspnea and diarrhea. Thickened, stiff tricuspid-valve leaflets and tricuspid regurgitation were seen on transthoracic echocardiography (shown in videos), and abdominal imaging showed liver masses.
- N Engl J Med 2022; 386:1833-1833
A 74-year-old man with end-stage kidney disease and coronary artery disease presented with decreased responsiveness, anorexia, and generalized weakness. Computed tomography of the chest showed intramural gas in the ascending and descending aorta.
- N Engl J Med 2022; 386:1547-1558
Early-onset disease (at <50 years of age) accounts for 10% of colorectal cancer cases, and the incidence is increasing, particularly in high-income countries. Patients often present with advanced disease in the left colon. One in six patients has deficient DNA mismatch repair. Screening is now recommended to begin at 45...
- N Engl J Med 2022; 386:796-798
In this study involving non-Hispanic Black members and non-Hispanic White members of the Kaiser Permanente Northern California health plan from 2000 through 2019, colorectal cancer screening increased markedly among both Black members and White members, and racial disparities in colorectal cancer incidence and mortality were virtually eliminated.
- N Engl J Med 2022; 386:505-507
While facing an ophthalmic cancer diagnosis and treatment of his own, a gastroenterologist refocuses his good eye on his patients, helping them play whatever cards they have been dealt, as his scar is etched in survivor’s guilt.
- N Engl J Med 2022; 386:568-581
The third most common lymphoma, MZL is usually indolent and often a consequence of chronic antigenic stimulation from a pathogen such as Helicobacter pylori or hepatitis C virus. Some MZLs regress with treatment of the infection. Patients with genetic lesions are treated with chemoimmunotherapy.
- N Engl J Med 2022; 386:449-462
Previously untreated patients with advanced esophageal cancer were randomly assigned to receive chemotherapy alone, chemotherapy plus nivolumab, or nivolumab plus ipilimumab. Among patients with tumor-cell PD-L1 expression of 1% or greater, the two nivolumab regimens resulted in longer overall survival than chemotherapy. The side-effect profile was consistent with past reports...
- N Engl J Med 2022; 386:100-102
New guidelines recommend expansions of the populations that should undergo screening for lung or colorectal cancer. Without other changes, a substantial increase in screening could exacerbate inequities in access and delay follow-up of abnormal test results.