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41. Trastuzumab Deruxtecan plus Pertuzumab for HER2-Positive Metastatic Breast Cancer.
作者: Sara M Tolaney.;Zefei Jiang.;Qingyuan Zhang.;Romualdo Barroso-Sousa.;Yeon Hee Park.;Mothaffar F Rimawi.;Cristina Saura.;Andreas Schneeweiss.;Masakazu Toi.;Yee Soo Chae.;Yasemin Kemal.;Mukesh Chaudhari.;Mehmet A N Şendur.;Toshinari Yamashita.;Monica Casalnuovo.;Michael A Danso.;Jie Liu.;Jagdish Shetty.;Pia Herbolsheimer.;Sibylle Loibl.; .
来源: N Engl J Med. 2026年394卷6期551-562页
Trastuzumab deruxtecan has shown efficacy in patients with previously treated human epidermal growth factor receptor 2 (HER2)-positive advanced or metastatic breast cancer. The efficacy and safety of trastuzumab deruxtecan in patients with no previous therapy for HER2-positive advanced or metastatic breast cancer are unclear.
42. A Pragmatic Trial of Glucocorticoids for Community-Acquired Pneumonia.
作者: Ruth K Lucinde.;Henry Gathuri.;Paul Mwaniki.;Benedict Orindi.;Edwin O Otieno.;Stella Mwakio.;Lillian Mulemi.;Lynda Isaaka.;Jimmy Shangala.;Metrine Saisi.;Elizabeth Isinde.;Irene N Oginga.;Alvin W Wachira.;Evans Manuthu.;Hazel Kariuki.;Patrick Asaava.;Jared Nyikuli.;Cyprian Wekesa.;Amos Otedo.;Hannah Bosire.;Steve B Okoth.;Winston Ongalo.;David M Mukabi.;Wilberforce Lusamba.;Beatrice Muthui.;Isaac Adembesa.;Caroline Mithi.;Mohammed Sood.;Nadia A Aliyan.;Bernard Gituma.;Matiko G Matiko.;Charles A Omondi.;Loice A Ombajo.;Nicholas Kirui.;Lucy Ochola.;Abdirahman I Abdi.;Eunice W Kagucia.;Mike English.;Mainga Hamaluba.;Isabella Ochola-Oyier.;Dorcas Kamuya.;Philip Bejon.;Edwine Barasa.;Ambrose Agweyu.;Samuel Akech.;Anthony O Etyang.
来源: N Engl J Med. 2025年393卷22期2187-2197页
Adjunctive glucocorticoids may reduce mortality among patients with severe community-acquired pneumonia (CAP) in well-resourced settings. Whether these drugs are beneficial in low-resource settings with limited diagnostic and treatment facilities is unclear.
43. Deferring Arterial Catheterization in Critically Ill Patients with Shock.
作者: Grégoire Muller.;Damien Contou.;Stephan Ehrmann.;Maëlle Martin.;Pascal Andreu.;Toufik Kamel.;Florence Boissier.;Marie-Ange Azais.;Alexandra Monnier.;Sylvie Vimeux.;Amélie Chenal.;Mai-Anh Nay.;Charlotte Salmon Gandonnière.;Jean-Baptiste Lascarrou.;Jean-Baptiste Roudaut.;Gaëtan Plantefève.;Bruno Giraudeau.;Karim Lakhal.;Elsa Tavernier.;Thierry Boulain.; .
来源: N Engl J Med. 2025年393卷19期1875-1888页
In patients with shock, whether noninvasive blood-pressure monitoring is an effective alternative to the recommended use of an arterial catheter is uncertain.
44. Immediate or Deferred Nonculprit-Lesion PCI in Myocardial Infarction.
作者: Robin Nijveldt.;Michael Maeng.;Casper W H Beijnink.;Jan J Piek.;Rasha K Al-Lamee.;Luís Raposo.;Sergio Bravo Baptista.;Javier Escaned.;Justin Davies.;Igor Klem.;Bahram Yosofi.;Robert-Jan M van Geuns.;Christian A Frederiksen.;Lars Jakobsen.;Abdelilah El Barzouhi.;Dirk J van der Heijden.;Mustafa Ilhan.;Saman Rasoul.;Stijn Brinckman.;Colette Saraber.;Daniel A Jones.;Steffen E Petersen.;Tomaž Podlesnikar.;Matjaž Bunc.;Marcel A M Beijk.;Lieuwe H Piers.;Johannes B van Rees.;Henry Seligman.;Graham Cole.;Juan F Iglesias.;Sophie Degrauwe.;Arnoud W J van 't Hof.;Erik Lipsic.;Gabija Pundziute-do Prado.;Pairoj Chattranukulchai.;José F Rodríguez-Palomares.;Johannes Rigger.;Martijn Meuwissen.;Lennaert Kleijn.;Bruno Pereira.;Lorenzo Monti.;René J van der Schaaf.;Juan Sanchis.;Guido Belli.;Jan G P Tijssen.;Troels Thim.;Niels van Royen.; .
来源: N Engl J Med. 2026年394卷10期958-968页
The preferred timing of treatment of nonculprit lesions in patients with ST-segment elevation myocardial infarction (STEMI) remains uncertain. A comparison of immediate percutaneous coronary intervention (PCI) guided by instantaneous wave-free ratio (iFR) and deferred PCI guided by cardiac stress magnetic resonance imaging (MRI) in patients with STEMI and multivessel disease is warranted.
45. Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years.
作者: Martin B Leon.;Michael J Mack.;Philippe Pibarot.;Rebecca T Hahn.;Vinod H Thourani.;S H Kodali.;Philippe Généreux.;Samir R Kapadia.;David J Cohen.;Stuart J Pocock.;Yiran Zhang.;Molly Szerlip.;Julien Ternacle.;S Chris Malaisrie.;Howard C Herrmann.;Wilson Y Szeto.;Mark J Russo.;Vasilis Babaliaros.;Tamim Nazif.;John G Webb.;Raj R Makkar.; .
来源: N Engl J Med. 2026年394卷8期773-783页
Five-year data from the PARTNER 3 trial showed that among low-risk patients with severe, symptomatic aortic stenosis, outcomes were similar among patients who had undergone transcatheter aortic-valve replacement (TAVR) and those who had undergone surgical aortic-valve replacement. Longer-term assessments of clinical outcomes and valve durability are needed.
46. Sacituzumab Govitecan in Untreated, Advanced Triple-Negative Breast Cancer.
作者: Javier Cortés.;Kevin Punie.;Carlos Barrios.;Sara A Hurvitz.;Andreas Schneeweiss.;Joohyuk Sohn.;Eriko Tokunaga.;Adam Brufsky.;Yeon Hee Park.;Binghe Xu.;Roberto Hegg.;Mafalda Oliveira.;Alessandra Fabi.;Natalya Vaksman.;Theresa Valdez.;Xinrui Zhang.;Catherine Lai.;Sara M Tolaney.; .
来源: N Engl J Med. 2025年393卷19期1912-1925页
Patients with previously untreated, locally advanced, unresectable or metastatic triple-negative breast cancer who are not candidates for inhibitors of programmed cell death protein 1 (PD-1) or programmed death ligand 1 (PD-L1) have limited treatment options.
47. Sacituzumab Tirumotecan in EGFR-TKI-Resistant, EGFR-Mutated Advanced NSCLC.
作者: Wenfeng Fang.;Lin Wu.;Xiangjiao Meng.;Yu Yao.;Wei Zuo.;Wenxiu Yao.;Yanyan Xie.;Yu Zhang.;Jiuwei Cui.;Yongchang Zhang.;Xingya Li.;Wu Zhuang.;Jian Fang.;Qiming Wang.;Wei Jiang.;Kai Li.;Yuju Bai.;Yongzhong Luo.;Fang Ma.;Yan Yu.;Wei Zheng.;Zhentian Liu.;Bin Yang.;Rui Ma.;Yong Fang.;Runxiang Yang.;Liyan Jiang.;Jie Hu.;Jiacheng Yang.;Yina Diao.;Xiaoping Jin.;Junyou Ge.;Yunpeng Yang.;Li Zhang.
来源: N Engl J Med. 2026年394卷1期13-26页
Sacituzumab tirumotecan (sac-TMT) is an antibody-drug conjugate targeting trophoblast cell-surface antigen 2 that has shown significant survival benefits in patients with EGFR-mutated non-small-cell lung cancer (NSCLC) that has progressed after epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) therapy and platinum-based chemotherapy.
48. Disitamab Vedotin plus Toripalimab in HER2-Expressing Advanced Urothelial Cancer.
作者: Xinan Sheng.;Gongqian Zeng.;Cuijian Zhang.;Qingyun Zhang.;Jiasheng Bian.;Haitao Niu.;Jun Li.;Yanxia Shi.;Kai Yao.;Bin Hu.;Ziling Liu.;Hong Liao.;Zhixian Yu.;Baiye Jin.;Peng Zhao.;Tiejun Yang.;Xianling Liu.;Yang Qin.;Xueyi Xue.;Xin Gou.;Jian Huang.;Jiang Gu.;Xiaolong Qi.;Lu Zhang.;Guoxian Ma.;Beisong Liu.;Jianmin Fang.;Shusuan Jiang.;Zhisong He.;Aiping Zhou.;Jun Guo.; .
来源: N Engl J Med. 2025年393卷23期2324-2337页
Human epidermal growth factor receptor 2 (HER2)-directed antibody-drug conjugate monotherapy has shown preliminary clinical efficacy in patients with chemotherapy-refractory HER2-positive locally advanced or metastatic urothelial cancer. Previous data showed promising antitumor activity and safety of HER2-specific disitamab vedotin as monotherapy and when combined with programmed cell death protein 1 (PD-1)-directed immunotherapy in this cancer.
49. ctDNA-Guided Adjuvant Atezolizumab in Muscle-Invasive Bladder Cancer.
作者: Thomas Powles.;Ariel G Kann.;Daniel Castellano.;Marine Gross-Goupil.;Hiroyuki Nishiyama.;Sergio Bracarda.;Jørgen Bjerggaard Jensen.;Lydia Makaroff.;Shusuan Jiang.;Ja Hyeon Ku.;Se Hoon Park.;Oscar Reig Torras.;Dingwei Ye.;Marco Maruzzo.;Andrea Necchi.;Rafael Morales-Barrera.;Emilio Francesco Giunta.;Jae Lyun Lee.;Giampaolo Tortora.;Yüksel Ürün.;Lukasz Dolowy.;Dilek Erdem.;Alvaro Pinto.;Fabricio Grando.;Wei Zou.;Zoe June Assaf.;Jacqueline Vuky.;Viraj Degaonkar.;Elizabeth E Steinberg.;Joaquim Bellmunt.;Jürgen E Gschwend.; .
来源: N Engl J Med. 2025年393卷24期2395-2408页
Patients with muscle-invasive bladder cancer have varied outcomes after cystectomy. Circulating tumor DNA (ctDNA)-based detection of molecular residual disease may identify patients at high risk for recurrence after cystectomy who can benefit from adjuvant immunotherapy, thus sparing patients at lower risk from unnecessary treatment burden.
50. Improved Survival with Enzalutamide in Biochemically Recurrent Prostate Cancer.
作者: Neal D Shore.;Murilo de Almeida Luz.;Ugo De Giorgi.;Martin Gleave.;Geoffrey T Gotto.;Christopher M Pieczonka.;Gabriel P Haas.;Choung-Soo Kim.;Miguel Ramirez-Backhaus.;Antti Rannikko.;Matko Kalac.;Swetha Sridharan.;Matt Rosales.;Yiyun Tang.;Ronald F Tutrone.;Balaji Venugopal.;Arnauld Villers.;Henry H Woo.;Fong Wang.;Stephen J Freedland.
来源: N Engl J Med. 2026年394卷6期563-575页
In the phase 3 EMBARK trial, enzalutamide plus leuprolide and enzalutamide monotherapy were associated with longer metastasis-free survival than leuprolide alone among patients with biochemically recurrent prostate cancer. The final analysis of overall survival has not been reported.
51. Nivolumab for Resected Stage III or IV Melanoma at 9 Years.
作者: Paolo A Ascierto.;Michele Del Vecchio.;Barbara Merelli.;Helen Gogas.;Ana M Arance.;Stéphane Dalle.;Charles Lance Cowey.;Michael Schenker.;Caroline Gaudy-Marqueste.;Jacopo Pigozzo.;Iván Márquez-Rodas.;Marcus O Butler.;Anna Maria Di Giacomo.;Oleg Gligich.;Luis De La Cruz-Merino.;Petr Arenberger.;Victoria Atkinson.;Paul Nathan.;Andrew Hill.;Michael Millward.;Leslie A Fecher.;Nikhil I Khushalani.;Paola Queirolo.;Raheela Soomro.;Dhanrajsinh Rathod.;Margarita Askelson.;Melanie Pe Benito.;Devanand Joseph.;James Larkin.
来源: N Engl J Med. 2026年394卷4期333-342页
In the CheckMate 238 trial, patients with resected stage IIIB-C or stage IV melanoma who were treated with nivolumab had longer recurrence-free survival than those who received ipilimumab. Data were needed on longer-term survival.
52. Survival with Osimertinib plus Chemotherapy in EGFR-Mutated Advanced NSCLC.
作者: Pasi A Jänne.;David Planchard.;Kunihiko Kobayashi.;James Chih-Hsin Yang.;Ying Liu.;Natalia Valdiviezo.;Tae Min Kim.;Liyan Jiang.;Hiroshi Kagamu.;Noriko Yanagitani.;Jialei Wang.;Bivas Biswas.;Artem Poltoratskiy.;Yeni Neron.;Carlos Rojas.;Leona Koubkova.;Carles Escriu.;Doreen A Ezeife.;Helen Mann.;Elena Armenteros-Monterroso.;Yuri Rukazenkov.;Chee Khoon Lee.; .
来源: N Engl J Med. 2026年394卷1期27-38页
The primary analysis of this trial showed that first-line treatment with osimertinib plus chemotherapy with a platinum-based agent and pemetrexed led to significantly longer progression-free survival than osimertinib monotherapy among patients with epidermal growth factor receptor (EGFR)-mutated advanced non-small-cell lung cancer (NSCLC). Results from the planned final analysis of overall survival are needed.
53. Mass Administration of Azithromycin to Infants in Mali to Reduce Mortality.
作者: Fadima Cheick Haidara.;Laura Adubra.;Mahamadou Abdou.;Dagmar Alber.;Ulla Ashorn.;Yin Bun Cheung.;Elaine Cloutman-Green.;Mamadou Diallo.;Camilla Ducker.;Yue-Mei Fan.;Gwydion Gruffudd.;Lotta Hallamaa.;Tiia Haapaniemi.;Rikhard Ihamuotila.;Jane Juma.;Nigel Klein.;Juho Luoma.;Owen Martell.;Akshaya Murugesan.;Collins Okello.;Oumar Samaké.;Cheick Amadou Tidiane Traore.;Taru Vehmasto.;Kaisa Ylikruuvi.;Samba Sow.;Per Ashorn.
来源: N Engl J Med. 2025年393卷15期1498-1508页
Mass administration of azithromycin to children 1 to 59 months of age has been shown to reduce mortality among infants and children in this age group in some areas of sub-Saharan Africa. The largest effects have appeared to be among infants younger than 12 months of age, within 3 months after treatment; this observation motivated the design of the current trial.
54. A Phase 3 Trial of Telitacicept for Systemic Lupus Erythematosus.
作者: Ronald F van Vollenhoven.;Li Wang.;Joan T Merrill.;Yi Liu.;Chunde Bao.;Fen Li.;Jiankang Hu.;Chenghui Huang.;Jianhong Zhao.;Cibo Huang.;Hanyou Mo.;Wei Wei.;Fu'ai Lu.;Jingyang Li.;Dongbao Zhao.;Wenxiang Wang.;Lin Li.;Qing Zuraw.;Xiaofei Wang.;Xuebin Wang.;Jianmin Fang.;Fengchun Zhang.; .
来源: N Engl J Med. 2025年393卷15期1475-1485页
Telitacicept, a new dual inhibitor of the cytokines B-lymphocyte stimulator (BLyS) and APRIL (a proliferation-inducing ligand), showed efficacy in adults with active systemic lupus erythematosus (SLE) in a phase 2b trial when added to standard therapy.
55. Sentinel-Lymph-Node Biopsy Alone or with Lymphadenectomy in Cervical Cancer.
作者: Hua Tu.;He Huang.;Yanfang Li.;Xiaojun Chen.;Chunyan Wang.;Min Zheng.;Yanna Zhang.;Weidong Zhao.;Yanling Feng.;Ting Wan.;Yongwen Huang.;Aijun Yu.;Weiguo Lu.;Jing Xiao.;Weiwei Shan.;Ping Zhang.;Changkun Zhu.;Danbo Wang.;Hu Zhou.;Jibin Li.;Beihua Kong.;Weiwei Feng.;Xipeng Wang.;Rongzhen Luo.;Xin Huang.;Jundong Li.;Zejian Lin.;Shuzhong Yao.;Jihong Liu.; .
来源: N Engl J Med. 2025年393卷15期1463-1474页
Limited data are available on survival outcomes after sentinel-lymph-node biopsy alone as compared with lymphadenectomy in cervical cancer.
56. Randomized Trial of Targeted Indoor Spraying to Prevent Aedes-Borne Diseases.
作者: Natalie E Dean.;Amy M Crisp.;Azael Che-Mendoza.;Oscar D Kirstein.;Gloria A Barrera-Fuentes.;James T Earnest.;Henry N Puerta-Guardo.;Matthew H Collins.;Norma Pavia-Ruz.;Guadalupe Ayora-Talavera.;Gabriela González-Olvera.;Anuar Medina-Barreiro.;Wilbert Bibiano-Marín.;Shirin Jabbarzadeh.;M Elizabeth Halloran.;Ira M Longini.;Audrey Lenhart.;Lance A Waller.;Fabian Correa-Morales.;Jorge Palacio-Vargas.;Hector Gomez-Dantes.;Pablo Manrique-Saide.;Gonzalo M Vazquez-Prokopec.
来源: N Engl J Med. 2025年393卷14期1387-1398页
Targeted indoor residual spraying focuses insecticide applications on common resting surfaces of Aedes aegypti mosquitoes (an arboviral disease vector) in houses, such as exposed lower sections of walls and under furniture.
57. Sotatercept for Pulmonary Arterial Hypertension within the First Year after Diagnosis.
作者: Vallerie V McLaughlin.;Marius M Hoeper.;David B Badesch.;H Ardeschir Ghofrani.;J Simon R Gibbs.;Mardi Gomberg-Maitland.;Ioana R Preston.;Rogerio Souza.;Aaron B Waxman.;Grzegorz Kopeć.;Gisela Meyer.;Karen M Olsson.;Wei Fu.;Yaru Shi.;Barry Miller.;Samuel S Kim.;Harald S Mackenzie.;Michela Brambatti.;Mahesh J Patel.;Joerg Koglin.;Alexandra G Cornell.;Marc Humbert.; .
来源: N Engl J Med. 2025年393卷16期1599-1611页
Sotatercept, an activin-signaling inhibitor, reduces morbidity and mortality among patients with long-standing pulmonary arterial hypertension. Its effects in patients with pulmonary arterial hypertension within the first year after diagnosis are unclear.
58. Hypertonic Saline or Carbocisteine in Bronchiectasis.
作者: Judy M Bradley.;Brenda O'Neill.;Daniel F McAuley.;James D Chalmers.;Anthony De Soyza.;Adam T Hill.;Mary Carroll.;Michael R Loebinger.;Jamie Duckers.;Mike Clarke.;Rebecca H McLeese.;Kathryn Ferguson.;Andrew Jackson.;Christina Campbell.;Clíona McDowell.;Ashley Agus.;John Norrie.;Fiona Copeland.;Damian G Downey.;Rory Convery.;Martin Kelly.;William Flight.;Nick P Talbot.;John R Hurst.;John Steer.;Muhammad Anwar.;Mitra Shahidi.;Timothy Gatheral.;Mohamed Etumi.;Anita L Sullivan.;Andreea Alina Ionescu.;Veeresh Patil.;Milan Bhattacharya.;Steven Caskey.;Denise Cosgrove.;Conor Hagan.;Amelia Shoemark.;Terence McManus.;Gareth Davies.;J Stuart Elborn.; .
来源: N Engl J Med. 2025年393卷16期1565-1577页
Bronchiectasis guidelines are inconsistent with regard to the effectiveness of mucoactive agents, and their use varies geographically. Large trials are needed to assess safety and effectiveness.
59. Permethrin-Treated Baby Wraps for the Prevention of Malaria.
作者: Ross M Boyce.;Bonnie E Shook-Sa.;Ronnie Ndizeye.;Emmanuel Baguma.;Dana Giandomenico.;Caitlin A Cassidy.;Solomon Eshun.;Mark J Siedner.;Sarah G Staedke.;Moses Ntaro.;Jonathan J Juliano.;Raquel Reyes.;Edgar M Mulogo.
来源: N Engl J Med. 2025年393卷14期1399-1408页
Malaria remains a major cause of childhood death in sub-Saharan Africa. We leveraged the traditional practice of mothers carrying children on their backs in cloth wraps to assess whether treating the wraps with an insect repellent might provide a layer of protection against malaria.
60. Clesrovimab for Prevention of RSV Disease in Healthy Infants.
作者: Heather J Zar.;Eric A F Simões.;Shabir A Madhi.;Octavio Ramilo.;Shelly D Senders.;Julie S Shepard.;Kamolwish Laoprasopwattana.;Jorge Piedrahita.;Jose M Novoa.;Sergio L Vargas.;Marc Dionne.;Teresa Jackowska.;Enmei Liu.;Yasunori Ishihara.;Kazushige Ikeda.;Ying Zhang.;Radha A Railkar.;Jeannine Lutkiewicz.;Kalpit A Vora.;Xiaowei Zang.;Brian M Maas.;Andrew W Lee.;Andrea Guerra.;Anushua Sinha.; .
来源: N Engl J Med. 2025年393卷13期1292-1303页
Clesrovimab is a long-acting investigational monoclonal antibody against site IV of the respiratory syncytial virus (RSV) fusion protein. Data regarding the safety and efficacy of clesrovimab in healthy infants are needed.
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