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101. A Randomized Trial of Acute Normovolemic Hemodilution in Cardiac Surgery.
作者: Fabrizio Monaco.;Chong Lei.;Matteo Aldo Bonizzoni.;Sergey Efremov.;Federica Morselli.;Fabio Guarracino.;Giuseppe Giardina.;Cristina Arangino.;Domenico Pontillo.;Michelangelo Vitiello.;Alessandro Belletti.;Valentina Ajello.;Margherita Licheri.;Caetano Nigro Neto.;Gaia Barucco.;Nazar A Bukamal.;Carolina Faustini.;Lorenzo Filippo Mantovani.;Alessandro Oriani.;Cristina Santonocito.;Marta Mucchetti.;Francesco Federici.;Chiara Gerli.;Sabrina Porta.;Anna Mara Scandroglio.;Hui Zhang.;Marina Pieri.;Roman Osinsky.;Stefano Lazzari.;Elizaveta Leonova.;Maria Grazia Calabrò.;Daniele Amitrano.;Stefano Turi.;Paolo Prati.;Stefano Fresilli.;Filippo D'Amico.;Jacopo D'Andria Ursoleo.;Rosa Labanca.;Marilena Marmiere.;Alessandro Pruna.;Tommaso Scquizzato.;Kaan Kırali.;Giacomo Monti.;Maria José Carvalho Carmona.;Kenichi Tanaka.;Valery Likhvantsev.;Lian Kah Ti.;Tiziana Bove.;Gianluca Paternoster.;Karen Singh.;Mustafa Emre Gürcü.;Vladimir Lomivorotov.;Giovanni Landoni.;Rinaldo Bellomo.;Alberto Zangrillo.; .
来源: N Engl J Med. 2025年393卷5期450-460页
Patients undergoing cardiac surgery often receive red-cell transfusions, along with the associated risks and costs. Early intraoperative normovolemic hemodilution (i.e., acute normovolemic hemodilution [ANH]) is a blood-conservation technique that entails autologous blood collection before initiation of cardiopulmonary bypass and reinfusion of the collected blood after bypass weaning. More data are needed on whether ANH reduces the number of patients receiving allogeneic red-cell transfusion.
102. Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes.
作者: Rajiv Agarwal.;Jennifer B Green.;Hiddo J L Heerspink.;Johannes F E Mann.;Janet B McGill.;Amy K Mottl.;Julio Rosenstock.;Peter Rossing.;Muthiah Vaduganathan.;Meike Brinker.;Robert Edfors.;Na Li.;Markus F Scheerer.;Charlie Scott.;Masaomi Nangaku.; .
来源: N Engl J Med. 2025年393卷6期533-543页
Limited evidence exists to support the simultaneous initiation of sodium-glucose cotransporter-2 inhibitors and finerenone, a nonsteroidal mineralocorticoid receptor antagonist, in persons with chronic kidney disease and type 2 diabetes.
103. A Trial of Trimethoprim-Sulfamethoxazole in Pregnancy to Improve Birth Outcomes.
作者: Bernard Chasekwa.;Fortunate Munhanzi.;Lenin Madhuyu.;Gabriel Mbewe.;Vincent Mabika.;Dzivaidzo Chidhanguro.;Tendai Kofi.;Jonthan Munengiwa.;Hilda Mapfumo.;Mercy Musapa.;Sipho Shumba.;Elizabeth Hungwe.;Mary Nhokwara.;Nester Bushe.;Rudo Kufa.;Phatisiwe Mazula.;Muchaneta Chikombingo.;Alice Tengende.;Admire Zanga.;Asaph Ziruma.;Tsitsi Bere.;Success Munyengwa.;Charity Mudimbu.;Zvikomborero Murwira.;Shepherd Mudzingwa.;Eddington Mpofu.;Batsirai Mutasa.;Virginia Sauramba.;Elisha Masakadze.;Thompson Runodamoto.;Courage Chiorera.;Alfred Mushininga.;Claire D Bourke.;Ruairi C Robertson.;Jeniffer Perussolo.;Nikos Donos.;Chandiwana Nyachowe.;Mary Muchekeza.;Jefrey Chikunya.;Melanie Smuk.;Kuda Mutasa.;Naume V Tavengwa.;Lisa L Langhaug.;Robert Ntozini.;Stephen P Munjanja.;Andrew J Prendergast.
来源: N Engl J Med. 2025年392卷21期2125-2134页
Maternal infections underlie several adverse birth outcomes. Whether trimethoprim-sulfamethoxazole prophylaxis during pregnancy will improve birth outcomes is unknown.
104. Omitting Regional Nodal Irradiation after Response to Neoadjuvant Chemotherapy.
作者: Eleftherios P Mamounas.;Hanna Bandos.;Julia R White.;Thomas B Julian.;Atif J Khan.;Simona F Shaitelman.;Mylin A Torres.;Frank A Vicini.;Patricia A Ganz.;Susan A McCloskey.;Peter C Lucas.;Nilendu Gupta.;X Allen Li.;Beryl McCormick.;Benjamin Smith.;Rahul D Tendulkar.;Vivek S Kavadi.;Koji Matsumoto.;Samantha Andrews Seaward.;William J Irvin.;Jolinta Y Lin.;Robert W Mutter.;Thierry M Muanza.;Jannifer Stromberg.;Reshma Jagsi.;Anna C Weiss.;Walter J Curran.;Norman Wolmark.
来源: N Engl J Med. 2025年392卷21期2113-2124页
The benefit of regional nodal irradiation in the treatment of breast cancer is well established for patients with pathologically positive axillary nodes, but whether it is also beneficial for patients whose nodes become pathologically tumor free (ypN0) after neoadjuvant chemotherapy remains unclear.
105. Measurable Residual Disease-Guided Therapy in Newly Diagnosed Myeloma.
作者: Aurore Perrot.;Jérôme Lambert.;Cyrille Hulin.;Andrea Pieragostini.;Lionel Karlin.;Bertrand Arnulf.;Philippe Rey.;Laurent Garderet.;Margaret Macro.;Martine Escoffre-Barbe.;Julie Gay.;Thomas Chalopin.;Romain Gounot.;Jean-Marc Schiano.;Mohamad Mohty.;Xavier Leleu.;Salomon Manier.;Clara Mariette.;Carine Chaleteix.;Thorsten Braun.;Bernard De Prijck.;Hervé Avet-Loiseau.;Jean-Yves Mary.;Jill Corre.;Philippe Moreau.;Cyrille Touzeau.; .
来源: N Engl J Med. 2025年393卷5期425-437页
Measurable residual disease (MRD) is a major prognostic factor in newly diagnosed multiple myeloma. An assessment of an MRD-guided consolidation strategy in patients who are eligible for autologous stem-cell transplantation (ASCT) may be useful.
106. Tarlatamab in Small-Cell Lung Cancer after Platinum-Based Chemotherapy.
作者: Giannis Mountzios.;Longhua Sun.;Byoung Chul Cho.;Umut Demirci.;Sofia Baka.;Mahmut Gümüş.;Antonio Lugini.;Bo Zhu.;Yan Yu.;Ippokratis Korantzis.;Ji-Youn Han.;Tudor-Eliade Ciuleanu.;Myung-Ju Ahn.;Pedro Rocha.;Julien Mazières.;Sally C M Lau.;Martin Schuler.;Fiona Blackhall.;Tatsuya Yoshida.;Taofeek K Owonikoko.;Luis Paz-Ares.;Tony Jiang.;Ali Hamidi.;Diana Gauto.;Gonzalo Recondo.;Charles M Rudin.; .
来源: N Engl J Med. 2025年393卷4期349-361页
Tarlatamab, a bispecific delta-like ligand 3-directed T-cell engager immunotherapy, received accelerated approval for the treatment of patients with previously treated small-cell lung cancer. Whether tarlatamab is more effective than chemotherapy in the treatment of patients whose small-cell lung cancer has progressed during or after initial platinum-based chemotherapy is not known.
107. Vepdegestrant, a PROTAC Estrogen Receptor Degrader, in Advanced Breast Cancer.
作者: Mario Campone.;Michelino De Laurentiis.;Komal Jhaveri.;Xichun Hu.;Sylvain Ladoire.;Anne Patsouris.;Claudio Zamagni.;Jiuwei Cui.;Marina Cazzaniga.;Timucin Cil.;Katarzyna J Jerzak.;Christian Fuentes.;Tetsuhiro Yoshinami.;Alvaro Rodriguez-Lescure.;Ahmet Sezer.;Andrea Fontana.;Valentina Guarneri.;Andrea Molckovsky.;Marie-Ange Mouret-Reynier.;Umut Demirci.;Yongqiang Zhang.;Olga Valota.;Dongrui R Lu.;Marcella Martignoni.;Janaki Parameswaran.;Xin Zhi.;Erika P Hamilton.; .
来源: N Engl J Med. 2025年393卷6期556-568页
Vepdegestrant is an oral proteolysis-targeting chimera (PROTAC) estrogen receptor (ER) degrader that directly harnesses the ubiquitin-proteasome system.
108. Perioperative Durvalumab in Gastric and Gastroesophageal Junction Cancer.
作者: Yelena Y Janjigian.;Salah-Eddin Al-Batran.;Zev A Wainberg.;Kei Muro.;Daniela Molena.;Eric Van Cutsem.;Woo Jin Hyung.;Lucjan Wyrwicz.;Do-Youn Oh.;Takeshi Omori.;Markus Moehler.;Marcelo Garrido.;Sulene C S Oliveira.;Moishe Liberman.;Victor Castro Oliden.;Elizabeth C Smyth.;Alexander Stein.;Mehmet Bilici.;Maria Lorena Alvarenga.;Vadim Kozlov.;Fernando Rivera.;Akihito Kawazoe.;Olivier Serrano.;Eric Heilbron.;Alejandra Negro.;John F Kurland.;Josep Tabernero.; .
来源: N Engl J Med. 2025年393卷3期217-230页
Perioperative FLOT (fluorouracil, leucovorin, oxaliplatin, and docetaxel) is a standard therapy for resectable gastric and gastroesophageal junction adenocarcinomas, but recurrence rates remain high. Immunotherapy plus chemotherapy may improve outcomes.
109. Overall Survival with Neoadjuvant Nivolumab plus Chemotherapy in Lung Cancer.
作者: Patrick M Forde.;Jonathan D Spicer.;Mariano Provencio.;Tetsuya Mitsudomi.;Mark M Awad.;Changli Wang.;Shun Lu.;Enriqueta Felip.;Scott J Swanson.;Julie R Brahmer.;Keith Kerr.;Janis M Taube.;Tudor-Eliade Ciuleanu.;Fumihiro Tanaka.;Gene B Saylors.;Ke-Neng Chen.;Hiroyuki Ito.;Moishe Liberman.;Claudio Martin.;Stephen Broderick.;Lily Wang.;Junliang Cai.;Quyen Duong.;Stephanie Meadows-Shropshire.;Joseph Fiore.;Sumeena Bhatia.;Nicolas Girard.; .
来源: N Engl J Med. 2025年393卷8期741-752页
Neoadjuvant nivolumab plus chemotherapy significantly improved pathological complete response and event-free survival in patients with resectable non-small-cell lung cancer (NSCLC) in a phase 3 trial. Data are needed on overall survival.
110. Overall Survival with Inavolisib in PIK3CA-Mutated Advanced Breast Cancer.
作者: Komal L Jhaveri.;Seock-Ah Im.;Cristina Saura.;Sibylle Loibl.;Kevin Kalinsky.;Peter Schmid.;Sherene Loi.;Eirini Thanopoulou.;Noopur Shankar.;Yanling Jin.;Thomas J Stout.;Tiffany D Clark.;Chunyan Song.;Dejan Juric.;Nicholas C Turner.
来源: N Engl J Med. 2025年393卷2期151-161页
In the phase 3, double-blind, randomized INAVO120 trial, treatment with inavolisib plus palbociclib-fulvestrant led to a significant progression-free survival benefit, as compared with placebo plus palbociclib-fulvestrant, among patients with PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative locally advanced or metastatic breast cancer who had had relapse during or within 12 months after completion of adjuvant endocrine therapy.
111. Adjuvant Cemiplimab or Placebo in High-Risk Cutaneous Squamous-Cell Carcinoma.
作者: Danny Rischin.;Sandro Porceddu.;Fiona Day.;Daniel P Brungs.;Hayden Christie.;James E Jackson.;Brian N Stein.;Yungpo Bernard Su.;Rahul Ladwa.;Gerard Adams.;Samantha E Bowyer.;Zulfiquer Otty.;Naoya Yamazaki.;Paolo Bossi.;Amarnath Challapalli.;Axel Hauschild.;Annette M Lim.;Vishal A Patel.;Joanna L Walker.;Maite De Liz Vassen Schurmann.;Paola Queirolo.;Javier Cañueto.;Flavio Augusto Ferreira da Silva.;Alexander Stratigos.;Alexander Guminski.;Charles Lin.;Fernanda Damian.;Lukas Flatz.;Anne E Taylor.;David R Carr.;Samuel Harris.;Dmitry Kirtbaya.;Gaëlle Quereux.;Piotr Rutkowski.;Nicole Basset-Seguin.;Nikhil I Khushalani.;Caroline Robert.;Haisong Ju.;Camryn Joseph.;Shikha Bansal.;Chieh-I Chen.;Frank Seebach.;Suk-Young Yoo.;Israel Lowy.;Priscila Goncalves.;Matthew G Fury.; .
来源: N Engl J Med. 2025年393卷8期774-785页
Patients who have cutaneous squamous-cell carcinoma with high-risk features are at risk for recurrence after definitive local therapy. The benefit of systemic adjuvant therapy options has not been well established in clinical trials.
112. First-Line Camizestrant for Emerging ESR1-Mutated Advanced Breast Cancer.
作者: François-Clément Bidard.;Erica L Mayer.;Yeon Hee Park.;Wolfgang Janni.;Cynthia Ma.;Massimo Cristofanilli.;Giampaolo Bianchini.;Kevin Kalinsky.;Hiroji Iwata.;Stephen Chia.;Peter A Fasching.;Adam Brufsky.;Zbigniew Nowecki.;Javier Pascual.;Lionel Moreau.;Shin-Cheh Chen.;Nuri Karadurmus.;Einav Nili Gal-Yam.;Kyung Hae Jung.;Sonia Pernas.;Sasha McClain.;Wei He.;Teresa Klinowska.;Cynthia Huang-Bartlett.;Nicholas C Turner.; .
来源: N Engl J Med. 2025年393卷6期569-580页
Mutations in ESR1 are the most common mechanism of acquired resistance to treatment with an aromatase inhibitor plus a cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor for advanced breast cancer. Camizestrant, a next-generation selective estrogen-receptor (ER) degrader and complete ER antagonist, has shown antitumor activity in ER-positive advanced breast cancer.
113. Elinzanetant for Vasomotor Symptoms from Endocrine Therapy for Breast Cancer.
作者: Fatima Cardoso.;Susanne Parke.;Donal J Brennan.;Paula Briggs.;Gilbert Donders.;Nick Panay.;Nazanin Haseli-Mashhadi.;Michael Block.;Cecilia Caetano.;Maja Francuski.;Claudia Haberland.;Kaisa Laapas.;Christian Seitz.;Lineke Zuurman.
来源: N Engl J Med. 2025年393卷8期753-763页
Women receiving endocrine therapy for hormone receptor (HR)-positive breast cancer or its prevention among those at high risk for breast cancer commonly have vasomotor symptoms. Data are lacking on the effects of elinzanetant, a neurokinin-targeted therapy shown to be effective in treating vasomotor symptoms, in this population.
114. Trastuzumab Deruxtecan or Ramucirumab plus Paclitaxel in Gastric Cancer.
作者: Kohei Shitara.;Eric Van Cutsem.;Mahmut Gümüş.;Sara Lonardi.;Christelle de la Fouchardière.;Clélia Coutzac.;Jeroen Dekervel.;Daniel Hochhauser.;Lin Shen.;Wasat Mansoor.;Bo Liu.;Lorenzo Fornaro.;Min-Hee Ryu.;Jeeyun Lee.;Cátia Faustino.;Jean-Philippe Metges.;Josep Tabernero.;Fábio Franke.;Yelena Y Janjigian.;Fabricio Souza.;Lori Jukofsky.;Yumin Zhao.;Takahiro Kamio.;Aziz Zaanan.;Filippo Pietrantonio.; .
来源: N Engl J Med. 2025年393卷4期336-348页
On the basis of phase 2 studies, trastuzumab deruxtecan was approved for patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic gastric cancer or gastroesophageal junction adenocarcinoma who had previously received trastuzumab-based therapy. Ramucirumab plus paclitaxel is also a standard second-line treatment option regardless of HER2 status.
115. Structured Exercise after Adjuvant Chemotherapy for Colon Cancer.
作者: Kerry S Courneya.;Janette L Vardy.;Christopher J O'Callaghan.;Sharlene Gill.;Christine M Friedenreich.;Rebecca K S Wong.;Haryana M Dhillon.;Victoria Coyle.;Neil S Chua.;Derek J Jonker.;Philip J Beale.;Kamal Haider.;Patricia A Tang.;Tony Bonaventura.;Ralph Wong.;Howard J Lim.;Matthew E Burge.;Stacey Hubay.;Michael Sanatani.;Kristin L Campbell.;Fernanda Z Arthuso.;Jane Turner.;Ralph M Meyer.;Michael Brundage.;Patti O'Brien.;Dongsheng Tu.;Christopher M Booth.; .
来源: N Engl J Med. 2025年393卷1期13-25页
Preclinical and observational studies suggest that exercise may improve cancer outcomes. However, definitive level 1 evidence is lacking.
116. Encorafenib, Cetuximab, and mFOLFOX6 in BRAF-Mutated Colorectal Cancer.
作者: Elena Elez.;Takayuki Yoshino.;Lin Shen.;Sara Lonardi.;Eric Van Cutsem.;Cathy Eng.;Tae Won Kim.;Harpreet Singh Wasan.;Jayesh Desai.;Fortunato Ciardiello.;Rona Yaeger.;Timothy S Maughan.;Van K Morris.;Christina Wu.;Tiziana Usari.;Robert Laliberte.;Samuel S Dychter.;Xiaosong Zhang.;Josep Tabernero.;Scott Kopetz.; .
来源: N Engl J Med. 2025年392卷24期2425-2437页
First-line treatment with encorafenib plus cetuximab (EC) with or without chemotherapy (oxaliplatin, leucovorin, and fluorouracil [mFOLFOX6]) for BRAF V600E-mutated metastatic colorectal cancer, an aggressive subtype with a poor prognosis, was compared with standard care (chemotherapy with or without bevacizumab) in an open-label, phase 3 trial, which showed significance regarding one of the two primary end points, objective response according to blinded independent central review (odds ratio for EC+mFOLFOX6 vs. standard care, 2.44; one-sided P<0.001). This result led to accelerated Food and Drug Administration approval of this investigational combination therapy for BRAF V600E-mutated metastatic colorectal cancer, including as first-line therapy. Data on progression-free survival (the second primary end point) and an updated interim analysis of overall survival are now available.
117. Once-Weekly Mazdutide in Chinese Adults with Obesity or Overweight.
作者: Linong Ji.;Hongwei Jiang.;Yan Bi.;Hua Li.;Junhang Tian.;Dexue Liu.;Yuzhu Zhao.;Wei Qiu.;Chongbing Huang.;Lei Chen.;Shao Zhong.;Jie Han.;Yawei Zhang.;Qiufang Lian.;Ping Yang.;Lingchun Lv.;Jieyu Gu.;Zihan Liu.;Huan Deng.;Yanqi Wang.;Li Li.;Lijuan Pei.;Lei Qian.; .
来源: N Engl J Med. 2025年392卷22期2215-2225页
Evidence suggests that incretin-based dual agonist pharmacotherapy is helpful in persons with obesity. Mazdutide, a glucagon-like peptide-1 and glucagon receptor dual agonist, may have efficacy in persons with overweight or obesity.
118. Intravenous Tenecteplase before Thrombectomy in Stroke.
作者: Zhongming Qiu.;Fengli Li.;Hongfei Sang.;Guangxiong Yuan.;Dongjing Xie.;Kai Zhou.;Maohua Li.;Zhaoyou Meng.;Zhenyu Kong.;Zhongfan Ruan.;Chaoqun Li.;Guangui Yang.;Junxiong Wu.;Chen Long.;Bo Yang.;Hai Hu.;Yanling Li.;Jun Luo.;Zhonghua Shi.;Xianjun Huang.;Shunfu Jiang.;Tingyu Yi.;Guoyong Zeng.;Jincheng Liu.;Xiaojun Luo.;Shudong Liu.;Mingze Chang.;Youlin Wu.;Yufeng Tang.;Zhenxuan Tian.;Zhizhong Yan.;Haojin Zhao.;Yuqi Peng.;Hongguo Dai.;Peiyang Zhou.;Huagang Li.;Wenhua Liu.;Dengwen Song.;Bo Lei.;Zhongbin Xia.;Xiaolin Tan.;Maojun Zhao.;Xinggang Feng.;Lingyu Cai.;Qi Li.;Yuelu Wu.;Bingwu Jiang.;Yan Tian.;Linyu Li.;Ling Jiang.;Xingmin Long.;Feng You.;Jian Tao.;Jin Zhou.;Derong Wu.;Chong Zheng.;Congguo Yin.;Duolao Wang.;Mengjie Lu.;Gregory W Albers.;Raul G Nogueira.;Bruce C V Campbell.;Thanh N Nguyen.;Jeffrey L Saver.;Wenjie Zi.;Qingwu Yang.; .
来源: N Engl J Med. 2025年393卷2期139-150页
The safety and efficacy of treatment with intravenous tenecteplase before endovascular thrombectomy in patients with acute ischemic stroke due to large-vessel occlusion remain uncertain.
119. As-Needed Albuterol-Budesonide in Mild Asthma.
作者: Craig LaForce.;Frank Albers.;Anna Danilewicz.;Allison Jeynes-Ellis.;Monica Kraft.;Reynold A Panettieri.;Robert Rees.;Samuel Bardsley.;Lynn Dunsire.;Tim Harrison.;Olami Sobande.;Raulin Surujbally.;Frank Trudo.;Christy Cappelletti.;Alberto Papi.;Richard Beasley.;Bradley E Chipps.;Elliot Israel.;Hitesh Pandya.;Martin Clancy.;Leonard B Bacharier.; .
来源: N Engl J Med. 2025年393卷2期113-124页
As-needed use of albuterol-budesonide has been shown to result in a significantly lower risk of severe asthma exacerbation than as-needed use of albuterol alone among patients with moderate-to-severe asthma. Data on albuterol-budesonide in mild asthma are needed.
120. Nerandomilast in Patients with Progressive Pulmonary Fibrosis.
作者: Toby M Maher.;Shervin Assassi.;Arata Azuma.;Vincent Cottin.;Anna-Maria Hoffmann-Vold.;Michael Kreuter.;Justin M Oldham.;Luca Richeldi.;Claudia Valenzuela.;Marlies S Wijsenbeek.;Emmanuelle Clerisme-Beaty.;Carl Coeck.;Hui Gu.;Ivana Ritter.;Arno Schlosser.;Susanne Stowasser.;Florian Voss.;Gerrit Weimann.;Donald F Zoz.;Fernando J Martinez.; .
来源: N Engl J Med. 2025年392卷22期2203-2214页
Nerandomilast (BI 1015550) is an orally administered preferential inhibitor of phosphodiesterase 4B with antifibrotic and immunomodulatory properties. Nerandomilast has been shown to slow the progression of idiopathic pulmonary fibrosis, but an assessment of its effects in other types of progressive pulmonary fibrosis is needed.
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