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1. Atezolizumab plus FOLFOX for Stage III Mismatch Repair-Deficient Colon Cancer.
作者: Frank A Sinicrope.;Fang-Shu Ou.;Dirk Arnold.;Walter R Peters.;Robert J Behrens.;Christopher H Lieu.;Khalid Matin.;Deirdre J Cohen.;Samara L Potter.;Andrew B Nixon.;Lisa A Kottschade.;Emily Kathol.;Wendy L Frankel.;Ardaman Shergill.;Dennis Hsu.;Anke Reinacher-Schick.;Paul Mehan.;Philip J Gold.;Maged F Khalil.;Tyler Zemla.;Clare Gatten.;Eileen M O'Reilly.;Jeffrey A Meyerhardt.
来源: N Engl J Med. 2026年394卷12期1155-1166页
Standard adjuvant chemotherapy for stage III colon cancer consists of a fluoropyrimidine-plus-oxaliplatin regimen. Whether the addition of atezolizumab (an anti-programmed death ligand 1 agent) to a modified FOLFOX6 regimen (fluorouracil, oxaliplatin, and leucovorin; called mFOLFOX6) would improve outcomes in patients with stage III colon cancer with mismatch repair-deficient (dMMR) status is unclear.
2. Trial of High-Dose Oral Rifampin in Adults with Tuberculous Meningitis.
作者: David B Meya.;Fiona V Cresswell.;Biyue Dai.;Nicole Engen.;Kogieleum Naidoo.;Ahmad Rizal Ganiem.;Darma Imran.;Mable Kabahubya.;Richard J Lessells.;Vycke Yunivita.;Riwanti Estiasari.;Lillian Tugume.;Bongeka Hlabisa.;Media Yuni Kurniawati.;Noveline Sagita.;Enock Kagimu.;Kartika Maharani.;Jane Gakuru.;Maula N Gaharu.;Timothy Mugabi.;Sarah Kimuda.;Suzan Namombwe.;Lindsey Te Brake.;Rob Aarnoutse.;Elin M Svensson.;Ananta S Bangdiwala.;Sylvia Namanda.;Nathan C Bahr.;Abdu K Musubire.;Mahomed Yunus Suleman Moosa.;Raph L Hamers.;Suzaan Marais.;David R Boulware.;Reinout van Crevel.;Rovina Ruslami.; .
来源: N Engl J Med. 2025年393卷24期2434-2446页
Tuberculous meningitis is often lethal, and many survivors have disabilities despite antimicrobial treatment and adjunctive glucocorticoid therapy. Standard-dose rifampin has limited central nervous system penetration. Whether high-dose rifampin could improve survival outcomes is unknown.
3. Daily Mosnodenvir as Dengue Prophylaxis in a Controlled Human Infection Model.
作者: Anna P Durbin.;Liesbeth Van Wesenbeeck.;Kristen K Pierce.;Guillermo Herrera-Taracena.;Laura Ebone.;Annemie Buelens.;Patricia Lutton.;Beulah P Sabundayo.;Veerle Van Eygen.;Kim De Clerck.;Isabel Fetter.;Natalia V Voge.;Xi Fang.;Nele Goeyvaerts.;Yannick Vandendijck.;Jeffrey Mayfield.;Oliver Lenz.;Sandra De Meyer.;Thomas N Kakuda.;Huili He.;Emérito Amaro-Carambot.;Ruxandra Draghia Akli.;Marya Carmolli.;Tine De Marez.;Stephen S Whitehead.;Marnix Van Loock.;Freya Rasschaert.
来源: N Engl J Med. 2025年393卷21期2107-2118页
Approximately half the worldwide population is at risk for dengue. No antiviral prophylaxis or treatment options are available.
4. Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation.
作者: Atul Verma.;David H Birnie.;Chenyang Jiang.;Hein Heidbüchel.;Gerhard Hindricks.;Paulus Kirchhof.;Jeff S Healey.;Yunhe Wang.;Nikolaos Dagres.;Marc W Deyell.;Prashanthan Sanders.;Rajeev K Pathak.;Pieter Koopman.;Dieter Nuyens.;Paul Novak.;Guy Amit.;Charles Dussault.;Bhavanesh Makanjee.;F Russell Quinn.;Umjeet Jolly.;Leon Iden.;Malte Kuniss.;Mukul Sharma.;Andrew Ha.;Vidal Essebag.;Jean Champagne.;Michael D Hill.;Eric E Smith.;George A Wells.; .
来源: N Engl J Med. 2026年394卷4期323-332页
Whether successful catheter ablation for atrial fibrillation eliminates the need for long-term oral anticoagulant therapy is unknown.
5. Safety and Immunogenicity of an rVSV Lassa Fever Vaccine Candidate.
作者: Elissa Malkin.;Marija Zaric.;Mark Kieh.;Lindsey R Baden.;David Fitz-Patrick.;Arianna Marini.;Heejin Yun.;Peter Hayes.;Rachel Bromell.;Morolayo Ayorinde.;Natalia Fernandez.;Ruhani Varma.;Faith Sigei.;Matthew Ward.;Hema Pindolia.;Shayna Sewell.;Fahimah Amini.;Julie Blie.;Barthalomew Wilson.;Patrick Faley.;John McCullough.;Franklin Tokpah.;Cecelia Wisseh.;Elvis Towalid.;Swapnil Hadawale.;Eddy Sayeed.;Devin Hunt.;Nahid Keshavarzi.;Burc Barin.;Irina Maljkovic Berry.;Christopher L Parks.;Shobhna Gopal Truter.;Kathleen Walker.;Johan Vekemans.;Jennifer Lehrman.;Michelle Engelbrecht.;Mariette Malherbe.;Dagna Laufer.;Vincent Philiponis.;Elizabeth Higgs.;Gaudensia Mutua.;Patricia E Fast.;Swati B Gupta.; .
来源: N Engl J Med. 2025年393卷18期1807-1818页
No vaccine is currently available for Lassa fever, a viral hemorrhagic disease that is estimated to cause thousands of deaths each year in western Africa. A replication-competent recombinant vesicular stomatitis virus-vectored vaccine encoding a Lassa virus (LASV) glycoprotein complex, rVSVΔG-LASV-GPC, has been developed, but data on its safety and immunogenicity are limited.
6. Ten-Year Survival after Postmastectomy Chest-Wall Irradiation in Breast Cancer.
作者: Ian H Kunkler.;Nicola S Russell.;Niall Anderson.;Richard Sainsbury.;J Michael Dixon.;David Cameron.;Juliette Loncaster.;Matthew Hatton.;Helen Westenberg.;Jackie Clarke.;Heather McCarty.;Rhun Evans.;Konstantinos Geropantas.;Virginia Wolstenholme.;Abdulla Alhasso.;Pamela Woodings.;Lisa Barraclough.;Neil Bayman.;Richard Welch.;Fidelis Muturi.;Tracy McEleney.;Jacqueline Burns.;Kathleen Riddle.;Eve Macdonald.;Joanna Dunlop.;Nicole Sergenson.;Geertjan van Tienhoven.;Karen J Taylor.;John M S Bartlett.;Tammy Piper.;Galina Velikova.;Edwin Aird.;Boon Chua.;Coen Hurkmans.;Karen Venables.;Linda J Williams.;Jeremy S Thomas.;Andrew M Hanby.;Marjory Maclennan.;Susan Cleator.;Eldo T Verghese.;Yexiong Li.;Shulian Wang.;Peter Canney.; .; .
来源: N Engl J Med. 2025年393卷18期1771-1783页
The role of postmastectomy chest-wall irradiation in patients with breast cancer classified as pN1 (with involvement of one to three axillary nodes) or pN0 (pathologically node negative) with additional risk factors is uncertain.
7. A Randomized Trial of Physical Therapy for Meniscal Tear and Knee Pain.
作者: Jeffrey N Katz.;Jamie E Collins.;Leslie Bisson.;Morgan H Jones.;James J Irrgang.;Faith Selzer.;Clare E Safran-Norton.;Kurt P Spindler.;Heidi Y Yang.;Swastina Shrestha.;Kim L Bennell.;James K Sullivan.;Melissa A Kluczynski.;Kaetlyn Arant.;Maame Opare-Addo.;Jamie L Huizinga.;Zoe Zimmerman.;Derek Sople.;Peter Tonsoline.;Madhuri Kale.;William M Wind.;Antonia F Chen.;Michael Freitas.;Bryson Lesniak.;Kelly Jordan.;Elizabeth G Matzkin.;Courtney Dawson.;Lutul Farrow.;Volker Musahl.;John J Leddy.;Scott D Martin.;Elena Losina.
来源: N Engl J Med. 2025年393卷17期1694-1703页
Physical therapy is routinely recommended for knee pain attributed to a degenerative meniscal tear, but its efficacy has not been established.
8. 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.
9. 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.
10. 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.
11. A Randomized Trial of Shunting for Idiopathic Normal-Pressure Hydrocephalus.
作者: Mark G Luciano.;Michael A Williams.;Mark G Hamilton.;Heather L Katzen.;Nickolas A Dasher.;Abhay Moghekar.;Jun Hua.;Jan Malm.;Anders Eklund.;Naomi Alpert Abel.;Ahmed M Raslan.;Benjamin D Elder.;Jesse J Savage.;Daniel L Barrow.;Kiarash Shahlaie.;Hailey Jensen.;Thomas J Zwimpfer.;Jessica Wollett.;Daniel F Hanley.;Richard Holubkov.; .
来源: N Engl J Med. 2025年393卷22期2198-2209页
Idiopathic normal-pressure hydrocephalus is a neurologic disorder characterized by impaired gait, balance, cognition, and bladder control in older adults. The disorder is treated with shunt surgery, but the effectiveness of shunting is unclear.
12. One Dose versus Three Doses of Benzathine Penicillin G in Early Syphilis.
作者: Edward W Hook.;Jodie A Dionne.;Kimberly Workowski.;Candice J McNeil.;Stephanie N Taylor.;Teresa A Batteiger.;Julia C Dombrowski.;Kenneth H Mayer.;Arlene C Seña.;Matthew M Hamill.;Harold C Wiesenfeld.;Chunming Zhu.;Charlotte Perlowski.;Jorge E Mejia-Galvis.;Lori M Newman.
来源: N Engl J Med. 2025年393卷9期869-878页
Controversy persists regarding the appropriate duration of therapy with benzathine penicillin G in persons with early (i.e., primary, secondary, or early latent) syphilis (Treponema pallidum infection).
13. Home-Based Care for Hypertension in Rural South Africa.
作者: Mark J Siedner.;Nombulelo Magula.;Lusanda Mazibuko.;Nsika Sithole.;Alison Castle.;Siyabonga Nxumalo.;Thabang Manyaapelo.;Shafika Abrahams-Gessel.;Dickman Gareta.;Joanna Orne-Gliemann.;Kathy Baisley.;Max Bachmann.;Thomas A Gaziano.
来源: N Engl J Med. 2025年393卷13期1304-1314页
Poorly controlled hypertension is a common problem worldwide, particularly in low-resource settings.
14. Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension.
作者: John M Flack.;Michel Azizi.;Jenifer M Brown.;Jamie P Dwyer.;Jakub Fronczek.;Erika S W Jones.;Daniel S Olsson.;Shira Perl.;Hirotaka Shibata.;Ji-Guang Wang.;Ulrica Wilderäng.;Janet Wittes.;Bryan Williams.; .
来源: N Engl J Med. 2025年393卷14期1363-1374页
Aldosterone dysregulation plays an important pathogenic role in hard-to-control hypertension. In several studies, baxdrostat, an aldosterone synthase inhibitor, reduced the seated systolic blood pressure of patients with uncontrolled or resistant hypertension.
15. Beta-Blockers after Myocardial Infarction in Patients without Heart Failure.
作者: John Munkhaugen.;Anna Meta D Kristensen.;Sigrun Halvorsen.;Therese Holmager.;Michael Hecht Olsen.;Arnhild Bakken.;Thomas S G Sehested.;Vidar Ruddox.;Michael Mæng.;Kjell Vikenes.;Svend E Jensen.;Terje Steigen.;Jess Lambrechtsen.;Jarle Jortveit.;Ann Bovin.;Henrik Schirmer.;Morten Krogh Christiansen.;Rune Wiseth.;Dennis Mikkelsen.;Alf Inge Larsen.;Camilla Lyngby Kjærgaard.;Kristoffer Andresen.;Ida Gustafsson.;Vegard Tuseth.;Mogens Lytken Larsen.;Peter Stefan Deeg.;Karsten Veien.;Ellen Bøhmer.;Hans Erik Bøtker.;Anja Otrebska Brattrud.;Jens Brønnum-Schou.;Alf-Åge Reistad Pettersen.;Lia Evi Bang.;Erik Øie.;Thomas Engstrøm.;Eva Bostad Borg.;Kjeld Kristensen.;Ståle Haugset Nymo.;Gunnar Gislason.;Nils Tore Vethe.;Jawdat Abdul Majid Abdulla.;Toril Dammen.;Mette Rauhe Mouridsen.;Bjørn Bendz.;Mette Lykke Norgaard Bertelsen.;Jens Dahlgaard Hove.;Louise Schierbeck.;Martin Snoer.;Cedric Davidsen.;Gro Egholm.;Kristian Korsgaard Thomsen.;Ghassan Jadou.;Monica Poenaru.;Nikolaj Thure Krarup.;Morten Böttcher.;Peter Bisgaard Stæhr.;Ann-Dorthe Zwisler.;Thor Edvardsen.;Christian Torp-Pedersen.;Jan Erik Otterstad.;Theis Lange.;Morten W Fagerland.;Dan Atar.;Eva Prescott.; .
来源: N Engl J Med. 2025年393卷19期1901-1911页
The evidence supporting beta-blocker therapy after myocardial infarction was established before the introduction of modern coronary reperfusion therapy and secondary prevention strategies.
16. Ciprofloxacin versus Aminoglycoside-Ciprofloxacin for Bubonic Plague.
作者: Rindra Vatosoa Randremanana.;Mihaja Raberahona.;Josephine Bourner.;Minoarisoa Rajerison.;Tansy Edwards.;Ravaka Randriamparany.;Tsinjo Fehizoro Razafindratsinana.;Lisy Hanitra Razananaivo.;Gabriella Zadonirina.;Théodora Mayouya-Gamana.;Alex Paddy Abdel Salam.;Reziky Tiandraza Mangahasimbola.;Voahangy Andrianaivoarimanana.;Elise Pesonel.;Rivonirina Andry Rakotoarivelo.;Mamy Jean de Dieu Randria.;Peter Horby.;Piero Olliaro.; .
来源: N Engl J Med. 2025年393卷6期544-555页
Plague is a high-consequence infectious disease with epidemic potential. Current treatment guidelines are based on weak evidence.
17. Measurable Residual Disease-Guided Therapy for Chronic Lymphocytic Leukemia.
作者: Talha Munir.;Sean Girvan.;David A Cairns.;Adrian Bloor.;David Allsup.;Abraham M Varghese.;Satyen Gohil.;Shankara Paneesha.;Andrew Pettitt.;Toby Eyre.;Christopher P Fox.;Francesco Forconi.;Ben Kennedy.;Constantine Balotis.;Nicholas Pemberton.;Oonagh Sheehy.;John Gribben.;Nagah Elmusharaf.;Simona Gatto.;Gavin Preston.;Anna Schuh.;Renata Walewska.;Lelia Duley.;Nichola Webster.;Surita Dalal.;Andrew Rawstron.;Dena Howard.;Anna Hockaday.;Sharon Jackson.;Natasha Greatorex.;Sue Bell.;David Stones.;Julia M Brown.;Piers E M Patten.;Peter Hillmen.; .
来源: N Engl J Med. 2025年393卷12期1177-1190页
An interim analysis of progression-free survival in this trial showed that ibrutinib-venetoclax was superior to fludarabine-cyclophosphamide-rituximab (FCR) among patients with chronic lymphocytic leukemia (CLL). Whether ibrutinib-venetoclax is more effective than ibrutinib alone is unclear.
18. Intravenous Rehydration for Severe Acute Malnutrition with Gastroenteritis.
作者: Kathryn Maitland.;San Maurice Ouattara.;Hadiza Sainna.;Abdullahi Chara.;Oluwakemi F Ogundipe.;Temmy Sunyoto.;M Hamaluba.;Peter Olupot-Olupot.;Florence Alaroker.;Roisin Connon.;Amadou Saidou Maguina.;William Okiror.;Denis Amorut.;Eric Mwajombo.;Emmanuel Oguda.;Christabel Mogaka.;Céline Langendorf.;Juan Emmanuel Dewez.;Iza Ciglenecki.;Diana M Gibb.;Matthew E Coldiron.;Roberta Petrucci.;Elizabeth C George.; .
来源: N Engl J Med. 2025年393卷13期1257-1268页
International recommendations advise against the use of intravenous rehydration therapy in children with severe acute malnutrition because of the concern about fluid overload, but evidence to support this concern is lacking. Given the high mortality associated with the current recommendations, the adoption of intravenous rehydration strategies might improve outcomes.
19. 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.
20. 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.
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