jamanetwork.com
Open in
urlscan Pro
40.76.153.40
Public Scan
Submitted URL: https://jamanetwork.com/journals/jama/fullarticle/2817337?utm_campaign=articlePDF
Effective URL: https://jamanetwork.com/journals/jama/article-abstract/2817337?utm_campaign=articlePDF
Submission: On July 03 via manual from IN — Scanned from DE
Effective URL: https://jamanetwork.com/journals/jama/article-abstract/2817337?utm_campaign=articlePDF
Submission: On July 03 via manual from IN — Scanned from DE
Form analysis 1 forms found in the DOM
POST ./2817337?utm_campaign=articlePDF
<form method="post" action="./2817337?utm_campaign=articlePDF" id="webform" class="m0" novalidate="novalidate">
<div class="aspNetHidden">
<input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" value="auZ3W4AaqUBm7Tzl89rYa4gX72BEzg0StgcG6VqT0OJ7No/iNylz3NLsEw6tozUWyhcCBxSQdmGj+XxgesbDMJ9rSEw=">
</div>
<div class="aspNetHidden">
<input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="2FAFABAE">
<input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION"
value="9BOLAH88xXr+r6Qfmu0T2EMeYdJPjrNpqh2gKBqxY13k0GRDvwnzwxUM2J3r1jA/7bhw25U+K2+RI5k9gFu33XcaN7r4zbRH7HY65nSzbxDj2WUH1DcgvAEXixCbtngHLuMJd3MCQ0Y4Xn9zMtiPHIy4q8KW0wXSJ717QHPD7EbxZMZZCQ74q3xKungwjBFPEs1Jqy6rgVVT6oqb1i0WerMW8zRWFgfA9qOf2b52P3xEO0JP4wyQJOS6hQgpOsbgQZbouPyUN+WfyuSGyEA7e2heoc6ZMQXtaAOnDlk17nvv37calAkiiYVuWr+akkHKIRpHca2fC+qbciwnUf1CvU2ixbuKJikufVnmypuWkjgRnj7uvs4XNFDwqrmLFEYSw5IjFpTtcnYUQ5p5hWMga2KSlHQFFmjJ1Lze0FQRQDjeU8a9HvyKyZEuGIFl2ODqDmwlCx2/PJQIZPoBq6wuA6YMXGs0IthfiRFw63TwpeLg53E/U5y6w9IpzQjRitRoM7VihEOQNiXegHf6HmUFxI/c7zK7KJwugNEGEKng6LYzZQ9Jd4TtTx+7apdpUqHS4yZSuJ3VQ0eboSbb3RULI5l5IGQN7Tt6ovK6CUXyTC+CUfOI1ZqlIdc6gCud0wjvAVQY2Pq06zFBFrwzmJ2QVIDckXI=">
</div>
<input id="hdnSiteID" type="hidden" value="3">
<input id="hdnDomain" type="hidden" value=".jamanetwork.com">
<section class="master-header">
<script type="text/javascript">
var App = App || {};
App.LoginUserInfo = {
isInstLoggedIn: [0],
currentSessionId: 'wipd1grigmp54rbudc0onobc'
};
</script>
<input name="ctl00$ctl00$BodyContent$Header$hfGlobalSearchSiteURL" type="hidden" id="hfGlobalSearchSiteURL" value="https://jamanetwork.com/">
<input name="ctl00$ctl00$BodyContent$Header$hfAppIsPaidUser" type="hidden" id="hfAppIsPaidUser" value="false">
<input name="ctl00$ctl00$BodyContent$Header$hfAppIsMember" type="hidden" id="hfAppIsMember" value="false">
<input name="ctl00$ctl00$BodyContent$Header$hfAppSubscribedTo" type="hidden" id="hfAppSubscribedTo">
<input name="ctl00$ctl00$BodyContent$Header$hfAppIsIndividual" type="hidden" id="hfAppIsIndividual" value="false">
<input name="ctl00$ctl00$BodyContent$Header$hfAppHasAccess" type="hidden" id="hfAppHasAccess" value="false">
<input name="ctl00$ctl00$BodyContent$Header$hfAppIsReferredFromGoogle" type="hidden" id="hfAppIsReferredFromGoogle" value="False">
<input name="ctl00$ctl00$BodyContent$Header$hfSolrAutoSuggestMinimumCharactersLength" type="hidden" id="hfSolrAutoSuggestMinimumCharactersLength" value="2">
<input name="ctl00$ctl00$BodyContent$Header$hfSolrJournalName" type="hidden" id="hfSolrJournalName" value="JAMA">
<input name="ctl00$ctl00$BodyContent$Header$hfSolrJournalID" type="hidden" id="hfSolrJournalID" value="J67">
<input name="ctl00$ctl00$BodyContent$Header$hfAppIsLucy" type="hidden" id="hfAppIsLucy" value="false">
<div class="header-wrap">
<header class="header">
<div class="widget-GdprCookieBanner widget-instance-GdprCookieBanner">
<div class="gdpr-cookie-wrapper js-gdpr-banner">
<div class="gdpr-cookie-body"> Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our
<a href="https://jamanetwork.com/pages/privacy-policy#cookies">Cookie Policy</a> <span class="pipe">|</span> <a href="javascript:;" class="js-gdpr-cookie-acceptLink at-acceptgdpr">Continue</a> </div>
<input id="hdnDomain" type="hidden" value=".jamanetwork.com">
<input id="hdnDomainGdpr" type="hidden" value=".jamanetwork.com">
<input id="hdnClientIdGdpr" type="hidden" value="3">
</div>
</div>
<div class="network-bar">
<a class="jama-network" href="/" title="JAMA Network Home">
<img alt="JAMA Network Home" class="title-image" width="443" height="52" src="//cdn.jamanetwork.com/UI/app/svg/Jama_Network_Logo.svg">
</a>
</div>
<a class="nav-toggler" href="#nav">
<div class="nav-toggler-indicator">
<span class="indicator-stroke"></span>
<span class="indicator-stroke"></span>
<span class="indicator-stroke"></span>
<span class="indicator-stroke"></span>
</div>
<div class="nav-toggler-site">
<span id="BodyContent_Header_siteFullNamenav" class="nav-toggler-microsite"><span class="network">JAMA</span></span>
</div>
</a>
<nav id="nav" class="nav hide">
<div class="nav-journal-level sb-nav-journal-level">
<a href="https://jamanetwork.com/journals/jama" id="BodyContent_Header_rptMicrositeHeaders_aItemResourceList_0" class="home">Home</a><a href="https://jamanetwork.com/journals/jama/newonline" id="BodyContent_Header_rptMicrositeHeaders_aItemResourceList_1" class="new-online">New Online</a><a href="https://jamanetwork.com/journals/jama/currentissue" id="BodyContent_Header_rptMicrositeHeaders_aItemResourceList_2" class="current-issue">Current Issue</a><a href="https://jamanetwork.com/journals/jama/pages/for-authors" id="BodyContent_Header_rptMicrositeHeaders_aItemResourceList_3" class="for-authors">For Authors</a>
</div>
<div class="nav-journals">
<div class="widget-SelfServeContent widget-instance-HamburgerPublicationMenu">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="HamburgerPublicationMenu">
<input type="hidden" class="SelfServeVersionId" value="0">
<style type="text/css">
.nav-journals {
margin-bottom: 1em;
}
.nav-heading {
color: #B9B9B9;
border-bottom: 1px solid #242424;
border-top: 1px solid #242424;
font-size: 1.15em;
font-weight: 400;
margin: 0;
padding: .7em .75em;
text-transform: uppercase;
}
a.no-bullet:before {
content: none !important;
}
.nav-heading {
font-size: 1.15em;
margin-bottom: 0;
padding-left: 38px;
}
.nav-journals a.theme-jama {
background-color: #242424;
border-bottom: 1px solid #fff;
border-top: 1px solid #fff;
color: #fff;
font-size: 1.15em;
margin-bottom: 8px;
padding: 11px 0 9px 37px;
}
.nav-journals a.theme-jama::before {
background: unset;
content: "\e91b";
display: none;
font-family: ama_icons !important;
font-size: 1.25em;
line-height: 1;
}
.nav-journals a.theme-jama-network-open {
border-bottom: 0;
}
.nav .widget-instance-HamburgerPublicationMenu a {
padding-left: 36px;
}
.fake-ribbon {
border-left: 8px solid #BE1E32;
}
.fake-ribbon a:before {
content: none;
}
.nav .widget-instance-HamburgerPublicationMenu .fake-ribbon a {
padding-left: 30px;
}
</style>
<h2 class="nav-heading">Journals</h2>
<a href="/journals/jama" class="theme-jama">JAMA</a>
<a href="/journals/jamanetworkopen" class="theme-jama-network-open">JAMA Network Open</a>
<a href="/journals/jamacardiology" class="theme-jama-cardiology">JAMA Cardiology</a>
<a href="/journals/jamadermatology" class="theme-jama-dermatology">JAMA Dermatology</a>
<a href="/journals/jama-health-forum" class="theme-jama-health-forum">JAMA Health Forum</a>
<a href="/journals/jamainternalmedicine" class="theme-jama-internal-medicine">JAMA Internal Medicine</a>
<a href="/journals/jamaneurology" class="theme-jama-neurology">JAMA Neurology</a>
<a href="/journals/jamaoncology" class="theme-jama-oncology">JAMA Oncology</a>
<a href="/journals/jamaophthalmology" class="theme-jama-ophthalmology">JAMA Ophthalmology </a>
<a href="/journals/jamaotolaryngology" class="theme-jama-otolaryngology-head-neck-surgery">JAMA Otolaryngology–Head & Neck Surgery</a>
<a href="/journals/jamapediatrics" class="theme-jama-pediatrics">JAMA Pediatrics</a>
<a href="/journals/jamapsychiatry" class="theme-jama-psychiatry">JAMA Psychiatry</a>
<a href="/journals/jamasurgery" class="theme-jama-surgery">JAMA Surgery</a>
<a href="/journals/archneurpsyc" class="theme-archives-of-neurology-psychiatry-1919-1959-">Archives of Neurology & Psychiatry (1919-1959)</a>
<h2 class="nav-heading">Podcasts</h2>
<a href="/journals/jama/pages/jama-clinical-reviews">Clinical Reviews</a>
<a href="/journals/jama/pages/jama-editors-summary">Editors' Summary</a>
<a href="/journals/jama/pages/jama-medical-news">Medical News</a>
<a href="/journals/jama/pages/jama-author-interviews">Author Interviews</a>
<a href="/pages/audio" class="no-bullet">More</a>
</div>
</div>
</div>
<div class="nav-network-other">
<a href="https://edhub.ama-assn.org/jn-learning" id="BodyContent_Header_rptOtherResources_aItemResourceList_0" class="is-b link-jn-learning-cme" target="_blank">JN Learning / CME</a><a href="https://store.jamanetwork.com/index.aspx?productcode=64" id="BodyContent_Header_rptOtherResources_aItemResourceList_1" class="is-b link-subscribe" target="_blank">Subscribe</a><a href="https://careers.jamanetwork.com/" id="BodyContent_Header_rptOtherResources_aItemResourceList_2" class="is-b link-jobs" target="_blank">Jobs</a><a href="https://jamanetwork.com/pages/resources-for-librarians" id="BodyContent_Header_rptOtherResources_aItemResourceList_3" class="is-b link-institutions-librarians">Institutions / Librarians</a><a href="https://jamanetwork.com/pages/reprints-and-permissions" id="BodyContent_Header_rptOtherResources_aItemResourceList_4" class="is-b link-reprints-permissions" rel="nofollow">Reprints & Permissions</a>
</div>
<div class="white text-xxs">
<div class="p05 ml4 mr3 mb1 mt10 flex hamburger-menu-legal">
<a href="/pages/conditions-of-use" class="p0" rel="nofollow">Terms of Use</a>
<span class="pl1 pr1">| </span>
<a href="/pages/privacy-policy" class="p0" rel="nofollow">Privacy Policy</a>
<span class="pl1 pr1">| </span>
<a href="/pages/accessibility-statement" class="p0" rel="nofollow">Accessibility Statement</a>
</div>
<div class="ta-c">
<span class="pb1">2024 American Medical Association. All Rights Reserved</span>
</div>
</div>
</nav>
<a class="toolbar-search-trigger is-b" data-mobile-tog-target=".site-search"></a>
<div id="site-search" role="search" class="site-search">
<div class="site-search-bar">
<div role="search">
<div class="cs-select cs-skin-border" tabindex="0"><span class="cs-placeholder is-a">Search All</span>
<div class="cs-options">
<ul>
<li role="options" data-option="" data-value="J*" aria-label="Search All" name="Search All" value="J*"><span>Search All</span></li>
<li role="options" data-option="" data-value="3" aria-label="JAMA" name="JAMA" value="3"><span>JAMA</span></li>
<li role="options" data-option="" data-value="214" aria-label="JAMA Network Open" name="JAMA Network Open" value="214"><span>JAMA Network Open</span></li>
<li role="options" data-option="" data-value="192" aria-label="JAMA Cardiology" name="JAMA Cardiology" value="192"><span>JAMA Cardiology</span></li>
<li role="options" data-option="" data-value="12" aria-label="JAMA Dermatology" name="JAMA Dermatology" value="12"><span>JAMA Dermatology</span></li>
<li role="options" data-option="" data-value="261" aria-label="JAMA Forum Archive" name="JAMA Forum Archive" value="261"><span>JAMA Forum Archive</span></li>
<li role="options" data-option="" data-value="193" aria-label="JAMA Health Forum" name="JAMA Health Forum" value="193"><span>JAMA Health Forum</span></li>
<li role="options" data-option="" data-value="15" aria-label="JAMA Internal Medicine" name="JAMA Internal Medicine" value="15"><span>JAMA Internal Medicine</span></li>
<li role="options" data-option="" data-value="16" aria-label="JAMA Neurology" name="JAMA Neurology" value="16"><span>JAMA Neurology</span></li>
<li role="options" data-option="" data-value="159" aria-label="JAMA Oncology" name="JAMA Oncology" value="159"><span>JAMA Oncology</span></li>
<li role="options" data-option="" data-value="17" aria-label="JAMA Ophthalmology" name="JAMA Ophthalmology" value="17"><span>JAMA Ophthalmology</span></li>
<li role="options" data-option="" data-value="18" aria-label="JAMA Otolaryngology–Head & Neck Surgery" name="JAMA Otolaryngology–Head & Neck Surgery" value="18"><span>JAMA Otolaryngology–Head & Neck Surgery</span></li>
<li role="options" data-option="" data-value="19" aria-label="JAMA Pediatrics" name="JAMA Pediatrics" value="19"><span>JAMA Pediatrics</span></li>
<li role="options" data-option="" data-value="14" aria-label="JAMA Psychiatry" name="JAMA Psychiatry" value="14"><span>JAMA Psychiatry</span></li>
<li role="options" data-option="" data-value="20" aria-label="JAMA Surgery" name="JAMA Surgery" value="20"><span>JAMA Surgery</span></li>
<li role="options" data-option="" data-value="23" aria-label="Archives of Neurology & Psychiatry" name="Archives of Neurology & Psychiatry" value="23"><span>Archives of Neurology & Psychiatry</span></li>
</ul>
</div><select name="ctl00$ctl00$BodyContent$Header$ddlForSearch" id="BodyContent_Header_ddlForSearch" class="cs-select cs-skin-border" title="Search Site Selector" role="options" aria-labelledby="searchLabel">
<option value="J*">Search All</option>
<option value="3">JAMA</option>
<option value="214">JAMA Network Open</option>
<option value="192">JAMA Cardiology</option>
<option value="12">JAMA Dermatology</option>
<option value="261">JAMA Forum Archive</option>
<option value="193">JAMA Health Forum</option>
<option value="15">JAMA Internal Medicine</option>
<option value="16">JAMA Neurology</option>
<option value="159">JAMA Oncology</option>
<option value="17">JAMA Ophthalmology</option>
<option value="18">JAMA Otolaryngology–Head & Neck Surgery</option>
<option value="19">JAMA Pediatrics</option>
<option value="14">JAMA Psychiatry</option>
<option value="20">JAMA Surgery</option>
<option value="23">Archives of Neurology & Psychiatry</option>
</select>
</div>
</div>
<div class="search-input-container">
<input type="search" name="textbox" autocomplete="off" role="textbox" id="search-term" aria-labelledby="searchLabel" class="search-term at-microsite-search-term" placeholder="Enter Search Term" maxlength="255" title="Enter Search Term">
<ul id="umbrellaSiteAutoCompleteResults" class="term-list hidden"></ul>
<label style="display:none" for="umbrellaSiteSearchInputHint" id="searchLabel">Input Search Term</label>
<input class="searchTerm search-input" name="textbox" role="textbox" type="text" id="umbrellaSiteSearchInputHint" aria-labelledby="searchLabel" title="Input Search Term" autocomplete="off">
</div>
<!-- /.search-input-container -->
<a name="button" role="button" class="search-button is-b" alt="search button" href="javascript:;"></a>
</div>
</div>
<div id="BodyContent_Header_GlobalSignIn_auth" class="auth">
<a class="auth--trigger is-b is-a" href="javascript:;">
<span id="BodyContent_Header_GlobalSignIn_spnUserFullName" class="user-full-name">Sign In</span>
</a>
<div class="auth--dropdown js-signIn-dropdown">
<div class="auth--option auth--ind">
<div id="BodyContent_Header_GlobalSignIn_divUserFullName" class="auth--ind-user"></div>
<div id="BodyContent_Header_GlobalSignIn_divIndSignIn" class="auth--ind-auth">
<div class="auth--title">Individual Sign In</div>
<a href="https://jamanetwork.com/oauthsignin?return_url=https%3a%2f%2fjamanetwork.com%2fjournals%2fjama%2ffullarticle%2f2817337%3futm_campaign%3darticlepdf" id="BodyContent_Header_GlobalSignIn_oauthSignInLink" rel="nofollow" class="auth--ind-sign-in">Sign in</a><a href="https://jamanetwork.com/oauthsignin?return_url=https%3a%2f%2fjamanetwork.com%2fjournals%2fjama%2ffullarticle%2f2817337%3futm_campaign%3darticlepdf" id="BodyContent_Header_GlobalSignIn_oauthSignUpLink" rel="nofollow" class="auth--ind-create">Create an Account</a>
</div>
</div>
<div id="BodyContent_Header_GlobalSignIn_divInstSignIn" class="auth--option auth--inst">
<div class="auth--inst-auth">
<div class="auth--title">Access through your institution</div>
<a href="/signinshibboleth?returnUrl=https%3a%2f%2fjamanetwork.com%2fjournals%2fjama%2ffullarticle%2f2817337%3futm_campaign%3darticlepdf" id="BodyContent_Header_GlobalSignIn_institutionSignIn" rel="nofollow" class="auth--shib">Sign In</a>
</div>
</div>
<div id="BodyContent_Header_GlobalSignIn_divPurchaseOptions" class="auth--option auth--purchase">
<div class="auth--title">Purchase Options:</div>
<a id="BodyContent_Header_GlobalSignIn_lnkBuyArticle" class="auth--buy" href="https://jamanetwork.com/oauthsignin?return_url=https://store.jamanetwork.com/CustomerType.aspx?articleId=2817337">Buy this article</a>
<div class="widget-DeepDyve widget-instance-AMAv2_DeepDyve">
<a rel="nofollow" data-doi="10.1001/jama.2024.2396" data-fieldname="journal_doi" data-issneissn="0098-7484" data-affiliate="JAMA" class="deepDiveLink auth--shib deep-dive-wrap js-deepdyve-link show" href="https://www.deepdyve.com/lp/jama/clinical-benefit-and-regulatory-outcomes-of-cancer-drugs-receiving-8hqwSvGHms?key=JAMA" target="_blank">Rent this article</a>
</div>
<a id="BodyContent_Header_GlobalSignIn_lnkSubscribeJournal" class="auth--subscribe" rel="nofollow" href="https://store.jamanetwork.com/index.aspx?productcode=64">Subscribe to the JAMA journal</a>
</div>
</div>
</div>
</header>
</div>
<div class="editors-choice-header">
</div>
<div id="BodyContent_Header_divAds" class="header-ad-wrap sb-background-primary-dark">
<div class="leader-ad desktop-only">
<div id="ad-leaderboard" class="ad-leaderboard advertisement desktop-only ad-text vert" data-slot="1" data-google-query-id="CPLu0eDsiYcDFQXluwgdr8wJfg">
<div id="google_ads_iframe_/6479/ama.jama/abstract_1__container__" style="border: 0pt none;"><iframe id="google_ads_iframe_/6479/ama.jama/abstract_1" name="google_ads_iframe_/6479/ama.jama/abstract_1" title="3rd party ad content"
width="728" height="90" scrolling="no" marginwidth="0" marginheight="0" frameborder="0" aria-label="Advertisement" tabindex="0" allow="attribution-reporting" data-load-complete="true" data-google-container-id="2"
style="border: 0px; vertical-align: bottom;"></iframe></div>
</div>
</div>
</div>
<!-- /.header-ad-wrap -->
</section>
<section class="master-main">
<span class="hide tagmanagervalue" data-attribute="template" data-value="abstract" data-type="string"></span>
<script type="application/ld+json">
{
"@context": "https://schema.org/",
"@type": "Article",
"headline": "Clinical Benefit and Regulatory Outcomes of Cancer Drugs Receiving Accelerated Approval",
"author": "Ian T. T. Liu, MD, JD, MPH, MS",
"url": "https://jamanetwork.com/journals/jama/fullarticle/2817337",
"datePublished": "2024-05-07",
"description": "This study aims to determine whether cancer drugs granted accelerated approval from the US Food and Drug Administration ultimately demonstrate clinical benefit and to evaluate the basis of conversion to regular approval.",
"publisher": {
"@type": "Organization",
"name": "JAMA Network",
"logo": {
"@type": "ImageObject",
"url": "//cdn.jamanetwork.com/UI/app/img/favicons/jama/favicon.ico"
}
},
"image": [
"https://cdn.jamanetwork.com/ama/content_public/journal/jama/939367/joi240021f1_1714069796.68679.png?Expires=2147483647&Signature=N-keObEtwwU-fVVvLVt341q1q2Mc-Tm9F6NrNRkYlLSoKg3i9O1v25wBcYmV4YHXXJPQGcv9G4haNf15aAE29FWEV0T4pYPioBuXNbIiecQGbTL3~VonJtd3wj9MKwGuudIckW9qF-yVP7FReJoQD5whAH9HbBqMM0rw9jI42Czjm8LLpsR8jGQlAg9Cw1UZex2K29Tsviy8NopH3ZFRM~rNM4x9lnclKGtJUDuD62QBPFIhf~W1QSqMenSMouCmeWptpoVR6vDnrfX9OOxqLj274SA0ZqN6vmFQkI-prdTYoxkVmfPA3dQp8cTBEPKB~gRPf8xlaOx9bercWK~glQ__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA",
"https://cdn.jamanetwork.com/ama/content_public/journal/jama/939367/joi240021t1_1714069796.70079.png?Expires=2147483647&Signature=0kWQSoi5DxqyF6UHCQiKgJ~GWEGy-LOP0Mnw50G9a4tv3HLhLPikHelJS9BSP27J5lZmMixu3DakufgUzz8ZnemQVjvjoGKhDTVcXWYG4oj9iI8nHXPUp9TuzvAXxBHrt5~alERoNrNPVQSx44NAvJPuVm-MhhsSoW-QK7R0k6ILoU0IS7by8L-AoQQEx3tAP5B40TDSLEAtyF-bryVpwPUtqRgwfsyIDZRywuFLB7vzsCtrIX1BcAqwFf963cgdu~scFgDI9GusHi96r6zhpj5iCZW4caEoX67YRcK1BvDjy621Nda7UsgDSYPZnRqh1QXWTPx6GkvyQVNCGxjz-w__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA",
"https://cdn.jamanetwork.com/ama/content_public/journal/jama/939367/joi240021f2_1714069796.72479.png?Expires=2147483647&Signature=QkK5Mg6axIrILclxRtxrwWkCjYjhyjrGj2DJUlrqP8e0elac5ot22GTgSxkuxrSIZRKCbDa5-Z6DSmL24W5FUOwbFdjf-PKdSFZABL5j1oG8EzCJ2LS5AmjiN93UoDDPjNn2lUM9QJVFZ7Xoztv24kXUKNOwAUztITzzDV9~LbOicRqTIAyPYPm0DhOyy05QgMl4asaPdbFzGaZ8B6oo~WkreAvIiEP2fO0iOxvHVAm0OVSDUqa-~PQSyD7nL0UvzakSuuH6j44n~84k3dIeKf3GFmLB8VHBor3VZeyUGJeC0E0yVZiwTbIvlQAehS7YdFh1FYCyney2KH5EonJJcw__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA",
"https://cdn.jamanetwork.com/ama/content_public/journal/jama/939367/joi240021f3_1714069796.73579.png?Expires=2147483647&Signature=1I-y9srv0GlSCvgOzS45Oiqm01M0ysabU0O8a~Bwdeyp~ZBCsodAuwjPzE39dRxUYFO6NuyADnagzHqoe7--oqjhrYmAC6i1EBS6iPwF2ZcaDsqg95EDgOzBdny97hJf-8rIJZ8IQ7Ab28Td4ALxfIqBibTOd7O-5AkE~TOZxTd6ftKoJYUrasPmDBaZpewAtKcLyWRJz4iQEXcXPf3ig4On-p2F8gNZeAHj4NwblzRxtxdzV3BaK4UA5HV9YPI0xzEKa4bhoYYvE2AurAr45kgv338xI7aTN6Lx1igo6t-Fj8Z7wSUONBAVEHDQPr5nWPP6EO3isVvJDWx47IwqiA__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA"
],
"articleSection": ["Introduction", "Methods", "Cohort Selection and Data Extraction", "Accelerated Approval Determinations", "Overall Survival and Quality-of-Life Data", "Time to Regulatory Outcome", "Conversion to Regular Approval",
"Statistical Analysis", "Results", "Five-Year Outcomes of Accelerated Approval", "Time to Conversion or Withdrawal", "Indications Converted to Regular Approval", "Discussion", "Limitations", "Conclusions", "Article Information",
"References"
],
"keyWords": "antineoplastic agents, posttreatment followup, accelerated approval, quality of life, surrogate endpoints"
}
</script>
<div class="widget-UserContentAccessWrite widget-instance-AMA_UserContentAccessWrite_AbstractView">
<div class="SCM-SharedWidgets-LocalStorage-UserContentAccessWrite" data-values="{"id":"2817337","type":"Article","date":"7/3/2024 2:43:34 AM"}"></div>
</div>
<a id="skip-to-navigation" href="#" tabindex="-1"></a>
<div class="ymal--leader hide-small">
<div id="BodyContent_PageContent_ymalPersonalized" class="ymal--personalized js-ymal-personalized">
<div class="widget-PersonalizedContent widget-instance-AMA_PersonalizedContent_AbstractView_Leaderboard loaded">
<div class="row ymal">
<h4 class="ymal--hed thm-col-sec"> Trending </h4>
<ul class="ymal--content featured-list--contents">
<li class="article ymal--item thm-bd-top bd-jama-sec">
<a class="article--title d-b mb05" href="https://jamanetwork.com/journals/jama/fullarticle/2819132?widget=personalizedcontent&previousarticle=2817337">Survival Benefit Associated With Participation in Clinical Trials of Anticancer Drugs</a>
<div class="article--type meta-item">Research</div>
<div class="article--date meta-item no-wrap">May 20, 2024</div>
</li>
<li class="article ymal--item thm-bd-top bd-jama-sec">
<a class="article--title d-b mb05" href="https://jamanetwork.com/journals/jama/fullarticle/2785217?widget=personalizedcontent&previousarticle=2817337">Paying for Cancer Drugs That Prove Their Benefit</a>
<div class="article--type meta-item">Opinion</div>
<div class="article--date meta-item no-wrap">October 11, 2021</div>
</li>
</ul>
</div>
<script type="text/javascript">
SCM.AMA.DataLayerAsync.push("arrYMALtop", "10.1001/jama.2024.6281,10.1001/jama.2021.18308", "array");
</script>
</div>
</div>
<div id="BodyContent_PageContent_ymalCurated" class="ymal--curated js-ymal-curated hide">
<div class="ymal row">
</div>
</div>
</div>
<div class="content pb0">
<a id="top"></a>
<div class="article-content">
<div class="social-share hide" data-share-journal="JAMA_current" data-share-title="Clinical Benefit and Regulatory Outcomes of Cancer Drugs Receiving Accelerated Approval">
<a class="st-custom-button addthis_button_twitter is-b toolbar-twitter toolbar-share" data-network="twitter" data-title="Clinical Benefit and Regulatory Outcomes of Cancer Drugs Receiving Accelerated Approval" data-url="https://jamanetwork.com/journals/jama/fullarticle/2817337?utm_source=twitter&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=070324" data-email-subject="Clinical Benefit and Regulatory Outcomes of Cancer Drugs Receiving Accelerated Approval" rel="nofollow" href="javascript:;">
<span class="share-text">X</span>
</a>
<a class="st-custom-button addthis_button_facebook is-b toolbar-facebook toolbar-share" data-network="facebook" data-title="Clinical Benefit and Regulatory Outcomes of Cancer Drugs Receiving Accelerated Approval" data-url="https://jamanetwork.com/journals/jama/fullarticle/2817337?utm_source=facebook&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=070324" data-email-subject="Clinical Benefit and Regulatory Outcomes of Cancer Drugs Receiving Accelerated Approval" rel="nofollow" href="javascript:;">
<span class="share-text">Facebook</span>
</a>
<div class="toolbar-share-more">
<a class="st-custom-button addthis_button_linkedin is-b toolbar-linkedin toolbar-share" data-network="linkedin" data-title="Clinical Benefit and Regulatory Outcomes of Cancer Drugs Receiving Accelerated Approval" data-url="https://jamanetwork.com/journals/jama/fullarticle/2817337?utm_source=linkedin&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=070324" data-email-subject="Clinical Benefit and Regulatory Outcomes of Cancer Drugs Receiving Accelerated Approval" rel="nofollow" href="javascript:;">
<span class="share-text">LinkedIn</span>
</a>
</div>
<a class="toolbar-share-more-link is-a" rel="nofollow" data-tog-target=".social-share .toolbar-share-more"><span class="icon icon-carrot_down social-arrow"></span>More</a>
</div>
<div class="widget-ArticleLinks widget-instance-AMA_ErrataArticleLinks_Abstract">
</div>
<div class="widget-ArticleLinks widget-instance-AMA_ArticleLinks_ToErrata_Abstract">
</div>
<div class="widget-ArticleNavLinks widget-instance-AMA_ArticleNavLinks_Abstract">
<a class="toc-link btn" href="https://jamanetwork.com/journals/jama/issue/331/17">This Issue</a>
</div>
<div id="BodyContent_PageContent_divArticleLevelMetrics" class="article-metrics-wrapper">
<div class="widget-ArticleLevelMetrics widget-instance-AMA_ArticleMetrics">
<div class="artmet-condensed-wrap clearfix">
<div class="artmet-condensed-stats clearfix">
<div class="artmet-item artmet-views">
<span class="artmet-text sb-sc">Views</span>
<span class="artmet-number sb-sc">29,962</span>
</div>
<div class="artmet-item artmet-citations">
<a class="artmet-citations-link" href="https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=silverchair&SrcAuth=WosAPI&KeyUT=WOS:001201438000001&DestLinkType=FullRecord&DestApp=WOS_CPL" target="_blank">
<span class="artmet-text">Citations</span>
<span class="artmet-number">1</span>
</a>
</div>
<div class="artmet-item artmet-altmetric">
<div class="widget-AltmetricLink widget-instance-AMAv2_ArticleLevelMetrics_AltmetricLinkSummary">
<!-- Altmetrics -->
<div id="altmetricEmbedId" class="altmetric-embed" data-link-target="_blank" data-badge-type="text" data-hide-no-mentions="false" data-doi="10.1001/jama.2024.2396" data-uuid="44aca3d2-a7f4-420e-31fa-ff6185c4c4bf"><a target="_blank" href="https://www.altmetric.com/details.php?domain=jamanetwork.com&citation_id=161631354" style="display:inline-block;">
<span class="_altmetric_score sb-sc visible">1874</span>
</a></div>
</div>
</div>
</div>
<div class="artmet-modal-trigger-wrap">
<a rel="nofollow" class="artmet-modal-trigger" data-article-id="2817337"><i class="icon-metrics"></i><span>View Metrics</span></a>
</div>
</div>
</div>
</div>
<ul class="toolbar-trigger">
<li class="toolbar-pdf-wrap toolbar-tool-wrap">
<a class="toolbar-tool toolbar-pdf is-b" data-trigger=".abstract-toolbar .toolbar-pdf"><span class="toolbar-pdf-text"><span class="toolbar-link-text-extra">Download </span><span class="toolbar-link-text">PDF</span></span></a>
</li>
<li class="toolbar-full-text-wrap toolbar-tool-wrap">
<a class="toolbar-tool toolbar-full-text is-b" data-url="" data-article-id="2817337" data-trigger=".abstract-toolbar .toolbar-full-text">Full Text</a>
</li>
<li class="toolbar-share-wrap toolbar-tool-wrap">
<div class="toolbar-tool toolbar-share is-b">
<a class="toolbar-share-more-link">Share</a>
<div class="toolbar-share-more">
<a class="toolbar-share toolbar-twitter is-b" rel="nofollow" data-trigger=".social-share .toolbar-twitter"><span class="share-text">X</span></a>
<a class="toolbar-share toolbar-facebook is-b" rel="nofollow" data-trigger=".social-share .toolbar-facebook"><span class="share-text">Facebook</span></a>
<a class="toolbar-share toolbar-email is-b" rel="nofollow" data-trigger=".social-share .toolbar-email"><span class="share-text">Email</span></a>
<a class="toolbar-share toolbar-linkedin is-b" rel="nofollow" data-trigger=".social-share .toolbar-linkedin"><span class="share-text">LinkedIn</span></a>
</div>
</div>
</li>
<li class="toolbar-citation-wrap toolbar-tool-wrap">
<a class="toolbar-tool toolbar-citation is-b stats-citation" rel="nofollow" data-trigger=".abstract-toolbar .toolbar-citation"><span class="toolbar-link-text">Cite</span> <span class="toolbar-link-text-extra">This</span></a>
</li>
<li class="toolbar-permissions-wrap toolbar-tool-wrap">
<a class="toolbar-tool toolbar-permissions is-b" rel="nofollow" data-trigger=".abstract-toolbar .toolbar-permissions"><span class="toolbar-link-text">Permissions</span></a>
</li>
</ul>
<div class="widget-ArticleTopInfo widget-instance-AMA_ArticleTop_Info_Widget">
<span class="hide tagmanagervalue" data-attribute="articleId" data-value="2817337" data-type="string"></span>
<span class="hide tagmanagervalue" data-attribute="arrArticleAuthor"
data-value="Ian%20T.%20T.%C2%A0Liu%2C%C2%A0MD%2C%20JD%2C%20MPH%2C%20MS,Aaron%20S.%C2%A0Kesselheim%2C%C2%A0MD%2C%20JD%2C%20MPH,Edward%20R.%20Scheffer%C2%A0Cliff%2C%C2%A0MBBS%2C%20MPH" data-type="array"></span>
<span class="hide tagmanagervalue" data-attribute="articleDOI" data-value="10.1001/jama.2024.2396" data-type="string"></span>
<span class="hide tagmanagervalue" data-attribute="articleTitle" data-value="Clinical Benefit and Regulatory Outcomes of Cancer Drugs Receiving Accelerated Approval" data-type="string"></span>
<span class="hide tagmanagervalue" data-attribute="type" data-value="Original Investigation" data-type="string"></span>
<span class="hide tagmanagervalue" data-attribute="issueVolume" data-value="331" data-type="string"></span>
<span class="hide tagmanagervalue" data-attribute="issueNo" data-value="17" data-type="string"></span>
<span class="hide tagmanagervalue" data-attribute="publishDate" data-value="May 7, 2024" data-type="string"></span>
<span class="hide tagmanagervalue" data-attribute="topics" data-value="Oncology, Drug Development, Law and Medicine" data-type="array"></span>
<span class="hide tagmanagervalue" data-attribute="topicCode" data-value="5801, 42054, 5716" data-type="array"></span>
<span class="hide tagmanagervalue" data-attribute="category" data-value="Research" data-type="string"></span>
<span class="hide tagmanagervalue" data-attribute="journalClub" data-value="No" data-type="string"></span>
<span class="hide tagmanagervalue" data-attribute="contentStatus" data-value="Locked" data-type="string"></span>
<span class="hide tagmanagervalue" data-attribute="articlePubState" data-value="Final" data-type="string"></span>
<span class="hide tagmanagervalue" data-attribute="contentMedium" data-value="Article" data-type="string"></span>
<div class="meta-article-type-wrap">
<div class="meta-article-type thm-col">Original Investigation </div>
</div>
<div class="meta-date">April 7, 2024</div>
<div class="meta-article-title-wrap">
<h1 class="meta-article-title ">Clinical Benefit and Regulatory Outcomes of Cancer Drugs Receiving Accelerated Approval</h1>
</div>
<div class="meta-authors">
<span class="wi-fullname brand-fg"><a href="/searchresults?author=Ian+T.+T.+Liu&q=Ian+T.+T.+Liu" rel="nofollow" target="_blank">Ian T. T. Liu, MD, JD, MPH, MS<sup>1</sup></a></span><span class="al-author-delim">;
</span><span class="wi-fullname brand-fg"><a href="/searchresults?author=Aaron+S.+Kesselheim&q=Aaron+S.+Kesselheim" rel="nofollow" target="_blank">Aaron S. Kesselheim, MD, JD, MPH<sup>1</sup></a></span><span
class="al-author-delim">; </span><span
class="wi-fullname brand-fg"><a href="/searchresults?author=Edward+R.+Scheffer+Cliff&q=Edward+R.+Scheffer+Cliff" rel="nofollow" target="_blank">Edward R. Scheffer Cliff, MBBS, MPH<sup>1</sup></a></span>
</div>
<div class="meta-author">
<a class="meta-author-title is-b stats-meta-author-toggle" data-tog-target=".meta-author-content">Author Affiliations</a>
<a class="meta-articleinfo-jumplink section-jump-link scroll-to stats-scroll-to-articleinfo" data-tab-toggle=".tab-nav-full-text" href="#249664869">Article Information</a>
<div class="meta-author-content">
<ul class="meta-author-affiliations">
<li class="meta-author-affiliation">
<div class="meta-author-name"><sup>1</sup>Program on Regulation, Therapeutics, and Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston,
Massachusetts</div>
</li>
</ul>
</div>
</div>
<div class="meta-citation-wrap">
<span class="meta-citation-journal-name">JAMA. </span><span class="meta-citation"> 2024;331(17):1471-1479. doi:10.1001/jama.2024.2396</span>
</div>
</div>
<div class="widget-EditorsChoice widget-instance-AMA_EditorsChoice_Links">
</div>
<div class="widget-LinkedContentToolbar widget-instance-AMA_LinkedContentToolbar">
<div class="linked-content-toolbar activated">
<div class="hidden js-search-open-multimedia-by-default" showcontentbydefault="False"></div>
<div class="linked-content-controls">
<a class="linked-content-trigger td-n stats-graphical-abstract tab-no-content" href="#graphical-abstract-tab" style="display: none!important">
<i class="icon-visual-abstract"><span class="sr-t">visual abstract icon</span></i>
<div class="trigger-text d-ib va-m ta-l fw-5 visuallyhidden">Visual <div>Abstract</div></div>
</a>
<a class="linked-content-trigger td-n stats-editorial-comment tab-no-content" href="#editorial-comment-tab" style="display: none!important">
<i class="icon-document"><span class="sr-t">editorial comment icon</span></i>
<div class="trigger-text d-ib va-m ta-l fw-5 visuallyhidden">Editorial <div>Comment</div></div>
</a>
<a class="linked-content-trigger td-n stats-related-articles" href="#related-articles-tab">
<i class="icon-related"><span class="sr-t">related articles icon</span></i>
<div class="trigger-text d-ib va-m ta-l fw-5 visuallyhidden">Related <div>Articles</div></div>
</a>
<a class="linked-content-trigger td-n stats-author-interviews tab-no-content" href="#author-interviews-tab" style="display: none!important">
<i class="icon-author_interview"><span class="sr-t">author interview icon</span></i>
<div class="trigger-text d-ib va-m ta-l fw-5 visuallyhidden">Interviews</div>
</a>
<a class="linked-content-trigger td-n stats-more-multimedia tab-no-content" href="#more-multimedia-tab" style="display: none!important">
<i class="icon-multimedia"><span class="sr-t">multimedia icon</span></i>
<div class="trigger-text d-ib va-m ta-l fw-5 visuallyhidden">Multimedia</div>
</a>
<a class="linked-content-trigger td-n stats-listen-to-this-article tab-no-content" href="#listen-to-this-article-tab" style="display: none!important">
<i class="icon-audio"><span class="sr-t">audio icon</span></i>
<div class="trigger-text d-ib va-m ta-l fw-5 visuallyhidden">Listen to <div>this article</div></div>
</a>
</div>
<div class="linked-content-tabs">
<div id="graphical-abstract-tab" class="linked-content-tab graphical-abstract-tab" style="display: none!important">
<div class="widget-SectionDisplay widget-instance-AMA_GraphicalAbstract_Tab">
</div>
</div>
<div id="editorial-comment-tab" class="linked-content-tab editorial-comment-tab" style="display: none!important">
<div class="widget-ArticleLinks widget-instance-AMA_LinkedContentToolbar_EditorialComments">
</div>
</div>
<div id="related-articles-tab" class="linked-content-tab related-article-tab">
<div class="widget-ArticleLinks widget-instance-AMA_LinkedContentToolbar_RelatedArticle">
<ul class="article-abstract-links related-abstract-content">
<li class="article-link related-abstract-article">
<a class="related-article-title" href="https://jamanetwork.com/journals/jama/fullarticle/2819132">
<div class="related-article-type">Original Investigation</div>
<div class="related-article-title sb-tc">Survival Benefit Associated With Participation in Clinical Trials of Anticancer Drugs</div>
</a>
<div class="related-article-authors">Renata Iskander, MSc; Hannah Moyer, MSc; Karine Vigneault, BSc; Salaheddin M. Mahmud, MD, PhD; Jonathan Kimmelman, PhD</div>
<div class="related-article-journal-name">JAMA</div>
</li>
<li class="article-link related-abstract-article">
<a class="related-article-title" href="https://jamanetwork.com/journals/jama-health-forum/fullarticle/2795472">
<div class="related-article-type">Original Investigation</div>
<div class="related-article-title sb-tc">Therapeutic Value of Drugs Granted Accelerated Approval or Conditional Marketing Authorization</div>
</a>
<div class="related-article-authors">Kerstin N. Vokinger, MD, JD, PhD, LLM; Aaron S. Kesselheim, MD, JD, MPH; Camille E. G. Glaus, BSc, JD, LLM; Thomas J. Hwang, MD</div>
<div class="related-article-journal-name">JAMA Health Forum</div>
</li>
<li class="article-link related-abstract-article">
<a class="related-article-title" href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2801800">
<div class="related-article-type">Research Letter</div>
<div class="related-article-title sb-tc">Exposure to Cancer Drugs Without Confirmed Benefit After FDA Accelerated Approval</div>
</a>
<div class="related-article-authors">Ravi B. Parikh, MD, MPP; Rebecca A. Hubbard, PhD; Erkuan Wang, MA; Trevor J. Royce, MD, MPH; Aaron B. Cohen, MD, MSCE; Amy
S. Clark, MD, MSCE; Ronac Mamtani, MD, MSCE</div>
<div class="related-article-journal-name">JAMA Oncology</div>
</li>
<li class="article-link related-abstract-article">
<a class="related-article-title" href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2804689">
<div class="related-article-type">Research Letter</div>
<div class="related-article-title sb-tc">Time to Confirmatory Study Initiation After Accelerated Approval of Drugs in the US</div>
</a>
<div class="related-article-authors">Shelley A. Jazowski, PhD, MPH; Avi U. Vaidya, MPH; Julie M. Donohue, PhD; Stacie B. Dusetzina, PhD; Rachel E. Sachs, JD, MPH</div>
<div class="related-article-journal-name">JAMA Internal Medicine</div>
</li>
<li class="article-link related-abstract-article">
<a class="related-article-title" href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811820">
<div class="related-article-type">Original Investigation</div>
<div class="related-article-title sb-tc">NCCN Recommendations of Cancer Drugs</div>
</a>
<div class="related-article-authors">Edward R. Scheffer Cliff, MBBS, MPH; Rachel S. Rome, MD; Aaron S. Kesselheim, MD, JD, MPH; Benjamin N. Rome, MD, MPH</div>
<div class="related-article-journal-name">JAMA Network Open</div>
</li>
</ul>
</div>
<div class="widget-ArticleLinks widget-instance-AMA_LinkedContentToolbar_RelatedEditorsChoices">
</div>
</div>
<div id="author-interviews-tab" class="linked-content-tab linked-author-interviews-tab" style="display: none!important">
<div class="widget-AudioPlayer widget-instance-AMA_LinkedContentToolbar_PlatformAudioPlayer_AuthorInterviews">
</div>
</div>
<div id="listen-to-this-article-tab" class="linked-content-tab linked-listen-to-this-article-tab" style="display: none!important">
<div class="widget-AudioPlayer widget-instance-AMA_LinkedContentToolbar_PlatformAudioPlayer_ListenToThisArticle">
</div>
</div>
<div id="more-multimedia-tab" class="linked-content-tab more-multimedia-tab" style="display: none!important">
</div>
</div>
</div>
</div>
<a class="full-text-link is-b" data-url="" data-article-id="2817337">
<div class="full-text-link--text"><span class="full-text-link--text-top">Full </span>Text</div>
</a>
<div class="abstract-content">
<div class="widget-ArticleFulltext widget-instance-AMA_Article_Abstract_Widget">
<div class="article-full-text" data-userhasaccess="False">
<a class="article-section-id-anchor" id="249664812"></a>
<span class="heading-text thm-col h3 cb section-type-keyPoints decorated-hed sb-sc ">Key Points</span>
<p><strong>Question</strong> <span>What is the clinical benefit of cancer drugs granted accelerated approval, and on what basis are they converted to regular approval?</span></p>
<p><strong>Findings</strong> <span>In this cohort study of cancer drugs granted accelerated approval from 2013 to 2017, 41% (19/46) did not improve overall survival or quality of life in confirmatory trials after more than 5 years
of follow-up, with results not yet available for another 15% (7/46). Among drugs converted to regular approval, 60% (29/48) of conversions relied on surrogate measures.</span></p>
<p><strong>Meaning</strong> <span>Although accelerated approval can be useful, some cancer drugs do not end up demonstrating benefit in extending patients’ lives or improving their quality of life.</span></p>
<a class="article-section-id-anchor" id="249664813"></a>
<div class="h3 cb section-type-abstract decorated-hed ">
<div class="heading-text thm-col sb-sc"> Abstract </div>
</div>
<p><strong>Importance</strong> <span>The US Food and Drug Administration’s (FDA) accelerated approval pathway allows approval of investigational drugs treating unmet medical needs based on changes to surrogate measures considered
“reasonably likely” to predict clinical benefit. Postapproval clinical trials are then required to confirm whether these drugs offer clinical benefit.</span></p>
<p><strong>Objective</strong> <span>To determine whether cancer drugs granted accelerated approval ultimately demonstrate clinical benefit and to evaluate the basis of conversion to regular approval.</span></p>
<p><strong>Design, Setting, and Participants</strong> <span>In this cohort study, publicly available FDA data were used to identify cancer drugs granted accelerated approval from 2013 to 2023.</span></p>
<p><strong>Main Outcomes and Measures</strong> <span>Demonstrated improvement in quality of life or overall survival in accelerated approvals with more than 5 years of follow-up, as well as confirmatory trial end points and time
to conversion for drug-indication pairs converted to regular approval.</span></p>
<p><strong>Results</strong> <span>A total of 129 cancer drug–indication pairs were granted accelerated approval from 2013 to 2023. Among 46 indications with more than 5 years of follow-up (approved 2013-2017), approximately
two-thirds (29, 63%) were converted to regular approval, 10 (22%) were withdrawn, and 7 (15%) remained ongoing after a median of 6.3 years. Fewer than half (20/46, 43%) demonstrated a clinical benefit in confirmatory trials. Time to
withdrawal decreased from 9.9 years to 3.6 years, and time to regular approval increased from 1.6 years to 3.6 years. Among 48 drug-indication pairs converted to regular approval, 19 (40%) were converted based on overall survival,
21 (44%) on progression-free survival, 5 (10%) on response rate plus duration of response, 2 (4%) on response rate, and 1 (2%) despite a negative confirmatory trial. Comparing accelerated and regular approval indications, 18 of 48
(38%) were unchanged, while 30 of 48 (63%) had different indications (eg, earlier line of therapy).</span></p>
<p><strong>Conclusions and Relevance</strong> <span>Most cancer drugs granted accelerated approval did not demonstrate benefit in overall survival or quality of life within 5 years of accelerated approval. Patients should be
clearly informed about the cancer drugs that use the accelerated approval pathway and do not end up showing benefits in patient-centered clinical outcomes.</span></p>
<div class="movable-ad-target bta"> </div>
</div>
</div>
<div class="widget-ArticleLinks widget-instance-AMA_Abstract_EditorialComments">
</div>
<a class="full-text-link is-b d-b bd-none ta-c fl-n radius mt1 mb1 m-auto" data-url="" data-article-id="2817337">
<div class="full-text-link--text fw-b"><span class="full-text-link--text-top">Full </span>Text</div>
</a>
<div class="seamless-access-button--mobile-only">
<div class="widget-AmaAdvancedSeamlessAccess widget-instance-AMA_AdvancedSeamlessAccessButton_Mobile">
<div class="seamless-access-button--wrap">
<button class="d-flex sa-button align-items-center" role="button" type="button">
<div class="sa-button-logo-wrap">
<img src="//cdn.jamanetwork.com/UI/app/svg/seamless-access.svg" class="sa-button-logo" alt="Seamless Access Logo">
</div>
<div class="d-flex justify-content-center align-items-center sa-button-text text-truncate">
<div class="sa-button-text-primary text-truncate">Access through your institution</div>
</div>
</button>
<div class="sa-access-text text-truncate hide">
<div class="sa-cta-access"><span>Add or change institution</span></div>
</div>
</div>
</div>
</div>
<div id="ad-dual-box-mobile" class="ad-dual-box-mobile lazy-ad advertisement ad-text tablet-down" data-slot="8" style="">
<script>
googletag.cmd.push(function() {
if (!App.suppressAds && (App.isAbstract || ((App.isSplitScreen || App.isMag) && !App.hasAccess))) {
App.Ads.Mappings.dualMobile = googletag.sizeMapping().addSize([1023, 600], [0, 0]).addSize([0, 600], [
[300, 250],
[300, 600]
]).addSize([0, 0], [300, 250]).build();
App.Ads.slots[8] = googletag.defineSlot(App.Ads.adPath + '/abstract', [300, 250], 'ad-dual-box-mobile').setTargeting('pos', ['bta']).defineSizeMapping(App.Ads.Mappings.dualMobile).addService(googletag.pubads());
googletag.display('ad-dual-box-mobile');
} else {
$(".ad-dual-box-mobile").removeClass("ad-text");
}
});
</script>
</div>
</div>
<div class="widget-RelatedTopics widget-instance-AMA_Related_Topics_Abstract">
<div class="related-topics-block">
<h4 class="related-topics-heading topic-suggestions-heading sb-sc"> Read More About </h4>
<div class="related-topics topic-suggestions">
<a href="https://jamanetwork.com/collections/5801/oncology" id="item_Link" class="related-topic topic-suggestion no-wrap sb-anchor-light">Oncology</a>
<a href="https://jamanetwork.com/collections/42054/drug-development" id="item_Link_1" class="related-topic topic-suggestion no-wrap sb-anchor-light">Drug Development</a>
<a href="https://jamanetwork.com/collections/5716/law-and-medicine" id="item_Link_2" class="related-topic topic-suggestion no-wrap sb-anchor-light">Law and Medicine</a>
</div>
</div>
</div>
</div>
<div class="sidebar">
<div class="branded-bar"></div>
<div class="abstract-toolbar">
<a id="pdf-link" class="toolbar-tool toolbar-pdf al-link pdfaccess" data-article-id="2817337" data-article-url="/journals/jama/articlepdf/2817337/jama_liu_2024_oi_240021_1714069796.52779.pdf" data-ajax-url="/Content/CheckPdfAccess" style="width: 50%;"><span class="toolbar-pdf-text"><span class="toolbar-link-text-extra">Download </span><span class="toolbar-link-text">PDF</span></span>
</a>
<a class="toolbar-tool toolbar-full-text is-b" data-url="" data-article-id="2817337" style="width: 50%;"><span class="toolbar-link-text-extra">Full</span> Text</a>
<div class="widget-ToolboxGetCitation widget-instance-AMA_Get_Citation_Abstract">
<a class="toolbar-tool toolbar-citation is-b stats-citation" rel="nofollow" data-reveal-id="get-citation" data-reveal="" style="width: 50%;">
<span class="toolbar-link-text">Cite</span>
<span class="toolbar-link-text-extra">This</span>
</a>
<div id="get-citation" class="reveal-modal get-citation" data-reveal="">
<h3 class="get-citation-title">Citation</h3>
<p class="get-citation-citation">Liu ITT<span class="al-author-delim">, </span>Kesselheim AS<span class="al-author-delim">, </span>Cliff ERS. Clinical Benefit and Regulatory Outcomes of Cancer Drugs Receiving Accelerated Approval.
<em>JAMA.</em> 2024;331(17):1471–1479. doi:10.1001/jama.2024.2396</p>
<h4 class="get-citation-download-heading">Manage citations:</h4>
<div class="get-citation-types">
<a class="get-citation-format" rel="nofollow" href="/Citation/Download?resourceId=2817337&resourceType=3&citationFormat=0">Ris (Zotero)</a>
<a class="get-citation-format" rel="nofollow" href="/Citation/Download?resourceId=2817337&resourceType=3&citationFormat=1">EndNote</a>
<a class="get-citation-format" rel="nofollow" href="/Citation/Download?resourceId=2817337&resourceType=3&citationFormat=2">BibTex</a>
<a class="get-citation-format" rel="nofollow" href="/Citation/Download?resourceId=2817337&resourceType=3&citationFormat=3">Medlars</a>
<a class="get-citation-format" rel="nofollow" href="/Citation/Download?resourceId=2817337&resourceType=3&citationFormat=0">ProCite</a>
<a class="get-citation-format" rel="nofollow" href="/Citation/Download?resourceId=2817337&resourceType=3&citationFormat=3">RefWorks</a>
<a class="get-citation-format" rel="nofollow" href="/Citation/Download?resourceId=2817337&resourceType=3&citationFormat=0">Reference Manager</a>
<a class="get-citation-format" rel="nofollow" href="/Citation/Download?resourceId=2817337&resourceType=3&citationFormat=0">Mendeley</a>
</div>
<p class="get-citation-copyright">© 2024 </p>
<a class="close-reveal-modal icon-close" rel="nofollow"></a>
</div>
</div>
<div class="widget-ToolboxPermissions widget-instance-AMA_Get_Permissions_Abstract">
<a href="http://s100.copyright.com/AppDispatchServlet?publisherName=AMA&publication=0098-7484&title=Clinical+Benefit+and+Regulatory+Outcomes+of+Cancer+Drugs+Receiving+Accelerated+Approval&publicationDate=2024-05-07&volumeNum=331&issueNum=17&author=Liu%2c+Ian+T.+T.%3b+Kesselheim%2c+Aaron+S.&startPage=1471&endPage=1479&contentId=10.1001%2fjama.2024.2396&oa=&orderBeanReset=True" rel="nofollow" id="PermissionsLink" class="toolbar-tool toolbar-permissions is-b" target="_blank" style="width: 50%;"><span class="toolbar-link-text">Permissions</span></a>
</div>
</div>
<div class="seamless-access-button--desktop-only">
<div class="widget-AmaAdvancedSeamlessAccess widget-instance-AMA_AdvancedSeamlessAccessButton_Desktop">
<div class="seamless-access-button--wrap">
<button class="d-flex sa-button align-items-center" role="button" type="button">
<div class="sa-button-logo-wrap">
<img src="//cdn.jamanetwork.com/UI/app/svg/seamless-access.svg" class="sa-button-logo" alt="Seamless Access Logo">
</div>
<div class="d-flex justify-content-center align-items-center sa-button-text text-truncate">
<div class="sa-button-text-primary text-truncate">Access through your institution</div>
</div>
</button>
<div class="sa-access-text text-truncate hide">
<div class="sa-cta-access"><span>Add or change institution</span></div>
</div>
</div>
</div>
</div>
<div class="widget-SignUpAffinityAlert widget-instance-AMAv2_AffinityAlertSignUp">
</div>
<div class="cme-promo ta-c">
<div class="widget-SelfServeContent widget-instance-AMA_SelfServe_Promote_Cme_To_Inst_SubUsers">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="AMAV2_Rightrail_Other_Promo">
<input type="hidden" class="SelfServeVersionId" value="0">
<div class="bc_right_rail_article_promo">
<div class="pg-container">
<a href="https://r451.jamanetwork.com/s/1Kt?profileid=492d8968-e548-4c4d-925e-0da4ac9c831f"><img class="pg-image" data-bc-filename="JDB240006.jpg" src="https://r451.jamanetwork.com/rest/v2/dialogues/files/c7fac065-c0b7-44eb-af85-d621c6a956a9/JDB240006.jpg" style="display:block;margin:0 auto; width: 100%;"> </a>
<div class="pg-text-container">
<div class="pg-link-container">
<a class="pg-header-link" href="https://r451.jamanetwork.com/s/1Ku?profileid=492d8968-e548-4c4d-925e-0da4ac9c831f">Evidence Mounts That About 7% of US Adults Have Had Long COVID</a>
</div><a class="pg-button-link" href="https://r451.jamanetwork.com/s/1Kv?profileid=492d8968-e548-4c4d-925e-0da4ac9c831f">Read the Data Brief</a>
</div>
</div>
<style type="text/css">
.bc_right_rail_article_promo {
padding: 25px 15px;
}
.pg-header-link {
display: block;
font-size: 1.25em;
font-weight: 700;
line-height: 1.4;
margin-bottom: .5em;
}
.pg-image {
display: block;
margin: 0 auto;
width: 100%;
}
.pg-text-container {
padding: 15px;
}
.pg-link-container {
padding: 0 3px;
}
.pg-paragraph {
line-height: 1.5;
margin-bottom: .5em;
}
a.pg-button-link {
border-radius: 6px;
color: #fff;
display: block;
font-size: 1.25em;
font-weight: 500;
line-height: 1.4;
margin: 1em 0 0 0;
padding: 15px;
text-align: center;
}
a.pg-button-link:hover {
background-color: #000 !important;
color: #fff !important;
text-decoration: none !important;
}
[data-thm=jama] a.pg-button-link {
background-color: #981b1e;
}
[data-thm=jama] .bc_right_rail_article_promo {
border-top: 4px solid #d71635;
}
[data-thm=jaman] a.pg-button-link {
background-color: #ed0973;
}
[data-thm=jaman] .bc_right_rail_article_promo {
border-top: 4px solid #9e1f63;
}
[data-thm=cardi] a.pg-button-link {
background-color: #981b1e;
}
[data-thm=cardi] .bc_right_rail_article_promo {
border-top: 4px solid #be1e32;
}
[data-thm=derm] a.pg-button-link {
background-color: #3b923f;
}
[data-thm=derm] .bc_right_rail_article_promo {
border-top: 4px solid #006f3b;
}
[data-thm=jama-] a.pg-button-link {
background-color: #fb5252;
}
[data-thm=jama-] .bc_right_rail_article_promo {
border-top: 4px solid #133763;
}
[data-thm=intem] a.pg-button-link {
background-color: #005276;
}
[data-thm=intem] .bc_right_rail_article_promo {
border-top: 4px solid #006e96;
}
[data-thm=neur] a.pg-button-link {
background-color: #d71635;
}
[data-thm=neur] .bc_right_rail_article_promo {
border-top: 4px solid #981b1e;
}
[data-thm=oncol] a.pg-button-link {
background-color: #006f3b;
}
[data-thm=oncol] .bc_right_rail_article_promo {
border-top: 4px solid #3b923f;
}
[data-thm=ophth] a.pg-button-link {
background-color: #006f3b;
}
[data-thm=ophth] .bc_right_rail_article_promo {
border-top: 4px solid #66bc29;
}
[data-thm=otol] a.pg-button-link {
background-color: #005276;
}
[data-thm=otol] .bc_right_rail_article_promo {
border-top: 4px solid #34b6e4;
}
[data-thm=peds] a.pg-button-link {
background-color: #005276;
}
[data-thm=peds] .bc_right_rail_article_promo {
border-top: 4px solid #0084c0;
}
[data-thm=psych] a.pg-button-link {
background-color: #0084c0;
}
[data-thm=psych] .bc_right_rail_article_promo {
border-top: 4px solid #005276;
}
[data-thm=surg] a.pg-button-link {
background-color: #981b1e;
}
[data-thm=surg] .bc_right_rail_article_promo {
border-top: 4px solid #f47920;
}
.widget-instance-AMA_Contents_Tab_SelfServe .bc_right_rail_article_promo {
border-top: 0;
}
.pg-container {
background: #f2f2f2;
border: 1px solid #ddd;
color: #1a1a1a;
font-weight: 400;
margin: auto;
max-width: 300px;
padding: 0;
text-align: left;
}
.bc_right_rail_article_promo {
margin: auto;
}
.bc_right_rail_article_promo img {
max-width: 500px;
}
.widget-instance-AMA_Contents_Tab_SelfServe .bc_right_rail_article_promo {
max-width: 300px;
padding: 15px 0 0 0;
}
.widget-instance-AMA_Contents_Tab_SelfServe .bc_right_rail_article_promo a.pg-button-link {
padding: 10px;
}
@media only screen and (min-width:1024px) {
/* .bc_right_rail_article_promo {max-width: 310px;} .pg-container { border: unset; } */
.widget-instance-AMA_Contents_Tab_SelfServe .bc_right_rail_article_promo {
margin-top: 2em;
max-width: 250px;
}
}
</style>
</div>
<link rel="stylesheet" href="https://cdn.jamanetwork.com/data/CSSUploads/jamanetwork-selfserve-maintenance.css?versionId=80028">
<style type="text/css">
.jn-rr-feature {
border-top: 4px solid #d71635;
border-bottom: 4px solid #d71635;
}
p.globe-icon {
font-weight: 700;
padding: 0.35em 0
}
.icon-url:before {
font-size: 24px;
margin-right: 6px;
}
.icon-url:hover {
text-decoration: none;
}
</style>
<div class="jn-rr-feature">
<p class="globe-icon"><a href="/channels/ai" target="_blank"><span class="badge icon-url"></span>Artificial Intelligence Resource Center</a></p>
</div>
<!--
<div class="jn-rr-feature">
<p class="globe-icon"><a href="/collections/5548/cardiology?fl_Categories=Cardiology&fl_ContentType=Article&f_SiteID=3" target="_blank"><span class="badge icon-url"></span>Cardiology in <em>JAMA</em>: Read the Latest</a></p>
</div>
<div class="jn-rr-feature">
<p>
<a href="https://sites.jamanetwork.com/audio" target="_blank"><span class="badge icon-audio"></span>Browse and subscribe</a> to JAMA Network podcasts!
</p>
</div>
-->
<iframe id="selfserve-maintenance" src="https://sites.jamanetwork.com/maintenance/index.html" width="100%" frameborder="0"></iframe>
<!--AMAV2 Rightrail Other Promo-->
</div>
</div>
</div>
<div class="widget-PersonalizedContent widget-instance-AMA_PersonalizedContent_AbstractView_RightRail loaded">
<h4 class="ymal--hed thm-col-sec"> Trending </h4>
<ul class="ymal--content featured-list--contents">
<li class="article ymal--item">
<div class="article--type black fw-b text-normal fs-n d-ib va-m"> Research </div>
<span class="badge icon-cme mb0"><span class="sr-t">is learning</span></span>
<a class="article--title fw-n d-b lh-text" href="https://jamanetwork.com/journals/jama/fullarticle/2819132?widget=personalizedcontent&previousarticle=2817337">
Survival Benefit Associated With Participation in Clinical Trials of Anticancer Drugs
</a>
<div class="article--date meta-item no-wrap">May 20, 2024</div>
</li>
<li class="article ymal--item">
<div class="article--type black fw-b text-normal fs-n d-ib va-m"> Opinion </div>
<a class="article--title fw-n d-b lh-text" href="https://jamanetwork.com/journals/jama/fullarticle/2785217?widget=personalizedcontent&previousarticle=2817337">
Paying for Cancer Drugs That Prove Their Benefit
</a>
<div class="article--date meta-item no-wrap">October 11, 2021</div>
</li>
<li class="article ymal--item">
<div class="article--type black fw-b text-normal fs-n d-ib va-m"> Research </div>
<a class="article--title fw-n d-b lh-text" href="https://jamanetwork.com/journals/jama/fullarticle/2807298?widget=personalizedcontent&previousarticle=2817337">
Utilization Management Trends in Medicare Part D Oncology Drugs, 2010-2020
</a>
<div class="article--date meta-item no-wrap">July 18, 2023</div>
</li>
</ul>
<div class="btn-interests js-btn-interests"><strong>Select Your Interests</strong></div>
<script type="text/javascript">
App.Global.bindInterestsButton();
App.Collection.bindEvents();
</script>
<script type="text/javascript">
SCM.AMA.DataLayerAsync.push("arrYMALside", "10.1001/jama.2024.6281,10.1001/jama.2021.18308,10.1001/jama.2023.10753", "array");
</script>
</div>
<div id="ad-dual-box-6" class="ad-dual-box lazy-ad advertisement ad-text" data-slot="6">
<script>
googletag.cmd.push(function() {
if (App.suppressAds) {
return;
}
App.Ads.Mappings.dual = googletag.sizeMapping().addSize([0, 600], [
[300, 250],
[300, 600]
]).addSize([0, 0], [300, 250]).build();
App.Ads.slots[6] = googletag.defineSlot(App.Ads.adPath + '/abstract', [300, 250], 'ad-dual-box-6').setTargeting('pos', ['mid']).defineSizeMapping(App.Ads.Mappings.dual).addService(googletag.pubads());
googletag.display('ad-dual-box-6');
});
</script>
</div>
<div class="widget-JobsAd widget-instance-AMA_JobsAd">
<div class="jobs-ad">
<div class="jobs-ad--text">
<h6 class="tt-u black">JOB LISTINGS ON JAMA CAREER CENTER®</h6>
<div class="jobs-ad-wrapper thm-col-sec">
<a href="https://careers.jamanetwork.com/job/110448883/or-facility-is-looking-for-a-locums-medical-oncologist/?TrackID=61&utm_source=widget&utm_medium=referral&utm_campaign=61" target="_blank">
<span class="jobs-ad-title">OR Facility Is Looking for a Locums Medical Oncologist</span>
<span class="jobs-ad-location">Oregon</span>
</a>
</div>
<div class="jobs-ad-wrapper thm-col-sec">
<a href="https://careers.jamanetwork.com/job/110448868/a-medical-oncologist-is-wanted-for-locum-tenens-help-in-california/?TrackID=61&utm_source=widget&utm_medium=referral&utm_campaign=61" target="_blank">
<span class="jobs-ad-title">A Medical Oncologist Is Wanted for Locum Tenens Help in California</span>
<span class="jobs-ad-location">Redding, California</span>
</a>
</div>
<div class="jobs-ad-wrapper thm-col-sec">
<a href="https://careers.jamanetwork.com/job/110448841/locum-tenens-opportunity-in-tennessee-for-medical-oncologist/?TrackID=61&utm_source=widget&utm_medium=referral&utm_campaign=61" target="_blank">
<span class="jobs-ad-title">Locum Tenens Opportunity in Tennessee for Medical Oncologist</span>
<span class="jobs-ad-location">Tennessee</span>
</a>
</div>
<div class="jobs-ad-wrapper thm-col-sec">
<a href="https://careers.jamanetwork.com/job/110448840/medical-oncologist-is-needed-for-locums-assistance-in-tn/?TrackID=61&utm_source=widget&utm_medium=referral&utm_campaign=61" target="_blank">
<span class="jobs-ad-title">Medical Oncologist Is Needed for Locums Assistance in TN</span>
<span class="jobs-ad-location">Tennessee</span>
</a>
</div>
<div class="jobs-ad-wrapper thm-col-sec">
<a href="https://careers.jamanetwork.com/job/110448772/a-locum-tenens-radiation-oncologist-is-needed-in-nj/?TrackID=61&utm_source=widget&utm_medium=referral&utm_campaign=61" target="_blank">
<span class="jobs-ad-title">A Locum Tenens Radiation Oncologist Is Needed in NJ</span>
<span class="jobs-ad-location">New Jersey</span>
</a>
</div>
<a href="https://careers.jamanetwork.com" target="_blank" class="jobs-ad-see-more"> See more at JAMA Career Center </a>
</div>
</div>
</div>
<h4 class="thm-col-sec">Others Also Liked</h4>
<div id="trendmd-suggestions">
<div class="trendmd-widget-container trendmd-widget_title-normal trendmd-widget_body-normal" data-trendmd-journal-id="39135" data-trendmd-article-id="84bc553f-e0d5-49af-9258-012275f092a2" data-trendmd-swoop="e30="
similar-nonsponsored-merged="true" style="display: block;" data-trendmd-widget-id="0" similar-sponsored-merged="true">
<div class="trendmd-widget trendmd-widget_vertical">
<div class="trendmd-widget-inner">
<div class="trendmd-widget-section">
<div class="trendmd-widget-header">
<h3 class="trendmd-widget-header__heading">We recommend</h3>
</div>
<ol class="trendmd-widget-list">
<li class="trendmd-widget-list-item">
<a class="trendmd-widget-list-item__link" data-trendmd-id="6c146444-fa3f-4fa1-ae61-0156f4ff6fc3" data-trendmd-journal-id="56755" data-trendmd-content-category="Scholarly" data-trendmd-campaign-id="42666" data-trendmd-ct="%7B%22i%22:true,%22c%22:true,%22n%22:%7B%22specificNpi%22:false,%22anyNpi%22:false%7D%7D" data-trendmd-sponsored="true" href="https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09383-w?utm_medium=cpc&utm_source=trendmd&utm_content=paid&utm_term=null&utm_campaign=MLSR_OAJRN_AWA1_GL_PMLS_03BOZ_TrendMD" rel="sponsored nofollow" target="_blank" data-trendmd-flags="2" data-trendmd-model-type="0">Response rate of anticancer drugs approved by the Food and Drug Administration based on a single-arm trial<span class="trendmd-widget-list-item__link__external"></span></a>
<div class="trendmd-widget-list-item__meta">
<span class="js_authors">Yoshihiro Oda et al.,</span> BMC Cancer, <span class="js_publication_date">2022</span>
</div>
</li>
<li class="trendmd-widget-list-item">
<a class="trendmd-widget-list-item__link" data-trendmd-id="913ece8e-285e-4c6d-bc42-bdf9ebf04de1" data-trendmd-journal-id="56755" data-trendmd-content-category="Scholarly" data-trendmd-campaign-id="42666" data-trendmd-ct="%7B%22i%22:true,%22c%22:true,%22n%22:%7B%22specificNpi%22:false,%22anyNpi%22:false%7D%7D" data-trendmd-sponsored="true" href="https://bmccancer.biomedcentral.com/articles/10.1186/s12885-023-11305-3?utm_medium=cpc&utm_source=trendmd&utm_content=paid&utm_term=null&utm_campaign=MLSR_OAJRN_AWA1_GL_PMLS_03BOZ_TrendMD" rel="sponsored nofollow" target="_blank" data-trendmd-flags="2" data-trendmd-model-type="0">Comparison of clinical outcomes among cancer patients treated in and out of clinical trials<span class="trendmd-widget-list-item__link__external"></span></a>
<div class="trendmd-widget-list-item__meta">
<span class="js_authors">Jose A. Carreno Duenas et al.,</span> BMC Cancer, <span class="js_publication_date">2023</span>
</div>
</li>
</ol>
</div>
<div class="trendmd-widget-section">
<div class="trendmd-widget-header">
</div>
<ol class="trendmd-widget-list">
<li class="trendmd-widget-list-item">
<a class="trendmd-widget-list-item__link" data-trendmd-id="55533310-08c6-4ce1-9195-d7e7cf96f837" data-trendmd-journal-id="87368" data-trendmd-content-category="Scholarly" data-trendmd-campaign-id="42663" data-trendmd-ct="%7B%22i%22:true,%22c%22:true,%22n%22:%7B%22specificNpi%22:false,%22anyNpi%22:false%7D%7D" data-trendmd-sponsored="true" href="https://link.springer.com/article/10.1007/s41669-022-00383-x?utm_medium=cpc&utm_source=trendmd&utm_content=paid&utm_term=null&utm_campaign=MLSR_SPROA_AWA1_GL_PMLS_03BP3_TrendMD" rel="sponsored nofollow" target="_blank" data-trendmd-flags="2" data-trendmd-model-type="0">Economic Evaluation of Nivolumab Versus Docetaxel for the Treatment of Advanced Squamous and Non-squamous Non-small Cell Lung Cancer After Prior Chemotherapy in China<span class="trendmd-widget-list-item__link__external"></span></a>
<div class="trendmd-widget-list-item__meta">
<span class="js_authors">Shanlian Hu et al.,</span> PharmacoEconomics - Open, <span class="js_publication_date">2023</span>
</div>
</li>
<li class="trendmd-widget-list-item">
<a class="trendmd-widget-list-item__link" data-trendmd-id="1c82820c-d356-4083-b842-0f3d5a98bf04" data-trendmd-journal-id="81308" data-trendmd-content-category="Scholarly" data-trendmd-campaign-id="42663" data-trendmd-ct="%7B%22i%22:true,%22c%22:true,%22n%22:%7B%22specificNpi%22:false,%22anyNpi%22:false%7D%7D" data-trendmd-sponsored="true" href="https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01108-x?utm_medium=cpc&utm_source=trendmd&utm_content=paid&utm_term=null&utm_campaign=MLSR_SPROA_AWA1_GL_PMLS_03BP3_TrendMD" rel="sponsored nofollow" target="_blank" data-trendmd-flags="2" data-trendmd-model-type="0">Long-term outcomes after severe acute kidney injury in critically ill patients: the SALTO study<span class="trendmd-widget-list-item__link__external"></span></a>
<div class="trendmd-widget-list-item__meta">
<span class="js_authors">Khalil Chaïbi et al.,</span> Annals of Intensive Care, <span class="js_publication_date">2023</span>
</div>
</li>
</ol>
</div>
</div>
<div class="trendmd-widget-footer">
<div class="trendmd-widget-footer-inner">
<div class="trendmd-widget-footer-inner-left">
<a href="https://www.trendmd.com/how-it-works-readers" target="_blank" class="trendmd-widget-brand">
<span class="trendmd-widget-brand__recommended">Powered by</span>
<span class="trendmd-widget-brand__logo trendmd-widget-brand__logo__normal" style="display: inline-block; width: 93px">
<svg viewBox="0 0 234 57" version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink">
<g id="logo">
<path d="M227.7,56.9 L149.7,56.9 C146.7,56.9 143.7,53.8 143.7,50.9 L143.7,6.9 C143.7,4 146.7,0.9 149.7,0.9 L227.7,0.9 C230.7,0.9 233.7,4 233.7,6.9 L233.7,50.9 C233.7,53.9 230.6,56.9 227.7,56.9 L227.7,56.9 Z" id="shape0" fill="#CA2127"></path>
<g id="group1" transform="translate(0.000000, 14.000000)" fill="#16325c">
<path d="M15.8,5.9 L15.8,29.6 L9.2,29.6 L9.2,5.9 L0.9,5.9 L0.9,0.2 L24.1,0.2 L24.1,5.9 L15.8,5.9 L15.8,5.9 Z" id="shape1"></path>
<path d="M50.2,10 C50.2,14.7 48.3,17.7 44.6,19.1 L52,29.6 L44,29.6 L37.5,20.2 L33,20.2 L33,29.6 L26.4,29.6 L26.4,0.2 L37.5,0.2 C42.1,0.2 45.3,1 47.3,2.5 C49.2,4.1 50.2,6.6 50.2,10 L50.2,10 Z M42.3,13.5 C43.1,12.8 43.5,11.6 43.5,10 C43.5,8.4 43.1,7.3 42.2,6.7 C41.4,6.1 39.9,5.8 37.8,5.8 L32.9,5.8 L32.9,14.5 L37.7,14.5 C40,14.6 41.5,14.2 42.3,13.5 L42.3,13.5 Z" id="shape2"></path>
<path d="M75.6,0.3 L75.6,6.1 L61,6.1 L61,12.1 L74.1,12.1 L74.1,17.7 L61,17.7 L61,23.8 L76,23.8 L76,29.6 L54.4,29.6 L54.4,0.2 L75.6,0.2 L75.6,0.3 Z" id="shape3"></path>
<path d="M99.9,0.3 L106.5,0.3 L106.5,29.7 L99.9,29.7 L85.9,11.3 L85.9,29.7 L79.3,29.7 L79.3,0.3 L85.4,0.3 L99.8,19.2 L99.8,0.3 L99.9,0.3 Z" id="shape4"></path>
<path d="M133.6,4.1 C136.4,6.7 137.8,10.2 137.8,14.8 C137.8,19.4 136.4,23 133.7,25.6 C131,28.3 126.8,29.6 121.2,29.6 L111.2,29.6 L111.2,0.2 L121.6,0.2 C126.7,0.3 130.8,1.5 133.6,4.1 L133.6,4.1 Z M128.8,21.6 C130.4,20.1 131.2,17.9 131.2,15 C131.2,12.1 130.4,9.9 128.8,8.3 C127.2,6.7 124.7,6 121.4,6 L117.7,6 L117.7,23.9 L121.9,23.9 C124.8,23.8 127.1,23.1 128.8,21.6 L128.8,21.6 Z" id="shape5"></path>
</g>
<g id="group2" transform="translate(156.000000, 14.000000)" fill="#FFFFFF">
<path d="M26.9,11.1 L19,27.1 L15,27.1 L7.1,11.1 L7.1,29.6 L0.5,29.6 L0.5,0.2 L9.4,0.2 L17,16.3 L24.6,0.2 L33.4,0.2 L33.4,29.6 L26.8,29.6 L26.8,11.1 L26.9,11.1 Z" id="shape6"></path>
<path d="M60.6,4.1 C63.4,6.7 64.8,10.2 64.8,14.8 C64.8,19.4 63.4,23 60.7,25.6 C58,28.3 53.8,29.6 48.2,29.6 L38.2,29.6 L38.2,0.2 L48.6,0.2 C53.7,0.3 57.8,1.5 60.6,4.1 L60.6,4.1 Z M55.8,21.6 C57.4,20.1 58.2,17.9 58.2,15 C58.2,12.1 57.4,9.9 55.8,8.3 C54.2,6.7 51.7,6 48.4,6 L44.7,6 L44.7,23.9 L48.9,23.9 C51.8,23.8 54.1,23.1 55.8,21.6 L55.8,21.6 Z" id="shape7"></path>
</g>
</g>
</svg>
</span>
</a>
</div>
<div class="trendmd-widget-footer-inner-right">
<div class="trendmd-widget-settings"><span class="trendmd-widget-settings__cog"></span>
<div class="trendmd-widget-settings__modal">
<ul class="trendmd-widget-settings__list">
<li class="trendmd-widget-settings__item">
<a href="https://www.trendmd.com/privacy" target="_blank" class="trendmd-widget-settings__link">Privacy policy</a>
</li>
<li class="trendmd-widget-settings__item trendmd-widget-dns" style="display:none">
<a href="https://www.trendmd.com/personaldata" target="_blank" class="trendmd-widget-settings__link">Do not sell my personal information</a>
</li>
<li class="trendmd-widget-settings__item">
<a href="https://www.trendmd.com/google-analytics" target="_blank" class="trendmd-widget-settings__link">Google Analytics settings</a>
</li>
</ul>
</div>
</div>
</div>
<div class="trendmd-widget-footer-inner-clear"></div>
<div class="trendmd-widget-footer-inner-bottom">
<div class="trendmd-widget-cookie-notification" style="display: block!important">
<div class="trendmd-widget-cookie-notification__info"><span>I consent to the use of Google Analytics and related cookies across the TrendMD network (widget, website, blog). For more information,
</span><a href="https://www.trendmd.com/google-analytics#" target="_blank">see our Privacy Settings and Terms of Use</a>.</div>
<div class="trendmd-widget-cookie-notification__actions">
<button onclick="(function() { window.TrendMD.gdpr().setGaConsent(true); })(); return false;" style="display: inline-block;">Yes</button>
<button onclick="(function() { window.TrendMD.gdpr().setGaConsent(false); })(); return false;" style="display: inline-block;">No</button>
<span></span>
</div>
</div>
</div>
</div>
</div>
</div>
<div id="trendmd-check">
<div id="ad-holder"></div>
</div>
</div>
</div>
</div>
</div>
<div class="ymal--footer">
<div class="widget-PersonalizedContent widget-instance-AMA_PersonalizedContent_AbstractView_Footer loaded">
<div class="row ymal">
<h4 class="ymal--hed thm-col-sec"> Trending </h4>
<ul class="ymal--content featured-list--contents">
<li class="article ymal--item thm-bd-top bd-jama-network-open-sec">
<a class="article--title d-b mb05" href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811820?widget=personalizedcontent&previousarticle=2817337">NCCN Recommendations of Cancer Drugs</a>
<div class="article--pub-name meta-item">JAMA Network Open</div>
<div class="article--type meta-item">Research</div>
<div class="article--date meta-item no-wrap">November 14, 2023</div>
</li>
<li class="article ymal--item thm-bd-top bd-jama-network-open-sec">
<a class="article--title d-b mb05" href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2819040?widget=personalizedcontent&previousarticle=2817337">Cancer Treatment Before and After Physician-Pharmacy Integration</a>
<div class="article--pub-name meta-item">JAMA Network Open</div>
<div class="article--type meta-item">Research</div>
<div class="article--date meta-item no-wrap">May 23, 2024</div>
</li>
<li class="article ymal--item thm-bd-top bd-jama-sec">
<a class="article--title d-b mb05" href="https://jamanetwork.com/journals/jama/fullarticle/2819132?widget=personalizedcontent&previousarticle=2817337">Survival Benefit Associated With Participation in Clinical Trials of Anticancer Drugs</a>
<div class="article--pub-name meta-item">JAMA</div>
<div class="article--type meta-item">Research</div>
<div class="article--date meta-item no-wrap">May 20, 2024</div>
</li>
</ul>
</div>
<script type="text/javascript">
SCM.AMA.DataLayerAsync.push("arrYMALbottom", "10.1001/jamanetworkopen.2023.43285,10.1001/jamanetworkopen.2024.12998,10.1001/jama.2024.6281", "array");
</script>
</div>
</div>
<div class="manage-interest">
<div class="widget-ManageCollectionInterests widget-instance-ManageCollectionInterests_Magazine">
<div class="manage-interests-modal reveal-modal small modal" data-reveal="">
<div class="manage-interests--header">
<div class="widget-SelfServeContent widget-instance-AMA_ManageInterests_Header">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="AllSitesManageInterestsHeader">
<input type="hidden" class="SelfServeVersionId" value="0">
<style>
h4 {
font-size: 20px !important;
}
</style>
<h4>Select Your Interests</h4>
<p>Customize your JAMA Network experience by selecting one or more topics from the list below.</p>
</div>
</div>
</div>
<div class="manage-interests--categories">
<ul class="category-list">
<li><span class="category-list-item " data-categoryid="46425">Academic Medicine</span></li>
<li><span class="category-list-item " data-categoryid="5489">Acid Base, Electrolytes, Fluids</span></li>
<li><span class="category-list-item " data-categoryid="5504">Allergy and Clinical Immunology</span></li>
<li><span class="category-list-item " data-categoryid="46447">American Indian or Alaska Natives</span></li>
<li><span class="category-list-item " data-categoryid="5510">Anesthesiology</span></li>
<li><span class="category-list-item " data-categoryid="42143">Anticoagulation</span></li>
<li><span class="category-list-item " data-categoryid="6261">Art and Images in Psychiatry</span></li>
<li><span class="category-list-item " data-categoryid="44024">Artificial Intelligence</span></li>
<li><span class="category-list-item " data-categoryid="42097">Assisted Reproduction</span></li>
<li><span class="category-list-item " data-categoryid="42099">Bleeding and Transfusion</span></li>
<li><span class="category-list-item " data-categoryid="5548">Cardiology</span></li>
<li><span class="category-list-item " data-categoryid="44036">Caring for the Critically Ill Patient</span></li>
<li><span class="category-list-item " data-categoryid="6255">Challenges in Clinical Electrocardiography</span></li>
<li><span class="category-list-item " data-categoryid="46435">Climate and Health</span></li>
<li><span class="category-list-item " data-categoryid="46448">Climate Change</span></li>
<li><span class="category-list-item " data-categoryid="44038">Clinical Challenge</span></li>
<li><span class="category-list-item " data-categoryid="5589">Clinical Decision Support</span></li>
<li><span class="category-list-item " data-categoryid="44039">Clinical Implications of Basic Neuroscience</span></li>
<li><span class="category-list-item " data-categoryid="5614">Clinical Pharmacy and Pharmacology</span></li>
<li><span class="category-list-item " data-categoryid="5575">Complementary and Alternative Medicine</span></li>
<li><span class="category-list-item " data-categoryid="44040">Consensus Statements</span></li>
<li><span class="category-list-item " data-categoryid="46099">Coronavirus (COVID-19)</span></li>
<li><span class="category-list-item " data-categoryid="5584">Critical Care Medicine</span></li>
<li><span class="category-list-item " data-categoryid="46325">Cultural Competency</span></li>
<li><span class="category-list-item " data-categoryid="44019">Dental Medicine</span></li>
<li><span class="category-list-item " data-categoryid="5598">Dermatology</span></li>
<li><span class="category-list-item " data-categoryid="44011">Diabetes and Endocrinology</span></li>
<li><span class="category-list-item " data-categoryid="46320">Diagnostic Test Interpretation</span></li>
<li><span class="category-list-item " data-categoryid="42054">Drug Development</span></li>
<li><span class="category-list-item " data-categoryid="5620">Electronic Health Records</span></li>
<li><span class="category-list-item " data-categoryid="5621">Emergency Medicine</span></li>
<li><span class="category-list-item " data-categoryid="5819">End of Life, Hospice, Palliative Care</span></li>
<li><span class="category-list-item " data-categoryid="42107">Environmental Health</span></li>
<li><span class="category-list-item " data-categoryid="46387">Equity, Diversity, and Inclusion</span></li>
<li><span class="category-list-item " data-categoryid="42108">Ethics</span></li>
<li><span class="category-list-item " data-categoryid="5644">Facial Plastic Surgery</span></li>
<li><span class="category-list-item " data-categoryid="44012">Gastroenterology and Hepatology</span></li>
<li><span class="category-list-item " data-categoryid="5664">Genetics and Genomics</span></li>
<li><span class="category-list-item " data-categoryid="44041">Genomics and Precision Health</span></li>
<li><span class="category-list-item " data-categoryid="5668">Geriatrics</span></li>
<li><span class="category-list-item " data-categoryid="5670">Global Health</span></li>
<li><span class="category-list-item " data-categoryid="46427">Guide to Statistics and Methods</span></li>
<li><span class="category-list-item " data-categoryid="5672">Guidelines</span></li>
<li><span class="category-list-item " data-categoryid="5674">Hair Disorders</span></li>
<li><span class="category-list-item " data-categoryid="42113">Health Care Delivery Models</span></li>
<li><span class="category-list-item " data-categoryid="42114">Health Care Economics, Insurance, Payment</span></li>
<li><span class="category-list-item " data-categoryid="42116">Health Care Quality</span></li>
<li><span class="category-list-item " data-categoryid="5680">Health Care Reform</span></li>
<li><span class="category-list-item " data-categoryid="5830">Health Care Safety</span></li>
<li><span class="category-list-item " data-categoryid="5682">Health Care Workforce</span></li>
<li><span class="category-list-item " data-categoryid="5679">Health Disparities</span></li>
<li><span class="category-list-item " data-categoryid="46328">Health Inequities</span></li>
<li><span class="category-list-item " data-categoryid="44020">Health Policy</span></li>
<li><span class="category-list-item " data-categoryid="46451">Health Systems Science</span></li>
<li><span class="category-list-item " data-categoryid="5688">Hematology</span></li>
<li><span class="category-list-item " data-categoryid="5692">History of Medicine</span></li>
<li><span class="category-list-item " data-categoryid="5514">Humanities</span></li>
<li><span class="category-list-item " data-categoryid="5697">Hypertension</span></li>
<li><span class="category-list-item " data-categoryid="44043">Images in Neurology</span></li>
<li><span class="category-list-item " data-categoryid="45887">Implementation Science</span></li>
<li><span class="category-list-item " data-categoryid="5702">Infectious Diseases</span></li>
<li><span class="category-list-item " data-categoryid="44044">Innovations in Health Care Delivery</span></li>
<li><span class="category-list-item " data-categoryid="44070">JAMA Infographic</span></li>
<li><span class="category-list-item " data-categoryid="5716">Law and Medicine</span></li>
<li><span class="category-list-item " data-categoryid="45308">Leading Change</span></li>
<li><span class="category-list-item " data-categoryid="44045">Less is More</span></li>
<li><span class="category-list-item " data-categoryid="46327">LGBTQIA Medicine</span></li>
<li><span class="category-list-item " data-categoryid="5720">Lifestyle Behaviors</span></li>
<li><span class="category-list-item " data-categoryid="45311">Medical Coding</span></li>
<li><span class="category-list-item " data-categoryid="5738">Medical Devices and Equipment</span></li>
<li><span class="category-list-item " data-categoryid="44023">Medical Education</span></li>
<li><span class="category-list-item " data-categoryid="5739">Medical Education and Training</span></li>
<li><span class="category-list-item " data-categoryid="5713">Medical Journals and Publishing</span></li>
<li><span class="category-list-item " data-categoryid="5746">Melanoma</span></li>
<li><span class="category-list-item " data-categoryid="44025">Mobile Health and Telemedicine</span></li>
<li><span class="category-list-item " data-categoryid="5766">Narrative Medicine</span></li>
<li><span class="category-list-item " data-categoryid="5769">Nephrology</span></li>
<li><span class="category-list-item " data-categoryid="5777">Neurology</span></li>
<li><span class="category-list-item " data-categoryid="44052">Neuroscience and Psychiatry</span></li>
<li><span class="category-list-item " data-categoryid="44053">Notable Notes</span></li>
<li><span class="category-list-item " data-categoryid="5787">Nursing</span></li>
<li><span class="category-list-item " data-categoryid="5788">Nutrition</span></li>
<li><span class="category-list-item " data-categoryid="44027">Nutrition, Obesity, Exercise</span></li>
<li><span class="category-list-item " data-categoryid="5791">Obesity</span></li>
<li><span class="category-list-item " data-categoryid="44013">Obstetrics and Gynecology</span></li>
<li><span class="category-list-item " data-categoryid="5796">Occupational Health</span></li>
<li><span class="category-list-item " data-categoryid="5801">Oncology</span></li>
<li><span class="category-list-item " data-categoryid="5804">Ophthalmology</span></li>
<li><span class="category-list-item " data-categoryid="5808">Orthopedics</span></li>
<li><span class="category-list-item " data-categoryid="5811">Otolaryngology</span></li>
<li><span class="category-list-item " data-categoryid="44028">Pain Medicine</span></li>
<li><span class="category-list-item " data-categoryid="46446">Palliative Care</span></li>
<li><span class="category-list-item " data-categoryid="44029">Pathology and Laboratory Medicine</span></li>
<li><span class="category-list-item " data-categoryid="45306">Patient Care</span></li>
<li><span class="category-list-item " data-categoryid="6258">Patient Information</span></li>
<li><span class="category-list-item " data-categoryid="5843">Pediatrics</span></li>
<li><span class="category-list-item " data-categoryid="44060">Performance Improvement</span></li>
<li><span class="category-list-item " data-categoryid="45315">Performance Measures</span></li>
<li><span class="category-list-item " data-categoryid="42050">Perioperative Care and Consultation</span></li>
<li><span class="category-list-item " data-categoryid="42125">Pharmacoeconomics</span></li>
<li><span class="category-list-item " data-categoryid="42126">Pharmacoepidemiology</span></li>
<li><span class="category-list-item " data-categoryid="5851">Pharmacogenetics</span></li>
<li><span class="category-list-item " data-categoryid="44030">Pharmacy and Clinical Pharmacology</span></li>
<li><span class="category-list-item " data-categoryid="5856">Physical Medicine and Rehabilitation</span></li>
<li><span class="category-list-item " data-categoryid="42059">Physical Therapy</span></li>
<li><span class="category-list-item " data-categoryid="45313">Physician Leadership</span></li>
<li><span class="category-list-item " data-categoryid="44061">Poetry</span></li>
<li><span class="category-list-item " data-categoryid="45316">Population Health</span></li>
<li><span class="category-list-item " data-categoryid="46445">Primary Care</span></li>
<li><span class="category-list-item " data-categoryid="45309">Professional Well-being</span></li>
<li><span class="category-list-item " data-categoryid="44064">Professionalism</span></li>
<li><span class="category-list-item " data-categoryid="5871">Psychiatry and Behavioral Health</span></li>
<li><span class="category-list-item " data-categoryid="42128">Public Health</span></li>
<li><span class="category-list-item " data-categoryid="5877">Pulmonary Medicine</span></li>
<li><span class="category-list-item " data-categoryid="42129">Radiology</span></li>
<li><span class="category-list-item " data-categoryid="42058">Regulatory Agencies</span></li>
<li><span class="category-list-item " data-categoryid="46443">Reproductive Health</span></li>
<li><span class="category-list-item " data-categoryid="5916">Research, Methods, Statistics</span></li>
<li><span class="category-list-item " data-categoryid="42142">Resuscitation</span></li>
<li><span class="category-list-item " data-categoryid="5896">Rheumatology</span></li>
<li><span class="category-list-item " data-categoryid="46326">Risk Management</span></li>
<li><span class="category-list-item " data-categoryid="38802">Scientific Discovery and the Future of Medicine</span></li>
<li><span class="category-list-item " data-categoryid="5833">Shared Decision Making and Communication</span></li>
<li><span class="category-list-item " data-categoryid="5912">Sleep Medicine</span></li>
<li><span class="category-list-item " data-categoryid="5915">Sports Medicine</span></li>
<li><span class="category-list-item " data-categoryid="5533">Stem Cell Transplantation</span></li>
<li><span class="category-list-item " data-categoryid="5921">Substance Use and Addiction Medicine</span></li>
<li><span class="category-list-item " data-categoryid="5923">Surgery</span></li>
<li><span class="category-list-item " data-categoryid="44065">Surgical Innovation</span></li>
<li><span class="category-list-item " data-categoryid="44066">Surgical Pearls</span></li>
<li><span class="category-list-item " data-categoryid="44067">Teachable Moment</span></li>
<li><span class="category-list-item " data-categoryid="45310">Technology and Finance</span></li>
<li><span class="category-list-item " data-categoryid="44034">The Art of JAMA</span></li>
<li><span class="category-list-item " data-categoryid="44037">The Arts and Medicine</span></li>
<li><span class="category-list-item " data-categoryid="6257">The Rational Clinical Examination</span></li>
<li><span class="category-list-item " data-categoryid="5936">Tobacco and e-Cigarettes</span></li>
<li><span class="category-list-item " data-categoryid="5938">Toxicology</span></li>
<li><span class="category-list-item " data-categoryid="46433">Translational Medicine</span></li>
<li><span class="category-list-item " data-categoryid="42136">Trauma and Injury</span></li>
<li><span class="category-list-item " data-categoryid="5942">Treatment Adherence</span></li>
<li><span class="category-list-item " data-categoryid="46323">Ultrasonography</span></li>
<li><span class="category-list-item " data-categoryid="5947">Urology</span></li>
<li><span class="category-list-item " data-categoryid="44069">Users' Guide to the Medical Literature</span></li>
<li><span class="category-list-item " data-categoryid="5950">Vaccination</span></li>
<li><span class="category-list-item " data-categoryid="5955">Venous Thromboembolism</span></li>
<li><span class="category-list-item " data-categoryid="45312">Veterans Health</span></li>
<li><span class="category-list-item " data-categoryid="5957">Violence</span></li>
<li><span class="category-list-item " data-categoryid="42139">Women's Health</span></li>
<li><span class="category-list-item " data-categoryid="45307">Workflow and Process</span></li>
<li><span class="category-list-item " data-categoryid="42140">Wound Care, Infection, Healing</span></li>
</ul>
</div>
<div class="manage-interests--save-preferences">
<div class="save-preferences-btn thm-bg ">
<span class="save-preferences-btn-text fw-b">Save Preferences</span>
</div>
</div>
<div class="manage-interests--privacy-terms"> <a class="manage-interests--privacy-terms-color" href="/pages/privacy-policy">Privacy Policy</a> | <a class="manage-interests--privacy-terms-color" href="/pages/terms-of-use">Terms of Use</a>
</div>
<a class="close-reveal-modal icon-close"></a>
</div>
</div>
</div>
</section>
<section id="secFooterControl" class="master-footer">
<script>
var App = App || {};
function scmByClass(className) {
return document.getElementsByClassName(className);
}
function scmById(id) {
return document.getElementById(id);
}
function scmquery(selector) {
return document.querySelector(selector);
}
function queryAll(selector) {
return document.querySelectorAll(selector);
}
function isTrueString(string) {
if (typeof string === 'string') {
return string.toLowerCase() === 'true';
}
return undefined;
}
function updateViewportDimensions() {
var w = window,
d = document,
e = d.documentElement,
g = d.getElementsByTagName('body')[0],
x = w.innerWidth || e.clientWidth || g.clientWidth,
y = w.innerHeight || e.clientHeight || g.clientHeight;
return {
width: x,
height: y
};
}
var viewport = updateViewportDimensions();
var debounce = function(func, wait, immediate) {
var timeout;
return function() {
var context = this,
args = arguments;
var later = function() {
timeout = null;
if (!immediate) func.apply(context, args);
};
var callNow = immediate && !timeout;
clearTimeout(timeout);
timeout = setTimeout(later, wait);
if (callNow) func.apply(context, args);
};
};
(function(App) {
App.mobileUpperBreakpoint = 767;
App.mobileAltBreakpoint = 640;
App.mobileMinBreakpoint = 547;
App.tabletUpperBreakpoint = 1023;
function setVariables() {
viewport = updateViewportDimensions();
App.isMobile = (viewport.width <= App.mobileUpperBreakpoint);
App.isMobileAlt = (viewport.width <= App.mobileAltBreakpoint);
App.isTablet = (viewport.width > App.mobileUpperBreakpoint && viewport.width <= App.tabletUpperBreakpoint);
App.isTabletDown = (viewport.width <= App.tabletUpperBreakpoint);
App.isDesktop = (viewport.width > App.tabletUpperBreakpoint);
App.activeViewport = App.isMobile ? 'small' : App.isTablet ? 'med' : 'large';
}
setVariables();
App.cachedViewport = App.isMobile ? 'small' : App.isTablet ? 'med' : 'large';
App.isAnyArticle = !!(scmByClass('widget-ArticleFullView').length || scmByClass('pg_abstract').length || scmByClass('widget-MagazineView').length || scmByClass('widget-ChannelsMagazineView').length);
App.isSplitScreen = !!scmByClass('widget-ArticleFullView').length;
App.isAbstract = !!scmByClass('pg_abstract').length;
App.isMag = !!(scmByClass('widget-MagazineView').length);
App.isChannel = !!(scmByClass('channel-site').length);
App.isChannelMag = !!(scmByClass('widget-ChannelsMagazineView').length);
App.isFreeArticle = !!(scmquery('.widget-ArticleTopInfo .free-access') || scmquery('.widget-ArticleTopInfo .open-access') || scmquery('.widget-ArticleTopInfo .icon-free') || scmquery('.widget-ChannelsMagazineView .free-access'));
App.isTollFreeAccess = false;
App.isIssue = !!scmByClass('pg_issue').length || !!scmByClass('pg_newonline').length || !!scmByClass('pg_currentissue').length || !!scmByClass('pg_pastissues').length;
App.isNewOnline = !!scmByClass('pg_newonline').length;
App.isCurrentIssue = !!scmByClass('pg_currentissue').length;
App.isPastIssues = !!scmByClass('pg_pastissues').length;
App.isJournal = !!scmByClass('pg_journal').length;
App.isNetworkHome = !!scmByClass('pg_index').length;
App.isSearch = !!scmByClass('pg_searchresults').length;
App.isAdvancedSearch = !!scmByClass('pg_advancedsearch').length;
App.isPlayer = !!scmByClass('pg_multimediaplayer').length;
App.isSelfServe = !!scmByClass('pg_sspage').length;
App.isCmsPage = !!scmByClass('pg_cmspage').length;
App.isMyAccount = !!scmByClass('pg_myaccount').length;
App.supportsFlexbox = !!scmByClass('flexbox').length;
App.isCollection = !!scmByClass('pg_collection').length;
App.isPaidUser = isTrueString(scmById('hfAppIsPaidUser').getAttribute('value'));
App.isMember = isTrueString(scmById('hfAppIsMember').getAttribute('value'));
App.isIndividual = isTrueString(scmById('hfAppIsIndividual').getAttribute('value'));
App.hasAccess = isTrueString(scmById('hfAppHasAccess').getAttribute('value'));
App.isReferredFromGoogle = isTrueString(scmById('hfAppIsReferredFromGoogle').getAttribute('value'));
var subscribedTo = scmById('hfAppSubscribedTo').getAttribute('value');
App.userSubscribedTo = subscribedTo ? subscribedTo.split(',') : undefined;
App.isLucy = isTrueString(scmById('hfAppIsLucy').getAttribute('value'));
App.currentJournalCount = 27;
App.isChannelPage = !!(scmByClass('channels-page'));
App.updateAppVariables = debounce(function() {
setVariables();
}, 50, false);
})(App);
</script>
<div class="footer-ad-wrapper">
<div id="BodyContent_Footer_divAds" class="footer-ad desktop-only">
<div id="ad-anchorboard" class="ad-anchorboard lazy-ad advertisement desktop-only ad-text vert" data-slot="11">
<script>
googletag.cmd.push(function() {
if (App.suppressAds) {
return;
}
App.Ads.Mappings.anchor = googletag.sizeMapping().addSize([1024, 1], [728, 90]).addSize([0, 0], []).build();
App.Ads.slots[11] = googletag.defineSlot(App.Ads.adPath + '/abstract', [728, 90], 'ad-anchorboard').setTargeting('pos', ['btf']).defineSizeMapping(App.Ads.Mappings.anchor).addService(googletag.pubads());
googletag.display('ad-anchorboard');
});
</script>
</div>
</div>
</div>
<div class="ad-riser-wrap desktop-only">
<div class="ad-riser--dismiss t-c">X</div>
</div>
<div class="footer-wrap">
<footer class="footer" id="footer">
<div id="footer-microsite" class="footer-microsite">
<input type="hidden" class="SelfServeContentId" value="v2_Footer_Left">
<input type="hidden" class="SelfServeVersionId" value="0">
<style type="text/css">
@media (min-width: 1024px) {
.split-screen .footer-microsite-contents {
border-bottom: 0 !important;
}
}
.footer-microsite-contents {
margin-bottom: 1em;
width: 100%;
}
.footer-network-other .link-apps:before {
width: 23px;
}
.footer-network-other .link-institutions-librarians:before {
width: 23px;
}
.jn-ss-footer-border-top {
border-top: 1px solid #555;
padding-top: 15px;
}
.jn-ss-footer-border-bottom {
border-bottom: 1px solid #555;
padding-bottom: 10px;
padding-right: 3px;
}
</style>
<div class="footer-heading-wrap">
<h3 id="BodyContent_Footer_h3SiteName" class="footer-heading is-b footer-microsite-heading" data-mobile-tog-target=".footer-microsite-links-wrap">JAMA</h3>
</div>
<div class="footer-microsite-links-wrap">
<div class="footer-microsite-contents jn-ss-footer-border-bottom">
<h4 id="BodyContent_Footer_ContentHeader" class="footer-subheading">Content</h4>
<a href="/journals/jama">Home</a>
<a href="/journals/jama/newonline">New Online</a>
<a href="/journals/jama/currentissue">Current Issue</a>
</div>
<div class="footer-microsite-contents jn-ss-footer-border-bottom">
<h4 class="footer-subheading">Podcasts</h4>
<a href="/journals/jama/pages/covid-19-interviews#audio">Coronavirus (COVID-19) Q&A</a>
<a href="/journals/jama/pages/jama-clinical-reviews">Clinical Reviews</a>
<a href="/journals/jama/pages/jama-editors-summary">Editors' Summary</a>
<a href="/journals/jama/pages/jama-medical-news">Medical News</a>
<a href="/journals/jama/pages/jama-author-interviews">Author Interviews</a>
<a href="/journals/jama/pages/jamaevidence-jama-guide-to-statistics-and-methods">JAMAevidence: <em>JAMA Guide to Statistics and Methods</em></a>
<a href="/journals/jama/pages/jamaevidence-the-rational-clinical-examination">JAMAevidence: The Rational Clinical Examination</a>
<a href="/journals/jama/pages/jamaevidence-users-guides-to-the-medical-literature">JAMAevidence: Users' Guides to the Medical Literature</a>
</div>
<div class="footer-microsite-services cf">
<h4 id="BodyContent_Footer_ServiceHeader" class="footer-subheading">Journal Information</h4>
<a href="/journals/jama/pages/for-authors">For Authors</a>
<a href="/journals/jama/pages/jama-editors">JAMA Editors</a>
<a href="/journals/jama/editors-and-publishers">Editors & Publishers</a>
<a href="/pages/rss">RSS</a>
<a href="/journals/jama/pages/contact-us">Contact Us</a>
</div>
<div class="footer-network-other jn-ss-footer-border-bottom">
<a href="https://edhub.ama-assn.org/jn-learning" class="link-network-other is-b link-learning">JN Learning / CME</a>
<a href="https://store.jamanetwork.com" class="link-network-other is-b link-store" target="_blank">Store</a>
<a href="/pages/apps" class="link-network-other is-b link-mobile" target="_blank">Apps</a>
<a href="https://careers.jamanetwork.com/" class="link-network-other is-b link-jobs" target="_blank">Jobs</a>
<a href="/pages/resources-for-librarians" class="link-network-other is-b link-institutions-librarians" target="_blank">Institutions</a>
<a href="/pages/reprints-and-permissions" class="link-network-other is-b link-reprints-permissions">Reprints & Permissions</a>
</div>
<div id="BodyContent_Footer_divSubscribe" class="footer-microsite-subscribe">
<img src="//cdn.jamanetwork.com/UI/app/img/covers/jama.jpg" class="subscribe-image" alt="Journal Cover">
<div class="subscribe-meta">
<h4 class="subscribe-heading footer-subheading">Subscribe</h4>
<a href="https://store.jamanetwork.com/productDetails.aspx?productcodeID=64" class="subscribe-submit btn">Go</a>
</div>
</div>
</div>
</div>
<div id="footer-network" class="footer-network">
<input type="hidden" class="SelfServeContentId" value="v2_Footer_Middle">
<input type="hidden" class="SelfServeVersionId" value="0">
<style type="text/css">
.footer-network-sites {
width: 62.85542%;
}
.footer-network-info {
width: 35.93976%
}
.jn-ss-subheading-mt {
margin-top: 1.5em;
}
.jn-registered:after {
content: "\00AE";
font-size: 50%;
vertical-align: top;
}
.jn-trademark:after {
content: "\2122";
font-size: 50%;
vertical-align: top;
}
</style>
<div class="footer-heading-wrap">
<h3 class="footer-heading is-b jn-registered" data-mobile-tog-target=".footer-network-links-wrap"><strong>JAMA</strong> Network</h3>
</div>
<div class="footer-network-links-wrap">
<div class="footer-network-sites">
<div class="internal">
<h4 id="BodyContent_Footer_JournalHeader" class="footer-subheading">Publications</h4>
<a href="/journals/jama">JAMA</a>
<a href="/journals/jamanetworkopen" target="_blank">JAMA Network Open</a>
<a href="/journals/jamacardiology">JAMA Cardiology</a>
<a href="/journals/jamadermatology">JAMA Dermatology</a>
<a href="/journals/jama-health-forum">JAMA Health Forum</a>
<a href="/journals/jamainternalmedicine">JAMA Internal Medicine</a>
<a href="/journals/jamaneurology">JAMA Neurology</a>
<a href="/journals/jamaoncology">JAMA Oncology</a>
<a href="/journals/jamaophthalmology">JAMA Ophthalmology</a>
<a href="/journals/jamaotolaryngology">JAMA Otolaryngology–Head & Neck Surgery</a>
<a href="/journals/jamapediatrics">JAMA Pediatrics</a>
<a href="/journals/jamapsychiatry">JAMA Psychiatry</a>
<a href="/journals/jamasurgery">JAMA Surgery</a>
<a href="/journals/archneurpsyc">Archives of Neurology & Psychiatry (1919-1959)</a>
</div>
<div class="external">
<h4 class="footer-subheading">Sites</h4>
<div id="BodyContent_Footer_ssFooterSiteMenu">
<div class="selfServe">
<a target="_blank" href="/channels/ai-in-clinical-practice">AI in Clinical Practice</a>
<a target="_blank" href="https://sites.jamanetwork.com/art-and-images-in-psychiatry/">Art and Images in Psychiatry</a>
<a target="_blank" href="/journals/jama/pages/2023-most-viewed-jama">Best of the JAMA Network</a>
<a target="_blank" href="/channels/caring-for-the-critically-ill-patient">Caring for the Critically Ill Patient</a>
<a target="_blank" href="/journals/jama/pages/crosswords">Clinical Crosswords from JAMA</a>
<a target="_blank" href="/journals/jama/pages/coronavirus-alert">Coronavirus Resource Center</a>
<a target="_blank" href="https://ebm.jamanetwork.com/index.html">Evidence-Based Medicine: An Oral History</a>
<a target="_blank" href="/pages/fishbein-fellowship">Fishbein Fellowship</a>
<a target="_blank" href="/channels/genomics/">Genomics and Precision Health</a>
<a target="_blank" href="/channels/hypertension">Hypertension</a>
<a target="_blank" href="/channels/health-forum/archive">JAMA Forum Archive</a>
<a target="_blank" href="https://sites.jamanetwork.com/audio">JAMA Network Audio</a>
<a target="_blank" href="/pages/video">JAMA Network Video</a>
<a target="_blank" href="/pages/conferences">JAMA Network Conferences </a>
<a target="_blank" href="/pages/jama-summit">JAMA Summit </a>
<a target="_blank" href="/journals/jamasurgery/pages/statistics-and-methods">JAMA Surgery Guide to Statistics and Methods</a>
<a target="_blank" href="/channels/medical-news">Medical News</a>
<a target="_blank" href="/channels/monkeypox">Mpox (Monkeypox)</a>
<a target="_blank" href="https://sites.jamanetwork.com/research-ethics/">Research Ethics</a>
<a target="_blank" href="/pages/collections">Topics and Collections</a>
<a target="_blank" href="/pages/visual-abstracts">Visual Abstracts</a>
<a target="_blank" href="/channels/war">War and Health</a>
<a target="_blank" href="/channels/womens-health">Women's Health</a>
<h4 class="footer-subheading jn-ss-subheading-mt">Featured Articles</h4>
<a href="/journals/jama/fullarticle/2799240">Antiretroviral Drugs for HIV Treatment and Prevention in Adults - 2022 IAS-USA Recommendations</a>
<a href="/journals/jama/fullarticle/2781397">CONSERVE 2021 Guidelines for Reporting Trials Modified for the COVID-19 Pandemic</a>
<a href="/journals/jama/fullarticle/2808296">Creation and Adoption of Large Language Models in Medicine</a>
<a href="/journals/jamaoncology/fullarticle/2787350">Global Burden of Cancer, 2010-2019</a>
<a href="/journals/jama/fullarticle/2797443">Global Burden of Long COVID</a>
<a href="/journals/jamadermatology/fullarticle/2790344">Global Burden of Melanoma</a>
<a href="/journals/jamadermatology/fullarticle/2787350">Global Burden of Skin Diseases, 1990-2017</a>
<a href="/journals/jamaneurology/fullarticle/2793874">Global Disparities in Parkinson Disease</a>
<a href="/journals/jama/fullarticle/2799547">Guidelines for Reporting Outcomes in Trial Protocols: The SPIRIT-Outcomes 2022 Extension</a>
<a href="/journals/jamapsychiatry/fullarticle/2799486">Mass Violence and the Complex Spectrum of Mental Illness and Mental Functioning</a>
<a href="/journals/jamapsychiatry/fullarticle/2793903">Neuropsychiatry Sequelae of COVID-19</a>
<a href="/journals/jamaneurology/fullarticle/2810313">A New Framework for Dementia Nomenclature</a>
<a href="/journals/jama/fullarticle/2800656">Organization and Performance of US Health Systems</a>
<a href="/journals/jama-health-forum/fullarticle/2791195">Pharmacy Benefit Managers: History, Business Practices, Economics, and Policy</a>
<a href="/journals/jama-health-forum/fullarticle/2791195">Promoting EDI in Genetics Research</a>
<a href="/journals/jamacardiology/fullarticle/2781972">PTSD and Cardiovascular Disease</a>
<a href="/journals/jama/fullarticle/2810754">Red Blood Cell Transfusion: 2023 AABB International Guidelines</a>
<a href="/journals/jamapediatrics/fullarticle/2797600">Reimagining Children’s Rights in the US</a>
<a href="/journals/jama/fullarticle/2794049">Spirituality in Serious Illness and Health</a>
<a href="/journals/jama/fullarticle/2796374">The US Medicaid Program: Coverage, Financing, Reforms, and Implications for Health Equity</a>
<h4 class="footer-subheading jn-ss-subheading-mt">USPSTF Recommendation Statements</h4>
<a href="/journals/jama/fullarticle/2779985">Screening for Colorectal Cancer</a>
<a href="/journals/jama/fullarticle/2779190">Screening for Hypertension</a>
<a href="/journals/jama/fullarticle/2777244">Screening for Lung Cancer</a>
<a href="/journals/jama/fullarticle/2796244">Screening for Prediabetes and Type 2 Diabetes In Children</a>
<a href="/journals/jama/fullarticle/2783414">Screening for Prediabetes and Type 2 Diabetes In Adults</a>
<a href="/journals/jama/fullarticle/2795521">Statins for Primary Prevention of Cardiovascular Disease</a>
<a href="/journals/jama/fullarticle/2793446">Vitamin and Mineral Supplements for Primary Prevention of of Cardiovascular Disease and Cancer</a>
<h4 class="footer-subheading jn-ss-subheading-mt">Blogs</h4>
<a target="_blank" href="https://amastyleinsider.com/">AMA Style Insider</a>
</div>
</div>
</div>
</div>
<div id="footer-network-info" class="footer-network-info">
<div class="information-for-links">
<h4 id="BodyContent_Footer_InfoHeader" class="footer-subheading">Information</h4>
<a href="/pages/for-authors">For Authors</a>
<a href="/pages/resources-for-librarians">For Institutions & Librarians</a>
<a href="/pages/advertisers">For Advertisers</a>
<a href="/pages/subscription-agents">For Subscription Agents</a>
<a href="https://careers.jamanetwork.com/" target="_blank">For Employers & Job Seekers</a>
<a href="https://media.jamanetwork.com" rel="nofollow" target="_blank">For the Media</a>
<a href="/pages/equity-diversity-inclusion">Equity, Diversity, Inclusion</a>
<a href="/pages/commenting-policy">Online Commenting Policy</a>
<a href="/pages/access-at-jama-network">Public Access and Open Access Policy</a>
<a href="/pages/offensive-content-statement">Statement on Potentially Offensive Content</a>
</div>
<div class="services-links">
<h4 id="BodyContent_Footer_JAMANetworkProductsHeader" class="footer-subheading">JAMA Network Products</h4>
<a href="http://www.amamanualofstyle.com/" class="footer-service-link" target="_blank">AMA Manual of Style</a>
<a href="https://jamaevidence.mhmedical.com/" class="footer-service-link" target="_blank"><span class="jn-registered">JAMAevidence</span></a>
<a href="http://www.peerreviewcongress.org/" class="footer-service-link" target="_blank">Peer Review Congress</a>
</div>
<div class="learning-links">
<h4 id="BodyContent_Footer_LearningHeader" class="footer-subheading">JN Learning</h4>
<a href="https://edhub.ama-assn.org/jn-learning">Home</a>
<a href="https://edhub.ama-assn.org/jn-learning/state-cme">State CME</a>
<a href="https://edhub.ama-assn.org/jn-learning/pages/clinical-challenge-courses">Clinical Challenge CME</a>
<a href="https://edhub.ama-assn.org/jn-learning/course/288 ">Atrial Fibrillation Course</a>
<a href="https://edhub.ama-assn.org/jn-learning/course/294 ">Women's Health Course</a>
<a target="_blank" href="https://edhub.ama-assn.org/pages/auto-credit-reporting">CME / MOC Reporting Preferences</a>
<a href="https://edhub.ama-assn.org/jn-learning/pages/about-cme">About CME & MOC</a>
</div>
</div>
</div>
</div>
<div id="footer-resources-wrap" class="footer-resources-wrap">
<input type="hidden" class="SelfServeContentId" value="v2_Footer_Right">
<input type="hidden" class="SelfServeVersionId" value="0">
<style type="text/css">
.footer-resources-wrap .footer-subheading {
color: grey;
display: block !important;
font-size: 1.17647em;
font-weight: 400;
text-transform: uppercase;
}
</style>
<div class="footer-heading-wrap">
<h3 class="footer-heading is-b footer-resources-heading" data-mobile-tog-target=".footer-resources">Help</h3>
</div>
<div class="footer-resources">
<a href="https://store.jamanetwork.com" class="footer-service-link" target="_blank">Subscriptions & Renewals</a>
<a href="https://jamanetwork.com/oauthsignin?return_url=http%3A%2F%2Fjamanetwork.com%2Fmyaccount%23my-alerts" class="footer-service-link" rel="nofollow">Manage Emails</a>
<a href="https://jamanetwork.com/oauthsignin?return_url=http%3A%2F%2Fjamanetwork.com%2Fmyaccount%23my-profile" class="footer-service-link" rel="nofollow">Update My Address</a>
<a href="https://support.jamanetwork.com/hc/en-us" class="footer-service-link">Support Center</a>
<a href="/myaccount " class="footer-service-link">My Account</a>
<h4 class="footer-subheading jn-ss-subheading-mt">JAMA Career Center</h4>
<a href="https://careers.jamanetwork.com/" class="footer-service-link" target="_blank">Physician Job Listings</a>
</div>
<input type="hidden" class="SelfServeContentId" value="v2_Footer_Socials">
<input type="hidden" class="SelfServeVersionId" value="0">
<style type="text/css">
.widget-instance-AMA_Journal_Home_Socials .iconsocial {
display: inline-block !important;
width: 34px;
height: 34px;
min-width: unset !important;
margin: 0 2px !important;
background-color: #fff;
border-radius: 20px;
border: 1px solid #191919;
vertical-align: middle;
}
.widget-instance-AMA_Journal_Home_Socials .iconsocial.instagram {
background-image: url(https://cdn.jamanetwork.com/ImageLibrary/JamaNetwork/social/instagram-icon-black.svg);
background-position: 7px 7px;
background-repeat: no-repeat;
background-size: 18px;
}
.widget-instance-AMA_Journal_Home_Socials .iconsocial.instagram:hover,
.widget-instance-AMA_Journal_Home_Socials .iconsocial.instagram:focus {
background-image: url(https://cdn.jamanetwork.com/ImageLibrary/JamaNetwork/social/instagram-icon-fill.png);
border-color: #C13584;
}
.footer-resources-wrap .iconsocial {
display: inline-block !important;
width: 32px;
height: 32px;
min-width: unset !important;
margin: 0 2px 0 3px !important;
background-color: #fff;
border-radius: 20px;
border: 1px solid #191919;
vertical-align: middle;
}
.footer-resources-wrap .iconsocial.instagram {
background-image: url(https://cdn.jamanetwork.com/ImageLibrary/JamaNetwork/social/instagram-icon-black.svg);
background-position: 6px 6px;
background-repeat: no-repeat;
background-size: 18px;
}
.footer-resources-wrap .iconsocial.instagram:hover,
.footer-resources-wrap .iconsocial.instagram:focus {
background-color: #C13584;
border-color: #191919;
}
#load-instagram-image {
background: url(https://cdn.jamanetwork.com/ImageLibrary/JamaNetwork/social/instagram-icon-fill.png) no-repeat -9999px -9999px;
}
</style>
<div id="BodyContent_Footer_divSocial" class="social-links footer-social-links">
<a target="_blank" rel="nofollow" data-emailid="6d35777a-fc12-4d2d-9b49-81d031835d91" href="https://www.facebook.com/JAMAJournal/" class="social-link is-b facebook"></a>
<a target="_blank" rel="nofollow" data-emailid="6d35777a-fc12-4d2d-9b49-81d031835d91" href="https://twitter.com/JAMA_current" class="social-link is-b twitter"></a>
<a target="_blank" rel="nofollow" data-emailid="6d35777a-fc12-4d2d-9b49-81d031835d91" href="https://www.instagram.com/jamanetwork/?hl=en" class="iconsocial instagram"></a>
<a target="_blank" rel="nofollow" data-emailid="6d35777a-fc12-4d2d-9b49-81d031835d91" href="https://www.linkedin.com/company/jamanetwork/" class="social-link is-b linked-in"></a>
<a target="_blank" rel="nofollow" data-emailid="6d35777a-fc12-4d2d-9b49-81d031835d91" href="https://www.youtube.com/jamanetwork" class="social-link is-b you-tube"></a>
<a target="_blank" rel="nofollow" data-emailid="6d35777a-fc12-4d2d-9b49-81d031835d91" href="https://www.pinterest.com/jamanetwork/" class="social-link is-b pinterest"></a>
<a target="_blank" rel="nofollow" data-emailid="6d35777a-fc12-4d2d-9b49-81d031835d91" href="/rss/site_3/67.xml" class="social-link is-b rss"></a>
<a target="_blank" rel="nofollow" data-emailid="6d35777a-fc12-4d2d-9b49-81d031835d91" href="https://jamanetwork.com/journals/jama/pages/jama-editors-summary" class="social-link is-b podcast"></a>
<div id="load-instagram-image"> </div>
</div>
<div id="BodyContent_Footer_divEmailUpdate" class="footer-email-updates">
<div class="widget-EmailListSignUp widget-instance-AMAv2_EmailListSignUp_Footer">
<div class="email-signup">
<div class="email-signup--text sb-pc">Get the latest from JAMA</div>
<div class="email-signup--input-wrap is-b">
<input type="text" name="email" class="email-signup--input" placeholder="Email address" title="Email address">
<a rel="nofollow" href="javascript:;" class="email-signup--submit sb-sc btn">Sign Up</a>
</div>
<div class="email-signup--link"> <a class="email-signup--privacy" href="/pages/privacy-policy">Privacy Policy</a> | <a class="email-signup--terms" href="/pages/terms-of-use">Terms of Use</a></div>
<div class="email-signup--user-message"></div>
</div>
</div>
</div>
</div>
<div class="footer-bar" itemscope="" itemtype="https://schema.org/Organization">
<input type="hidden" class="SelfServeContentId" value="v2_Footer_Bottom_Bar">
<input type="hidden" class="SelfServeVersionId" value="0">
<style type="text/css">
.nav-journals a.theme-jama-health-forum:before {
background: #133763;
}
.jn-bottom-bar {
color: #fff;
float: left;
font-size: 10px;
padding: 13px 20px;
width: 33.33%;
}
.jn-bottom-bar p {
line-height: 2;
}
@media (max-width: 900px) {
.jn-bottom-bar {
float: none;
width: 100%;
}
}
.jn-footer-copyright {
font-size: 12px;
line-height: 1.5;
margin-bottom: 10px;
}
.jn-footer-pipe {
margin: 0 10px;
}
.footer-bar-jn-logo img {
width: 230px;
}
@media (max-width: 900px) {
.footer-bar-jn-logo img {
width: 200px;
}
}
[data-thm=umb] .jobs-ad--text h6 {
color: #d71635 !important;
}
[data-thm=jama] .jobs-ad--text h6 {
color: #d71635 !important;
}
[data-thm=jaman] .jobs-ad--text h6 {
color: #ed0973 !important;
}
[data-thm=cardi] .jobs-ad--text h6 {
color: #be1e32 !important;
}
[data-thm=derm] .jobs-ad--text h6 {
color: #006f3b !important;
}
[data-thm=faci] .jobs-ad--text h6 {
color: #ed1c24 !important;
}
[data-thm=jama-] .jobs-ad--text h6 {
color: #fb5252 !important;
}
[data-thm=intem] .jobs-ad--text h6 {
color: #006e96 !important;
}
[data-thm=neur] .jobs-ad--text h6 {
color: #981b1e !important;
}
[data-thm=oncol] .jobs-ad--text h6 {
color: #3b923f !important;
}
[data-thm=ophth] .jobs-ad--text h6 {
color: #66bc29 !important;
}
[data-thm=otol] .jobs-ad--text h6 {
color: #34b6e4 !important;
}
[data-thm=peds] .jobs-ad--text h6 {
color: #0084c0 !important;
}
[data-thm=psych] .jobs-ad--text h6 {
color: #005276 !important;
}
[data-thm=surg] .jobs-ad--text h6 {
color: #f47920 !important;
}
.blockquote .para {
margin: 0 0 1em 1em;
}
.jn-footer-copyright {
display: block;
}
.inline-block {
display: inline-block;
}
</style>
<a class="footer-bar-jn-logo d-b no-mw mb1" href="/" title="JAMA Network Home"><img class="mw-100" src="https://cdn.jamanetwork.com/ImageLibrary/global/jn-signature-reversed-r.svg?versionId=81753" alt="Jama Network Logo"></a>
<div class="jn-bottom-bar">
<p>
<span class="jn-footer-copyright">© 2024 American Medical Association. <span class="inline-block">All rights reserved,</span> including those for text and data mining, AI training, <span class="inline-block">and similar
technologies.</span></span>
<span class="inline-block"><a href="https://www.ama-assn.org/about/terms-use" rel="nofollow" class="p0">Terms of Use</a><span class="jn-footer-pipe">|</span></span>
<span class="inline-block"><a href="https://www.ama-assn.org/about/privacy-policy" rel="nofollow" class="p0">Privacy Policy</a><span class="jn-footer-pipe">|</span></span>
<span class="inline-block"><a href="https://www.ama-assn.org/about/accessibility-statement" rel="nofollow" class="p0">Accessibility Statement</a><span class="jn-footer-pipe">|</span></span>
<span class="inline-block"><a onclick="OneTrust.ToggleInfoDisplay()" rel="nofollow" class="p0" id="CookieFooter">Cookie Settings</a></span>
</p>
</div>
<!--
#selfserve-maintenance {display:block;margin:20px 0;max-height:none !important;min-height:200px;visibility:visible;}
-->
<a class="footer-bar-sis no-mw relative nudge-down" href="https://www.silverchair.com" target="_blank"><img class="footer-bar-sis-img mt05 mw-100" width="600" height="70" src="//cdn.jamanetwork.com/UI/app/img/powered.png" alt="Silverchair Logo"></a>
</div>
</footer>
</div>
<div class="ss-ui-only">
<div class="widget-SelfServeContent widget-instance-AMA_SS_UI_Only">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="SsUiOnly">
<input type="hidden" class="SelfServeVersionId" value="0"> .
</div>
</div>
</div>
</section>
<div id="revealModal" class="reveal-modal" data-reveal="">
<div id="revealContent"></div>
<a class="close-reveal-modal icon-close"></a>
</div>
<div class="artmet-modal" id="MetricsModal">
<div class="artmet-modal-contents">
<a class="artmet-close-modal">×</a>
</div>
</div>
<div class="widget-SigninModals widget-instance-AMA_SigninModals">
<div class="js-modal-no-access-reveal no-access reveal-modal modal tiny" data-reveal="">
<div class="modal--box">
<div class="modal--title">Access your subscriptions</div>
<hr>
<button type="button" role="button" class="modal--btn js-btn-signin-personal"
data-oauth-signin-url="https://jamanetwork.com/oauthsignin?return_url=https%3a%2f%2fjamanetwork.com%2fjournals%2fjama%2ffullarticle%2f2817337%3futm_campaign%3darticlepdf"> Sign in<span class="fw-normal"> | personal account</span>
</button>
<div class="widget-AmaAdvancedSeamlessAccess widget-instance-AMA_NoAccess_AdvancedSeamlessAccessButton">
<div class="seamless-access-button--wrap">
<button class="d-flex sa-button align-items-center" role="button" type="button">
<div class="sa-button-logo-wrap">
<img src="//cdn.jamanetwork.com/UI/app/svg/seamless-access.svg" class="sa-button-logo" alt="Seamless Access Logo">
</div>
<div class="d-flex justify-content-center align-items-center sa-button-text text-truncate">
<div class="sa-button-text-primary text-truncate">Access through your institution</div>
</div>
</button>
<div class="sa-access-text text-truncate hide">
<div class="sa-cta-access"><span>Add or change institution</span></div>
</div>
</div>
</div>
<div class="widget-SelfServeContent widget-instance-AMA_NoAccess_SigninModal_CreateAccount">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="SigninModal_CreateAccount">
<input type="hidden" class="SelfServeVersionId" value="0">
<div class="modal--title">Free access to newly published articles</div>
<hr>
<button class="modal--btn js-btn-create-personal-account" type="button" role="button">
<div class="text-truncate">Create a free personal account</div>
</button>
<div class="modal--btn-desc">To register for email alerts, access free PDF, and more</div>
<!--<div class="jn-selfServe-modal-label">JAMA|SigninModal_CreateAccount</div>-->
</div>
</div>
<div class="widget-SelfServeContent widget-instance-AMA_NoAccess_SigninModal_PurchaseOptions_NoAccessAndPaidPDF">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="SigninModal_PurchaseOptions_NoAccessAndPaidPDF">
<input type="hidden" class="SelfServeVersionId" value="0">
<div class="modal--title">Purchase access</div>
<hr>
<button class="modal--btn js-btn-subscribe-journal" type="button" role="button">
<div class="text-truncate">Subscribe to journal</div>
</button>
<div class="modal--btn-desc">Get full journal access for 1 year</div>
<button class="modal--btn js-btn-purchase-article" type="button" role="button">
<div class="text-truncate">Buy article</div>
</button>
<div class="modal--btn-desc">Get unlimited access and a printable PDF ($40.00)—<br>
<em>Sign in or create a free account</em>
</div>
<!--<div class="jn-selfServe-modal-label">JAMA|SigninModal_PurchaseOptions_NoAccessAndPaidPDF</div>-->
</div>
</div>
<div class="widget-DeepDyve widget-instance-AMA_NoAccess_DeepDyve">
<button type="button" role="button" class="modal--btn js-deepdyve-link show" data-deepdyveurl="https://www.deepdyve.com/doc-view?docId=10.1001/jama.2024.2396&fieldName=journal_doi&affiliateId=JAMA" data-doi="10.1001/jama.2024.2396"
data-fieldname="journal_doi" data-issneissn="0098-7484" data-affiliate="JAMA" href="https://www.deepdyve.com/lp/jama/clinical-benefit-and-regulatory-outcomes-of-cancer-drugs-receiving-8hqwSvGHms?key=JAMA">Rent article</button>
<div class="modal--btn-desc js-deepdyve-desc show">Rent this article from DeepDyve</div>
</div>
</div>
<a class="close-reveal-modal icon-close"></a>
</div>
<div class="js-modal-paid-pdf-reveal no-access reveal-modal modal tiny" data-reveal="">
<div class="modal--box">
<div class="modal--title">Access your subscriptions</div>
<hr>
<button type="button" role="button" class="modal--btn js-btn-signin-personal"
data-oauth-signin-url="https://jamanetwork.com/oauthsignin?return_url=https%3a%2f%2fjamanetwork.com%2fjournals%2fjama%2ffullarticle%2f2817337%3futm_campaign%3darticlepdf"> Sign in<span class="fw-normal"> | personal account</span>
</button>
<div class="widget-AmaAdvancedSeamlessAccess widget-instance-AMA_PaidPdf_AdvancedSeamlessAccessButton">
<div class="seamless-access-button--wrap">
<button class="d-flex sa-button align-items-center" role="button" type="button">
<div class="sa-button-logo-wrap">
<img src="//cdn.jamanetwork.com/UI/app/svg/seamless-access.svg" class="sa-button-logo" alt="Seamless Access Logo">
</div>
<div class="d-flex justify-content-center align-items-center sa-button-text text-truncate">
<div class="sa-button-text-primary text-truncate">Access through your institution</div>
</div>
</button>
<div class="sa-access-text text-truncate hide">
<div class="sa-cta-access"><span>Add or change institution</span></div>
</div>
</div>
</div>
<div class="widget-SelfServeContent widget-instance-AMA_PaidPdf_SigninModal_CreateAccount">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="SigninModal_CreateAccount">
<input type="hidden" class="SelfServeVersionId" value="0">
<div class="modal--title">Free access to newly published articles</div>
<hr>
<button class="modal--btn js-btn-create-personal-account" type="button" role="button">
<div class="text-truncate">Create a free personal account</div>
</button>
<div class="modal--btn-desc">To register for email alerts, access free PDF, and more</div>
<!--<div class="jn-selfServe-modal-label">JAMA|SigninModal_CreateAccount</div>-->
</div>
</div>
<div class="widget-SelfServeContent widget-instance-AMA_PaidPdf_SigninModal_PurchaseOptions_NoAccessAndPaidPDF">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="SigninModal_PurchaseOptions_NoAccessAndPaidPDF">
<input type="hidden" class="SelfServeVersionId" value="0">
<div class="modal--title">Purchase access</div>
<hr>
<button class="modal--btn js-btn-subscribe-journal" type="button" role="button">
<div class="text-truncate">Subscribe to journal</div>
</button>
<div class="modal--btn-desc">Get full journal access for 1 year</div>
<button class="modal--btn js-btn-purchase-article" type="button" role="button">
<div class="text-truncate">Buy article</div>
</button>
<div class="modal--btn-desc">Get unlimited access and a printable PDF ($40.00)—<br>
<em>Sign in or create a free account</em>
</div>
<!--<div class="jn-selfServe-modal-label">JAMA|SigninModal_PurchaseOptions_NoAccessAndPaidPDF</div>-->
</div>
</div>
<div class="widget-DeepDyve widget-instance-AMA_PaidPDF_DeepDyve">
<button type="button" role="button" class="modal--btn js-deepdyve-link show" data-deepdyveurl="https://www.deepdyve.com/doc-view?docId=10.1001/jama.2024.2396&fieldName=journal_doi&affiliateId=JAMA" data-doi="10.1001/jama.2024.2396"
data-fieldname="journal_doi" data-issneissn="0098-7484" data-affiliate="JAMA" href="https://www.deepdyve.com/lp/jama/clinical-benefit-and-regulatory-outcomes-of-cancer-drugs-receiving-8hqwSvGHms?key=JAMA">Rent article</button>
<div class="modal--btn-desc js-deepdyve-desc show">Rent this article from DeepDyve</div>
</div>
</div>
<a class="close-reveal-modal icon-close"></a>
</div>
<div class="js-modal-free-pdf-reveal no-access reveal-modal modal tiny" data-reveal="">
<div class="modal--box">
<div class="modal--title">Sign in to access free PDF</div>
<hr>
<button type="button" role="button" class="modal--btn js-btn-signin-personal"
data-oauth-signin-url="https://jamanetwork.com/oauthsignin?return_url=https%3a%2f%2fjamanetwork.com%2fjournals%2fjama%2ffullarticle%2f2817337%3futm_campaign%3darticlepdf"> Sign in<span class="fw-normal"> | personal account</span>
</button>
<div class="widget-AmaAdvancedSeamlessAccess widget-instance-AMA_FreePdf_AdvancedSeamlessAccessButton">
<div class="seamless-access-button--wrap">
<button class="d-flex sa-button align-items-center" role="button" type="button">
<div class="sa-button-logo-wrap">
<img src="//cdn.jamanetwork.com/UI/app/svg/seamless-access.svg" class="sa-button-logo" alt="Seamless Access Logo">
</div>
<div class="d-flex justify-content-center align-items-center sa-button-text text-truncate">
<div class="sa-button-text-primary text-truncate">Access through your institution</div>
</div>
</button>
<div class="sa-access-text text-truncate hide">
<div class="sa-cta-access"><span>Add or change institution</span></div>
</div>
</div>
</div>
<div class="widget-SelfServeContent widget-instance-AMA_FreePdf_SigninModal_CreateAccount">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="SigninModal_CreateAccount">
<input type="hidden" class="SelfServeVersionId" value="0">
<div class="modal--title">Free access to newly published articles</div>
<hr>
<button class="modal--btn js-btn-create-personal-account" type="button" role="button">
<div class="text-truncate">Create a free personal account</div>
</button>
<div class="modal--btn-desc">To register for email alerts, access free PDF, and more</div>
<!--<div class="jn-selfServe-modal-label">JAMA|SigninModal_CreateAccount</div>-->
</div>
</div>
</div>
<a class="close-reveal-modal icon-close"></a>
</div>
<div class="js-modal-save-search-reveal no-access reveal-modal modal tiny" data-reveal="">
<div class="modal--box">
<div class="modal--title">Save your search</div>
<hr>
<button type="button" role="button" class="modal--btn js-btn-signin-personal"
data-oauth-signin-url="https://jamanetwork.com/oauthsignin?return_url=https%3a%2f%2fjamanetwork.com%2fjournals%2fjama%2ffullarticle%2f2817337%3futm_campaign%3darticlepdf"> Sign in<span class="fw-normal"> | personal account</span>
</button>
<div class="widget-SelfServeContent widget-instance-AMA_SaveSearch_SigninModal_CreateAccount">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="SigninModal_CreateAccount">
<input type="hidden" class="SelfServeVersionId" value="0">
<div class="modal--title">Free access to newly published articles</div>
<hr>
<button class="modal--btn js-btn-create-personal-account" type="button" role="button">
<div class="text-truncate">Create a free personal account</div>
</button>
<div class="modal--btn-desc">To register for email alerts, access free PDF, and more</div>
<!--<div class="jn-selfServe-modal-label">JAMA|SigninModal_CreateAccount</div>-->
</div>
</div>
<div class="widget-SelfServeContent widget-instance-AMA_SigninModal_PurchaseOptions_SaveSearch">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="SigninModal_PurchaseOptions_SaveSearch">
<input type="hidden" class="SelfServeVersionId" value="0">
<div class="modal--title">Purchase access</div>
<hr>
<button class="modal--btn js-btn-subscribe-now">Subscribe now</button>
<!--<div class="jn-selfServe-modal-label">JAMA|SigninModal_PurchaseOptions_SaveSearch</div>-->
</div>
</div>
</div>
<a class="close-reveal-modal icon-close"></a>
</div>
<div class="js-modal-follow-collection-reveal no-access reveal-modal modal tiny" data-reveal="">
<div class="modal--box">
<div class="modal--title">Customize your interests</div>
<hr>
<button type="button" role="button" class="modal--btn js-btn-signin-personal"
data-oauth-signin-url="https://jamanetwork.com/oauthsignin?return_url=https%3a%2f%2fjamanetwork.com%2fjournals%2fjama%2ffullarticle%2f2817337%3futm_campaign%3darticlepdf"> Sign in<span class="fw-normal"> | personal account</span>
</button>
<div class="widget-SelfServeContent widget-instance-AMA_FollowCollection_SigninModal_CreateAccount">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="SigninModal_CreateAccount">
<input type="hidden" class="SelfServeVersionId" value="0">
<div class="modal--title">Free access to newly published articles</div>
<hr>
<button class="modal--btn js-btn-create-personal-account" type="button" role="button">
<div class="text-truncate">Create a free personal account</div>
</button>
<div class="modal--btn-desc">To register for email alerts, access free PDF, and more</div>
<!--<div class="jn-selfServe-modal-label">JAMA|SigninModal_CreateAccount</div>-->
</div>
</div>
<div class="widget-SelfServeContent widget-instance-AMA_SigninModal_PurchaseOptions_FollowCollection">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="SigninModal_PurchaseOptions_FollowCollection">
<input type="hidden" class="SelfServeVersionId" value="0">
<div class="modal--sub-title">Create a personal account or sign in to:</div>
<ul>
<li>Register for email alerts with links to free full-text articles</li>
<li>Access PDFs of free articles</li>
<li>Manage your interests</li>
<li>Save searches and receive search alerts</li>
<ul>
<!--<div class="jn-selfServe-modal-label">JAMA|SigninModal_PurchaseOptions_FollowCollection</div>-->
</ul>
</ul>
</div>
</div>
<div class="modal--link-wrap">
<a class="modal--link" href="/pages/privacy-policy" rel="nofollow">Privacy Policy</a>
</div>
</div>
<a class="close-reveal-modal icon-close"></a>
</div>
<div class="js-modal-user-comment-reveal no-access reveal-modal modal tiny" data-reveal="">
<div class="modal--box">
<div class="modal--title">Make a comment</div>
<hr>
<button type="button" role="button" class="modal--btn js-btn-signin-personal"
data-oauth-signin-url="https://jamanetwork.com/oauthsignin?return_url=https%3a%2f%2fjamanetwork.com%2fjournals%2fjama%2ffullarticle%2f2817337%3futm_campaign%3darticlepdf"> Sign in<span class="fw-normal"> | personal account</span>
</button>
<div class="widget-SelfServeContent widget-instance-AMA_UserComment_SigninModal_CreateAccount">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="SigninModal_CreateAccount">
<input type="hidden" class="SelfServeVersionId" value="0">
<div class="modal--title">Free access to newly published articles</div>
<hr>
<button class="modal--btn js-btn-create-personal-account" type="button" role="button">
<div class="text-truncate">Create a free personal account</div>
</button>
<div class="modal--btn-desc">To register for email alerts, access free PDF, and more</div>
<!--<div class="jn-selfServe-modal-label">JAMA|SigninModal_CreateAccount</div>-->
</div>
</div>
<div class="widget-SelfServeContent widget-instance-AMA_SigninModal_PurchaseOptions_UserComment">
<div class="self-serve">
<input type="hidden" class="SelfServeContentId" value="SigninModal_PurchaseOptions_UserComment">
<input type="hidden" class="SelfServeVersionId" value="0">
<div class="modal--sub-title">Create a personal account or sign in to:</div>
<ul>
<li>Register for email alerts with links to free full-text articles</li>
<li>Access PDFs of free articles</li>
<li>Manage your interests</li>
<li>Save searches and receive search alerts</li>
<ul>
<!--<div class="jn-selfServe-modal-label">JAMA|SigninModal_PurchaseOptions_UserComment</div>-->
</ul>
</ul>
</div>
</div>
<div class="modal--link-wrap">
<a class="modal--link" href="/pages/privacy-policy" rel="nofollow">Privacy Policy</a>
</div>
</div>
<a class="close-reveal-modal icon-close"></a>
</div>
<div class="hidden-true js-modal-page-data" data-store-url="https://store.jamanetwork.com" data-store-purchase-url="https://jamanetwork.com/oauthsignin?return_url=https://store.jamanetwork.com"
data-store-subscribe-url="https://store.jamanetwork.com/index.aspx?productcode=64">
</div>
</div>
<script src="//cdn.jamanetwork.com/UI/app/vendor/jquery-2.2.4.min.js?v=638533618535209510"></script>
<script>
window.jQuery || document.write('<script src="/UI/app/vendor/jquery-2.2.4.min.js">\x3C/script>')
</script>
<script src="//cdn.jamanetwork.com/UI/app/dist/app.min.js?v=638548502740625847"></script>
<script src="//cdn.jsdelivr.net/chartist.js/latest/chartist.min.js" type="text/javascript"></script>
<script src="//d1bxh8uas1mnw7.cloudfront.net/assets/embed.js" type="text/javascript"></script>
<script defer="" src="//js.trendmd.com/trendmd.min.js" data-trendmdconfig="{"element":"#trendmd-suggestions"}"></script>
<script type="text/javascript" src="https://platform-api.sharethis.com/js/sharethis.js#property=643701de45aa460012e1032e&product=sop" async="async"></script>
</form>Text Content
[Skip to Navigation]
Our website uses cookies to enhance your experience. By continuing to use our
site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue
JAMA
HomeNew OnlineCurrent IssueFor Authors
JOURNALS
JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA
Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA
Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery
Archives of Neurology & Psychiatry (1919-1959)
PODCASTS
Clinical Reviews Editors' Summary Medical News Author Interviews More
JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions
Terms of Use | Privacy Policy | Accessibility Statement
2024 American Medical Association. All Rights Reserved
Search All
* Search All
* JAMA
* JAMA Network Open
* JAMA Cardiology
* JAMA Dermatology
* JAMA Forum Archive
* JAMA Health Forum
* JAMA Internal Medicine
* JAMA Neurology
* JAMA Oncology
* JAMA Ophthalmology
* JAMA Otolaryngology–Head & Neck Surgery
* JAMA Pediatrics
* JAMA Psychiatry
* JAMA Surgery
* Archives of Neurology & Psychiatry
Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum
Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology
JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA
Psychiatry JAMA Surgery Archives of Neurology & Psychiatry
Input Search Term
Sign In
Individual Sign In
Sign inCreate an Account
Access through your institution
Sign In
Purchase Options:
Buy this article
Rent this article
Subscribe to the JAMA journal
TRENDING
* Survival Benefit Associated With Participation in Clinical Trials of
Anticancer Drugs
Research
May 20, 2024
* Paying for Cancer Drugs That Prove Their Benefit
Opinion
October 11, 2021
X Facebook
LinkedIn
More
This Issue
Views 29,962
Citations 1
1874
View Metrics
* Download PDF
* Full Text
* Share
X Facebook Email LinkedIn
* Cite This
* Permissions
Original Investigation
April 7, 2024
CLINICAL BENEFIT AND REGULATORY OUTCOMES OF CANCER DRUGS RECEIVING ACCELERATED
APPROVAL
Ian T. T. Liu, MD, JD, MPH, MS1; Aaron S. Kesselheim, MD, JD, MPH1; Edward R.
Scheffer Cliff, MBBS, MPH1
Author Affiliations Article Information
* 1Program on Regulation, Therapeutics, and Law, Division of
Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham
and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
JAMA. 2024;331(17):1471-1479. doi:10.1001/jama.2024.2396
visual abstract icon
Visual
Abstract
editorial comment icon
Editorial
Comment
related articles icon
Related
Articles
author interview icon
Interviews
multimedia icon
Multimedia
audio icon
Listen to
this article
* Original Investigation
Survival Benefit Associated With Participation in Clinical Trials of
Anticancer Drugs
Renata Iskander, MSc; Hannah Moyer, MSc; Karine Vigneault, BSc; Salaheddin
M. Mahmud, MD, PhD; Jonathan Kimmelman, PhD
JAMA
* Original Investigation
Therapeutic Value of Drugs Granted Accelerated Approval or Conditional
Marketing Authorization
Kerstin N. Vokinger, MD, JD, PhD, LLM; Aaron S. Kesselheim, MD, JD, MPH;
Camille E. G. Glaus, BSc, JD, LLM; Thomas J. Hwang, MD
JAMA Health Forum
* Research Letter
Exposure to Cancer Drugs Without Confirmed Benefit After FDA Accelerated
Approval
Ravi B. Parikh, MD, MPP; Rebecca A. Hubbard, PhD; Erkuan Wang, MA; Trevor
J. Royce, MD, MPH; Aaron B. Cohen, MD, MSCE; Amy S. Clark, MD, MSCE;
Ronac Mamtani, MD, MSCE
JAMA Oncology
* Research Letter
Time to Confirmatory Study Initiation After Accelerated Approval of Drugs in
the US
Shelley A. Jazowski, PhD, MPH; Avi U. Vaidya, MPH; Julie M. Donohue, PhD;
Stacie B. Dusetzina, PhD; Rachel E. Sachs, JD, MPH
JAMA Internal Medicine
* Original Investigation
NCCN Recommendations of Cancer Drugs
Edward R. Scheffer Cliff, MBBS, MPH; Rachel S. Rome, MD; Aaron
S. Kesselheim, MD, JD, MPH; Benjamin N. Rome, MD, MPH
JAMA Network Open
Full Text
Key Points
Question What is the clinical benefit of cancer drugs granted accelerated
approval, and on what basis are they converted to regular approval?
Findings In this cohort study of cancer drugs granted accelerated approval from
2013 to 2017, 41% (19/46) did not improve overall survival or quality of life in
confirmatory trials after more than 5 years of follow-up, with results not yet
available for another 15% (7/46). Among drugs converted to regular approval, 60%
(29/48) of conversions relied on surrogate measures.
Meaning Although accelerated approval can be useful, some cancer drugs do not
end up demonstrating benefit in extending patients’ lives or improving their
quality of life.
Abstract
Importance The US Food and Drug Administration’s (FDA) accelerated approval
pathway allows approval of investigational drugs treating unmet medical needs
based on changes to surrogate measures considered “reasonably likely” to predict
clinical benefit. Postapproval clinical trials are then required to confirm
whether these drugs offer clinical benefit.
Objective To determine whether cancer drugs granted accelerated approval
ultimately demonstrate clinical benefit and to evaluate the basis of conversion
to regular approval.
Design, Setting, and Participants In this cohort study, publicly available FDA
data were used to identify cancer drugs granted accelerated approval from 2013
to 2023.
Main Outcomes and Measures Demonstrated improvement in quality of life or
overall survival in accelerated approvals with more than 5 years of follow-up,
as well as confirmatory trial end points and time to conversion for
drug-indication pairs converted to regular approval.
Results A total of 129 cancer drug–indication pairs were granted accelerated
approval from 2013 to 2023. Among 46 indications with more than 5 years of
follow-up (approved 2013-2017), approximately two-thirds (29, 63%) were
converted to regular approval, 10 (22%) were withdrawn, and 7 (15%) remained
ongoing after a median of 6.3 years. Fewer than half (20/46, 43%) demonstrated a
clinical benefit in confirmatory trials. Time to withdrawal decreased from 9.9
years to 3.6 years, and time to regular approval increased from 1.6 years to 3.6
years. Among 48 drug-indication pairs converted to regular approval, 19 (40%)
were converted based on overall survival, 21 (44%) on progression-free survival,
5 (10%) on response rate plus duration of response, 2 (4%) on response rate, and
1 (2%) despite a negative confirmatory trial. Comparing accelerated and regular
approval indications, 18 of 48 (38%) were unchanged, while 30 of 48 (63%) had
different indications (eg, earlier line of therapy).
Conclusions and Relevance Most cancer drugs granted accelerated approval did
not demonstrate benefit in overall survival or quality of life within 5 years of
accelerated approval. Patients should be clearly informed about the cancer drugs
that use the accelerated approval pathway and do not end up showing benefits in
patient-centered clinical outcomes.
Full Text
Access through your institution
Add or change institution
READ MORE ABOUT
Oncology Drug Development Law and Medicine
Download PDF Full Text
Cite This
CITATION
Liu ITT, Kesselheim AS, Cliff ERS. Clinical Benefit and Regulatory Outcomes of
Cancer Drugs Receiving Accelerated Approval. JAMA. 2024;331(17):1471–1479.
doi:10.1001/jama.2024.2396
MANAGE CITATIONS:
Ris (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley
© 2024
Permissions
Access through your institution
Add or change institution
Evidence Mounts That About 7% of US Adults Have Had Long COVID
Read the Data Brief
Artificial Intelligence Resource Center
TRENDING
* Research
is learning Survival Benefit Associated With Participation in Clinical Trials
of Anticancer Drugs
May 20, 2024
* Opinion
Paying for Cancer Drugs That Prove Their Benefit
October 11, 2021
* Research
Utilization Management Trends in Medicare Part D Oncology Drugs, 2010-2020
July 18, 2023
Select Your Interests
JOB LISTINGS ON JAMA CAREER CENTER®
OR Facility Is Looking for a Locums Medical Oncologist Oregon
A Medical Oncologist Is Wanted for Locum Tenens Help in California Redding,
California
Locum Tenens Opportunity in Tennessee for Medical Oncologist Tennessee
Medical Oncologist Is Needed for Locums Assistance in TN Tennessee
A Locum Tenens Radiation Oncologist Is Needed in NJ New Jersey
See more at JAMA Career Center
OTHERS ALSO LIKED
WE RECOMMEND
1. Response rate of anticancer drugs approved by the Food and Drug
Administration based on a single-arm trial
Yoshihiro Oda et al., BMC Cancer, 2022
2. Comparison of clinical outcomes among cancer patients treated in and out of
clinical trials
Jose A. Carreno Duenas et al., BMC Cancer, 2023
1. Economic Evaluation of Nivolumab Versus Docetaxel for the Treatment of
Advanced Squamous and Non-squamous Non-small Cell Lung Cancer After Prior
Chemotherapy in China
Shanlian Hu et al., PharmacoEconomics - Open, 2023
2. Long-term outcomes after severe acute kidney injury in critically ill
patients: the SALTO study
Khalil Chaïbi et al., Annals of Intensive Care, 2023
Powered by
* Privacy policy
* Do not sell my personal information
* Google Analytics settings
I consent to the use of Google Analytics and related cookies across the TrendMD
network (widget, website, blog). For more information, see our Privacy Settings
and Terms of Use.
Yes No
TRENDING
* NCCN Recommendations of Cancer Drugs
JAMA Network Open
Research
November 14, 2023
* Cancer Treatment Before and After Physician-Pharmacy Integration
JAMA Network Open
Research
May 23, 2024
* Survival Benefit Associated With Participation in Clinical Trials of
Anticancer Drugs
JAMA
Research
May 20, 2024
SELECT YOUR INTERESTS
Customize your JAMA Network experience by selecting one or more topics from the
list below.
* Academic Medicine
* Acid Base, Electrolytes, Fluids
* Allergy and Clinical Immunology
* American Indian or Alaska Natives
* Anesthesiology
* Anticoagulation
* Art and Images in Psychiatry
* Artificial Intelligence
* Assisted Reproduction
* Bleeding and Transfusion
* Cardiology
* Caring for the Critically Ill Patient
* Challenges in Clinical Electrocardiography
* Climate and Health
* Climate Change
* Clinical Challenge
* Clinical Decision Support
* Clinical Implications of Basic Neuroscience
* Clinical Pharmacy and Pharmacology
* Complementary and Alternative Medicine
* Consensus Statements
* Coronavirus (COVID-19)
* Critical Care Medicine
* Cultural Competency
* Dental Medicine
* Dermatology
* Diabetes and Endocrinology
* Diagnostic Test Interpretation
* Drug Development
* Electronic Health Records
* Emergency Medicine
* End of Life, Hospice, Palliative Care
* Environmental Health
* Equity, Diversity, and Inclusion
* Ethics
* Facial Plastic Surgery
* Gastroenterology and Hepatology
* Genetics and Genomics
* Genomics and Precision Health
* Geriatrics
* Global Health
* Guide to Statistics and Methods
* Guidelines
* Hair Disorders
* Health Care Delivery Models
* Health Care Economics, Insurance, Payment
* Health Care Quality
* Health Care Reform
* Health Care Safety
* Health Care Workforce
* Health Disparities
* Health Inequities
* Health Policy
* Health Systems Science
* Hematology
* History of Medicine
* Humanities
* Hypertension
* Images in Neurology
* Implementation Science
* Infectious Diseases
* Innovations in Health Care Delivery
* JAMA Infographic
* Law and Medicine
* Leading Change
* Less is More
* LGBTQIA Medicine
* Lifestyle Behaviors
* Medical Coding
* Medical Devices and Equipment
* Medical Education
* Medical Education and Training
* Medical Journals and Publishing
* Melanoma
* Mobile Health and Telemedicine
* Narrative Medicine
* Nephrology
* Neurology
* Neuroscience and Psychiatry
* Notable Notes
* Nursing
* Nutrition
* Nutrition, Obesity, Exercise
* Obesity
* Obstetrics and Gynecology
* Occupational Health
* Oncology
* Ophthalmology
* Orthopedics
* Otolaryngology
* Pain Medicine
* Palliative Care
* Pathology and Laboratory Medicine
* Patient Care
* Patient Information
* Pediatrics
* Performance Improvement
* Performance Measures
* Perioperative Care and Consultation
* Pharmacoeconomics
* Pharmacoepidemiology
* Pharmacogenetics
* Pharmacy and Clinical Pharmacology
* Physical Medicine and Rehabilitation
* Physical Therapy
* Physician Leadership
* Poetry
* Population Health
* Primary Care
* Professional Well-being
* Professionalism
* Psychiatry and Behavioral Health
* Public Health
* Pulmonary Medicine
* Radiology
* Regulatory Agencies
* Reproductive Health
* Research, Methods, Statistics
* Resuscitation
* Rheumatology
* Risk Management
* Scientific Discovery and the Future of Medicine
* Shared Decision Making and Communication
* Sleep Medicine
* Sports Medicine
* Stem Cell Transplantation
* Substance Use and Addiction Medicine
* Surgery
* Surgical Innovation
* Surgical Pearls
* Teachable Moment
* Technology and Finance
* The Art of JAMA
* The Arts and Medicine
* The Rational Clinical Examination
* Tobacco and e-Cigarettes
* Toxicology
* Translational Medicine
* Trauma and Injury
* Treatment Adherence
* Ultrasonography
* Urology
* Users' Guide to the Medical Literature
* Vaccination
* Venous Thromboembolism
* Veterans Health
* Violence
* Women's Health
* Workflow and Process
* Wound Care, Infection, Healing
Save Preferences
Privacy Policy | Terms of Use
X
JAMA
CONTENT
Home New Online Current Issue
PODCASTS
Coronavirus (COVID-19) Q&A Clinical Reviews Editors' Summary Medical News Author
Interviews JAMAevidence: JAMA Guide to Statistics and Methods JAMAevidence: The
Rational Clinical Examination JAMAevidence: Users' Guides to the Medical
Literature
JOURNAL INFORMATION
For Authors JAMA Editors Editors & Publishers RSS Contact Us
JN Learning / CME Store Apps Jobs Institutions Reprints & Permissions
SUBSCRIBE
Go
JAMA NETWORK
PUBLICATIONS
JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA
Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA
Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery
Archives of Neurology & Psychiatry (1919-1959)
SITES
AI in Clinical Practice Art and Images in Psychiatry Best of the JAMA Network
Caring for the Critically Ill Patient Clinical Crosswords from JAMA Coronavirus
Resource Center Evidence-Based Medicine: An Oral History Fishbein Fellowship
Genomics and Precision Health Hypertension JAMA Forum Archive JAMA Network Audio
JAMA Network Video JAMA Network Conferences JAMA Summit JAMA Surgery Guide to
Statistics and Methods Medical News Mpox (Monkeypox) Research Ethics Topics and
Collections Visual Abstracts War and Health Women's Health
FEATURED ARTICLES
Antiretroviral Drugs for HIV Treatment and Prevention in Adults - 2022 IAS-USA
Recommendations CONSERVE 2021 Guidelines for Reporting Trials Modified for the
COVID-19 Pandemic Creation and Adoption of Large Language Models in Medicine
Global Burden of Cancer, 2010-2019 Global Burden of Long COVID Global Burden of
Melanoma Global Burden of Skin Diseases, 1990-2017 Global Disparities in
Parkinson Disease Guidelines for Reporting Outcomes in Trial Protocols: The
SPIRIT-Outcomes 2022 Extension Mass Violence and the Complex Spectrum of Mental
Illness and Mental Functioning Neuropsychiatry Sequelae of COVID-19 A New
Framework for Dementia Nomenclature Organization and Performance of US Health
Systems Pharmacy Benefit Managers: History, Business Practices, Economics, and
Policy Promoting EDI in Genetics Research PTSD and Cardiovascular Disease Red
Blood Cell Transfusion: 2023 AABB International Guidelines Reimagining
Children’s Rights in the US Spirituality in Serious Illness and Health The US
Medicaid Program: Coverage, Financing, Reforms, and Implications for Health
Equity
USPSTF RECOMMENDATION STATEMENTS
Screening for Colorectal Cancer Screening for Hypertension Screening for Lung
Cancer Screening for Prediabetes and Type 2 Diabetes In Children Screening for
Prediabetes and Type 2 Diabetes In Adults Statins for Primary Prevention of
Cardiovascular Disease Vitamin and Mineral Supplements for Primary Prevention of
of Cardiovascular Disease and Cancer
BLOGS
AMA Style Insider
INFORMATION
For Authors For Institutions & Librarians For Advertisers For Subscription
Agents For Employers & Job Seekers For the Media Equity, Diversity, Inclusion
Online Commenting Policy Public Access and Open Access Policy Statement on
Potentially Offensive Content
JAMA NETWORK PRODUCTS
AMA Manual of Style JAMAevidence Peer Review Congress
JN LEARNING
Home State CME Clinical Challenge CME Atrial Fibrillation Course Women's Health
Course CME / MOC Reporting Preferences About CME & MOC
HELP
Subscriptions & Renewals Manage Emails Update My Address Support Center My
Account
JAMA CAREER CENTER
Physician Job Listings
Get the latest from JAMA
Sign Up
Privacy Policy | Terms of Use
© 2024 American Medical Association. All rights reserved, including those for
text and data mining, AI training, and similar technologies. Terms of Use|
Privacy Policy| Accessibility Statement| Cookie Settings
.
×
Access your subscriptions
--------------------------------------------------------------------------------
Sign in | personal account
Access through your institution
Add or change institution
Free access to newly published articles
--------------------------------------------------------------------------------
Create a free personal account
To register for email alerts, access free PDF, and more
Purchase access
--------------------------------------------------------------------------------
Subscribe to journal
Get full journal access for 1 year
Buy article
Get unlimited access and a printable PDF ($40.00)—
Sign in or create a free account
Rent article
Rent this article from DeepDyve
Access your subscriptions
--------------------------------------------------------------------------------
Sign in | personal account
Access through your institution
Add or change institution
Free access to newly published articles
--------------------------------------------------------------------------------
Create a free personal account
To register for email alerts, access free PDF, and more
Purchase access
--------------------------------------------------------------------------------
Subscribe to journal
Get full journal access for 1 year
Buy article
Get unlimited access and a printable PDF ($40.00)—
Sign in or create a free account
Rent article
Rent this article from DeepDyve
Sign in to access free PDF
--------------------------------------------------------------------------------
Sign in | personal account
Access through your institution
Add or change institution
Free access to newly published articles
--------------------------------------------------------------------------------
Create a free personal account
To register for email alerts, access free PDF, and more
Save your search
--------------------------------------------------------------------------------
Sign in | personal account
Free access to newly published articles
--------------------------------------------------------------------------------
Create a free personal account
To register for email alerts, access free PDF, and more
Purchase access
--------------------------------------------------------------------------------
Subscribe now
Customize your interests
--------------------------------------------------------------------------------
Sign in | personal account
Free access to newly published articles
--------------------------------------------------------------------------------
Create a free personal account
To register for email alerts, access free PDF, and more
Create a personal account or sign in to:
* Register for email alerts with links to free full-text articles
* Access PDFs of free articles
* Manage your interests
* Save searches and receive search alerts
Privacy Policy
Make a comment
--------------------------------------------------------------------------------
Sign in | personal account
Free access to newly published articles
--------------------------------------------------------------------------------
Create a free personal account
To register for email alerts, access free PDF, and more
Create a personal account or sign in to:
* Register for email alerts with links to free full-text articles
* Access PDFs of free articles
* Manage your interests
* Save searches and receive search alerts
Privacy Policy
x
We have recognized your opt-out signal. To learn more about changing your opt-in
signal preferences, please visit globalprivacycontrol.org
OPT OUT OF TARGETED ADVERTISING
When you visit our website, we store cookies on your browser to collect
information. The information collected may be used on our Sites to assess what
features are most important to users, and to allow you to access the Sites
without re-entering a username or password, personalize Sites for future use,
and other similar activities. Ad networks and data analytics firms track and
analyze traffic on our Sites and other websites, in part, to determine
advertising effectiveness, browser types and website usage trends, website and
systems performance and to present targeted ads based on information collected
through tracking. However, you can choose not to allow cookies related to
targeted advertising. For more information about the First and Third Party
Cookies used please review our Privacy Policy.
Privacy Policy
Allow All
MANAGE CONSENT PREFERENCES
TARGETED ADVERTISING
Targeted Advertising
Third party trackers collect information used for analytics and to personalize
your experience with targeted ads. Under the Colorado Privacy Act, you have the
right to opt out of targeted advertising. You may exercise your right to opt out
of targeted advertising by turning off this toggle. If you opt out, we will not
serve you personalized ads based on your actions on other websites, but you may
still receive personalized ads based on your interactions with us. Please review
our Privacy Policy for additional information. Additionally, you may contact our
legal department for further clarification about your rights as a Colorado
consumer.
STRICTLY NECESSARY COOKIES
These cookies are necessary for the website to function and cannot be switched
off in our systems. They are usually only set in response to actions made by you
which amount to a request for services, such as setting your privacy
preferences, logging in or filling in forms. You can set your browser to block
or alert you about these cookies, but some parts of the site will not then work.
Back Button
COOKIE LIST
Search Icon
Filter Icon
Clear
checkbox label label
Apply Cancel
Consent Leg.Interest
checkbox label label
checkbox label label
checkbox label label
Confirm My Choices