New England Journal of Medicine

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    Breast Cancer Patients Get Early Warning of Faltering Drugs With Blood Test

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    A clinical trial found that women could switch drugs without waiting for scans showing cancer progression, which improved their quality of life.Breast cancer patients whose tumors have spread to other parts of their bodies live from scan to scan. Is their treatment working? Or will they learn their cancer is growing again?But a new study sponsored by the drug company AstraZeneca showed that there is an alternative: Instead of waiting for a scan to show that a cancer is growing, it’s possible to find early signs that the cancer is resisting the drugs that were controlling it.To do that, researchers used a blood test to find mutations in cancer cells that let the tumors defy standard treatments. Early detection allowed patients to be switched to a different drug that overcomes the mutated cancer. The result was to keep the cancers in check longer, and allow patients to have more than an extra year without deteriorating quality of life.The study was reported Sunday at the annual meeting of the American Society of Clinical Oncology and published in The New England Journal of Medicine.Breast cancer specialists who were not associated with the study applauded the results, saying blood tests could transform the way they monitor patients.“This is a paradigm change,” said Dr. Mary Disis, professor of medicine and oncology at the University of Washington and the Fred Hutchinson Cancer Center.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Citing N.I.H. Cuts, a Top Science Journal Stops Accepting Submissions

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      With federal support, Environmental Health Perspectives has long published peer-reviewed studies without fees to readers or scientists.Environmental Health Perspectives, widely considered the premier environmental health journal, has announced that it would pause acceptance of new studies for publication, as federal cuts have left its future uncertain.For more than 50 years, the journal has received funding from the National Institutes of Health to review studies on the health effects of environmental toxins — from “forever chemicals” to air pollution — and publish the research free of charge.The editors made the decision to halt acceptance of studies because of a “lack of confidence” that contracts for critical expenses like copy-editing and editorial software would be renewed after their impending expiration dates, said Joel Kaufman, the journal’s top editor.He declined to comment on the publication’s future prospects. “If the journal is indeed lost, it is a huge loss,” said Jonathan Levy, chair of the department of environmental health at Boston University. “It’s reducing the ability for people to have good information that can be used to make good decisions.”The news comes weeks after a federal prosecutor in Washington sent letters to several scientific journals, including The New England Journal of Medicine, with questions that suggested that they were biased against certain views and influenced by external pressures.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      New England Journal of Medicine Ignored Nazi Atrocities, Historians Find

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      The New England Journal of Medicine published an article condemning its own record during World War II.A new article in the New England Journal of Medicine, one of the oldest and most esteemed publications for medical research, criticizes the journal for paying only “superficial and idiosyncratic attention” to the atrocities perpetrated in the name of medical science by the Nazis.The journal was “an outlier in its sporadic coverage of the rise of Nazi Germany,” wrote the article’s authors, Allan Brandt and Joelle Abi-Rached, both medical historians at Harvard. Often, the journal simply ignored the Nazis’ medical depredations, such as the horrific experiments conducted on twins at Auschwitz, which were based largely on Adolf Hitler’s spurious “racial science.”In contrast, two other leading science journals — Science and the Journal of the American Medical Association — covered the Nazis’ discriminatory policies throughout Hitler’s tenure, the historians noted. The New England journal did not publish an article “explicitly damning” the Nazis’ medical atrocities until 1949, four years after World War II ended.The new article, published in this week’s issue of the journal, is part of a series started last year to address racism and other forms of prejudice in the medical establishment. Another recent article described the journal’s enthusiastic coverage of eugenics throughout the 1930s and ’40s.“Learning from our past mistakes can help us going forward,” said the journal’s editor, Dr. Eric Rubin, an infectious disease expert at Harvard. “What can we do to ensure that we don’t fall into the same sorts of objectionable ideas in the future?”In the publication’s archives, Dr. Abi-Rached discovered a paper endorsing Nazi medical practices: “Recent changes in German health insurance under the Hitler government,” a 1935 treatise written by Michael Davis, an influential figure in health care, and Gertrud Kroeger, a nurse from Germany. The article praised the Nazis’ emphasis on public health, which was infused with dubious ideas about Germans’ innate superiority.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More