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2. Extending the duration of endocrine treatment for early breast cancer: patient-level meta-analysis of 12 randomised trials of aromatase inhibitors in 22 031 postmenopausal women already treated with at least 5 years of endocrine therapy.
In postmenopausal women with oestrogen receptor-positive early breast cancer, 5 years of adjuvant tamoxifen substantially reduces 15-year recurrence and mortality; aromatase inhibitor treatment (AIT) is even more effective. We assess the effects of further AIT among women recurrence-free after at least 5 years of endocrine therapy.
4. Estimating the effect of maternal viral load on perinatal and postnatal HIV transmission: a systematic review and meta-analysis.
作者: Caitlin M Dugdale.;Ogochukwu Ufio.;John Giardina.;Fatma Shebl.;Elif Coskun.;Eden Pletner.;Pamela R Torola.;Duru Cosar.;Roger Shapiro.;Maria Kim.;Lynne Mofenson.;Andrea L Ciaranello.
来源: Lancet. 2025年406卷10501期349-357页
Although a growing body of evidence supports zero risk of sexual HIV transmission from a person with sustained virological suppression, known as U=U (undetectable equals untransmittable), data have been insufficient to determine whether this is also true for vertical HIV transmission. We conducted a systematic review and meta-analysis to quantify vertical transmission risk by maternal HIV viral load (mHVL) and to evaluate the applicability of U=U to perinatal and postnatal HIV transmission.
5. The case for optimal investment in combating HIV, tuberculosis, and malaria: a global modelling study.
作者: Timothy B Hallett.;Nicolas A Menzies.;Stephen Resch.;Carel Pretorius.;John Stover.;Jiaying Stephanie Su.;Peter Winskill.;Matt Gordon.;Richard Grahn.;Firdaus Mahmood.;Mikaela Smit.;Mehran Hosseini.;Johannes Hunger.
来源: Lancet. 2025年406卷10500期261-270页
The Sustainable Development Goals (SDGs) include ending the epidemics of HIV, tuberculosis, and malaria by 2030. With 5 years remaining to meet this goal, and with the Global Fund to Fight AIDS, Tuberculosis and Malaria seeking funding for programmes in 2027-29, establishing what can be achieved through continued investment in combatting these diseases is crucial. We aimed to estimate the potential for impact by analysing the funding landscape and epidemiological situations of these three diseases, the costs of key programmes, and the extent of possible future progress in the countries eligible for Global Fund support.
7. Evaluating the impact of two decades of USAID interventions and projecting the effects of defunding on mortality up to 2030: a retrospective impact evaluation and forecasting analysis.
作者: Daniella Medeiros Cavalcanti.;Lucas de Oliveira Ferreira de Sales.;Andrea Ferreira da Silva.;Elisa Landin Basterra.;Daiana Pena.;Caterina Monti.;Gonzalo Barreix.;Natanael J Silva.;Paula Vaz.;Francisco Saute.;Gonzalo Fanjul.;Quique Bassat.;Denise Naniche.;James Macinko.;Davide Rasella.
来源: Lancet. 2025年406卷10500期283-294页
The US Agency for International Development (USAID) is the largest funding agency for humanitarian and development aid worldwide. The aim of this study is to comprehensively evaluate the effect of all USAID funding on adult and child mortality over the past two decades and forecast the future effect of its defunding.
8. Global, regional, and national trends in routine childhood vaccination coverage from 1980 to 2023 with forecasts to 2030: a systematic analysis for the Global Burden of Disease Study 2023.
Since its inception in 1974, the Essential Programme on Immunization (EPI) has achieved remarkable success, averting the deaths of an estimated 154 million children worldwide through routine childhood vaccination. However, more recent decades have seen persistent coverage inequities and stagnating progress, which have been further amplified by the COVID-19 pandemic. In 2019, WHO set ambitious goals for improving vaccine coverage globally through the Immunization Agenda 2030 (IA2030). Now halfway through the decade, understanding past and recent coverage trends can help inform and reorient strategies for approaching these aims in the next 5 years.
9. Collaboration on the optimal timing of anticoagulation after ischaemic stroke and atrial fibrillation: a systematic review and prospective individual participant data meta-analysis of randomised controlled trials (CATALYST).
作者: Hakim-Moulay Dehbi.;Urs Fischer.;Signild Åsberg.;Truman J Milling.;Stefanie Abend.;Norin Ahmed.;Mattia Branca.;Lisa A Davis.;Stefan T Engelter.;Nick Freemantle.;Thomas Gattringer.;Tatevik Ghukasyan Lakic.;Ziad Hijazi.;Martin James.;Masatoshi Koga.;Patrick Lawrence.;Robin Lemmens.;Gregory Y H Lip.;Susan Massingham.;Philip S Nash.;Amalia Ndoutoumou.;Bo Norrving.;Georgia Salanti.;Nikola Sprigg.;Götz Thomalla.;Tishok Vanniyasingam.;Per Wester.;Steven J Warach.;Jonas Oldgren.;Jesse Dawson.;David J Werring.
来源: Lancet. 2025年406卷10498期43-51页
The optimal timing of oral anticoagulation for prevention of early ischaemic stroke recurrence in people with acute ischaemic stroke and atrial fibrillation remains uncertain. We aimed to estimate the effects of starting a direct oral anticoagulant (DOAC) early (≤4 days) versus later (≥5 days) after onset of ischaemic stroke.
10. Biomarker risk stratification with capsule sponge in the surveillance of Barrett's oesophagus: prospective evaluation of UK real-world implementation.
作者: W Keith Tan.;Caryn S Ross-Innes.;Timothy Somerset.;Greta Markert.;Florian Markowetz.;Maria O'Donovan.;Massimiliano di Pietro.;Peter Sasieni.;Rebecca C Fitzgerald.; .
来源: Lancet. 2025年406卷10500期271-282页
Endoscopic surveillance is the clinical standard for Barrett's oesophagus, but its effectiveness is inconsistent. We have developed a test comprising a pan-oesophageal cell collection device coupled with biomarkers to stratify patients into three risk groups. We aimed to prospectively evaluate the prespecified risk stratification tool to establish whether it can identify those at highest risk of dysplasia or cancer to prioritise the timing of endoscopy; and safely be used to follow up the low-risk group, thus sparing patients from unnecessary endoscopies.
12. Community-based mentoring to reduce maternal and perinatal mortality in adolescent pregnancies in Sierra Leone (2YoungLives): a pilot cluster-randomised controlled trial.
作者: Cristina Fernandez Turienzo.;Lucy November.;Mangenda Kamara.;Osman Conteh.;Philemon Kamara.;Appiah M Kingsford.;Peter J S Koroma.;Michael Munu.;Alexandra E Ridout.;Betty Sam.;Paul T Seed.;Suzanne Thomas.;Prince T Williams.;Andrew H Shennan.;Jane Sandall.; .
来源: Lancet. 2025年405卷10497期2302-2312页
Sierra Leone has very high maternal and neonatal mortality rates, and a large proportion of these deaths occur in adolescents, a particularly vulnerable group, and is usually driven by poverty, lack of education, and sparse employment opportunities. We evaluated the feasibility and potential effects of a community-based mentoring intervention from pregnancy up to 1 year after birth to inform a subsequent larger trial aiming to reduce mortality among adolescent girls and their newborns (2YoungLives).
13. Thyroidectomy with or without postoperative radioiodine for patients with low-risk differentiated thyroid cancer in the UK (IoN): a randomised, multicentre, non-inferiority trial.
作者: Ujjal Mallick.;Kate Newbold.;Matthew Beasley.;Kate Garcez.;Jonathan Wadsley.;Sarah J Johnson.;Tim Stephenson.;Mark Gaze.;Andrew Goodman.;Sarah Jefferies.;Suganya Sivabalasingham.;Nicholas Slevin.;David P Wilkinson.;Elena Macias-Fernandez.;Danielle Power.;Tom Roques.;Lesley Speed.;Christopher Nutting.;George Mochloulis.;Georgina Gerrard.;Charles Candish.;Sally Morgan.;Devashish Tripathi.;Peter Truran.;Claire Arthur.;Andrzej Wieczorek.;Krishnaswamy Madhavan.;Jillian Maclean.;David Boote.;Dae Kim.;Abigail Pascoe.;Gayani Pitiyage.;Sharon Forsyth.;Emily Ambrose.;Elizabeth Chang.;Kate Farnell.;Allan Hackshaw.
来源: Lancet. 2025年406卷10498期52-62页
Patients with differentiated thyroid cancer can often be treated with postoperative radioiodine (also called radioiodine ablation) after total thyroidectomy. The IoN trial was designed to assess whether recurrence-free survival was non-inferior after no ablation compared with ablation in patients with low-risk differentiated thyroid cancer.
14. Retifanlimab with carboplatin and paclitaxel for locally recurrent or metastatic squamous cell carcinoma of the anal canal (POD1UM-303/InterAACT-2): a global, phase 3 randomised controlled trial.
作者: Sheela Rao.;Emmanuelle Samalin-Scalzi.;Ludovic Evesque.;Meher Ben Abdelghani.;Federica Morano.;Amitesh Roy.;Laetitia Dahan.;Stefano Tamberi.;Amandeep Singh Dhadda.;Mark P Saunders.;Nathalie Casanova.;Rosine Guimbaud.;Astrid Lievre.;Joan Maurel.;Marwan Fakih.;Chuan Tian.;Jill Harrison.;Mark M Jones.;Mark Cornfeld.;Jean-Philippe Spano.;Pauline Rochefort.; .
来源: Lancet. 2025年405卷10495期2144-2152页
Retifanlimab has activity in programmed death ligand 1-positive advanced squamous cell anal carcinoma (SCAC) that has progressed on platinum chemotherapy. We aimed to prospectively assess the benefit of adding retifanlimab to initial carboplatin-paclitaxel for this disease.
16. Comparison of supplemental breast cancer imaging techniques-interim results from the BRAID randomised controlled trial.
作者: Fiona J Gilbert.;Nicholas R Payne.;Iris Allajbeu.;Lim Yit.;Sarah Vinnicombe.;Iain Lyburn.;Nisha Sharma.;Will Teh.;Jonathan James.;Archana Seth.;Tamara Suaris.;Reena Aggarwal.;Miaad Al-Attar.;Sarah Savaridas.;Antonis Antoniou.;Paul Pharoah.;Stephen Duffy.
来源: Lancet. 2025年405卷10493期1935-1944页
It is not known which supplemental imaging technique is most beneficial for women with dense breasts attending breast screening. This study compares abbreviated MRI, automated whole breast ultrasound (ABUS), and contrast-enhanced mammography versus standard of care in women with dense breasts and a negative mammogram. We report on interim results from the first round of supplemental imaging.
17. Efficacy and safety of low-dose IL-2 as an add-on therapy to riluzole (MIROCALS): a phase 2b, double-blind, randomised, placebo-controlled trial.
作者: Gilbert Bensimon.;P Nigel Leigh.;Timothy Tree.;Andrea Malaspina.;Christine Am Payan.;Hang-Phuong Pham.;Pieter Klaassen.;Pamela J Shaw.;Ahmad Al Khleifat.;Maria D M Amador.;Shahram Attarian.;Simon M Bell.;Stéphane Beltran.;Emilien Bernard.;William Camu.;Philippe Corcia.;Jean-Christophe Corvol.;Philippe Couratier.;Véronique Danel.;Rabab Debs.;Claude Desnuelle.;Aikaterini Dimitriou.;John Ealing.;Florence Esselin.;Marie-Céline Fleury.;George H Gorrie.;Aude-Marie Grapperon.;Adèle Hesters.;Raul Juntas-Morales.;Ivan Kolev.;Géraldine Lautrette.;Nadine Le Forestier.;Christopher J McDermott.;Nicolas Pageot.;François Salachas.;Nikhil Sharma.;Marie-Hélène Soriani.;Jemeen Sreedharan.;Juliette Svahn.;Nick Verber.;Annie Verschueren.;Ozlem Yildiz.;Carey M Suehs.;Safaa Saker-Delye.;Claudie Muller.;Christophe Masseguin.;Hana Hajduchova.;Janine Kirby.;Cecilia Garlanda.;Massimo Locati.;Henrik Zetterberg.;Bernard Asselain.;Ammar Al-Chalabi.; .
来源: Lancet. 2025年405卷10492期1837-1850页
Amyotrophic lateral sclerosis (ALS) is a life-threatening disease characterised by progressive loss of motor neurons with few therapeutic options. The MIROCALS study tested the hypothesis that low-dose interleukin-2 (IL-2LD) improves survival and function in ALS.
18. Nivolumab plus ipilimumab versus lenvatinib or sorafenib as first-line treatment for unresectable hepatocellular carcinoma (CheckMate 9DW): an open-label, randomised, phase 3 trial.
作者: Thomas Yau.;Peter R Galle.;Thomas Decaens.;Bruno Sangro.;Shukui Qin.;Leonardo G da Fonseca.;Hatim Karachiwala.;Jean-Frederic Blanc.;Joong-Won Park.;Edward Gane.;Matthias Pinter.;Ana Matilla Peña.;Masafumi Ikeda.;David Tai.;Armando Santoro.;Gonzalo Pizarro.;Chang-Fang Chiu.;Michael Schenker.;Aiwu He.;Hong Jae Chon.;Joanna Wojcik-Tomaszewska.;Gontran Verset.;Qi Qi Wang.;Caitlyn Stromko.;Jaclyn Neely.;Prianka Singh.;Maria Jesus Jimenez Exposito.;Masatoshi Kudo.; .
来源: Lancet. 2025年405卷10492期1851-1864页
Patients with unresectable hepatocellular carcinoma have a poor prognosis, and treatments with long-term benefits are needed. We report results from the preplanned interim analysis of the CheckMate 9DW trial assessing nivolumab plus ipilimumab versus lenvatinib or sorafenib for unresectable hepatocellular carcinoma in the first-line setting.
20. Prevalence of sexual violence against children and age at first exposure: a global analysis by location, age, and sex (1990-2023).
作者: Jack Cagney.;Cory Spencer.;Luisa Flor.;Molly Herbert.;Mariam Khalil.;Erin O'Connell.;Erin Mullany.;Flavia Bustreo.;Joht Singh Chandan.;Nicholas Metheny.;Felicia Knaul.;Emmanuela Gakidou.
来源: Lancet. 2025年405卷10492期1817-1836页
Measuring sexual violence against children (SVAC) is vital to prevention and advocacy efforts, yet existing prevalence studies present estimates for few countries. Here we estimate the prevalence of SVAC for 204 countries by age and sex, from 1990 to 2023, and also report the age at which young survivors of lifetime sexual violence first experienced sexual violence.
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