tbuckley/cabot-search huggingface dataset:
Indurative Mediastino-Pericarditis
Journal: JAMA (1895)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved 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
Accidental strangulation from vest restraints
Authors: A. H. Dube
Journal: JAMA (1986)

IN A recent survey of nursing homes, of 183 administrators replying, 181 reported that their homes used restraints.<sup>1</sup>Of 620 patients at our facility, 257 have restraint orders—usually vest or draw-sheet restraints. In view of the widespread use of restraints, we are reporting two patients who strangled on vest restraints. <h3>Report of Cases</h3><h3>CASE 1.—</h3> A 60-year-old woman was admitted on Aug 12, 1981. She had developed gait and speech disturbances 11 years previously. Her neurological disorder progressed, and in April 1981 Huntington's chorea was diagnosed. When she could no longer be cared for at home, she was admitted to our skilled nursing facility. She had periods of great agitation that became continuous despite large doses of haloperidol (Haldol), 3 mg three times a day. She would thrash about and fall out of bed despite having on a vest restraint. After her first year, special pads were made for
Incorrect Wording
Journal: JAMA (1986)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved 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
Thyroid Function in Patients with Aspermiogenesis and Testicular Tubular Sclerosis
Journal: JAMA (1963)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved 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
Oral Polio Vaccine
Authors: James W. Bass
Journal: JAMA (1978)

We studied the persistence of antibody after vaccination and the response to booster revaccination with trivalent oral polio vaccine (TOPV) administered at varied intervals after the primary series in a large group of children. Decline in antibody was related to intervals since last vaccination, and not to sex, age, age at primary vaccination, or type and number of previous administrations. Geometric mean titers of neutralizing antibody were 11.3 for type 1 and 8.0 for types 2 and 3 poliovirus when vaccine had been given within the previous year, declining to 3.2, 3.0, and 2.1 for types 1, 2, and 3 after nine years. Most children with an initial titer of 4 or less responded to revaccination with a fourfold or greater increase in titer of IgG. Geometric mean titers for all three types of polio dropped to this level when last TOPV administration had been five to six years or more. (<i>JAMA</i>239:2252-2255, 1978)
SPECIAL ATTRACTIONS FOR THE GENERAL MEETINGS.
Journal: JAMA (1904)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved 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
LGG-06. CLINICAL FEATURES OF 1136 TUMORS OF CENTRAL NERVOUS SYSTEM IN CHILDREN: SINGLE INSTITUTIONAL REPORT FROM SHANGHAI XINHUA HOSPITAL, THE FOUNDING MEMBER OF CNOG
Authors: Yipeng Han, Yang Zhao, Feng Jiang, Chenran Zhang, Qifeng Li, Baocheng Wang, Jie Ma
Journal: Neuro-Oncology (2019)

BACKGROUND: Central nervous system (CNS) tumor is the most common solid neoplasm in children. Here we report clinical features of children with CNS tumor treated in our institute during recent 11 years. METHODS: Retrospective study was conducted in children with CNS tumor treated in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, during 2006 to 2017. Clinical data were collected. Statistical calculation was conduct for characteristic analyses. RESULTS: 1136 cases of CNS tumor in children were collected, with 712 males and 424 females. Age ranges were 9.33% in infants (< 1 y/o), 26.32% in toddler (1 - 3 y/o), 35.30% in preschool children (3 - 7 y/o), 27.11% in school-age children (7 - 15 y/o) and 1.94% in adolescence (> 15 y/o). 437 cases were diagnosed with WHO I-II grades and 392 cases were with WHO III-IV grades. There were 548 supratentorial tumors and 441 subtentorial tumors. The most common tumor type was medulloblastoma (n=168, 14.79%), followed by pilocytic astrocytoma (n=166, 14.61%). CONCLUSION: The gender ratios in different age ranges were stable, with high incidence in male than in female. In total, low grade tumors were more common than high grade tumors. Compare to our previous report, pilocytic astrocytoma was second most common tumor, following medulloblastoma.
Incomplete and Incorrect Information in Author Affiliations
Journal: JAMA Internal Medicine (2020)

Misa Imaizumi, MD, PhD; Waka Ohishi, MD, PhD; Eiji Nakashima, PhD; Nobuko Sera, MD, PhD; Kazuo Neriishi, MD, PhD; Michiko Yamada, MD, PhD; Yoshimi Tatsukawa, MD, PhD; Ikuno Takahashi, MD, PhD; Saeko Fujiwara, MD, PhD; Keizo Sugino, MD, PhD; Takao Ando, MD, PhD; Toshiro Usa, MD, PhD; Atsushi Kawakami, MD, PhD; Masazumi Akahoshi, MD, PhD; Ayumi Hida, MD, PhD
Photocopying and Communication in the Health Sciences
Journal: JAMA (1972)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved 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
Politics and Professionalism
Authors: William P. Sexauer
Journal: Annals of Internal Medicine (2018)

Letters7 August 2018Politics and ProfessionalismWilliam P. Sexauer, MDWilliam P. Sexauer, MDSidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (W.P.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0241 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:I agree with Dr. Berger that the many and varied aspects of physician conduct encompassed under the term “professionalism” would be difficult to teach or enforce online. The skepticism communicated in my essay's first paragraph continues to this day. I also agree that one takes on a new set of responsibilities and a unique position of authority when one enters the medical field. However, I do not believe that the transition “changes one's very identity.” I suspect that the set of qualities that underlie medical professionalism are present early–albeit perhaps underdeveloped–in optimal physician candidates. The challenge is to ... Author, Article, and Disclosure InformationAffiliations: Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (W.P.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-2926. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPolitics and Professionalism William P. Sexauer Politics and Professionalism William Berger Metrics 7 August 2018Volume 169, Issue 3Page: 204KeywordsConflicts of interestDisclosure ePublished: 7 August 2018 Issue Published: 7 August 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The GMC and its responsibilities towards struck off doctors
Journal: BMJ (1989)

coronary disease in Asians could be achieved only by a large (and expensive) prospective population based study.We believe that premature coronary disease presents the single greatest threat to the health of British Asians and many (perhaps as many as suggested by Dr McKeigue) will die at a young age from heart disease.More important than the accurate calculation of relative risk, however, is an understanding of the pathological processes which predispose Asians to coronary disease.Only then can effective preventive measures be introduced that might reverse the present unacceptable situa- tion.
CANCER AND VACCINATION.
Journal: JAMA (1899)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved 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
Psychosocial stress in pregnancy and its relation to low birth weight
Authors: R. Newton
Journal: BMJ (1984)

The relation of low birth weight to psychosocial stress in pregnancy was examined using a life events inventory and a state anxiety index.Two hundred and fifty women were randomly selected and interviewed three times during pregnancy and shortly after delivery.Twenty six were excluded.Of the remaining 224 women, nine miscarried, 195 had healthy term babies, and 20 gave birth to babies that were either premature or of low birth weight at term.Low birth weight and prematurity were significantly associated with objective major life events but not state anxiety.The occurrence of objective major life events in the third trimester may be important in precipitating preterm labour.Cigarette smoking was the best pre- dictor and objective major life events the second best predictor of low birth weight.The result was not depen- dent on social class.These findings suggest that cigarette smoking may be an important mediator of stress on the fetus.Antenatal care should take greater account of stress in pregnancy, and social support systems should be evaluated.
A phase I dose escalation study of BIBW 2992, an irreversible dual EGFR/HER2 receptor tyrosine kinase inhibitor, in a 3 week on 1 week off schedule in patients with advanced solid tumors
Authors: N. Lewis, J. Marshall, A. Amelsberg, R. B. Cohen, P. Stopfer, J. Hwang, S. Malik
Journal: Journal of Clinical Oncology (2006)

3091 Background: BIBW 2992 is a highly potent irreversible dual EGFR /HER2 receptor tyrosine kinase inhibitor. This is the first trial performed in the United States with this compound. Methods: Patients with refractory solid tumors (historically known to express EGFR and/or HER2) with normal end-organ function and PS 0–1 were enrolled into a phase I dose-escalation clinical trial. After completion of eligibility and informed consent, BIBW 2992 was administered orally, once daily, for 21 days followed by a 7-day rest. Three patients were accrued in each cohort using a traditional dose escalation 3+3 trial design. After reaching DLT, the MTD dose group was expanded to 18 patients. PK sampling and skin biopsies were performed at baseline and day 21. Tumor biopsies in appropriate patients were obtained pre- and post-treatment in the final cohort to analyze inhibition of the EGFR pathway. Results: Forty-three patients were enrolled. Dose levels ranged from 10 to 65 mg daily. Tumor types included colon (10), breast (8), pancreas and ovarian (4), thyroid and esophageal (3), prostate and NSCLC (2), gastric, cholangiocarcinoma, basal cell, parotid, NPC, HCC, and mesothelioma (1 ). An interim PK analysis showed that BIBW 2992 exposure and peak plasma concentrations increased with increasing dose on day 1 and at steady state. Steady state was reached at day 8. Adverse events were diarrhea, skin rash, pruritus, mucositis, nausea, and vomiting. Doses were escalated to 65 mg/day, with two DLTs noted (skin rash and mucositis). The 40-mg dose was chosen as the recommended phase II dose based on acceptable toxicity when administered chronically. No objective responses have been observed; however, 15 of 35 evaluable patients (43%) experienced stable disease and have been on treatment for &gt; 3 mos. Four patients have continued in an extension study. Two of these patients are still active and one has been taking BIBW 2992 for approximately 1 year. Conclusion: BIBW 2992 is well tolerated at 40 mg per day using a 21-day, 7-day off-treatment schedule. The adverse events observed were typical of receptor tyrosine kinases, including skin rash, pruritis, mucositis and GI disturbance. [Table: see text]
Safety and angiography data of amediplase, a new fibrin thrombolytic agent, given as a single bolus to patients with acute myocardial infarction: The 2K2 dose finding trial Frank Vermeer, Jurgen Pohl, Keith Oldroyd, Stefano Giannelli, Bernard Charbonnier. University Hospital Maastricht, Maastricht, The Netherlands
Journal: Journal of the American College of Cardiology (2001)
TITLES OF PAPERS.
Journal: JAMA (1904)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved 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
JAMA 100 Years Ago
Journal: JAMA (1986)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved 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
A multicenter phase Ib-IIR trial assessing the activity of regorafenib combined with modified gemcitabine: Oxaliplatin (mGEMOX) in patients with advanced biliary tract cancer (aBTC).
Authors: Eric Assenat, Rosine Guimbaud, Julien Fraisse, Emmanuelle Samalin, Fabienne Portales, Thibault Mazard, Lobna Rifai, Jean-Pierre Delord, Marc Ychou
Journal: Journal of Clinical Oncology (2018)

e16134 Background: New therapeutic options are needed for systemic treatment of aBTC. Regorafenib showed efficacy in several types of digestive tumors and could be associated with conventional chemotherapy in BTC. The phase Ib primary objective was to determine the recommended phase II dose (RP2D) of regorafenib combined with mGEMOX as first-line therapy of aBTC. The randomized phase II will assess the combination efficacy compared with that of mGEMOX alone. Phase Ib results are presented here. Methods: A standard 3+3 escalation design was performed, with 3 regorafenib dose levels (80, 120 and 160mg) combined with mGEMOX. Patients received regorafenib from day 1 to 14, and mGEMOX on days 1 and 8 (30 min IV 900mg/m2 gemcitabine followed with 120min IV 80mg/m2 oxaliplatin). Results: 20 patients, 70% male, of median age 62.5 years (20-74) were included in 2 centers, between 2014 and 2016. Performance status was 0 (60.0%) or 1 (40.0%). The primary tumor was intrahepatic in 60% of patients. Seven patients (35%) had undergone surgery. The median number of cycles was 10 (2-38). Main grade 3-4 toxicities were neutropenia (45%), hypertension (40%), thrombopenia (35%), fatigue (30%), anemia (15%), diarrhea (5%) and paresthesia (5%). No toxic death was reported. Four dose-limiting toxicities were reported at levels 1 (n = 1) and 3 (n = 3). The maximum tolerated dose was not reached. The regorafenib RP2D was set at 160 mg/day (level 3). Partial response was observed in 8 (40%) patients and disease was stable in 10 (50%) patients. Only 2 patients were progressive (10%). The median follow-up was of 23.8 months (95% CI: 5.4-33.7). Progression-free and overall survival rates are presented in the table. Conclusions: Regorafenib combined with mGEMOX shows an acceptable toxicity profile; the DLTs reported were mainly related to conventional chemotherapy. The observed activity will require confirmation in the ongoing randomized phase II part assessing efficacy of this combination. Clinical trial information: NCT02386397. Acknowledgements: This study was supported by Bayer Healthcare. Time (months) PFS rate (%) 95% CI OS rate (%) 95% CI 12 49.1 [26-68.7] 74.1 [48.5-88.3] 24 21.0 [4.1-46.8] 57.7 [29.5-78]
Gemtuzumab Ozogamicin Makes a Comeback
Journal: Cancer Discovery (2017)

After being pulled from the market 7 years ago, gemtuzumab ozogamicin has been reapproved by the FDA, this time for adults newly diagnosed with acute myeloid leukemia, as well as patients 2 years of age and older with relapsed/refractory disease. The CD33-targeting antibody-drug conjugate can be given as a single agent or in combination with chemotherapy.