Volume 14 Issue 12, December 2017

Potential strategies for improving the outcomes of patients with early stage HER2-positive (HER2+) breast cancer have included dual anti-HER2 therapy. Recent results from the APHINITY trial show a statistically significant, but clinically modest, benefit from the addition of pertuzumab to trastuzumab and chemotherapy. Subsequent trials should focus on biomarkers to identify patients with HER2+ breast cancer who require more-intensive or less-intensive therapy.

Virtually all successful treatments of cancer either create, restore or enhance the antitumour immune response. Therefore, the specific features of the immune microenvironment, both before and after treatment, are important determinants of patients' outcomes. In this Review, the authors describe the influence of the immunological characteristics of the tumour microenvironment on responses to treatment in patients with a variety of cancers.

A wide range of gene fusions have been detected in solid tumours, and the products of these fusions, some of which result in constitutive activation of kinase signalling, can be targeted using tyrosine-kinase inhibitors. However, the development of acquired resistance is almost inevitable. In this Review, the authors describe strategies used to diagnose and treat patients with fusion-positive cancers.

Radiomics is the high-throughput mining of quantitative image features from standard-of-care medical imaging to enable data to be extracted and applied within clinical-decision support systems. The process of radiomics is described and its pitfalls, challenges, opportunities, and capacity to improve clinical decision making. The radiomics field requires standardized evaluation of scientific findings and their clinical relevance. This review provides guidance for investigations to meet this urgent need in the field of radiomics.

In the past decade, the importance of patient-reported outcomes (PROs) as a key measure of the quality of care delivered to patients with cancer has been acknowledged. PROs were used in the context of research studies, but growing evidence indicates that the incorporation of electronic PRO (ePRO) assessments into standard health-care settings can improve the quality of care delivered to patients with cancer. The authors of this Review discuss aspects related to PROs such as measurements, implementation challenges, and outcome improvements associated with their use.