Collection 01 February 2016

Key Advances in Medicine 2016

Since man first journeyed into outer space and orbited the Earth, advances in space exploration have been matched by equally momentous advances in medicine and biomedical research. Key Advances in Medicine summarizes the groundbreaking clinical and biomedical discoveries of 2015 and highlights the trends to watch out for in 2016.

The 44 articles are written by international experts who have identified the most important research papers published within their specialty in 2015. Between them, the authors summarize 191 key papers from journals such as The New England Journal of Medicine and The Lancet, across eight medical specialties.

Key Advances in Medicine is ideal for busy medical students, physicians and clinical researchers who want to boost their career by keeping up with the most important clinical and biomedical developments.

Download/View the Key Advances in Medicine 2016 PDF (15 MB).

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Advances in drug, ablation, and device therapy for cardiac arrhythmias

Cardiac arrhythmias produce considerable morbidity and mortality, and are challenging to treat. Advances reported in 2015 will help to guide physicians in the use of therapeutic approaches ranging from established pharmaceutical agents through ablation of arrhythmic sources to novel uses of implanted devices for life-threatening bradyarrhythmias and tachyarrhythmias.
- Laurent Macle
- Stanley Nattel
Year in Review4 Jan 2016 Nature Reviews Cardiology
Improvement of long-term outcomes after PCI

Third-generation drug-eluting stents (DES) have emerged as first-line devices for percutaneous coronary intervention, even in patients with high bleeding risk. Studies published in 2015 report that bioabsorbable vascular scaffolds are equally effective and safe as DES in low-risk populations and, with the addition of extended dual antiplatelet therapy, might improve long-term outcomes.
- Uwe Zeymer
Year in Review14 Jan 2016 Nature Reviews Cardiology
Improving outcomes after OHCA — targeting the layperson

The proportion of the lay population that is trained in cardiopulmonary resuscitation is closely linked to the probability of an individual surviving cardiac arrest. New mobile-assisted technologies might increase the benefit of population-based training. Furthermore, admission of patients to specialized hospitals can increase the likelihood of survival.
- Clifton W. Callaway
Year in Review14 Jan 2016 Nature Reviews Cardiology
Using genomic approaches to identify CVD-causing variants

Cardiovascular genomics has evolved substantially in the past 2 decades. Numerous papers published in 2015 demonstrate that new genomic approaches, often used synergistically, can yield noteworthy findings. A range of laboratory, analytical, and bioinformatic techniques to uncover genetic contributors to coronary artery disease, myocardial infarction, and dilated cardiomyopathy are described.
- Donna K. Arnett
Year in Review14 Jan 2016 Nature Reviews Cardiology
Advances in treatment of dyslipidaemia

Statins remain the first-line therapy for dyslipidaemia. In 2015, however, effectiveness in reducing serum cholesterol levels and decreasing rates of cardiovascular disease in combination with statins has been demonstrated for two new classes of drugs: cholesterol-absorption inhibitors and PCSK9 inhibitors. The latter rival statins in their capacity to lower cholesterol levels.
- Scott M. Grundy
Year in Review14 Jan 2016 Nature Reviews Cardiology
Better results from prevention than from additional treatment

In 2015, success in clinical trials in heart failure was obtained mainly from prevention, whereas treatments showed neutral or even adverse effects. A new glucose-lowering medication prevents development of heart failure. Treating central sleep apnoea might be harmful. In Chagas cardiomyopathy, benznidazole treatment did not affect long-term clinical outcomes.
- Lars Køber
Year in Review4 Jan 2016 Nature Reviews Cardiology
Academic research sheds light on issues that matter to patients

In 2015, academic-led trials provided evidence for safe de-escalation of adjuvant treatment in early stage breast cancer and answered important questions related to adjuvant regional irradiation and optimal first-line chemotherapy in advanced-stage disease. Furthermore, the development of novel therapies and potential tools for treatment tailoring will offer new hope to patients with breast cancer.
- Martine J. Piccart
- Isabelle Gingras
Year in Review20 Jan 2016 Nature Reviews Clinical Oncology
The development of new agents and molecular classifications

In a little over the past year, several clinical trials have evaluated new drugs in patients with metastatic colorectal cancer and gastric cancer. Furthermore, genomics studies that attempted to unravel the molecular characteristics of colorectal and gastric cancer were published in 2015. The results of these endeavours will influence clinical practice in 2016 and beyond.
- Eric Van Cutsem
- Michel Ducreux
Year in Review15 Dec 2015 Nature Reviews Clinical Oncology
Insights into strategies for optimizing ovarian cancer care

Advances in key areas of research have enabled improved outcomes for patients diagnosed with ovarian cancer in the past three decades. In 2015, this trend was maintained with important progress in areas such as guideline compliance, design of targeted approaches and molecular profiling.
- Robert L. Coleman
Year in Review31 Dec 2015 Nature Reviews Clinical Oncology
The new and the old that is new again

In 2015, published trials highlighted the remarkable efficacy of docetaxel combined with androgen-deprivation therapy in patients with newly diagnosed metastatic prostate cancer. Also in 2015, a large study revealing potential molecular targets for metastatic castration-resistant prostate cancer therapies was published, along with a study showing activity of PARP inhibition in patients harbouring mutations in genes governing DNA repair.
- Julie N. Graff
- Tomasz M. Beer
Year in Review31 Dec 2015 Nature Reviews Clinical Oncology
Bypassing checkpoints, overcoming resistance, and honing in on new targets

Lung-cancer treatment paradigms continue to advance as we exploit our growing understanding of the genetic basis of both tumorigenesis and therapy resistance. Moreover, ongoing developments with targeted therapies are improving patient outcomes, with two new drugs approved in 2015 for non-small-cell lung cancer and many others showing promise.
- Egbert F. Smit
- Paul Baas
Year in Review31 Dec 2015 Nature Reviews Clinical Oncology
Immune-checkpoint blockade — durable cancer control

In 2015, advances in immunotherapy for metastatic melanoma have come to fruition, with phase III data supporting the combination of ipilimumab and nivolumab as first-line therapy. Understanding the mechanisms involved in an effective antitumour immune response are now key to further advances. Several studies published in 2015 have increased our understanding of the complex relationships that exist between our immune system and malignancy.
- Elizabeth I. Buchbinder
- F. Stephen Hodi
Year in Review20 Jan 2016 Nature Reviews Clinical Oncology
Advances in managing obesity

Successful management of obesity requires integration of pharmaceutical agents and bariatric surgeries with traditional lifestyle modifications. Notable developments for managing obesity in 2015 included the demonstration of weight-beneficial outcomes for liraglutide and empagliflozin, and the first 5-year follow-up of patients with type 2 diabetes mellitus and obesity randomly assigned to receive bariatric surgery or conventional medical therapy.
- John B. Dixon
Year in Review4 Jan 2016 Nature Reviews Endocrinology
Molecular landscape of thyroid cancer continues to be deciphered

Studies published in 2015 have continued to unravel the genomic landscape of thyroid cancer, particularly of its less common forms (such as medullary and anaplastic carcinomas) and of familial forms of thyroid cancer. As a result, new diagnostic and therapeutic markers have been identified and validated for clinical use.
- Yuri E. Nikiforov
Year in Review15 Dec 2015 Nature Reviews Endocrinology
Epigenetic transgenerational inheritance

Endocrine disruptors are critical environmental exposures that influence health and can promote epigenetic transgenerational inheritance of disease and abnormal physiology. Advances in 2015 included analyses of the effects of endocrine disruptors on human disease, further examples of endocrine disruptors promoting transgenerational behavioural effects, insights into effects of endocrine disruptors on epigenetic programming of primordial germ cells and the finding that endocrine disruptors can transgenerationally promote genetic mutations.
- Michael K. Skinner
Year in Review20 Nov 2015 Nature Reviews Endocrinology
Nutrient and hormone-sensing-dependent regulation

In 2015, four studies demonstrated that hepatic glucose metabolism is altered by targeting the farnesoid X-activated receptor in the gut, the insulin receptor in extrahepatic tissues such as the brain and an S-nitrosylation–endoplasmic reticulum-stress-dependent pathway in the liver. Targeting nutrient-dependent and hormone-dependent signalling pathways in these organs could help regulate hepatic glucose production in patients with diabetes mellitus and obesity.
- Tony K. T. Lam
Year in Review27 Nov 2015 Nature Reviews Endocrinology
Understanding secretion, ageing and death in β cells

The pancreatic islets of Langerhans have been intensively investigated for many years, largely because of their central role in the pathogenesis of type 1 and type 2 diabetes mellitus. Notable advances in 2015 related to glucose-stimulated insulin secretion in β cells, β-cell death and the role of epigenetics in β-cell heterogeneity.
- Gordon C. Weir
Year in Review4 Jan 2016 Nature Reviews Endocrinology
New insights into the genetics of polycystic ovary syndrome

In 2015, large-scale genetic and functional studies brought us closer to understanding the underlying aetiology of polycystic ovary syndrome (PCOS), implicating genes involved in modulation of gonadotropin and neuroendocrine action, ovarian androgen biosynthesis and possibly insulin action, providing clues to the evolutionary path and potential evolutionary advantages of PCOS.
- Ricardo Azziz
Year in Review4 Jan 2016 Nature Reviews Endocrinology
Generating and regenerating the digestive system

Advances into understanding stem and progenitor cells and organoids of the gastrointestinal tract have continued apace. New research published in 2015 identified new cell populations involved in liver regeneration and highlighted the development of pancreatic and gastric organoids.
- James M. Wells
Year in Review13 Jan 2016 Nature Reviews Gastroenterology & Hepatology
Crucial steps towards an effective treatment

In 2015, new tools were developed to modulate fibroblast and macrophage activity to halt liver fibrogenesis and stimulate resolution. Essential factors for resolution were identified and clinical trials yielded potential new antifibrotic drugs. Although innovations were made this year, clinical trials are still hampered by the lack of methods to monitor disease progression.
- Klaas Poelstra
Year in Review13 Jan 2016 Nature Reviews Gastroenterology & Hepatology
Prevotella in the gut: choose carefully

Gut microbial communities often contain many Bacteroides or their close relatives, Prevotella, but not both. Prevotella strains are associated with plant-rich diets but are also linked with chronic inflammatory conditions. In 2015, papers probed the genomic diversity of Prevotella strains and interactions of Prevotella copri with its host and other bacteria.
- Ruth E. Ley
Year in Review1 Feb 2016 Nature Reviews Gastroenterology & Hepatology
Advances in hepatitis C research and treatment

In 2015, new treatment regimens were revealed that achieve >95% cure rates for all HCV genotypes. The HCV polymerase structure was solved in catalytically relevant HCV replication steps and in the context of nucleotide analogue inhibition. Moreover, HCV research taught us new links between innate antiviral responses, lipid metabolism and intracellular membrane formation.
- Barbara Rehermann
Year in Review21 Jan 2016 Nature Reviews Gastroenterology & Hepatology
Emerging trends in endoscopic imaging

Several key papers published in 2015 highlight important emerging trends in endoscopic imaging that promise to improve patient diagnosis and guidance of therapy. These studies reflect the future role for 'smart' contrast agents and fluorescence endoscopes to provide a molecular basis for disease detection, identify precancerous lesions and determine optimal choice of therapy.
- Bishnu P. Joshi
- Thomas D. Wang
Year in Review4 Jan 2016 Nature Reviews Gastroenterology & Hepatology
Precision medicine in pancreatic cancer — fact or fiction?

Late diagnosis and an inability to personalize treatment are major problems preventing reductions in pancreatic cancer mortality. In 2015, the identification of a highly discriminatory exosomal biomarker, culture systems that recapitulate human disease and new methods of analysing large data sets to identify prognostic markers have improved the future outlook for patients with this cancer.
- Thomas Seufferlein
- Julia Mayerle
Year in Review13 Jan 2016 Nature Reviews Gastroenterology & Hepatology
New insights into the mechanisms of podocyte health

Podocyte biologists can boast of some important advances in 2015. Some of the key developments include defining the transcriptional targets of the Wilms' tumour protein on a genome-wide scale, the identification of new mitochondria-centred pathways for maintaining podocyte homeostasis, and new insights into the regulation and pathogenic activation of TRPC6.
- Jeffrey H. Miner
Year in Review21 Dec 2015 Nature Reviews Nephrology
Updates on immunosuppression in kidney disease

Numerous studies in 2015 focused on therapeutic immune modulation and immunosuppression. Trials of budenoside in patients with IgA nephropathy who are unresponsive to supportive therapy, and of low-dose IL-2 to enforce regulatory T-cell-mediated immunosuppression in autoimmune disease all produced promising results.
- Hans-Joachim Anders
Year in Review14 Dec 2015 Nature Reviews Nephrology
Advances in generating and maintaining nephron progenitors

2015 saw the publication of several important studies in the renal stem cell and developmental biology fields. Key studies provided insights into the ageing of nephron progenitors and optimal conditions to stimulate the expansion of nephron progenitors, and reported the in vitro generation of kidney organoids.
- Ryuichi Nishinakamura
Year in Review21 Dec 2015 Nature Reviews Nephrology
Understanding the mechanisms of kidney fibrosis

The year 2015 has seen great progress in the renal fibrosis field, as key studies began to build a consensus on the importance of epithelial-to-mesenchymal transition, cell cycle arrest, and defective metabolism in the pathogenesis of kidney fibrosis. New findings also point to a role of developmental signalling in renal fibrogenesis.
- Dong Zhou
- Youhua Liu
Year in Review30 Dec 2015 Nature Reviews Nephrology
Resistant hypertension: impact and evolving treatment options

Combination therapy with optimal doses of multiple antihypertensive drugs fails to achieve blood pressure (BP) control in up to 15% of hypertensive patients. Key studies in 2015 highlighted the risks of uncontrolled hypertension and evaluated new therapeutic modalities designed to achieve satisfactory BP control in patients with treatment-resistant hypertension.
- Lilach O. Lerman
- Stephen C. Textor
Year in Review14 Dec 2015 Nature Reviews Nephrology
Evolving basic, pathological and clinical concepts in PD

Important advances in Parkinson disease (PD) in 2015 included a revision of its clinical diagnostic criteria and a proposal for research criteria defining prodromal PD. Research published in the past year has also continued to expand our understanding of the roles of Lewy pathology and α-synuclein in the pathobiology of PD.
- Lorraine V. Kalia
- Anthony E. Lang
Year in Review18 Jan 2016 Nature Reviews Neurology
Acute endovascular recanalization therapy comes of age

The past year has seen practice-changing findings in stroke research. Strong evidence now supports endovascular thrombectomy as the new gold standard of care in acute ischaemic stroke, and a pragmatic trial raised concerns over early intensive mobilization after stroke. Moreover, new insights were gained into the trajectory of stroke-associated cognitive decline.
- Alejandro A. Rabinstein
Year in Review8 Jan 2016 Nature Reviews Neurology
Progress in glioma diagnosis, classification and treatment

Gliomas are the most common form of malignant primary brain tumour. In the past year, substantial progress has been made in the classification and treatment of lower-grade gliomas (WHO grades II and III), and the FDA has approved a new therapy for newly diagnosed glioblastomas.
- Patrick Y. Wen
- David A. Reardon
Year in Review18 Jan 2016 Nature Reviews Neurology
Managing the complexity of multiple sclerosis

The application of imaging biomarkers has provided new insights into the mechanisms of damage in multiple sclerosis (MS) and the risk of MS development and progression. The goal of eliminating all disease activity requires a timely escalation of treatment. This increasing complexity is compounded by the need to treat comorbidities.
- Olga Ciccarelli
- Alan Thompson
Year in Review29 Jan 2016 Nature Reviews Neurology
Classic antiepileptic drugs under fire, and new options emerge

Diagnosis and management of epilepsy remain challenging, particularly among women of child-bearing age. In 2015, notable steps were taken in the right direction, with work that provided insight into the diagnosis of epilepsy, management of this condition during pregnancy, and new treatment options.
- Christian E. Elger
Year in Review22 Jan 2016 Nature Reviews Neurology
Targeting tauopathies for therapeutic translation

Tau protein abnormalities are key pathogenic features of Alzheimer disease and other neurodegenerative diseases. In 2015, new studies of the less common tauopathies, including progressive supranuclear palsy, chronic traumatic encephalopathy and frontotemporal lobar degeneration, have identified in vivo biomarkers and mechanisms that initiate tau pathology.
- Julio C. Rojas
- Adam L. Boxer
Year in Review22 Jan 2016 Nature Reviews Neurology
New answers to old problems

Since glucocorticoids were first used to treat patients with rheumatoid arthritis in 1949, they have become the most common therapy for inflammatory disorders; however, their use is associated with major metabolic adverse events. Here, we review three 2015 reports with clinical and fundamental implications for the use of glucocorticoid therapy in rheumatology.
- Sarah A. Jones
- Eric F. Morand
Year in Review24 Dec 2015 Nature Reviews Rheumatology
Cellular and metabolic requirements of effector T cells

Key advances in lupus research in 2015 highlight the contribution of T cells to the pathogenesis of the disease. The findings not only shed light on the regulation and activity of these cells, but also suggest several novel therapeutic targets.
- George C. Tsokos
Year in Review5 Jan 2016 Nature Reviews Rheumatology
Advancement continues in imaging, tight control and new drugs

In 2015, a EULAR task force released evidence-based recommendations on the use of imaging in the clinical management of spondyloarthritis, including psoriatic arthritis. These recommendations, together with articles dealing with tight control strategies and use of the IL-17A inhibitor secukinumab, have consolidated progress in the management of psoriatic arthritis.
- Ignazio Olivieri
- Salvatore D'Angelo
Year in Review22 Jan 2016 Nature Reviews Rheumatology
New tools to tackle inflammatory arthritis

Novel therapies to reduce the progressive and destructive nature of inflammatory joint disease are always welcome, provided that safety is not compromised. Among the many 2015 studies in the field, we highlight a targetable mechanism of uric-acid-induced inflammation in gouty arthritis and the expected efficacy — but unforeseen safety concerns — of anti-IL-17 antibodies.
- Charles A. Dinarello
- Leo A. B. Joosten
Year in Review14 Jan 2016 Nature Reviews Rheumatology
Recovering sex drive in women — progress and opportunities

In 2015, the approval of flibanserin opened a debate about diagnosis and treatment of female sexual dysfunction. Designing clinical trials with suitable end points is difficult, but some studies indicate correlations between hormone levels and low desire. New research demonstrates opportunities for a better understanding of this multifaceted condition.
- Rossella E. Nappi
- Francesca Albani
Year in Review12 Jan 2016 Nature Reviews Urology
Novel findings continue to challenge researchers and clinicians

2015 has seen advances in various bladder conditions. MicroRNAs might become therapeutic targets, the MAPP network characterized central neurological changes in chronic pelvic pain syndrome, and urologists were reminded to consider cognitive effects of long-term anticholinergics use. A study of obstetric vesicovaginal fistula repair shows how evidence-based research might improve public health in poorly resourced countries.
- Rose Khavari
- Tim Boone
Year in Review31 Dec 2015 Nature Reviews Urology
Changes in stone management — suspending belief for evidence

In 2015, population-based studies in patients with urinary stones informed us of the changing trends in contemporary stone management and identified areas for improvement. Although meta-analyses aim to provide the highest level of evidence, a randomized controlled trial of medical expulsive therapy challenged current paradigms and was the defining publication of the year.
- Sapan N. Ambani
- Khurshid R. Ghani
Year in Review8 Dec 2015 Nature Reviews Urology
HIV protection with PrEP — implications for controlling other STIs

HIV and bacterial sexually transmitted infection incidence remains persistently high for men who have sex with men. Results of new studies show that clinicians might be able to address this challenge by providing oral HIV pre-exposure prophylaxis and by intensifying efforts to diagnose and treat other sexually transmitted infections.
- Douglas S. Krakower
- Kenneth H. Mayer
Year in Review1 Dec 2015 Nature Reviews Urology
Improving indication, technique and outcome of radical cystectomy

Radical cystectomy is the standard treatment for patients with bladder cancer, but the prognosis of patients undergoing this procedure has not changed for decades. Small steps towards improvement include better selection of high-risk T1 patients, the use of perioperative chemotherapy and, maybe, robotic cystectomy.
- J. Alfred Witjes
Year in Review24 Nov 2015 Nature Reviews Urology

Key Advances in Medicine 2016

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