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Key Advances in Medicine 2018

Much like our oceans, the world of clinical and biomedical research is vast, fast-paced, dynamic and full of unanswered questions. In 2017, numerous advances were made that could change the tide of efforts to fight disease. The Key Advances in Medicine eBook distils the major discoveries made in 2017 and highlights trends to look out for in 2018.

This eBook is free* to access and download, and contains 44 articles written by international experts who have identified the top ground-breaking papers published within their specialties. Altogether, the authors provide summaries and critiques of >200 key papers published in leading journals.

Key Advances in Medicine, a product from the eight clinical Nature Reviews journals, is a vital resource for busy students, physicians and clinical researchers who want expert opinion on the most important developments in 2017.

Download the Key Advances in Medicine 2018 PDF

*The individual articles are not free. For free access, please download the eBook.

Cardiology – Clinical Oncology

  • Nature Reviews Cardiology | Year in Review

    In 2017, a cluster of papers have provided strong evidence in favour of the inflammation hypothesis in cardiovascular disease. From fundamental observations on clonal haematopoiesis to clinical evidence indicating that blocking an inflammatory cytokine mitigates heart disease, 2017 has been a watershed year.

    • Filip K. Swirski
  • Nature Reviews Cardiology | Year in Review

    Important milestones in cardiac regenerative medicine that will define future research were reached in 2017: demonstration of adult cardiomyocyte renewal capacity, recognition of the importance of the extracellular matrix and the higher regenerative efficacy of repetitive dose protocols, and the publication of human data supporting paracrine effects of stem cell therapies and guidelines from TACTICS, the first international alliance on cardiac regenerative medicine.

    • Francisco Fernández-Avilés
  • Nature Reviews Cardiology | Year in Review

    In 2017, several high-impact studies in thrombosis were published. Refinements were made in the optimal therapy for patients with stable atherosclerosis or with atrial fibrillation undergoing percutaneous coronary intervention. Risk scores to determine duration of antiplatelet therapy were developed. The potential risk of subclinical valve leaflet thrombosis was identified.

    • Deepak L. Bhatt
  • Nature Reviews Clinical Oncology | Year in Review

    In 2017, three groundbreaking immunotherapies for relapsed and/or refractory B-cell acute lymphoblastic leukaemia (ALL) were approved based on impressive outcomes observed in clinical trials. Additional breakthroughs included seminal research into ALL genomics and the importance of adherence to chemotherapy, which will have direct implications for clinical care.

    • David T. Teachey
    •  &  Stephen P. Hunger
  • Nature Reviews Clinical Oncology | Year in Review

    In 2017, major advances in the treatment of non-small-cell lung cancer (NSCLC) continued to emanate from the fields of molecularly targeted therapy and immunotherapy. In the former, new drugs with improved efficacy and reduced toxicity entered the clinic; in the latter, immune-checkpoint inhibition proved efficacious after chemoradiotherapy for stage III disease, but had disparate results in the frontline treatment of stage IV disease.

    • David F. Heigener
    •  &  Martin Reck
  • Nature Reviews Clinical Oncology | Year in Review

    2017 saw the publication of clinical trial data and the approval of new treatment approaches for metastatic urothelial carcinoma. Pembrolizumab is now a well-established treatment for patients with disease progression after cisplatin, with high-level evidence supporting its superiority over second-line chemotherapy. For patients ineligible for cisplatin, atezolizumab and pembrolizumab provide meaningful clinical benefit as frontline therapies.

    • Joaquim Bellmunt
    •  &  Rosa Nadal

Endocrinology – Gastroenterology & Hepatology

  • Nature Reviews Endocrinology | Year in Review

    The risk of death from cardiovascular causes in people with type 2 diabetes mellitus remains around twice that in the general population, with heart failure a common event. In 2017, results from cardiovascular outcome trials in people with diabetes mellitus showed that some drugs have dual utility — reducing cardiovascular risk and improving glycaemic control.

    • Rury R. Holman
  • Nature Reviews Endocrinology | Year in Review

    Extracellular danger-associated molecular patterns signal to NOD-like receptors, but the exact signalling pathways remain unclear. The inflammasomes, a subgroup of these receptors, translate danger signals into inflammatory responses by maturing IL-1 and IL-18. In 2017, researchers reported novel functions of the mutual interaction between metabolism and the inflammasomes in health and disease.

    • Thomas Mandrup-Poulsen
  • Nature Reviews Endocrinology | Year in Review

    The artificial pancreas — the automated closed-loop control of diabetes mellitus — made its first outpatient strides in 2011. In 2017, the results of long-term clinical trials on the artificial pancreas were published, the first hybrid commercial artificial pancreas system was approved and the artificial pancreas was tested under increasingly demanding conditions. Thus, artificial pancreas technology is here to stay.

    • Boris Kovatchev
  • Nature Reviews Gastroenterology & Hepatology | Year in Review

    2017 has witnessed key advances in knowledge about the metabolic capacities of the gut microbiota, enabling the progression of our understanding of the principles driving xenobiotic–bacteria–host interplay. This research paves the way for the long road towards personalized medicine and nutrition, which could be based on gut microbial metabolism.

    • Nathalie M. Delzenne
    •  &  Laure B. Bindels
  • Nature Reviews Gastroenterology & Hepatology | Year in Review

    In 2017, there have been substantial advances in our understanding of the immunological and endocrine mechanisms of disease progression in NAFLD, paving the way for novel therapeutic strategies.

    • Reenam S. Khan
    •  &  Philip N. Newsome
  • Nature Reviews Gastroenterology & Hepatology | Year in Review

    2017 has witnessed major advances in gut stem cell and cancer stem cell research, delivering key insights into their regulation, more defined culture methods and novel stem cell markers that collectively drive us ever closer to breakthroughs for regenerative medicine and cancer treatment in the clinic.

    • Nick Barker

Nephrology – Neurology

  • Nature Reviews Nephrology | Year in Review

    Studies of cellular energetics have revealed important roles of metabolic pathways in determining cell fate and response to injury. Insights from 2017 into the mechanisms underlying these pathways might identify therapeutic targets to minimize injury and promote repair.

    • Ton J. Rabelink
    •  &  Peter Carmeliet
  • Nature Reviews Nephrology | Year in Review

    2017 saw the emergence of a new era in renoprotective medicine for diabetic kidney disease with reports of promising renal outcomes with the sodium–glucose cotransporter 2 (SGLT2) inhibitors empagliflozin and canagliflozin from follow-up analyses of the EMPA-REG OUTCOME trial and the CANVAS Program, respectively, and with use of the glucagon-like peptide 1 (GLP1) agonist liraglutide in the LEADER trial.

    • Christoph Wanner
  • Nature Reviews Nephrology | Year in Review

    New findings in 2017 enhanced our understanding of the mechanisms that regulate blood pressure. Key studies provided insights into immune mechanisms, the role of the gut microbiota, the adverse effects of perivascular fat and inflammation on the vasculature, and the contribution of rare variants in renin–angiotensin–aldosterone system genes to salt sensitivity.

    • Ernesto L. Schiffrin
  • Nature Reviews Neurology | Year in Review

    In 2017, dramatic advances have been made in the treatment of motor neuron diseases. New therapies have been approved for spinal muscular atrophy and amyotrophic lateral sclerosis, and a host of other therapies that are currently under development are showing promising results.

    • Matthew C. Kiernan
  • Nature Reviews Neurology | Year in Review

    2017 saw the publication of new classifications for epilepsy and seizure types, which emphasize the importance of understanding the underlying disease mechanisms. This aetiology-based approach is already beginning to inform developments in therapies and trial design in the epilepsies.

    • Sameer M. Zuberi
    •  &  Andreas Brunklaus
  • Nature Reviews Neurology | Year in Review

    The past year saw advances in endovascular treatment for acute stroke, speech therapy for aphasia after stroke, and cardiac disease management to prevent stroke. These treatments were characterized by more intensive or more extensive effects than standard care, necessitating thoughtful translation of the clinical trial findings into routine clinical practice.

    • Meng Lee
    •  &  Bruce Ovbiagele

Rheumatology – Urology

  • Nature Reviews Rheumatology | Year in Review

    Multiple scientific fields pertaining to inflammation, including the fields of cardiovascular, infection and cancer research, are increasingly contributing to our understanding of rheumatoid arthritis (RA). In 2017, such research has helped develop our understanding of RA comorbidity, the link between RA pathogenesis and infection, and the effects of new therapies.

    • Pierre Miossec
  • Nature Reviews Rheumatology | Year in Review

    A large number of patients with osteoporosis are not receiving appropriate treatment, due in part to concerns regarding drug safety. Great progress has been made to address this crisis in therapy in 2017, including highlighting the patients' views, developing new therapies and treatment strategies and addressing these safety concerns.

    • Christian Roux
    •  &  Karine Briot
  • Nature Reviews Rheumatology | Year in Review

    The rarity, severity and complexity of paediatric rheumatic diseases make progress in treating these diseases a challenge. In 2017, a new series of recommendations for treatment, studies that unravel the complexity of juvenile idiopathic arthritis and clinical trials that tackle sight-threatening uveitis have helped to improve paediatric care.

    • Michael W. Beresford
    •  &  Athimalaipet V. Ramanan
  • Nature Reviews Urology | Year in Review

    Landmark papers published in 2017 have advanced our understanding of the molecular heterogeneity of urothelial cancer, provided insights into the genomic evolution of the disease in the context of metastasis and therapy, and established new treatment standards for patients with previously limited treatment options.

    • Matthew D. Galsky
  • Nature Reviews Urology | Year in Review

    Treatment paradigms for advanced renal cell carcinoma (RCC) continue to be challenged and refined. Recent studies in metastatic RCC have demonstrated the efficacy of first-line cabozantinib and the safety and efficacy of dual checkpoint blockade; in the adjuvant setting, pazopanib failed to improve progression-free survival in high-risk localized RCC compared with placebo.

    • Mark W. Ball
    •  &  Ramaprasad Srinivasan
  • Nature Reviews Urology | Year in Review

    Major advances in the management of all stages of upper tract urothelial carcinoma have been made in 2017. Radical nephroureterectomy can be valuable in patients with metastatic disease and adjuvant platinum-based chemotherapy can improve outcomes in those with advanced disease. Kidney-sparing surgery with early follow-up ureterorenoscopy has shown benefit in patients with low-grade tumours. Avoiding unnecessary ureterorenoscopy might decrease intravesical tumour recurrence.

    • Pietro Grande
    •  &  Morgan Rouprêt