Editorials

Cancer surveillance programs have reported a global downward trend in cancer mortality rates for most common tumor types. However, startling geographic inequalities exist, and some cancers continue to pose a challenge. Ensuring global access to high-quality diagnostic and treatment approaches is needed to make decreasing cancer deaths a more widespread trend.

As the world reckons with the news of the first use of genome editing in the human germline, researchers, clinicians, ethicists and policy makers must work across international boundaries to outline a transparent path forward for the responsible translation of this technology in the future.

As Nature Medicine celebrates its 25th anniversary, we bring you a special Focus on Digital Medicine that highlights the new technologies transforming medicine and healthcare, as well as the related regulatory challenges ahead.

Recent news stories about conflict of interest in biomedical research have shaken up public and private institutions alike, but their focus was on clinical research. Amidst the renewed focus on conflicts of interest in clinical work, let’s not disregard the fact that financial conflicts also pose a concern to basic and preclinical research.

Thanks to improvements in data collection and analysis, some polygenic risk scores that predict disease risk are approaching the same predictive accuracy offered by tests for monogenic mutations. The time to think about how best to incorporate polygenic tests in the clinic is now.

To facilitate access to and improve the discoverability of the data in our papers, Nature Medicine is making the data availability statement in our papers more prominent and its language more transparent.

Concerns about potential unintended DNA changes that might accidentally arise from CRISPR gene editing have emerged to varying degrees with the advent of the technology. As new therapies move from bench to bedside, scientists need to redouble their efforts to document the spectrum of these off-target effects while also acknowledging the reality that a certain degree of risk is embedded in many promising and successful medical therapies.

With the ongoing demand for assisted reproduction, the need and ability to study the fundamentals of human reproduction at a cellular level have never been greater. At this juncture, we join other Nature Research Journals in formalizing our ethical guidelines for papers in this growing field.

For more than two decades, Nature Medicine has been the prime venue for publication of outstanding work in the translational space. Now the journal’s scope is evolving to embrace the clinical research that meets the challenges and complexities of contemporary medicine.

Influenza causes almost 650,000 deaths worldwide each year, yet a long-lasting, protective vaccine remains elusive. Global investment—both scientific and financial—in a universal flu vaccine is overdue.

Therapies for Alzheimer's disease and other neurodegenerative diseases are desperately needed. Yet, a string of disappointments in the neurodegenerative therapy space has meant that several companies over the years have ended their investment in the field. Some companies have diversified their research and development (R&D) models to hedge their bets. Maintaining this diversity to bring down the silos between big pharma and smaller research teams may be necessary to jumpstart and sustain progress in combatting neurodegenerative conditions.

Tailoring treatment to the individual patient has revolutionized cancer therapy, but personalized medicine has yet to make much headway in the treatment of cardiovascular disease. With emerging insight into disease mechanisms and new treatment options, the time is now ripe for the cardiovascular field to adopt a more personalized approach to therapy.

Mental illnesses impose a grave disease burden worldwide, yet progress in managing and treating them has largely stalled. Harnessing the power of big data may break the current impasse and open new avenues for better diagnosis, treatment and prevention of these devastating illnesses.

Better animal models of nonalcoholic steatohepatitis are needed to more fully understand the disease and to identify potential new therapeutic treatments for this increasingly common condition.

Genetic association studies of the human genome often omit the X chromosome because of the unique analytical challenges it presents. A concerted effort to undo this exclusion could offer medically relevant insights into basic biology that might otherwise be missed.

A growing number of clinical trials on combination therapies raises the question of to what degree they may be redundant. Systems biology and hypothesis-driven preclinical studies could help to identify the most promising candidates for clinical trials, and also offer new insights into the biological mechanisms that underlie drug synergies.

Drugs administered to children with cancer were typically developed under the assumption that childhood cancers are similar to their tissue-matched adult counterparts. Focusing on identifying and targeting alterations present specifically in childhood tumors will accelerate the development of tailored therapies and improve the prognosis of children with cancer.

Recent evidence shows that both acute and chronic infections can persist in tissue reservoirs that act as a source of subsequent disease. Identifying the parallels of reservoir maintenance by diverse pathogens might offer new leads to enable their control.