Increasing evidence indicates that intratumoural bacteria can have crucial roles in both the pathogenesis and treatment of cancer. In this Review, the authors discuss the characteristics of intratumoural bacteria and the emerging understanding of their tumour-promoting and antitumour activities. They also describe a range of innovative strategies that are being used to engineer bacteria for use in the treatment of cancer and summarize clinical trials of various bacteria-mediated cancer immunotherapies.

Novel immunotherapeutic strategies based on targeting specific tumour-associated antigens with antibody–drug conjugates (ADCs), chimeric antigen receptor (CAR) T cells and bispecific T cell engagers (BTEs) are revolutionizing the treatment of multiple myeloma. In this Review, the authors describe the clinical experience to date with ADCs, CAR T cells and BTEs targeting B cell maturation antigen, G protein-coupled receptor family C group 5 member D and Fc receptor-like protein 5. In addition, they discuss the mechanisms of resistance to such therapies, and potential strategies by which resistance could be overcome to improve patient outcomes.

Traditionally, patients with small-cell lung cancer (SCLC), a malignancy with a dismal prognosis, have had limited treatment options. Over the past few years, advances in the molecular characterization of SCLC have revealed novel therapeutic targets. The authors of this Review summarize these findings and discuss emerging opportunities and challenges for their translation into new treatment approaches.

Artificial intelligence (AI) has the potential to dramatically change several aspects of oncology including diagnosis, early detection and treatment-related decision making. However, many of the underlying algorithms have been or are being trained on datasets that do not necessarily reflect the diversity of the target population. For this, and other reasons, many AI tools might not be suitable for application in less economically developed countries and/or in patients of certain ethnicities. In this Perspective, the authors discuss possible sources of inequity in AI development, and how to ensure the development and implementation of equitable AI tools for use in patients with cancer.

Despite recent FDA approval, the clinical utility of vorasidenib in the treatment of IDH-mutant low-grade gliomas remains unclear. Herein, we critique the pivotal trial of vorasidenib, and highlight the questionable choice of control intervention and end points, ethical concerns, as well as the uncertain efficacy observed, and argue that the approval might be premature given the high cost of this drug and lack of clear benefit over standard treatments.

Precision oncology has reached a milestone as data from two trials in which molecular profiling guided both site-specific and tumour-agnostic therapies indicate improved survival outcomes in patients with cancer of unknown primary. These findings can also be extrapolated and support the use of tissue-agnostic approaches in general, and also suggest that the tissue of origin might have a role in the agnostic classification of cancers and their response to treatment.

My close experience with cancer and interactions with other patients, caregivers and health-care providers have shaped my belief that patients must be at the centre of research and care. In this Comment, I advocate for a redirection of research efforts in order to measure patient-centred outcomes and address health disparities.