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  • Data on a new treatment approach utilizing bispecific monoclonal antibodies targetting B-cell maturation antigen (BCMA) were recently published, yielding very encouraging results in the setting of relapsed and/or refractory multiple myeloma (RRMM). How to safely and effectively deliver this treatment to patients and where it fits in the RRMM treatment paradigm are important questions for the future.

    • Krina Patel
    • Sagar Lonial
    News & Views
  • Advances in circulating tumour DNA (ctDNA) detection and analysis are beginning to be implemented in clinical practice. Nonetheless, much of this development has thus far focused on plasma ctDNA. Theoretically, all bodily fluids, including urine, cerebrospinal fluid, saliva, pleural fluid and others, can also contain measurable ctDNA and can provide several advantages over the reliance on plasma ctDNA. In this Review, Tivey et al. describe the potential roles of ctDNA obtained from non-plasma sources in optimizing the outcomes of patients with cancer.

    • Ann Tivey
    • Matt Church
    • Natalie Cook
    Review Article
  • In randomized controlled trials in oncology, changes in quality of life are usually reported together with a description of the differences considered a priori to be clinically important, but overall survival outcomes are rarely provided together with information of what constitutes a clinically meaningful threshold. In this Comment, we propose the benefits that could be derived from reporting overall survival in a similar way to quality of life.

    • Bishal Gyawali
    • Christopher M. Booth
    Comment
  • Median overall survival for patients with newly diagnosed multiple myeloma may surpass ten years. Nonetheless, many patients face considerable treatment-related morbidity and relapsed disease. Owing to this typically long overall survival, most multiple myeloma trials now use progression-free survival as their primary end point. In this Comment, we highlight circumstances in which this end point does not best answer the questions that various trials seek to investigate.

    • Edward R. Scheffer Cliff
    • Ghulam Rehman Mohyuddin
    Comment
  • The oligometastatic state is generally considered to constitute an intermediate point along the spectrum of cancer dissemination at which the metastatic burden is limited and local ablative therapies can result in meaningful clinical benefit, and possibly even cure. In this Review, Katipally et al. reframe the oligometastatic phenotype as a dynamic state that expands beyond merely the number or size of metastases. They highlight important risk factors defining the metastatic spectrum that can inform both staging and therapy, and identify themes in the literature that might guide strategies to optimally combine metastasis-directed local therapies with modern systemic treatments.

    • Rohan R. Katipally
    • Sean P. Pitroda
    • Ralph R. Weichselbaum
    Review Article
  • Tracking circulating tumour DNA (ctDNA) after surgery holds promise for patient management and therapeutic intervention in non-small-cell lung cancer (NSCLC). A study published by Zhang and colleagues tracks ctDNA from 261 patients with stages I–III NSCLC and suggests that the likelihood of disease relapse decreases for high-risk stage II/III patients after 18 months without ctDNA detection.

    • Alexander Frankell
    • Mariam Jamal-Hanjani
    News & Views
  • After a frustratingly slow pace of development of new effective treatments for mesothelioma, single or dual therapy with immune-checkpoint inhibitors has substantially improved overall survival over previous standard-of-care therapies in various disease settings. The authors of this Review summarize the current evidence on immunotherapies for mesothelioma, focusing on strategies evaluated in randomized clinical trials and emerging predictors of response, and discuss future treatment opportunities.

    • Dean A. Fennell
    • Sean Dulloo
    • James Harber
    Review Article