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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.

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.

Reporting of toxic adverse effects of anticancer treatments by clinicians generally results in the underreporting of these toxicities. Patient-reported outcomes, which fully reflect the experiences of patients receiving treatment, offer an alternative to reporting of toxicities by clinicians. In this Perspective, the authors describe the barriers and challenges to routine integration of patient-reported outcomes into clinical trials, and describe the PRO–CTCAE, which is designed to help circumvent some of these challenges.

Patients with advanced-stage ovarian cancer are widely believed to have a dismal prognosis; however, around 20% of women with this disease survive beyond 12 years after treatment and are effectively cured. In this Perspectives, Steven Narod presents the case that this proportion could be substantially increased through the combination of maximal debulking surgery and intraperitoneal chemotherapy.

The recently updated breast cancer screening guidelines from the American Cancer Society are less aggressive than previous versions and clearer about overdiagnosis. However, a lack of attention was placed on the differences in effect estimates between trials at high and low risk of bias, and the authors failed to quantify the most serious harm.

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.

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.

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.

A meaningful revolution in managing malignant diseases has occurred since the advent of molecular targeted therapies; while some agents have resulted in a clinical benefit, these novel agents are also associated with undesired effects and assessing these risks in the correct context of potential clinical benefit is paramount. The authors overview of the development and toxicity profiles of kinase inhibitors and monoclonal antibodies, with an emphasis on their clinical management, including patient supportive care needs, and the impact of these treatments use on the health-care expenditures at the end of life.