Articles in 2018

Perioperative chemotherapy is the standard of care for localized gastric cancer (GC). In 2018, additional postoperative radiotherapy was found to be ineffective; although, docetaxel was found to be superior to epirubicin in perioperative three-drug chemotherapy regimens. Validated biomarkers are needed for benefit from immunotherapy in advanced-stage GC. Metachronous GC can be prevented by Helicobacter pylori eradication.

The first-in-human study of anti-CD47 antibodies blocking CD47–SIRPα interactions in combination with rituximab in patients with non-Hodgkin lymphoma shows encouraging clinical responses accompanied with mild levels of toxicity. Inhibition of the CD47–SIRPα interaction might provide a generic method of promoting the effects of antitumour antibodies in a variety of cancer types. This reveals, for the first time, an innate immune checkpoint as a bona fide target for therapy.

Breakthrough findings reported in 2018 provide the foundations for paradigm shifts in the care of patients with ovarian cancer. These results have implications for treatment in the first-line setting (with improved and refined use of established treatment modalities), firmly introduce concepts of consolidation and maintenance therapy, and enable more accurate prediction of drug sensitivity and resistance.

Women with early-stage oestrogen receptor (ER)-positive (ER⁺) breast cancer remain at risk of distant recurrence for at least 15 years after discontinuation of 5 years of standard endocrine therapy. The authors of this Review discuss the epidemiology and mechanisms underlying late recurrence and examine several models used for risk prognostication and for estimating the presence of minimal residual disease.

Multidisciplinary team meetings have several flaws; herein, we propose approaches for cancer centres to transform these limitations into improvements in the quality control of oncological care and into research opportunities.

Herein, advances in our understanding of the genomic landscape of childhood acute lymphoblastic leukaemia (ALL), encompassing both somatic and germline alterations, are reviewed. The clinical implications of these alterations, particularly those in the germ line, are discussed with regard to susceptibility to ALL, treatment responses and therapy-related toxicities.

In 2018, advances in the treatment of non-small-cell lung cancer (NSCLC) have been observed both in trials of immunotherapies and targeted agents, leading to dramatically improved options for patients with metastatic and stage III NSCLC.

In 2018, the results of multiple phase III trials in metastatic renal cell carcinoma (mRCC) were presented. A phase III noninferiority trial demonstrated the importance of careful patient selection before cytoreductive nephrectomy. Additionally, three randomized phase III trials demonstrated the superiority of combination therapy with an immune-checkpoint inhibitor backbone versus sunitinib in patients with treatment-naive mRCC.

The mechanisms of resistance to immunotherapy seem to broadly overlap with the immunoediting process whereby cancers evade detection by the immune system. The authors of this Review discuss these interactions as well as the strategies that can be used to overcome therapeutic resistance

Patients with cancer might be at a higher risk of nonmedical opioid use than was previously thought; however, opioid analgesics remain the gold standard to treat cancer-related pain. The authors of this Review examine the role of opioids in cancer-related pain, the risk of substance use disorder and methods to achieve the right balance between both to ensure safe opioid use.