Volume 14 Issue 4, April 2017

The 69 National Cancer Institute-designated Cancer Centers are premier academic institutions that place significant value on research integrity and an ethic that rigorous evidence should guide patient care and define expectations. Recent patient-focused advertising has strayed from these values, obscuring valid reasons for seeking care at these centres.

Data from the recent Stop 2G-TKI study confirm that around 60% of patients with chronic myeloid leukaemia who discontinue second-generation BCR–ABL1 tyrosine-kinase inhibitor (TKI) therapy after a sustained deep molecular response remain in remission for longer than 1 year. Importantly, the interim findings suggest that prior response to first-line TKI treatment might predict relapse risk after treatment discontinuation.

Immune-checkpoint inhibitors are revolutionizing the treatment of many types of solid cancer. Expression of the inhibitory immune-checkpoint proteins programmed cell-death 1 (PD-1) and its ligands (PD-L1 and PD-L2) are frequently detected in haematological malignancies, and agents targeting these proteins have activity in such diseases, notably Hodgkin lymphoma. Herein, the current evidence supporting the roles of PD-1–PD-L1 blockade in the treatment of various B-cell malignancies is reviewed.

In this Review, the authors describe the developing therapeutic landscape for patients with muscle-invasive bladder cancer. In particular, the data supporting the use of neoadjuvant cisplatin-based chemotherapy as a standard of care, the potential impact of genomic profiling on treatment approaches, and the emerging importance of immunotherapy are discussed.

Recent advances in molecular biology and our understanding of the development of colorectal cancer (CRC) has enabled the more-precise use of innovative targeted therapies for this disease. In particular, large databases to capture and store genomic information on causative genes frequently deregulated in CRC, the use of gene-expression profiling to differentiate the subtypes of CRC into prognostic and predictive groups, and results from next-generation sequencing analyses have led to an appreciation of the extensive intratumour heterogeneity of this disease. The authors highlight these advances, place them into clinical context, and present other novel targets and therapeutic opportunities on the horizon.

Autophagy is fundamental to cellular homeostasis and also has a central role in the development and progression of cancer. However, autophagy is also required for optimal immune system function, including the development of an anticancer immune response. In this Perspective, the authors present the available preclinical and clinical evidence that autophagy might enhance the effectiveness of both immunogenic chemotherapy and radiotherapy, as opposed to the general view of inhibition of autophagy as an antitumour strategy.