Volume 18 Issue 10, October 2021

Artificial intelligence and machine learning have the potential to make cancer care more accessible, efficient, cost-effective and personalized. However, meticulously planned prospective deployment strategies are required to validate the performance of these technologies in real-world clinical settings and overcome the human trust barrier.

The paradigm of precision medicine implies that breast cancer treatment should be tailored based on inherent risk of recurrence and/or individual sensitivity to various chemotherapies. A recent trial of olaparib in women with a BRCA1/2 mutation provides supporting evidence for this paradigm and suggests that the identification of genetic variants at the time of diagnosis might benefit an increasing number of patients.

Despite being the most common primary bone cancer in children and young adults, osteosarcoma is a rare cancer, a fact that has complicated efforts to improve patient outcomes. Moreover, the molecular biology of disease is highly heterogeneous and most of the recurrent genetic alterations occur in tumour-suppressor genes that are challenging therapeutic targets. Herein, Gill and Gorlick discuss the new biological discoveries, technologies, and therapeutic agents and approaches that, through collaborative efforts, are poised to generate advances in the treatment of osteosarcoma after more than four decades of stagnation.

Immune-checkpoint inhibitors (ICIs) are now standard-of-care therapies for patients with advanced-stage non-small-cell lung cancer (NSCLC) without a targetable driver alteration. Various ICIs or combination regimens have been approved in this setting, relative to chemotherapy, although no prospective data are available comparing the various ICI-based approaches. Here, the authors provide guidance on selecting the optimal ICI-based therapy and highlight several future research directions that will probably further improve the outcomes of patients with advanced-stage NSCLC.

Hotspot genetic alterations that confer the enzymes isocitrate dehydrogenase (IDH) 1 and 2 with neomorphic activity to produce the oncometabolite D-2-hydroxyglutarate are common in several cancer types, including acute myeloid leukaemia, cholangiocarcinoma, chondrosarcoma and glioma. Herein, Pirozzi and Yan describe the current understanding of the biological, pathogenetic and prognostic implications of IDH mutations in these cancers. They also review the available preclinical and clinical data on the various therapeutic strategies that are being pursued for IDH-mutant cancers and discuss whether treatment approaches will converge or be context dependent.

Assuming that the latest incidence trends continue for the major cancer types, the incidence of all cancers combined will double by 2070 relative to 2020, with the greatest increases predicted in lower-resource settings. The authors of this Perspective discuss how population-level approaches with amenable goals should be considered an integral part of cancer control.