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A careful integration of the effectiveness and safety of the therapies for inflammatory bowel disease, considering patients’ disease risks, treatment complications and preferences, is warranted to inform the positioning of therapies in clinical practice. Precision medicine might help choose the best option for an individual patient.

Cholangiocarcinoma is the second most common primary liver cancer, and its incidence is rising worldwide. This Review discusses the immunology of cholangiocarcinoma and provides a comprehensive overview of the preclinical and clinical immunotherapy studies.

The therapeutic landscape of metastatic colorectal cancer (mCRC) is changing. This Review provides a comprehensive overview discussing the current mCRC advances in precision oncology and suggests a treatment strategy for mCRC with rare genomic alterations.

In this Review, the authors discuss gene therapy involving the use of recombinant adeno-associated virus vectors for the treatment of inherited liver diseases, including ongoing clinical trials that are producing promising results.

Key studies published in 2022 highlight the emergence of several novel drugs for inflammatory bowel disease. Head-to-head trials and network meta-analyses have also been conducted to identify the sequencing of these treatments, but we still have a long way to go to achieve personalized medicine.

There is an increasing burden of gastrointestinal cancers in East Asia. This Review provides an updated summary of the epidemiology of gastrointestinal cancers in this region and discusses risk factors and implications for prevention.

In this Review, the authors consider various paths to functional cure of chronic hepatitis B (CHB) and the need to individualize therapy of this heterogeneous infection until a therapeutic avenue for all patients with CHB is available.

The gut microbiome field is shifting from association to modulation. Microbiota-based treatments come in many shapes and sizes, ranging from dietary intervention to live bacterial products. Recent methodological advances are instrumental to developing innovative new treatment strategies in microbiome-linked pathologies.

New data suggest that moderate fluid resuscitation is safer in acute pancreatitis than the standard aggressive fluid resuscitation. The findings suggest that an approach that includes safety and goal-directed checkpoints could enable treatment to be individualized and highlight the importance of clinical evidence in challenging dogma and improving evidence-based medicine.

The feasibility of long-term organ preservation ex vivo has been reported for the first time with proof of concept in human transplantation. Here, we discuss the possible applications of this novel technology in the clinical setting.

A new report from the World Health Organization has evaluated the risks of dietary exposure to nanoplastic and microplastic particles (NMPs) to human health. Although challenges in the detection of NMPs in food and beverages remain, it is clear that humans are being exposed. Presently, no convincing evidence of adverse health effects are found, but major knowledge gaps remain.

The European Medicines Agency safety committee has revisited the label and recommended the use of Janus kinase inhibitors in patients with certain risk factors only if no suitable treatment alternatives are available. Although regulatory decisions are key to place therapeutic options based on safety, broad restrictions might lead to unintended consequences without an individualized benefit–risk evaluation.

The year 2022 was notable for substantial research progress related to pancreatic ductal adenocarcinoma (PDAC). The first single-cell and spatial transcriptomic atlases of PDAC were reported, a mechanism for how Schwann cells promote perineural invasion was explored, and, finally, the role of exercise in abrogating immunosuppression was shown.