Research Highlight |
Featured
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Research Highlight |
Early MRD predicts disease recurrence and benefit from adjuvant chemotherapy in CRC
- David Killock
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Research Highlight |
Targeted biopsy reduces detection of clinically insignificant cancer
- Diana Romero
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Review Article |
Criteria for the translation of radiomics into clinically useful tests
Despite a considerable increase in research output over the past decades, the translation of radiomic research into clinically useful tests has been limited. In this Review, the authors provide 16 key criteria to guide the clinical translation of radiomics with the hope of accelerating the use of this technology to improve patient outcomes.
- Erich P. Huang
- , James P. B. O’Connor
- & Lalitha K. Shankar
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Viewpoint |
Barriers in access to oncology drugs — a global crisis
In the past decade, oncologists worldwide have seen unprecedented advances in drug development and approvals but have also become increasingly cognizant of the rising costs of and increasing inequities in access to these therapies. These trends have resulted in the current problematic situation in which dramatic disparities in outcomes exist among patients with cancer worldwide owing, in part, to the lack of access to drugs that provide clinically meaningful benefits. In this Viewpoint, we have asked six oncologists working in different countries to describe how they perceive this issue in their region and propose potential solutions.
- Carlos Barrios
- , Gilberto de Lima Lopes
- & Manju Sengar
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News & Views |
BFAST but be smart: bTMB remains an exploratory biomarker in NSCLC
A high tumour mutational burden (≥10 mutations per megabase) is a companion biomarker in the histology-agnostic approval of pembrolizumab for treatment-refractory advanced-stage solid tumours, and continues to be an exploratory predictive biomarker for immune-checkpoint inhibitors in non-small-cell lung cancer. Herein, we discuss recent results from the first phase III trial evaluating blood-based tumour mutational burden in patients with treatment-naive advanced-stage non-small-cell lung cancer.
- So Yeon Kim
- & Roy S. Herbst
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Research Highlight |
Activity of selpercatinib in RET fusion-positive cancers confirmed
- Diana Romero
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News & Views |
Improving outcomes demands patient-centred interventions and equitable delivery
A recent study not only confirms mounting evidence that technology-facilitated symptom monitoring improves care and should be considered for all patients with cancer, but also suggests that patient navigators can help to deliver such interventions. Herein we discuss how such an approach can minimize disparities and maximize access to culturally appropriate patient-centred care.
- Gabrielle B. Rocque
- & Abby R. Rosenberg
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Review Article |
Advancing therapy for neuroblastoma
Neuroblastomas are tumours of sympathetic origins typically seen in infants (≤5 years of age). In this Review, the authors describe progress in the treatment of patients with neuroblastoma, which has resulted in considerable improvements in survival outcomes over the past several decades. The authors then summarize ongoing attempts to personalize therapy in patients with high-risk disease, and to safely de-escalate therapy in those with low-risk disease.
- Bo Qiu
- & Katherine K. Matthay
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Comment |
Ensuring completeness and timeliness of cancer treatment guidelines
Timely and comprehensive updating of treatment guidelines remains a challenge and necessity in medical oncology. Herein we discuss our assessment of how trial results with four off-patent drugs have been considered for integration into major guidelines in the absence of a commercial sponsor, in which we found reasons for concern.
- Gauthier Bouche
- & Lydie Meheus
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Research Highlight |
Response to neoadjuvant endocrine therapy complements recurrence score
- Diana Romero
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Perspective |
An appraisal of FDA approvals for adult solid tumours in 2017–2021: has the eagle landed?
In this Perspective, Nathan Cherny appraises the FDA approvals of therapeutic agents granted for use in adult patients with solid tumours during the 5 years 2017–2021 against the aspirations of the Cancer Moonshot, in terms of sheer number of approvals, the strength of the supporting evidence and the magnitude of clinical benefit. He also outlines areas where improvements are needed to more confidently ensure that the clinical benefits of approved treatments justify the associated risks.
- Nathan I. Cherny
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Viewpoint |
Optimal systemic therapy for high-risk resectable melanoma
Immune-checkpoint inhibitors and BRAF-targeted therapy have revolutionized the treatment of advanced-stage, unresectable melanoma and have been successfully transitioned into the resectable disease setting as (neo)adjuvant treatments. The expanding range of treatment options available for resectable high-risk melanoma raises questions over selection of the optimal therapeutic strategy and agents for each individual. Furthermore, the use of perioperative therapy has potentially important implications for the management of patients who have disease recurrence. In this Viewpoint, we asked four expert investigators who have been involved in the key studies of perioperative systemic therapies for their perspectives on the optimal management of patients with high-risk melanoma.
- Alexander M. M. Eggermont
- , Omid Hamid
- & Jason J. Luke
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News & Views |
Improving breast cancer risk prediction with epigenetic risk factors
Over the past decade, iterative improvements to models predicting breast cancer risk have primarily come from new information about genetic risk factors and improvements to mammogram-based risk scores. Epigenetic risk factors offer some potential to further improve risk stratification. However, the recently developed DNA methylation score (the WID-BC index) is not yet convincing for predicting breast cancer risk.
- Melissa C. Southey
- & Pierre-Antoine Dugué
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Review Article |
COVID-19 vaccines in patients with cancer: immunogenicity, efficacy and safety
Vaccination against COVID-19 confers robust protection from severe disease. However, the extent to which this applies to patients with cancer remains uncertain given that these patients were excluded from most of the pivotal studies. In this Review, the authors provide an overview of the efficacy and immunogenicity of COVID-19 vaccines in patients with cancer, and discuss alternatives to vaccination for those who might be unable to develop a proficient immune response following vaccination.
- Annika Fendler
- , Elisabeth G. E. de Vries
- & Marie von Lilienfeld-Toal
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Correspondence |
Quality versus quantity in surgical oncology — what is the future?
- Philip Baum
- , Jacopo Lenzi
- & Armin Wiegering
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News & Views |
The role of neoadjuvant therapy for resectable pancreatic cancer remains uncertain
Patients with pancreatic ductal adenocarcinoma (PDAC) usually have a dismal prognosis, and even after curative resection most patients will have disease relapse and ultimately die. Nonetheless, adjuvant chemotherapy has considerably improved the outcomes of patients who are able to undergo surgery. The PREOPANC trial provides some evidence supporting the use of neoadjuvant therapy for patients with borderline resectable PDACs but not, as claimed, for those with resectable tumours.
- Christoph Springfeld
- & John P. Neoptolemos
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News & Views |
Risk-adjusting away volume as a quality metric for surgical oncology: a perspective worth re-visiting
Surgical quality remains a priority for patients with cancer, payers and policymakers. Whether the risk-standardized mortality rate (RSMR) is a better metric than surgical volume to inform the regionalization of cancer surgery remains controversial. In particular, RSMR has been criticized on both theoretical and methodological grounds. Novel alternative means that incorporate surgical volume, as well as evidence-based process measures, are needed.
- Karl Y. Bilimoria
- & Timothy M. Pawlik
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Review Article |
Mechanisms regulating PD-L1 expression in cancers and associated opportunities for novel small-molecule therapeutics
Antibodies targeting PD-1 or its ligand PD-L1 have revolutionized cancer therapy. Increased understanding of the mechanisms regulating PD-L1 has revealed links with several important oncogenic signalling pathways. Herein, the authors review the transcriptional, post-transcriptional and translational regulation of PD-L1 expression in cancers as well as the diverse post-translational modifications, including phosphorylation, palmitoylation, glycosylation, acetylation and ubiquitination, that affect PD-L1 stability and activity. They also discuss the possibility to simultaneously target key oncogenic pathways and modulate PD-L1 expression using small-molecule agents, which have potential advantages over or might synergize with anti-PD-1/PD-L1 antibodies.
- Hirohito Yamaguchi
- , Jung-Mao Hsu
- & Mien-Chie Hung
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Research Highlight |
Survival benefit with second-line combination in endometrial cancer
- Diana Romero
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Review Article |
Immune-checkpoint inhibitors: long-term implications of toxicity
Immune-checkpoint inhibitors (ICIs) have dramatically improved the outcomes of patients with advanced-stage solid tumours, including the potential for long-term remission in a subset. However, long-term follow-up data reveal a risk of chronic toxicities from these agents, which can have important quality-of-life implications. In this Review, the authors describe the current level of evidence of chronic toxicities of ICIs and their implications for patients
- Douglas B. Johnson
- , Caroline A. Nebhan
- & Justin M. Balko
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Comment |
Fertility support for patients with gynaecological cancers — a vital but neglected issue
Gynaecological cancer diagnosis and treatment can affect reproductive function. Fertility preservation is a complex issue for women with these cancers but one that needs to be addressed during cancer management as it can restore not only fertility but also a threatened or lost sense of femininity. In this Comment, we discuss the importance of fertility counselling to provide optimal cancer care.
- Vânia Gonçalves
- & Gwendolyn P. Quinn
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