Nature Reviews Clinical Oncology

Vokinger, Kerstin N.; Kesselheim, Aaron S.

doi: 10.1038/s41571-021-00561-6pmid: 34556845

Legislators in the USA have been discussing reforms to reduce the high cost of brand-name drugs, which are much higher in the USA than in other industrialized countries. One solution is to actively negotiate prices based on drugs’ clinical benefits. We discuss two important complexities from such an approach: drugs that have been approved for multiple indications and as part of a combination regimen.

Mohyuddin, Ghulam Rehman; Mian, Hira

doi: 10.1038/s41571-021-00581-2pmid: 34773086

Daratumumab is an anti-CD38 monoclonal antibody that has transformed the landscape of treatment both for transplant-eligible and -ineligible patients with newly diagnosed multiple myeloma. Addressing important ongoing questions, such as when to de-escalate therapy, will be an important step forward in delivering patient-centred care for those with newly diagnosed multiple myeloma.

Sidaway, Peter

doi: 10.1038/s41571-021-00577-ypmid: 34711952

Killock, David

doi: 10.1038/s41571-021-00578-xpmid: 34716415

Sidaway, Peter

doi: 10.1038/s41571-021-00582-1pmid: 34759356

Romero, Diana

doi: 10.1038/s41571-021-00586-xpmid: 34845385

Killock, David

doi: 10.1038/s41571-021-00583-0pmid: 34785812

Remon, Jordi; Besse, Benjamin

doi: 10.1038/s41571-021-00574-1pmid: 34707252

Efforts are being made to incorporate immune-checkpoint inhibitors into therapy for early stage non-small-cell lung cancer. The IMpower010 trial of adjuvant atezolizumab has recently become the first study to demonstrate that this strategy can improve disease-free survival in a subset of patients. This trial opens a new area of research in the quest for the optimal perioperative strategy to increase overall survival.

Mieog, J. Sven D.; Achterberg, Friso B.; Zlitni, Aimen; Hutteman, Merlijn; Burggraaf, Jacobus; Swijnenburg, Rutger-Jan; Gioux, Sylvain; Vahrmeijer, Alexander L.

doi: 10.1038/s41571-021-00548-3pmid: 34493858

Fluorescence-guided surgery using tumour-targeted imaging agents has emerged over the past decade as a promising and effective method of intraoperative cancer detection. An impressive number of fluorescently labelled antibodies, peptides, particles and other molecules related to cancer hallmarks have been developed for the illumination of target lesions. New approaches are being implemented to translate these imaging agents into the clinic, although only a few have made it past early-phase clinical trials. For this translational process to succeed, target selection, imaging agents and their related detection systems and clinical implementation have to operate in perfect harmony to enable real-time intraoperative visualization that can benefit patients. Herein, we review key aspects of this imaging cascade and focus on imaging approaches and methods that have helped to shed new light onto the field of intraoperative fluorescence-guided cancer surgery with the singular goal of improving patient outcomes.

Dhanasekaran, Renumathy; Deutzmann, Anja; Mahauad-Fernandez, Wadie D.; Hansen, Aida S.; Gouw, Arvin M.; Felsher, Dean W.

doi: 10.1038/s41571-021-00549-2pmid: 34508258

The MYC proto-oncogenes encode a family of transcription factors that are among the most commonly activated oncoproteins in human neoplasias. Indeed, MYC aberrations or upregulation of MYC-related pathways by alternate mechanisms occur in the vast majority of cancers. MYC proteins are master regulators of cellular programmes. Thus, cancers with MYC activation elicit many of the hallmarks of cancer required for autonomous neoplastic growth. In preclinical models, MYC inactivation can result in sustained tumour regression, a phenomenon that has been attributed to oncogene addiction. Many therapeutic agents that directly target MYC are under development; however, to date, their clinical efficacy remains to be demonstrated. In the past few years, studies have demonstrated that MYC signalling can enable tumour cells to dysregulate their microenvironment and evade the host immune response. Herein, we discuss how MYC pathways not only dictate cancer cell pathophysiology but also suppress the host immune response against that cancer. We also propose that therapies targeting the MYC pathway will be key to reversing cancerous growth and restoring antitumour immune responses in patients with MYC-driven cancers.