Nature Reviews Clinical Oncology最新文献

Unresectable stage III non-small-cell lung cancer: state of the art and challenges. 不可切除的III期非小细胞肺癌：现状和挑战。

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-10-09 DOI: 10.1038/s41571-025-01080-4

Jordi Remon,Antonin Levy,Romane Gille,Isabelle Martel-Lafay,Martina Bortolot,Lizza E L Hendriks,Corinne Faivre-Finn,Natasha Leighl,Martin Reck,Maurice Pérol

{"title":"Unresectable stage III non-small-cell lung cancer: state of the art and challenges.","authors":"Jordi Remon,Antonin Levy,Romane Gille,Isabelle Martel-Lafay,Martina Bortolot,Lizza E L Hendriks,Corinne Faivre-Finn,Natasha Leighl,Martin Reck,Maurice Pérol","doi":"10.1038/s41571-025-01080-4","DOIUrl":"https://doi.org/10.1038/s41571-025-01080-4","url":null,"abstract":"Despite advances in immunotherapy, unresectable stage III non-small-cell lung cancer (NSCLC) remains a highly challenging disease, with only around one-third of patients remaining disease-free at 5 years. The PACIFIC trial established consolidation with the anti-PD-L1 antibody durvalumab after concurrent chemoradiotherapy as the standard-of-care approach. Furthermore, the LAURA trial has redefined the treatment of patients with stage III unresectable EGFR-mutant NSCLC, demonstrating unprecedented progression-free survival durations with osimertinib consolidation. Despite these advances, novel approaches are urgently needed. Circulating tumour DNA-based monitoring of minimal residual disease is emerging as a personalized method of tailoring treatment duration and escalation strategies. Novel radiotherapy techniques have the potential to provide synergy with immunotherapy while minimizing toxicities. Additionally, ongoing trials evaluating chemoimmunotherapy combinations adapted from the neoadjuvant setting with the potential for conversion to resectable disease might, in the near future, redefine the boundary of surgical resectability. In this Review, we describe the rapidly evolving field of unresectable stage III NSCLC, providing a state-of-the-art overview that includes challenging topics such as biomarkers, personalization of therapy and the role of immunotherapy rechallenge.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"113 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Achieving control of nasopharyngeal carcinoma: the role of Epstein-Barr virus-based screening and vaccines. 实现鼻咽癌的控制：基于eb病毒的筛查和疫苗的作用。

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-10-08 DOI: 10.1038/s41571-025-01079-x

W K Jacky Lam,Brigette B Y Ma,Ann D King,Yasine Malki,K C Allen Chan,Anthony T C Chan

{"title":"Achieving control of nasopharyngeal carcinoma: the role of Epstein-Barr virus-based screening and vaccines.","authors":"W K Jacky Lam,Brigette B Y Ma,Ann D King,Yasine Malki,K C Allen Chan,Anthony T C Chan","doi":"10.1038/s41571-025-01079-x","DOIUrl":"https://doi.org/10.1038/s41571-025-01079-x","url":null,"abstract":"Nasopharyngeal carcinoma (NPC) is a major disease burden in endemic regions, where Epstein-Barr virus (EBV) infection has a key aetiological role in this malignancy. Both plasma EBV DNA and serum antibodies targeting EBV antigens have been validated independently in large-scale prospective trials as effective biomarkers for early detection of NPC. Plasma EBV DNA analysis by PCR could identify patients with early-stage, asymptomatic NPC. Emergent studies have shown that fragmentomics analysis of plasma EBV DNA can further enhance the specificity of NPC detection at the time of testing and better predict the future risk of NPC. Initial antibody-based NPC screening approaches were based on the detection of immunoglobulin A antibodies targeting EBV viral capsid antigen or Epstein-Barr nuclear antigen 1, which resulted in a subsequent reduction in NPC-specific mortality in a population screening trial. Subsequently, the detection of anti-BNLF2b antibodies alone has been reported to achieve higher sensitivity and specificity relative to the dual antibody approach. Cost-effectiveness analyses support the implementation of NPC screening in endemic regions using either EBV DNA or antibodies. Ongoing research initiatives are focusing on developing prophylactic and therapeutic vaccines as preventive measures against EBV-associated diseases, including NPC. In this Review, we discuss these advances as well as their relevance for the implementation of prevention strategies such as population-wide NPC screening and vaccination in endemic areas of NPC prevalence. We also highlight valuable insights from plasma EBV DNA studies that might facilitate optimization of liquid biopsy-based screening strategies for other types of cancer.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"1656 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical relevance of extracellular vesicles in cancer - therapeutic and diagnostic potential. 细胞外囊泡在癌症治疗和诊断中的临床意义。

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-10-08 DOI: 10.1038/s41571-025-01074-2

David W Greening,Rong Xu,Alin Rai,Wittaya Suwakulsiri,Maoshan Chen,Richard J Simpson

{"title":"Clinical relevance of extracellular vesicles in cancer - therapeutic and diagnostic potential.","authors":"David W Greening,Rong Xu,Alin Rai,Wittaya Suwakulsiri,Maoshan Chen,Richard J Simpson","doi":"10.1038/s41571-025-01074-2","DOIUrl":"https://doi.org/10.1038/s41571-025-01074-2","url":null,"abstract":"Extracellular vesicles (EVs) encompass a multitude of lipid bilayer-delimited particles, of which exosomes are the most widely studied. Bidirectional cell-cell communications via EVs have a pivotal role in the physiology of multicellular organisms. EVs carry biological cargoes (including proteins, RNA, DNA, lipids and metabolites) capable of mediating a range of pleiotropic cellular functions. Over the past decade, EVs released by cancer cells (onco-EVs) have been shown to promote cancer progression including tumour outgrowth and metastatic dissemination. Furthermore, the innate ability of EVs to protect vulnerable molecular cargoes (such as RNA, DNA or proteins) from enzymatic degradation, their presence in most biofluids and the ability to transverse biological barriers to reach distant organs make them ideal targeted drug delivery systems, including in patients with cancer. Many of these properties also support investigations of EVs as biomarkers with potential roles in both diagnosis and treatment monitoring. In this Review, we describe advances in the development of EVs as cancer therapeutics or biomarkers, including cancer vaccines, targeted drug delivery systems and immunotherapies, as well as potential roles in early cancer detection, diagnosis and clinical management. We also describe the potential of emerging technologies to support further discoveries as well as the clinical translation of EVs into diagnostic and therapeutic clinical tools. We highlight the potential of single-EV and onco-EV detection and discuss how advances in multi-omic and artificial intelligence-enabled integration are providing new biological insights and driving clinical translation.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"128 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The tumour microenvironment in pancreatic cancer - new clinical challenges, but more opportunities. 胰腺癌的肿瘤微环境-新的临床挑战，但更多的机会。

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-10-03 DOI: 10.1038/s41571-025-01077-z

Heng-Chung Kung,Kevin W Zheng,Jacquelyn W Zimmerman,Lei Zheng

{"title":"The tumour microenvironment in pancreatic cancer - new clinical challenges, but more opportunities.","authors":"Heng-Chung Kung,Kevin W Zheng,Jacquelyn W Zimmerman,Lei Zheng","doi":"10.1038/s41571-025-01077-z","DOIUrl":"https://doi.org/10.1038/s41571-025-01077-z","url":null,"abstract":"Patients with advanced-stage pancreatic ductal adenocarcinoma (PDAC) predominantly receive chemotherapy, and despite initial responses in some patients, most will have disease progression and often dismal outcomes. This lack of clinical effectiveness partly reflects not only cancer cell-intrinsic factors but also the presence of a tumour microenvironment (TME) that precludes access of both systemic therapies and circulating immune cells to the primary tumour, as well as supporting the growth of PDAC cells. Combined with improved preclinical models of PDAC, advances in single-cell spatial multi-omics and machine learning-based models have provided novel methods of untangling the complexities of the TME. In this Review, we focus on the desmoplastic stroma and both the intratumoural and intertumoural heterogeneity of PDAC, with an emphasis on cancer-associated fibroblasts and their surrounding immune cell niches. We describe new approaches in converting the immunologically 'cold' PDAC TME into a 'hot' TME by priming T cell activation, overcoming T cell exhaustion and unravelling myeloid cell-mediated immunosuppression. Furthermore, we explore integrated targets involving the TME, such as points of convergence among tumour, stromal and immune cell metabolism as well as oncogenic KRAS signalling. Finally, building on our experience with failed clinical trials in the past, we consider how this evolving comprehensive understanding of the TME will ensure future success in developing more effective therapies for patients with PDAC.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"94 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Author Correction: Stereotactic radiosurgery for patients with brain metastases: current principles, expanding indications and opportunities for multidisciplinary care. 作者更正：脑转移患者的立体定向放射手术：目前的原则，扩大适应症和多学科护理的机会。

IF 82.2 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-10-03 DOI: 10.1038/s41571-025-01083-1

Alireza Mansouri, Ahmad Ozair, Debarati Bhanja, Hannah Wilding, Elad Mashiach, Waqas Haque, Nicholas Mikolajewicz, Leonardo de Macedo Filho, Sean S Mahase, Mitchell Machtay, Philippe Metellus, Frédéric Dhermain, Jason Sheehan, Douglas Kondziolka, L Dade Lunsford, Ajay Niranjan, Giuseppe Minniti, Jing Li, Steven N Kalkanis, Patrick Y Wen, Rupesh Kotecha, Michael W McDermott, Chetan Bettegowda, Graeme F Woodworth, Paul D Brown, Arjun Sahgal, Manmeet S Ahluwalia

引用次数: 0

Optimizing CAR T cell therapy for solid tumours: a clinical perspective. 优化CAR - T细胞治疗实体肿瘤：临床观点。

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-10-02 DOI: 10.1038/s41571-025-01075-1

Jiarui Li,Chang Liu,Panpan Zhang,Lin Shen,Changsong Qi

{"title":"Optimizing CAR T cell therapy for solid tumours: a clinical perspective.","authors":"Jiarui Li,Chang Liu,Panpan Zhang,Lin Shen,Changsong Qi","doi":"10.1038/s41571-025-01075-1","DOIUrl":"https://doi.org/10.1038/s41571-025-01075-1","url":null,"abstract":"Chimeric antigen receptor (CAR) T cell therapy is revolutionizing the management of haematological malignancies but faces particular hurdles in the treatment of solid tumours. In this Review, we discuss important advances in refining CAR T cell therapy to provide practical clinical insights to address these challenges. We describe key strategies, including target antigen selection to enhance efficacy while minimizing on-target, off-tumour toxicities; early apheresis, rapid manufacturing and frontline application to preserve T cell fitness and ensure timely treatment; lymphodepletion to augment CAR T cell expansion; locoregional delivery to maximize local therapeutic concentrations and reduce systemic toxicity; and repeat infusions to prolong therapeutic effects. Furthermore, we discuss advanced response evaluation frameworks that will be essential for accurate assessment of the efficacy of CAR T cell therapies, and we highlight the need for robust toxicity management approaches to mitigate severe adverse events. By systematically addressing these multifaceted challenges, this Review provides a comprehensive guide for the optimization of CAR T cell therapy for solid tumours to enhance both efficacy and safety.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"10 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

ALASCCA: an aspirin a day keeps colorectal cancer away. ALASCCA：一天一片阿斯匹林可以预防结直肠癌。

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-09-26 DOI: 10.1038/s41571-025-01082-2

David Killock

引用次数: 0

MARIPOSA demonstrates overall survival benefit from amivantamab-lazertinib. MARIPOSA证明amivantamab-lazertinib的总体生存获益。

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-09-23 DOI: 10.1038/s41571-025-01081-3

Diana Romero

引用次数: 0

Neoantigen vaccines at the crossroads: lessons from AMPLIFY-201. 十字路口的新抗原疫苗：来自AMPLIFY-201的经验教训

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-09-22 DOI: 10.1038/s41571-025-01076-0

Hejia Henry Wang,Mark Yarchoan

引用次数: 0

Maintenance tarlatamab extends overall survival. 维持性tarlatamab延长了总生存期。

IF 82.2 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-09-22 DOI: 10.1038/s41571-025-01078-y

Peter Sidaway

引用次数: 0