{"title":"Zanidatamab shows promise as first-line therapy for advanced-stage HER2+ GEA","authors":"David Killock","doi":"10.1038/s41571-025-01048-4","DOIUrl":"https://doi.org/10.1038/s41571-025-01048-4","url":null,"abstract":"<p>Trastuzumab plus platinum–fluoropyrimidine chemotherapy has been the backbone of frontline therapy for advanced-stage HER2-positive gastroesophageal adenocarcinoma (HER2<sup>+</sup> GEA) since 2010 on the basis of results from the landmark phase III ToGA trial. Now, data from a phase II trial indicate that zanidatamab, a biparatopic antibody targeting two distinct epitopes of HER2, might improve outcomes in this setting.</p><p>In this single-arm trial, patients with previously untreated advanced-stage HER2<sup>+</sup> GEA received zanidatamab in combination with either 5-fluorouracil, folinic acid and oxaliplatin (<i>n</i> = 24), capecitabine and oxaliplatin (<i>n</i> = 20), or 5-fluorouracil and cisplatin (<i>n</i> = 2). The primary end point was confirmed objective response rate (ORR).</p>","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"19 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311789","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}
{"title":"The next generation of immunotherapies for lung cancers","authors":"Shen Zhao, Hongyun Zhao, Weiwei Yang, Li Zhang","doi":"10.1038/s41571-025-01035-9","DOIUrl":"https://doi.org/10.1038/s41571-025-01035-9","url":null,"abstract":"<p>Immunotherapies, specifically immune-checkpoint inhibitors (ICIs) targeting PD-(L)1 or CTLA4, have revolutionized the treatment of lung cancer; however, many patients do not have a response to ICIs and most of those with an initial tumour response eventually have disease progression owing to acquired resistance. Over the past few years, numerous therapeutic strategies have been explored to address the problems of intrinsic and acquired resistance to ICIs. In 2024, regulatory approvals of the bispecific PD-1 × VEGF antibody ivonescimab for the treatment of non-small-cell lung cancer in China and the bispecific DLL3 × CD3 T cell engager tarlatamab for patients with small cell lung cancer in the USA provided clinical proof-of-concept for overcoming the challenge of ICI resistance using novel immunotherapeutic agents, thereby increasing enthusiasm for the exploration of next-generation immunotherapies for lung cancer. A large variety of immunotherapies with diverse targets and mechanisms of action are currently being tested in clinical trials involving patients with lung cancer. In this Review, we provide an overview of these emerging immunotherapies in clinical development for non-small-cell lung cancer and/or small cell lung cancer, including novel immune-checkpoint modulators, immune cell engagers, adoptive cell therapies and therapeutic cancer vaccines. We describe the designs of these agents and the mechanisms by which they might overcome resistance to the current generation of ICIs. We also discuss hurdles impeding the clinical translation of each immunotherapeutic modality and potential strategies to address these challenges, using representative examples of agents that have entered the later phases of clinical testing.</p>","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"25 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144305168","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}
Jonathan C. M. Wan, Peter Sasieni, Nitzan Rosenfeld
{"title":"Promises and pitfalls of multi-cancer early detection using liquid biopsy tests","authors":"Jonathan C. M. Wan, Peter Sasieni, Nitzan Rosenfeld","doi":"10.1038/s41571-025-01033-x","DOIUrl":"https://doi.org/10.1038/s41571-025-01033-x","url":null,"abstract":"<p>Cancer screening is an essential public health intervention for diagnosing cancers at an early stage that can enable earlier treatment — ideally with curative intent — and thus lead to improved outcomes. Over the past decade, liquid biopsy-based tests have emerged as a promising, minimally invasive and broadly applicable screening approach by combining multi-cancer early detection (MCED) with tumour tissue-of-origin identification. Large-scale randomized clinical trials evaluating liquid biopsy-based MCED approaches are now under way, although whether the diagnostic performance of this first generation of MCED tests is sufficient to translate into clinical benefits remains to be determined. In this Review, we discuss the promises and pitfalls of current MCED tests and highlight possible trajectories for the field of early cancer detection.</p>","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"174 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288632","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}
{"title":"Adding lurbinectedin to maintenance therapy improves outcomes in ES-SCLC","authors":"Diana Romero","doi":"10.1038/s41571-025-01043-9","DOIUrl":"https://doi.org/10.1038/s41571-025-01043-9","url":null,"abstract":"<p>Patients with extensive-stage small cell lung cancer (ES-SCLC) typically receive first-line combinations of immune-checkpoint inhibitors (ICIs) and platinum-based chemotherapy followed by maintenance ICIs to limit the risk of disease progression. Now, results from the phase III IMforte trial demonstrate that the addition of lurbinectedin to maintenance therapy improves patient outcomes.</p><p>A total of 660 patients with an ongoing response or stable disease after first-line therapy were randomly allocated (1:1) to receive maintenance therapy with atezolizumab with or without lurbinectedin. Progression-free survival (PFS) and overall survival (OS) were the co-primary end points.</p>","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"151 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278423","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}
{"title":"T-DXd effective as second-line therapy in G/GEJ cancers","authors":"Peter Sidaway","doi":"10.1038/s41571-025-01044-8","DOIUrl":"https://doi.org/10.1038/s41571-025-01044-8","url":null,"abstract":"<p>Patients with HER2-positive (HER2<sup>+</sup>) metastatic gastric or gastroesophageal junction (G/GEJ) adenocarcinoma with disease progression on first-line therapy have various treatment options available, although the most-effective agent remains uncertain. Now, data from the phase III DESTINY-Gastric04 trial confirm the superiority of trastuzumab deruxtecan (T-DXd) over ramucirumab plus paclitaxel in this setting.</p><p>A total of 494 patients with disease progression on chemotherapy plus trastuzumab with or without an anti-PD-(L)1 antibody were randomized (1:1) to second-line therapy with T-DXd versus ramucirumab plus paclitaxel. Overall survival (OS) was the primary end point.</p>","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"41 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268980","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}
{"title":"A new first-line standard-of-care for BRAFV600E-mutated mCRC","authors":"Diana Romero","doi":"10.1038/s41571-025-01042-w","DOIUrl":"https://doi.org/10.1038/s41571-025-01042-w","url":null,"abstract":"<p>The combination of the BRAF inhibitor encorafenib and the anti-EGFR antibody cetuximab is the standard-of-care (SOC) second-line treatment for patients with <i>BRAF</i><sup>V600E</sup>-mutated metastatic colorectal cancers (mCRC; 8–12% of patients). Now, results from the phase III BREAKWATER trial demonstrate the efficacy of encorafenib–cetuximab plus mFOLFOX6 chemotherapy as a first-line treatment for these patients.</p><p>Patients with previously untreated <i>BRAF</i><sup>V600E</sup>-mutated mCRC were randomly assigned to receive encorafenib–cetuximab, encorafenib–cetuximab plus mFOLFOX6 (triplet combination) or physician’s choice of SOC chemotherapy. After a protocol amendment, enrolment in the encorafenib–cetuximab group was stopped and patients were randomly assigned to receive triplet combination (<i>n</i> = 236) versus SOC chemotherapy (<i>n</i> = 243). Progression-free survival (PFS) and objective response rate (ORR) were the co-primary end points.</p>","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"41 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268501","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}
{"title":"Neoadjuvant nivolumab plus chemotherapy improves overall survival in resectable NSCLC","authors":"Peter Sidaway","doi":"10.1038/s41571-025-01045-7","DOIUrl":"https://doi.org/10.1038/s41571-025-01045-7","url":null,"abstract":"<p>Earlier data from the phase III CheckMate 816 trial led to the approval of nivolumab plus platinum-doublet chemotherapy as neoadjuvant therapy for patients with resectable non-small-cell lung cancer (NSCLC). Now, 5-year follow-up data from this trial confirm that this approach improves overall survival (OS).</p><p>A total of 358 patients with stage IB–IIIA NSCLC were randomly assigned (2:1) to receive three cycles of neoadjuvant nivolumab plus chemotherapy or chemotherapy alone, followed by surgery with optional adjuvant chemotherapy and/or radiotherapy permitted in both groups. The co-primary end points (pathological complete response (pCR) rate and event-free survival (EFS)) were met at a previous cutoff; overall survival (OS) was a key secondary end point.</p>","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"61 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268502","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}