Nature Reviews Clinical Oncology最新文献

{"title":"Empowering oncologists: a practical approach to overcoming barriers to clinical trial enrolment","authors":"Changchuan Jiang, Ryan D. Nipp, Tian Zhang","doi":"10.1038/s41571-025-01038-6","DOIUrl":"10.1038/s41571-025-01038-6","url":null,"abstract":"Oncologists have crucial yet under-studied and often under-supported roles in promoting clinical trial referral and enrolment. Herein, we advocate for a systemic shift that acknowledges the operational barriers oncologists face and enhances structural support through streamlined workflows and behavioural science-informed strategies to facilitate their participation in clinical trial enrolment.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"22 8","pages":"541-542"},"PeriodicalIF":82.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201378","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":"Daratumumab and missed sequencing opportunities in transplant-ineligible multiple myeloma: lessons for future trials","authors":"Ghulam Rehman Mohyuddin, Aaron M. Goodman","doi":"10.1038/s41571-025-01034-w","DOIUrl":"10.1038/s41571-025-01034-w","url":null,"abstract":"In pivotal trials testing daratumumab in patients with transplant-ineligible newly diagnosed multiple myeloma, inadequate crossover provisions have not only compromised the interpretation of survival data but also left fundamental questions about optimal treatment sequencing unanswered. Herein, we address the ethical implications of trial designs that fail to guarantee access to effective post-progression therapy for patients in the control arm, particularly in studies across regions in which standard-of-care treatment varies dramatically.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"22 8","pages":"539-540"},"PeriodicalIF":82.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164845","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":"Prospective comparisons support the use of navigational bronchoscopy","authors":"Peter Sidaway","doi":"10.1038/s41571-025-01039-5","DOIUrl":"10.1038/s41571-025-01039-5","url":null,"abstract":"","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"22 7","pages":"460-460"},"PeriodicalIF":82.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164844","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":"Benefit from huCAR19-IL18 cells in patients with CD19+ lymphomas after CAR T cells","authors":"Diana Romero","doi":"10.1038/s41571-025-01036-8","DOIUrl":"10.1038/s41571-025-01036-8","url":null,"abstract":"","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"22 7","pages":"460-460"},"PeriodicalIF":82.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122536","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":"Tumour and microenvironment crosstalk in NSCLC progression and response to therapy","authors":"Zahraa Rahal, Roy El Darzi, Seyed Javad Moghaddam, Tina Cascone, Humam Kadara","doi":"10.1038/s41571-025-01021-1","DOIUrl":"10.1038/s41571-025-01021-1","url":null,"abstract":"The treatment landscape of non-small-cell lung cancer (NSCLC) is evolving rapidly, driven by advances in the development of targeted agents and immunotherapies. Despite this progress, some patients have suboptimal responses to treatment, highlighting the need for new therapeutic strategies. In the past decade, the important role of the tumour microenvironment (TME) in NSCLC progression, metastatic dissemination and response to treatment has become increasingly evident. Understanding the complexity of the TME and its interactions with NSCLC can propel efforts to improve current treatment modalities, overcome resistance and develop new treatments, which will ultimately improve the outcomes of patients. In this Review, we provide a comprehensive view of the NSCLC TME, examining its components and highlighting distinct archetypes characterized by spatial niches within and surrounding tumour nests, which form complex neighbourhoods. Next, we explore the interactions within these components, focusing on how inflammation and immunosuppression shape the dynamics of the NSCLC TME. We also address the emerging influences of patient-related factors, such as ageing, sex and health disparities, on the NSCLC–TME crosstalk. Finally, we discuss how various therapeutic strategies interact with and are influenced by the TME in NSCLC. Overall, we emphasize the interconnectedness of these elements and how they influence therapeutic outcomes and tumour progression. Despite advances in drug development, some patients with non-small-cell lung cancer (NSCLC) have suboptimal responses to treatment. The authors of this Review provide an overview of the complexity of the tumour microenvironment in NSCLC, including the influence of patient-related factors, such as ageing, sex and health disparities, on the cancer–TME crosstalk, and discuss how various therapeutic strategies interact with and are influenced by the TME in NSCLC.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"22 7","pages":"463-482"},"PeriodicalIF":82.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144066883","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":"Roles of the gut microbiota in immune-related adverse events: mechanisms and therapeutic intervention","authors":"Ya-Qi Gao, Yong-Jie Tan, Jing-Yuan Fang","doi":"10.1038/s41571-025-01026-w","DOIUrl":"10.1038/s41571-025-01026-w","url":null,"abstract":"Immune checkpoint inhibitors (ICIs) constitute a major breakthrough in the field of cancer therapy; their use has resulted in improved outcomes across various tumour types. However, ICIs can cause a diverse range of immune-related adverse events (irAEs) that present a considerable challenge to the efficacy and safety of these treatments. The gut microbiota has been demonstrated to have a crucial role in modulating the tumour immune microenvironment and thus influences the effectiveness of ICIs. Accumulating evidence indicates that alterations in the composition and function of the gut microbiota are also associated with an increased risk of irAEs, particularly ICI-induced colitis. Indeed, these changes in the gut microbiota can contribute to the pathogenesis of irAEs. In this Review, we first summarize the current clinical challenges posed by irAEs. We then focus on reported correlations between alterations in the gut microbiota and irAEs, especially ICI-induced colitis, and postulate mechanisms by which these microbial changes influence the occurrence of irAEs. Finally, we highlight the potential value of gut microbial changes as biomarkers for predicting irAEs and discuss gut microbial interventions that might serve as new strategies for the management of irAEs, including faecal microbiota transplantation, probiotic, prebiotic and/or postbiotic supplements, and dietary modulations. The composition of the gut microbiota has been implicated as a key determinant of not only the clinical efficacy but also the immune-related adverse effects (irAEs) of immune checkpoint inhibitors. This Review describes the reported correlations between alterations in the gut microbiota and irAEs, as well as their potential underlying mechanisms and possible predictive utility. Gut microbial interventions that might serve as new strategies for the management of irAEs are also discussed.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"22 7","pages":"499-516"},"PeriodicalIF":82.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945670","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":"Targeting the glioblastoma resection margin with locoregional nanotechnologies","authors":"Thomas Kisby, Gerben R. Borst, David J. Coope, Kostas Kostarelos","doi":"10.1038/s41571-025-01020-2","DOIUrl":"10.1038/s41571-025-01020-2","url":null,"abstract":"Surgical resection is the first stage of treatment for patients diagnosed with resectable glioblastoma and is followed by a combination of adjuvant radiotherapy and systemic single-agent chemotherapy, which is typically commenced 4–6 weeks after surgery. This delay creates an interval during which residual tumour cells residing in the resection margin can undergo uninhibited proliferation and further invasion, even immediately after surgery, thus limiting the effectiveness of adjuvant therapies. Recognition of the postsurgical resection margin and peri-marginal zones as important anatomical clinical targets and the need to rethink current strategies can galvanize opportunities for local, intraoperative approaches, while also generating a new landscape of innovative treatment modalities. In this Perspective, we discuss opportunities and challenges for developing locoregional therapeutic strategies to target the glioblastoma resection margin as well as emerging opportunities offered by nanotechnology in this clinically transformative setting. We also discuss how persistent barriers to clinical translation can be overcome to offer a potential path forward towards broader acceptability of such advanced technologies. Patients with resectable glioblastoma undergo upfront surgery followed by adjuvant radiotherapy plus chemotherapy. This approach implies a period of approximately 4–6 weeks between surgery and the start of adjuvant therapy in which the patient receives no active treatment. In this Perspective, the authors describe the potential of local therapies targeting the tumour resection margin that can be administered during this time window, including biological feasibility, the potential role of nanomedicines and various technical and regulatory challenges that will need to be addressed before clinical implementation becomes feasible.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"22 7","pages":"517-537"},"PeriodicalIF":82.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945669","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":"Emerging advances and future opportunities in the molecular and therapeutic landscape of anal cancer","authors":"Franz Rödel, Maximilian Fleischmann, Markus Diefenhardt, Hendrik Dapper, Annett Hoffmann, Claus Rödel, Daniel Martin, Emmanouil Fokas","doi":"10.1038/s41571-025-01025-x","DOIUrl":"10.1038/s41571-025-01025-x","url":null,"abstract":"Anal squamous cell carcinoma (ASCC) is a rare malignancy with an increasing incidence. Primary chemoradiotherapy (CRT) is the standard-of-care treatment for patients with localized ASCC. In the metastatic setting, trials testing immune-checkpoint inhibitor monotherapy have demonstrated outcomes similar to those of patients receiving chemotherapy. Conversely, adding the anti-PD-1 antibody retifanlimab to chemotherapy in patients with recurrent or metastatic ASCC has been shown to significantly improve outcomes. Despite considerable efforts to develop personalized therapy, treatment guidance and prognosis remain reliant on baseline clinical characteristics. An improved understanding of the molecular characteristics of ASCC has provided insights into the mechanisms that mediate tumour progression and response to CRT. For example, human papillomavirus (HPV) infection is known to have an aetiological role in most ASCCs and can modulate cellular responses to CRT via several distinct mechanisms. In this Review, we summarize emerging advances in the molecular and therapeutic landscape of ASCC, including the implementation of biomarkers for treatment guidance and translation into new therapeutic approaches, with HPV infection constituting a global determinant of both tumour biology and clinical outcome. We also discuss the rationale for combining immune-checkpoint inhibitors with CRT in patients with HPV+ tumours. Anal squamous cell carcinoma (ASCC) is a rare malignancy, albeit with an increasing prevalence in most economically developed countries. Despite considerable advances in our understanding of the biology of ASCC, chemoradiotherapy (CRT) remains the standard-of-care therapy for most patients, albeit with promising data emerging on the role of CRT plus immune-checkpoint inhibitors in the metastatic setting. In this Review, the authors describe the biology of ASCC and relate this to the various attempts to improve outcomes via the development of more effective systemic therapies and/or combinations.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"22 7","pages":"483-498"},"PeriodicalIF":82.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939966","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":"Promising results with zongertinib in advanced-stage HER2-mutant NSCLC","authors":"Diana Romero","doi":"10.1038/s41571-025-01030-0","DOIUrl":"10.1038/s41571-025-01030-0","url":null,"abstract":"","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"22 7","pages":"459-459"},"PeriodicalIF":82.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939945","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":"Next-generation KRAS-G12C inhibitor D3S-001 shows promise","authors":"David Killock","doi":"10.1038/s41571-025-01028-8","DOIUrl":"10.1038/s41571-025-01028-8","url":null,"abstract":"","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"22 7","pages":"459-459"},"PeriodicalIF":82.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927168","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}