Articles in 2016

The treatment landscape for lymphoma has become crowded, requiring efficient prioritization for expedited drug development. New challenges include the optimal duration of therapy, as well as the need to balance cost, benefit, and late-onset toxicity. Herein, the authors overview of the most-promising agents in clinical development for the treatment of lymphoma, and provide expert opinion on new strategies to streamline drug development as well as approaches for patient selection and for incorporating new end points into clinical trials.

In 2016, a revised WHO classification of glioma was published, in which molecular data and traditional histological information are incorporated into integrated diagnoses. Herein, the authors highlight the developments in our understanding of the molecular genetics of gliomas that underlie this classification, and review the current landscape of molecular biomarkers used in the classification of disease subtypes. In addition, they discuss how these advances can promote the development of novel pathogenesis-based therapeutic approaches, paving the way to precision medicine.

Assessment of tumour burden has become an integral part of most oncology clinical trials, and enables the evaluation of the activity and efficacy of new cancer therapeutics in solid tumours. Although RECIST was developed to assess treatment activity in early phase II trials with tumour response as the primary end point, it is now applied across the spectrum from early phase I trials through to confirmatory phase III trials. Several questions regarding the role of RECIST in the rapidly changing landscape of oncology therapeutics, and the challenges faced in its evaluation, are highlighted.

After curative treatment, 30% of patients with stage I–III and up to 65% of patients with stage IV colorectal cancer (CRC) develop recurrent disease. Thus, surveillance for disease recurrence is clearly needed in these patients, but controversy surrounds the optimal follow-up approaches. Herein, the current evidence relating to surveillance strategies for patients with CRC is comprehensively reviewed, and the future development of patient-centred programmes is discussed.

In 2016, the pace of biological insights into small-cell lung cancer (SCLC) was reflected in new treatment approaches that have suggested meaningful clinical benefit to patients. We focus on three highlights of 2016: preclinical studies defining NFIB as a putative driver of metastasis, and two clinical studies; one that assessed the efficacy of an agent targeting the Notch ligand DLL3, and the other that explored T-cell checkpoint-blockade therapies targeting PD-1 and CTLA-4.

In 2016, novel findings on the role of predisposing gene variants in sarcoma oncogenesis were published, as well as studies addressing novel molecular classifications and results from randomized controlled trials highlighting successful new treatments. Herein, we discuss these meaningful advances.

The PARP inhibitor olaparib has been approved for clinical use in patients with ovarian cancer withBRCA 1/2 mutations; however, this agent, which can confer substantial improvements in patient survival might also be effective in those without a BRCA mutation. Here, the authors describe the potential for expanding the use of BRCA-mutation testing and PARP inhibition beyond those who are likely to have a BRCAmutation.

In 2016, results of an extensive trial broadened the range of malignancies that can be treated with everolimus to include neuroendocrine tumours (NETs) of the lung and gastrointestinal tract. Furthermore, studies aimed at identifying biomarkers with increased specificity, and at better defining high-grade NETs have enabled substantial progress towards delivering effective targeted treatments to patients with NETs.