Jeanne Tie, MD, MBChB, of the Peter MacCallum Cancer Centre, discusses how to improve the current, somewhat imprecise, approach based on pathologic staging alone, used to select patients for adjuvant treatment. Circulating tumor DNA analysis after curative-intent treatment may detect minimal residual disease and might be used to predict recurrence and adjuvant treatment efficacy across multiple tumor types.
Dennis J. Slamon, MD, PhD, of the UCLA David Geffen School of Medicine, reflects on the ways in which breast cancer research pioneered the targeted treatment approach, as understanding of the basic biology of tumors deepened and new pathways were uncovered. He sees a future ripe with possibilities for new molecular targets to further improve outcomes for patients with breast cancer and other types of tumors.
Karen H. Vousden, PhD, of The Francis Crick Institute, and Matthew G. Vander Heiden, MD, PhD, of the Koch Institute for Integrative Cancer Research at MIT, discuss emerging evidence that diet may affect which nutrients are available to tumor cells, which can influence both tumor growth and response to therapy. Clinicians may be able to personalize dietary interventions to optimize patient care.
Samra Turajlic, MBBS, PhD, of The Francis Crick Institute, discusses our limited understanding of metastases in terms of the timing of dissemination, the many metastatic phenotypes and varieties of seeding, as well as how the spread of cancer evades the immune system and resists treatment. Expanding this knowledge base is critical to better managing malignant disease.
Charlotte E. Ariyan, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses improved outcomes with metastasectomy in the setting of checkpoint inhibitors, with the removal of residual disease and “escape” lesions. Surgical outcomes may also be better than targeted treatments, although long-term data and biomarkers are needed to confirm these findings.