We have a solid understanding that genetic mutation may predispose to different cancers. BRCA 1 /2 are one of the best known mutations that would lead to ovarian and breast cancers. Now new mutations of RAD51C and RAD51D genes identified have a 5 to 12 fold higher risk for ovarian cancer; therefore consideration of surgery for risk reduction is now recommended. Another study also showed compelling evidence that detecting early cancers is possible with favorable outcomes using pancreatic cancer screening in patients with pancreatic cancer susceptibility genes (e.g., CDKN2A, BRCA1/2, and PALB2).

 

Excessive sun exposure is a well-known risk factor for skin cancer. A recent study revealed that vitamin B3 (nicotinamide) can lower the risk of developing skin cancer by 23% in people who are at high risk for the disease.

 

This year was marked with a wave of advances in precision medicine–based approaches. Midostaurin, a drug that targets mutation FLT3 became the first drug approved for acute myeloid leukemia treatment after 20 years. Inotuzumab ozogamicin is a novel treatment which is an antibody–drug conjugate that improves delivery of the drug into the cancer cell. This new drug may improve outcomes for older people with recurrent acute lymphoblastic leukemia.

 

Progress is also noted in non-small cell lung cancers. In patients with ALK mutations alectinib treatment produced encouraging results in patients resistant to first line therapy including those with brain metastases.

 

Multiple myeloma is a cancer of plasma cells, which are found in the blood that produce antibodies to fight infections. CD38 is a molecule that is expressed on plasma cells. Daratumumab is a drug that targets CD38 and a study has shown that incorporation of daratumumab to standard regimen reduced lower risk of cancer progression by 70%.

 

Hormone receptor–positive breast cancer is the most common type of breast cancer. Hormone therapy is the standard of care but resistance is a huge problem. Palbociclib is a drug that blocks CDK4 therefore diminishing the hormone resistance mechanism of breast cancer. Clinical trials demonstrated better tumor control; therefore, it is approved by the FDA in combination with hormone therapy.

 

In other cancer types, new developments also occurred. In kidney cancer, cabozantinib is a drug that targets vascular endothelial growth factor receptor and has been shown that it was more effective compared to standard of care patients with recurrent disease. In patients with glioma, which is a brain tumor, adding chemotherapy to radiation extended glioma survival. This study led to a change in the standard of care for high-risk gliomas. In colon cancer, studies have showed that patients with advanced colorectal cancer with left-side tumors of the colon survived longer compared to right-side tumors. Now the clinicians have taken into account the location of the primary tumor.

 

Immune checkpoints such as PD-1 or CTLA-4 are usually exploited by the tumor to suppress that immune response against tumor. In just a few short years, immunotherapies mainly block these checkpoints and have transformed the outcomes of many cancers. Over the past year, the FDA approved five new uses for immune checkpoint inhibitors: lung cancer, head and neck cancer, bladder cancer, kidney cancer and Hodgkin lymphoma. Atezolizumab, an immunotherapy, is the first new treatment for bladder cancer in 30 years. Recently, the FDA approved first CAR-T cell therapy (tisagenlecleucel) for acute lymphoblastic leukemia. These cells are genetically modified to include a new gene that targets the cancer cell. This development may be the beginning of a new era.

 

Relentless work to conquer cancer is ongoing. Each year, our knowledge of cancer grows and many new treatments are being developed in an effort to improve the outlook for patients with cancer.