With this inaugural issue going to press, Oncology Advances is now joining the arena of scientific publication in cancer medicine, an ever-changing field. We are delighted to introduce Oncology Advances, a comprehensive platform dedicated to advancing cancer care through cutting-edge research, clinical insights and transformative translational discoveries. With unwavering commitment, this journal aims to bridge the gap between bench and bedside, uniting the worlds of oncological research, clinical oncology and translational science to address the formidable challenges of cancer with innovative solutions.
Cancer, a multifaceted disease affecting millions of people worldwide,1 demands an integrated approach that leverages our evolving understanding of its complex biology and the translation of scientific breakthroughs into tangible patient benefits. This journal serves as a catalyst for the exchange of knowledge, ideas, and experiences among clinicians, researchers, and allied healthcare professionals involved in the fight against cancer.
Major advances made in oncology
Thanks to advances made in diagnosis, treatment and prevention, significant progress has been made in oncological research and cancer patient care.2 For example, in the United States, the overall cancer death rate has been steadily declining since the 1990s2; such a decline has been observed in cancers of the breast, colon and rectum, lung, and prostate. Unfortunately, progress has not been consistent across all cancer types, and inequities in cancer burdens across different sociodemographic groups/populations remain worldwide. Additionally, the economic burden of cancer on individuals, families and communities as well as the entire public healthcare system is expected to rise in the coming decades, highlighting the urgent need for more research to accelerate the pace of progress against cancer.
These advancements in basic, translational and clinical oncological research pave the new avenue for future development in cancer medicine. Several novel approaches, including multi-omics (e.g., genomics, transcriptomics, epigenomics, proteomics, metabolomics, and immunogenomics), single-cell sequencing, patient-derived xenograft models, liquid biopsy, artificial intelligence (AI) and machine learning, real-world evidence and data sharing, have been developed recently and matured as novel diagnostic and treatment modalities. Herein, we would like to highlight a few excellent examples of revolutionary achievements in cancer medicine as follows:
Immunotherapy: Advances in immunotherapy, such as immune checkpoint inhibitors and chimeric antigen receptor (CAR)-T-cell therapy, have made significant strides in the treatment of various cancers (3).3 These therapies aim to enhance the body’s immune system to recognize and attack cancer cells. Several novel approaches, such as CRISPR-Cas9 and other gene editing strategies, have been used in developing advanced immunotherapies. Cancer immunogenomics, the integration of genomics and immunology, has led to a deeper understanding of the interactions between the immune system and cancer cells, providing new insights into potential therapeutic targets.
Precision Medicine: The use of molecular profiling and genetic testing to identify specific genetic mutations in tumors has allowed for more personalized and targeted treatments.4 This approach helps match patients with the most effective therapies based on the genetic characteristics of their cancer, creating transformative cancer therapies targeting the sequelae of molecular abnormalities or immune mechanisms and combining drugs and for each patient at the right stage of the disease. With recent advances in multi-omics,5–7 personalized treatment of individual patients will become reality.
Modern Radiation Therapy: Improvements in radiation therapy techniques, such as proton therapy and stereotactic body radiation therapy, have been helping to enhance precision and reduce damage to surrounding healthy tissues. Another excellent example is the recent development of radiotheranostics.8
Liquid Biopsies: One of the major advancements in cancer diagnosis is the development and use of liquid biopsies, which involve analyzing blood samples for circulating tumor cells or fragments of tumor DNA and have shown great promise for early cancer detection, monitoring treatment response, and detecting minimal residual disease.9,10
AI in Oncology: As one of the rapidest developing areas in oncology, AI and machine learning applications are being developed to analyze large datasets, including medical images and patient records, to improve diagnostic accuracy, treatment planning, and patient outcomes. More in-depth discussions on this topic can be found in the AI and Cancer Medicine section below.11
Cancer Gene Therapy: Cancer gene therapy involves the introduction, alteration, or silencing of genes to treat or prevent cancer. The long history of cancer gene therapy is marked by significant milestones and evolving strategies.12,13 The first gene therapy trials for cancer began in the late 1980s and early 1990s. These early attempts primarily focused on delivering tumor suppressor genes or suicide genes directly into cancer cells to inhibit their growth or induce cell death. Both viral and non-viral delivery approaches were attempted. Several setbacks, including limited efficacy and safety concerns, occurred in the late 1990s–early 2000s. Some early trials faced challenges related to the immune system’s response to the viral vectors used for gene delivery. To address safety concerns associated with viral vectors, researchers have explored the use of non-viral vectors, such as liposomes and nanoparticles, for gene delivery. Between the mid-2000s and the 2010s, advances in viral vector design, including the development of adenoviruses, lentiviruses, and adeno-associated viruses, improved gene delivery efficiency and safety. Nowadays, several frontiers in cancer gene therapy become fruitful, including several strategies, such as CAR T-cell therapy, targeting tumor suppressor and oncogenes, RNA therapeutics (mRNA vaccines and RNA interference/RNAi), and CRISPR/Cas9 technology. Recent developments in cancer gene therapy also include the expansion of indications to broader cancer types and the trend toward combining gene therapies with other treatment modalities, such as chemotherapy, radiation, or immunotherapy, to increase treatment efficacy.
Major aspects of clinical oncology
Clinical Oncology is a specialized branch of medicine that deals with the diagnosis, treatment, and management of cancer in patients. It involves a wide range of aspects focused on providing comprehensive care to individuals with cancer.14 Examples of major aspects of clinical oncology are given as follows:
Cancer Screening and Early Detection: Oncologists work on developing and implementing cancer screening programs to detect cancer at its earliest stages when treatment is often more effective. Regular screenings, such as mammograms, colonoscopies, and Pap smears, can help identify cancer in its early and more treatable stages.
Cancer Diagnosis: Clinical oncologists are responsible for accurately diagnosing cancer in patients by reviewing medical histories, conducting physical examinations, ordering diagnostic tests, such as imaging studies and biopsies, and interpreting test results to determine the presence and type of malignancy.
Cancer Staging and Prognosis: Standardized staging systems are often employed to assess the extent of cancer spread within the body. Staging helps determine the prognosis and guide treatment decisions.
Treatment Planning: Based on the type, stage, and extent of cancer, clinical oncologists can develop individualized treatment plans for each patient. Treatment options may include surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy, gene therapy and/or a combination of these modalities.
Surgical Oncology: Surgical oncologists may perform curative surgeries to remove localized tumors or palliative surgeries to alleviate symptoms and improve quality of life.
Medical Oncology: Medical oncologists are responsible for managing systemic cancer treatments, such as chemotherapy, immunotherapy, targeted therapy, hormone therapy, and immunotherapy; monitoring treatment responses; adjusting treatment plans as needed; and addressing treatment-related side effects.
Radiation Oncology: Radiation oncologists are responsible for planning and delivering precise radiation treatments to specific areas of the body affected by cancer.
Supportive Care: Clinical oncologists collaborate with a multidisciplinary team to provide supportive care to cancer patients, including palliative care, pain management, nutritional support, and psychosocial services, to improve quality of life during and after cancer treatment.
Clinical Trials: Clinical oncologists conduct and oversee clinical trials to evaluate new cancer treatments, experimental therapies, and novel approaches to comprehensive cancer care. They involve testing new treatments, drugs, or therapeutic approaches on human subjects. Clinical trials are being conducted in multiple phases to assess safety, dosage, and effectiveness. Clinical trials aiming at developing novel therapies, including combination therapies, typically include Phase I, II, and trials before marketing and Phase IV trials post-marketing of novel therapeutics. Participation in clinical trials provides patients with access to potentially cutting-edge treatments.
Monitoring and Follow-up Care: Following the completion of cancer treatment, clinical oncologists continue to monitor patients for any signs of recurrence or treatment-related side effects. Regular follow-up visits are essential to ensure ongoing health surveillance and address any new concerns.
Palliative Care: Oncologists work in tandem with palliative care specialists to improve the quality of life for cancer patients and manage symptoms such as pain, nausea, and fatigue. Palliative care is focused on providing supportive care while addressing the physical, emotional, and psychological needs of both patients and their families.
End-of-Life Care: In cases where cancer is advanced and curative treatment is not feasible, clinical oncologists play a critical role in providing compassionate end-of-life care. They work with patients and their families to address pain management, emotional support, and ensure a dignified and comfortable end-of-life experience.
Patient Education and Counseling: Clinical oncologists educate patients about their cancer diagnosis, treatment options, potential side effects, and prognosis. They also offer counseling and support to help patients make informed decisions about their care.
Psychosocial Support: Coping with cancer can be emotionally and mentally challenging for patients and their families. Oncology teams provide psychosocial support, counseling, and resources to help patients navigate the emotional impact of a cancer diagnosis and treatment.
Survivorship Care: Oncologists provide long-term follow-up care for cancer survivors, monitoring for potential recurrence or late effects of cancer treatments. Survivorship care focuses on maintaining overall health and promoting a healthy lifestyle after cancer treatment.
Multidisciplinary Collaboration: Clinical oncology involves collaboration with various specialists, including radiologists, pathologists, nurses, social workers, nutritionists, and other healthcare professionals. This multidisciplinary approach ensures comprehensive and well-coordinated care for cancer patients.
Overall, clinical oncology is dedicated to providing compassionate and evidence-based care to cancer patients, with the ultimate goal of improving patient outcomes and enhancing quality of life throughout the cancer journey.
Major aspects involved in translational oncology
Translational Oncology is an interdisciplinary field that focuses on bridging the gap between basic cancer research and clinical applications, with the ultimate goal of improving patient outcomes and developing better cancer treatments. Translational oncological research plays a crucial role in bridging the gap between scientific discoveries in the laboratory and their practical applications in clinical settings. We would like to address some of the essential reasons for the necessity of translational research in oncology practice. First, the primary goal of translational research is to translate scientific knowledge into tangible benefits for patients. By applying findings from basic science to clinical practice, translational researchers aim to develop more effective diagnostic tools, treatments, and preventive strategies, ultimately improving patient outcomes. Second, translational research enables the development of personalized or precision medicine approaches. By better understanding the genetic, molecular, and environmental factors contributing to diseases, researchers can tailor treatments to individual patients, increasing the likelihood of successful outcomes and minimizing adverse effects. Third, translational research expedites the translation of promising laboratory discoveries into viable therapeutic interventions, accelerating drug development by reducing the time it takes for new treatments to reach patients. Fourth, translational research often addresses unmet medical needs. For various types of cancer, there are unmet medical needs where existing treatments are limited or inadequate; translational research helps identify those needs, including novel targets, therapeutic strategies, and interventions, to address the existing gaps and improve the standard of care. Translational research provides clinicians with valuable insights into the underlying mechanisms of diseases, informing clinical decision-making, allowing for more accurate diagnoses, better treatment selection, and improved patient management. This approach avoids trial-and-error approaches and unnecessary treatments, and allows healthcare resources to be used more efficiently. Translational research not only focuses on treatment but also on preventive strategies. Understanding the risk factors and early indicators of cancers allows for the development of effective preventive measures, further reducing the incidence and burden of diseases. Finally, translational research accelerates innovation and scientific progress by encouraging collaboration between scientists, clinicians, and other stakeholders. This multidisciplinary approach promotes the exchange of ideas and expertise among researchers and clinicians, drives scientific progress and discovery, and promotes a patient-centered research approach by taking into account the unique characteristics and needs of individual patients. This shift toward personalized medicine enhances the relevance and applicability of research findings to diverse patient populations. Cancer exhibits complexity and heterogeneity, requiring comprehensive and multifaceted approaches. Translational research helps unravel the complexities of diseases, leading to more effective strategies for diagnosis, treatment, and prevention. It serves as a critical bridge between bench science and bedside care, addressing real-world healthcare challenges. Some of the research models used in translational oncology have been well-developed.15–17 The following are some major aspects involved in translational oncology.
Biological Understanding of Cancer: Translational oncology starts with a deep understanding of the underlying biology of cancer. This involves studying the molecular mechanisms, genetic mutations, and cellular processes that drive cancer initiation, progression, and metastasis. Researchers aim to identify potential targets for therapeutic interventions.
Preclinical Research: In this stage, findings from basic research are translated into preclinical studies using cell lines, animal models, and other in vitro and in vivo approaches. These studies help evaluate the efficacy and safety of potential cancer therapies before moving on to clinical trials.
Clinical Trials and Research: As mentioned above, clinical trials are one of the major aspects of clinical oncology. The goal of clinical trials is to validate the findings from preclinical studies and determine the potential benefits of treatments for cancer patients. Therefore, translational oncology emphasizes the transition from bench results to clinical development and the improved design of clinical trials, especially first-in-human trials, including dose selection and schedules, biomarker selection and monitoring, safety and adverse effects and clinical pharmacology and pharmacogenomics. A best example of this aspect may be Phase 0 trials for developing novel targeted therapies.
Precision Medicine and Personalized Therapy: Translational oncology aims to develop personalized treatment strategies based on the specific molecular characteristics of a patient’s tumor. This involves using genomic and molecular profiling to identify genetic mutations and biomarkers that can guide treatment decisions and predict patient responses to specific therapies.
Biomarker Development: Biomarkers are measurable indicators that can help diagnose cancer, predict its behavior, and monitor treatment response. Translational oncology focuses on discovering and validating biomarkers that can aid in early detection, prognosis, and treatment selection.
Immunotherapy, Targeted Therapy, and Gene Therapy: Translational oncology has been instrumental in advancing immunotherapy and targeted therapy approaches. Immunotherapy harnesses the body’s immune system to fight cancer, while targeted therapies specifically target cancer cells based on their unique molecular characteristics, sparing healthy cells.
Translational Imaging: Advanced imaging techniques play a crucial role in translational oncology. Molecular imaging and other imaging modalities help in the early detection of cancer, monitoring treatment response, and assessing disease progression.
Translational Bioinformatics: As vast amounts of data are generated through genomic profiling, clinical trials, and other translational efforts, the field of translational informatics is essential for analyzing and integrating this information. Data science and bioinformatics techniques are employed to extract meaningful insights from large datasets.
Regulatory and Ethical Considerations: Translational oncology involves navigating complex regulatory pathways and ethical considerations, particularly when dealing with human subjects in clinical trials and the use of experimental treatments.
Collaboration and Team Science: Translational oncology requires collaboration among researchers, clinicians, pharmaceutical companies, regulatory authorities, and patients. Team science is essential for the successful translation of research findings into clinical practice.
In summary, translational oncology encompasses a multidisciplinary approach that integrates research findings into clinical applications, with the aim of advancing cancer treatments and improving patient outcomes. It is a dynamic and evolving field that holds great promise for the future of cancer care.
AI and cancer medicine
With rapid progress being made in the area of AI, there is significant potential for revolutionizing cancer medicine in various ways. Its applications range from early detection and diagnosis to personalized treatment plans and drug development. Here, examples in which AI is being used and/or can be used in cancer medicine are selected.18–22
Early detection and diagnosis: AI algorithms can analyze large datasets of medical images, such as mammograms, MRIs, and CT scans, to detect cancerous tumors at an earlier stage. It can help identify patterns and anomalies that may be difficult for human radiologists to detect, leading to earlier intervention and better outcomes.
Predictive analytics: AI can analyze patient data, including genetics, lifestyle, and medical history, to predict cancer risk. This can aid in identifying high-risk individuals who may benefit from increased screening or preventive measures.
Personalized treatment plans: AI can analyze vast amounts of patient data, including genetic information and treatment outcomes, to develop personalized treatment plans for cancer patients. This can help oncologists choose the most effective therapies with fewer side effects based on an individual’s unique profile.
Cancer Drug discovery: AI can significantly accelerate the drug discovery process by analyzing large datasets to identify potential drug candidates. It can predict how drugs will interact with cancer cells and help researchers prioritize the most promising candidates for further testing.
Precision medicine: AI can facilitate precision medicine by matching patients with specific cancer subtypes to targeted therapies that are more likely to be effective against their cancer, potentially improving treatment outcomes and reducing unnecessary treatments.
Treatment response monitoring: AI can continuously analyze patient data during treatment to monitor how a patient is responding to therapy. This allows real-time adjustments to treatment plans, improving the chances of successful outcomes.
Prognostic modeling: AI can be used to develop predictive models that estimate patient prognosis based on various factors, such as age, cancer type, stage, and comorbidities. This information can help patients and healthcare providers make more informed decisions about treatment options and end-of-life care.
Clinical trial optimization: AI can analyze patient data and identify potential candidates for clinical trials, making the recruitment process more efficient and increasing the chances of success for new treatments.
Despite these promising applications, integrating AI into cancer medicine also comes with challenges. Ensuring data privacy, developing unbiased algorithms, and obtaining regulatory approval are some of the hurdles that need to be addressed. However, ongoing research and collaborations between medical professionals and AI experts are pushing the boundaries of what is possible and helping unlock the full potential of AI in cancer medicine.
Communication and scientific publishing
Although the impact of the COVID-19 pandemic on cancer medicine and public health remains being felt,23–25 the recovery in research and development in the field has been rapid, offering us both opportunities and challenges in cancer research and scientific publishing. Such challenges due to the impact of COVID-19 on the healthcare and research landscape are also observed in the field of cancer drug discovery and development. For example, clinical trials for new cancer therapies were largely disrupted during the pandemic, leading to delays and difficulties in data collection and analysis. The pandemic has exposed vulnerabilities in global supply chains and manufacturing processes for drugs, chemicals, and other research supplies. The restrictions imposed during the pandemic have also limited scientific conferences, networking, and collaborations, largely hindering the exchange of ideas and knowledge.
We at Oncology Advances are delighted to have an opportunity to improve scientific publishing after COVID-19. Some key areas we will focus on include open access, the peer review process, multidisciplinary collaboration, data sharing and public engagement. The scope of our journal is vast and encompassing, covering major aspects of clinical oncology and translational research. As illustrated by our editorial board members, Oncology Advances embraces diverse disciplines, including oncology, surgery, radiation oncology, pathology, medical genetics, molecular biology, bioinformatics, pharmacology, toxicology, regulatory affairs, and more. By fostering interdisciplinary collaboration, we seek to promote holistic approaches to cancer care that intertwine therapeutic innovation with personalized patient management.
In this journal, readers will find a rich tapestry of original research articles, reviews, case studies, and commentaries exploring the latest advancements in cancer treatment modalities, clinical trial outcomes, precision medicine, biomarker development, survivorship care, and supportive oncology. Our editorial board, comprised of esteemed experts from around the globe, diligently selects contributions that uphold the highest standards of scientific rigor and clinical relevance.
The journey towards conquering cancer is arduous, but it is brimming with hope and possibilities. It is our firm belief that the marriage of clinical oncology and translational science will unravel mysteries, unveil novel therapeutic targets, and empower healthcare professionals to deliver personalized, effective, and compassionate care to every patient with cancer.
As we embark on this exciting endeavor, we extend our heartfelt gratitude to the researchers, clinicians, and patients who have generously shared their knowledge and experiences. We also express our appreciation to the peer reviewers; their discerning insights ensure the integrity and excellence of the content published within these pages.
We invite all basic, clinical and translational researchers to join us on this transformative expedition into the realm of clinical and translational oncology. Together, let us foster innovation, nurture collaboration, and create a lasting impact in the fight against cancer.
Abbreviations
- AAVs:
adeno-associated viruses
- AI:
artificial intelligence
- CAR:
chimeric antigen receptor
- PDX:
patient-derived xenograft
- RWE:
real-world evidence
- SBRT:
stereotactic body radiation therapy
Declarations
Funding
None.
Conflict of interest
Prof. Ruiwen Zhang is the Editor-in-Chief of Oncology Advances. This manuscript is reviewed and edited by an independent peer review and editing team. The author has no other conflict of interests to declare.