Nicole Fernandez

There is a continuing debate about the proportion of cancer patients that benefit from precision oncology, attributable in part to conflicting views as to which molecular alterations are clinically actionable. To quantify the expansion of clinical actionability since 2017, we annotated 47,271 solid tumors sequenced with the MSK-IMPACT clinical assay using two temporally distinct versions of the OncoKB knowledge base deployed 5 years apart. Between 2017 and 2022, we observed an increase from 8.9% to 31.6% in the fraction of tumors harboring a standard care (level 1 or 2) predictive biomarker of therapy response and an almost halving of tumors carrying nonactionable drivers (44.2% to 22.8%). In tumors with limited or no clinical actionability, TP53 (43.2%), KRAS (19.2%), and CDKN2A (12.2%) were the most frequently altered genes. SIGNIFICANCE: Although clear progress has been made in expanding the availability of precision oncology-based treatment paradigms, our results suggest a continued unmet need for innovative therapeutic strategies, particularly for cancers with currently undruggable oncogenic drivers. See related commentary by Horak and Fröhling, p. 18. This article is featured in Selected Articles from This Issue, p. 5.

This article discusses the specific advances made in precision oncology in 2024. We comment on the evolving nature of predictive molecular events used to select patients who will most benefit clinically from treatment. We also discuss advances in the development of strategic treatment regimens for combination therapies, rational drug design of small-molecule inhibitors, and structurally informed drug repurposing.

Adipose tissue contains resident B lymphocytes (B cells) with varying immune functions and mechanisms, depending on the adipose depot type and location. The heterogeneity of B cells and their functions affect the immunometabolism of the adipose tissue in aging and age-associated metabolic disorders. B cells exist in categorizations of subsets that have developmental or phenotypic differences with varying functionalities. Subsets can be categorized as either protective or pathogenic depending on their secretion profile or involvement in metabolic maintenance. In this article, we summarized recent finding on the B cell heterogeneity and discuss how we can utilize our current knowledge of adipose resident B lymphocytes for potential treatment for age-associated metabolic disorders. © 2022 American Physiological Society. Compr Physiol 12: 1-13, 2022.

This article discusses the specific advances made in precision oncology in 2025, in which we saw the approval of multiple new indications for known precision oncology agents and early promising data for novel agents that target either classical pathways or previously so-called undruggable targets. Additionally, we observed the continued development of antibody-drug conjugates and proteolysis-targeting chimeras, the advent of multiple blood-based methodologies for the early detection of cancer, the identification of nontraditional precision oncology biomarkers, and the growing presence of artificial intelligence technologies to generate precision oncology insights.

Our hospital developed and implemented a major redesign of interdisciplinary rounds in order to achieve more efficient interdisciplinary communication in this challenging post-COVID era. The goal was to involve all key participants in a structured initiative to improve discharge planning, review important patient safety indicators, and enhance patient-physician communication. The comprehensive redesign, based on the Institute for Healthcare Improvement model, restructured the rounds into two distinct components: interdisciplinary disposition and clinical rounds. This new, dichotomous structure resulted in improved median discharge time, better identified estimated date of discharge and streamlined communication among care team providers. Combined with second rounds by physicians on patients getting discharged, there was an improvement in patient experience domains.