Neoadjuvant administration of immune-checkpoint inhibitors (ICIs) has substantially improved the outcomes in patients with various solid tumours, including those with head and neck cancer. However, not all patients derive benefit, indicating a need for biomarkers that enable accurate predictions of a response to these agents. In this Review the authors describe changes in both intratumour and circulating T cells in patients with locally advanced head and neck cancer receiving neoadjuvant ICIs, and consider the role of specific T cell subsets as biomarkers in this setting.

Third-generation EGFR tyrosine-kinase inhibitors (TKIs) are the standard-of-care first-line treatment for patients with advanced-stage EGFR-mutant NSCLC and their efficacy is being investigated in early stage and locally advanced disease. The authors of this Review describe the current first-line treatment options for EGFR-mutant NSCLC, discuss mechanisms of acquired resistance to third-generation EGFR TKIs and new promising treatment strategies, such as bispecific antibodies, next-generation TKIs, antibody–drug conjugates, immunotherapy approaches and targeted protein degraders.

Leptomeningeal metastatic disease (LMD) arises secondary to the metastatic dissemination of cancer cells into the leptomeninges and cerebrospinal fluid. Novel therapies against systemic disease have not yet translated into improved outcomes for patients with LMD, in whom median survival after diagnosis remains at 2–6 months. The authors of this Review, a multidisciplinary group of experts, describe the emerging evidence and areas of active investigation in LMD and provide directed recommendations for future research.

Increased recognition of the roles of epigenetic reprogramming in cancer has spurred the development of epigenetic therapies, although these drugs have meaningful efficacy as single agents in only a narrow range of malignancies. In this Review, the authors discuss advances and pitfalls in the use of epigenetic drugs combined with chemotherapies, immunotherapies or other targeted agents, including epigenetic–epigenetic combinations.

First-line treatment of advanced-stage classic Hodgkin lymphoma (HL) has successfully entered the era of targeted agents based on results from the phase III German Hodgkin Study Group HD21 and US intergroup S1826 trials. Although these trials bring about important advances, many uncertainties remain and the outcomes of all patients with HL can be further improved.

Patients with advanced-stage cancer seek treatments that prolong survival and improve quality of life. We analysed new anticancer drug indications approved by the FDA and EMA between 2020 and 2023 using the European Society for Medical Oncology-Magnitude of Clinical Benefit Scale quality-of-life checklist. Our findings highlight critical gaps in the availability and reliability of quality-of-life outcomes from the pivotal trials that support these approvals.