Recent developments in the treatment of cancer patients have been driven by major technological and therapeutic advances. First, precision medicine has emerged to detect and target genetic and molecular abnormalities. Thanks to the sequencing of a patient’s tumor, it is now possible to personalize treatment according to the patient’s profile and tumor. This approach has enabled the development of targeted therapies that reduce adverse effects and improve clinical efficacy. In 2024, further significant advances have been achieved, including the emergence of new forms of hormone therapy, which make it possible to further delay the use of conventional chemotherapy in certain patients.
Second, and in parallel, immunotherapy via immune checkpoint blockade, for example with anti-PD-1/L1 antibodies, has taken a central place in the oncologist’s treatment armamentarium. These antibodies have shown spectacular results in melanoma, lung and kidney cancers, and gynecological malignancies. There is talk of curing patients with metastatic disease with the 10-year hindsight of the first clinical studies in cutaneous melanoma. New indications for anti-PD-1/L1 antibodies and new molecules, such as anti-LAG3 antibodies, were approved in 2024.
Another new therapeutic advance is the advent of antibody-drug conjugates (ADC). This approach combines the specificity of a monoclonal antibody targeting a protein on the surface of tumor cells with the efficacy of a potent chemotherapeutic agent that is often toxic at high doses, but is delivered more selectively with this combination. A growing number of new ADCs are significantly improving patient prognosis, but at the cost of new toxicities.
These treatment strategies are combined with increasingly sophisticated imaging modalities, sometimes with therapeutic intent. Radioligand therapy is a good example of this. It combines a ligand for a protein receptor overexpressed by tumor cells with a beta radiation-emitting radioisotope. 117Lu-PSMA is a radioligand that targets PSMA, which is primarily overexpressed on prostate cancer cells. It has been successfully used in prostate cancer.
All these new therapies not only allow for more precise and less invasive treatment, but also increase patients’ chances of long-term survival. However, these advances also pose new challenges, such as the emergence of resistance, the sequential combination of these therapies, and the need for careful monitoring of long-term effects, driving ongoing research to further refine and personalize oncology treatments.