In the global health emergency caused by the SARS-CoV-2 virus, clinical trial management has proven critical for the pharmaceutical industry and healthcare professionals. This article discussed the importance of adopting measures which, primarily, prioritize patient safety and data validity, as well as the use of contingency measures such as telemedicine, virtual medical examination and remote monitoring. All with the goal of ensuring that clinical cancer research continues during the SARS-CoV-2 pandemic.

DOI: 10.1038/s41523-021-00249-1

The objective of this study was to identify HER2-positive breast tumours that present a high sensitivity to anti-HER2 therapies, and in which the use of chemotherapy could therefore be avoided. Tumours with intrinsic HER2-enriched subtype and high HER2 RNA expression are more sensitive to anti-HER2 therapies.

DOI: 10.1093/jnci/djz042

The PAMELA phase II clinical trial is a study that evaluated which HER2-positive localized breast cancer patients might benefit from a de-escalation in treatment intensity. This study demonstrated that patients with the HER2-enriched subtype benefited most from exclusive treatment with a dual HER2 blockade of trastuzumab and lapatinib.

DOI: 10.1016/S1470-2045(17)30021-9

This review discussed the possibility of treating breast tumours with low HER2 expression with anti-HER2 therapies and proposed an algorithm to define this type of tumour, which means rethinking the traditional classification of breast tumours as HER2-positive or HER2-negative.

DOI: 10.1200/JCO.19.02488

This article outlined the factors that cause disparities in cancer survival between and within countries, such as limited access to adequate diagnosis, essential cancer drugs and high-quality care, exposing possible strategies to address access issues, including universal health coverage for essential cancer drugs, fairer approaches to setting the price of cancer drugs, reducing development costs, optimizing regulation and improving equity in the global supply chain.

DOI: https://doi.org/10.3322/caac.21597

This phase I clinical trial confirmed that the antitumour activity of the combination of the CXCR4 inhibitor balixafortide with eribulin appears superior to that reported with eribulin monotherapy in previous studies, with a favourable toxicity profile. This combination is currently being evaluated in a phase III clinical study (FORTRESS).

DOI: 10.1016/S1470-2045(18)30147-5

This groundbreaking paper proposed a different approach to cancer classification with important implications for both treatment and basic, translational and clinical research. In the paper, it was postulated that cancers with multiple organs of origin, but with similar molecular traits, should be treated in the same way.

DOI: 10.3322/caac.21211

The KEYNOTE 522 phase III clinical trial is the first randomized clinical trial to confirm an increased pathologic complete response rate with the addition of pembrolizumab immunotherapy to neoadjuvant chemotherapy treatment in patients diagnosed with stage II and III triple-negative breast cancer. Approval of pembrolizumab in this group of patients is being evaluated by regulatory agencies based on the results of this study.

DOI: 10.1056/NEJMoa1910549

The Destiny Breast-01 phase II clinical trial demonstrated the impressive antitumour activity of the anti-HER2 therapy trastuzumab deruxtecan in extensively pretreated HER2-positive metastatic breast cancer patients. This clinical trial led to the approval of trastuzumab deruxtecan in the US and Europe for this patient group. It is the first time in history that a drug has been approved in this context based on the results of a phase II study.

DOI: 10.1056/NEJMoa1914510