[{"id":"aminolevulinic-acid-gleolan","name":"5-Aminolevulinic acid (oral, for glioma surgery)","tldr":"A drink taken before brain surgery that makes high-grade glioma glow under blue light, letting surgeons remove more tumour safely.","route":"/drugs/aminolevulinic-acid-gleolan/","status":"approved","kind":"drug","molecule":"aminolevulinic-acid-gleolan","modality":"Fluorescence-guided surgery agent (protoporphyrin IX precursor)","sub":"Gleolan / Gliolan","facets":{"kind":["Treatment"],"cancers":["Glioma & glioblastoma"],"year":["2007"]},"cols":{"kind":{"facet":"kind","value":"Treatment","tip":"Approved and pipeline products, with what they hit and who makes them."},"cancers":[{"label":"Glioma & glioblastoma","href":"/cancers/glioblastoma/","tip":"Gliomas are now diagnosed by molecular class, and three classes got their first targeted drugs in 2024-25 (vorasidenib for IDH-mutant glioma, tovorafenib for BRAF-altered paediatric glioma, dordaviprone for H3 K27M). Glioblastoma is the hardest to treat: surgery, radiotherapy with temozolomide and tumour treating fields are its backbone, with CAR-T into the brain and focused ultrasound in trials."}],"year":{"facet":"year","value":"2007"},"tags":[{"label":"diagnostic","href":"/tagged/diagnostic/","tip":"Every record tagged diagnostic."}]},"sortKeys":{"year":2007}},{"id":"idea-upgrade-clot-risk-score-and-preventive-anticoagulation","name":"A blood clot risk score at the start of chemotherapy, with preventive anticoagulation offered to those at higher risk","tldr":"People with cancer get blood clots more often than others. A score built from the cancer type and routine blood tests picks out those at higher risk, and in two placebo-controlled trials a low-dose blood-thinning tablet reduced clots but caused more bleeding. United States guidance says it may be offered; surveys in the Netherlands and China found most specialists do not use the score.","route":"/ideas/idea-upgrade-clot-risk-score-and-preventive-anticoagulation/","kind":"idea","cancerIcon":"pancreatic","facets":{"kind":["Idea"],"cancers":["Pancreatic ductal adenocarcinoma","Non-small-cell lung cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Idea","tip":"Hypotheses and new directions, linked to the evidence."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"tags":[{"label":"protocol-upgrade","href":"/tagged/protocol-upgrade/","tip":"Every record tagged protocol-upgrade."},{"label":"upgrade:proven-unevenly-used","href":"/tagged/upgrade-proven-unevenly-used/","tip":"Every record tagged upgrade:proven-unevenly-used."}]},"sortKeys":{"year":0}},{"id":"idea-pu-pelvic-filling-protocol","name":"A measured drink of water before pelvic radiotherapy, and bowel preparation kept to what trials support","tldr":"The bladder and rectum change size from day to day and move the prostate with them. A randomised trial found that drinking about half a litre of water before each treatment kept the bladder more consistent than drinking a litre, and small trials of anti-wind medicines before prostate radiotherapy found no effect.","route":"/ideas/idea-pu-pelvic-filling-protocol/","kind":"idea","cancerIcon":"prostate","facets":{"kind":["Idea"],"cancers":["Prostate cancer","Cervical cancer","Bladder & urothelial cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Idea","tip":"Hypotheses and new directions, linked to the evidence."},"cancers":[{"label":"Prostate cancer","href":"/cancers/prostate/","tip":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype."},{"label":"Cervical cancer","href":"/cancers/cervical/","tip":"A cancer that could be eliminated by HPV vaccination and screening. For those who develop it, immunotherapy and a tissue-factor ADC have improved survival."},{"label":"Bladder & urothelial cancer","href":"/cancers/urothelial/","tip":"Bladder cancer went from 40 years of cisplatin to an ADC-immunotherapy combination that nearly doubled survival, and in 2026 the first blood-test-guided drug approval."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"protocol-upgrade","href":"/tagged/protocol-upgrade/","tip":"Every record tagged protocol-upgrade."},{"label":"upgrade:promising","href":"/tagged/upgrade-promising/","tip":"Every record tagged upgrade:promising."}]},"sortKeys":{"year":0}},{"id":"adaptive-radiotherapy","name":"Adaptive radiotherapy (online replanning)","tldr":"Re-shaping the treatment plan to the anatomy of the day, using the images taken on the treatment couch, so the dose follows a shrinking tumour or a moving bladder.","route":"/technologies/adaptive-radiotherapy/","status":"emerging","kind":"technology","schematic":{"id":"adaptive-radiotherapy","sections":["radiation"]},"facets":{"kind":["Technology"],"cancers":[],"year":["2010"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[],"year":{"facet":"year","value":"2010"},"tags":[{"label":"radiation-wave1","href":"/tagged/radiation-wave1/","tip":"Every record tagged radiation-wave1."}]},"sortKeys":{"year":2010}},{"id":"auto-contouring-ai","name":"AI auto-contouring and adaptive planning","tldr":"Software that draws organs and tumours on scans automatically, saving hours per patient and making daily plan adaptation practical.","route":"/technologies/auto-contouring-ai/","status":"established","kind":"technology","schematic":{"id":"auto-contouring-ai","sections":["radiation","ai-computation"]},"facets":{"kind":["Technology"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[],"tags":[{"label":"supporting","href":"/tagged/supporting/","tip":"Every record tagged supporting."}]},"sortKeys":{"year":0}},{"id":"ai-pathology-scoring","name":"AI scoring of biomarkers and grade on pathology slides","tldr":"Software that reads digitised biopsy slides to detect cancer, grade it, and score biomarkers such as HER2, PD-L1 and Ki-67 more consistently than the eye alone.","route":"/technologies/ai-pathology-scoring/","status":"approved","kind":"technology","schematic":{"id":"ai-pathology-scoring","sections":["diagnostics","ai-computation"]},"facets":{"kind":["Technology"],"cancers":["Prostate cancer","HER2-positive breast cancer","Non-small-cell lung cancer"],"year":["2021"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Prostate cancer","href":"/cancers/prostate/","tip":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype."},{"label":"HER2-positive breast cancer","href":"/cancers/breast-her2-positive/","tip":"HER2-positive breast cancer was once the most aggressive subtype and is now one of the most treatable, thanks to trastuzumab and, more recently, Enhertu."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"year":{"facet":"year","value":"2021"},"tags":[]},"sortKeys":{"year":2021}},{"id":"paper-cohen-msi-dmmr-misdiagnosis-colorectal-jama-oncol-2019","name":"Association of primary resistance to immune checkpoint inhibitors in metastatic colorectal cancer with misdiagnosis of microsatellite instability or mismatch repair deficiency status","tldr":"When colorectal cancers labelled mismatch-repair deficient did not respond to immunotherapy, three of five turned out on retesting not to be deficient at all; local results were wrong about one time in ten.","route":"/key-papers/paper-cohen-msi-dmmr-misdiagnosis-colorectal-jama-oncol-2019/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=jamanetwork.com&sz=128","sub":"Cohen R, Hain E, Buhard O, et al. · JAMA Oncology 2019","facets":{"kind":["Key paper"],"cancers":["Mismatch-repair deficient (MSI-high) colorectal cancer"],"year":["2019"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[{"label":"Mismatch-repair deficient (MSI-high) colorectal cancer","href":"/cancers/msi-high-colorectal/","tip":"Mismatch-repair deficient bowel cancer has lost its DNA spell-checker, so it carries thousands of mutations that the immune system can recognise. Immunotherapy alone controls most metastatic cases for years and makes most localised tumours disappear before surgery, sometimes so completely that no surgery is needed."}],"year":{"facet":"year","value":"2019"},"tags":[]},"sortKeys":{"year":2019}},{"id":"paper-marabelle-keynote-158-tmb-lancet-oncol-2020","name":"Association of tumour mutational burden with outcomes in patients with advanced solid tumours treated with pembrolizumab: prospective biomarker analysis of KEYNOTE-158","tldr":"In ten hard-to-treat cancer types, 29 in 100 people whose tumours carried at least 10 mutations per million DNA letters responded to pembrolizumab, against 6 in 100 below that line.","route":"/key-papers/paper-marabelle-keynote-158-tmb-lancet-oncol-2020/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=thelancet.com&sz=128","sub":"Marabelle A, Fakih M, Lopez J, et al. · The Lancet Oncology 2020","facets":{"kind":["Key paper"],"cancers":[],"year":["2020"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[],"year":{"facet":"year","value":"2020"},"tags":[]},"sortKeys":{"year":2020}},{"id":"paper-liao-proton-vs-imrt-nsclc-jco-2018","name":"Bayesian adaptive randomization trial of passive scattering proton therapy and intensity-modulated photon radiotherapy for locally advanced non-small-cell lung cancer","tldr":"The first randomised comparison of protons with modern photon radiotherapy for lung cancer. Protons spared the heart but not the lung overall, and neither severe lung inflammation nor local failure was reduced: 10.5 per cent against 6.5 per cent for lung inflammation, 10.5 against 10.9 per cent for local failure.","route":"/key-papers/paper-liao-proton-vs-imrt-nsclc-jco-2018/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=ascopubs.org&sz=128","sub":"Liao Z, Lee JJ, Komaki R, et al. · Journal of Clinical Oncology 2018","facets":{"kind":["Key paper"],"cancers":["Non-small-cell lung cancer"],"year":["2018"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"year":{"facet":"year","value":"2018"},"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":2018}},{"id":"oral-targeted-therapy-drug-monitoring","name":"Blood-level monitoring of oral targeted cancer drugs","tldr":"Cancer tablets such as kinase inhibitors are given at one dose for everyone, though the amount in the blood differs widely between people. A Dutch study of 600 patients measured trough levels and adjusted when they were low, cutting the share of people with too little drug by 39 per cent, but no trial has yet shown that this improves survival.","route":"/technologies/oral-targeted-therapy-drug-monitoring/","status":"emerging","kind":"technology","schematic":{"id":"oral-targeted-therapy-drug-monitoring","sections":["targeted-therapy","supportive-care"]},"facets":{"kind":["Technology"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"body-surface-area-dosing","name":"Body-surface-area dosing","tldr":"Chemotherapy doses are usually written per square metre of body surface, a convention from 1958 that scales drug clearance between species and people; it is imprecise, and for many newer drugs flat or weight-based doses have replaced it.","route":"/technologies/body-surface-area-dosing/","status":"established","kind":"technology","schematic":{"id":"body-surface-area-dosing","sections":["ai-computation","drug-discovery"]},"facets":{"kind":["Technology"],"cancers":[],"year":["1958"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[],"year":{"facet":"year","value":"1958"},"tags":[{"label":"mathematical-model","href":"/tagged/mathematical-model/","tip":"Every record tagged mathematical-model."}]},"sortKeys":{"year":1958}},{"id":"idea-pu-breath-hold-coaching-before-planning","name":"Breath-hold coaching and home practice a week before the planning scan, in the patient's own language","tldr":"Breath-hold is usually taught on the day of the planning scan. Two hospital series found that teaching it at least five days earlier, with practice at home, went with lower heart doses and shorter set-up times, and a survey of American radiation oncologists found interpreters were present at fewer than one in three first treatments for people who do not speak English.","route":"/ideas/idea-pu-breath-hold-coaching-before-planning/","kind":"idea","cancerIcon":"breast-cancer","facets":{"kind":["Idea"],"cancers":["Breast cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Idea","tip":"Hypotheses and new directions, linked to the evidence."},"cancers":[{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."}],"tags":[{"label":"protocol-upgrade","href":"/tagged/protocol-upgrade/","tip":"Every record tagged protocol-upgrade."},{"label":"upgrade:promising","href":"/tagged/upgrade-promising/","tip":"Every record tagged upgrade:promising."},{"label":"breast","href":"/tagged/breast/","tip":"Every record tagged breast."}]},"sortKeys":{"year":0}},{"id":"carboplatin-calvert-dosing","name":"Carboplatin dosing by kidney function: the Calvert formula and how kidney function is measured","tldr":"Carboplatin is dosed by kidney function rather than body size, using a formula from 1989 that aims at a set drug exposure. The formula is only as good as the kidney measurement fed into it: in a study of 2,471 people with cancer, the usual blood-test estimates missed the intended dose by more than a fifth in about one person in five to one in four.","route":"/technologies/carboplatin-calvert-dosing/","status":"standard-of-care","kind":"technology","schematic":{"id":"carboplatin-calvert-dosing","sections":["chemotherapy"]},"facets":{"kind":["Technology"],"cancers":["Ovarian cancer","Non-small-cell lung cancer","Testicular germ cell tumours","Head and neck squamous cell carcinoma","Breast cancer"],"year":["1989"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Ovarian cancer","href":"/cancers/ovarian/","tip":"Usually found late. PARP inhibitors transformed maintenance therapy, and ADCs against folate receptor and CDH6 are arriving for platinum-resistant disease."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."},{"label":"Testicular germ cell tumours","href":"/cancers/testicular/","tip":"Testicular germ cell tumours are the most curable adult solid cancer: cisplatin-based chemotherapy cures the large majority even when the disease has spread to distant sites. Today's research is about giving less treatment to the majority who are cured, rescuing the minority who relapse, and limiting lifelong survivorship harms."},{"label":"Head and neck squamous cell carcinoma","href":"/cancers/head-and-neck/","tip":"Cancers of the mouth and throat, increasingly caused by HPV. Immunotherapy is first line for advanced disease and now used before surgery."}],"year":{"facet":"year","value":"1989"},"tags":[]},"sortKeys":{"year":1989}},{"id":"cfdna","name":"Cell-free DNA (cfDNA)","tldr":"Short pieces of DNA floating in the blood, shed by dying cells all over the body. Most is from normal cells; the small tumour-derived fraction (ctDNA) is what liquid biopsies fish out.","route":"/terms/cfdna/","kind":"term","schematic":{"id":"liquid-biopsy","sections":["diagnostics"]},"facets":{"kind":["Term"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"fragmentomics","name":"cfDNA fragmentomics","tldr":"Fragmentomics reads the sizes and positions of DNA fragments in blood, not the mutations. Cancer cells die messily and leave a recognisable fragmentation pattern.","route":"/technologies/fragmentomics/","status":"established","kind":"technology","schematic":{"id":"fragmentomics","sections":["early-detection","diagnostics"]},"facets":{"kind":["Technology"],"cancers":["Non-small-cell lung cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"tags":[{"label":"frontier","href":"/tagged/frontier/","tip":"Every record tagged frontier."}]},"sortKeys":{"year":0}},{"id":"ctdna","name":"Circulating tumour DNA (ctDNA)","tldr":"Circulating tumour DNA (ctDNA) consists of fragments of DNA shed by tumour cells into the blood, detectable with sensitive sequencing.","route":"/terms/ctdna/","kind":"term","schematic":{"id":"liquid-biopsy","sections":["diagnostics"]},"facets":{"kind":["Term"],"cancers":["Non-small-cell lung cancer","Prostate cancer","Metastatic castration-resistant prostate cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."},{"label":"Prostate cancer","href":"/cancers/prostate/","tip":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype."},{"label":"Metastatic castration-resistant prostate cancer","href":"/cancers/prostate-mcrpc/","tip":"Metastatic castration-resistant prostate cancer is disease that grows despite castrate testosterone. Sequenced treatments now include androgen receptor inhibitors, docetaxel and cabazitaxel, PARP inhibitors for men with BRCA-type mutations, the radioligand 177Lu-PSMA-617 and radium-223 for bone-predominant disease."}],"tags":[]},"sortKeys":{"year":0}},{"id":"ctdna-tumour-fraction","name":"Circulating tumour DNA fraction (and what a negative plasma result means)","tldr":"How much of the DNA floating in a blood sample came from the cancer. Above a few per cent, a plasma test finds what a biopsy would find; below it, a negative result means the test could not see, not that there is nothing there.","route":"/biomarkers/ctdna-tumour-fraction/","kind":"biomarker","sub":"Genome-wide readout","facets":{"kind":["Biomarker"],"cancers":["Prostate cancer","Metastatic castration-resistant prostate cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Biomarker","tip":"The readouts a pathology report gives (PD-L1 CPS, HER2 IHC 3+, MSI-high), each under its gene or protein, with the thresholds approvals use and the tests that measure them."},"cancers":[{"label":"Prostate cancer","href":"/cancers/prostate/","tip":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype."},{"label":"Metastatic castration-resistant prostate cancer","href":"/cancers/prostate-mcrpc/","tip":"Metastatic castration-resistant prostate cancer is disease that grows despite castrate testosterone. Sequenced treatments now include androgen receptor inhibitors, docetaxel and cabazitaxel, PARP inhibitors for men with BRCA-type mutations, the radioligand 177Lu-PSMA-617 and radium-223 for bone-predominant disease."}],"tags":[{"label":"biomarker","href":"/tagged/biomarker/","tip":"Every record tagged biomarker."},{"label":"prostate","href":"/tagged/prostate/","tip":"Every record tagged prostate."}]},"sortKeys":{"year":0}},{"id":"cgp","name":"Comprehensive genomic profiling","tldr":"Sequencing hundreds of cancer genes at once from a biopsy to find the mutations a drug can target.","route":"/technologies/cgp/","status":"standard-of-care","kind":"technology","schematic":{"id":"cgp","sections":["diagnostics"]},"facets":{"kind":["Technology"],"cancers":["Colorectal cancer","Non-small-cell lung cancer","Small-cell lung cancer","Diffuse large B-cell lymphoma","Non-Hodgkin lymphoma","Mantle cell lymphoma","Peripheral T-cell lymphomas"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."},{"label":"Small-cell lung cancer","href":"/cancers/sclc/","tip":"A fast-growing lung cancer. About a third of cases are confined to one side of the chest and are treated to cure with chemotherapy and radiotherapy together; the rest respond to chemotherapy and relapse quickly. After 30 years without progress, durvalumab consolidation, the T-cell engager tarlatamab and antibody-drug conjugates have each lengthened survival since 2024."},{"label":"Diffuse large B-cell lymphoma","href":"/cancers/dlbcl/","tip":"Diffuse large B-cell lymphoma (DLBCL) is an aggressive but curable lymphoma. CAR-T cures about 40% of relapsed patients, and off-the-shelf bispecifics are now approved."}],"tags":[]},"sortKeys":{"year":0}},{"id":"ct-body-composition-sarcopenia","name":"CT body composition and sarcopenia measurement","tldr":"The staging CT scan every cancer patient already has can be measured for muscle and fat at the level of the third lumbar vertebra; low muscle predicts chemotherapy toxicity and shorter survival across cancers, and software now does the measuring automatically.","route":"/technologies/ct-body-composition-sarcopenia/","status":"emerging","kind":"technology","schematic":{"id":"ct-body-composition-sarcopenia","sections":["imaging","nutrition-lifestyle","supportive-care","rejuvenation"]},"facets":{"kind":["Technology"],"cancers":["Pancreatic ductal adenocarcinoma","Gastric & gastro-oesophageal junction cancer","Colorectal cancer","Non-small-cell lung cancer","Hepatocellular carcinoma","Oesophageal and junctional adenocarcinoma","Head and neck squamous cell carcinoma"],"year":["2008"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Gastric & gastro-oesophageal junction cancer","href":"/cancers/gastric/","tip":"A cancer with three new targets in five years: Claudin 18.2, FGFR2b, and HER2 with new ADCs, plus immunotherapy in first line."},{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"year":{"facet":"year","value":"2008"},"tags":[]},"sortKeys":{"year":2008}},{"id":"ctdna-mrd-positive","name":"ctDNA MRD positivity (molecular residual disease after curative treatment)","tldr":"A ctDNA MRD test looks for the tumour's own mutations in blood after surgery. Detection predicts relapse months before scans, and in 2026 the FDA approved Signatera as the companion test selecting bladder cancer patients for adjuvant atezolizumab.","route":"/biomarkers/ctdna-mrd-positive/","kind":"biomarker","sub":"Genome-wide readout","facets":{"kind":["Biomarker"],"cancers":["Bladder & urothelial cancer","Colorectal cancer","Triple-negative breast cancer","Non-small-cell lung cancer","Breast cancer","Early triple-negative breast cancer","Pancreatic ductal adenocarcinoma","Resectable pancreatic ductal adenocarcinoma","Diffuse large B-cell lymphoma","Non-Hodgkin lymphoma","Hodgkin lymphoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Biomarker","tip":"The readouts a pathology report gives (PD-L1 CPS, HER2 IHC 3+, MSI-high), each under its gene or protein, with the thresholds approvals use and the tests that measure them."},"cancers":[{"label":"Bladder & urothelial cancer","href":"/cancers/urothelial/","tip":"Bladder cancer went from 40 years of cisplatin to an ADC-immunotherapy combination that nearly doubled survival, and in 2026 the first blood-test-guided drug approval."},{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"tags":[{"label":"biomarker","href":"/tagged/biomarker/","tip":"Every record tagged biomarker."},{"label":"genome-wide","href":"/tagged/genome-wide/","tip":"Every record tagged genome-wide."},{"label":"ctdna","href":"/tagged/ctdna/","tip":"Every record tagged ctdna."}]},"sortKeys":{"year":0}},{"id":"ctdna-tests","name":"ctDNA tests roadmap: from a curiosity in plasma to blood tests that decide treatment","tldr":"Blood carries fragments of tumour DNA. This roadmap follows the tests that read them, from the first sighting in 1948 to blood tests that now choose a drug, spare chemotherapy, or screen for many cancers at once, and it lists the readouts to watch next.","route":"/roadmaps/ctdna-tests/","kind":"roadmap","cancerIcon":"tnbc","facets":{"kind":["Roadmap"],"cancers":["Triple-negative breast cancer","Gallbladder cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Roadmap","tip":"Where a technology has been and where it is heading."},"cancers":[{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."},{"label":"Gallbladder cancer","href":"/cancers/gallbladder/","tip":"Gallbladder cancer starts in the small bile-storing sac under the liver and is one of the biliary tract cancers. Most cases are found late, or by chance when a gallbladder is removed for gallstones. It is rare in the UK, with about 1,300 cases a year, and much commoner in Chile, Bolivia and northern India. Found early, an operation can cure it."}],"tags":[{"label":"ctdna","href":"/tagged/ctdna/","tip":"Every record tagged ctdna."},{"label":"liquid-biopsy","href":"/tagged/liquid-biopsy/","tip":"Every record tagged liquid-biopsy."},{"label":"mrd","href":"/tagged/mrd/","tip":"Every record tagged mrd."},{"label":"mced","href":"/tagged/mced/","tip":"Every record tagged mced."}]},"sortKeys":{"year":0}},{"id":"paper-de-crevoisier-daily-weekly-igrt-ijrobp-2018","name":"Daily versus weekly prostate cancer image guided radiation therapy: phase 3 multicenter randomized trial","tldr":"A French trial of 470 men compared checking the prostate's position with imaging before every radiotherapy session against checking weekly. Daily imaging lowered rectal side effects and PSA-defined progression, but the main endpoint, recurrence-free survival, did not differ, and overall survival was worse in the daily group.","route":"/key-papers/paper-de-crevoisier-daily-weekly-igrt-ijrobp-2018/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=redjournal.org&sz=128","sub":"de Crevoisier R, Bayar MA, Pommier P, et al. · International Journal of Radiation Oncology, Biology, Physics 2018","facets":{"kind":["Key paper"],"cancers":["Prostate cancer"],"year":["2018"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[{"label":"Prostate cancer","href":"/cancers/prostate/","tip":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype."}],"year":{"facet":"year","value":"2018"},"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":2018}},{"id":"deep-inspiration-breath-hold","name":"Deep inspiration breath-hold (DIBH)","tldr":"Taking and holding a deep breath during each radiation beam. For left-sided breast cancer it pulls the heart away from the chest wall and cuts heart dose by about half.","route":"/terms/deep-inspiration-breath-hold/","kind":"term","schematic":{"id":"respiratory-motion-management","sections":["radiation"]},"facets":{"kind":["Term"],"cancers":["HR-positive / HER2-negative breast cancer","HER2-positive breast cancer","Triple-negative breast cancer","Hodgkin lymphoma","Breast cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"HR-positive / HER2-negative breast cancer","href":"/cancers/breast-hr-positive/","tip":"HR-positive breast cancer is the most common breast cancer, driven by oestrogen. It was treated for years with hormone-blocking pills, now joined by CDK4/6 inhibitors, PI3K-pathway drugs, degraders, and ADCs."},{"label":"HER2-positive breast cancer","href":"/cancers/breast-her2-positive/","tip":"HER2-positive breast cancer was once the most aggressive subtype and is now one of the most treatable, thanks to trastuzumab and, more recently, Enhertu."},{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."},{"label":"Hodgkin lymphoma","href":"/cancers/hodgkin-lymphoma/","tip":"Hodgkin lymphoma is one of the most curable cancers, where the goal is now to cure with less toxicity, using brentuximab and, from 2026, first-line nivolumab."}],"tags":[{"label":"radiation-wave1","href":"/tagged/radiation-wave1/","tip":"Every record tagged radiation-wave1."}]},"sortKeys":{"year":0}},{"id":"idea-pu-breath-hold-left-breast-routine","name":"Deep-breath-hold radiotherapy for every suitable person with left-sided breast cancer","tldr":"Taking and holding a deep breath during each beam moves the heart away from the treated breast and roughly halves the dose it receives. England's national guideline has recommended it for left-sided breast cancer since 2018, yet surveys in Germany, Austria, Switzerland, Australia and the United States found it applied to a fraction of the people who could have it.","route":"/ideas/idea-pu-breath-hold-left-breast-routine/","kind":"idea","cancerIcon":"breast-cancer","facets":{"kind":["Idea"],"cancers":["Breast cancer","HR-positive / HER2-negative breast cancer","HER2-positive breast cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Idea","tip":"Hypotheses and new directions, linked to the evidence."},"cancers":[{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."},{"label":"HR-positive / HER2-negative breast cancer","href":"/cancers/breast-hr-positive/","tip":"HR-positive breast cancer is the most common breast cancer, driven by oestrogen. It was treated for years with hormone-blocking pills, now joined by CDK4/6 inhibitors, PI3K-pathway drugs, degraders, and ADCs."},{"label":"HER2-positive breast cancer","href":"/cancers/breast-her2-positive/","tip":"HER2-positive breast cancer was once the most aggressive subtype and is now one of the most treatable, thanks to trastuzumab and, more recently, Enhertu."}],"tags":[{"label":"protocol-upgrade","href":"/tagged/protocol-upgrade/","tip":"Every record tagged protocol-upgrade."},{"label":"upgrade:proven-unevenly-used","href":"/tagged/upgrade-proven-unevenly-used/","tip":"Every record tagged upgrade:proven-unevenly-used."},{"label":"breast","href":"/tagged/breast/","tip":"Every record tagged breast."}]},"sortKeys":{"year":0}},{"id":"paper-kirkpatrick-srs-margin-trial-ijrobp-2015","name":"Defining the optimal planning target volume in image-guided stereotactic radiosurgery of brain metastases: results of a randomized trial","tldr":"Brain metastases treated with radiosurgery were randomly given a 1 millimetre or a 3 millimetre margin. Control of the treated tumours was similar, the larger margin irradiated more healthy brain, and five of the six biopsy-proven cases of radiation damage were in the 3 millimetre group.","route":"/key-papers/paper-kirkpatrick-srs-margin-trial-ijrobp-2015/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=redjournal.org&sz=128","sub":"Kirkpatrick JP, Wang Z, Sampson JH, et al. · International Journal of Radiation Oncology, Biology, Physics 2015","facets":{"kind":["Key paper"],"cancers":["Brain metastases","Metastatic cancer"],"year":["2015"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[{"label":"Brain metastases","href":"/cancers/secondary-brain-tumours/","tip":"Brain metastases are cancers that have spread to the brain from elsewhere, most often from the lung, breast or skin. Focused radiation aimed at each spot (radiosurgery) has largely replaced radiation to the whole brain, and for some cancers modern targeted drugs and immunotherapy reach the brain well enough to shrink the deposits on their own."},{"label":"Metastatic cancer","href":"/cancers/metastatic-cancer/","tip":"Metastatic cancer means the original cancer has spread to other parts of the body, most often the bones, liver, lungs or brain. It keeps the name of where it started, is treated with therapies that reach the whole body, and can increasingly be controlled for years; with limited spread it is sometimes treated with the aim of cure."}],"year":{"facet":"year","value":"2015"},"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":2015}},{"id":"paper-bettegowda-ctdna-early-late-stage-stm-2014","name":"Detection of circulating tumor DNA in early- and late-stage human malignancies","tldr":"Tumour DNA could be found in the blood of more than three quarters of people with many advanced cancers, but in fewer than half with brain, kidney, prostate or thyroid cancers, and less often when the cancer was localised.","route":"/key-papers/paper-bettegowda-ctdna-early-late-stage-stm-2014/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=science.org&sz=128","sub":"Bettegowda C, Sausen M, Leary RJ, et al. · Science Translational Medicine 2014","facets":{"kind":["Key paper"],"cancers":[],"year":["2014"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[],"year":{"facet":"year","value":"2014"},"tags":[]},"sortKeys":{"year":2014}},{"id":"dose-painting","name":"Dose painting and biologically guided radiotherapy","tldr":"Instead of one uniform dose, the plan gives more to the parts of the tumour that imaging says are most resistant, such as hypoxic or highly active regions on PET.","route":"/technologies/dose-painting/","status":"emerging","kind":"technology","schematic":{"id":"dose-painting","sections":["radiation"]},"facets":{"kind":["Technology"],"cancers":["Head and neck squamous cell carcinoma","Glioma & glioblastoma"],"year":["2005"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Head and neck squamous cell carcinoma","href":"/cancers/head-and-neck/","tip":"Cancers of the mouth and throat, increasingly caused by HPV. Immunotherapy is first line for advanced disease and now used before surgery."},{"label":"Glioma & glioblastoma","href":"/cancers/glioblastoma/","tip":"Gliomas are now diagnosed by molecular class, and three classes got their first targeted drugs in 2024-25 (vorasidenib for IDH-mutant glioma, tovorafenib for BRAF-altered paediatric glioma, dordaviprone for H3 K27M). Glioblastoma is the hardest to treat: surgery, radiotherapy with temozolomide and tumour treating fields are its backbone, with CAR-T into the brain and focused ultrasound in trials."}],"year":{"facet":"year","value":"2005"},"tags":[{"label":"radiation-wave1","href":"/tagged/radiation-wave1/","tip":"Every record tagged radiation-wave1."}]},"sortKeys":{"year":2005}},{"id":"dpyd-genotyping","name":"DPYD genotyping and DPD phenotyping before fluoropyrimidines","tldr":"A one-off blood test done before fluorouracil or capecitabine that finds the roughly one in twenty-five people who break the drug down too slowly. Lowering their starting dose reduces severe and occasionally fatal toxicity, and in the one matched comparison published so far survival was not shortened overall.","route":"/technologies/dpyd-genotyping/","status":"standard-of-care","kind":"technology","schematic":{"id":"dpyd-genotyping","sections":["diagnostics","chemotherapy","supportive-care"]},"facets":{"kind":["Technology"],"cancers":["Colorectal cancer","Gastric & gastro-oesophageal junction cancer","Pancreatic ductal adenocarcinoma","Breast cancer","Head and neck squamous cell carcinoma","Anal cancer","Oesophageal and junctional adenocarcinoma"],"year":["2013"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Gastric & gastro-oesophageal junction cancer","href":"/cancers/gastric/","tip":"A cancer with three new targets in five years: Claudin 18.2, FGFR2b, and HER2 with new ADCs, plus immunotherapy in first line."},{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."}],"year":{"facet":"year","value":"2013"},"tags":[]},"sortKeys":{"year":2013}},{"id":"paper-esmo-ctdna-assay-recommendations-ann-oncol-2022","name":"ESMO recommendations on the use of circulating tumour DNA assays for patients with cancer: a report from the ESMO Precision Medicine Working Group","tldr":"Europe's oncology society advised that blood tests for tumour DNA can guide targeted treatment in advanced cancer, that tissue is still preferred for many patients, and that residual disease tests after surgery were not yet ready for routine use.","route":"/key-papers/paper-esmo-ctdna-assay-recommendations-ann-oncol-2022/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=annalsofoncology.org&sz=128","sub":"Pascual J, Attard G, Bidard FC, et al. · Annals of Oncology 2022","facets":{"kind":["Key paper"],"cancers":[],"year":["2022"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[],"year":{"facet":"year","value":"2022"},"tags":[{"label":"guideline","href":"/tagged/guideline/","tip":"Every record tagged guideline."}]},"sortKeys":{"year":2022}},{"id":"paper-marquart-genome-driven-oncology-benefit-jama-oncol-2018","name":"Estimation of the percentage of US patients with cancer who benefit from genome-driven oncology","tldr":"Counting every drug approved for a gene change up to January 2018, about 8 in 100 Americans with advanced cancer were eligible for one and about 5 in 100 were estimated to benefit.","route":"/key-papers/paper-marquart-genome-driven-oncology-benefit-jama-oncol-2018/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=jamanetwork.com&sz=128","sub":"Marquart J, Chen EY, Prasad V · JAMA Oncology 2018","facets":{"kind":["Key paper"],"cancers":[],"year":["2018"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[],"year":{"facet":"year","value":"2018"},"tags":[]},"sortKeys":{"year":2018}},{"id":"fiducial-markers","name":"Fiducial markers","tldr":"Tiny gold seeds or electromagnetic beacons placed in or near a tumour so the treatment machine can see exactly where it is each day.","route":"/terms/fiducial-markers/","kind":"term","schematic":{"id":"respiratory-motion-management","sections":["radiation"]},"facets":{"kind":["Term"],"cancers":["Prostate cancer","Hepatocellular carcinoma","Pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Prostate cancer","href":"/cancers/prostate/","tip":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype."},{"label":"Hepatocellular carcinoma","href":"/cancers/hcc/","tip":"Liver cancer almost always grows in a liver already damaged by hepatitis, alcohol or fatty liver disease. It is one of the most preventable cancers, and since 2020 immunotherapy combinations have roughly doubled how long people with advanced disease live."},{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."}],"tags":[{"label":"radiation-wave1","href":"/tagged/radiation-wave1/","tip":"Every record tagged radiation-wave1."}]},"sortKeys":{"year":0}},{"id":"flash-rt","name":"FLASH radiotherapy","tldr":"Delivering an entire dose in under a second, which in animals spares healthy tissue while still killing the tumour.","route":"/technologies/flash-rt/","status":"phase-1","kind":"technology","schematic":{"id":"flash-rt","sections":["radiation"]},"facets":{"kind":["Technology"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[],"tags":[{"label":"frontier","href":"/tagged/frontier/","tip":"Every record tagged frontier."}]},"sortKeys":{"year":0}},{"id":"flash-research-accelerators","name":"FLASH research accelerators (Oriatron, Mobetron FLASH, ProBeam FLASH)","tldr":"Machines built or modified to deliver a whole radiation dose in a fraction of a second, so scientists can test whether ultra-fast dosing spares healthy tissue in people the way it does in animals.","route":"/technologies/flash-research-accelerators/","status":"phase-1","kind":"technology","schematic":{"id":"flash-research-accelerators","sections":["radiation","devices"]},"facets":{"kind":["Technology"],"cancers":["Cutaneous T-cell lymphoma","Bone metastases and skeletal-related events","Skin cancer","Head and neck squamous cell carcinoma"],"year":["2018"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Cutaneous T-cell lymphoma","href":"/cancers/cutaneous-t-cell-lymphoma/","tip":"Cutaneous T-cell lymphoma is a family of nine lymphomas that start in the skin and mostly stay there, of which mycosis fungoides is by far the commonest. Most of them are long-term skin conditions managed over decades rather than cancers that are cured or not cured, and two of the nine are genuinely aggressive."},{"label":"Bone metastases and skeletal-related events","href":"/terms/bone-metastases/","tip":"Cancer spread to the bones, most common in prostate, breast, lung, kidney and thyroid cancer and myeloma. It causes pain, fractures and high calcium, and the complications are counted in trials as 'skeletal-related events'."},{"label":"Skin cancer","href":"/cancers/skin-cancer/","tip":"Skin cancer covers the very common and rarely dangerous basal cell and squamous cell carcinomas, the less common but more serious melanoma, and rarer tumours such as Merkel cell carcinoma and Kaposi sarcoma. Almost all of it is caused by ultraviolet light and most of it is found and cured by simple surgery."},{"label":"Head and neck squamous cell carcinoma","href":"/cancers/head-and-neck/","tip":"Cancers of the mouth and throat, increasingly caused by HPV. Immunotherapy is first line for advanced disease and now used before surgery."}],"year":{"facet":"year","value":"2018"},"tags":[{"label":"machines-wave2","href":"/tagged/machines-wave2/","tip":"Every record tagged machines-wave2."}]},"sortKeys":{"year":2018}},{"id":"fluorescence-guided-surgery","name":"Fluorescence-guided surgery","tldr":"Injecting a dye that makes tumour glow so the surgeon can see exactly where to cut.","route":"/technologies/fluorescence-guided-surgery/","status":"established","kind":"technology","schematic":{"id":"fluorescence-guided-surgery","sections":["surgery","imaging"]},"facets":{"kind":["Technology"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"fluorouracil-pharmacokinetic-dosing","name":"Fluorouracil dosing by measured blood level","tldr":"Fluorouracil is dosed by body size, yet the amount of drug in the blood varies widely between people given the same dose. Measuring the level during the infusion and adjusting the next dose raised the response rate from 18 to 34 per cent in one randomised trial and is recommended by an international pharmacology society, but it is not routine care and no survival gain has been established.","route":"/technologies/fluorouracil-pharmacokinetic-dosing/","status":"emerging","kind":"technology","schematic":{"id":"fluorouracil-pharmacokinetic-dosing","sections":["chemotherapy","supportive-care"]},"facets":{"kind":["Technology"],"cancers":["Colorectal cancer","Head and neck squamous cell carcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Head and neck squamous cell carcinoma","href":"/cancers/head-and-neck/","tip":"Cancers of the mouth and throat, increasingly caused by HPV. Immunotherapy is first line for advanced disease and now used before surgery."}],"tags":[]},"sortKeys":{"year":0}},{"id":"paper-flame-focal-boost-prostate-jco-2021","name":"Focal boost to the intraprostatic tumor in external beam radiotherapy for patients with localized prostate cancer: results from the FLAME randomized phase III trial","tldr":"A trial of 571 men with intermediate or high-risk prostate cancer gave half of them an extra dose, up to 95 Gy, to the tumour visible on MRI inside the prostate. After five years 92 per cent of the boosted group were free of PSA relapse against 85 per cent, with no measurable increase in side effects and no difference in survival.","route":"/key-papers/paper-flame-focal-boost-prostate-jco-2021/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=ascopubs.org&sz=128","sub":"Kerkmeijer LGW, Groen VH, Pos FJ, et al. · Journal of Clinical Oncology 2021","facets":{"kind":["Key paper"],"cancers":["Prostate cancer"],"year":["2021"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[{"label":"Prostate cancer","href":"/cancers/prostate/","tip":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype."}],"year":{"facet":"year","value":"2021"},"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":2021}},{"id":"chemotherapy-dosing-in-obesity","name":"Full weight-based chemotherapy dosing for people with obesity","tldr":"Chemotherapy doses used to be capped for larger people for fear of overdose. The American Society of Clinical Oncology guideline found that up to 40 per cent of people with obesity were given reduced doses, that the feared extra toxicity is unfounded, and recommends full doses based on actual body weight.","route":"/technologies/chemotherapy-dosing-in-obesity/","status":"standard-of-care","kind":"technology","schematic":{"id":"chemotherapy-dosing-in-obesity","sections":["chemotherapy","supportive-care"]},"facets":{"kind":["Technology"],"cancers":["Breast cancer","Ovarian cancer","Colorectal cancer","Non-small-cell lung cancer"],"year":["2012"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."},{"label":"Ovarian cancer","href":"/cancers/ovarian/","tip":"Usually found late. PARP inhibitors transformed maintenance therapy, and ADCs against folate receptor and CDH6 are arriving for platinum-resistant disease."},{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"year":{"facet":"year","value":"2012"},"tags":[]},"sortKeys":{"year":2012}},{"id":"paper-zviran-whole-genome-cfdna-residual-disease-nat-med-2020","name":"Genome-wide cell-free DNA mutational integration enables ultra-sensitive cancer monitoring","tldr":"Reading the whole genome of DNA in the blood, rather than a few genes very deeply, let researchers detect tumour DNA at one part in 100,000 by adding up thousands of mutations.","route":"/key-papers/paper-zviran-whole-genome-cfdna-residual-disease-nat-med-2020/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=nature.com&sz=128","sub":"Zviran A, Schulman RC, Shah M, et al. · Nature Medicine 2020","facets":{"kind":["Key paper"],"cancers":[],"year":["2020"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[],"year":{"facet":"year","value":"2020"},"tags":[]},"sortKeys":{"year":2020}},{"id":"genomic-profiling","name":"Genomic profiling","tldr":"Reading the DNA (and sometimes RNA) of a tumour, usually with a panel of a few hundred genes, to list its mutations, fusions and amplifications and match them to approved drugs or trials. Guidelines now require it before first-line treatment in lung, colorectal, breast and prostate cancer, though in several cancer types most tumours still show no actionable finding.","route":"/terms/genomic-profiling/","kind":"term","schematic":{"id":"cgp","sections":["diagnostics"]},"facets":{"kind":["Term"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"idea-acc-geriatric-assessment-by-default","name":"Geriatric assessment by default for every patient over 70 starting cancer treatment","tldr":"A short structured check of memory, mobility, nutrition and medicines before treatment cuts serious side effects in older patients without reducing benefit. It should be automatic, not optional.","route":"/ideas/idea-acc-geriatric-assessment-by-default/","kind":"idea","schematic":{"id":"g8-geriatric-screening","sections":["supportive-care","diagnostics"]},"facets":{"kind":["Idea"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Idea","tip":"Hypotheses and new directions, linked to the evidence."},"cancers":[],"tags":[{"label":"protocol-upgrade","href":"/tagged/protocol-upgrade/","tip":"Every record tagged protocol-upgrade."},{"label":"upgrade:proven-unevenly-used","href":"/tagged/upgrade-proven-unevenly-used/","tip":"Every record tagged upgrade:proven-unevenly-used."}]},"sortKeys":{"year":0}},{"id":"planning-target-volume","name":"GTV, CTV and PTV (target volumes)","tldr":"The nested outlines a radiation plan is built on: the visible tumour (GTV), the tumour plus the tissue likely to hold microscopic spread (CTV), and a further margin for daily movement and setup error (PTV).","route":"/terms/planning-target-volume/","kind":"term","schematic":{"id":"imrt-igrt","sections":["radiation"]},"facets":{"kind":["Term"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[],"tags":[{"label":"radiation-wave1","href":"/tagged/radiation-wave1/","tip":"Every record tagged radiation-wave1."}]},"sortKeys":{"year":0}},{"id":"her2-low","name":"HER2-low and HER2-ultralow","tldr":"Tumours with a little HER2 (IHC 1+ or 2+ without amplification), or a trace (ultralow), which older HER2 drugs ignored but Enhertu can attack.","route":"/terms/her2-low/","kind":"term","molecule":"trastuzumab-deruxtecan","modality":"ADC","facets":{"kind":["Term"],"cancers":["Triple-negative breast cancer","HR-positive / HER2-negative breast cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."},{"label":"HR-positive / HER2-negative breast cancer","href":"/cancers/breast-hr-positive/","tip":"HR-positive breast cancer is the most common breast cancer, driven by oestrogen. It was treated for years with hormone-blocking pills, now joined by CDK4/6 inhibitors, PI3K-pathway drugs, degraders, and ADCs."}],"tags":[]},"sortKeys":{"year":0}},{"id":"paper-mcgrail-tmb-pan-cancer-response-ann-oncol-2021","name":"High tumor mutation burden fails to predict immune checkpoint blockade response across all cancer types","tldr":"Pooling more than 10,000 tumours, a high mutation count predicted response to immunotherapy in melanoma, lung and bladder cancers but not in breast, prostate or brain tumours.","route":"/key-papers/paper-mcgrail-tmb-pan-cancer-response-ann-oncol-2021/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=annalsofoncology.org&sz=128","sub":"McGrail DJ, Pilié PG, Rashid NU, et al. · Annals of Oncology 2021","facets":{"kind":["Key paper"],"cancers":[],"year":["2021"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[],"year":{"facet":"year","value":"2021"},"tags":[]},"sortKeys":{"year":2021}},{"id":"paper-razavi-cfdna-variant-sources-clonal-haematopoiesis-nat-med-2019","name":"High-intensity sequencing reveals the sources of plasma circulating cell-free DNA variants","tldr":"Sequencing blood plasma and white blood cells side by side showed that most mutations found in plasma came from ageing blood-forming cells, not from the cancer.","route":"/key-papers/paper-razavi-cfdna-variant-sources-clonal-haematopoiesis-nat-med-2019/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=nature.com&sz=128","sub":"Razavi P, Li BT, Brown DN, et al. · Nature Medicine 2019","facets":{"kind":["Key paper"],"cancers":[],"year":["2019"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[],"year":{"facet":"year","value":"2019"},"tags":[]},"sortKeys":{"year":2019}},{"id":"imrt-igrt","name":"IMRT / IGRT (modern external beam)","tldr":"IMRT and IGRT shape the radiation beam to the tumour's outline from multiple angles and check the patient's position with a scan before every session, so surrounding organs receive less dose. Fewer, larger doses are now standard in breast and prostate cancer, but a low-dose bath still spreads across normal tissue.","route":"/technologies/imrt-igrt/","status":"standard-of-care","kind":"technology","schematic":{"id":"imrt-igrt","sections":["radiation"]},"facets":{"kind":["Technology"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"imrt-term","name":"IMRT / IGRT / VMAT (modern external beam radiotherapy)","tldr":"Radiation beams shaped and varied in intensity from multiple angles, or while the machine rotates around the patient (VMAT), so the dose hugs the tumour and misses healthy tissue, checked against imaging before each session so it lands where planned. It cut dry mouth in head and neck cancer and rectal toxicity in prostate cancer.","route":"/terms/imrt-term/","kind":"term","schematic":{"id":"imrt-igrt","sections":["radiation"]},"facets":{"kind":["Term"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"intraoperative-margin-assessment-breast","name":"Intraoperative margin assessment in breast-conserving surgery","tldr":"Ways of checking, before the operation ends, whether cancer reaches the edge of the breast tissue removed, so the surgeon can take more there and then instead of operating again days later. In randomised trials a radiofrequency probe cut second operations from 25.8 to 19.8 per cent, and routinely shaving an extra layer from the cavity cut them from 21 to 10 per cent.","route":"/technologies/intraoperative-margin-assessment-breast/","status":"established","kind":"technology","schematic":{"id":"intraoperative-margin-assessment-breast","sections":["surgery","imaging","diagnostics"]},"facets":{"kind":["Technology"],"cancers":["Breast cancer","HR-positive / HER2-negative breast cancer","HER2-positive breast cancer","Triple-negative breast cancer","Ductal carcinoma in situ"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."},{"label":"HR-positive / HER2-negative breast cancer","href":"/cancers/breast-hr-positive/","tip":"HR-positive breast cancer is the most common breast cancer, driven by oestrogen. It was treated for years with hormone-blocking pills, now joined by CDK4/6 inhibitors, PI3K-pathway drugs, degraders, and ADCs."},{"label":"HER2-positive breast cancer","href":"/cancers/breast-her2-positive/","tip":"HER2-positive breast cancer was once the most aggressive subtype and is now one of the most treatable, thanks to trastuzumab and, more recently, Enhertu."},{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."}],"tags":[]},"sortKeys":{"year":0}},{"id":"idea-pu-breath-hold-visual-feedback","name":"Let the patient see their own breath-hold on a screen or in video glasses","tldr":"During breath-hold radiotherapy a camera or sensor measures how deep the breath is, but often only the radiographers see the trace. Showing it to the patient, on a screen or in video glasses with a target band to stay inside, made holds steadier and more repeatable in the clinical comparisons OnCo found, though none has yet measured whether it changes side effects.","route":"/ideas/idea-pu-breath-hold-visual-feedback/","kind":"idea","cancerIcon":"breast-cancer","facets":{"kind":["Idea"],"cancers":["Breast cancer","Lung cancer","Non-small-cell lung cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Idea","tip":"Hypotheses and new directions, linked to the evidence."},"cancers":[{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."},{"label":"Lung cancer","href":"/cancers/lung-cancer/","tip":"Lung cancer splits into non-small-cell disease, about 85 percent of it, and small-cell disease, which was 6.6 percent of English cases in 2024 and 9.1 percent of Welsh ones (National Lung Cancer Audit, State of the Nation 2026); the two behave and are treated very differently. Screening, staging and the things both types share are common ground; the rest belongs to each subtype."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"tags":[{"label":"protocol-upgrade","href":"/tagged/protocol-upgrade/","tip":"Every record tagged protocol-upgrade."},{"label":"upgrade:promising","href":"/tagged/upgrade-promising/","tip":"Every record tagged upgrade:promising."}]},"sortKeys":{"year":0}},{"id":"liquid-biopsy","name":"Liquid biopsy (ctDNA)","tldr":"A blood test that reads fragments of DNA shed by the tumour, so you can genotype or monitor cancer without a needle in the tumour.","route":"/technologies/liquid-biopsy/","status":"standard-of-care","kind":"technology","schematic":{"id":"liquid-biopsy","sections":["diagnostics"]},"facets":{"kind":["Technology"],"cancers":["Pancreatic ductal adenocarcinoma","Colorectal cancer","Lung cancer","Non-small-cell lung cancer","Diffuse large B-cell lymphoma","Non-Hodgkin lymphoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Lung cancer","href":"/cancers/lung-cancer/","tip":"Lung cancer splits into non-small-cell disease, about 85 percent of it, and small-cell disease, which was 6.6 percent of English cases in 2024 and 9.1 percent of Welsh ones (National Lung Cancer Audit, State of the Nation 2026); the two behave and are treated very differently. Screening, staging and the things both types share are common ground; the rest belongs to each subtype."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"tags":[]},"sortKeys":{"year":0}},{"id":"low-dose-ct-screening","name":"Low-dose CT lung screening","tldr":"A yearly low-radiation CT scan for current and former heavy smokers that finds lung cancer early enough to cure it.","route":"/technologies/low-dose-ct-screening/","status":"standard-of-care","kind":"technology","schematic":{"id":"low-dose-ct-screening","sections":["early-detection","imaging"]},"facets":{"kind":["Technology"],"cancers":["Non-small-cell lung cancer","Small-cell lung cancer","Lung cancer"],"year":["2011"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."},{"label":"Small-cell lung cancer","href":"/cancers/sclc/","tip":"A fast-growing lung cancer. About a third of cases are confined to one side of the chest and are treated to cure with chemotherapy and radiotherapy together; the rest respond to chemotherapy and relapse quickly. After 30 years without progress, durvalumab consolidation, the T-cell engager tarlatamab and antibody-drug conjugates have each lengthened survival since 2024."},{"label":"Lung cancer","href":"/cancers/lung-cancer/","tip":"Lung cancer splits into non-small-cell disease, about 85 percent of it, and small-cell disease, which was 6.6 percent of English cases in 2024 and 9.1 percent of Welsh ones (National Lung Cancer Audit, State of the Nation 2026); the two behave and are treated very differently. Screening, staging and the things both types share are common ground; the rest belongs to each subtype."}],"year":{"facet":"year","value":"2011"},"tags":[]},"sortKeys":{"year":2011}},{"id":"lung-rads","name":"Lung-RADS and nodule reporting","tldr":"The scoring systems that turn a screening CT into an action. Each nodule gets a category from the scan, and the category dictates the next step: rescan in a year, rescan in three months, or go to a lung cancer clinic. They exist so that the same scan gets the same answer in every centre.","route":"/terms/lung-rads/","kind":"term","schematic":{"id":"low-dose-ct-screening","sections":["early-detection","imaging"]},"facets":{"kind":["Term"],"cancers":["Lung cancer","Non-small-cell lung cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Lung cancer","href":"/cancers/lung-cancer/","tip":"Lung cancer splits into non-small-cell disease, about 85 percent of it, and small-cell disease, which was 6.6 percent of English cases in 2024 and 9.1 percent of Welsh ones (National Lung Cancer Audit, State of the Nation 2026); the two behave and are treated very differently. Screening, staging and the things both types share are common ground; the rest belongs to each subtype."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"tags":[{"label":"lung","href":"/tagged/lung/","tip":"Every record tagged lung."}]},"sortKeys":{"year":0}},{"id":"breast-margins-and-re-excision","name":"Margins after breast-conserving surgery, and second operations","tldr":"After conserving surgery a pathologist measures how close the cancer came to the edge of the tissue removed. Cancer at the inked edge means another operation is offered; within 1 mm it is considered; and the threshold was lowered in 2024 specifically to spare people a second operation.","route":"/terms/breast-margins-and-re-excision/","kind":"term","schematic":{"id":"intraoperative-margin-assessment-breast","sections":["surgery","imaging","diagnostics"]},"facets":{"kind":["Term"],"cancers":["Breast cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."}],"tags":[]},"sortKeys":{"year":0}},{"id":"mrd","name":"Minimal / molecular residual disease (MRD)","tldr":"Cancer still present after treatment but too small to see on scans, detected by blood or marrow tests.","route":"/terms/mrd/","kind":"term","schematic":{"id":"mrd-testing","sections":["diagnostics"]},"facets":{"kind":["Term"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"mr-linac","name":"MR-guided adaptive radiotherapy","tldr":"An MR-linac is a radiation machine with an MRI scanner built in, so images taken during setup let the plan be re-optimised in minutes to that day's anatomy. It allows tighter margins and higher doses in pancreatic and prostate cancer, but treatment is slow and costly, and whether daily adaptation improves cure rates rather than only toxicity is unproven.","route":"/technologies/mr-linac/","status":"established","kind":"technology","schematic":{"id":"mr-linac","sections":["radiation"]},"facets":{"kind":["Technology"],"cancers":["Pancreatic ductal adenocarcinoma","Prostate cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Prostate cancer","href":"/cancers/prostate/","tip":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype."}],"tags":[]},"sortKeys":{"year":0}},{"id":"mrd-testing","name":"MRD / molecular residual disease testing","tldr":"An ultra-sensitive blood test after surgery that detects leftover cancer months before a scan would.","route":"/technologies/mrd-testing/","status":"established","kind":"technology","schematic":{"id":"mrd-testing","sections":["diagnostics"]},"facets":{"kind":["Technology"],"cancers":["Colorectal cancer","Bladder & urothelial cancer","Triple-negative breast cancer","Non-small-cell lung cancer","Multiple myeloma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Bladder & urothelial cancer","href":"/cancers/urothelial/","tip":"Bladder cancer went from 40 years of cisplatin to an ADC-immunotherapy combination that nearly doubled survival, and in 2026 the first blood-test-guided drug approval."},{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"tags":[]},"sortKeys":{"year":0}},{"id":"msi-mmr-testing","name":"MSI and mismatch-repair testing","tldr":"Tests that show whether a tumour has lost its DNA spell-checker; if so, immunotherapy works unusually well and an inherited syndrome may be present.","route":"/technologies/msi-mmr-testing/","status":"standard-of-care","kind":"technology","schematic":{"id":"msi-mmr-testing","sections":["diagnostics"]},"facets":{"kind":["Technology"],"cancers":["Colorectal cancer","Endometrial cancer","Gastric & gastro-oesophageal junction cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Endometrial cancer","href":"/cancers/endometrial/","tip":"The gynaecological cancer where immunotherapy has had the biggest impact, guided by molecular classification."},{"label":"Gastric & gastro-oesophageal junction cancer","href":"/cancers/gastric/","tip":"A cancer with three new targets in five years: Claudin 18.2, FGFR2b, and HER2 with new ADCs, plus immunotherapy in first line."}],"tags":[]},"sortKeys":{"year":0}},{"id":"mced","name":"Multi-cancer early detection (MCED)","tldr":"A single blood test intended to screen for dozens of cancers at once, including ones with no screening today.","route":"/technologies/mced/","status":"phase-3","kind":"technology","schematic":{"id":"mced","sections":["early-detection","diagnostics"]},"facets":{"kind":["Technology"],"cancers":["Pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."}],"tags":[]},"sortKeys":{"year":0}},{"id":"nci-match","name":"NCI-MATCH (EAY131)","tldr":"NCI-MATCH was the largest trial to sequence tumours from thousands of patients across the United States and give each a drug matched to the mutation rather than to the organ. It proved the system could work at national scale, found real activity for a handful of matches, and showed that most single drugs given for a single mutation do little.","route":"/trials/nci-match/","status":"active","kind":"trial","cancerIcon":"rare-cancers","sub":"NCT02465060","facets":{"kind":["Trial"],"cancers":["Rare cancers"],"year":["2020"]},"cols":{"kind":{"facet":"kind","value":"Trial","tip":"Landmark and current trials that define the standard of care."},"cancers":[{"label":"Rare cancers","href":"/terms/rare-cancers/","tip":"Rare cancers are those with fewer than about 6 new cases per 100,000 people per year. Individually rare, together they are a quarter of all cancers and have worse survival because of late diagnosis, few trials and scattered expertise."}],"year":{"facet":"year","value":"2020"},"tags":[{"label":"precision-medicine","href":"/tagged/precision-medicine/","tip":"Every record tagged precision-medicine."}]},"sortKeys":{"year":2020}},{"id":"ngs-mrd-clonoseq","name":"NGS-based MRD (clonoSEQ and molecular MRD)","tldr":"Sequencing the unique genetic barcode of a patient's leukaemia to find one cancer cell in a million.","route":"/technologies/ngs-mrd-clonoseq/","status":"standard-of-care","kind":"technology","schematic":{"id":"ngs-mrd-clonoseq","sections":["diagnostics"]},"facets":{"kind":["Technology"],"cancers":["Acute myeloid leukaemia","Acute lymphoblastic leukaemia","Chronic lymphocytic leukaemia","Multiple myeloma","Non-Hodgkin lymphoma","Diffuse large B-cell lymphoma","Mantle cell lymphoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Acute myeloid leukaemia","href":"/cancers/aml/","tip":"Acute myeloid leukaemia is an aggressive blood cancer where, after 40 years of the same chemotherapy, a wave of targeted drugs (FLT3, IDH, BCL-2, menin) arrived."},{"label":"Acute lymphoblastic leukaemia","href":"/cancers/all-leukemia/","tip":"Acute lymphoblastic leukaemia is the childhood cancer success story, and was the first disease treated with CAR-T and with a T-cell engager."},{"label":"Chronic lymphocytic leukaemia","href":"/cancers/cll/","tip":"A slow leukaemia that no longer needs chemotherapy: BTK inhibitors and venetoclax control it for years, often in fixed-duration courses."},{"label":"Multiple myeloma","href":"/cancers/multiple-myeloma/","tip":"Multiple myeloma is a plasma-cell cancer with more new drug classes than any other: proteasome inhibitors, IMiDs, CD38 antibodies, BCMA CAR-T, bispecifics, and an ADC."}],"tags":[]},"sortKeys":{"year":0}},{"id":"paper-open-trial-open-face-masks-sgrt-radiother-oncol-2026","name":"OPEN: optimising patient experience in head and neck radiotherapy, a phase 3 randomised control trial comparing open versus closed face masks","tldr":"People having radiotherapy for head and neck cancer were randomly given the standard closed face mask or one of two open masks, with cameras tracking the face during treatment. The open masks were set up as accurately and were significantly better tolerated.","route":"/key-papers/paper-open-trial-open-face-masks-sgrt-radiother-oncol-2026/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=thegreenjournal.com&sz=128","sub":"Nicholson J, Ryan S, Malone C, et al. · Radiotherapy and Oncology 2026","facets":{"kind":["Key paper"],"cancers":["Head and neck squamous cell carcinoma"],"year":["2026"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[{"label":"Head and neck squamous cell carcinoma","href":"/cancers/head-and-neck/","tip":"Cancers of the mouth and throat, increasingly caused by HPV. Immunotherapy is first line for advanced disease and now used before surgery."}],"year":{"facet":"year","value":"2026"},"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":2026}},{"id":"paige-prostate","name":"Paige Prostate Detect","tldr":"The first AI for reading biopsy slides authorised by the FDA, which points pathologists to prostate cancer they might otherwise miss.","route":"/drugs/paige-prostate/","status":"approved","kind":"drug","molecule":"paige-prostate","modality":"AI digital pathology detection software (prostate biopsy)","sub":"Paige Prostate","facets":{"kind":["Treatment"],"cancers":["Prostate cancer"],"year":["2019"]},"cols":{"kind":{"facet":"kind","value":"Treatment","tip":"Approved and pipeline products, with what they hit and who makes them."},"cancers":[{"label":"Prostate cancer","href":"/cancers/prostate/","tip":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype."}],"year":{"facet":"year","value":"2019"},"tags":[{"label":"test","href":"/tagged/test/","tip":"Every record tagged test."}]},"sortKeys":{"year":2019}},{"id":"idea-acc-reflex-genomic-profiling-at-diagnosis","name":"Pathologists order genomic profiling automatically at diagnosis of advanced cancer","tldr":"A substantial share of patients with advanced non-small-cell lung cancer start first-line treatment before their biomarker results arrive, or without full testing, and so miss targeted therapy. Letting the pathologist order the full genomic panel the moment a cancer of a defined type and stage is confirmed shortens time to result and makes testing complete.","route":"/ideas/idea-acc-reflex-genomic-profiling-at-diagnosis/","kind":"idea","cancerIcon":"nsclc","facets":{"kind":["Idea"],"cancers":["Non-small-cell lung cancer","Colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Idea","tip":"Hypotheses and new directions, linked to the evidence."},"cancers":[{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."},{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."}],"tags":[{"label":"protocol-upgrade","href":"/tagged/protocol-upgrade/","tip":"Every record tagged protocol-upgrade."},{"label":"upgrade:promising","href":"/tagged/upgrade-promising/","tip":"Every record tagged upgrade:promising."}]},"sortKeys":{"year":0}},{"id":"patient-positioning-surface-guidance-systems","name":"Patient positioning and surface guidance systems (AlignRT, Catalyst, ExacTrac Dynamic)","tldr":"Cameras that watch the patient's skin in three dimensions, robotic couches and moulded shells that hold the body still, so each radiotherapy dose lands where the plan says without tattoos and with the beam paused if the patient moves.","route":"/technologies/patient-positioning-surface-guidance-systems/","status":"established","kind":"technology","schematic":{"id":"patient-positioning-surface-guidance-systems","sections":["radiation","devices"]},"facets":{"kind":["Technology"],"cancers":["Breast cancer","Brain metastases","Head and neck squamous cell carcinoma","Prostate cancer","Non-small-cell lung cancer"],"year":["2000"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."},{"label":"Brain metastases","href":"/terms/brain-metastases/","tip":"Tumour deposits that have travelled to the brain from a cancer elsewhere, ten times more common than cancers that start in the brain, mostly from lung, breast, melanoma and kidney cancer. Because the blood-brain barrier excludes most drugs, whether a medicine reaches and shrinks them now decides which drug is chosen, and trials report intracranial progression separately."},{"label":"Head and neck squamous cell carcinoma","href":"/cancers/head-and-neck/","tip":"Cancers of the mouth and throat, increasingly caused by HPV. Immunotherapy is first line for advanced disease and now used before surgery."},{"label":"Prostate cancer","href":"/cancers/prostate/","tip":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype."}],"year":{"facet":"year","value":"2000"},"tags":[{"label":"machines-wave2","href":"/tagged/machines-wave2/","tip":"Every record tagged machines-wave2."}]},"sortKeys":{"year":2000}},{"id":"pd-l1-assay-discordance","name":"PD-L1 assay discordance (SP142, SP263 and 22C3 in breast cancer)","tldr":"Three commercial PD-L1 stains give different answers on the same breast tumour: the SP142 assay used with atezolizumab called fewer than half of tumours positive while the 22C3 and SP263 assays called about three quarters. Because the pembrolizumab licence rests on 22C3 combined positive score 10, which test a laboratory runs, and how it scores it, decides who is offered immunotherapy.","route":"/terms/pd-l1-assay-discordance/","kind":"term","target":{"id":"pdl1","name":"PD-L1","targetClass":"checkpoint","tldr":"PD-L1 is the tumour's side of the PD-1 brake, and also the biomarker that decides who gets immunotherapy."},"facets":{"kind":["Term"],"cancers":["Triple-negative breast cancer","Metastatic triple-negative breast cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."},{"label":"Metastatic triple-negative breast cancer","href":"/cancers/tnbc-metastatic/","tip":"The treatment of triple-negative breast cancer that has spread has been transformed since 2020, though it is not yet curable. By PD-L1 score, first treatment is pembrolizumab with chemotherapy or with sacituzumab govitecan, or datopotamab deruxtecan or sacituzumab govitecan alone; BRCA carriers can take a PARP inhibitor tablet; and trastuzumab deruxtecan reaches the third of tumours with low HER2."}],"tags":[{"label":"breast","href":"/tagged/breast/","tip":"Every record tagged breast."},{"label":"tnbc","href":"/tagged/tnbc/","tip":"Every record tagged tnbc."}]},"sortKeys":{"year":0}},{"id":"pegulicianine","name":"Pegulicianine","tldr":"A cavity-imaging dye used during breast lumpectomy to spot leftover tumour before the operation ends; in its main trial it spared a second operation for 9 of 62 patients whose margins were positive.","route":"/drugs/pegulicianine/","status":"approved","kind":"drug","molecule":"pegulicianine","modality":"Protease-activated fluorescent imaging agent","sub":"Lumisight","facets":{"kind":["Treatment"],"cancers":["HR-positive / HER2-negative breast cancer","Triple-negative breast cancer","HER2-positive breast cancer"],"year":["2024"]},"cols":{"kind":{"facet":"kind","value":"Treatment","tip":"Approved and pipeline products, with what they hit and who makes them."},"cancers":[{"label":"HR-positive / HER2-negative breast cancer","href":"/cancers/breast-hr-positive/","tip":"HR-positive breast cancer is the most common breast cancer, driven by oestrogen. It was treated for years with hormone-blocking pills, now joined by CDK4/6 inhibitors, PI3K-pathway drugs, degraders, and ADCs."},{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."},{"label":"HER2-positive breast cancer","href":"/cancers/breast-her2-positive/","tip":"HER2-positive breast cancer was once the most aggressive subtype and is now one of the most treatable, thanks to trastuzumab and, more recently, Enhertu."}],"year":{"facet":"year","value":"2024"},"tags":[{"label":"diagnostic","href":"/tagged/diagnostic/","tip":"Every record tagged diagnostic."}]},"sortKeys":{"year":2024}},{"id":"intensity-modulated-proton-therapy","name":"Pencil-beam scanning and intensity-modulated proton therapy","tldr":"Modern proton machines paint the tumour spot by spot with a magnetically steered pencil beam, so the dose can be shaped in three dimensions and the proton's stop-point is put to full use.","route":"/technologies/intensity-modulated-proton-therapy/","status":"established","kind":"technology","schematic":{"id":"intensity-modulated-proton-therapy","sections":["radiation"]},"facets":{"kind":["Technology"],"cancers":["Childhood cancers","Head and neck squamous cell carcinoma","Brain and spinal cord tumours"],"year":["2008"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Childhood cancers","href":"/cancers/childhood-cancers/","tip":"Cancer in children is rare and different from adult cancer: the common types are leukaemias, brain tumours, lymphomas and embryonal tumours such as neuroblastoma and Wilms tumour, most are curable in well-resourced health systems, and the great challenge is bringing the same cures to the majority of children who live where they are not available."},{"label":"Head and neck squamous cell carcinoma","href":"/cancers/head-and-neck/","tip":"Cancers of the mouth and throat, increasingly caused by HPV. Immunotherapy is first line for advanced disease and now used before surgery."},{"label":"Brain and spinal cord tumours","href":"/cancers/brain-tumours/","tip":"Brain and spinal cord tumours range from slow-growing meningiomas and low-grade gliomas to glioblastoma, the commonest malignant brain tumour in adults, and a distinct set of childhood tumours such as medulloblastoma and diffuse midline glioma. Molecular markers now define them, and treatment is surgery, radiotherapy and, for some, drugs chosen by those markers."}],"year":{"facet":"year","value":"2008"},"tags":[{"label":"radiation-wave1","href":"/tagged/radiation-wave1/","tip":"Every record tagged radiation-wave1."}]},"sortKeys":{"year":2008}},{"id":"oncology-pharmacogenomics","name":"Pharmacogenomic testing before chemotherapy","tldr":"Testing a patient's inherited genes before certain chemotherapies to spot people who cannot break the drug down and would suffer severe, sometimes fatal, side effects.","route":"/technologies/oncology-pharmacogenomics/","status":"established","kind":"technology","schematic":{"id":"oncology-pharmacogenomics","sections":["diagnostics","chemotherapy","supportive-care"]},"facets":{"kind":["Technology"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"precision-roadmap","name":"Precision roadmap: margins measured in millimetres → tests that find a target → doses fitted to the person → precision that changes outcomes","tldr":"Cancer care is limited by how precise it is: how small a tumour a test can find, how close to it a surgeon can cut, how tightly a beam can be aimed and how well a dose fits the person. This roadmap follows each of those from where it stands now to the next step, and says plainly where more precision has been shown to help a patient and where it has not.","route":"/roadmaps/precision-roadmap/","kind":"roadmap","schematic":{"id":"imrt-igrt","sections":["radiation"]},"facets":{"kind":["Roadmap"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Roadmap","tip":"Where a technology has been and where it is heading."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"project-optimus","name":"Project Optimus","tldr":"An FDA programme pushing companies to find the best dose of a cancer drug, not just the highest tolerable one.","route":"/terms/project-optimus/","kind":"term","molecule":"sotorasib","modality":"Small-molecule inhibitor (KRAS G12C)","facets":{"kind":["Term"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"proton-range-uncertainty","name":"Proton range uncertainty and the range margin","tldr":"A proton beam stops at a depth that cannot be predicted exactly, so planners deliberately aim it a few millimetres past the tumour. At one leading centre the allowance is 3.5 per cent of the beam's range plus 1 millimetre, which for a beam reaching 20 centimetres into soft tissue means overshooting by about 8 millimetres.","route":"/terms/proton-range-uncertainty/","kind":"term","schematic":{"id":"proton-therapy","sections":["radiation"]},"facets":{"kind":["Term"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[],"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":0}},{"id":"proton-therapy","name":"Proton therapy","tldr":"Radiation using protons, which stop inside the tumour instead of passing through, so tissue behind it gets no dose.","route":"/technologies/proton-therapy/","status":"established","kind":"technology","schematic":{"id":"proton-therapy","sections":["radiation"]},"facets":{"kind":["Technology"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"psma-pet","name":"PSMA PET","tldr":"A prostate-cancer-specific PET scan that finds spread far earlier than CT or bone scan, and tells you whether a matched radioactive drug will work.","route":"/technologies/psma-pet/","status":"standard-of-care","kind":"technology","schematic":{"id":"psma-pet","sections":["imaging","radiopharma"]},"facets":{"kind":["Technology"],"cancers":["Prostate cancer"],"year":["2020"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Prostate cancer","href":"/cancers/prostate/","tip":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype."}],"year":{"facet":"year","value":"2020"},"tags":[]},"sortKeys":{"year":2020}},{"id":"r0-r1-margin-pancreatic","name":"R0 and R1 margins in pancreatic cancer: the 1 mm rule and standardised specimen reporting","tldr":"After a pancreatic cancer is removed, the pathologist checks whether cancer reaches the cut edges of the specimen. In the UK, cancer within one millimetre of an edge counts as an incomplete (R1) resection even if it does not touch it. Reported this way most operations are R1, because the tumour creeps along nerves behind the gland; cancer touching the edge carries a worse outlook.","route":"/terms/r0-r1-margin-pancreatic/","kind":"term","schematic":{"id":"histopathology-ihc","sections":["diagnostics"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Resectable pancreatic ductal adenocarcinoma","Borderline resectable pancreatic ductal adenocarcinoma","Invasive carcinoma arising in an intraductal papillary mucinous neoplasm"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Resectable pancreatic ductal adenocarcinoma","href":"/cancers/resectable-pdac/","tip":"Resectable pancreatic cancer is the minority of pancreatic cancer that the surgeon can remove with clear margins because it has not wrapped around the main arteries or spread. Treatment is an operation, usually a Whipple procedure, followed by six months of combination chemotherapy, which is what turns surgery alone into a real chance of cure."},{"label":"Borderline resectable pancreatic ductal adenocarcinoma","href":"/cancers/borderline-resectable-pdac/","tip":"Borderline resectable pancreatic cancer touches the big blood vessels behind the pancreas, so an operation straight away would probably leave cancer behind. Chemotherapy first, usually FOLFIRINOX for several months and sometimes radiotherapy, shrinks the edge of the tumour, and patients whose disease has not spread go on to surgery with a better chance of a clean removal."},{"label":"Invasive carcinoma arising in an intraductal papillary mucinous neoplasm","href":"/cancers/ipmn-associated-carcinoma/","tip":"IPMN-associated carcinoma is pancreatic cancer that has grown out of a mucus-producing cyst in the pancreatic duct. Because the cyst is often being watched, the cancer is found smaller and earlier, and about four in ten patients are alive five years after surgery against two in ten for ordinary pancreatic cancer; the advantage belongs to the colloid type, not the tubular type."}],"tags":[{"label":"gi","href":"/tagged/gi/","tip":"Every record tagged gi."},{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"idea-pu-tattoo-free-set-up","name":"Radiotherapy set-up without permanent ink tattoos, using surface guidance or invisible ink","tldr":"Most people having breast radiotherapy are given small permanent ink dots to line them up on the couch. In a United Kingdom survey of 204 people afterwards, half rated the impact of those tattoos as negative, and surface cameras or ultraviolet ink line people up as accurately without leaving a visible mark.","route":"/ideas/idea-pu-tattoo-free-set-up/","kind":"idea","cancerIcon":"breast-cancer","facets":{"kind":["Idea"],"cancers":["Breast cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Idea","tip":"Hypotheses and new directions, linked to the evidence."},"cancers":[{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."}],"tags":[{"label":"protocol-upgrade","href":"/tagged/protocol-upgrade/","tip":"Every record tagged protocol-upgrade."},{"label":"upgrade:promising","href":"/tagged/upgrade-promising/","tip":"Every record tagged upgrade:promising."},{"label":"breast","href":"/tagged/breast/","tip":"Every record tagged breast."}]},"sortKeys":{"year":0}},{"id":"paper-paganetti-range-uncertainties-pmb-2012","name":"Range uncertainties in proton therapy and the role of Monte Carlo simulations","tldr":"A review of why the depth at which a proton beam stops cannot be predicted exactly, and how much margin centres add for it. One common recipe, 3.5 per cent of the range plus 1 millimetre, overshoots by about 8 millimetres for a beam reaching 20 centimetres into soft tissue.","route":"/key-papers/paper-paganetti-range-uncertainties-pmb-2012/","kind":"paper","sub":"Paganetti H. · Physics in Medicine and Biology 2012","facets":{"kind":["Key paper"],"cancers":[],"year":["2012"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[],"year":{"facet":"year","value":"2012"},"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":2012}},{"id":"resection-margins","name":"Resection margins (R0 / R1 / R2)","tldr":"Whether the edge of the removed tissue is free of cancer. R0 means clear under the microscope, R1 means microscopic cancer at the edge, R2 means visible tumour left behind. R0 is what 'complete resection' means.","route":"/terms/resection-margins/","kind":"term","cancerIcon":"breast-cancer","facets":{"kind":["Term"],"cancers":["Breast cancer","Skin cancer","Basal cell carcinoma","Cutaneous squamous cell carcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."},{"label":"Skin cancer","href":"/cancers/skin-cancer/","tip":"Skin cancer covers the very common and rarely dangerous basal cell and squamous cell carcinomas, the less common but more serious melanoma, and rarer tumours such as Merkel cell carcinoma and Kaposi sarcoma. Almost all of it is caused by ultraviolet light and most of it is found and cured by simple surgery."},{"label":"Basal cell carcinoma","href":"/cancers/basal-cell-carcinoma/","tip":"Basal cell carcinoma is a skin cancer and the most common cancer of all, caused by sun exposure and almost never life-threatening. Nearly all are removed surgically; the rare advanced cases are treated with drugs that block the hedgehog signalling pathway, and with immunotherapy if those fail."},{"label":"Cutaneous squamous cell carcinoma","href":"/cancers/cutaneous-scc/","tip":"Cutaneous squamous cell carcinoma is a sun-related skin cancer with over a million US cases a year, almost all cured by removing them. The 2 to 5% that grow deep or spread respond to PD-1 immunotherapy (cemiplimab, pembrolizumab), which is now also given after surgery in high-risk cases; transplant recipients cannot safely receive it."}],"tags":[]},"sortKeys":{"year":0}},{"id":"respiratory-gating-tumour-tracking-systems","name":"Respiratory gating and tumour tracking systems (RPM, ABC, Calypso, Synchrony)","tldr":"Hardware that copes with tumours that move when the patient breathes: belts and cameras that switch the beam on only in part of the breathing cycle, devices that hold the breath, and implanted beacons or X-ray tracking that let the beam follow the tumour.","route":"/technologies/respiratory-gating-tumour-tracking-systems/","status":"established","kind":"technology","schematic":{"id":"respiratory-gating-tumour-tracking-systems","sections":["radiation","devices"]},"facets":{"kind":["Technology"],"cancers":["Non-small-cell lung cancer","Hepatocellular carcinoma","Pancreatic ductal adenocarcinoma","Breast cancer","Prostate cancer"],"year":["2000"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."},{"label":"Hepatocellular carcinoma","href":"/cancers/hcc/","tip":"Liver cancer almost always grows in a liver already damaged by hepatitis, alcohol or fatty liver disease. It is one of the most preventable cancers, and since 2020 immunotherapy combinations have roughly doubled how long people with advanced disease live."},{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."}],"year":{"facet":"year","value":"2000"},"tags":[{"label":"machines-wave2","href":"/tagged/machines-wave2/","tip":"Every record tagged machines-wave2."}]},"sortKeys":{"year":2000}},{"id":"respiratory-motion-management","name":"Respiratory motion management (4D-CT, gating, breath-hold, tracking)","tldr":"Ways of dealing with tumours that move as the patient breathes: image the motion, treat only in part of the breathing cycle, hold the breath, or chase the tumour with the beam.","route":"/technologies/respiratory-motion-management/","status":"established","kind":"technology","schematic":{"id":"respiratory-motion-management","sections":["radiation"]},"facets":{"kind":["Technology"],"cancers":["Non-small-cell lung cancer","Hepatocellular carcinoma","Pancreatic ductal adenocarcinoma"],"year":["2000"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."},{"label":"Hepatocellular carcinoma","href":"/cancers/hcc/","tip":"Liver cancer almost always grows in a liver already damaged by hepatitis, alcohol or fatty liver disease. It is one of the most preventable cancers, and since 2020 immunotherapy combinations have roughly doubled how long people with advanced disease live."},{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."}],"year":{"facet":"year","value":"2000"},"tags":[{"label":"radiation-wave1","href":"/tagged/radiation-wave1/","tip":"Every record tagged radiation-wave1."}]},"sortKeys":{"year":2000}},{"id":"robotic-surgery","name":"Robotic & minimally invasive surgery","tldr":"Surgeons operate through small incisions using robotic arms with tremor-free precision and 3D vision.","route":"/technologies/robotic-surgery/","status":"standard-of-care","kind":"technology","schematic":{"id":"robotic-surgery","sections":["surgery"]},"facets":{"kind":["Technology"],"cancers":["Prostate cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Prostate cancer","href":"/cancers/prostate/","tip":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype."}],"tags":[]},"sortKeys":{"year":0}},{"id":"sbrt","name":"SBRT / SABR (stereotactic radiotherapy)","tldr":"Stereotactic body radiotherapy converges multiple beams with sub-millimetre accuracy to deliver tumour-destroying doses in one to five outpatient sessions, doing the job of surgery for inoperable early lung cancer and for metastases in liver, spine and brain. Tumour size and location limit its use, and late toxicity is a concern near the central airways.","route":"/technologies/sbrt/","status":"standard-of-care","kind":"technology","schematic":{"id":"sbrt","sections":["radiation"]},"facets":{"kind":["Technology"],"cancers":["Lung cancer","Non-small-cell lung cancer","Small-cell lung cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Lung cancer","href":"/cancers/lung-cancer/","tip":"Lung cancer splits into non-small-cell disease, about 85 percent of it, and small-cell disease, which was 6.6 percent of English cases in 2024 and 9.1 percent of Welsh ones (National Lung Cancer Audit, State of the Nation 2026); the two behave and are treated very differently. Screening, staging and the things both types share are common ground; the rest belongs to each subtype."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."},{"label":"Small-cell lung cancer","href":"/cancers/sclc/","tip":"A fast-growing lung cancer. About a third of cases are confined to one side of the chest and are treated to cure with chemotherapy and radiotherapy together; the rest respond to chemotherapy and relapse quickly. After 30 years without progress, durvalumab consolidation, the T-cell engager tarlatamab and antibody-drug conjugates have each lengthened survival since 2024."}],"tags":[]},"sortKeys":{"year":0}},{"id":"sentinel-node","name":"Sentinel lymph node biopsy","tldr":"Removing just the first lymph node a tumour drains to, instead of all of them, to check for spread.","route":"/technologies/sentinel-node/","status":"standard-of-care","kind":"technology","schematic":{"id":"sentinel-node","sections":["surgery"]},"facets":{"kind":["Technology"],"cancers":["Triple-negative breast cancer","HR-positive / HER2-negative breast cancer","Melanoma","Breast cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."},{"label":"HR-positive / HER2-negative breast cancer","href":"/cancers/breast-hr-positive/","tip":"HR-positive breast cancer is the most common breast cancer, driven by oestrogen. It was treated for years with hormone-blocking pills, now joined by CDK4/6 inhibitors, PI3K-pathway drugs, degraders, and ADCs."},{"label":"Melanoma","href":"/cancers/melanoma/","tip":"The skin cancer that proved immunotherapy works: half of advanced patients now live 10 years. Also the first with an approved TIL therapy, an oncolytic virus, and a positive phase 3 personalised vaccine."},{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."}],"tags":[]},"sortKeys":{"year":0}},{"id":"sentinel-lymph-node-biopsy","name":"Sentinel node biopsy","tldr":"Finding and removing the first one or two lymph nodes a tumour drains to, to see whether cancer has spread, instead of removing the whole nodal basin.","route":"/terms/sentinel-lymph-node-biopsy/","kind":"term","schematic":{"id":"sentinel-node","sections":["surgery"]},"facets":{"kind":["Term"],"cancers":["Breast cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."}],"tags":[]},"sortKeys":{"year":0}},{"id":"paper-shiva-off-label-targeted-therapy-lancet-oncol-2015","name":"SHIVA: molecularly targeted therapy based on tumour molecular profiling versus conventional therapy for advanced cancer","tldr":"The one randomised test of giving people a targeted drug matched to their tumour's mutation but outside its licence found they did no better than with their doctor's choice of treatment.","route":"/key-papers/paper-shiva-off-label-targeted-therapy-lancet-oncol-2015/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=thelancet.com&sz=128","sub":"Le Tourneau C, Delord JP, Gonçalves A, et al. · The Lancet Oncology 2015","facets":{"kind":["Key paper"],"cancers":[],"year":["2015"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[],"year":{"facet":"year","value":"2015"},"tags":[{"label":"failure","href":"/tagged/failure/","tip":"Every record tagged failure."}]},"sortKeys":{"year":2015}},{"id":"sbrt-term","name":"Stereotactic body radiotherapy (SBRT / SABR)","tldr":"A course of one to five large, pinpoint-accurate radiation doses that destroy a tumour outside the brain almost like surgery, for patients who cannot or prefer not to have an operation. It is standard for inoperable early lung cancer and the backbone of oligometastatic treatment; toxicity is mostly to whatever lies within a centimetre of the target.","route":"/terms/sbrt-term/","kind":"term","schematic":{"id":"sbrt","sections":["radiation"]},"facets":{"kind":["Term"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"radiosurgery-srs","name":"Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS)","tldr":"A single very high dose, or a few doses, aimed at a small brain or spine target with millimetre precision, replacing whole-brain radiotherapy for most brain metastases.","route":"/technologies/radiosurgery-srs/","status":"established","kind":"technology","schematic":{"id":"radiosurgery-srs","sections":["radiation"]},"facets":{"kind":["Technology"],"cancers":["Brain and spinal cord tumours","Metastatic cancer","Brain metastases","Meningioma","Vestibular schwannoma","Spinal cord tumours"],"year":["1968"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Brain and spinal cord tumours","href":"/cancers/brain-tumours/","tip":"Brain and spinal cord tumours range from slow-growing meningiomas and low-grade gliomas to glioblastoma, the commonest malignant brain tumour in adults, and a distinct set of childhood tumours such as medulloblastoma and diffuse midline glioma. Molecular markers now define them, and treatment is surgery, radiotherapy and, for some, drugs chosen by those markers."},{"label":"Metastatic cancer","href":"/cancers/metastatic-cancer/","tip":"Metastatic cancer means the original cancer has spread to other parts of the body, most often the bones, liver, lungs or brain. It keeps the name of where it started, is treated with therapies that reach the whole body, and can increasingly be controlled for years; with limited spread it is sometimes treated with the aim of cure."},{"label":"Brain metastases","href":"/cancers/secondary-brain-tumours/","tip":"Brain metastases are cancers that have spread to the brain from elsewhere, most often from the lung, breast or skin. Focused radiation aimed at each spot (radiosurgery) has largely replaced radiation to the whole brain, and for some cancers modern targeted drugs and immunotherapy reach the brain well enough to shrink the deposits on their own."},{"label":"Meningioma","href":"/cancers/meningioma/","tip":"Meningiomas grow from the membranes covering the brain and spinal cord rather than from the brain itself. Most are slow and benign and are either watched or removed; radiotherapy or radiosurgery treats what surgery cannot reach or what grows back, and no drug has yet been approved for them."}],"year":{"facet":"year","value":"1968"},"tags":[{"label":"radiation-wave1","href":"/tagged/radiation-wave1/","tip":"Every record tagged radiation-wave1."}]},"sortKeys":{"year":1968}},{"id":"stereotactic-radiosurgery","name":"Stereotactic radiosurgery (SRS)","tldr":"A single high dose of radiation delivered to a brain tumour or metastasis by beams converging from all sides, so the target gets a destructive dose while the surrounding brain gets little; no scalpel is involved despite the name. It treats metastases up to about 3-4 cm and has replaced whole-brain radiotherapy for limited disease because it spares cognition.","route":"/terms/stereotactic-radiosurgery/","kind":"term","schematic":{"id":"sbrt","sections":["radiation"]},"facets":{"kind":["Term"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"surface-guided-radiotherapy","name":"Surface-guided radiotherapy (SGRT)","tldr":"Cameras track the patient's skin surface in three dimensions during treatment, replacing tattoos and pausing the beam if the patient moves.","route":"/technologies/surface-guided-radiotherapy/","status":"established","kind":"technology","schematic":{"id":"surface-guided-radiotherapy","sections":["radiation"]},"facets":{"kind":["Technology"],"cancers":["HR-positive / HER2-negative breast cancer","HER2-positive breast cancer","Triple-negative breast cancer"],"year":["2010"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"HR-positive / HER2-negative breast cancer","href":"/cancers/breast-hr-positive/","tip":"HR-positive breast cancer is the most common breast cancer, driven by oestrogen. It was treated for years with hormone-blocking pills, now joined by CDK4/6 inhibitors, PI3K-pathway drugs, degraders, and ADCs."},{"label":"HER2-positive breast cancer","href":"/cancers/breast-her2-positive/","tip":"HER2-positive breast cancer was once the most aggressive subtype and is now one of the most treatable, thanks to trastuzumab and, more recently, Enhertu."},{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."}],"year":{"facet":"year","value":"2010"},"tags":[{"label":"radiation-wave1","href":"/tagged/radiation-wave1/","tip":"Every record tagged radiation-wave1."}]},"sortKeys":{"year":2010}},{"id":"targeted-axillary-dissection","name":"Targeted axillary dissection","tldr":"When chemotherapy is given before surgery, the surgeon marks the lymph node that was known to contain cancer with a clip before treatment starts, then removes that exact node afterwards along with the sentinel nodes. It is the difference between missing leftover cancer one time in ten and one time in fifty.","route":"/terms/targeted-axillary-dissection/","kind":"term","schematic":{"id":"sentinel-node","sections":["surgery"]},"facets":{"kind":["Term"],"cancers":["Breast cancer","HR-positive / HER2-negative breast cancer","HER2-positive breast cancer","Triple-negative breast cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Breast cancer","href":"/cancers/breast-cancer/","tip":"Breast cancer is not one disease, and the result that decides which page you need is the receptor result: whether the cancer carries oestrogen and progesterone receptors, and whether it carries too much HER2. Those two answers give four boxes, not three, with a page for each. Grade and stage do not change which page you read; they change what happens on it."},{"label":"HR-positive / HER2-negative breast cancer","href":"/cancers/breast-hr-positive/","tip":"HR-positive breast cancer is the most common breast cancer, driven by oestrogen. It was treated for years with hormone-blocking pills, now joined by CDK4/6 inhibitors, PI3K-pathway drugs, degraders, and ADCs."},{"label":"HER2-positive breast cancer","href":"/cancers/breast-her2-positive/","tip":"HER2-positive breast cancer was once the most aggressive subtype and is now one of the most treatable, thanks to trastuzumab and, more recently, Enhertu."},{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."}],"tags":[]},"sortKeys":{"year":0}},{"id":"idea-tr1-pre-emptive-pharmacogenomic-testing","name":"Test DPYD, UGT1A1 and TPMT/NUDT15 before the first dose, everywhere","tldr":"A cheap gene test for DPYD, UGT1A1 and TPMT or NUDT15 before fluoropyrimidines, irinotecan or thiopurines identifies people at risk of severe or fatal toxicity so their dose can be lowered. The EMA has recommended DPD testing since 2020; US uptake remains partial.","route":"/ideas/idea-tr1-pre-emptive-pharmacogenomic-testing/","kind":"idea","cancerIcon":"colorectal","facets":{"kind":["Idea"],"cancers":["Colorectal cancer","Gastric & gastro-oesophageal junction cancer","Pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Idea","tip":"Hypotheses and new directions, linked to the evidence."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Gastric & gastro-oesophageal junction cancer","href":"/cancers/gastric/","tip":"A cancer with three new targets in five years: Claudin 18.2, FGFR2b, and HER2 with new ADCs, plus immunotherapy in first line."},{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."}],"tags":[{"label":"protocol-upgrade","href":"/tagged/protocol-upgrade/","tip":"Every record tagged protocol-upgrade."},{"label":"upgrade:proven-unevenly-used","href":"/tagged/upgrade-proven-unevenly-used/","tip":"Every record tagged upgrade:proven-unevenly-used."}]},"sortKeys":{"year":0}},{"id":"paper-smyth-dibh-cardiac-sparing-review-jmrs-2015","name":"The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review","tldr":"A review of ten studies comparing radiotherapy plans for left breast cancer made in deep breath-hold and in free breathing. Breath-hold cut the average heart dose by up to 3.4 Gy, which on published dose-risk estimates corresponds to a 13.6 per cent smaller projected rise in heart disease risk.","route":"/key-papers/paper-smyth-dibh-cardiac-sparing-review-jmrs-2015/","kind":"paper","sub":"Smyth LM, Knight KA, Aarons YK, Wasiak J. · Journal of Medical Radiation Sciences 2015","facets":{"kind":["Key paper"],"cancers":["HR-positive / HER2-negative breast cancer","HER2-positive breast cancer","Triple-negative breast cancer"],"year":["2015"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[{"label":"HR-positive / HER2-negative breast cancer","href":"/cancers/breast-hr-positive/","tip":"HR-positive breast cancer is the most common breast cancer, driven by oestrogen. It was treated for years with hormone-blocking pills, now joined by CDK4/6 inhibitors, PI3K-pathway drugs, degraders, and ADCs."},{"label":"HER2-positive breast cancer","href":"/cancers/breast-her2-positive/","tip":"HER2-positive breast cancer was once the most aggressive subtype and is now one of the most treatable, thanks to trastuzumab and, more recently, Enhertu."},{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."}],"year":{"facet":"year","value":"2015"},"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":2015}},{"id":"paper-van-herk-ptv-margin-recipe-ijrobp-2000","name":"The probability of correct target dosage: dose-population histograms for deriving treatment margins in radiotherapy","tldr":"The paper behind the margin most radiotherapy departments add around a target. It showed that errors repeated every day matter far more than errors that vary day to day, and turned that into a formula: a margin of 2.5 times the systematic error plus 0.7 times the random error.","route":"/key-papers/paper-van-herk-ptv-margin-recipe-ijrobp-2000/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=redjournal.org&sz=128","sub":"van Herk M, Remeijer P, Rasch C, Lebesque JV. · International Journal of Radiation Oncology, Biology, Physics 2000","facets":{"kind":["Key paper"],"cancers":[],"year":["2000"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[],"year":{"facet":"year","value":"2000"},"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":2000}},{"id":"paper-heartspare-stage-ii-clin-oncol-2017","name":"The UK HeartSpare Study (Stage II): multicentre evaluation of a voluntary breath-hold technique in patients receiving breast radiotherapy","tldr":"In ten UK centres, women having radiotherapy for left breast cancer were taught to hold a deep breath during treatment without any machine to help. Ninety-five per cent had a lower heart dose as a result, and the average heart dose fell from 1.8 to 1.1 Gy.","route":"/key-papers/paper-heartspare-stage-ii-clin-oncol-2017/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=clinicaloncologyonline.net&sz=128","sub":"Bartlett FR, Donovan EM, McNair HA, et al. · Clinical Oncology 2017","facets":{"kind":["Key paper"],"cancers":["HR-positive / HER2-negative breast cancer","HER2-positive breast cancer","Triple-negative breast cancer"],"year":["2017"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[{"label":"HR-positive / HER2-negative breast cancer","href":"/cancers/breast-hr-positive/","tip":"HR-positive breast cancer is the most common breast cancer, driven by oestrogen. It was treated for years with hormone-blocking pills, now joined by CDK4/6 inhibitors, PI3K-pathway drugs, degraders, and ADCs."},{"label":"HER2-positive breast cancer","href":"/cancers/breast-her2-positive/","tip":"HER2-positive breast cancer was once the most aggressive subtype and is now one of the most treatable, thanks to trastuzumab and, more recently, Enhertu."},{"label":"Triple-negative breast cancer","href":"/cancers/tnbc/","tip":"A breast cancer that lacks the three receptors (oestrogen, progesterone, HER2) that other breast cancers can be treated through. It was the hardest subtype for decades; since 2020 immunotherapy and ADCs have changed that."}],"year":{"facet":"year","value":"2017"},"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":2017}},{"id":"tmb-high","name":"TMB-high (tumour mutational burden >= 10 mutations per megabase)","tldr":"TMB counts how many mutations a tumour carries per million DNA letters. Ten or more, measured by FoundationOne CDx, allows pembrolizumab for almost any solid tumour after other treatment has failed.","route":"/biomarkers/tmb-high/","kind":"biomarker","sub":"Genome-wide readout","facets":{"kind":["Biomarker"],"cancers":["Metastatic cancer","Non-small-cell lung cancer","Melanoma","Bladder & urothelial cancer","Triple-negative breast cancer","Metastatic triple-negative breast cancer","Pancreatic ductal adenocarcinoma","Colorectal cancer","Gallbladder cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Biomarker","tip":"The readouts a pathology report gives (PD-L1 CPS, HER2 IHC 3+, MSI-high), each under its gene or protein, with the thresholds approvals use and the tests that measure them."},"cancers":[{"label":"Metastatic cancer","href":"/cancers/metastatic-cancer/","tip":"Metastatic cancer means the original cancer has spread to other parts of the body, most often the bones, liver, lungs or brain. It keeps the name of where it started, is treated with therapies that reach the whole body, and can increasingly be controlled for years; with limited spread it is sometimes treated with the aim of cure."},{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."},{"label":"Melanoma","href":"/cancers/melanoma/","tip":"The skin cancer that proved immunotherapy works: half of advanced patients now live 10 years. Also the first with an approved TIL therapy, an oncolytic virus, and a positive phase 3 personalised vaccine."},{"label":"Bladder & urothelial cancer","href":"/cancers/urothelial/","tip":"Bladder cancer went from 40 years of cisplatin to an ADC-immunotherapy combination that nearly doubled survival, and in 2026 the first blood-test-guided drug approval."}],"tags":[{"label":"biomarker","href":"/tagged/biomarker/","tip":"Every record tagged biomarker."},{"label":"genome-wide","href":"/tagged/genome-wide/","tip":"Every record tagged genome-wide."}]},"sortKeys":{"year":0}},{"id":"tpmt-nudt15-genotyping","name":"TPMT and NUDT15 genotyping before thiopurines","tldr":"Before children and adults with acute lymphoblastic leukaemia start two years of daily mercaptopurine, two genes are checked; carriers of low-activity variants need a fraction of the standard dose or their bone marrow shuts down within weeks.","route":"/technologies/tpmt-nudt15-genotyping/","status":"standard-of-care","kind":"technology","schematic":{"id":"tpmt-nudt15-genotyping","sections":["diagnostics","chemotherapy","supportive-care"]},"facets":{"kind":["Technology"],"cancers":["Acute lymphoblastic leukaemia","Childhood cancers","Leukaemia"],"year":["2011"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Acute lymphoblastic leukaemia","href":"/cancers/all-leukemia/","tip":"Acute lymphoblastic leukaemia is the childhood cancer success story, and was the first disease treated with CAR-T and with a T-cell engager."},{"label":"Childhood cancers","href":"/cancers/childhood-cancers/","tip":"Cancer in children is rare and different from adult cancer: the common types are leukaemias, brain tumours, lymphomas and embryonal tumours such as neuroblastoma and Wilms tumour, most are curable in well-resourced health systems, and the great challenge is bringing the same cures to the majority of children who live where they are not available."},{"label":"Leukaemia","href":"/cancers/leukaemia/","tip":"Leukaemia means cancer of the blood-forming cells, but the four main types share little beyond the name: acute lymphoblastic and acute myeloid leukaemia are emergencies treated with intensive therapy, while chronic lymphocytic and chronic myeloid leukaemia are slow diseases controlled for years with pills. Each has its own page."}],"year":{"facet":"year","value":"2011"},"tags":[]},"sortKeys":{"year":2011}},{"id":"paper-abbosh-tracerx-ctdna-relapse-nature-2023","name":"Tracking early lung cancer metastatic dissemination in TRACERx using ctDNA","tldr":"Tracking about 200 of each patient's own tumour mutations in blood after lung cancer surgery found tumour DNA in half of those who later relapsed from one sample, and in more with repeated testing.","route":"/key-papers/paper-abbosh-tracerx-ctdna-relapse-nature-2023/","kind":"paper","logo":"/logos/nature.svg","sub":"Abbosh C, Frankell AM, Harrison T, et al. · Nature 2023","facets":{"kind":["Key paper"],"cancers":["Non-small-cell lung cancer"],"year":["2023"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"year":{"facet":"year","value":"2023"},"tags":[]},"sortKeys":{"year":2023}},{"id":"tmb-testing","name":"Tumour mutational burden testing","tldr":"Counting how many mutations a tumour carries per stretch of DNA; heavily mutated tumours are more likely to respond to immunotherapy.","route":"/technologies/tmb-testing/","status":"established","kind":"technology","schematic":{"id":"tmb-testing","sections":["diagnostics"]},"facets":{"kind":["Technology"],"cancers":["Non-small-cell lung cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Non-small-cell lung cancer","href":"/cancers/nsclc/","tip":"Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story."}],"tags":[]},"sortKeys":{"year":0}},{"id":"tumour-informed-assay","name":"Tumour-informed versus tumour-naive ctDNA assays","tldr":"A tumour-informed blood test is built for one patient: the tumour is sequenced first and the test then hunts for that patient's own mutations in blood. A tumour-naive test uses the same fixed panel, often of methylation marks, for everyone, so it needs no tumour sample and returns faster.","route":"/terms/tumour-informed-assay/","kind":"term","schematic":{"id":"mrd-testing","sections":["diagnostics"]},"facets":{"kind":["Term"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"ugt1a1-genotyping","name":"UGT1A1 genotyping before irinotecan","tldr":"A gene test that finds people who clear irinotecan's active form slowly because of a common variant in the UGT1A1 enzyme, the same variant behind harmless Gilbert syndrome; they run a higher risk of severe diarrhoea and low white cells at full dose.","route":"/technologies/ugt1a1-genotyping/","status":"established","kind":"technology","schematic":{"id":"ugt1a1-genotyping","sections":["diagnostics","chemotherapy","supportive-care"]},"facets":{"kind":["Technology"],"cancers":["Colorectal cancer","Pancreatic ductal adenocarcinoma","Gastric & gastro-oesophageal junction cancer","Small-cell lung cancer","Triple-negative breast cancer","Bladder & urothelial cancer"],"year":["2005"]},"cols":{"kind":{"facet":"kind","value":"Technology","tip":"Every way we see, measure, or attack a tumour, explained."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Gastric & gastro-oesophageal junction cancer","href":"/cancers/gastric/","tip":"A cancer with three new targets in five years: Claudin 18.2, FGFR2b, and HER2 with new ADCs, plus immunotherapy in first line."},{"label":"Small-cell lung cancer","href":"/cancers/sclc/","tip":"A fast-growing lung cancer. About a third of cases are confined to one side of the chest and are treated to cure with chemotherapy and radiotherapy together; the rest respond to chemotherapy and relapse quickly. After 30 years without progress, durvalumab consolidation, the T-cell engager tarlatamab and antibody-drug conjugates have each lengthened survival since 2024."}],"year":{"facet":"year","value":"2005"},"tags":[]},"sortKeys":{"year":2005}},{"id":"paper-favaudon-flash-mice-sci-transl-med-2014","name":"Ultrahigh dose-rate FLASH irradiation increases the differential response between normal and tumor tissue in mice","tldr":"The mouse study that started modern FLASH research. Radiation given in a fraction of a second spared the lungs of mice from scarring at doses that scarred them when given at the usual rate, while controlling tumours just as well. It was in mice, and the effect in people has not been shown.","route":"/key-papers/paper-favaudon-flash-mice-sci-transl-med-2014/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=science.org&sz=128","sub":"Favaudon V, Caplier L, Monceau V, et al. · Science Translational Medicine 2014","facets":{"kind":["Key paper"],"cancers":[],"year":["2014"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[],"year":{"facet":"year","value":"2014"},"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":2014}},{"id":"paper-vinod-delineation-uncertainty-review-radiother-oncol-2016","name":"Uncertainties in volume delineation in radiation oncology: a systematic review and recommendations for future studies","tldr":"A review of 119 studies in which several clinicians drew the same radiotherapy targets. The studies measured the disagreement in so many different ways that they could not be combined, and only 21 per cent checked what it did to the dose.","route":"/key-papers/paper-vinod-delineation-uncertainty-review-radiother-oncol-2016/","kind":"paper","logo":"https://www.google.com/s2/favicons?domain=thegreenjournal.com&sz=128","sub":"Vinod SK, Jameson MG, Min M, Holloway LC. · Radiotherapy and Oncology 2016","facets":{"kind":["Key paper"],"cancers":[],"year":["2016"]},"cols":{"kind":{"facet":"kind","value":"Key paper","tip":"The papers that changed practice or thinking, each explained: what it found, what it means, and what to be careful about."},"cancers":[],"year":{"facet":"year","value":"2016"},"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":2016}},{"id":"target-delineation-variability","name":"Variation between clinicians in drawing the radiotherapy target","tldr":"Before a radiotherapy plan can be made, a doctor draws the tumour and the organs around it on the planning scan, and two doctors given the same scan do not draw the same outline. A 2016 review found 119 studies measuring this across every major cancer site, and only one in five checked what the differences did to the dose.","route":"/terms/target-delineation-variability/","kind":"term","schematic":{"id":"auto-contouring-ai","sections":["radiation","ai-computation"]},"facets":{"kind":["Term"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[],"tags":[{"label":"radiation","href":"/tagged/radiation/","tip":"Every record tagged radiation."}]},"sortKeys":{"year":0}}]