Oncology Updates

[News] Saint Lucia launches national cancer registry https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00401-8/fulltext?rss=yes The eastern Caribbean island nation of Saint Lucia has launched a national population-based cancer registry, 7 years after first announcing plans to establish one, as it seeks to replace fragmented records and modelled estimates with systematic data on cancer incidence. The registry comes as the country develops a cancer control plan, but its usefulness will depend on complete case reporting, specialist staff, sustained financing, and whether the resulting data influence policy making.

[News] New liver cancer medicine fast-tracked by UK Government https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00400-6/fulltext?rss=yes A new medicine for hepatocellular liver cancer has been granted an Innovation Passport through the UK's Innovative Licensing and Access Pathway (ILAP), the Medicines and Healthcare products Regulatory Agency (MHRA) announced last week.

[News] UK–Japan research collaboration for cancers in children and young people https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00392-X/fulltext?rss=yes On July 28, 2026, organisations from the UK and Japan announced a partnership that will provide funding opportunities for international collaborative clinical trials aimed at developing innovative treatments for cancers affecting children and young people (CYP).

[News] 2030 hepatitis elimination targets might be missed in Europe https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00393-1/fulltext?rss=yes Europe is set to miss the WHO target to eliminate viral hepatitis as a public health threat by 2030 despite progress in screening because of gaps in vaccination and reaching key populations, according to the European Centre for Disease Prevention and Control (ECDC).

[News] Sweden plans to restrict PFAS https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00382-7/fulltext?rss=yes On July 23, 2026, the Government of Sweden announced plans to prohibit perfluoroalkyl and polyfluoroalkyl substances (PFAS), also called forever chemicals, in certain consumer products such as clothing, footwear, cosmetics, and kitchen utensils starting Jan 1, 2028. This plan will make Sweden one of the latest European countries to propose national restrictions ahead of the broader EU legislation.

[News] CARICOM moves towards regional framework for cancer https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00383-9/fulltext?rss=yes The Caribbean Community (CARICOM) is moving towards a regional framework for cancer care after calling for stronger cooperation between members, although questions remain over funding, governance, and implementation. The call followed the 14th Annual Caribbean Association for Oncology and Hematology (CAOH) Scientific Conference, held in Trinidad and Tobago, on July 17–19, 2026.

[Policy Review] Local management of second ipsilateral breast cancer events after primary breast-conserving therapy: an international Delphi consensus https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00177-4/fulltext?rss=yes Management of second ipsilateral breast cancer events (iBCEs) remains controversial, and there is a need to collate existing evidence and international guidance on patient selection and local treatment strategies. This project, endorsed by US and European surgical and radiation oncology societies, aimed to gather expert consensus on these issues. A questionnaire on second iBCE local treatment was developed and reviewed by a core group of eight experts, and Delphi methodology was applied over two rounds to 36 panellists, including radiation oncologists, breast surgeons, a plastic surgeon, and medical physicists.

[News] UK study to report cancer risk in armed services personnel https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00375-X/fulltext?rss=yes The UK Government has announced it is to conduct a study into cancer risk in armed services personnel, both past and present. The UK's Ministry of Defence says the study is part of its efforts to improve the long-term health of those who serve and have served in the armed services. The UK-wide epidemiological study (covering all four nations) will examine cancer incidence among those who have served since 1990, including some 1·4 million currently serving and veterans. No personnel will need to take action to be included in the study, as it will use existing records held in by the country's National Health Service (NHS).

[News] First Nations cancer inequalities in Canada https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00349-9/fulltext?rss=yes The expansion of colorectal cancer screening in Ontario, Canada, has coincided with new evidence showing that registered First Nations people experience higher colon cancer incidence at younger ages and poorer survival after breast, cervical, and colon cancer diagnoses than other residents.

[News] New guidelines to advocate healthy eating and physical activity in school settings in the Americas https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00348-7/fulltext?rss=yes Addressing the persistent increase in rates of overweight, obesity, and physical inactivity in children and adolescents living in the WHO Americas Region, the Pan American Health Organization (PAHO) and the Organization of American States (OAS; Washington, DC, USA) have released new guidelines to assist countries in the region in developing, executing, monitoring, and assessing policies that foster healthy eating and physical activity in school environments.

[Comment] A step forward for precision oncology in thyroid cancer https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00254-8/fulltext?rss=yes Radioactive iodine-refractory differentiated thyroid cancer remains a therapeutically challenging disease despite important advances over the last decade. Multi-kinase inhibitors targeting vascular endothelial growth factor receptor (VEGFR) signaling have improved progression-free survival compared with placebo,1–3 and these inhibitors are now considered standard of care for patients with locally advanced or metastatic disease.4 However, these therapies are associated with substantial toxicity, and durable responses remain uncommon.

[Articles] Efficacy and safety of dabrafenib plus trametinib in adults with differentiated thyroid cancer: a randomised, double-blind, placebo-controlled, phase 3 trial https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00133-6/fulltext?rss=yes In previously-treated patients with locally advanced or metastatic, radioactive iodine-refractory BRAFV600E-positive differentiated thyroid cancer, dabrafenib plus trametinib showed significant benefits for progression-free survival and overall response rate, with no new safety signals. These findings support the second-line use of dabrafenib plus trametinib in patients with radioactive iodine-refractory BRAFV600E-positive differentiated thyroid cancer.

[Comment] Now or later? Switching therapies in metastatic breast cancer https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00332-3/fulltext?rss=yes In contemporary management of patients with hormone receptor-positive, HER2-negative metastatic breast cancer, it is standard to switch therapies at tumour progression, defined by RECIST criteria in clinical trials, and by other measures (many, ironically, considered non-measurable by RECIST) in clinical practice, including subtler radiological changes, findings on examination, rising tumour markers, or increased symptoms related to cancer.1 Accordingly, in the clinic, a treatment change can be considered for symptomatic progression despite radiologically stable disease, or the same treatment might be continued beyond asymptomatic oligoprogression.

[Articles] Switching to camizestrant at ESR1 mutation emergence before disease progression during first-line treatment of hormone receptor-positive advanced breast cancer (SERENA-6): extended analysis of a double-blind, placebo-controlled, randomised, phase 3 trial https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00287-1/fulltext?rss=yes Switching to camizestrant plus CDK4/6 inhibitor at ESR1 mutation emergence, versus continuing aromatase inhibitor plus CDK4/6 inhibitor, resulted in sustained progression-free survival benefit that translated into a statistically significant improvement in second progression-free survival. These results further support switching endocrine treatment to camizestrant from aromatase inhibitor upon detection of ESR1 mutation, with continuation of any of the globally approved CDK4/6 inhibitor, to extend first-line treatment benefit.

[Articles] Single, early intravesical instillation of pirarubicin in the prevention of bladder recurrence after radical nephroureterectomy for upper tract urothelial carcinoma (JCOG1403): a multicentre, open-label, randomised, phase 3 trial https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00130-0/fulltext?rss=yes A single, postoperative pirarubicin instillation after radical nephroureterectomy is an efficacious treatment with manageable adverse events to reduce recurrence in patients with upper tract urothelial carcinoma.

[Comment] Intravesical pirarubicin after nephroureterectomy https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00204-4/fulltext?rss=yes Randomised trials in rare cancers are scarce, and those that achieve adequate enrolment and methodological rigour warrant recognition. Upper tract urothelial carcinoma, which comprises only 5–10% of urothelial malignancies, presents unique challenges for trialists because of its low incidence and heterogeneous presentation. Despite its rarity, however, upper tract urothelial carcinoma carries a disproportionately high risk of bladder recurrence after radical nephroureterectomy, affecting 22–47% of patients in contemporary series.

[Comment] Gastric cancer with peritoneal metastases: hype or hope for HIPEC? https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00234-2/fulltext?rss=yes Gastric cancer remains a major cause of cancer mortality, and prognosis is particularly poor in individuals with peritoneal metastases.1,2 Although the integration of immunotherapy and targeted agents—such as trastuzumab or zolbetuximab—into systemic chemotherapy has improved survival in selected populations,3,4 treatment for these patients remains a clinical challenge, prompting the exploration of aggressive locoregional strategies.

[Articles] Systemic therapy, gastrectomy, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy versus systemic therapy alone for gastric cancer with limited peritoneal metastases (PERISCOPE II): final results of a multicentre, randomised, controlled, phase 3 trial after an unplanned commissioned interim analysis https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00144-0/fulltext?rss=yes Gastrectomy with cytoreductive surgery and HIPEC provided no survival benefit in patients with gastric cancer and limited peritoneal metastases compared with systemic therapy alone.

[Policy Review] Somatostatin receptor PET response assessment framework for patients with neuroendocrine tumours (V1.0): a modified Delphi consensus from the European Neuroendocrine Tumor Society (endorsed by EANM and NANETS) https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00145-2/fulltext?rss=yes Somatostatin receptor PET imaging is integral to the management of patients with neuroendocrine tumours (NETs), yet standardised criteria for therapy response assessment with the use of this modality are not available. This Policy Review reports the development of the European Neuroendocrine Tumor Society somatostatin receptor PET response assessment framework, established through a structured modified Delphi process coordinated by the European Neuroendocrine Tumor Society. 34 international experts from nuclear medicine, radiology, oncology, endocrinology, surgery, and related disciplines participated in four iterative rounds evaluating 76 statements, with consensus defined as at least 75% agreement.

[Articles] Differential impact of proton pump inhibitors and antibiotics on immunotherapy efficacy after chemoradiotherapy in locally advanced non-small-cell lung cancer: a post-hoc analysis of the PACIFIC trial https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00191-9/fulltext?rss=yes Baseline exposure to proton pump inhibitors and antibiotics was associated with inferior outcomes with durvalumab, but not with placebo, consistent with potential attenuation of the benefit of durvalumab with proton pump inhibitors and antibiotics in patients with unresectable stage III NSCLC.