Radiotherapy has an established role in the treatment of many patients with cancer, with evidence suggesting that this modality can also have immunostimulatory effects in certain scenarios. More recently, evidence has emerged supporting a role of the microbiome in influencing the incidence and severity of toxicities in patients receiving radiotherapy as well as in mediating possible synergy with other therapeutic interventions, including immunotherapy. In this Review, the authors explore the clinical potential of these emerging relationships.

This Review synthesizes the current understanding of host–microbiota dynamics in patients with cancer and proposes to integrate microbiota management approaches guided by ecological principles in cancer care. Mathematical ecology could help to predict the risk of microbiota-related complications and guide treatment choices that minimize disturbance to microbial ecosystems, ultimately informing microbiota-targeted interventions that could improve responses to cancer treatments.

MET mutations, amplifications and fusions and MET overexpression are promising therapeutic targets across various cancers. In this Review, the authors summarize the prevalence, molecular diagnosis and prognostic implications of these alterations and discuss the clinical efficacy and toxicity profiles of diverse MET-targeted therapies, including tyrosine-kinase inhibitors, monoclonal or bispecific antibodies and antibody–drug conjugates.

In these Evidence-Based Guidelines, a multidisciplinary panel of experts from the European Hematology Association and the European Myeloma Network provide key treatment recommendations for patients with smouldering multiple myeloma, and newly diagnosed or relapsed and/or refractory multiple myeloma, addressing the use of established drugs and novel immunotherapies as well as the management of disease-specific and treatment-related complications and adverse events.

Some of the most consequential conflicts in oncology and medicine overall are not financial; these remain poorly defined and weakly regulated. Here we offer a policy-relevant definition and examine how reputation, ambition, ideology and institutional loyalty can shape research, guidelines, policy and hiring decisions. We argue for structural safeguards to preserve trust in medicine.

Drug-induced interstitial lung disease (DIILD) is emerging as a hidden toll of modern oncology. Diagnosis of DIILD is confounded by non-specific symptoms and the absence of validated biomarkers, leaving clinicians to navigate heterogeneous, drug-specific guidelines. Herein, we discuss this predicament and advocate a shift from reactive management towards proactive survivorship.