Patients with meningioma, the most common type of intracranial primary tumour, have been traditionally managed with surgery and radiotherapy, although advances over the past decade have brought about promising novel treatment options. In addition, new molecularly driven classification tools can improve prognostic accuracy and guide personalized management decisions. The authors of this Review provide an integrated roadmap for meningioma care as well as a framework for ongoing and future research in this field.

Rare lymphoproliferative and lymphomatous disorders occurring after chimeric antigen receptor (CAR) T cell therapy are garnering increased attention but remain incompletely characterized, complicating early recognition and management. This Review describes the spectrum of post-CAR T cell therapy lymphoproliferations reported so far, highlighting recurrent pathological and molecular features as well as factors implicated in promoting clonal expansion and/or malignant transformation, which might provide a framework to improve the diagnosis and management of these disorders.

Long considered undruggable, hypoxia-inducible factor 2α (HIF2α) has now been validated as a therapeutic target in several cancers. This Review discusses the structural basis for HIF2α druggability, the clinical results to date and key challenges, including toxicities and the need for predictive biomarkers, as well as emerging targeting modalities and combination strategies that might enhance efficacy, overcome resistance and broaden indications for HIF2 inhibition.

Myelodysplastic neoplasms (MDS) comprise a heterogeneous group of malignancies that can lead to ineffective haematopoiesis, cytopenias and, potentially, progression to acute myeloid leukaemia. In this Review, the authors describe the epidemiology of MDS, which appears to be rising, as well as advances in diagnosis, risk stratification and clinical management.

Since the introduction of vaping with electronic cigarettes in the late 2000s, controversy has continued to exist regarding the risks and benefits. Many studies indicate that electronic cigarettes are an effective smoking-cessation tool. Now, a large database analysis by Kim et al. provides a glimpse of the risks of lung cancer for smokers who quit with versus without vaping.

Crossover in trials should not be viewed as confounding, but as informative. Crossover reveals whether deferring therapy produces outcomes comparable to those from earlier use. Statistical crossover-adjustment methods carry unaccounted biases and limited clinical utility. Crossover should instead guide treatment-sequencing decisions, weighing toxicity and cost against any overall survival benefit from earlier intervention.

Modern oncology has built highly efficient pathways for patent-protected innovation, but no equivalent machinery for evaluating and developing promising off-patent therapeutics. Herein, we frame ‘open-source oncology’ as a parallel public-interest infrastructure to test, authorize and implement credible generic agents. Designed to translate ownerless evidence into standard-of-care treatments, this framework applies the same scientific seriousness devoted to proprietary drugs, decoupling clinical value from commercial ownership.