Nature Reviews Cardiology, Published online: 03 March 2025; doi:10.1038/s41569-025-01140-3The brain–heart axis comprises the anatomical and functional interaction between the neural and cardiovascular systems that regulate physiological, cognitive and emotional states in both health and disease. In this Review, Valenza and colleagues explore the three primary pathways of the brain–heart axis — neural, mechanical and biochemical — discussing the regulatory mechanisms generated by each individual pathway and by interactions between the pathways.

Nature Reviews Cardiology, Published online: 26 February 2025; doi:10.1038/s41569-025-01138-xIn this Review, Mocumbi and colleagues provide an overview of the determinants and pathophysiology of endomyocardial fibrosis, describe the trends in epidemiology, and highlight the need for more cost-effective diagnostic and therapeutic strategies.

Nature Reviews Cardiology, Published online: 19 February 2025; doi:10.1038/s41569-025-01130-5In this Roadmap, Stellos and colleagues discuss the mechanisms of cardiovascular system ageing and how the ageing of blood, vessels and heart relates to the decline in organ function, and highlight potential therapeutic interventions, challenges in ageing research and future directions for preclinical and clinical studies.

Nature Reviews Cardiology, Published online: 12 February 2025; doi:10.1038/s41569-025-01137-yDiffering definitions and questionable prognostic significance have caused confusion and controversy around the applicability of the current definitions of periprocedural and perioperative myocardial infarction in clinical practice. In this Clinical Outlook, we review the definitions and the clinical and prognostic relevance of the various entities and provide implications for clinical practice.

Nature Reviews Clinical Oncology, Published online: 06 March 2025; doi:10.1038/s41571-025-01000-6Immunotherapies, predominantly immune-checkpoint inhibitors and chimaeric antigen receptor T cells, have transformed oncology. Nonetheless, these systemically administered agents have several limitations, including the risk of off-target toxicities and a lack of activity owing to an inability to overcome an immunosuppressive tumour microenvironment (TME). In this Review, the authors describe the potential to overcome these challenges using functionalized nanomaterials that are designed to release a wide range of immunotherapeutic cargoes in response to specific TME characteristics, including hypoxia, differences in pH, the presence of specific enzymes, reactive oxygen species and/or high levels of extracellular ATP.

Nature Reviews Clinical Oncology, Published online: 28 February 2025; doi:10.1038/s41571-025-01003-3Single-cell RNA sequencing has transformed our understanding of the biology of cancer cells and that of nonmalignant cells present in the tumour microenvironment. However, how this new knowledge can be translated into improved outcomes for patients often remains uncertain. In this Review, the authors describe the results of single-cell RNA analyses of samples from patients with cancer with an emphasis on how the findings of these studies have, or are anticipated to lead to, improved patient outcomes, with a focus on four key aspects: refinement of tumour subtyping, characterization of treatment-induced changes, identification of gene expression programmes predictive of treatment response and resistance, and the discovery of novel therapeutic targets.

Nature Reviews Clinical Oncology, Published online: 24 February 2025; doi:10.1038/s41571-025-01004-2The thought-provoking SONIA trial showed that patients with hormone receptor-positive, HER2-negative advanced-stage breast cancer receiving deferred (second-line) versus first-line cyclin dependent-kinase (CDK) 4/6 inhibitors have noninferior progression-free survival after second-line treatment; such an approach also results in substantial cost savings. Herein, we discuss some important limitations of this trial and argue that, owing to their effect on overall survival, CDK4/6 inhibitors should remain the standard-of-care first-line therapy.

Nature Reviews Clinical Oncology, Published online: 18 February 2025; doi:10.1038/s41571-025-00992-5CD19-targeted CAR T cells have transformed the management of patients with relapsed and/or refractory large B cell lymphoma, and these therapies are increasingly being administered as earlier-line therapies. Nonetheless, the prognosis of these patients is often difficult to predict, with various prospective and real-world studies suggesting that a wide range of factors are associated with treatment outcomes. In this Review, the authors summarize these various associations as well as their implications for patient selection and management.