Hello Nature readers,

This week, we explore a new off-the-shelf CAR T-cell therapy that has been tested in phase I clinical trials, learn that 'inflammatory memory' seems to play a part in drug resistance in tumours, and hear that scientists have taught ants to sniff out cancer.

Supercharged T cells to the rescue!

When researcher Crystal Mackall first heard about engineering T cells to attack cancer, she couldn't believe her ears. A paediatric oncologist in the audience turned to the person next to her and said: "No way. That's too crazy." Now, more than 500 clinical trials of cancer-killing T-cell therapies are underway — and Mackall is developing one to treat brain cancer.

TB vaccine for cancer prevention?

The bacillus Calmette–Guérin (BCG) vaccine against tuberculosis (TB), which is hardly used in developed countries these days, seems to protect against cancer, Alzheimer's and many infectious diseases. A study in Native Americans found that those who had received the BCG vaccine as children had a reduced risk of lung cancer as adults — and 60 years after the trial began, the incidence was 2.5-fold lower in this group. In another study, people with bladder cancer who were treated with BCG as an immunotherapy had a fourfold lower risk of developing Alzhiemer's disease over eight years of follow-up. The evidence is mostly observational, however, and researchers don't agree on whether we should bring the BCG vaccine back for diseases other than TB. "I've never come across a topic that is more polarizing," says pediatric infectious-diseases physician Nigel Curtis.

The KRAS craze

After decades of searching for a way to latch onto a slippery cancer protein called KRAS, two inhibitors have been approved by the US Food and Drug Administration — and a dozen or so more are in the pipeline. These include pan-KRAS drugs, a molecular 'glue' that sticks to the KRAS protein and a drug that uses the cell's trash-disposal system to degrade the protein. (This story includes a handy list of all the KRAS inhibitors in the works.)

Are we being too 'tumour-centric'?

Although there is now some understanding of the role of lifestyle, hormones, ageing, metabolism, diet and microbiota in cancer biology, "the view of cancer has remained tumour-centric", physician Laurence Zitvogel and her co-authors write. "We advocate for a whole-body 'ecological' exploration of malignant disease." The authors argue that cancer treatments should go beyond agents that target the tumour and its microenvironment, and take a holistic approach using lifestyle interventions, nutritional and psychiatric counselling and drugs.

Donor CAR T cells tested in humans

An off-the-shelf chimeric antigen receptor (CAR) T-cell therapy for multiple myeloma has been tested in humans for the first time, and seems to be safe. This kind of treatment usually involves extracting a person's own immune cells and modifying them to attack their cancer. But that's expensive, so researchers have been looking for ways to use T cells donated from healthy people instead. In a trial published last month, one of these 'universal' CAR-T-cell therapies — ALLO-715 — was tested in 43 people with multiple myeloma. More than half of the people in the trial had a response. The trial "represents steady progress on the long road to clinical use", write cancer researchers Jennifer Brudno and James Kochenderfer.

'Epigenetic memory' drives drug resistance

Chronic inflammation can give cancer cells an 'epigenetic memory' that makes them more resistant to treatment with immunotherapy. Prolonged signalling between proteins called interferons "initiates epigenetic changes resembling inflammatory memory", researchers report. When this was prevented in even a minority of cancer cells, the immunotherapy response improved.

World-first heart guidelines for kids with cancer

The world's first guidelines for cardiac health in children being treated for cancer will focus on how to identify at-risk kids and how to monitor them over time. Cardiac complications following therapy are a leading cause of death in these children, second only to cancer recurrence.