Cutting-edge therapies are emerging to tackle difficult cancers. The investigational drug elranatamab shows superior efficacy against relapsed multiple myeloma in UK real-world settings. Chimeric exosomes modulate lymph node immune microenvironments, enhancing triple-negative breast cancer immunotherapy responses. Additionally, metabolic interventions and natural compounds improve treatment responses in lung and head and neck cancers. These studies highlight expanding molecularly targeted and immune-based therapeutic avenues.