Molecular biomarkers, precision medicine and artificial intelligence (AI) are all contributing to rapid developments in oncology – and we are watching it in real time! Here are five areas of development in cancer prevention, diagnosis and treatment that have drawn our attention in the past few months:
mRNA vaccines in combination therapies
An mRNA vaccine for pancreatic cancer administered in combination with another immunotherapy – an immune checkpoint inhibitor – has shown preliminary promise in a small clinical study. The results from the study, published on May 10, 2023, in Nature, come hot on the heels of the February news that an mRNA vaccine for melanoma, in combination with an immune checkpoint inhibitor, received FDA breakthrough therapy designation.
Essentially, these mRNA vaccines work by training the immune system to identify proteins specific to a patient’s cancer. Meanwhile, immune checkpoint inhibitors make it harder for the tumor to evade targeted immune attack. Growing clinical evidence is establishing this combination therapy as a powerful new therapeutic option for patients with hard-to-treat cancers. An understanding that the most effective immunotherapies should take a two-pronged approach – both training the immune system to target cancer cells, and countering immune-evasion and suppression – has also informed the development of an mRNA therapeutic targeting precancerous cells, which was recently supported by encouraging preclinical results.
ctDNA biomarkers for evaluating adjuvant cancer therapy response
Recent research presented at ASCO demonstrated the value of circulating tumor DNA (ctDNA) as a biomarker that predicts lung cancer outcomes of patients with advanced non-small cell lung cancer. This biomarker has also demonstrated value in other cancers, including colorectal, bladder, and breast cancer.
The study contributes to accumulating evidence that ctDNA can be an invaluable indicator of how well a patient is responding to adjuvant therapy, which can help to guide treatment decisions. If levels of ctDNA decline during treatment, it can serve as an early indicator that treatment is working. Conversely, if ctDNA levels do not decline, it can indicate that the treatment is not working, and should be adjusted or changed.
Cancer treatments targeting microbes
Recent studies show that bacteria residing in tumors can help cancer survive by suppressing the human immune response, opening the door for future therapeutics that target cancer-supporting bacteria. In fact, a recent study published in Cell Reports found that some anti-cancer drugs that have already been developed may be effective because of their ability to kill cancer-supporting bacteria.
Obesity treatments also reducing cancer risk
In-demand weight-loss drugs could have implications for cancer prevention. GLP-1 receptor agonists have received a lot of well-deserved attention as a medicine for type 2 diabetes, and demand for the drug has spiked considerably since the FDA approved it for the treatment of obesity in 2021. Preliminary research suggests that GLP-1 receptor agonists could also help restore the immune system’s natural ability to fight cancer in obese patients.
The findings are in line with the growing perspective that obesity is a chronic inflammatory condition, which impairs immune function. In fact, another recent observational study suggests a long-standing obesity treatment – bariatric surgery – also lowers the risk of developing some cancers.
AI in cancer diagnosis
AI’s applications are far reaching. However, applications in early cancer diagnosis are especially promising, with recent research demonstrating its application in breast and prostate cancers. Recently developed AI has been demonstrated to identify risk of breast cancer long before it can be detected by a clinician in an ongoing trial run by Aberdeen Royal Infirmary. Another recent study demonstrated that AI could be used to make diagnosis of prostate cancer more efficient.