Cancer and Alzheimer breakthroughs

From newer therapies for Alzheimer’s disease to developing off-the-shelf gene therapies for cancer, 2024 holds out hope for exciting developments in medicine that can transform our lives. Wider availability of cheaper CAR-T cell therapy or engineering immune cells to treat blood cancer and a government HPV vaccination programme will be among the key breakthroughs we must watch out for in India.

1) Use of mRNA vaccines for cancer treatment

While the mRNA vaccines came into prominence — and received first regulatory approvals — during the pandemic, researchers for years have been working with the technology to treat cancers. Although these therapies have not been approved yet for standard treatment of cancers, early clinical trials have shown encouraging results. Over 25 trials of mRNA-based vaccines are under way for the treatment of cancers of the lung, pancreas, skin, nerve cells, head, neck and prostate among others.

These vaccines don’t really protect you from getting the cancer, they help in boosting immune response against cancer cells, thereby helping in treatment of the cancers or preventing a relapse.

2) New Alzheimer’s therapies

The approval of the Alzheimer’s drug Lecanemab in 2023 led to a lot of excitement among doctors. This is because the condition remains without any targetted drug, with researchers still not agreeing on the root cause of the disease. The drug reduces beta-amyloid protein deposition — one of the key features visible on MRIs of Alzheimer’s patients — thereby slowing cognitive decline. Lilly’s Donanemab is another drug that targets the same pathway and is currently in late clinical trial stages. In addition, there are therapies under development that work on synaptic plasticity (ability of the neurons to modify connections), neurotransmitter receptors and inflammation.

Studies are also under way to see whether the blockbuster weight-loss drug, Semaglutide, that is thought to improve nerve cells, inflammation and vascular health, may slow the progression of Alzheimer’s disease.

3) More CRISPR therapies

Last year, the first therapy based on the Nobel Prize-winning CRISPR technology received approval for the treatment of sickle cell disease and beta thalassemia. This, however, marked the beginning of other therapies based on the technology. The company, CRISPR Therapeutics, is also working on therapies for Type-1 diabetes and cardiovascular diseases. One of the important applications of the easy-to-use gene editing technology will be to develop off-the-shelf CAR-T cell therapies for cancer treatment. These cutting edge therapies currently depend on taking the patient’s own immune cells and modifying them in a lab to identify and kill cancer cells. This kind of personalised therapies do not allow for large scale manufacturing, thereby keeping costs high. Crispr can help in developing universal CAR-T therapies.

4) CAR-T therapies become accessible in India

With an indigenous Chimeric Antigen Receptor T-Cell therapy or CAR-T cell therapy developed by IIT Bombay and Tata Memorial receiving approval in India, several tertiary care hospitals have now adopted the technology. This year will see more and more patients of two types of relapsed blood cancers receiving the cutting-edge treatment, which is also much cheaper than its counterparts available elsewhere in the world. The data of the patients receiving the therapy in big hospitals will be maintained for a period of 15 years to see whether there are any side-effects of the treatment.

5) Government HPV vaccination programme

With a cheaper, indigenously developed vaccine against the Human Papillomavirus by the Serum Institute of India becoming available, the government is soon likely to roll out a vaccination campaign for girls between the ages of 9 and 14 years in a phased manner.

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