Hosted annually by the Cleveland Clinic, the Medical Innovation Summit is the health care industry’s oldest and largest meeting focused on the latest medical breakthroughs and advancements. One of the highlights of the summit is the announcement of the top 10 medical innovations that experts from the Cleveland Clinic anticipate will impact health and patient care over the coming year. For 2017, the selections include the following four advancements from the world of medical biotechnology:
1. The microbiome in disease prevention, diagnosis, and treatment
The microbiome is a term for the trillions of bacteria that live and comprise communities within the human body. Although the microbiome has, in a broad sense, long been known as an essential aspect of human health, it has only been within the last decade that new discoveries have revealed just how critical these microbes are. The chemicals they emit affect a wide range of bodily functions, from how humans digest our food and absorb medicine to how conditions such as heart disease or cancer progress through the system. Today, biotech companies are focusing their attention and effort on cracking the microbiome’s potential to prevent, diagnose, and even treat disease through detecting and correcting relevant microbe imbalances, as well as using bacteria to kick off an immune system reaction to fight particular diseases.
2. Cellular immunotherapy for leukemia and lymphoma
The white blood cells known as T-cells serve as a sort of army of security guards for the human body. When they detect foreign or abnormal cells, they latch on to those cells while signaling the immune system to launch an attack. However, with diseases such as leukemia or non-Hodgkin lymphoma, this immune response is not usually fast or aggressive enough to overcome the quick-growing tumors. What’s more, some tumors even learn to evade the T-cells—and consequently the immune system—altogether.
However, this may be about to change, as researchers have recently discovered a way to put these T-cells into overdrive using a gene therapy method. A patient’s own T-cells are removed, genetically reprogrammed to find and attack tumor cells, and then infused back into the patient, where they take up their “search and destroy” mission with renewed vigor. While cellular immunotherapy is still in the early days of clinical trials in humans, the results have been mostly positive so far, with some studies on acute lymphoblastic leukemia (ALL) reporting remission rates of up to 90%. In 2017, this ALL immunotherapy method is expected to be presented for FDA approval. Industry experts anticipate that this will trigger a wave of further approvals for immunotherapies targeting other blood cancers and lymphomas.
3. Liquid biopsies for locating circulating tumor DNA
Imagine if physicians could use a simple blood test to provide not only a cancer diagnosis, but also specific details on the location and progress of the cancer, as well as a defined treatment plan. That day may be just around the corner due to the invention of the liquid biopsy. The development of the liquid biopsy dates began in 2009, when researchers discovered that circulating tumor cells could be found in the bloodstream of a person with cancer, making it possible to diagnose or track the progression of particular cancers with only a blood test rather than the standard diagnostic method of a tissue biopsy (which, in addition to being invasive and uncomfortable, does not always produce accurate results).
In 2014, the liquid biopsy took a huge step forward when researchers developed a test that was able to detect circulating tumor DNA (ctDNA) in the bloodstream. ctDNA is the genetic material that the circulating tumor cells shed into the bloodstream. Since it is over 100 times more abundant in the blood than circulating tumor cells themselves, ctDNA is able to provide far more accurate results, and it has even been shown to capture information on clinically relevant mutations that standard tissue biopsies were not able to identify. At present, several companies are developing ctDNA testing kits for the commercial market. Others are investigating ctDNA from sources other than blood, such as urine or cerebral spinal fluid.
4. Bioabsorbable stents
For more than 20 years, metal stents have been the standard treatment for coronary artery blockage. The tiny tubes, which are comprised of wire mesh, are inserted into a patient’s narrowed arteries (narrowed by the buildup of cholesterol deposits), where they serve as a kind of scaffolding, helping to hold the artery open and preventing blockages in the artery that can cause a heart attack. Although this treatment for artery blockage is only needed in the short term, the metal stents remain in patients’ bodies for their entire life, carrying with them the potential of ongoing complications such as scar tissue formation and the inhibition of natural vessel motion.
After more than a decade spent attempting to solve this problem, the first bioabsorbable stent was approved in the US in 2016. Rather than metal, the stent is composed of a polymer that dissolves naturally over time. After it is inserted, the bioabsorbable stent widens the clogged artery for two years, and then it is gradually absorbed into the body much like dissolvable sutures. At the moment, only the one bioabsorbable stent has been approved by the FDA. However, at least 15 other similar stent programs are ongoing. The market potential for this innovation has been estimated at $2 billion over the next few years.