Predicting the future is always a tricky business, as TV weather meteorologists and Las Vegas odds-makers well know. But when it comes to medical issues, several scientific breakthroughs reported in the past year are likely to become major health stories in 2015 and find their way into clinical practices that boost Americans’ healthcare.
Medical experts are predicting big advances in the fields of Alzheimer’s disease diagnosis, medical technology, stem cell research, immunotherapy, and personalized medicine over the next 12 months.
Here’s a look ahead at a handful of health developments that bear watching in 2015.
No. 1: New Alzheimer’s tests. Several big breaks on the Alzheimer’s research front were made in 2014 that could pave the way for new diagnostic tests in the next year.
Researchers with Georgetown University Medical Center in Washington devised a blood test that can predict with 90 percent accuracy whether a healthy person will develop Alzheimer's or cognitive decline within 3 years. The test tracks 10 biomarkers and could identify individuals at risk before they even begin having symptoms, such as memory loss and mental confusion.
If further studies of the prototype test confirm its safety and effectiveness, it could become available for use by doctors as early as this year, experts say. Although there is no cure for Alzheimer’s — the leading cause of dementia and sixth leading cause of death in the U.S. — new drugs and therapies can slow its progression. As a result, early detection is the best way to speed treatment for Alzheimer’s and help preserve mental functions and memories of those who suffer from the brain-wasting condition.
Other recent Alzheimer’s research findings that could lead to better clinical diagnosis and treatment:
- Scientists at King's College London identified a group of 10 proteins in the blood that they believe can predict the onset of Alzheimer's — providing another potential way to detect and treat the disease early.
- The Institute of Neuroscience and Medicine in Jülich, Germany, discovered a promising drug candidate for Alzheimer's in a turmeric compound — aromatic turmerone, found in the curry spice — that could promote the growth and development of brain stem cells.
- Northwestern University medical specialists are testing a new device that uses MRIs to detect Alzheimer’s in early stages by tracking toxins in brain that lead to beta amyloid plaques — proteins that accumulate and clump together in the brains of those with the disease. The device could flag the plaque-causing toxins early, giving doctors a chance to get brain-saving drugs to patients before serious symptoms appear.
Without new diagnosis and treatment methods, Alzheimer’s rates projected to triple over the next three decades as the Baby Boom generation ages.
No. 2: Med-tech advances. Watch for big developments in refining implantable brain chips that allow quadriplegics to regain use of their arms by simply using their thoughts, as well as hand remote-controlled “exoskeleton” devices that allow paraplegics to walk with assistance.
Over the past year, several prototype devices were unveiled that mark a major leap forward in helping paralyzed individuals move again. Among them:
- Neurosurgeons at Ohio State's Wexner Medical Center working with computer engineers from Battelle implanted a chip — dubbed “neurobridge” — in a paraplegic man's brain, allowing him to maneuver a paralyzed hand using only his thoughts.
- Doctors at Massachusetts General Hospital implanted a chip in the brain of a woman paralyzed from neck down that allowed her to move a mechanical arm — also controlled with her mind — to reach out, and bring a drink with a straw to her lips.
- Several biotech companies rolled out new remote-controlled mechanical “exoskeleton” devices that are strapped to paraplegics’ legs and allow them to walk with assistance. Ex-Olympian Amy Van Dyken-Rouen demonstrated one line of the devices and others were publicized during the World Cup of soccer.
In addition, Oxford University researchers developed a new Google Glass-like device that allows the blind to regain partial sight, major advances were made in medical applications for 3D printing (producing organs and tissues), and a variety of new cellphone apps and wearable monitors have been developed to help healthcare workers diagnose depression, sleep disorders, heart conditions, and diabetes.
No. 3: Immunotherapy. A spate of new drugs and therapies are under development that target cancer and other diseases by boosting the body’s own immune systems, with major successes reported in a handful of novel treatments.
The approach marks a huge departure from conventional cancer therapies like radiation, chemotherapy, and surgery that aim to burn, poison, or cut out tumors, but also harm healthy tissues and have nasty side effects. By studying cancer “super survivors,” researchers at MD Anderson Cancer Center in Houston and other leading medical institutions are hoping to make immunotherapy a viable alternative to those traditional cancer treatments.
Among the most promising players in the emerging field are drugs called “checkpoint inhibitors” that work by taking off the natural brakes of the immune system — enabling cancer-destroying killer T-cells to attack tumors. In a clinical trial involving 4,846 advanced melanoma patients, the new Bristol-Myers Squibb Co.’s checkpoint inhibitor Yervoy was found to be a major success — with 21 percent of treated patients still alive three years later (representing more than 1,000 people who would have died otherwise).
Newer drugs that work similarly are getting even better results and are extending the benefits beyond melanoma to other cancers. More than two dozen companies are also testing other approaches — including “cancer vaccines” and monoclonal antibodies — against cancers of the brain, breast, prostate, colon, lungs, and kidneys.
While immunotherapy is still in its early stages, more than two dozen companies are now pursuing some form of immunotherapy, with studies on going and more results likely in the next year.
No. 4: Stem cells. 2014 was watershed year for stem cell research with a flurry of breakthroughs that could lead to new treatments for everything from Lou Gehrig’s disease to heart disorders in the year ahead.
Such developments have been accelerated by the discovery that adult cells can be returned to an almost embryo-equivalent state. In a huge step forward, researchers from Brigham and Women's Hospital, in collaboration with researchers from Japan, discovered a way of changing adult stem cells back to their original embryonic state by exposing them to low oxygen and acidic environments.
The findings may lead to the creation of embryonic stem cells specific to each individual without the use of embryonic stem cells — which is controversial — or the need for genetic manipulation. Stem cells possess the potential to grow into a number of different cell types. This has offered the hope in the field of regenerative medicine of creating new tissues or even whole organs.
In other breakthroughs:
- Scientists from Washington University School of Medicine in St. Louis used stem cells to convert human skin cells directly into brain cells and others at the University of Texas Medical Branch in Galveston succeeded in growing human lungs in the laboratory.
- Researchers from the University of Wisconsin-Madison used stem cells to regrow amyotrophic lateral sclerosis (ALS) nerve cells to discover what may be the origins of Lou Gehrig's disease.
- Israel's BrainStorm Cell Therapeutics said final results from a clinical trial of its adult stem cell treatment for ALS — called NurOwn — were positive, with most patients showing a slowing in the disease's progression.
BrainStorm is now conducting clinical trials at three sites in the United States — studies that could fast-track approval for wider use of the therapy in the year ahead.
No. 5: Personalized medicine. Many med-tech futurists are predicting 2015 will be the year of personalized medicine — with new drugs, treatments (for depression, heart disease, even cancer) tailored to individual patients based on genetic analysis of particular biological makeup.
Privately held biomedical companies like 23andMe Inc. and Genentech are commercializing genetic tests that now allow people to do genetic tests for dozens of conditions. Such tests are likely to help inform individualized approaches that allow doctors to choose certain drugs and therapies over others based on a person’s unique genome.
In recent years, a number of new tests have been developed that can help doctors know which antidepressants are likely to work best for patients with depression, the odds of certain cholesterol-lowering statins causing side effects for some patients, or whether certain types of chemotherapy will be effective against breast cancer.
Although those approaches are largely experimental today, the next year is likely to be a breakout year for the use of such patient-centered therapies, many experts predict.
In places like Memorial Sloan Kettering Cancer Center in New York, doctors are already testing the safety of an unconventional dosing schedule for lung cancer patients using this approach.