Oncology/Cancer: 2023 Advancements and Breakthroughs

When one thinks of the most wide-reaching, deadly health issues facing the world today, cancer has to be right up there at the top of the list.

The wide range of diseases encompassed by the disease affect people of all walks of life in all corners of the globe.

In the United States alone, recent figures show there were an estimated 1.9 million new diagnosed cases of cancer in 2022 along with 609,360 cancer deaths.

Zooming out for a more global perspective, cancer stands as the second most common cause of death worldwide, accounting for almost 10 million deaths in 2018, the World Health Organization (WHO) reports. That was nearly one in every six deaths.

The World Cancer Research Fund International states that there were 18 million cancer cases globally in 2020. About 9.5 million were reported in men while 8.5 million were seen in women.

Given these statistics, where are we today in the push to develop new treatments?

The research now out there is offering us a more comprehensive understanding of how cancers are affecting millions of people around the world.

Healthline spoke with some experts to contextualize the big breakthroughs in oncology research and treatment over the past year as well as predictions of what we should be looking in the year ahead.

How mRNA technology is helping reduce cancer deaths

Experts say that mRNA technology has yielded exciting results

Throughout this year, news was made regarding various clinical trials for potential cancer therapies that were developed by way of mRNA technology, which was used to develop the COVID-19 vaccines.

MRNA refers to a kind of nucleic acid, which essentially communicates ways the body can produce needed proteins. When mRNA is injected into the body via a vaccine, for instance, it communicates with the body’s cells to trigger an immune response to the kinds of abnormal proteins created by a cancer, according to the National Cancer Institute.

A range of trials are testing whether the success seen with COVID-19 can work with cancers.

A team from Memorial Sloan Kettering Cancer Center in New York funded by the National Institutes of Health (NIH) has been developing an mRNA vaccine for pancreatic cancer.

In this small study , customized vaccines were engineered successfully for 18 of the 19 participants.

Throughout the study, 16 remained at a healthy threshold to receive some of the vaccine doses and half of them saw the vaccine trigger T cells needed to target their pancreatic cancer.

The results were encouraging, but a mixed bag — after a year-and-a-half post-treatment period, those who had a strong T cell response did not show signs of the cancer returning. The other half who didn’t respond to the vaccines with T cell activation saw their cancer return within an average of one year, reports NIH Research Matters.

Dr. Janice Mehnert , a melanoma expert and medical director of NYU Perlmutter Cancer Center’s Clinical Trials Office in New York, told Healthline that the Moderna mRNA vaccine program is currently “a super exciting space to watch.”

The drug manufacturer has been engaging in promising mRNA vaccine clinical trials in non-small cell lung cancer, for which it’s partnering with Merck on a phase III trial, as well as two vaccine trials for melanoma.

In July, the companies announced a phase III trial of a combination therapy that consists of mRNA-4157 plus pembrolizumab, brand name Keytruda , for people who are at high risk and who’ve received surgery. The goal is to enroll 1,089 people at melanoma stages IIb to IV, with final trial results expected in 2029.

Earlier in the year, the two companies reported results from a phase 2b trial of mRNA-4157 and pembrolizumab in a 157-participant trial. It revealed a 44% decrease in risk of post-surgical melanoma recurrence or death, compared to the risk with pembrolizumab used on its own. This combination therapy has earned breakthrough designation from the U.S. Food and Drug Administration (FDA).

Mehnert said that these developments combine “two of the most exciting breakthroughs in medicine — mRNA vaccine technology and immunotherapy in a personalized tumor informed approach.”

Advancements in antibody drug conjugates to treat cancer

There was also news about antibody drug conjugates (ADCs)

“Antibody drug conjugates are a major space to watch with huge breakthroughs in breast and bladder cancer as well as lung and stomach cancer,” Mehnert said.

What are they?

Antibody drug conjugates (ADCs) are basically a way to directly target cancer cells without causing the toxic damage of chemotherapy. They consist of monoclonal antibodies attached to the drug itself by way of a linking chemical that can directly hit the cancer cells in question.

The journal Frontiers in Immunology reports that ADCs have proven successful in preclinical and clinical trials, and some have even been approved by the FDA to treat some types of cancer. It’s a growing field and 2023 saw it continue to be high on everyone’s radars.

A better understanding of how cancer evolves

Given how the disease presents itself so differently between individuals and the many forms it takes, cancer is one of the more complex health issues that frustrates clinicians and patients alike.

Samuel Godfrey , PhD, a research information lead at Cancer Research UK, said that is changing partially due to the work of TRACERx , a project that aims to deliver “the most detailed understanding of cancer evolution ever.”

“We learned how cancer’s capacity for rapid change is inexhaustible, which helps explain why this disease is such a challenge to beat. TRACERx has showed that it is actually possible to spot patterns and predict cancer’s behavior, even among such high levels of complexity. Realistically we could one day predict how a cancer progresses and perhaps even intervene before it becomes a problem,” Godfrey told Healthline.

The rise of bispecific T cell engagers

Mehnert added that the advent of novel bispecific T cell engagers marks another big 2023 cancer development.

These are artificial antibodies that essentially aim a person’s T cells to their intended cancer cell target.

“They can redirect the entire repertoire of T cells against tumor, independent of T-cell receptor specificity,” according to the BMJ Journal for ImmunoTherapy of Cancer .

Strides in cancer survival

Godfrey also pointed to clinical trials such FOxTROT from the University of Birmingham in the United Kingdom and INTERLACE out of University College London as showing great promise in “markedly improved cancer survival.”

“What I find exciting about these trials is that the breakthroughs weren’t about new, expensive medicines but rather using well-established, cheaper drugs,” he said. “In short, with treatment, it might be all about timing.”

Looking ahead in cancer research

Many of the advancements and breakthroughs these experts cited are currently in trials, some of them might be years away from making a direct, concrete impact in cancer care.

Some of them are already changing the game.

It’s a wide range, just in the same way cancers themselves affect people around the globe in such broad and varied ways.

When asked what he sees on the horizon, Godfrey said that now is a time of “much optimism and excitement in the science community.”

“As we look forward to 2024, I am particularly excited about seeing many small but vital steps toward better prevention, diagnosis and treatment,” he added. “I think there will be further innovation in the use of our own immune systems to tackle cancer. We’ll see more improvements to technology that can detect the earliest signs of cancer. And AI [artificial intelligence] will continue to allow our scientists to do more, taking on some of the toughest cancer challenges such as predicting who is most at risk of the disease.”

“There is still a long way to go, but it is very inspiring to see how we are steadily moving toward a future where cancer won’t be a major problem,” Godfrey said.