5 breakthrough cancer developments to look out for in 2021

To mark World Cancer Day 2021, we asked our experts to identify the five biggest cancer breakthroughs developing as we speak.

Cancer is a painfully ubiquitous feature of modern life. Whether friends or family have had the illness, or you are a survivor yourself, cancer has affected almost all of us in some way.

And it's getting more commonplace: 1 in 2 people born after 1960 in the UK will be diagnosed with some form of cancer in their lifetime.

With the number of new cancer cases in the UK set to rise to 22 million over the next two decades, the outlook seems bleak. But with breakthrough technologies currently at the research, development and implementation stages, the likelihood of providing earlier diagnoses, offering more effective treatments and even find a cure increases exponentially.

So what are these new technologies, and what effect can they have on different types of cancer going forward? Here are the five most exciting cancer developments to look out for in 2021.

Artificial intelligence (AI) in cancer diagnostics

In 2020, an international team at Google Health developed AI capable of evaluating breast cancer mammograms. Comparing the detection accuracy of the tech with the ability of experienced radiologists, the team found that the AI surpassed traditional methods of detection. It was also shown to reduce the number of false positives and false negatives.

This pioneering study represents a major leap in the use of AI during clinical care for cancer. By providing highly accurate results, AI tools look set to increasingly supplement and support the work of physicians and radiologists. The likely outcome? Significant time savings and increased capacity for over-stretched diagnosis facilities all over the globe.

With this work ongoing, there’s a lot of cause for optimism with regard to what AI can do for cancer care. Rather than replacing human experts, AI augments their work and frees them up to focus on more complex diagnostic issues. Through faster diagnosis, treatments can be administered to patients earlier on and prove more effective.

Digital health

The adoption of innovative approaches towards digital-based treatments is helping healthcare systems become better equipped in preparing for and addressing challenges in cancer treatment while improving quality of service delivery.

This is becoming evident in two areas.

In remote care (an increasing challenge during the COVID-19 pandemic), there has been a massive scale-up of the at-home monitoring of cancer patients, particularly in telehealth. As infrastructure improves, this likely to remain a prominent care pathway in the post-COVID health ecosystem. An increase in the use of ‘self-help’ apps and online therapeutic tools could also play an important role.

Secondly, digital pathology methods are becoming available to researchers through secure platforms and helping to diagnostics techniques. These breakthroughs are advancing our capability to share data across further distances, compare larger data sets, and integrate past case studies from the same patient or very similar cases. In all, this results in earlier and more accurate diagnoses.

PARP inhibitors

PARP (Poly ADP-Ribose Polymerase) inhibitors — a type of targeted cancer drug — are rapidly transforming the treatment of ovarian, breast, prostate, and other types of cancer. They work by stopping the PARP protein from repairing cancer cells and thus causing the cell to die.

In the pharmaceutical sector, more PARP inhibitor treatments are gaining regulatory approval. In December 2019 and June 2020, respectively, the FDA and EMA approved olaparib for BRCA1- and BRCA2-mutated metastatic pancreatic cancers. In May 2020, the FDA approved olaparib for BRCA1- and BRCA2-deficient metastatic prostate cancers.

By 2025, the global PARP inhibitor market is expected to register a 34.0% compound annual growth rate (CAGR) in terms of revenue by 2025 — demonstrating the sheer scale of the research and development of PARP treatments.

Blood diagnosis

In November 2020, NHS chief executive Sir Simon Stevens announced that pilot trials for a “potentially revolutionary” blood test would commence.

The so-called Galleri blood test, developed by the biotech company GRAIL, aims to detect different types of cancers early by looking for abnormal DNA shed from cells into the blood. NHS England rolled out the trial to see whether the test can detect cancer when there are no symptoms. Previously, such tests have only been trialled on individuals with cancer symptoms.

The pilot is scheduled for late 2021, consisting of 140,000 individuals with no cancer symptoms and 25,000 with possible cancer symptoms. The results are expected to be released in 2023.

Similar trials are also taking place in the United States. In Oct 2020, the FDA approved two blood tests, known as liquid biopsies, that could help guide treatment decisions for cancer patients. These separately-approved tests identify genetic changes, including mutations, by scanning DNA that tumours have shed into the blood.

If the trials are successful, doctors will then use the information to adapt treatments. Such insights can help them to identify a targeted therapy or immunotherapy that is likely to work for the patient.

CRISPR-based genome editing

Ever since researchers discovered that damage to DNA causes cancer, the scientific community has been exploring how manipulating DNA can potentially prevent cancers and also treat them. In 2013, a groundbreaking new technology was developed to enable researchers to manipulate DNA in a cheap, easy way: CRISPR/Cas9.

After years of research into how CRISPR treatment can be used in the cancer field, the University of Pennsylvania conducted the first clinical trial involving CRISPR in 2019. Though this trial had minimal short-term effects on patients’ cancers and the long-term effects still need to be monitored, it represents a step in the right direction.

Another prominent example of research in this field is that being conducted by Tel Aviv University. Beginning in November 2020, the study has so far demonstrated that the CRISPR/Cas9 system is very effective in treating metastatic cancers — a “significant step on the way to finding a cure for cancer.” The researchers have also developed a novel lipid nanoparticle-based delivery system that specifically targets cancer cells and destroys them by genetic manipulation.

A cause for optimism

2020 was a year unlike any other. Though COVID-19 has caused untold disruption to health systems and global supply chains, the cancer research community has remained resilient and continues to adapt and enhance new techniques and tools to advance our understanding of cancer. With so much innovation to build upon, 2021 is likely to be a landmark year for cancer research.