Hope on the Horizon: The Frontier of Cancer Research

Recently, you may have seen headlines of the rates of colon cancer increasing in adults under 50, with the passing of actor Chadwick Boseman at 43 from colon cancer shocking the world. However, it is not just colon cancer cases that are jumping: early onset cancer (cancer that occurs in individuals under 50) is expected to increase annually by 1-2% according to the American Cancer Society, with the journal of BMJ Oncology predicting a 30% increase in early onset cases from 2019-2030. Reading this news may elicit fearful and paranoid thoughts of your risk of cancer increasing, making it easy to neglect the incredible breakthroughs that are endlessly occurring in cancer research. While cancer still proves to be a deadly disease, progress is steadily being made in research to fill in the missing pieces of the puzzle.

Vaccinations

In a study expected to be completed by 2027, thousands of cancer patients in England will be able to trial personalised vaccines to treat their cancer. As opposed to traditional vaccines used to prevent diseases, these personalized cancer vaccines are utilized as a treatment after diagnosis; however, both train the immune system to look for the target enemy. The vaccinations are created through analyzing a sample of a patient’s tumor for its unique mutations to create an mRNA vaccine that instructs the cells to create mutated rogue proteins that are specific to the cancer cells. The mutated proteins aid the immune system in identifying the cancerous cells due to their resemblance to each other, with the end goal of training the immune system to defeat residual cancer cells as they resurface and hopefully remain cancer free.

Preclinical studies have in fact demonstrated vaccinations (non-personalized) to be incredibly successful in eliminating pancreatic cancer, the deadliest cancer according to the American Cancer society. More than half were completely cancer-free following a nano-vaccine, developed by researchers at Case Western Reserve University and Cleveland Clinic. This vaccine works by engineering antigens to commonly mutated oncogenes which are delivered into the body via nanoparticles made of lipids and train the immune system to destroy tumor cells. Incredibly, this vaccine generated immune system memory, allowing this vaccine to be both therapeutic or preventative. Further demonstrations of safety of the vaccine will be pursued before clinical trials in human patients. 

Artificial Intelligence 

Prevention: Regarding pancreatic cancer, there are currently no population based screening tools, rather only those with elevated risk, such as a family history or genetic mutations, complete targeted screening; consequently, there are individuals who slip through the cracks. A 2023 study from Nature Medicine discovered AI-based population screening was successful in identifying people at high risk for pancreatic cancer up to 3 years before actual diagnosis. The implications of AI-based screening tools that can easily identify high risk patients who may benefit from further testing are substantial in accelerating the detection of cancer and treatment.

Diagnosis: AI can aid considerably in efficient diagnosis of cancer through being trained to scan images from machines like MRIs and flag tumor-like structures. This allows radiologists and oncologists to quickly focus on examining the flagged areas and complete a truly thorough examination. Additionally, such tools can further prevent the need for further invasive diagnostic tests, allowing for increased patient safety. Moreover, researchers at the Perelman School of Medicine developed an AI tool, iSTAR (Inferring Super-Resolution Tissue Architecture), which they believe can aid in the diagnosis of cancers that would otherwise go undetected. This imaging details individual cells and how a patient’s genes operate, allowing clinicians and researchers to see cancer cells that are invisible to the eye. Further still, it can be transformative for molecular disease diagnosis at a microscopic level through identifying if safe margins were accomplished with cancer surgery and providing annotation for microscopic images. 

Treatment: Vast strides have been made in AI tools that can help guide patient care. Stanford medicine researchers developed MUSK (multimodal transformer with unified mask modeling), which is able to utilize both visual and language information. This model successfully outperformed standard methods in predicting the prognosis of thousands of people with varying types of cancer and stages, with 75% accuracy compared to 64% accuracy with traditional predictions. This provides substantial benefits to physicians by allowing them to determine the next best course of action more accurately, whether continuing with the same drug or pivoting to a new therapy, for a patient during treatment. Furthermore, Mustafa Raoof, M.D., M.S., and assistant professor of surgery and cancer genetics is collaborating with City of Hope (a collection of data scientists and imaging experts from the University of Carolina) to lead a project that aims to identify cancer cells during surgery. As opposed to waiting for a biopsy post surgery, the project aims to visualize tumors in 3 ways: cancer cells lit up with fluorescent labels, ultrasound with a balloon probe, and Raman spectroscopy which details the chemical composition of tissue. AI will accomplish this through its multimodal capabilities to help surgeons improve their precision and target their focus on important tasks. Additionally, Dr. Raoof hopes this technology will minimize the harm to healthy tissue and preserve organs by removing the necessity to remove whole organs that have tumors on them. 

RK-33

Venu Raman, professor and researcher at Johns Hopkins University for over 20 years, and his team developed the cancer drug RK-33, which has displayed tremendous success in treating many types of cancers, including those that have metastasized. This drug works by targeting DDX3, an RNA helicase gene, that facilitates tumor formation; suppressing DDX3 slows or even halts tumor growth and metastatic burden, which RK-33 accomplishes by fitting into a protein pocket in the gene and nullifying its activity. Animal trials were successfully completed and Professor Raman aims to begin human trials in 2025.

This research is just the surface of the abundance of progress being made every day in the battle against cancer. While the road ahead promises to be arduous, it is certain that researchers around the world will continue to dedicate themselves to finishing this intricate puzzle. As a HOSA-Future Health Professional, who knows, you may find yourself adding a missing piece in the puzzle in the near future. Until then, be sure to keep your eyes on this frontier of research, for hope remains on the horizon. 

Hayden Turner- Historian (2025-2026)