Sunday, January 1, 2012

5 Medical Advances Predicted for 2012



Great medical feats were accomplished in 2011. Dallas Wiens became the first recipient of a full-face transplant in the United States, Arizona congresswoman Gabrielle Giffords survived a gunshot to her brain, and HIV researchers found a way to lower an infected person's chance of transmitting the virus to sexual partners by 96 percent.

What significant advances can we expect in 2012? Here are five predictions, provided to MyHealthNewsDaily by experts in their fields.

Prediction 1: Medicine gets closer to treating cancer with vaccines.

Radiation and chemotherapy reign as the go-to treatments for cancer, but for 20 years researchers also have been exploring the use of therapeutic vaccines. In 2012 that work may come to fruition.

"It's an exciting time for cancer vaccine development," said Dr. Larry Kwak, professor and chairman of lymphoma and myeloma at the University of Texas M.D. Anderson Cancer Center in Houston.

"What's especially impressive is the diversity of cancer vaccine. It bodes well for what you're going to be seeing in the future," Kwak said.

More than 250 clinical trials of vaccines, including 34 for breast cancer, are under way, according to the National Cancer Institute.

Like other vaccines, cancer vaccines use a chemical marker of a disease (in one case, a virus; in another, a malignant tumor) to train a person's immune system to fight the disease.

But unlike vaccines for the flu or chicken pox, which are preventive, "we almost uniformly vaccinate after cancer is there," Kwak said.

Some cancer vaccines in development could be administered to many people, while others – including Kwak's vaccine for follicular lymphoma – would have to be tailored to each patient's tumors.

Kwak's vaccine has passed Phase III trials and is moving toward the final steps of regulatory approval.  The U.S. Food and Drug Administration approved the first cancer vaccine, called Provenge, in the spring of 2010 for the treatment of prostate cancer. A vaccine for melanoma performed well in the final stages of clinical trials last year.

"What ties them together is they are activating the immune system so it's primed and ready to fight,” Kwak said.

The National Cancer Institute reports there are ongoing clinical trials for therapeutic vaccines to treat bladder, breast, cervical, kidney, lung, pancreatic and other forms of cancer.

Prediction 2: Malaria vaccine development will advance.

Malaria remains a deadly and debilitating disease. The World Health Organization estimates there were 216 million cases of malaria and 655,000 deaths, mostly in children, in 2010. Communities can curb malaria infections through mosquito control, but no vaccine can prevent it.

Researchers at the University of Oxford caught international attention when they announced this month they developed a vaccine that could stop many strains of the deadliest malaria parasite, the P. falciparum parasite, in animal studies. They published the findings in the journal Nature Communications Dec. 20.

"There is no doubt that malaria has been an extraordinary challenge for vaccine creation," said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University School of Medicine, in Nashville, Tenn.

The key to the vaccine's success is that it targets a crucial stage of the parasite's development. When a mosquito bites a person (or an animal), the parasite travels through the blood to the liver, and then, in a new form, infects red blood cells, Schaffner said. There the parasite multiplies and changes into two new forms: one that attacks other red blood cells, and one that circulates in the bloodstream, ready to be picked up by another biting mosquito.

"You would think that anything that's that complicated couldn't possibly succeed as a parasite, but it is one of the most successful: The illness it creates is often mortal, if not debilitating," Schaffner said. As the parasite bursts out of blood cells, toxins escape that cause fever and chills. Enough red blood cell destruction causes anemia.

However, the vaccine developed at Oxford interrupts the parasite's entry into red blood cells. "That is an absolute critical stage. If we can keep it out of the red blood cell, it can't make you sick," Schaffner said.  Still, he said he is wary of too much excitement, because several malaria vaccines with other tactics to attack the parasite failed in human studies.