by Maria Giovanna Faiella
Among the promising trials according to Nature Medicine: Artificial intelligence for early diagnosis of lung cancer, stem cells for Parkinson’s, vaccine against HIV, app for women with depression during pregnancy
From new gene editing techniques for hereditary hypercholesterolemia, to artificial intelligence tools used in the early diagnosis of lung cancer and in emergency room triage to save the lives of those who fall ill; from the use of stem cells to fight Parkinson’s disease, to the new vaccine against HIV, to an app to help women who suffer from depression during pregnancy. They are among the revolutionary experiments that could change the history of some diseases (and those who suffer from them or could become ill) in 2024, according to eleven experts interviewed by the scientific magazine Nature Medicine
on the most promising clinical trials in the coming year.
Artificial intelligence for early lung cancer diagnosis
Diagnosing lung cancer early, when it is still small and localized, can save your life. A chest x-ray is usually the first test that suggests possible lung cancer, followed by a computed tomography (CT) scan, which can advance the diagnosis. The trial in corso on 150 thousand patients enrolled in six hospitals in the United Kingdom – selected by Nature Medicine and presented by pulmonologist David Baldwin, honorary professor of Medicine at the University of Nottingham in the United Kingdom – aims to verify whether Artificial Intelligence (Ai ) applied to chest Baldwin explains: We demonstrated previously that immediate reporting of chest x-rays by radiographers can make a substantial difference, almost halving the time to diagnosis, from 63 days to 32 days. We will complete recruitment in July 2024 and hope to have results in 2024. Our hypothesis, based on previous research, is that with the use of AI we can identify lung cancer earlier, reducing the time to diagnosis by up to at 50%. If preliminary results are confirmed, there could be a revolutionary change in the standards of diagnosis and treatment of this tumor: the use of artificial intelligence at the time of chest x-ray.
AI also supports the emergency room
Among the trials expected in 2024, according to researchers interviewed by Nature, there is also one clinical study – MARS-ED- which involves the use of Artificial Intelligence to identify the most at-risk patients in the Emergency Department, and therefore to be treated with greater urgency. The premise starts from a retrospective study conducted at the Maastricht University Medical Center, where a new clinical risk score, the RISKINDEX, was introduced, which used an artificial intelligence model to predict the 31-day mortality of patients who they were directed to an emergency room. The tool was developed and evaluated in four Dutch hospitals, using data from 266,327 patients with 7.1 million laboratory results available.
Hereditary high cholesterol, new gene editing techniques
About one person in three hundred is born with heterozygous familial hypercholesterolemia (the child inherits an altered copy of the gene from a parent, ed.), among the most common genetic conditions but also among the main cardiovascular risk factors. The disease is caused by mutations in the Pcsk9 gene, which encodes a protein that breaks down receptors for low-density lipoprotein, LDL, a type of “bad” cholesterol. Although statins can reduce the risk of cardiovascular disease in these patients, most fail to achieve optimal LDL cholesterol levels with chronic therapy. According to cardiologist Amit Khera, professor at Harvard Medical School in Boston, interviewed by Nature magazine, the solution could come from trial Heart-1with which in 2024 the effectiveness of an advanced therapy based on the CRISPR technique will be tested, which uses messenger RNA (mRna): in a single administration it aims to “turn off” the Pcsk9 gene in the liver, to permanently reduce LDL cholesterol, the cause of heterozygous familial hypercholesterolemia.
Stem cells for Parkinson’s disease
Among the trials expected in 2024, Nature Medicine includes the STEM-PD study which aims to test a stem cell therapy in Parkinson’s disease: dopaminergic neurons will be transplanted, derived from human embryonic stem cells, in the brains of patients between 50 and 75 years of age with moderate Parkinson’s disease. These are patients who are usually excluded from clinical trials – which mainly involve patients in an advanced stage of the disease – and who instead could have the greatest benefits. The researchers hope to have preliminary results by the end of 2024.
T-cell vaccine for HIV
A vaccine for the prevention of human immunodeficiency virus (HIV) infection: safety, reactogenicity and immunogenicity will be tested in 2024 in a trial phase 1, randomized, double-blind.
Adults between 18 and 55 years of age, in good health and without HIV, will be enrolled: they will receive one of the three doses of VIR-1388 or a placebo.
The first doses of the vaccine have already been administered to study participants.
The trial conducted by the HIV Vaccine Trials Network at ten sites in the United States and two sites in South Africa.
An app to cure depression during pregnancy
A team led by the University of Liverpool has developed an app which allows a female peer (from the same community with no prior healthcare experience) to provide a cognitive therapy-based intervention to women in the second or third trimester of pregnancy who have major depression. The application, funded by the National Institute for Research and Treatment of the United Kingdom, aims to guarantee adequate and effective assistance even in low- and middle-income countries where there is a lack of trained professionals.
In 2024 it will be tested in rural areas of Pakistan through a trial that will compare the app with the standard version of the Thinking Healthy program therapy, provided by healthcare workers in those areas.
Malaria vaccine, long-term effectiveness
A notable problem with malaria vaccines – and one of the reasons it has taken over a hundred years to implement a vaccine – is the need for an exceptionally high antibody response for the vaccine to actually work.
Among the promising trials in 2024, reported by Nature Medicine, there is study in phase 3
on the effectiveness of a long-term vaccine against malaria.
Brain metastases in patients with breast cancer
Brain metastases are a major problem in advanced breast cancer affecting approximately half of HER2-positive patients, but there is only one treatment approved by the American regulatory authority FDA – Food and Drug Administration for this patient population. Among the trials expected in 2024 there is one international study multicenter, DESTINY-Breast12, aimed at evaluating the efficacy and safety of an antibody-drug conjugate (Adc) against brain metastases in patients with breast cancer.
Corriere della Sera also on Whatsapp. sufficient click here to subscribe to the channel and always be updated.
December 29, 2023 (modified December 29, 2023 | 09:57)
© ALL RIGHTS RESERVED