Medical ‘advances’ of 2020 could transform future health care

Oncologists, vaccinologists, biomedical engineers and doctors have all told The Independent that the technological advancements seen throughout 2020 could come to have a “profound” impact on the future provision of care for patients struck down with a variety of conditions.

The technology used to develop the Pfizer vaccine could be used to tackle illnesses such as cancer and other infectious diseases similar to Covid-19, leading health experts have said, raising hope that humanity can take a major scientific “leap forward” in the wake of the coronavirus pandemic.

The developments made in diagnostics, therapeutics, vaccine manufacturing and medical telecommunications are expected to leave a transformative legacy that will endure beyond the pandemic, experts say.

From RNA-based technology that trains the body to fight cancer, to the so-called ‘factory in a box’ – which aims to manufacture 600 vaccine doses in as little as 60 seconds – the pandemic has helped fuel the creation of new and exciting technologies that were thought to be out of reach prior to Covid-19.

Sir Jeremy Farrar, director of the Wellcome Trust, said: “I think we’ll look back on the advances made in 2020 and say that was a moment when science really did make a leap forward, which we will come to celebrate in due course.”

The technology behind the Pfizer/BioNTech vaccine is seen as a notable game-changer.

The jab makes uses of genetic material called RNA which, when injected into human muscle cells, delivers a series of instructions to produce the ‘spike’ protein found on the surface of Sars-Cov-2.

Spotting what appears to be foreign invaders within the body, the immune system springs into action to produce the necessary antibodies and T-cells. This process leaves behind a protective memory that enables the body to build up immunity against coronavirus.

The apparent success of the vaccine, which is said to be 90 per cent effective in preventing disease, demonstrates that this RNA platform could be used in a similar way in cancer treatments.

“I’m very excited by the power and potential of vaccines, the immune system and cell therapies to prevent cancer, or block it’s progression when it’s been diagnosed,” professor Charles Swanton, chief clinician at Cancer Research UK, told The Independent.

Research into this treatment has been ongoing for a number of years, while a Nature paper published in August showed that an RNA vaccine had been capable of training the immune system in patients with advanced melanoma to tackle cancerous cells.

Prof Swanton said this study was ongoing and that “real efficacy is still be proven”, but he insisted that the effectiveness of Pfizer’s RNA vaccine was confirmation that the technology works in theory.

He was skeptical that this platform could be used to manufacture enough T cells in the body to overcome late-stage cancer, adding that the “diversification” of the disease over time “outwits” these patients’ immune systems.

However, he suggested that RNA vaccines could potentially be utilised as a prevention strategy.

“There’s also the possibility of using an RNA vaccine to prevent cancer,” he said. “If you stimulate the immune system in advance of the cancer emerging, the patient automatically has an advantage as there are many more T cells.

“Lets say you’d focus on high-risk smokers. There are 20 or so common mutations in lung cancer. From the patient’s genetic coding, you could develop an RNA vaccine that could potentially eradicate cells that are emerging in very small numbers.

“Or, you might able to give the immune system a boost to eradicate those tumour cells before they’ve got time to evolve further and cause trouble.”

At this stage, he said, it was only speculation. “There is some evidence for this,” Prof Swanton added. “But we’re testing it.”

Zoltán Kis, a research associate at Imperial College London’s Future Vaccine Manufacturing Hub, said the adaptability of the RNA technology meant it could be tweaked and tailored to produce a vaccine candidate for “virtually any disease – including unknown future ones”.

He explained the process for manufacturing doses of an RNA vaccine is also much simpler compared to conventional technologies.

“The reactors, the purification process, the formulation – everything stays the same, no matter what vaccine is produced,” Prof Kis told The Independent. “Traditionally, you would have to have to develop a new production line every time you made a new vaccine.”

Although well suited for provoking an immune response against infections, questions have been raised over the technology’s suitability in treating sick people due to the fact the RNA degrades once injected into human cells.

“It’s active for some time but then it decomposes,” Prof Kis. This essentially stops the production of the proteins needed to tackle whatever illness the body is facing, he added.

Nonetheless, the huge leaps in vaccine technology that have been taken throughout 2020 have also forced scientists to revolutionise the ways they produce and distribute large quantities of doses.

Professor Harris Makatsoris, from King’s College London, has led a team that has developed a device they call a ‘factory in a box’ which could provide a new way to manufacture the next generation of vaccines on a massive scale.

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