In 2023, medical breakthroughs featured mRNA cancer vaccines, targeted PCNA chemotherapy, insights on processed foods and mental health, AI-enabled spinal cord injury mobility, and deep brain stimulation aiding stroke recovery.

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As the year draws to a close, MDLinx takes a look at five major research breakthroughs with exciting clinical applications that emerged during 2023. 

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mRNA vaccines to treat cancer

mRNA vaccine technology is key to the new COVID-19 vaccinations. According to Vincent F. Carr, DO, member of the MDLinx medical advisory board, the potential role of mRNA vaccines has expanded into the cancer space.

The study authors concluded that the individualised neoantigen vaccination, in combination with immunotherapy and chemotherapy (atezolizumab and mFOLFIRINOX, respectively) was “safe, feasible, and generates substantial neoantigen-specific T cells in 50% of unselected patients with resectable PDAC.”

PDAC isn’t the only cancer for which mRNA vaccines have shown effectiveness. In February 2023, the US FDA awarded breakthrough therapy designation to the combination of a personalised mRNA vaccine (mRNA-4157/V940) and a monoclonal antibody (pembrolizumab) for adjuvant treatment of patients with high-risk melanoma following complete resection.[2]

"The biologicals for cancer have significant downsides, [but] the RNA vaccines, at this point, are not being reported as having the same adverse effects."

— Vincent F. Carr, DO

Despite this turning point, Dr. Carr tells MDLinx, the "misinformation against the RNA vaccines is severe and very misleading, depriving cancer patients of the benefits."

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Potential tumour treatment of the future

“Data suggests that PCNA is uniquely altered in cancer cells, and this fact allowed us to design a drug that targeted only the form of PCNA in cancer cells,” said senior author Linda Malkas, PhD, in a press release.[4] Dr. Malkas is a professor at City of Hope’s Department of Molecular Diagnostics and Experimental Therapeutics. 

“Our cancer-killing pill is like a snowstorm that closes a key airline hub, shutting down all flights in and out,” she said, “only in planes carrying cancer cells. [It] can suppress tumour growth as a monotherapy or combination treatment in cell and animal models without resulting in toxicity.”

MDLinx advisory board member Courtney Manser, MD, CCFP, explains the significance of this research: “There are ongoing phase 1 clinical trial for AOH1996—a medication that has shown promise in preclinical trials, in which it kills solid tumours,” she says.

"This may be the cancer treatment of the future."

— Courtney Manser, MD, CCFP

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Ultra-processed food’s effect on mental health

“The role of ultra-processed foods in the development of depression and other psychiatric conditions is an important 2023 breakthrough,” Robert M. Berman, MD, PhD, MBA, a Manhattan-based psychiatrist, tells MDLinx.

Researchers associated with Harvard TH Chan School of Public Health prospectively examined the association between ultra-processed foods (UPF) and its components with incident depression.[5] They assessed diet using food-frequency questionnaires every 4 years in 31,712 women (mean age: 52 years at baseline).

Notably, “models were not materially altered after inclusion of potential confounders,” the researchers emphasised. Artificial sweeteners and artificially sweetened beverages were particularly implicated. 

Similar findings were obtained by a group of Australian researchers who studied data from 23,299 adults in the Melbourne Collaborative Cohort Study.[6] They found increased odds of “elevated psychological distress” (an “indicator of depression”) with the highest compared to the lowest intake of UPF—even after adjusting for age, sex, and BMI. 

Dr. Berman elaborates on this study, saying that further data on the physical and mental health effects of UPF “could ultimately lead to potential treatment enhancements using a more holistic approach involving nutrition, diet, and exercise in addition to traditional medications and psychotherapy.” 

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Mobility in patients with spinal cord injury

Researchers in Switzerland used artificial intelligence (AI) to enable a man with spinal cord injury (SCI)–induced tetraplegia to walk.[7] SCI “interrupts the communication between the brain and the region of the spinal cord that produces walking, leading to paralysis,” the researchers explained.

For over a year, the patient maintained his ability to stand, walk, climb stairs, and even traverse “complex terrains.” Additionally, the BSI improved neurological recovery achieved during neurorehabilitation, such that he is able to walk with crutches—even when the BSI is switched off.

Rex Marco, MD, Chief of Reconstructive Spine Surgery and Orthopaedic Oncology at Houston Methodist, calls this innovation “exciting and filled with potential.”

Dr. Marco himself lives with quadriplegia as a result of an SCI sustained during a biking accident. “Until now, I thought that research could help people with SCI to have a better life. But the word ‘cure’ wasn’t in my vocabulary,” he tells MDLinx. “This innovative approach can pave the way for more people with SCI to regain use of their arms and legs. The ‘cure’ for paralysis may actually be on the horizon.”

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Neurostimulation to aid stroke recovery

Deep brain stimulation (DBS) has been used in a phase 1 study of patients with moderate to severe upper extremity hemiparesis resulting from stroke.[8] DBS was applied to the dentate nucleus of the cerebellum.

The clinical improvements were corroborated by findings of positron emission tomography (PET) scans that showed significant increments in brain metabolism in the areas of the brain that had been impacted by the stroke. The authors called DBS a “promising tool for modulation of late-stage neuroplasticity for functional recovery,” and noted it was both safe and feasible. 

Steven Cramer MS, MSc, who is a professor in the Department of Neurology at the David Geffen School of Medicine, UCLA, regards this as an “important and exciting” advance in treating patients with stroke.

“Unfortunately, at present, there are few options to boost recovery for patients who experience disability following stroke, although a number of restorative therapies are under study to improve outcomes,” he tells MDLinx. “[The] encouraging data presented in this study, coupled with favourable PET biomarker data, lay the groundwork for a phase 2 controlled clinical trial of this promising approach.”

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Disclaimer: This story is contributed by Batya Swift Yasgur and is a part of our Global Content Initiative, where we feature selected stories from our Global network which we believe would be most useful and informative to our doctor members.