Bowel and Ovarian Cancer Cases Rise Among U.K. Young Adults

Cases of bowel and ovarian cancer are rising, but only among people under 50, according to research published in the British Medical Journal Oncology today, April 28, 2026. While other types of cancer are also rising in older adults, this particular trend among younger adults is striking. 

A key factor, the researchers’ work suggests, is excess weight. But that does not fully explain the trends they saw.

In particular, there was a significant rise in 11 cancers among the younger adults with known behavioral risk factors. These cancers were: thyroid, multiple myeloma, liver, kidney, gallbladder, bowel, pancreatic, womb lining (endometrial), mouth, breast, and ovarian cancers. 

Rates of all these cancers also rose significantly among the older adults, with the notable exceptions of bowel and ovarian cancers.  

Besides mouth cancer, all 11 cancers associated with known behavioral risks were linked to obesity. And six (liver, bowel, mouth, pancreas, kidney, and ovary) were also linked to smoking; four (liver, bowel, mouth, and breast) were associated with alcohol intake; three (bowel, breast, and endometrial) were linked to physical inactivity; and one (bowel) was associated with dietary factors.

“Of the 11 cancers we identified which were increasing and linked to known lifestyle factors—the most common by far in younger adults was breast cancer,” the study’s lead author, professor Montserrat Garcia-Closas, MD, DrPH, told Inside Precision Medicine. Garcia-Closas is in Integrative Cancer Epidemiology, Division of Genetics and Epidemiology, and The Cancer Epidemiology and Prevention Research Unit, The Institute of Cancer Research, London.

The rising incidence of certain cancers among people under 50 isn’t unique to England, and one major question is whether changes in behavioral risk factors might be to blame.

This research group analyzed cancer incidence trends in England from the National Disease Registry Service for the period 2001 to 2019, comparing patterns by sex in two age groups: 20–49 year olds and those aged 50+ for more than 20 different cancer types.

This database, “Captures virtually every cancer diagnosis in England going back decades—one of the most complete registries in the world. That scale is what allows us to track trends reliably across the whole population, not just a sample,” said Garcia-Closas.

The team used national health surveys to look at trends in established risk factors: smoking, alcohol intake; diet (high red/processed meat, low fiber intake), excess weight (BMI), and physical inactivity to quantify any changes by age and sex and estimate the proportion of cancers attributable to specific risk factors.

Their analysis showed that new cases of 16 out of 22 cancers in younger women, and 11 out of 21 cancers in younger men, increased significantly in England between 2001 and 2019. 

And five cancers—endometrial, kidney, pancreatic, multiple myeloma, and thyroid cancer— increased significantly faster in younger than in older women, while multiple myeloma increased faster in younger than in older men. 

But with the exception of excess weight, trends in these risk factors over the past one to two decades have been stable or improving for younger adults, with the largest reductions of around 7% in red meat consumption. 

The average daily amount of red meat eaten, they report, fell from 38 grams in 2008 to 17 grams in 2018 among younger men, and from 22 grams to 10 grams in younger women. And average processed meat intake in younger women was half that of younger men: 10 grams versus around 20 grams. And while more than 90% of younger adults weren’t eating enough fiber in 2018, their intake remained stable or slightly improved in both sexes between 2009 and 2019. And these trends were similar in older adults. 

Established behavioral risk factors accounted for a substantial share of cancer cases. In 2019 these contributed 68%–65% of mouth cancers for younger and older men, respectively; 42%–48% of liver cancers; 49%–53% of bowel cancers, 29%–33% of kidney cancers, and 36%–34% of pancreatic cancers.  

Among women they accounted for 52%–45% of mouth cancers; 35%–42% of endometrial cancers; 44%–46% of liver cancers; 38%–42% of bowel cancers; 33%–37% of kidney cancers; 31%–28% of pancreatic cancers; and 19% to 24% of gallbladder cancers. 

Excess weight was the risk factor associated with most cancers in 2019, ranging from 5% for ovarian cancer to 37% for endometrial cancers. 

“These patterns suggest that while similar risk factors across ages are likely, some cancers may have age-specific exposures, susceptibilities, or differences in screening and detection practices,” write the researchers.

“Prevention takes a long time and we must act now with what we know, with better and more effective public health policy and programs to address the overweight and obesity epidemic,” said Garcia-Closas.

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Who Gets a Second Cancer—and When? Large Study Reveals Complex Patterns

As cancer survival rates improve, a new challenge is coming into sharper focus: what happens after the first cancer is treated. A large population-based study drawing on decades of U.S. registry data offers one of the most comprehensive looks yet at the risk of subsequent primary cancers (SPCs)—and reveals a complex, evolving landscape shaped by age, sex, and generational exposure. The work was published in PLOS Medicine.

Using data from more than 3.3 million individuals diagnosed with a first primary cancer between 1975 and 2019, investigators from the Virginia Commonwealth University (VCU) School of Medicine analyzed nearly 30 million person-years of follow-up, identifying more than 510,000 second cancers. Their findings, based on Surveillance, Epidemiology, and End Results (SEER) registries, show that SPC risk is not static but varies significantly depending on when patients were born, how old they were at diagnosis, and the type of cancer they initially had.

“We have follow-up guidelines after treatment for the primary cancer, but we don’t really know what risk profile these patients fall into for another cancer,” said Susan Hong, MD, who co-directs a cancer survivorship outcomes research program at VCU and co-directed the study. “They’re not average-risk individuals—but they’re not necessarily at extremely high risk across the board either. That’s where it becomes very nuanced and complex.”

Age and sex drive risk—but not uniformly

The analysis confirmed that SPC incidence increases with age at first cancer diagnosis, rising substantially in both men and women, though more steeply in males. Among women, rates climbed from 915 per 100,000 person-years at ages 35–39 to 1,980 at ages 75–79; in men, the increase was from 1,228 to 2,945.

But these patterns were not consistent across all cancer types. For breast cancer survivors, the risk of developing a second cancer remained relatively stable regardless of age at diagnosis—a finding that surprised the investigators.

“I was kind of surprised that the risk of subsequent cancer didn’t vary by age among breast cancer survivors,” said Hui Cheng, PhD, the study’s lead analyst. “I thought older patients would have higher risk, but that wasn’t necessarily the case.”

By contrast, survivors of lung and bladder cancers and melanoma showed a clear age-related increase in SPC risk, suggesting that surveillance strategies may need to differ significantly by index cancer type.

Cohort effects point to environmental and behavioral drivers

One of the study’s most striking findings emerged from its age–period–cohort modeling: SPC risk peaked among individuals born between 1935 and 1945, then declined in more recent birth cohorts—with notable exceptions.

Researchers observed rising risks among female lung cancer survivors and male bladder cancer survivors, even as overall SPC incidence declined in more recent decades. The cohort-specific patterns hint at underlying environmental or behavioral exposures that vary across generations.

“We observed higher risk in cohorts born in the ’40s and ’50s,” Cheng said. “If we think back, those individuals were young adults during peak tobacco use, which may be a contributing factor. But we don’t have individual-level smoking data, so we can’t confirm that directly.”

This limitation underscores a key challenge of large registry-based studies: while they offer statistical power and long-term follow-up, they often lack granular data on treatment exposures, genetics, and lifestyle factors.

Treatment advances and unintended consequences

The findings also reflect the dual-edged nature of cancer treatment progress. As therapies improve and patients live longer, the window for developing late effects—including second malignancies—widens.

“We’re doing so well treating primary cancers, and people are living longer,” Hong said. “But we also need to think about what risk profile these patients fall into over time.”

Radiation therapy and certain chemotherapies are known contributors to secondary malignancies, with risks often emerging 10 to 15 years after exposure. Yet without detailed treatment data, the current analysis cannot disentangle these effects.

Instead, the study serves as what investigators describe as a “hypothesis-generating” effort—mapping broad patterns that can guide more targeted research.

Toward risk-stratified survivorship care

“We’re trying to figure out how to risk-stratify patients and pay attention to their long-term health care needs without overreacting or underreacting,” Hong said.

In practice, that could mean more intensive surveillance for older survivors of certain cancers, while maintaining consistent monitoring across age groups for others, such as breast cancer.

The findings also highlight gaps in the current survivorship infrastructure—particularly for adult-onset cancers. While pediatric oncology has long benefited from coordinated long-term follow-up systems, similar frameworks are less developed for adult survivors.

“There’s been a long-standing effort to follow childhood cancer survivors, but we don’t have that kind of system in place for adults,” Hong noted. “Now that we’re seeing more cancers in younger adults, we need to think about how to address decades of survivorship.”

A starting point for deeper investigation

Ultimately, the study raises as many questions as it answers. Why do certain cohorts carry higher risks? How do treatment regimens, genetics, and lifestyle interact to drive SPC development? And which risk factors are modifiable?

The research team is already looking ahead to studies that can incorporate more detailed patient-level data, with a focus on identifying actionable prevention strategies.

“We’re very interested in understanding what factors are associated with better or worse outcomes—especially modifiable risk factors,” Cheng said.

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Hodgkin Lymphoma Develops as a Result of Arrested B Cell–Plasma Cell Transition

Weill Cornell Medicine researchers have defined new transcriptional and functional characteristics of Hodgkin and Reed-Sternberg (HRS) cells in classic Hodgkin lymphoma (cHL), detailing how malignant cells are the result of an arrested stage of B cell development. The research, published Blood Cancer Journal, shows that characteristics of HRS cells are incomplete plasma cell differentiation, robust unfolded protein response (UPR) activation, and coordinated immune evasion mechanisms that influence both T cells and natural killer (NK) cells.

“Hodgkin lymphoma is unique in that the tumor cells don’t form continuous sheets of tumor cells, but they are largely scattered within lymphoid tissues that are not cancerous,” senior author Ethel Cesarman, MD, PhD, pathologist at Weill Cornell Medicine told Inside Precision Medicine. “High proliferation or reduced cell death are not the predominant features of these cells. It is tumor of B cell origin, but unlike normal B cells that develop into plasma cells that produce antibodies but can no longer divide, the tumor cells of Hodgkin lymphoma are stuck in between.”

To define the molecular activity that leads to this arrested state, the researchers analyzed RNA sequencing data from 18 primary cHL tumors, four cHL cell lines, and matched intra-tumoral B cells. They then compared these data with 40 cases of primary mediastinal B cell lymphoma (PMBL).

The resulting data showed that HRS cells lose core B cell identity programs while simultaneously acquiring partial plasma cell-like gene expression. This reflects an “abortive plasma cell differentiation” process in which B cell development begins but is not completed. Normally, germinal center B cells transition into antibody-secreting plasma cells, but in cHL this process is interrupted, and immunoglobulin production is lost.

An important finding of this study was activation of the unfolded protein response (UPR) pathway, which is usually active in plasma cells to help manage the stress of high-volume antibody production. In HRS cells, however, immunoglobulin synthesis is absent. This mismatch appears to place the cells under chronic endoplasmic reticulum stress, which may then be redirected to serve as a survival mechanism.

The study also found that UPR-related genes, including XBP1, ATF6, and particularly PDIA6, were highly expressed in HRS cells. PDIA6 emerged as a potentially specific diagnostic marker. As Cesarman noted in her interview, Hodgkin lymphoma sometimes can be hard to diagnose. “A marker commonly used is CD30, but these may be expressed in other neoplastic and benign conditions, so PDIA6 may be a useful immunohistochemical marker for further differentiation,” she added.

This provides a new framework for understanding the role of UPR activation, which has not been widely implicated in prior models of Hodgkin lymphoma. Historically cHL research has focused on B cell receptor signaling defects, NF-κB activation, and immune checkpoint expression.

The team also noted that HRS cells showed many similarities to plasma cell malignancies such as multiple myeloma, notably their reliance on UPR signaling. However, unlike multiple myeloma, cHL cells fail to complete terminal plasma cell differentiation and do not consistently express CD138 or secrete immunoglobulins, showing that the two malignancies have only a partially shared differentiation trajectory.

The Weill Cornell team also found that immune evasion is another defining feature of cHL. They found evidence of downregulation of SLAM family ligands, including CD48, which are required for NK cell recognition and activation. This loss impairs NK cell-mediated cytotoxicity. The study also found reduced NK cell infiltration in tumor microenvironments. Additionally, HRS cells are known to evade T cell surveillance through antigen presentation defects and checkpoint ligand expression. Together, these findings show cHL mounts a coordinated escape from both innate and adaptive immunity.

The new findings could have implications for clinical care in the future. The identification of UPR dependency presents the opportunity to target proteostasis pathways as a treatment strategy.

“The UPR is a complex pathway, but there have been studies in solid tumors aiming to target it therapeutically, and in the context of multiple myeloma, it has been suggested that proteosomal inhibitors like bortezomib, act in part by leading to the accumulation of unfolded proteins leading to ER stress and eventually apoptosis,” Cesarman said. “While much more work needs to be done to fully characterize the UPR in Hodgkin lymphoma and identify therapeutically actionable aspects of this pathway, our findings point us in the right direction to explore the potential of such an approach.”

Cesarman also noted that while NK cell-based therapies are under development in oncology, the observed downregulation of NK ligands suggests this may not be a viable strategy for therapeutic development.

Future research will now focus on understanding more about how plasma cell differentiation programs become arrested in germinal center B cells, identifying upstream regulators of UPR activation in cHL, and determining whether these stress pathways are required for tumor cell survival. Additional studies are also expected to explore whether restoring immune recognition signals or targeting proteostasis can be combined with existing immune checkpoint therapies.

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An Internet of Things–Based Audio and Radio Connected System Supporting Older Adults With Physical and Cognitive Health Challenges: Qualitative Stakeholder-Informed Design Study

<strong>Background:</strong> Older adults managing chronic illnesses, such as cancer and Alzheimer disease and related dementias (ADRD), often experience significant physical or cognitive impairments that hinder daily activities and increase caregiver burden. Smart Internet of Things (IoT) technologies offer promising solutions by enabling passive monitoring, timely reminders, and personalized support at home. However, these technologies must be carefully tailored to accommodate users’ individualized needs and preferences. <strong>Objective:</strong> This formative qualitative study aimed to explore stakeholder perspectives, including patients, caregivers, health care providers, and technical experts, on the use of smart home–based IoT systems to support chronic illness management. The goal was to inform the early development of the audio and radio connected (AURA) system, an IoT prototype integrating Wi-Fi sensing, wearable trackers, and voice-assistive features. <strong>Methods:</strong> Semistructured interviews were conducted with 6 patients who underwent postostomy creation for colorectal or bladder cancer treatment and 5 patients with ADRD and their caregivers. Input from additional stakeholders, including 2 health care providers, 2 community health workers, and 2 computer scientists, was also included in the report. Stakeholders reviewed a demonstration video depicting the conceptual features of the AURA system. Interviews explored stakeholders’ needs and preferences for using such systems. Thematic analysis was guided by the extended Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) framework, with 5 adapted constructs: performance expectancy, effort expectancy, social influence, facilitating conditions, and hedonic motivation and habit. <strong>Results:</strong> Stakeholders identified distinct yet complementary needs across populations. Patients with cancer emphasized physical health monitoring, integration with health care systems, and customization; ADRD stakeholders prioritized routine support, emotional engagement, and simplicity; caregivers and clinicians emerged as key influencers of adoption. Barriers included privacy concerns, technology literacy, and fatigue, while facilitators included perceived caregiving support, streamlined interfaces, and electronic health record integration. Patients with cancer focused on motivational cues for physical activity, while emotional engagement and habit were more prominent for ADRD users. <strong>Conclusions:</strong> Stakeholder insights underscore the importance of designing adaptable, user-centered IoT systems that reflect the varied capabilities and care needs of older adults with chronic illnesses. These findings informed the design of the AURA prototype and highlighted theoretical considerations for technology acceptance in health care. Future work will test AURA in real-world settings to evaluate usability, acceptability, and clinical relevance. <strong>Trial Registration:</strong>

STAT+: Why conversations around health AI may be evolving beyond hype

You’re reading the web edition of STAT’s AI Prognosis newsletter, our subscriber-exclusive guide to artificial intelligence in health care and medicine. Sign up to get it delivered in your inbox every Wednesday. 

My phone blew up while I was on vacation last week: The Associated Press Stylebook announced “health care” should actually be one word, “healthcare.” STAT is still deciding which we should use. Which do you prefer? You can weigh in here.

(Will my newsletters technically be shorter if we switch to “healthcare”? Food for thought.)

Maybe now we can have a real conversation about AI in health care

In his recent video “The People Do Not Yearn for Automation,” The Verge editor-in-chief Nilay Patel explains “software brain” — thinking about the world as a series of databases that are easily manipulated to solve problems — and why that is creating a disconnect between the AI world and everyone else.

The AI world thinks that AI really can solve the world’s ills and thus anti-AI sentiment is just a marketing problem. But people who are trying to slow AI adoption have legitimate concerns about the tradeoffs and performance of the technology that software-brained people are dismissing, he says.

Continue to STAT+ to read the full story…

Supply Chain Digital Twins: An Evolution, Not a Breakthrough

Digital twins help optimize drug production processes by modeling the thousands of interactions that cells, raw materials, and reagents undergo in culture. And new analysis suggests they could do the same thing for supply chains.

Researchers at the U.S. National Institute of Standards and Technology (NIST) and EMD Millipore put forward the idea, arguing that twins could make drug distribution, which is also characterized by thousands of interactions, more resilient and efficient.

Lead author Perawit Charoenwut, a logistics researcher at NIST’s systems integration division, tells GEN, “A digital twin could be extremely helpful in all phases of the biopharmaceutical supply chain. Starting from demand planning triggered by global events such as pandemics, regional disease outbreaks, aging demographics, etc., through to being able to provide visibility on capacity requirements and limitations.”

In silico models could also provide solutions to disruption by identifying alternative supply options, such as distribution centers or regional inventories, in less time, Charoenwut says.

“Digital twins could also be helpful in evaluating different suppliers by running simulations on their potential performance, based on different demand scenarios versus their individual capacities and capabilities,” he continues.

Standards

In theory, digital twins are a good option for supply chain modeling and management. In practice, however, firms interested in the approach will need to overcome some technical challenges.

For example, one major hurdle is the lack of data standardization, according to study co-author Boonserm Kulvatunyou, PhD, a computer engineer at NIST. “Supply chain digital twins require data from across organizations and third-party sources,” he tells GEN. “The lack of industry standards creates challenges in obtaining all the necessary data.”

With this in mind, the NIST’s Industrial Ontology Foundry (IOF) is working with the National Innovation Institute for Manufacturing Biopharmaceuticals (NIIMBL) to develop open-source ontology and schema standards for connecting data.

Kulvatunyou says, “The aim is to provide a semantic foundation for connecting data and knowledge across the manufacturing and supply chain operations.

“Further work is being conducted to cover broader materials, processes, and quality data,” he says. “We would like to invite industry and academia to join this effort and benefit from these new standards.”

Industry interest

Biopharma firms interested in digital supply chains will also need to establish a solid data infrastructure, according to Charoenwut, who says companies should start small and pace themselves.

“We think that biopharma companies do believe that digital twins could make a significant difference in their supply chain efficiency and resiliency. Many of them are probably building prototypes and proofs-of-concept to demonstrate the value and potential benefits, but then soon realize the digital data foundation gaps that need to be addressed in parallel in order to fully adopt this technology.

“As digital twins can vary in detail and complexity, companies should strategize digital twin adoption by starting with lower-complexity cases based on available digital data and progressively moving up the scale to gain greater precision and new capabilities. In other words, the implementation of digital twins should be viewed as an evolution rather than a breakthrough,” he says.

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Milk Exosomes Transform Therapeutic Bioprocessing

Breast milk has long been understood as more than infant nutrition. It is a biologically active system packed with molecular signals that help shape immune development, metabolism, and even brain function. Among its most intriguing components are milk-derived extracellular vesicles—tiny lipid-bound particles often called milk exosomes—that are rapidly becoming one of bioprocessing’s most promising therapeutic tools.

These nanoscale carriers are naturally designed for transport. They can survive digestion, move into circulation, and distribute cargo throughout the body, with studies suggesting they may even reach the brain during early development. Researchers have shown that these vesicles can influence central nervous system communication, particularly through interactions with microglia, which are crucial to the brain’s immune cells. The ability of milk exosomes to carry microRNAs and regulate epigenetic pathways, including DNA methyltransferase 1 (DNMT1), points to a sophisticated biological delivery system that the industry is now learning to harness.

That potential is especially compelling in drug manufacturing, where delivery often determines whether a therapy succeeds or fails. Traditional nanoparticles can trigger toxicity, instability, or poor absorption. Milk exosomes offer a more elegant alternative: they are biocompatible, naturally abundant, and scalable for pharmaceutical development.

Huiming Tu, MD, a researcher and clinician in the department of gastroenterology at the Affiliated Hospital of Jiangnan University in Wuxi, China, and his colleagues recently demonstrated this with ulcerative colitis. Their team developed an oral delivery platform called mEXOs@TOF, which loads the pan-JAK inhibitor tofacitinib into milk-derived exosomes. The resulting formulation showed strong pharmaceutical performance, including consistent particle size, high drug-loading efficiency, and strong stability during delivery.

More importantly, the therapy improved anti-inflammatory outcomes through multiple mechanisms. It lowered inflammatory mediators such as IL-6, IFN-γ, and nitric oxide, while increasing anti-inflammatory IL-10. It also reduced oxidative stress and suppressed activation of the JAK-STAT3 signaling pathway. In both laboratory and animal studies, the system delivered strong therapeutic benefits without detectable toxicity—an ideal benchmark for translational bioprocessing.

Cancer therapy is seeing similar innovation. Min Suk Shim, PhD, professor of nano-bioengineering at Incheon National University in the Republic of Korea, and colleagues focused on sonodynamic therapy, in which ultrasound activates a sensitizing drug to destroy tumors. Their challenge was improving intracellular delivery of chlorin e6 (Ce6), a common sonosensitizer.

The team engineered glutathione-responsive milk exosomes by incorporating a diselenide bond-bearing fatty amine derivative. This allowed the vesicles to remain stable during circulation but release Ce6 inside breast cancer cells, where glutathione concentrations are higher. Once ultrasound was applied, reactive oxygen species production increased dramatically, leading to significant cancer cell death in MCF-7 breast cancer models. The work shows how responsive bioprocess design can turn natural vesicles into precision-triggered therapeutics.

Meanwhile, scientists from Hong Kong and China have reviewed the broader landscape of milk exosomes in breast cancer treatment. Beyond acting as delivery vehicles for drugs like doxorubicin, paclitaxel, and 5-fluorouracil, milk exosomes may also have direct anti-tumor effects. They can promote apoptosis, interrupt the cell cycle, and regulate pathways such as NF-κB and STAT3. Combined with plant-derived compounds like curcumin and resveratrol, they form hybrid nanoparticles with enhanced therapeutic power.

For bioprocessing, the message is clear: milk exosomes are no longer a niche curiosity. They represent a scalable, safe, and highly adaptable platform for next-generation therapeutics—one that begins with biology’s oldest delivery system and may define medicine’s next one.

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Hopes Raised for More Sustainable Oligonucleotide Manufacturing

Large-scale manufacturing of oligonucleotides could become more environmentally friendly if the biotech industry can overcome the challenges of a promising technique for synthesizing them. That’s according to QurAlis, a clinical-stage biotech company targeting neurodegenerative disease.

Hagen Cramer, PhD, QurAlis’s CTO, thinks synthesizing oligonucleotides using enzymes could be more sustainable than traditional solid-phase synthesis methods, but challenges remain for the industry.

“Solid-phase synthesis is convenient—you can have everything automated, it’s fast, and can be used for [many] types of therapeutics,” he says. “However, because it’s a solid-phase synthesis, you have to wash away the external reagents with lots of solvents, and that’s why the mass intensity is high.”

By contrast, manufacturing RNA and DNA using a process that happens in nature and is aqueous-based uses fewer materials in the production of any given mass of product, notes Cramer. However, creating a wide selection of enzymes to manufacture multiple products remains a challenge for the industry.

“Enzymatic synthesis]was explored a long time ago, but it went away because people couldn’t figure out the challenges,” he points out. “But there’s now a lot more money in the industry as we have approved drugs and, hence, it’s now being reinvestigated.”

Other challenges include using enzymatic techniques for manufacturing above the 100-g scale and also speeding up these techniques to be comparable with solid-phase synthesis.

“With solid-phase synthesis, if you have a 20-mer oligonucleotide, you might have to take 80 chemical steps, and you can be efficient and complete all of that in a day, but—with an enzymatic approach—it’s going to take much longer and the development time is also large,” explains Cramer, adding that clinical-stage companies making smaller volumes may want to stick with solid-phase synthesis. But, he continues, commercial-stage companies producing large volumes of product may want to investigate enzymatic approaches as they become available.

“At a certain stage, if you’re working at commercial stage already, you can plan ahead and I think the industry will move toward these new approaches starting post-market,” he says.

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Adaptive, Agent-Oriented Control for Biomanufacturing Systems

Agentic AI goes beyond predictive and generative AI and, in biomanufacturing, has the potential to enhance efficiency by integrating with existing manufacturing infrastructure such as IoT sensors, process information management systems, management execution systems, and even enterprise resource planning software. The challenge, however, is that industrial biomanufacturing processes are complex, demand resilience, and are tightly regulated.

The Adaptive Agent-Oriented System Control (AAOSC) framework developed by a team from the Technical University of Denmark (DTU) and SiC Systems addresses that challenge through a decentralized control layer. In it, “specialized autonomous agent ‘hives’ [are] coordinating digital twin enabled manufacturing infrastructure and real-time communications protocols.” The latter lets biomanufacturers integrate models, make learning-based inferences, and control process systems.

Four AAOSC case studies were discussed in a recent paper by Seyed Soheil Mansouri, PhD, professor at DTU and co-founder and CSO of SiC Systems and Christopher J. Savoie, PhD, co-founder and CEO of SiC Systems, and inventor of the agentic AI technology behind Siri. Those case studies “demonstrate AAOSO’s prowess [in] reducing deviating durations, averting shutdowns in severe fault scenarios, and boosting efficiency through virtual quantum and classical sensing and decentralized reasoning, all while aligning with regulatory imperatives…”

Despite its capabilities in monitoring process, identifying discrepancies, and recommending solutions, agentic AI “is not yet fully ready for complete, independent control in biopharmaceutical manufacturing,” Mansouri tells GEN. “Any AI that directly affects medicine quality still needs strong human oversight and full approval. We are getting closer, but full integration requires official [regulatory] clearance.”

The AAOSC framework that Mansouri and colleagues built may be unique in the industry. It isn’t all-knowing and “God-like,” he points out. Instead, “our methods are grounded in physics, chemistry, and biology within an agent ‘hive’—an orchestration of rule-based, mathematically informed agents. So, AAOSC is, foundationally, a different philosophy of building AI [in which] humans are in control.”

First, run in shadow mode

To introduce agentic AI, Mansouri advises starting gradually. “Run the AI alongside your current control systems in shadow mode—it watches everything and gives recommendations, but doesn’t make any actual changes without human oversight. This lets the teams learn how it works without any risks to production. Once confident, you can slowly expand its role while always keeping humans in final control.”

Both the FDA and EMA require systems that are fixed rather than continuously learning, he points out, and that can complicate adoption. To minimize the potential for regulatory issues that may arise by integrating AI into manufacturing processes, “work closely with your quality and regulatory teams from the beginning.

“Always maintain clear human responsibility, so no one is left wondering who is accountable if something goes wrong. Strong cybersecurity is essential,” Mansouri adds, “because these AI agents connect and talk to each other.” Therefore, “Start small, test thoroughly, and talk to regulators early.”

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Loss of Smell Therapies Informed by Olfactory Receptor Spatial Mapping

A new study published in Cell titled, “A spatial code governs olfactory receptor choice and aligns sensory maps in the nose and brain,” led by researchers from Harvard Medical School (HMS) has created the first detailed map of the spatial distribution of over 1,000 olfactory receptors in the epithelium. The study informs the development of therapies for loss of smell, where treatment options are limited.

The researchers examined approximately 5.5 million neurons in more than 300 individual mice using single-cell sequencing and spatial transcriptomics. Results showed that neurons are organized into tight, overlapping, horizontal stripes from the top to the bottom of the nose based on the type of smell receptor expressed. This highly organized receptor map was consistent across mouse models and mirrored the organization of smell maps in the brain. Similar maps have been observed in vision, hearing, and touch.

Notably, the olfactory map was informed by a gradient of retinoic acid in the nose, which allowed each neuron to express the correct type of smell receptor based on its spatial location.  

“Our results bring order to a system that was previously thought to lack order, which changes conceptually how we think this works,” said Sandeep (Robert) Datta, PhD, professor of neurobiology at HMS and senior author and corresponding author of the study. “We show that development can achieve this feat of organizing a thousand different smell receptors into an incredibly precise map that’s consistent across animals.” 

The authors also found that the receptor map in the nose matches up with smell maps in the olfactory bulb of the brain, shedding insight into how information moves from the nose to the brain. 

While sensory maps that describe how receptors in the eye, ear, and skin are organized to capture and interpret auditory, visual, and touch information, mapping olfactory receptors has been a longstanding challenge due to high receptor diversity. As an example, mice have approximately 20 million olfactory neurons that express more than a thousand types of smell receptors, compared with only three main types of visual receptors for color vision. Each type of smell receptor detects a unique subset of odor molecules. 

The team is also studying smell receptors in human tissue to understand to what degree the smell map is consistent across species to inform treatments, such as stem cell therapies and loss of smell and its consequences, such as an increased risk of depression. 

“Smell has a really profound and pervasive effect on human health, so restoring it is not just for pleasure and safety but also for psychological well-being,” Datta said. “Without understanding this map, we’re doomed to fail in developing new treatments.” 

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