Fast-Acting Malaria Drug Shows Promise in First-in-Human Study
A small-scale clinical study has shown that a new class of antimalarial drug can safely and quickly kill malaria parasites in the blood. Published today in Science Translational Medicine, these early clinical results open the door to much-needed treatment options to fight against malaria infections as cases of drug resistance continue to rise.
“Malaria continues to be responsible for a large global health burden, with an estimated 282 million cases and 610,000 deaths in 2024,” write the authors of the study, led by Stephan Chalon, MD, PhD, vice president of experimental medicine and clinical pharmacology at the nonprofit organization Medicines for Malaria Venture. “Fast-acting antimalarial drugs are needed to address the emergence of artemisinin resistance in Plasmodium falciparum, the major cause of severe malaria worldwide.”
Malaria infections caused by P. falciparum are typically treated with artemisinin-based combination therapy (ACT). As part of this first-line treatment, an artemisinin-derived drug dramatically reduces the numbers of malaria parasites circulating in the blood within a few hours while a companion drug with a slower mode of action eliminates the remaining parasites.
However, artemisinin-resistant malaria infections have been steadily increasing in Southeast Asia, and more recently in East Africa. As resistance spreads, the efficacy of first-line ACT progressively declines, driving an urgent need for fast-acting alternatives to artemisinin-based drugs.
The clinical trial evaluated the safety and tolerability of MMV367, an oral antimalarial drug candidate under development at Medicines for Malaria Venture. The drug belongs to the pyrrolidinamide class, a novel group of fast-acting antimalarials that interfere with two enzymes that are essential for malaria parasites to synthesize long-chain fatty acids.
As part of the study, 12 healthy volunteers were inoculated with P. falciparum and then treated with MMV367 after eight days. Results showed that doses of 20mg or above were able to quickly kill the parasites, with half of them being eliminated within 4.3 hours. The drug also proved safe in all participants, showing only mild side effects in some of them.
No evidence of emerging drug resistance against this novel drug class was found during the study. However, this will need to be confirmed in future studies with a larger patient population and longer follow-up period. While more research will be needed before this drug can reach people affected by malaria worldwide, these early clinical results support its potential as an alternative to artemisinins in antimalarial combination therapies as they increasingly lose efficacy in the face of escalating drug resistance.
As a product development partnership (PDP), Medicines for Malaria Venture works together with major pharmaceutical companies and academic institutions to promote the development of accessible and affordable medicines to treat and prevent malaria with a major focus on addressing the needs of children and pregnant women. Since its inception in 1999, the nonprofit has delivered 19 approved medicines, with many other candidates currently at various stages of clinical development.
The post Fast-Acting Malaria Drug Shows Promise in First-in-Human Study appeared first on Inside Precision Medicine.
Ultrasensitive HPV DNA Blood Test Could Help Personalize Head and Neck Cancer Treatment
Researchers from Mass General Brigham Cancer Institute have shown that HPV-DeepSeek, an ultrasensitive blood test that detects human papillomavirus (HPV) DNA, could predict which patients with HPV-associated head and neck cancer are most likely to benefit from adjuvant treatment after surgery.
“Right now, the decision to give adjuvant radiation or chemoradiation after surgery hinges almost entirely on TNM staging and surgical pathology,” explained senior author Daniel Faden, MD, director of the Head and Neck Cancer Genomics and Liquid Biopsy Program at Mass General Brigham Cancer Institute.
This means that surgeons and oncologists look at features like the number of involved lymph nodes, whether there’s extranodal extension, surgical margin status, and perineural invasion or lymphovascular invasion.
“The problem is, these are static, backward-looking variables,” Faden told Inside Precision Medicine. “They tell us what was in the tumor specimen, but they don’t tell us whether the patient has microscopic disease left behind after surgery.”
This can result in some patients receiving more treatment than they need, with potential unnecessary side effects, and others receiving less treatment than they should and later having their cancer come back.
Previous work has shown that circulating tumor (ct)HPV DNA is a promising biomarker for predicting head and neck cancer recurrence, but current assays, using droplet digital polymerase chain reaction (ddPCR), lack the sensitivity needed for detecting minimal residual disease (MRD) after surgery.
Faden and team therefore used their experience of studying HPV to build HPV-DeepSeek, a whole genome sequencing (WGS) assay that detects ctHPV DNA in blood samples.
He noted that the assay differs from most currently available MRD assays as it is not tumor-informed and does not require building a bespoke panel from each patient’s tumor. This makes HPV-DeepSeek tissue agnostic, and means the assay has a lower cost and faster turnaround times than tumor-informed WGS approaches.
Faden and team evaluated the performance of HPV-DeepSeek in the Clear-HPVca study, which included 103 patients (mean age 62 years, 89% men) with stage I to IV HPV-positive head and neck cancer who were treated with surgery.
The authors report in Science Translational Medicine that among 74 patients with ctHPV DNA status available during the postsurgery period (four days to six months after surgery, before adjuvant therapy), 23% were MRD-positive.
After a median follow-up of 27 months, patients with ctHPV DNA detected had worse outcomes than those with no ctHPV DNA. Specifically, the two-year disease-free survival rate was 60% among the patients who were MRD-positive, compared with 100% for those who were MRD-negative, and the two-year overall survival rates were 73% and 98%, respectively.
The researchers also found that HPV-DeepSeek could predict which patients benefit from adjuvant treatment; the recurrence rate was 27% among 15 MRD-positive patients who received adjuvant treatment compared with 100% among the two MRD positive patients who did not receive adjuvant treatment.
Conversely, there was no benefit of adjuvant treatment among MRD-negative patients; in this group, the recurrence rate was 3% among the 37 MRD-negative patients who received adjuvant therapy and 0% among the 21 MRD-negative patients who did not receive adjuvant therapy.
Furthermore, the assay identified molecular recurrence an average of seven months, and up to 17.5 months, earlier than clinical recurrence. With ddPCR, molecular recurrence was only detected four months earlier than clinical recurrence.
Although the team knew that HPV-DeepSeek was more sensitive than ddPCR, Faden described the size of the lead-time as striking.
“It tells us we’re detecting recurrence at a disease burden that’s genuinely clinically meaningful and actionable,” he said. “We had some patients where molecular detection preceded clinical detection by over a year. That kind of window creates real opportunities—time to discuss salvage surgery or systemic therapy before a patient ever develops symptomatic recurrence.”
Faden and team are now planning interventional trials that will investigate whether using HPV-DeepSeek to guide adjuvant therapy decisions improves outcomes and reduces toxicity.
Faden hopes that the assay will eventually be used to guide personalized treatment decisions.
“As a surgeon who treats this disease, not just a scientist who studies it, this is where I get genuinely excited—because it’s a shift in philosophy, not just methodology,” he said. “What HPV-DeepSeek does is make disease biology—specifically, whether there’s residual disease—visible in real time.”
He added: “If you can accurately detect MRD early after surgery, you can make treatment decisions based on that biology [and] the downstream implications are significant. You reduce unnecessary toxicity in patients who don’t need more treatment. You potentially intensify treatment in patients with residual disease. And you can rethink surveillance—if a patient remains MRD-negative after treatment, can we move to less frequent imaging and potentially spare them years of follow-up CT scans?”
“We’re not there yet clinically, but this is a first step—a research finding with real promise. It’s the beginning of a conversation about how to personalize care.”
The post Ultrasensitive HPV DNA Blood Test Could Help Personalize Head and Neck Cancer Treatment appeared first on Inside Precision Medicine.
Digital Portal Strengthens Patient Engagement in Cancer Clinical Trials
A digital platform designed to strengthen communication helped keep clinical trial participants engaged in a national oncology study, according to findings published in the journal JNCI Cancer Spectrum. The Participant Engagement Portal (PEP), developed by the Alliance for Clinical Trials in Oncology, was tested as part of the National Cancer Institute-sponsored Multi-Cancer Early Detection Biobank Study (A212102). Among participants who enrolled to use PEP, 84% reported a positive experience, 96% said it was easy to access, 93% found surveys easy to complete, and 93% agreed to be contacted about future research opportunities.
The findings provide a positive snapshot that digital tools designed to address participant needs can help improve their engagement throughout the term of a clinical trail, and aid in the the collection of data that can improve the efficiency and long-term value of oncology trials.
“We were eager to offer trial participants a format to allow connection to the study team,” said Suzanne George, MD, senior author of the study project and professor of medicine at Harvard Medical School. “Nearly all participants who engaged with the tool opted in for recontact for future research which allows the ability to build a research community. PEP gives patients a direct way [to] self-report key data elements, such as specific social and economic factors which may impact a person’s cancer journey.”
The intent in developing PEP was to find new ways to improve the experience of patients enrolled in clinical trials. Digital tools have the ability to simplify access to study materials, streamline data collection, aid in remote patient monitoring, and improve communication between researchers and trial participants. Specifically, PEP was created to improve engagement, which the researchers defined as sustained and beneficial interaction between participants and researchers over the course of the study. Unlike many digital tools focused on recruitment, PEP was designed to help researchers learn directly from patient experiences and maintain communication after trial enrollment.
“Historically, there are very few, if any, instances of trials providing consistent, longitudinal communication back to the patient about the overall clinical trial,” George told Inside Precision Medicine. “The large percentage of people reporting positive experience suggests PEP’s content and delivery methods resonate with them.”
To develop PEP, The Alliance used an iterative user-centered process that included advisory board input, usability testing with 19 patients, including 12 Spanish-speaking participants, and refinement using plain-language and health-literacy principles. Rather than requiring usernames and passwords, participants received secure links by text or email that allowed direct access to portal content and surveys.
The pilot was conducted within the MCED Biobank Study, an ongoing national clinical trial investigating future blood tests for the early detection of cancer. Of the total 2,221 study people enrolled in the trial, 40% chose to use PEP. Of the 899 users, 361 completed demographic questionnaires and 310 completed surveys addressing social determinants of health.
One of the portal’s central features was bidirectional communication that included trial participants receiving study updates, newsletters, and research information. PEP users could also provide feedback and report personal information that could help researchers better understand their experiences. According to George, participant feedback has influenced both the platform’s design and future patient engagement strategies.
“As noted in our manuscript, we conducted one-on-one focused interviews with people to evaluate the PEP on all levels, from communication methods and content to data security and privacy,” she said. “Through these findings, we were able to understand the need to transcreate documents into Spanish for cultural meaning and contextual relevance, rather than just translate them word-for-word.”
Feedback also led researchers to reconsider maintaining study-specific websites.
“Participant feedback substantiated our decision to eliminate dedicated study-specific PEP website(s),” George said. “Instead, we are transitioning to an IRB-approved newsletter format delivered directly to study participants for ongoing communication and education.”
The study also showed that people using PEP were willing to provide information about social determinants of health (SDoH), such as education, insurance status, housing stability, food insecurity, and financial concerns.
“If a trial chooses to formally integrate SDoH metrics, they could be included as protocol-directed surveys done via PEP, making results directly available to the protocol investigators,” George said. “Self-reported information is critical because it allows researchers to look beyond the actual study biology.”
Collecting this kind of information can help identify barriers that may affect treatment adherence, including transportation challenges, childcare responsibilities, and financial stress.
Another notable finding was that community-based practices enrolled a higher proportion of eligible participants into PEP than academic medical centers. The reasons remain under evaluation, but George suggested that established relationships between patients and local care teams may contribute to greater acceptance of the platform.
Further, the researchers found that 98% of participants were open to health-related follow-up communications. The research team believe this is an important outcome because it creates opportunities for future re-engagement and continued participation in research activities.
While the data from the pilot showed meaningful patient engagement, there were some limitations. Participants who enrolled in PEP were more likely to be female and White than the broader study population, raising questions about whether the data would be representative across diverse populations.
“Looking forward, PEP would ideally become a standard core functionality in all oncology studies,” George noted. “However, we will need to continue to expand outreach and continue to engage the participant community, to ensure we are indeed reaching all of those who would like to be part of such a platform.”
The post Digital Portal Strengthens Patient Engagement in Cancer Clinical Trials appeared first on Inside Precision Medicine.
AI Detects Breast Cancer Much Earlier than Radiologists Alone
Using AI, radiologists can see signs of breast cancer up to ten years earlier in the mammograms of patients later diagnosed with the disease, according to new research published this week in Radiology. These findings could help greatly accelerate diagnosis and improve decisions about who to screen sooner and with more regularity—questions that are increasingly important as more younger women are diagnosed with the disease.
The researchers tested three commercially available AI-based computer-assisted detection (AI-CAD) systems on mammogram data from a large screening population. Cancer prediction scores issued by AI-CAD were elevated for a significant number of patients later diagnosed with breast cancer compared to those who remained cancer-free. The team was led by researchers at the Karolinska University Hospital in Stockholm.
“Approximately 20% of breast cancer cases demonstrate mammographic signs that are already visible to AI around six years before diagnosis,” said senior coauthor Fredrik Strand, MD, PhD, of Karolinska. “Our study confirms the potential of AI to, in some cases, find signs of cancer in the mammograms much earlier than when radiologists detected it.”
Earlier diagnosis is crucial in breast cancer, as it is for most malignancies. Although annual breast screening, using mammography, is recommended for women in the U.S. aged 40 to 74, it is known that approximately 20-25% of women show early signs of breast cancer on their scans before they are diagnosed.
Strand’s team investigated AI’s potential to flag mammographic signs that were present up to 10 years in retrospect. The study included a total of 88,963 mammograms performed on 31,394 patients over 10 years—between January 2008 and April 2019. Of these participants, 12,072, or 38.5%, were diagnosed with cancer.
The data came from the Validation of Artificial Intelligence for Breast Imaging (VAI-B) database, which collects breast imaging data from volunteers across four regions of Sweden. The Swedish national breast screening program invites women between the ages of 40 and 74 to participate in screening examinations every two years, and each mammogram has traditionally been read by two radiologists. The average age of screening was 57.6 years.
The AI-CAD systems found many of those cancers at earlier screening points, achieving 90% specificity—distinguishing between a true positive and a true negative result—in up to 17% of patients at 10 years before diagnosis, up to 19.7% six years before diagnosis, up to 25.2% four years before diagnosis, and up to 39.3% two years before diagnosis.
“This study aims to add to the growing literature regarding the application of AI in breast cancer screening and how it can help play a role in earlier detection of breast cancer,” said Strand. “Analyzing the AI scores of screened individuals over time could provide insight into how early detectable changes arise, potentially allowing for earlier intervention.”
Breast cancer is the most commonly diagnosed cancer worldwide. It accounts for roughly 30% of all new female cancer diagnoses. In the U.S., AI-based systems have shown promise for predicting five-year risk of breast cancer and identifying women at risk of cancers that arise between regular screening mammograms.
The post AI Detects Breast Cancer Much Earlier than Radiologists Alone appeared first on Inside Precision Medicine.
In Silico Devices May Improve Drug Manufacturability
Using in silico tools to augment physical experiments can help identify manufacturability issues early in development. That’s according to an AI technology company that spoke on a recent panel.
BigHat Biosciences, which was among the companies presenting at PEGS Boston, explained that developing in silico models of antibody yields using a cell-free expression system allows the exploration of a wider range of mutations.
And this, in turn, lets companies better optimize their product for manufacturability.
“There’s only so many experiments you can do by putting an antibody into CHO [Chinese Hamster Ovary] cells,” explains Hunter Elliott, PhD, vice president of machine learning at BigHat Biosciences.
“With in silico tools augmenting that exploration side, we can build models that make predictions for improved sequences, screening many more antibodies in silico than we need to send to the lab.”
Elliott’s talk came alongside a panelist who argued it was important for preclinical researchers to communicate with the manufacturing departments of their companies to make a success of the latest generation of harder-to-manufacture drugs.
Speaking about his own products, Elliott argues that using in silico tools to explore a wider range of possible antibody mutations means it’s possible to select the handful with the highest possible yields as well as other improved biophysical properties.
“You’re derisking your processes because you’re combining your experiments with the in silico tools you’re using,” he says.
Talking about the panel, Elliott adds that discussion around the limitations of models included the lack of publicly available data on manufacturability and developability, especially for potential products that have failed to make it to the clinic.
Some have expressed concern that using in silico tools might also accidentally screen out the best-performing antibodies. Although, he says, “my personal opinion is that the ability to predict properties of sequences without sending them into the lab makes it easier for us to optimize from a suboptimal starting sequence.”
“With these models, we can keep this imperfect antibody in the loop and take it forward through several rounds of optimization, and then, instead of a candidate molecule being killed early on, it might be engineered into manufacturability.”
The post <i>In Silico</i> Devices May Improve Drug Manufacturability appeared first on GEN – Genetic Engineering and Biotechnology News.
Engineered Salmonella Delivers Cancer-Killing Virus to Tumors
Researchers have developed a bacterial delivery platform that uses engineered Salmonella to transport viral genetic material directly into tumors, producing near-complete tumor eradication in mouse models of pancreatic and liver cancer while generating durable antitumor immunity.
The approach, published in Cell Reports Medicine, combines two areas of cancer research that have largely advanced independently: bacterial cancer therapies and oncolytic viruses. By using tumor-targeting bacteria to protect and deliver viral genetic material, the investigators hope to overcome one of the major limitations facing systemic viral therapies for solid tumors.
“We put these two together,” said Neil Forbes, PhD, professor of chemical engineering at the University of Massachusetts Amherst and senior author of the study. “Our Salmonella protects the viral genetic material and delivers it specifically inside tumor cells.”
Combining bacterial and viral cancer therapies
Oncolytic viruses have attracted considerable attention as potential cancer therapies because they can selectively infect tumor cells, destroy them, and stimulate antitumor immune responses. However, delivering viruses to internal solid tumors has proven challenging. “If you inject the virus into the blood, it gets cleared by the immune system,” Forbes said. “You get a few to the tumor, but not enough that it either makes an effect, or you put in so many that it’s toxic.” As a result, many oncolytic virus clinical trials for solid tumors rely on direct injection into accessible tumors, limiting their use in cancers located deep within the body.
Forbes and colleagues sought to address that challenge using engineered Salmonella, which naturally accumulates within tumors after intravenous administration. The researchers modified the bacteria to invade cancer cells and then release their cargo intracellularly specifically into tumors.
Rather than administering intact viral particles, the team loaded the bacteria with plasmids containing the complete genome of an oncolytic virus. After entering tumor cells, the bacteria release the viral genetic material, which then migrates to the nucleus and begins the viral replication process.
“The Salmonella get inside the cancer cell, they release the genomic material that then traffics to the nucleus of the cancer cell, where the virus starts to work like it naturally does,” Forbes said. The virus subsequently replicates, forms infectious viral particles, destroys the host cancer cell, and spreads throughout the tumor microenvironment.
Strong responses in pancreatic and liver tumors
The researchers evaluated the platform in mouse models of pancreatic and liver cancer, using animals with fully functional immune systems. “We use mice with full immune systems because that’s the whole idea here—we’re going to trigger an immune response,” Forbes said.
The results were striking. According to Forbes, treatment produced near-complete tumor eradication in most animals. The study also demonstrated that intravenous administration was sufficient to achieve therapeutic activity. Tumor responses following systemic delivery were comparable to those observed with direct tumor injection.
“We showed that we can get the same tumor reduction from an IV injection as we do from an intratumoral injection,” Forbes said. The finding suggests that the bacterial carrier successfully protected the viral payload in circulation and delivered it to tumor sites after systemic administration.
Evidence of durable antitumor immunity
Beyond direct tumor destruction, the investigators found evidence that the therapy generated a robust adaptive immune response against cancer cells.
To test whether immune memory had developed, the researchers harvested splenocytes from treated mice and transferred them into naïve animals that had never been exposed to tumors, Salmonella, or the virus. The recipient animals were subsequently challenged with tumor cells. “In 100% of the cases they did not take any tumors,” Forbes said. “We’ve generated this antitumor immunity against the tumor.” Importantly, the protection appeared to be directed against the cancer itself rather than against the bacterial or viral components of the therapy.
According to Forbes, the findings suggest the treatment could potentially help prevent metastatic disease or tumor recurrence after elimination of the primary tumor.
Addressing safety concerns
The use of live bacteria as a cancer therapy has historically raised concerns about toxicity and safety. To address those issues, the researchers engineered additional modifications into the Salmonella strain.
During development of the platform, the team removed bacterial antiviral genes that would otherwise interfere with viral production. Unexpectedly, those modifications also appeared to improve safety. “We found that those Salmonella we made with those deletions end up being much safer,” Forbes said.
The modified bacteria were cleared more efficiently from normal tissues and were more susceptible to elimination by macrophages, reducing the likelihood of persistent infection.
While treatment was not entirely free of side effects, Forbes described the observed toxicities as relatively mild. “The side effects from any delivery of bacteria are going to be like standard flu-like symptoms,” he said. “We’re talking about late-stage cancer patients where the prognosis is usually really poor.”
Expanding the therapeutic toolbox
Although the current work remains preclinical, Forbes believes the study highlights the broader potential of engineered bacterial therapies as programmable platforms for cancer treatment. “I think that bacteria have massive potential to treat disease, specifically cancer, in ways that we can’t do with small molecules,” he said.
Unlike conventional drugs, bacteria can be engineered to carry multiple therapeutic payloads, control where treatment occurs and coordinate several biological mechanisms simultaneously.” It is very plastic, highly modifiable, very flexible,” Forbes said. “We can control timing, we can control localization, so we have a lot of power.”
Forbes hopes the findings encourage more researchers to explore bacterial approaches alongside other forms of immunotherapy and targeted therapy. “I want people to see the massive ways that we could treat cancer,” he said. “There are a lot of possibilities that I think are untapped.”
The post Engineered <i>Salmonella</i> Delivers Cancer-Killing Virus to Tumors appeared first on Inside Precision Medicine.
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