technologies

Boron neutron capture therapy used to need a nuclear reactor. These hospital-sized accelerators make the neutron beam instead, and in 2020 Japan approved the first one, with its boron drug, for head and neck cancers that have come back or cannot be removed.

Three more drugs are licensed for chronic GvHD that has not responded to earlier treatment. Their response rates look high, between half and three quarters, but they come from trials with no comparison group. Ibrutinib is the cautionary case: it looked good in a single-arm study and then did not beat prednisone alone when tested against placebo.

Real-time software that highlights polyps on the colonoscopy screen, helping doctors find more of the growths that could become bowel cancer.

Software that reads digitised biopsy slides to detect cancer, grade it, and score biomarkers such as HER2, PD-L1 and Ki-67 more consistently than the eye alone.

Software that reads screening mammograms alongside or before radiologists, catching more cancers and cutting the reading workload in large trials.

An antibody-drug conjugate is an antibody that homes to a protein on the tumour cell, is swallowed, and releases a chemotherapy payload inside it. That widens chemotherapy's safe dose window about a hundredfold, which is why payloads too toxic to give alone can be used, though lung inflammation, neutropenia and eye toxicity from the payload still occur.

Drugs that switch off BCL-2, the protein that lets cancer cells refuse to die; venetoclax transformed treatment of chronic lymphocytic leukaemia and acute myeloid leukaemia.

Eyelashes and eyebrows often fall out with chemotherapy and can be slow to return. Bimatoprost, a glaucoma eye drop approved for thin lashes, applied along the lash line each night increased lash length and thickness in a randomised trial that included people after chemotherapy.

A bispecific antibody is one antibody with two different grabbing arms, so it can block two targets at once or pull an immune cell onto a cancer cell.

A urine test from the Israeli company Nucleix that reads fifteen DNA methylation markers and gives a score for bladder cancer recurrence, aimed at sparing patients under surveillance some of their camera examinations.

In boron neutron capture therapy a boron drug accumulates in tumour cells, then a neutron beam makes only those cells explode from inside.

Two synthetic cannabinoid tablets, dronabinol and nabilone, have been approved for chemotherapy nausea since 1985 and can help when standard anti-sickness drugs fail. Modern antiemetics work better for most people, and evidence for herbal cannabis or vaped products is thin.

A patient's T cells are removed, given a synthetic receptor that recognises the cancer, multiplied, and put back as a living drug.

Pills that stop the cell-division engine, added to hormone therapy for the most common type of breast cancer.

Blood tests that read chemical marks on fragments of DNA shed by tumours; the marks tell cancer DNA from normal DNA and hint at where the cancer is.

The only regulator-cleared blood test that counts whole cancer cells; five or more cells in a small tube of blood marks a worse outlook in metastatic breast, prostate and bowel cancer, though changing treatment on the count alone has not helped patients.

Fishing whole cancer cells out of a blood sample to count them or study them; the count is prognostic in breast, prostate and colorectal cancer.

Cytokine therapy gives immune-signalling proteins as drugs. High-dose interleukin-2 was the first immunotherapy to cure some melanomas, at great toxicity.

Vaccines made from a patient's own antigen-presenting cells loaded with tumour proteins; sipuleucel-T for prostate cancer was the first approved, and newer versions are tested in brain and other cancers.

Drugs that change how genes are switched on and off without changing the DNA itself.

A PET scan using a radioactive form of oestrogen that lights up every tumour deposit still carrying the oestrogen receptor, so doctors can see whether metastases across the body will respond to hormone treatment without biopsying each one.

Drugs that block the enzyme that activates Notch signalling; nirogacestat became the first approved, in 2023, for desmoid tumours, a rare but destructive growth of connective tissue.

Tests that measure a set of genes in a removed tumour to estimate how likely it is to come back, so patients with low scores can safely skip chemotherapy.

Pills that block a developmental signalling pathway hijacked by basal cell skin cancer, shrinking tumours that cannot be operated on; also used in some leukaemia.

Small pills that block HER2 from inside the cell, complementing antibody drugs; tucatinib is notable for working against brain metastases.

Pills that block mutant IDH1 or IDH2 enzymes, which flood cells with a metabolite that blocks maturation; approved in leukaemia, bile duct cancer and low-grade glioma.

Drugs against the most common cancer gene, considered impossible to target until sotorasib in 2021.

Antibodies against LAG-3, another brake on tired T cells; relatlimab plus nivolumab became the first approved LAG-3 combination for melanoma in 2022.

Cancer-seeking molecules carrying the radioactive metal lutetium-177, which delivers short-range radiation to tumours it binds; approved for neuroendocrine tumours and prostate cancer.

Pills that break the interaction between menin and the KMT2A protein that acute leukaemias with KMT2A rearrangements or NPM1 mutations depend on; revumenib was the first approved, in 2024.

There is one licensed mesenchymal cell product in oncology and it is for one narrow use: children whose graft-versus-host disease has not responded to steroids. Everything else sold as a mesenchymal or stromal cell infusion for repair or rejuvenation is unlicensed and untested, and it is worth knowing the difference because the clinics rely on it being blurred.

A home stool test that reads RNA from cells shed by the bowel lining together with a haemoglobin test; approved in the United States in 2024 as an alternative to stool DNA tests for average-risk screening from age 45.

Viruses engineered to infect and burst cancer cells while leaving normal cells alone, and to alert the immune system in the process.

Oral drugs that destroy the oestrogen receptor rather than just blocking it, working even when the receptor has mutated to escape older hormone therapies.

Pills that block a DNA repair backup, killing cancer cells that already lost their main repair system (BRCA).

A microfluidic cassette that traps cancer cells from blood by their size and stiffness rather than a surface marker, then releases them alive for testing; the first such device cleared in the United States, for metastatic breast cancer.

A radioactive version of the hormone mimic used for the scan; it homes to neuroendocrine tumour cells and irradiates them from inside.

Like an ADC but with a small targeting peptide instead of an antibody, so it penetrates tumours faster and is cheaper to make.

Isolating the liver's circulation with catheters and balloons so that high-dose melphalan can be pumped through it and filtered out before it reaches the rest of the body; approved in 2023 for eye melanoma that has spread to the liver.

Red or near-infrared lasers and lamps that switch on a light-sensitive drug sitting in a tumour. Each drug has its own colour, so the machine is matched to the drug: skin lamps for sun damage, fibre-optic lasers for the oesophagus, lung and bladder, and a new near-infrared laser for the head and neck.

An antibody carries a light-sensitive dye to the tumour; shining near-infrared light then bursts the cells.

Drugs against one of the most commonly mutated growth pathways in cancer, now used with hormone therapy in breast cancer and in kidney and neuroendocrine tumours, with high blood sugar as the shared side effect.

Instead of blocking a protein, these drugs tag it for the cell's own garbage disposal, removing it entirely.

PSK, a protein-bound polysaccharide from the turkey tail mushroom, has been an approved adjuvant cancer drug in Japan since 1977. Meta-analyses of Japanese randomised trials in stomach and bowel cancer found a modest survival benefit added to chemotherapy, but these results have never been tested outside Japan.

A drug that finds tumour cells and carries a radioactive atom that irradiates them from inside the body.

Finding a second gene that a cancer needs only because its first gene is broken, then hitting the second one.

An off-the-shelf drug that physically links a killer T cell to a cancer cell, forcing the attack.

T cells engineered with a receptor that sees fragments of proteins inside the cancer cell, reaching targets CAR-T cannot.

Immune cells that have already found their way into the tumour are harvested, grown to billions, and returned.

Wearable electrodes that deliver alternating electric fields disrupting cancer cell division.

Off-the-shelf T cells from healthy donors that recognise Epstein-Barr virus, used to treat virus-driven lymphomas after transplant; tabelecleucel was approved in Europe in 2022.

First treatment for graft-versus-host disease is steroids, and in about half of people with chronic disease they do not work or cannot be reduced. Ruxolitinib is the only drug that has beaten the alternatives in a randomised trial here, and it has done so twice. About half of people respond; the common problems are low platelets and low haemoglobin.

For low-risk prostate cancer, monitoring with PSA, MRI, and repeat biopsy instead of treating, because most such cancers never cause harm.

In testicular and other germ cell cancers three blood tests, AFP, beta-hCG and LDH, are part of the staging itself: their levels after surgery sort patients into good, intermediate and poor risk groups that fix how many cycles of chemotherapy they get, and their return to normal defines cure.

The things worth asking a transplant team for, in one place: who follows you up and for how long, which screens are due at which year, what immunisations you need and when, and who to ring when something changes.

Germany does something no English-speaking country does: it funds a three-week structured rehabilitation stay after cancer treatment as an entitlement, inpatient or full-day outpatient, through the pension insurance system. Retired people and some non-insured relatives can have it too.

In England the offer has four named parts: an assessment of what you need and a plan written with you, information and support about living well, a summary of your treatment sent to you and your GP, and a review with your GP. Follow-up is increasingly not a routine clinic appointment but a pathway you manage yourself, with tests at set intervals and a route back in.

Allogeneic stem cell transplantation replaces a patient's blood system with a donor's after conditioning chemotherapy, so donor immune cells hunt down leukaemia left behind. It remains the only cure for adverse-risk acute myeloid leukaemia, high-risk acute lymphoblastic leukaemia and Richter transformation, at the price of graft-versus-host disease.

Androgen deprivation lowers testosterone or blocks its receptor, and has been the foundation of prostate cancer treatment since 1941 (Nobel Prize 1966).

Anti-angiogenic therapy cuts off the tumour's blood supply; it is now mostly used to help immunotherapy work better.