Top medical breakthroughs of 2021—and what’s ahead

2021 was a huge year for medicine. While the pandemic raged on, researchers and scientists managed to take significant steps forward in a number of other medical areas.

Here are five of the top medical breakthroughs from the past year.

A multi-cancer blood test enters trials

A recently developed blood test got a major boost this year after a large trial began in the United Kingdom. The Galleri blood test uses genetic sequencing technology and artificial intelligence to analyze cell-free DNA (cfDNA), which is shed by both tumor cells and healthy cells into the bloodstream. The test has the potential to detect more than 50 types of cancer.

The trial will build on evidence found in a study published in Annals of Oncology, in which researchers tested the Galleri test’s efficacy in a cohort of 4,077 participants (2,823 of whom had cancer). Overall sensitivity for cancer detection was 51.5%, and the sensitivity increased with tumor stage. It successfully predicted the location of the tumor about 89% of the time.

The UK-based trial is aiming to recruit a much larger cohort of 140,000 people aged 50 to 77 years, each of whom will have their blood analyzed over a period of 2 years. Initial results are expected by 2023. 

The rise of RNA therapies

You’ve likely heard a lot about RNA therapeutics during the past year due to the COVID-19 vaccines developed by Pfizer/BioNTech and Moderna. 

As described in a review published in Frontiers in Bioengineering and Biotechnology, RNA therapies can carry instructions for building proteins, assist in activating (or deactivating) certain genes, alter the activity of other RNAs, and play various other roles. 

This expanding range of drugs can target previously undruggable pathways, are cost-effective, and are a major part of the long march toward personalized care. 

According to a review published in the Journal of Microbiology and Biotechnology in August, the FDA has approved 14 RNA-based drugs thus far, while a host of others are waiting in the wings for regulatory approval. RNA therapies approved so far include treatments for disease-specific mutations of Duchenne muscular dystrophy disorder, spinal muscular atrophy, and polyneuropathy caused by hereditary transthyretin amyloidosis. 

But it was undoubtedly the rollout of the mRNA COVID-19 vaccines that brought RNA therapeutics into the spotlight in 2021.

Breaking the psychedelic ceiling 

As noted by the author of an article published in Nature, various psychedelic substances are beginning to show great promise in treating mental health conditions. With the COVID-19 pandemic ravaging America’s mental health over the past two years, interest in the therapeutic potential of psychedelics is ramping up. In 2020, the findings of a 4.5-year study indicated that psilocybin-assisted psychotherapy holds promise in offering long-term relief from cancer-related psychiatric distress.

Various other studies and trials are now underway. These include the FDA-overseen phase 3 trials of MDMA for the treatment of post-traumatic stress disorder, as well as the phase 2 trials of psilocybin for the treatment of drug-resistant depression. 

Another example is a 3-year study on the efficacy of psilocybin as an intervention to help people quit smoking, which will be conducted by Johns Hopkins Medicine. According to a release, the institute received a $4 million grant from the National Institutes of Health to explore this possible treatment for tobacco addiction.

This “psychedelic renaissance” has also been reflected in several recent ballot measures that were aimed at legalizing or decriminalizing the substances in question. In Oregon, a measure to legalize psilocybin mushrooms for medicinal purposes passed the vote in 2020. 

Wearable naloxone injector system

Overdose deaths from opioids remain a major public health issue exacerbated by the pandemic. From March 2020 to March 2021, a record 81,000 such deaths were reported in the United States. While naloxone has emerged as an effective reversal agent for opioid overdoses, accessibility has long been a concern. 

In light of this, researchers developed a prototype wearable naloxone injector system, which can detect when the wearer is experiencing symptoms of an overdose and can automatically administer naloxone when necessary. 

According to a study published in Scientific Reports, the machine completed these tasks in tests conducted in an approved, supervised injection facility and in a hospital environment where opioid-induced apneas were simulated in healthy participants.

While the studies had several limitations (researchers admitted that it may be tricky to persuade users to wear such a device all of the time), it proved that the concept works and that the device could pave the way to lowering the opioid overdose mortality rate. 

First-ever smart implant

In October, practitioners successfully completed the first-ever knee replacement using a smart implant. The device can remotely monitor the patient (ie, measuring data points such as the number of steps taken, walking speed, range of motion, etc) and send this information back to the orthopedic surgeon to track recovery. 

The implant, called the Persona IQ, received FDA approval in August, and some industry experts predict that it is the beginning of a smart implant revolution. Devices like these could lead to the personalization of physical therapy plans or inform decisions about anti-inflammatory medication use. 

Using the same basic material and technology found in pacemakers, smart implants represent a new era in patient data collection—one that could help improve health outcomes and provide patients with a wealth of information about their bodies.