Top 10 Medical Innovations for 2007

1. Cancer Vaccines:
These targeted therapies are being used to prevent cancer and treat patients more specifically according to the type of cancer they have. One example of a cancer vaccine is the HPV vaccine developed to prevent cervical cancer caused by human papillomaviruses.

This has been a clinical and commercial success, with sales over $1 billion for 2007-2008. This cervical cancer vaccine is now widely used, with 25% of American teenage girls vaccinated in 2007.

2. Designer Therapeutics Using Selective Receptor Antagonists:
Novel therapeutics have been created to block receptor activation that leads to improved patients' outcomes. Examples include therapeutics that: block the peripheral side effects-such as constipation and nausea-of opioid medications for pain which can adversely affect patients and lengthen hospitalizations; and control the body's stress response to mediate eating and smoking.

There have been some setbacks in this field, with the recent withdrawal of an SRA-obesity drug from U.S. market trials, and the suspension of the drug in the EU because of a poor risk/benefit ratio in clinical practice.

3. Neurostimulation for Psychiatric Disorders:
Neurostimulation, such as deep brain stimulation (DBS), is emerging as a significant treatment option for millions of Americans who are suffering from treatment-resistant depression and treatment-resistant obsessive-compulsive disorder.

Investigational results continue to show effectiveness of neurostimulation in the treatment of resistant forms of depression and OCD. There is also a growing acceptance of DBS for treatment of Parkinson's, essential tremor, and dystonia.

4. Optical Coherence Tomography (OCT):
This noninvasive imaging technology is used in the treatment and diagnosis of eye diseases, such as diabetic retinopathy and macular holes.

This technology has become ubiquitous in the identification and treatment of eye disease. In addition, OCT is being developed for intravascular imaging to assess unstable plaque in coronary arteries.

5. Bronchial Thermoplasty (BT):
BT involves the controlled application of heat in the lungs to improve pulmonary function and reduce asthma symptoms. This therapy is used to ward off asthma attacks.

In a recent international study with patients with severe asthma, 50% of the study subjects were able to completely stop taking their inhaled steroids after undergoing BT. One year later, they were still having positive asthma control. Commercial acceptance, however, is still a few years away.

6. Ranibizumab:
This drug therapy inhibits uncontrolled blood vessel formation in the eye, which is the primary cause of age-related macular degeneration, and the leading cause of new blindness in older Americans.

The drug has since become a clinical and commercial success ($700 million in sales since introduction) and remains the standard of care for age-related macular degeneration; new trials are testing combination therapies, which may allow similar or improved outcomes with fewer treatments.

7. Endografting:
This is a minimally invasive repair technique traditionally used in cardiology and now being used to treat vascular disease, including thoracic abdominal aneurysms.

This technique has since gained worldwide acceptance, with high success rates reported in trials in Asia. In the U.S., one device is approved by the FDA and competing devices are undergoing clinical trials.

8. Targeted cancer therapies:
This involves using second generation, small molecule tyrosine kinase inhibitors to block or modulate disease and provide treatments for advanced cancers, such as renal cell carcinoma.

An evolving success, with significant advances already reported. Lapatnib gained FDA approval in 2007 for patients with advanced, metastatic breast cancer that is HER2 positive.

9. Left Ventricular Assist System (LVAS):
This is the first implanted ventricular assist device that senses when to increase or decrease the rate of blood flow. The device takes over most of the function of the left ventricle, and helps generate the force necessary to propel oxygen-rich blood throughout the body.

This has been a commercial success and continues to give new hope for patients awaiting heart transplants. There have been several successful clinical trials and subsequent FDA approval for devices used as bridge-to-transplant. Several commercial models are now available from different manufacturers. New generation devices that minimize the biologic impact of support and that incorporate increasingly sophisticated responsiveness to the body's variable circulatory demands will continue to expand the utility of this revolutionary approach to end-stage heart failure.

10. Convection-enhanced delivery of drugs:
This emerging drug delivery method is being used to administer medication directly to the site where it is needed, without exposing the rest of the body to a drug's effects.

At this time, it's still too early to judge the technology's overall success. While the initial phase III trials failed to show benefit of the experimental drugs delivered via CED, other studies have shown that it is an effective drug delivery technique. Advancements in CED catheter technology and real-time imaging of drug distribution made over the past year are leading to the development of a new series of clinical trials for both brain tumors and movement disorders.