We may finally know what kick-starts muscle contractions in childbirth

An influx of immune cells into the uterus may be what initiates childbirth. These grab on to muscle cells via tiny tubes and send across mitochondria to provide energy for contractions

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Bursts of ‘pink noise’ during sleep seem to help clear waste from brain

vibration sound. Resonance. Pulse. cardiogram
Pink noise might have health benefits
Veleri/Shutterstock

Sleeping while listening to bursts of pink noise – background sounds akin to gentle radio static – seems to boost the flow of fluid through the brain, and so might enhance the clearance of waste products that are linked to conditions like Alzheimer’s disease. The pink noise seems to bolster the slow brainwaves that enhance the pumping of blood vessels, which drives the brain’s waste-disposal system.

We already knew that listening to bursts of pink noise during sleep can strengthen slow brainwaves, a kind of electrical activity that occurs during certain phases of non-REM sleep, known as N3 (deep sleep) and N2 (the lighter stage before it). This effect occurs when the bursts coincide with the peaks of slow brainwaves.

“They really don’t sound like much, they’re just little staticky beeps,” says Joshua Levitt at Boston University in Massachusetts.

Prior research has also shown that boosting slow brainwaves – using drugs, for instance – can enhance the flow of the brain’s cerebrospinal fluid (CSF), which bathes the brain and carries away waste products.

But it was unknown whether listening to pink noise has the same effect. That’s because measuring the brain’s CSF flow involves imaging it with MRI scans, but MRI interferes with EEG, the technique used to measure waves of electrical activity in the brain. One consequence of this interference is that slow waves recorded via EEG during MRI scans can’t be detected fast enough to align bursts of pink noise with their peaks.

“You have to do a lot of extensive processing of the EEG signals to detect slow brainwaves, so it’s hard to do that fast enough in real-time,” says Laura Lewis at the Massachusetts Institute of Technology.

To overcome this problem, Levitt, Lewis and their colleagues used EEG data collected during MRI scans from prior studies to train an AI model to rapidly predict when the brain’s slow waves will peak. “[The AI] says, ‘In about 70 milliseconds, a slow wave peak is coming,’ so now we should schedule our sound stimulation to arrive in accordance with that,” says Levitt.

“This, methodologically, really moves the field forward,” says Sephira Ryman at the University of New Mexico.

The researchers then recruited 27 healthy adults, aged 29 on average, to wear EEG electrodes on their scalp while taking an afternoon nap in an MRI scanner. Of these, 14 managed to fall asleep and enter N2 sleep. “It’s a difficult place to fall asleep,” says Lewis.

At the peak of half of each participant’s slow brainwaves, the researchers used the AI model to play 50-millisecond bursts of pink noise. During the remaining slow brainwaves, they played no noise as a control.

By analysing the MRI and EEG recordings, they found that bursts of pink noise strengthened the slow waves they coincided with and briefly boosted the flow of CSF into the brain, compared with no sonic stimulation. This suggests the pink noise also enhanced the flow of CSF through, and out of, the brain. “We know that the flow in is usually balanced with the flow that comes out,” says Lewis.

The increased CSF flow seemed to be driven by enhanced pumping of the brain’s blood vessels, which is known to push fluid through the brain’s waste-disposal system, called the glymphatic system.

Off the back of these results, the team is exploring whether the approach also works in older adults and whether it can boost the clearance of proteins, such as beta-amyloid, that are linked to conditions like Alzheimer’s disease. If the results are positive, the researchers hope to test whether the technique can slow cognitive decline in people during normal ageing, mild cognitive impairment – a condition that often precedes dementia – and the early stages of Alzheimer’s disease.

There is reason to think this could work. Exposing people to sounds and flickering lights – while they are awake – has previously shown promise at slowing cognitive decline in people with Alzheimer’s, potentially by boosting the glymphatic system.

But one benefit of the new approach is that it could eventually be delivered via a portable device while people are sleeping, which could be less disruptive, says Ryman.

Journal Reference:

Science Translational Medicine
DOI: 10.1126/scitranslmed.aed4290

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Common painkiller use in early pregnancy linked to smaller ovaries and testes

Advice around painkiller use during pregnancy hasn’t changed off the back of this finding
Getty Images

Girls whose mothers took paracetamol (acetaminophen) during pregnancy had smaller ovaries at three months old, on average, than those whose mothers didn’t take the drug, according to a study of about 300 infant girls in Denmark. Infant boys whose mothers took paracetamol had smaller testes on average too, the study found.

That doesn’t prove paracetamol caused the reduction in the average size of ovaries and testes, though – this association could be a result of the conditions that led to the women taking paracetamol during pregnancy, or even due to chance alone. Nor is it clear whether having smaller ovaries or testes as an infant affects fertility in adulthood. However, the findings are in line with separate studies done in rats and mice, in isolated human ovaries and in human embryonic cells.

“We still recommend that pregnant women should use paracetamol with high fever or strong pain,” says Margit Bistrup Fischer at Copenhagen University Hospital–Rigshospitalet. Not doing so can be risky, she says.

But most of the women in the study used paracetamol for headaches or musculoskeletal pain, rather than fevers, and could have managed their pain or discomfort in other ways, such as via rest, heat treatment or physiotherapy, says Fischer.

“We should have a dialogue about when paracetamol is actually necessary,” she says. “It is still a drug and it does have side effects. Maybe it shouldn’t be the first thing that we grab when we have discomfort.”

The issue is that there are almost no safe drug-based alternatives to paracetamol for pregnant women. Most other painkillers aren’t recommended because they can cause congenital conditions.

Fischer’s team recruited 685 pregnant women during their first trimester, who were asked about their use of medicines every two weeks. They had an fetal ultrasound during their third trimester, and 302 daughters were examined around three months after birth.

Those exposed to paracetamol as a fetus had, on average, 40 per cent smaller ovaries by volume, 13 per cent smaller uteruses by volume and 23 per cent fewer ovarian follicles – the sacs that nurture immature eggs – compared with those who weren’t exposed. Higher doses were associated with a bigger effect, says Fischer, but no women took more than the recommended daily maximum of 4000 milligrams.

The researchers also analysed data from another study on 1210 girls born in Copenhagen between 1997 and 2002, and found a link between fetal exposure to paracetamol and smaller ovaries during adolescence.

In animal studies, such effects led to reduced fertility and earlier reproductive ageing, but it isn’t clear whether this applies to people. “We cannot say anything about the reproductive consequences for these girls,” says Fischer. That will require long-term follow-up, which is hard to do.

The team also examined the boys who were born to the 685 women. “We do see a difference, on average, in the boys as well,” says Fischer. “[They] have a reduced testicular volume.”

Animal studies suggest this could affect fertility in adulthood, but again it is still unclear if this will be the case for the boys. “We can’t say anything about that because our cohort does not follow them that long,” she says.

A paper describing the findings in girls was published today. A separate paper describing the findings in boys has been accepted by the same journal, but not yet published, says Fischer.

“It is still too early to sound the alarm, and to remove this tool from the therapeutic arsenal for treating pain and fever,” says Séverine Mazaud-Guittot at the National Institute of Health and Medical Research in France, who, in 2022, co-authored research showing that paracetamol impairs the development of isolated human ovaries.

But this latest study, along with one from last year showing that paracetamol affects the proliferation of human embryonic cells, suggest that the precautionary principle should be applied, especially during the first trimester, says Mazaud-Guittot.

“Raising awareness of alternative, non-pharmacological methods should help to encourage a reduction in the use of medication for the treatment of various mild pains,” she says.

“This paper would not change my practice or advice,” says Dimitrios Siassakos at University College London. The team carried out a number of different statical analyses, he says, and the more of these you do, the greater the odds of getting a statistically significant association by chance.

“I do agree that we cannot exclude the possibility of chance findings,” says Fischer. “[But] adjusting for multiple testing could mean that we fail to detect a real effect.”

Another issue is that people taking these medications could be sicker, including with one of the many infections that affect fetal development. They might also eat and behave differently, or vary genetically, says Brian Lee at the University of Pennsylvania. The team tried to take account of such confounding factors, but couldn’t completely rule them out.

“I would not jump to the conclusion that the statistical association observed is a causal association,” says Lee. He thinks there should be further studies into this, but establishing a causal link, if there is one, won’t be easy. A trial in which women were randomly assigned to take paracetamol or not would be the best way, but this would be unethical in pregnant women, says Fischer.

There have been claims that taking paracetamol during pregnancy increases the risk of autism, but the evidence suggests otherwise. “This in no way changes the conclusion that paracetamol is not linked to autism, as multiple studies featuring millions of pregnancies across Sweden, Denmark, Norway, Hong Kong, Taiwan and Japan have shown,” says Lee.

Journal reference:

Human Reproduction Open
DOI: 10.1093/hropen/hoag074

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Laughter therapy may help people with chronic lung disease

A group practises laughter yoga
Laughter therapy has been linked to improvements in a variety of conditions
Nora Tam/South China Morning Post via Getty Images

People with chronic lung disease breathe better after two months of laughter therapy, results from a small trial show. The promising results may prompt further research into the low-cost treatment option.

In chronic obstructive pulmonary disease (COPD) – a leading cause of disability and death worldwide – air isn’t fully expelled when exhaling, meaning stale air remains trapped inside the lungs. The millions of people who are affected by the condition often feel breathless, even during simple daily activities.

Doctors treat COPD with medications like bronchodilators and corticosteroids, and may also recommend specialised breathing exercises. These include pursed-lip breathing, in which patients breathe in through the nose and out slowly through the lips, which creates a gentle build-up of pressure that helps release some of the air trapped in the lungs. But many people with COPD continue to become increasingly dependent on others for care over time, reducing their quality of life.

Goncagul Aldan, formerly at Hacettepe University Faculty of Nursing in Ankara, Turkey, had seen research showing that laughter therapy shows promise in people with diabetes, kidney failure and cancer and thought it might help those with COPD as well – both physically and mentally.

To find out, she and her colleagues recruited 63 people who were already being treated for COPD at Ankara Bilkent City Hospital and divided them into three groups of 21. In their randomised controlled trial, all participants continued their medications, but those in one group additionally performed pursed-lip breathing exercises and those in another group received laughter therapy. Participants in the third, control, group did neither.

The laughter therapy is an established programme that differs from simple responses to humour. It includes playful exercises like mimicking a motorcycle starting or a lion roaring, rhythmic clapping with vocal sounds and relaxation with calm breathing and smiling. The participants were coached by laughter therapists in face-to-face sessions and then instructed to perform the techniques on their own for 30 minutes, three times per week.

After eight weeks, participants in the laughter therapy and the pursed-lip breathing groups had less difficulty breathing and better overall health than those in the control group. Those benefits were still ongoing even a month after the trial ended, says Aldan. Even so, the therapies didn’t change how much daily assistance participants needed from caregivers. Aldan and her colleagues didn’t directly compare the effects of pursed-lip breathing and laughter therapy. They report the results today at the European Respiratory Society (ERS) Congress in Barcelona, Spain.

While more research could help clarify exactly how laughter therapy helps, Aldan suspects it might exercise the breathing muscles, promote deeper exhalation, improve lymphatic flow and trigger the release of endorphins, while also lowering levels of stress hormones.

“This structured approach may help facilitate gentle air expulsion and reduce air trapping without overwhelming the respiratory system,” she says. “Psychologically, it can also offer a safe, enjoyable way to reduce anxiety and support emotional wellbeing.”

Importantly, however, laughter therapy is distinct from intense or unguided laughter – like the response to a funny social media video – which can actually trigger adverse effects like acute airway collapse or exertion, says Aldan. “Laughter therapy is not merely ‘laughing’ – it is a structured protocol that naturally incorporates deep breathing exercises and rhythmic warm-ups to prepare the lungs and body for laughter.”

“This is a small but well-run study,” says Marc Miravitlles at Vall d’Hebron University Hospital in Barcelona, Spain, who wasn’t involved in the research. “These results – showing that patients can breathe more easily and feel better in general – are promising. Laughter therapy is simple and low-cost, meaning it could be used by anyone, anywhere in the world. We look forward to further research in this area.”

The team hopes to expand its work with international collaborators.

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How worried should we be about the invasive mosquitoes in the UK? 

An Aedes aegypti mosquito
An Aedes aegypti mosquito
Shutterstock/SILVIA MAQQ

Aedes aegypti mosquitoes and larvae – which can transmit infections like dengue, chikungunya and Zika virus – have been found breeding in the UK.

The UK Health Security Agency (UKHSA) announced on 3 September that the species has been detected at residential properties in east London. This marks the fourth time it has been detected in the UK in recent years, and the first time it has been found breeding.

The mosquitoes are usually found in more tropical climates. So, is this a result of climate change? How concerned should we be? Here’s what you need to know.

What do we know about Aedes aegypti?

Aedes aegypti mosquitoes are native to North Africa, but can be found in tropical and temperate regions around the world, including parts of Europe. Although the species has been seen in the UK before, this is the first time these mosquitoes have been found breeding in the country.

The species can transmit many different pathogens, including dengue, yellow fever, chikungunya and Zika virus. It commonly feeds at dusk and dawn, and indoors and in shady areas.

Where were the mosquitoes found?

According to the UKHSA, the mosquitoes and larvae were found breeding in residential properties in East London. They were spotted and reported under the government’s Mosquito Watch scheme, which aims to detect the presence of invasive mosquitoes.

The UKHSA said the larvae have been destroyed and promised the area will be monitored closely to eradicate any further mosquitoes and larvae that might emerge.

What’s the threat to public health?

The UKHSA insists the threat to public health remains very low. There is no evidence the Aedes aegypti mosquitoes found in London have transmitted any infections to people, and so far there have not been any more mosquitoes or larvae being found in nearby public areas.

César López-Camacho at the University of Oxford said in a statement to the Science Media Centre that the discovery of their presence should be seen as an “early warning rather than an immediate public health threat”.

It is worth noting the UK is home to many species of native mosquitoes, but these generally don’t carry serious infections, and are largely an annoyance rather than a public health threat.

How did they get to the UK?

Jolyon Medlock at the UKHSA said in a statement that the mosquitoes were likely to be “accidental importations”, having “hitchhiked” in vehicles, suitcases or via imported plants.

Are these mosquitoes here to stay?

The UK has just had its hottest summer on record. London has seen some of the highest temperatures in the country, as heatwaves are usually amplified in cities due to the urban heat island affect.

That may mean the mosquitoes have been able to successfully breed over the summer months this year. But Medlock said the UK’s climate is still too cold overall to enable the mosquitoes to breed over the long-term – for now.

Is this a sign of climate change?

Mosquitoes are expanding their range north as the climate warms. Warmer weather also increases the rate at which viruses replicate in an insect’s body.

That means mosquito-borne viruses are rapidly becoming more common in Europe as the continent warms. In late August, French authorities reported cases of locally transmitted dengue, west Nile and chikungunya virus across the country, including Paris.

And a study published earlier this year found that the Asian tiger mosquito, another invasive mosquito species in Europe, can transmit chikungunya over several months of the year on the continent. The study authors said Europe’s rapid rate of warming was enabling virus transmission to become more widespread across the continent.

Over time, the threat of mosquito-borne disease to the British public is also expected to rise. Last year, West Nile virus was detected in the UK for the first time in mosquitoes in Nottinghamshire. For now, authorities hope to keep invasive mosquitoes out of the country for as long as possible to prevent disease transmission.

What should I do if I am stung by a mosquito?

For most people in the UK, a mosquito bite is an annoyance but nothing to worry about. It will usually produce a red, itchy swelling that will subside within a few days. If you develop a fever or become unwell, and have recently travelled to a location where dengue, chikungunya or Zika is circulating, you should seek medical attention.

How can I prevent mosquitoes breeding in my home?

Scientist say it is important to minimise the chance of mosquitoes breeding in the UK, to try to prevent invasive species gaining a foothold on UK shores. Aedes aegypti mosquitoes are well adapted to human environments and can breed in small quantities of standing water, so the most important action people can take is to eliminate, as far as possible, any standing water around the home. That could include emptying water trays under houseplants, clearing rainfall from containers, keeping lids on waterbutts, washing out pet bowls and flower vases regularly, and keeping shower areas as clean and dry as possible between use.

If you spot a mosquito in the UK, you can report it to the Mosquito Watch scheme.

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Pig kidney kept a man off dialysis for nine months in world first

The pig kidney that was transplanted into Tim Andrews on 25 January 2025
The pig kidney that was transplanted into Tim Andrews on 25 January 2025
Kate Flock/MGH Photography/Massachusetts General Hospital

A genetically modified pig’s kidney kept a man with organ failure off dialysis for nine months while he waited for a suitable human donor’s kidney to become available. This suggests pig kidneys could act as a temporary measure amid lengthy organ waiting lists, but they may also work as a permanent replacement one day.

“I think it’s incredible in terms of the science behind it and what they’ve achieved,” says Michelle Willicombe at Imperial College London, who wasn’t involved in the work.

For people with severe kidney disease, where these organs are failing and dialysis is needed, a kidney transplant provides the best chance of survival and better quality of life. However, demand for donor organs exceeds supply.

One possible solution is xenotransplantation, the transfer of organs from other animals into humans. In January 2022, a pig heart was transplanted into a person for the first time, but the recipient died several months later, possibly due to the presence of a pig virus. A pig liver transplant also occurred last year.

A pig’s kidney was transplanted into a living person for the first time in 2024. The recipient, Richard Slayman, aged 62, died 52 days later from cardiac-related causes. In the latest development, Tim Andrews, a 66-year-old man with end-stage kidney failure, opted to receive a kidney from a pig to avoid dialysis while he waited for a suitable human organ.

Leonardo Riella at Mass General Brigham hospital in Boston and his colleagues transplanted the kidney, which came from a Yucatan miniature pig, into Andrews in January 2025. The organ had been genetically modified to improve compatibility with the human immune system, such as by removing some sugars that we produce antibodies against and adding seven human genes.

The transplant was initially a success, and Andrews – who also received immunosuppression drugs to stop his body rejecting the organ – came off dialysis and resumed normal life. However, after about six months, he was admitted to hospital with a methicillin-resistant Staphylococcus aureus (MRSA) infection, which most antibiotics can’t kill.  

Riella and his colleagues reduced the immunosuppression drugs Andrews was on, but then damage started to develop in the kidney’s blood vessels. This progressed to organ failure, and the kidney was removed a record 271 days after transplantation. “He had a kidney that lasted nine months, which is mind-blowing,” says Riella.

Andrews went back onto dialysis for about three months, before finally receiving a suitable human kidney in January 2026. This marks the first time a pig kidney has been used as a temporary bridge to a human transplant.

“Such transplants may allow patients to avoid going through dialysis, which is so important because it causes so much wear and tear to the body,” says Riella. “Hopefully, maybe 15 years from now, pig kidneys will compete with a human kidney transplant, but you’re not there yet.”

The procedure is experimental, and Riella couldn’t give an estimate of how much it might cost. But in the US, there are about 600,000 people on dialysis, which can cost about $100,000 a year per individual, he says.

Riella says the team has now done five such transplants and two more case reports will be published this year, including one of a person who has already beaten Andrews’s record of nine months with a functioning pig kidney.

“I think these will be carried out more widely in the future, but it’ll be a little while,” says Willicombe, largely due to their probable high cost. Scientists should also continue researching artificial kidneys, as well as ways to regenerate damaged organs and optimise donated ones, she says.

Journal reference:

The Lancet
DOI: 10.1016/S0140-6736(26)01295-X

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Psilocybin could prevent common and debilitating chemotherapy side effect

Digital artwork featuring magic mushrooms, which contain the psychedelic compound psilocybin
Digital artwork featuring magic mushrooms, which contain the psychedelic compound psilocybin
Yevhenii Khil/Getty Images

Psilocybin may prevent a debilitating side effect of chemotherapy: nerve damage that can cause lasting numbness, tingling or pain in the hands and feet. In tests in nerve samples from mice and humans, the psychedelic seemed to maintain the energy supply in nerve endings that is commonly disrupted by chemotherapy, resulting in less damage and fewer complications.

This is the first time a therapy has been shown to prevent this common side effect, which lacks effective treatments and can limit access to cancer drugs.

“If these findings can be replicated in clinical trials, the implications could be substantial,” says Maria Maiaru at the University of Reading in the UK, who wasn’t involved in the research. “Patients could avoid long-lasting sensory problems and chronic pain that often remain after cancer has been successfully treated.”

What’s more, “if nerve damage can be prevented, fewer patients may need dose reductions or interruptions of chemotherapy, potentially improving cancer outcomes”, she says.

But people with cancer shouldn’t take psilocybin, the psychedelic compound in magic mushrooms, without medical supervision. “Please don’t take psilocybin at home for chemotherapy-related pain,” says team member Moran Amit at the University of Texas MD Anderson Cancer Center in Houston. “It hasn’t been shown to be safe or effective in patients undergoing chemotherapy. It can interact dangerously with cancer medications.”

Chemotherapy-induced peripheral neuropathy (CIPN) affects about 75 per cent of cancer patients who undergo the treatment to some extent, said Patrick Dougherty, also at the University of Texas MD Anderson Cancer Center, in a press briefing. It is usually treated with duloxetine, an antidepressant that provides moderate pain relief. But no drug had been shown to prevent CIPN, said Amit at the briefing.

CIPN occurs when chemotherapy drugs enter nerve cells and disrupt machinery around microtubules. These are railway-like structures that usually transport mitochondria from the main body of neurons, near the spinal cord, to nerve endings in the skin. The mitochondria supply energy to maintain nerve endings, but the disruption means they wear out and retract, causing issues like tingling.

The researchers wondered whether psilocybin, which has been shown to alter nerve metabolism and growth, could preserve these nerve endings.

To find out, they studied a group of mice with abdominal tumours, half of which were given two doses of psilocybin – each equivalent to a 25-milligram dose in people – via injections into the abdomen, one week apart. The remaining mice had saline injections. All of them then received daily injections of cisplatin, a type of chemotherapy that commonly causes CIPN, for one week.

After receiving cisplatin, the mice underwent pain-sensitivity tests, where they were touched with a thin plastic filament to see how they responded. Those that received psilocybin before cisplatin responded similarly to a third group of mice with cancer that didn’t receive cisplatin or psilocybin. The mice that received cisplatin without psilocybin seemed to be much more sensitive to the filament’s touch.

To explore how psilocybin may be having this effect, the team analysed nerve samples from the mice. This showed that, after the psychedelic is processed to its active ingredient, psilocin, it activates a receptor called 5HT2A, confirming findings from prior studies. But it also revealed that this receptor sends molecular signals that prevent chemotherapy-related disruption of mitochondrial transport.

Finally, the researchers confirmed the results in human neurons treated with either psilocybin or a saline solution before receiving cisplatin. “Psilocybin seemed to help nerves withstand the toxic effects of chemotherapy and maintain normal function,” says Maiaru.

They now plan to begin a randomised controlled trial in November. This will be made up of about 80 people with breast, colorectal or head and neck cancer, testing two doses of psilocybin before chemotherapy. Results are expected in about five years. 

Psilocybin has already been shown to relieve symptoms of depression and anxiety in people with cancer. Although not a psychedelic, cannabis is also approved to treat cancer-related chronic pain in the UK. The US Food and Drug Administration has also approved two drugs that are made up of chemicals similar to those in cannabis to relieve chemotherapy-related nausea and vomiting.

Journal reference:

Science
DOI: 10.1126/science.aec6116

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The science behind an ambitious cancer strategy

While cancer has traditionally been classified by its tissue or organ of origin, advances in molecular science have transformed our understanding of the disease. Researchers are increasingly leveraging these biological insights to develop targeted therapies based on the underlying drivers of cancer, rather than its location alone.

“We now have a greater understanding of the behaviour of different segments of each cancer based on their underlying biology, meaning we can design better medicines,” says Susan Galbraith, Executive Vice President of Oncology Haematology R&D at the biopharmaceutical company, AstraZeneca. “We also better understand how to leverage the immune system. And we can diagnose cancers earlier, which makes a big difference to the chances we can offer patients.”

The long-term ambition at AstraZeneca is to one day eliminate cancer as a cause of death. “It’s definitely a stretch goal,” says Galbraith. “But the idea is that we can transform cancer treatment, step by step, to improve long-term outcomes for patients.”

Cancer remains a leading cause of death globally, killing around 10 million people every year. One reason it is so difficult to beat is that every form of cancer is different, both in terms of the underlying genomic aberrations and the cell-surface proteins that treatments must target. Tumours are not static targets but rather complex, dynamic populations of cells capable of mutating and adapting to evade and resist treatments.

The long-term ambition is to one day eliminate cancer as a cause of death

All of which is transforming the way oncologists think about research and development. Future progress will depend not only on advances in individual therapies, but on how different approaches are combined into transformative regimens that improve patient outcomes.

This approach is the first pillar of AstraZeneca’s strategy of building a diverse portfolio of therapeutic approaches that can attack cancer from multiple angles, with the ultimate aim to combine these therapies to achieve deep and more durable responses.

Conventional approaches such as chemotherapy and radiotherapy kill tumour cells directly. Newer therapies, such as antibody drug conjugates (ADCs) and radioconjugates (RCs), do the same, but deliver toxins more precisely to minimise damage to surrounding tissues.

However, there are also therapies that have emerged that kill cancer cells indirectly by mobilising the body’s own immune system to attack the cancer cells. They include immune checkpoint inhibitors, which help T-cells recognise tumours, as well as T-cell engagers that bring immune cells into contact with cancer cells.

“These technologies expand the range of immune-sensitive tumour types,” says Galbraith. “One area where they can be particularly well used is after you have debulked the cancer using direct cell-killing technologies like ADCs.”

AstraZeneca’s approach is to develop these therapies in parallel. “If you can use a combination of surgery, an ADC, and immune activation through a T-cell engager, then you’ve hit the cancer from multiple angles and stand the best chance that it can be fully cleared,” says Galbraith. “We look early at combination potential, and we design development plans not just for monotherapy approval but for combination regimens.”

The second pillar of AstraZeneca’s strategy is to treat cancer earlier, which may improve survival outcomes. One way to address this is with earlier detection through screening. “Many countries have established screening programmes for cancers such as breast cancer, and an increasing number are introducing lung cancer screening. However, many cancers, including pancreatic and ovarian cancer, still lack effective screening options,” says Galbraith. New technologies are beginning to close this gap, including blood tests that detect circulating tumour DNA (ctDNA), fragments of genetic material shed by tumours into the bloodstream. By identifying ctDNA from multiple cancer types, these simple blood tests offer a less invasive way to detect cancer earlier and help guide more personalised treatment decisions.

Beyond ctDNA, emerging biomarkers are enabling a more detailed understanding of cancer earlier in its course. Multimodal approaches—integrating molecular, genetic and imaging data—and analysing them with artificial intelligence (AI) can generate a more comprehensive tumour profile. These advances are helping to drive precision medicine, ensuring the right treatment reaches the right patient at the right time.

The final pillar of AstraZeneca’s strategy uses transformational technologies, big data, and digital tools to reimagine the entire R&D pipeline—from drug discovery to patient monitoring and delivery.

One of the biggest opportunities is computational pathology, which allows greater precision compared to traditional, manual pathology approaches. Quantitative Continuous Scoring (QCS), for instance, allows for a much deeper understanding of how drugs interact with tumours. QCS measures things that are not visible to the human eye, such as how much of a drug’s payload is internalised into the cell. “That is a key part of how antibody drug conjugates work,” says Galbraith. “By measuring this process, QCS can provide a deeper understanding of which tumours are most likely to respond to treatment.”

The idea is we can transform cancer treatment, step by step

Another opportunity comes from multimodal foundation models, which can analyse text, images and other data types together to generate deeper insights. Through partnership with tech companies Tempus and Pathos, AstraZeneca is helping build the largest multimodal foundation model in oncology.

“Multimodal foundation models have the potential to transform oncology R&D by unlocking insights from diverse, high-dimensional data at unprecedented scale, says Galbraith. “Through our collaborations, we aim to help accelerate clinical development, improve trial decision-making, and ultimately increase the probability of success for patients.”

Another area of focus is digital health tools. AstraZeneca’s global healthtech business, called Evinova, has a platform that allows patients to answer questionnaires and share health information from their mobile phones. “Digital health technologies are helping to reshape clinical research by bringing trials closer to patients,” says Cristina Duran, President, Evinova. “By capturing real-time patient insights and reducing barriers to participation, these tools can deliver a more patient-centred trial experience, while enhancing data quality and the ability to catch potential issues earlier.”

What ties all these advances together is that each has the potential to amplify the benefits of the others. Detecting cancer earlier transforms what is possible with treatment. Combining different kinds of therapies potentially produces better, more durable responses. And deeper analysis of tumour biology feeds back into both, allowing clinicians to more effectively tailor therapies to patients and may enhance patient experience and outcomes. “Overall, it has the potential to transform cancer treatment,” says Galbraith.

Find out more about AstraZeneca’s oncology R&D strategy.

This article was paid for and co-developed by AstraZeneca.

Veeva ID: Z4-85387 Date of preparation July 2026

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How Ukraine created world-leading prostheses amid the chaos of war

Injuries from the war in Ukraine have forced the country to develop highly advanced prostheses and fit them in record numbers. What can the rest of the world learn from its efforts? 

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How our bodies adapt to extreme temperatures – until it gets too hot

No matter where you’re from, there are things you can do to cope better with extreme temperatures. But it takes work to stop our bodies’ adaptations from slipping backwards over winter, and there are limits to how far we can go

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