Science's Top 10 Breakthroughs Of 2013

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The cancer research community experienced a sea change in 2013 as a strategy, decades in the making, finally cemented its potential. Promising results emerged from clinical trials of cancer immunotherapy, in which treatments target the body’s immune system rather than tumors directly. The new treatments push T cells and other immune cells to combat cancer—and the editors ofScience believe that such approaches are now displaying enough promise to top their list of the year’s most important scientific breakthroughs.

This annual list of groundbreaking scientific achievements, selected by Science and its international nonprofit publisher, AAAS, also includes major breakthroughs in solar cell technologies, genome-editing techniques and vaccine design strategies, to name a few. The top-10 list appears in the 20 December issue of the journal along with a related news feature and a multimedia component.

Cancer immunotherapy clinched the #1 spot on the list because, although its ultimate impact on the disease is unknown, recent results are highlighting its success so far.

“This year there was no mistaking the immense promise of cancer immunotherapy,” said Tim Appenzeller, chief news editor of the journal Science. “So far, this strategy of harnessing the immune system to attack tumors works only for some cancers and a few patients, so it’s important not to overstate the immediate benefits. But many cancer specialists are convinced that they are seeing the birth of an important new paradigm for cancer treatment.”

Many of today’s advances in cancer immunotherapy can be traced back to the late 1980′s, when French researchers identified a receptor on T cells, called CTLA-4. James Allison discovered that this receptor prevented T cells from attacking invaders with their full force. In the mid-1990′s Allison showed that blocking CTLA-4 in mice could unleash T cells against tumor cells in the animals, shrinking them dramatically.

In the meantime, Japanese researchers identified another “brake” on T cells known as PD-1. Clinical trialsinvolving this receptor began in 2006, and preliminary results in small groups of patients appear to be promising.

Another area of interest involves genetically modifying T cells to make them target tumors. In 2011 this strategy, known as chimeric antigen therapy, or CAR therapy, electrified the cancer research field, and it’s now the subject of numerous clinical trials, particularly in blood cancers.

Accordingly, many pharmaceutical companies that wanted nothing to do with immunotherapy several years ago are now investing heavily.

There’s still lots of uncertainty regarding how many patients will benefit from these therapies, most of which remain experimental—and for which forms of cancer they will work best. Scientists are busy trying to identify biomarkers that might offer answers, and thinking of ways to make treatments more potent. But a new chapter in cancer research and treatment has begun and the journalScience acknowledges this fact by recognizing cancer immunotherapy as the most significant scientific breakthrough of 2013.

The journal’s list of nine other groundbreaking scientific achievements from the past year follows.

CRISPR: This gene-editing technique was discovered in bacteria, but researchers now wield it as a scalpel for surgery on individual genes. Its popularity soared this year as more than a dozen teams of researchers used it to manipulate the genomes of various plant, animal and human cells.