Alzheimer’s Research Pivots to ‘Cancer Model’

Recent trials testing Novo Nordisk’s semaglutide for Alzheimer’s disease did not yield the desired results.

However, experts argue that this failure underscores a critical evolution in how the medical field approaches the brain-wasting condition.

Scientists are moving away from single-target treatments. Instead, they are viewing Alzheimer’s as a system of complex pathways, mirroring the transformation seen in cancer therapeutics over recent years.

Current Treatments and Limitations

Currently, only two drugs are approved to slow Alzheimer’s: Kisunla (Eli Lilly) and Leqembi (Eisai and Biogen). Both drugs delay disease progression by approximately 30% by removing toxic amyloid plaques from the brain.

However, researchers are actively seeking additional targets. Globally, over 55 million people suffer from dementia, with Alzheimer’s accounting for about 60% of cases. The disease is defined by the presence of both amyloid and tau proteins.

Howard Fillit of the Alzheimer’s Drug Discovery Foundation emphasized the need for a broader approach.

“All the diseases of aging, they all require combination therapy,” Fillit stated. “Just targeting one pathway isn’t going to be enough.”

Moving Toward Tailored Treatment

The medical community is drawing parallels to oncology. Cancer treatment once relied on one-size-fits-all chemotherapy. Today, it targets specific genetic mutations and unique signatures of malignant cells.

David Watson, CEO of the Alzheimer’s Research and Treatment Center, compared the current state of Alzheimer’s research to “oncology 20 years ago.” He cited advances in blood biomarkers and genetic testing as reasons for optimism.

While blood tests are becoming available, most diagnoses still rely on spinal taps or expensive scans. Furthermore, not all patients respond equally to anti-amyloid treatments. Studies suggest that Black patients may have more than one disease type, and men often respond better than women.

Novo’s Data and Lilly’s Strategy

Novo Nordisk’s oral semaglutide provided no cognitive benefit for people with early Alzheimer’s. However, the company will release full trial details in March. Experts hope a breakdown of patient characteristics will yield clues for future research.

Dawn Brooks, head of neurodegeneration development at Eli Lilly, noted that the industry wants to see potential subgroup analyses.

Lilly, the maker of the popular GLP-1 drug tirzepatide, is still evaluating whether the drug class has a role in Alzheimer’s treatment. Currently, its GLP-1 brain-health program focuses on alcohol and tobacco use disorders.

Future Drugs: Multiple Targets

The field is moving quickly toward drugs that target multiple aspects of the disease.

• Biogen: The company expects data next year on a novel drug targeting tau proteins.
• Roche: The pharmaceutical giant recently launched late-stage trials for trontinemab. This drug links an amyloid antibody to a “brain shuttle,” allowing it to cross the blood-brain barrier more effectively than current options.
• Annovis Bio: The company is developing buntanetap. Now in Phase 3 testing, this drug targets amyloid, tau, and two other neurotoxic proteins simultaneously.

Maria Maccecchini, CEO of Annovis, highlighted the importance of accurate screening. She noted that when non-Alzheimer’s patients were eliminated via blood testing in earlier studies, the drug showed statistically significant cognitive improvement.

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