When Earth Alone isn't Enough: Taking the Anti-Cancer Fight to Space

One of the most challenging things about attending Healthcare conferences is choosing which sessions to go to. Often, there are multiple interesting sessions happing at the same time, so you have to make a decision based on the the symposium/session title alone (if you are feeling particularly adventurous) or (recommended) on the titles of the individual lectures. When looking through the symposium titles that occupied the first time slot on Day 3 of KSMO 2025, I was initially torn between:

• [JS08] Biomarkers for Anti-body Drug Conjugates

• [SS07] Novel Opportunities to Target Cancer: Emerging Strategies in Molecular Oncology

Reading through the details of the second topic a bit more on the shuttle bus to the venue, my sleepy brain (it was 8am) did a bit of a double-take:

• SS07-1: Exploring the cell death phenotypic landscape for cancer (my thoughts: sounds somewhat interesting, but likely very pre-crinical)

• SS07-2: Repursing cardiac drugs beta-blockers for cancer treatment (that's a bit unexpected... could be worth attending)

• SS07-3: Targeting metastatic cancer via synthetic lethality (unsure based on the title alone)

• SS07-4: Research and commercial activities in low earth orbit for cancer therapeutics (oh, low earth... what?!.. this sound so cool!)

Take your protein pills and put your helmet on

I will skip over lectures 1-3 for now (though I may come back to the second one in a later post), and will go straight to space. The presenter was Dr. Hargsoon Yoon, who isn't just a faculty member of Norfolk State University, but is also the CEO of a company called Space Liin Tech. His slides, with an appropriately space-themed background (think a lot of black and lots of stars), honestly blew me away.

The thing about doing research on Earth is, it's messy. Having worked in a lab during my university days (think contaminated agar plates, burnt fingers in bunsen burners and general chaos), I can personally confirm this. Now, while my mishaps were probably almost entirely attributable to personal incompetence and clumsiness, the fact remains that Earth-based labs are not the most controlled environments imaginable. This is particularly true of undergrad laboratories, but even the most high-profile fancy research labs are subject to certain forces that simply cannot be turned off. Such as gravity.

Enter the International Space Station (ISS), which is in low Earth orbit (LOE), and hence presents a uniquely controlled environment in microgravity. The thing about gravity is, it messes with all sorts of things. One of the most important research tools in the pharmaceutical R&D world is protein crystallisation, which is the process of forming a protein crystal from a protein solution, which in turn then helps to study the 3-dimensional structure of proteins (using techniques like X-ray crystallography). Elucidating 3D protein structures is vital for identifying potential drug targets, so the accuracy of protein crystallisation is extremely important. If the crystal structure isn't 100% accurate, the structure of potential drug binding sites may be somewhat distorted, resulting in suboptimal drug targeting and binding.

The microgravity of LOE gets around all that, enabling much higher-resolution protein structures to be determined, leading to much more precise drug development, at least in theory.

I'm floating in the most peculiar way

Amazingly enough, these principles are no longer merely theoretical. Taiho Pharmaceuticals developed a Duchenne Muscular Dystrophy candidate based on this exact approach, partnering with JAXA (the Japanese Aerospace Exploration Agency). Unfortunately, the compound ultimately failed its phase III trial (this year), but it was an interesting proof of concept nevertheless.

Furthermore, Merck/MSD was involved with a space mission back in 2017, aiming to understand the key variables that affect mAb crystallisation and to identify conditions for improved crystallisation of pembrolizumab. The results, published in the journal Microgravity (which I had no idea existed until now), showed that crystallisation of pembrolizumab was much more uniform in LOE than back at home on Earth. The suspension also had lower viscosity. As noted in the paper, "the results of these studies may help widen the drug delivery options to improve the safety, adherence, and quality of life for patients and caregivers." BMS launched a similar mission in 2020 for nivolumab, with more planned. Lilly also launched a mission to study the protein structure of insulin, showing that "insulin crystals grown on the ISS using the PIL-BOX FC system are larger and more highly ordered than crystals grown on Earth" again with more planned. The partner for all three of these above collaborations was Redwire Space.

What I find interesting is that these missions have been going on for the best part of a decade, and this incredibly cool science had (until this week) completely passed me by. I feel it deserves a lot more attention. A figure that was quoted during the presentation, based on an analysis from Coherent Market Insights, is that the Space Medicine Market (still feels bizarre even typing those three words!) will be worth 1.7B USD by 2032.

And I think my spaceship knows which way to go

Space Liintech, the company founded by the speaker, conducts space-based, satellite-based and ground-based research. They just launched Korea's first space medicine mission to the ISS in August 2025, aboard a SpaceX rocket, and the company aims to provide commercial services in space medicine starting in 2027, depending on the outcome of this experiment. In other words, there is a lot of momentum in this space (pun intended).

Of course, there were questions from the audience, and the first question (perhaps predictably) related to the economics of these space medicine missions. The audience member figured that it's probably quite expensive to launch a rocket into space to study protein structures as opposed to - and I thought this was a really good point - using AlphaFold (which has revealed millions of 3D protein structures through AI). The presenter's response was that AlphaFold needs more data to improve the functions of its software, and that space missions can provide this data. In addition, the launch cost of space missions is dropping quite fast, predicted to soon by 10% of the current cost. Time will tell, I suppose.

One thing is for sure: I will be eagerly watching this...

Yeah.