What will be the next biotech breakthroughs?

It’s hard to imagine how things could possibly get better for the Cambridge life sciences cluster, save for an extended spell of money falling from the sky.

Things are clicking for the brainiacs who take breakthrough academic research, start companies around it, raise millions in venture capital, forge partnerships with big pharma companies, and one day — they hope — land new products on the market that can improve and extend lives.

“It’s just beyond ridiculous right now,” says Bernat Olle, chief executive of Vedanta Biosciences, a Cambridge biotech working on treatments for diseases of the digestive tract such as Crohn’s and colitis. The density of researchers, investors, and pharmaceutical industry execs found in Cambridge “doesn’t happen anywhere else in the world,” says Olle, who came here from Spain to earn his doctorate at MIT.

So what are the scientific areas and tech advances that people in the local life sciences scene think will bear fruit in the years and decades ahead? I’ve been asking investors, entrepreneurs, and industry-watchers over the last two months. Here’s a list of what they mentioned most often.

Cancer immunotherapy. A healthy immune system prevents you from catching the sniffles when you sit next to sick person on the T by attacking the germs invading your body before they can make you sick. The idea behind cancer immunotherapies is to “train” immune system cells to seek and destroy cancer cells. Merck & Co. of Kenilworth, N.J., and Bristol-Myers Squibb Co. of New York are working on immunotherapies for late-stage skin cancer and lung cancer. The Swiss drugmaker Novartis AG last year bought a Cambridge startup, CoStim, which was working in the field.

Gene silencing, gene therapy, and gene editing. Lots of diseases are caused by mutated or malfunctioning genes. So what if you could shut off specific genes that are wreaking havoc, or even “rewrite” their biological code to allow them to function normally? One big advance in gene therapy, says Katrine Bosley, chief executive of the Cambridge biotech Editas Medicine, has been figuring out how to deliver a corrected gene to the right place in the body. Recent successes in the gene therapy field by companies like Bluebird Bio Inc. in Cambridge “open the possibility of curing diseases with a single treatment,” says Glenn Batchelder, chairman of the Massachusetts Biotech Council.

All things neuro. Problems with the brain, from depression to autism to Alzheimer’s, are now seen as “addressable,” says David Berry, a general partner at the Cambridge investment firm Flagship Ventures and a founder of Seres Health Inc., which went public last month. Part of that, he says, is due to better understanding of how the brain works, and more precise and objective ways to measure improvements.

A Boston startup, Tal Medical, raised $14 million earlier this year to develop and test a device for treating depression and bipolar disorder that uses low-intensity magnetic pulses. Local companies like Biogen Inc. and Forum Pharmaceuticals Inc. are pursuing new drugs to treat Alzheimer’s disease. In many neurodegenerative diseases like Alzheimer’s and Parkinson’s, says Bosley, “you see protein is piling up in the cell — it’s like the garbage workers went on strike and the bags are piling up on the sidewalk.” New approaches to help brain cells eliminate the buildup of proteins — essentially take out the trash — may slow or stop the advance of those diseases.

The microbiome. When people say “microbiome,” they’re describing the millions of bacteria that live on your skin and inside your digestive tract. In the past, we’ve primarily focused on exterminating bacteria with antibiotics like penicillin, but research shows that some of this bacteria are good for your health. Future pills might contain “good” bacteria that would get into your gut and multiply over time to combat inflammatory bowel diseases or recurrent infections. In the future, says Olle at Vedanta, we may think of managing our microbiome a bit like gardening — if you don’t plant stuff like perennials or veggies, the weeds will take over.

Digital health and medical records. If you’re old enough to remember sitting across the desk from a travel agent, you probably remember getting paper airline tickets, too. Now think about how digital the travel process has become, from buying tickets online to using a mobile device to navigate a foreign city. Amir Nashat of Polaris Partners, a Boston venture capital firm, says health care is going through that transition, too, albeit slowly. Smartphones, watches, and other wearable devices will collect more data about how we’re feeling, and doctors and hospitals will get smarter about how they use that data.

The aging cure. The ultimate pursuit of the drug industry is a fountain of youth — a way to extend lifespans and fend off diseases of aging. Investors have poured hundreds of millions of dollars into local companies that thought they were on the right track, including Elixir Pharmaceuticals and Sirtris Pharmaceuticals. (The first is defunct, the second was acquired then shut down.) Be glad — and just a little bit skeptical — that yet one more company, Navitor Pharmaceuticals of Cambridge, raised $23 million last year to explore ways to control a mechanism inside the cell that, chief executive George Vlasuk says, “we believe is critical to a number of diseases of aging,” including type-2 diabetes and obesity.

Here’s hoping we all live long enough to see at least some of this potential realized.

Scott Kirsner writes the Innovation Economy column every Sunday in the Boston Globe, in which he tracks entrepreneurship, investment, and big company activities around New England.
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