The USC Clinical Trial Recruitment Lab will fund four projects testing how AI can strengthen recruitment for Alzheimer’s trials.

The initiative, dedicated to accelerating and improving Alzheimer’s clinical trials, selected the projects from more than 30 applicants to explore digital approaches.

Alzheimer’s clinical trials are more complex, costlier and take longer than those in other therapeutic areas, despite the pressing need for new treatments.

The lab evaluates innovative recruitment strategies to improve access and representation in trials, with the goal of identifying scalable evidence-based recruitment practices.

The USC Clinical Trial Recruitment Lab is a collaboration between the USC Schaeffer Center for Health Policy and Economics and the USC Epstein Family Alzheimer’s Therapeutic Research Institute.

The four projects will explore the following strategies.

• Miriam Ashford at University of California, San Francisco will develop and test a generative AI voice agent to support remote informed consent and assess patient capacity for Alzheimer’s clinical trials.
• Erika Cottrell at OCHIN, a national network of community health centres, and Vijaya Kolachalama at Cognimark will integrate an AI-enabled diagnostic platform into primary care electronic health record workflows to support earlier identification and referral of patients.
• Andrew Kiselica at University of Georgia will establish a digitally enabled, trial-ready cohort of rural older adults to improve recruitment, participant selection and engagement.
• Raeanne Moore at University of California, San Diego will leverage electronic health record portals and digital cognitive assessments to accelerate prescreening and better match potential participants.

An estimated 5.6 million Americans are living with Alzheimer’s and related dementias, a number expected to increase dramatically in the coming decades as the population ages.

An extensive therapeutic development pipeline and new early-detection approaches, such as diagnostic blood tests and advanced digital tools, have the potential to reduce the burden of the disease.

However, fewer than one per cent of eligible individuals participate in Alzheimer’s therapeutic trials due to barriers that include limited patient awareness, health system resource constraints and lack of access to diagnostics, according to research from USC Schaeffer.

Certain populations at higher risk for the disease, including Black and Hispanic patients, remain underrepresented.

“We can only innovate as quickly as we can test new therapies,” said Dana Goldman, founding director of the USC Schaeffer Institute.

“That’s why it’s crucial we keep expanding the toolkit of evidence-based recruitment strategies for running faster, better trials.”

The lab previously funded six pilots, some of which have already yielded insights.

For example, one found remote blood collection could help identify potential participants, while another showed that offering a small gift card significantly increased enrolment in an online memory concerns registry.

“Faster and more effective recruitment is essential, and we’re excited to incorporate these solutions in an integrated way as part of our clinical trials,” said Paul Aisen, founding director of the USC Epstein Family Alzheimer’s Therapeutic Research Institute.

“As studies move earlier into pre-symptomatic disease, this opens the door to new recruitment paradigms, and continuing to push forward the science of recruitment will be critical to what comes next in Alzheimer’s research.”

Scientists have developed a nanoparticle strategy to broaden which disease-causing proteins medicines can target, giving options for dementia and brain cancer.

A perspective outlines an approach designed to remove harmful proteins that drive disease. By broadening the proteins that can be treated, the technology could help tackle conditions such as dementia and brain cancer.

The work was led by chair professor in nanomedicine Bingyang Shi at the University of Technology Sydney, in collaboration with professor Kam Leong of Columbia University and professor Meng Zheng of Henan University.

Professor Shi said: “Proteins are essential for nearly every function in the body, but when they become mutated, misfolded, overproduced or build up in the wrong place, they can disrupt normal cell processes and trigger disease.

He added: “Many conditions, including cancer, dementia, and autoimmune disorders, are driven by abnormal proteins, and some have shapes or behaviours that make them particularly resistant to drug treatments.”

To tackle these challenges, the researchers created a type of engineered nanoparticle called nanoparticle-mediated targeting chimeras (NPTACs).

The particles are designed to recognise specific disease-associated proteins and promote their breakdown in the body.

Professor Shi said: “We have developed an efficient and flexible method to guide disease-causing proteins, whether inside or outside the cell, into the body’s natural recycling system, where they can be broken down and removed.”

Interest in targeted protein degradation has surged in recent years.

Companies such as Arvinas have attracted more than US$1bn in investment and formed partnerships with pharmaceutical firms including Pfizer, Bayer and Roche.

However, existing protein degradation technologies face limitations.

Challenges such as poor tissue penetration, unintended interactions with other proteins and complex chemical design have slowed their use, particularly for brain disorders and solid tumours.

Professor Shi said: “Our nanoparticle-based strategy overcomes these bottlenecks.”

The researchers say the NPTAC platform can enable degradation of both proteins inside and outside cells, offers tissue and disease-specific targeting including across the blood-brain barrier (the protective barrier around the brain), and has plug-and-play modularity to adapt to diverse protein targets.

They say it is scalable and clinically translatable, leveraging FDA-approved nanomaterials and industry-proven synthesis strategies, and can combine with diagnostic or therapeutic capabilities.

Protected by multiple international patents, NPTACs have shown preclinical results against targets such as EGFR (a protein often driving tumour growth) and PD-L1 (a protein that helps cancer cells evade the immune system).

Professor Shi said: “This progress paves the way for applications in oncology, neurology, and immunology. It changes how we think about nanoparticles, not only as delivery tools but also as active therapeutic agents.

He added: “With the targeted protein degradation market expected to surpass $10 billion USD by 2030, NPTACs provide a powerful platform for the next generation of smart, precision therapies.

“We are now seeking strategic industry partners to accelerate clinical development, licence applications across therapeutic fields, and prepare for regulatory approval.”