Who Will Win the 2024 Nobel Prize in Physiology or Medicine?

The Nobel Prize in Physiology or Medicine is one of the most prestigious honors in science, celebrating breakthroughs that significantly advance human knowledge and improve lives. Established by Alfred Nobel’s will, the prize has recognized extraordinary achievements that have reshaped our understanding of biology and medicine. From the discovery of insulin to the development of mRNA vaccines, laureates have been those whose work has had a profound and lasting impact on global health. 

Notable figures such as Camillo Golgi, Santiago Ramón y Cajal, and Katalin Karikó have left a legacy through their contributions, continuing to influence medical research and treatment today. As we approach this year’s Nobel Prize announcements, scheduled from October 7 to 14, there is growing anticipation about which groundbreaking achievements will be honored. 

In this article, we highlight three exceptional researchers who have made substantial impacts on global health: Zhijian Chen, known for discovering the cGAS enzyme; Lotte Bjerre Knudsen, who revolutionized treatments for diabetes and obesity with GLP-1-based therapies; and Carl June, whose development of CAR T-cell therapy has transformed cancer treatment. These three stand out for their significant contributions, making them strong contenders for the 2024 Nobel Prize in Physiology or Medicine. 

Overview of the Nobel Prize Selection Process

The Nobel Prize in Physiology or Medicine is awarded to up to three researchers whose work has profoundly influenced human health and medical science. The selection process is confidential and follows several steps. Each year, the Nobel Committee sends over 3,000 invitations to scientists, academics, and past laureates to submit nominations. These nominations are reviewed rigorously, leading to a shortlist, after which the committee consults experts in the relevant fields. 

Once the committee has made its recommendations, the Nobel Assembly at the Karolinska Institutet votes on the final laureates, a decision kept secret until the official announcement in early October. This high level of confidentiality, with nomination records sealed for 50 years, adds to the prestige and mystique of the Nobel Prize. 

This year, amid a wealth of potential nominees, three researchers—Chen, Knudsen, and June—stand out for their groundbreaking contributions in immunology, metabolic disorders, and cancer treatment. 

Zhijian "James" Chen, Ph.D.: Redefining Immunology 

Dr. Zhijian Chen's discovery of the cyclic GMP-AMP synthase (cGAS) enzyme is a revolutionary finding that has significantly deepened our understanding of the immune system’s response to foreign DNA. His work, which identified the cGAS-STING pathway, provides critical insights into how the body defends itself against viral infections, cancer, and even autoimmune diseases. Before Chen’s discovery, scientists lacked a clear explanation of how the immune system detected cytosolic DNA, especially from pathogens or damaged cells. 

Chen's breakthrough lies in the mechanism by which the cGAS enzyme recognizes foreign DNA in the cytoplasm—a signal that DNA is outside its normal place in the nucleus or mitochondria. When cGAS detects this DNA, it synthesizes cyclic GMP-AMP (cGAMP), a second messenger that binds to and activates the STING (Stimulator of Interferon Genes) protein. This activation triggers a cascade of immune responses, leading to the production of type I interferons and pro-inflammatory cytokines, which play a critical role in fighting infections and eliminating cancerous cells. 

Implications in Autoimmune Disease and Cancer 

One of the most significant aspects of Chen’s discovery is its dual role in fighting diseases. While the cGAS-STING pathway is essential for immune defense, its overactivation can lead to autoimmune diseases such as systemic lupus erythematosus (SLE), where the immune system mistakenly attacks healthy cells. Understanding this balance has allowed researchers to develop cGAS inhibitors that could prevent excessive immune responses in conditions like lupus and arthritis. Early-stage research has already shown promise in animal models, offering hope for new treatments for chronic inflammatory diseases. 

At the same time, the therapeutic potential of activating the cGAS-STING pathway in cancer immunotherapy is also being explored. STING agonists, which stimulate this pathway, are currently in clinical trials to enhance the immune system’s ability to detect and destroy cancer cells. When combined with other treatments such as immune checkpoint inhibitors, these drugs could significantly improve outcomes for cancer patients, making tumors more susceptible to immune system attacks. 

Ongoing Research and Recognition 

Dr. Chen’s discovery has opened the door to a new field of research, with pharmaceutical companies developing drugs that either inhibit or activate the cGAS-STING pathway, depending on the condition being treated. Researchers are also exploring this pathway’s role in infectious diseases, including tuberculosis and herpes, where boosting immune responses could lead to better treatments. 

In recognition of his groundbreaking work, Dr. Chen was awarded the 2024 Albert Lasker Basic Medical Research Award, a significant honor often considered a precursor to the Nobel Prize. His research has reshaped the field of immunology and continues to guide the development of therapies for a wide range of diseases, including autoimmune disorders, cancer, and infectious diseases.

Lotte Bjerre Knudsen: Revolutionizing Metabolic Disease Treatment

Lotte Bjerre Knudsen’s work on GLP-1-based therapies has transformed the treatment of two of the world’s most widespread chronic diseases: type 2 diabetes and obesity. As a pharmaceutical scientist at Novo Nordisk, Knudsen was instrumental in translating the hormone GLP-1 (glucagon-like peptide-1) into treatments that have dramatically improved the lives of millions of patients worldwide. 

GLP-1: The Science Behind the Treatment 

GLP-1 is a hormone that the gut releases in response to eating. It plays a vital role in regulating blood sugar by stimulating insulin production, inhibiting glucagon release, and slowing gastric emptying, which leads to a feeling of fullness. While GLP-1 was known to have potential therapeutic benefits, its natural form is rapidly degraded in the body, limiting its effectiveness. Knudsen and her team overcame this challenge by developing long-acting GLP-1 analogs, such as liraglutide and semaglutide, which can last much longer in the bloodstream. 

Liraglutide, which was first approved for the treatment of type 2 diabetes, later became a groundbreaking treatment for obesity. Semaglutide, a newer drug with a longer half-life, allows for weekly dosing and has shown even greater success in managing both blood sugar levels and inducing weight loss. In clinical trials, patients using semaglutide experienced weight loss averaging 15% of their body weight, an outcome that far surpasses previous obesity treatments.

Expanding Beyond Diabetes and Obesity 

Beyond its impact on diabetes and obesity, GLP-1 receptor agonists have shown promising cardioprotective benefits, significantly reducing the risk of heart attack and stroke in patients with diabetes. This dual action on both metabolic and cardiovascular health has made GLP-1 therapies a cornerstone in treating these chronic conditions. 

Knudsen’s research is now influencing the treatment of other conditions linked to metabolic dysfunction, such as nonalcoholic steatohepatitis (NASH) and chronic kidney disease. Emerging studies also suggest that GLP-1 receptor agonists may have anti-inflammatory effects, opening new possibilities for treating inflammatory diseases like asthma and NASH, further broadening the therapeutic reach of these drugs. 

Clinical Impact and Recognition 

The impact of GLP-1-based therapies on patient outcomes has been nothing short of transformative. Both liraglutide and semaglutide have become essential tools in managing not only diabetes and obesity but also improving overall health outcomes. Recognizing her contributions, Knudsen was awarded the 2024 Lasker~DeBakey Clinical Medical Research Award. Her work continues to influence the future of chronic disease management, with potential applications extending well beyond metabolic disorders. 

Carl June, M.D.: Transforming Cancer Treatment with CAR T-Cell Therapy 

Dr. Carl June has revolutionized cancer treatment with his development of CAR T-cell therapy, a type of immunotherapy that has dramatically improved outcomes for patients with certain types of cancer. This innovative therapy uses the body’s immune system to target and destroy cancer cells, particularly in hematologic cancers such as acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma. 

The Science of CAR T-Cell Therapy 

CAR T-cell therapy involves collecting a patient’s T cells—a type of white blood cell that plays a key role in the immune response—and genetically modifying them to express chimeric antigen receptors (CARs). These receptors are engineered to recognize specific antigens on the surface of cancer cells. Once the modified T cells are re-infused into the patient, they multiply and actively seek out and destroy cancer cells. 

In clinical trials, CAR T-cell therapy has shown unprecedented success. For instance, in patients with relapsed or refractory ALL, complete remission rates as high as 83% have been observed. The first FDA-approved CAR T-cell therapy, Kymriah (tisagenlecleucel), has provided life-saving options for patients who previously had few or no effective treatments. 

Challenges and Future Applications 

Despite its success, CAR T-cell therapy is not without challenges. The therapy can cause severe side effects, including cytokine release syndrome (CRS) and CAR T-cell-related encephalopathy syndrome (CRES). CRS results from an overactivation of the immune system, while CRES affects the central nervous system. Managing these side effects has required the development of new protocols, including the use of tocilizumab to treat severe CRS. 

Dr. June and his team are now working on expanding the use of CAR T-cell therapy beyond hematologic cancers to treat solid tumors, which are more challenging due to the complex tumor microenvironment. Innovative approaches, such as armored CAR T cells that secrete immune-enhancing proteins, are being tested in early-stage clinical trials for cancers like pancreatic and ovarian cancer. 

Recognition and Global Impact 

For his pioneering work, Dr. June received the 2024 Breakthrough Prize in Life Sciences, one of the most prestigious awards in science. His contributions have not only saved countless lives but also laid the foundation for future breakthroughs in cancer immunotherapy. As research continues, CAR T-cell therapy has the potential to become a more widespread treatment for both blood and solid tumors, offering hope to even more patients in the years to come. 

A New Era in Medicine: Conclusion and Broader Implications 

Zhijian Chen, Lotte Bjerre Knudsen, and Carl June represent three of the most important scientific advancements in recent history. Despite their work spanning diverse areas—immunology, metabolic disease, and cancer therapy—all three researchers have fundamentally changed how we approach disease treatment. Their contributions mark a shift towards precision medicine, where treatments are increasingly personalized and tailored to specific biological mechanisms. 

Dr. Chen’s discovery of the cGAS-STING pathway has provided new opportunities to treat autoimmune diseases, cancer, and infections by fine-tuning the immune response. Knudsen’s GLP-1-based therapies have not only transformed diabetes and obesity treatment but also paved the way for future therapies targeting related metabolic disorders and chronic conditions. Carl June’s CAR T-cell therapy has redefined cancer treatment, particularly for patients with previously untreatable blood cancers, and holds promise for solid tumors. 

It’s important to note that this is just our take on who might be among the strongest contenders for the 2024 Nobel Prize in Physiology or Medicine. The field of biomedical research is rich with talent, and there are countless other researchers whose extraordinary work deserves recognition. No matter who is ultimately awarded the prize, it’s certain that their contributions to science and healthcare will be profound and deserving of this prestigious honor. 

The global impact of the work by these three scientists is clear. From reducing the burden of chronic diseases like diabetes and obesity to offering life-saving cancer treatments, their breakthroughs are already improving healthcare outcomes for millions of patients. As their therapies continue to evolve, the potential to scale these treatments for broader access promises even greater global health benefits. 

Their collective achievements underscore the ripple effect of innovation in science: each discovery builds on existing knowledge, opening new pathways for research and treatment. Whether targeting the immune system, metabolic dysfunction, or cancer cells, the work of Chen, Knudsen, and June showcases the power of modern medical science to address some of the most complex challenges in healthcare. 

As we await the 2024 Nobel Prize announcements, the contributions of these researchers highlight a future where precision, personalized treatments will dominate the medical landscape, providing more effective and individualized care for patients across the globe. Whoever the winners may be, their contributions to medicine and science will be a testament to the brilliance of today’s researchers. Stay tuned—these innovations represent just the beginning of what's possible in the rapidly evolving field of medical science.

Read our breakdown of the science behind the 2023 Nobel Prize for Medicine winners here.