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Cancer is a group of diseases where abnormal cells grow uncontrollably, invading nearby tissues and sometimes spreading to distant organs of the body. In India, an estimated 1.87 million new cases are likely to be diagnosed in 2026, which means 1 in 9 Indians reading this article are at a lifetime risk of developing cancer.
Damage wreaked on the body apart, cancer is one of the most economically disruptive illnesses for families. Every year, ₹3,400 crores is spent on direct and indirect medical costs for cancer: this, however, excludes income loss, debt, asset depletion and caregiver burden.
It is no wonder then, that with the burden of cancer rising in India and globally that it is one of the most widely-studied diseases in the world. And it is this research that has led to the emergence of what could perhaps become a new frontier in cancer treatment: space oncology.
What is space oncology ?
Space oncology is a rapidly emerging field, investigating how microgravity and cosmic radiation impact cancer progression and treatment. Space is a natural laboratory for studying cancer biology. Space-based environments are studied to accelerate tumour modelling and drug discovery.
Space oncology has already produced useful, conceptual and technological spin-offs, ranging from 3D cell-culture systems to protein-crystal studies for cancer drug development. This is in addition to refined thinking about radiation risk, tissue response and biomarker discovery.
Why this is useful
Cancer is biologically diverse. Understanding divergent mechanobiological responses helps identify signalling pathways fundamental to metastasis, tissue invasion and treatment resistance.
Some cell changes that have been identified as a result of microgravity are cytoskeletal reorganisation, altered focal-adhesion signalling, changes in extracellular-matrix interactions and spontaneous formation of multicellular spheroids. Each is relevant to tumour spread and therapeutic response.
When it comes to drugs, researchers have found that microgravity changes the cytoskeleton and spheroid formation of cells, which can help hasten drug discovery and also lead to reduced animal testing for drugs. As microgravity also allows for more uniform protein crystals and lower-viscosity biologics, this could help develop more stable formulations.
Microgravity also changes the tumour-cell biology that drugs act on, and improves performance of delivery systems such as nanoparticles and 3D formulations. The effects of microgravity on cancer cells, cancer stem cells, and drug response therefore, could help future therapeutic strategies.
How does it work?
International Space Station (ISS) studies have covered real-space and simulated-microgravity experiments across breast, lung, thyroid, prostate, melanoma, glioblastoma and hematologic cancer models. Cancer cells studied in microgravity and exposed to unique radiation environment of space, behave differently than in conventional laboratory systems. These differences reveal mechanisms that are otherwise difficult to understand.
Reviews of real-space and simulated microgravity experiments show effects on cell adhesion, migration, proliferation, gene expression and formation of multicellular spheroids.
Microgravity also changes how tiny drug packages (nanoparticles) form. These particles carry chemotherapy directly into the tumours and release it slowly. Microgravity reorganises cancer-cell shapes, membrane behaviour and gene expression. This alters how cells take up drugs. Remove or reduce gravity, and cells experience major changes in fluid behaviour, mechanical loading and cell-to-cell interaction.
For cancer cells, these changes are not trivial. In microgravity, protein crystals and complex biologics form more slowly and uniformly without gravitational sedimentation. Microgravity, therefore, helps produce drug crystals and biologic formulations that are harder to make on Earth.
Breast & GI cancer in outer space
Breast cancer cells show changes in gene expression, morphology, signal transduction and invasive behaviour under microgravity. In a microgravity environment of space, breast cancer cells generally shift toward a less malignant and less aggressive phenotype. Under normal gravity, breast cancer cells attach strongly to their surrounding matrix using focal adhesions. In space, these adhesion points fail to mature, reducing the cells’ ability to crawl, migrate, and metastasize. Key proteins that regulate cell cycle checkpoints, specifically cyclin D1 and cyclin B1, are heavily downregulated, pausing the division process and stopping the rapid colony-forming ability of the tumour. Breast cancer spheroids grown in space are more susceptible to specialised therapies.
Gastrointestinal and colorectal cancer however react to microgravity by accelerating their disease trajectory and become more aggressive. Reduced expression of drug-resistance genes, increased DNA/RNA damage markers, and reorganisation of the protein, F-actin, make gastric cancer cells more sensitive to the chemotherapy drug, doxorubicin.
What has emerged – FDA approvalss
In 2025, the United States’ Food and Drug Administration (FDA) approved a subcutaneous form of an immunotherapy drug, pembrolizumab. The U.S. space agency, NASA, had developed this through protein crystal growth research performed on the ISS, targeting the ADAR1 gene. These crystals were more uniform and better suited to supporting formulation work for this route of delivery.
Similarly, rebecsinib, became the first space-tested cancer drug to enter clinical trials. Following successful ISS-linked testing it received the FDA ‘Investigational New Drug’ status. Microgravity-grown tumour organoids helped demonstrate antitumor activity strong enough to support further regulatory progression.
These cases show that space-based research is now a legitimate pathway for drug development, not just a novelty.
Regulations and investments
This year, U.K. regulators and the U.K. Space Agency publicly backed the development of a regulatory pathway in outer space. The Medicines and Healthcare Products Regulatory Agency (MHRA), the Civil Aviation Authority (CAA) and the Regulatory Innovation Office (RIO) have streamlined inter-agency bureaucracy. The specific ‘dual-regulation’ hurdles that previously made space-based pharmacology legally risky for heavy corporate investment were addressed.
This has enabled startups to engineer highly stable, concentrated cancer therapies that patients can self-inject at home instead of hours-long IV infusions. For companies, the costs of setting up a factory are removed; instead they may be able to deploy compact units that operate independently in orbit.
What can India do?
The Indian Space Research Organisation (ISRO), in spite of a modest $13 billion space economy, is the third- largest space-tech power globally and fifth among major government space agencies.
Falling launch costs and new commercial platforms are making space oncology and space pharmaceutical manufacturing more realistic. With successful space startups in India the prices may fall further.
Space manufacturing is no longer about research. The picture is clear: the industry is moving from proof-of-concept to commercial production.
The microgravity pharmaceutical manufacturing market valued at $1.5 billion in 2025 is projected to reach $9.8 billion by 2034. Commercial space stations and nano/microsatellites (CubeSats) are now essential platforms for experiments. Small, frequent launches are becoming viable for pharmaceutical payloads.
What the future holds
Over 700 peer reviewed papers, 40 chapters and 12 monographs have already been published in the area of space oncology. I am optimistic that in my grandchildren’s generation, cancer management on terra firma will use research and drugs made in outer space. At present, space oncology can be encapsulated by the well known saying: ‘A journey of a thousand miles begins with the first step.’ There is no doubt that humans will exploit outer space in the perpetual quest to solve the cancer conundrum on planet Earth.
(Dr. K. Ganapathy is past president of the Neurological Society of India and the Telemedicine Society of India. A former distinguished visiting professor at IIT, Kanpur he is currently a honorary distinguished professor at IIM, Jammu. drkganapathy@gmail.com)
