Cleveland Clinic, a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education, has announced its 9th annual list of Top 10 Medical Innovations likely to have major impact on improving patient care in 2015. The list of up-and-coming technologies and drug therapies was selected by a panel of 110 Cleveland Clinic physicians and scientists. The Top 10 Medical Innovations for 2015 are:

1. Mobile stroke unit: High-tech ambulances bring the emergency department straight to the patient with stroke symptoms. Using telemedicine, in-hospital stroke neurologists interpret symptoms via broadband video link, while an onboard paramedic, critical care nurse and CT technologist perform neurological evaluation and administer t-PA after stroke detection, providing faster, effective treatment for the affected patient.

2. Dengue Fever vaccine: More than 50 to 100 million people in more than 100 countries contract the dengue virus each year. The world’s first vaccine has been developed and tested, and is expected to be submitted to regulatory groups in 2015, with commercialization expected later that year.

3. Cost-effective, fast, painless blood-testing: The new form of blood collection uses a drop of blood drawn from the fingertip in a virtually painless procedure. Test results are available within hours of the original draw and are estimated to cost as little as 10% of the traditional Medicare reimbursement.

4. Inhibitors for cholesterol reduction: Effective statin medications have been used to reduce cholesterol in heart disease patients for over two decades, but some people are intolerant and cannot benefit from them. Several PCSK9 inhibitors, or injectable cholesterol lowering drugs, are in development for those who don’t benefit from statins. The FDA is expected to approve the first PCSK9 in 2015 for its ability to significantly lower LDL cholesterol to levels never seen before.

5. Antibody-drug conjugates: Chemotherapy, the only form of treatment available for treating some cancers, destroys cancer cells and harms healthy cells at the same time. A promising new approach for advanced cancer selectively delivers cytotoxic agents to tumor cells while avoiding normal, healthy tissue.

6. Checkpoint inhibitors: Cancer kills approximately eight million people annually and is difficult to treat, let alone cure. Immune checkpoint inhibitors have allowed physicians to make significantly more progress against advanced cancer than they’ve achieved in decades. Combined with traditional chemotherapy and radiation treatment, the novel drugs boost the immune system and offer significant, long-term cancer remissions for patients with metastatic melanoma, and there is increasing evidence that they can work on other types of malignancies.

7. Leadless cardiac pacemaker: Since 1958, the technology involved in cardiac pacemakers hasn’t changed much. A silver-dollar-sized pulse generator and a thin wire, or lead, inserted through the vein kept the heart beating at a steady pace. Leads, though, can break and crack, and become infection sites in 2% of cases. Vitamin-sized wireless cardiac pacemakers can be implanted directly in the heart without surgery and eliminate malfunction complications and restriction on daily physical activities.

8. New drugs for idiopathic pulmonary fibrosis: Nearly 80,000 American adults with idiopathic pulmonary fibrosis (IPF) may breathe easier in 2015 with the recent FDA-approval of two new experimental drugs. Pirfenidone and nintedanib slow the disease progress of the lethal lung disease, which causes scarring of the air sacs. Prior to these developments, there was no known treatment for IPF, in which life expectancy after diagnosis is just three to five years.

9. Single-dose intra-operative radiation therapy for breast cancer: For most women with early-stage breast cancer, a lumpectomy is performed, followed by weeks of radiation therapy to reduce the likelihood of recurrence. Intra-operative radiation therapy, or IORT, focuses the radiation on the tumor during surgery as a single-dose, and has proven effective as whole breast radiation.

10. New drug for heart failure: Angiotensin-receptor neprilysin inhibitor, or ARNI, has been granted Fast Track status by the FDA because of its impressive survival advantage over the ACE inhibitor enalapril, the current gold standard for treating patients with heart failure. The unique drug compound represents a paradigm shift in heart failure therapy.