Cancer cells multiply, spread and thrive in large measure because the body’s immune system doesn’t recognize the cancer as a lethal threat. Efforts to enable the immune system to “see” the cancer and attack the aberrant cells were the prime focus during Vanderbilt-Ingram Cancer Center’s Annual Retreat, held April 30 at the Vanderbilt University Student Life Center.
The field of immunotherapy is one of the most promising areas of cancer research at the moment. New therapies targeting this “cloak of invisibility” are in development and the FDA has already approved some immunotherapy drugs for use in cancers like melanoma, a deadly form of skin cancer.
VICC melanoma patient Kimberly Jessop told the attendees about her robust response to a new immunotherapy drug that took the brakes off of a population of anti-tumor immune cells, allowing them to destroy the tumor cells in multiple metastatic melanoma lesions in her body. She was treated by Jeffrey Sosman, M.D., for more than a year with the new immunotherapy reagent and has remained disease free from melanoma for the past three years.
Guest speaker Suzanne Topalian, M.D., director of the Melanoma Program at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, described results from clinical trials of immunotherapy drugs that target the proteins PD-1 and PD-L1 in patients with metastatic melanoma. She noted that the drugs in the trials have shown activity in many types of cancer with melanoma, lung and kidney cancer showing the most promising responses.
Topalian said it may be necessary to “prime” the tumor with a vaccine or other treatment prior to using PD-L1 drugs to help the immune system recognize the tumor cells.
But trying to stimulate the immune system is a risky business, according to speaker Lawrence Fong, M.D., professor of Medicine at the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco.
Researchers must ensure that the newly stimulated immune system attacks only the cancer while bypassing healthy cells.
Jedd Wolchok, M.D., Ph.D., chief of Melanoma and Immunotherapeutics Service and associate director of the Ludwig Center for Cancer Immunotherapy at Memorial Sloan Kettering Cancer Center, New York, detailed efforts to identify the checkpoints in the mechanisms of immune function and create “blockades” to those checkpoints. Combining several different therapies that address different checkpoints may be necessary for immunotherapies to be most effective.
The complexity of the immune system is problematic for investigators who are trying to understand why cancer cells can evade an immune response. Drew Pardoll, M.D., Ph.D., director of the Johns Hopkins Cancer Immunology and Hematopoiesis Program at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, is investigating the immune system’s “dark side.” He is studying bacteria in the gut that appear to cause colitis and inflammatory bowel disease, which can lead to colon cancer, in part due to chronic activation of STAT3 and Th17 immune cells in the colon.
“Clearly the new successes with immunotherapy provide one of the most promising advances in cancer therapy in this decade. However, not everyone responds. We need to develop methods to determine who is most likely to respond, and also develop new combinatorial protocols that will broaden the population of patients who will respond,” said Ann Richmond, Ph.D., Ingram Professor of Cancer Research and organizer of the VICC retreat.
During the event, awards were presented to outstanding students and fellows at VICC.
Anna Vilgelm, M.D., Ph.D., was named Postdoctoral Fellow of the Year for her research focused on next-generation sequencing of tumors and resistance to treatment in melanoma. Vilgelm works in the research laboratory of Richmond.
Postdoctoral candidate Alex Walsh, M.S., was recognized as Graduate Student of the Year for her research on optical metabolic imaging and its use in tracking and predicting the efficacy of cancer drugs. Walsh works with Melissa Skala, Ph.D., assistant professor of Bioengineering and Cancer Biology.
