Dr.Catherine Bollard, Washington Children’s Hospital, Washington, DC
Dr. Daniel Powell, University of Pennsylvania, Philadelphia, PA
Dirk Busch, University of Munich
Mark Dudley, Ph.D., Novartis
Terry Fry, M.D., National Cancer Institute
Steve Gottschalk, M.D., Texas Children's Hospital
Chris Hourigan, M.D., National Institute of Health
Patrick Hwu, M.D., MD Anderson Cancer Center
Michael Jensen, M.D., Seattle Children's Hospital
Leslie Kean, M.D., Ph.D., Seattle Children's Hospital
Chris Klebanoff, M.D., National Institute of Health
Stan Riddell, M.D., Fred Hutchinson Cancer Research Center
Barbara Savoldo, M.D., Ph.D., University of North Carolina
Jennifer Wargo, M.D., MD Anderson Cancer Center
Some of the most exciting results in cancer medicine, in the last decade, have come about by treating relapsed patients with B cell lymphoma with their own T cells that have been modified to attack the tumor cells. T cells in the body form part of the cellular immune response and they normally carry out a very important role in killing cells that are infected with viruses. These cells can be modified in the laboratory using sophisticated molecular techniques to change their specificity so that they can attack tumor cells. Once the cells are expanded in the laboratory they can be reintroduced into the patient and they target the cells one wants to eliminate. This technology has been around in one form or another for over fifteen years, but it now looks as if researchers have arrived at a watershed where the therapy appears to work really efficiently for this disease. Unfortunately, there are no markers available today that avoids the T cells attacking the patients normal as well as malignant cells and this may be a significant problem in the future.
Many questions remain concerning this new form of personalized medicine. Will it work for other cancers, particularly solid tumors where access of the T cells to the malignant tissues is more difficult to achieve. Many tumors also produce factors that inhibit T cell function so how does one deal with this? Apart from these questions there are others regarding the residence time of the modified T cells in the body, whether they are immunogenic and can the therapy be repeated. Finally, there is a question as to whether this type of therapy can be converted into one that is available outside of an academic research setting.
The topic of immune therapy is one that fits perfectly with the rationale underlying the Forbeck Foundation think tank meetings. I cannot think of a topic that is better suited to bring together basic reseachers in molecular biology and immunology with clinical colleagues to try and solve some of the problems eluded to above. Input from industry will also be encouraged. If this is possible and the early clinical results prove to be substantiated then we may be on the brink of changing the treatment of specific cancers, using the bodies own cells to attack the tumor as compared to use of more toxic chemotherapeutic regimens.