Driving the future of immuntherapy
What is the future of immunotherapy?
March 24, 2022
Medically Reviewed | Last reviewed by an MD Anderson Cancer Center medical professional on March 24, 2022
Immunotherapy represents a new paradigm in cancer care. It’s really an entirely new mechanism for treating cancer. We're not targeting the tumor cells; instead, we're targeting the immune system. This approach has had tremendous success and has allowed us to think of the word ‘cure’ more often for patients with metastatic cancers.
However, we’re not curing every patient yet. We know there’s room for improvement. Now, with the launch of MD Anderson’s James P. Allison Institute, we will be focused on learning how we can fully bring the immune system into play and bring the benefits of immunotherapy to all patients.
Building immunotherapy from a foundation of basic science
The benefits we’re now seeing with immunotherapy are possible because of basic scientific discoveries. We’ve wanted to incorporate the immune system into cancer care for more than 100 years. But we couldn’t do it successfully because we didn’t have the basic understanding.
It wasn’t until we understood how T cells are regulated by positive and negative stimulatory molecules that we had our “Aha!” moment — that we could block the inhibitory pathways. That came from discovery science by Nobel Laureate James Allison, Ph.D. Only with that strong foundation will we have success in the clinic.
So far, we’ve been focused on T cells, but there are other immune cell types that also play important roles. We need to figure out how to target different immune cell subsets, each of which has its own set of regulatory mechanisms and potential therapeutic targets.
That is our vision for the Allison Institute: to conduct exceptional science that leads us to a deeper understanding of immunobiology. This will enable us not only to develop new immunotherapy treatments, but also allow us to develop combination treatments that synergize immunotherapy with other cancer treatment approaches.
Developing synergetic therapies to improve cancer treatment
Combination strategies are essential to our future success. Surgery, chemotherapy, radiation therapy and targeted therapies work to target the cancer cells directly. Immunotherapy actually targets the immune cells. These different treatments all work very differently, but when we learn how to effectively combine them, we can weaken the tumor and prime the immune system to eliminate cancer permanently.
If you think about the different components of a tumor, it is much more than just cancer cells. The tumor microenvironment, as we call it, has immune cells, stromal cells, fibroblasts, etc. All these different pieces play a role, and they play different roles in different cancer types. With the right combination strategy matched to a particular tumor, we can target all of these components of the microenvironment to bring long-term benefit to our patients.
Envisioning the future of cancer care
This work should give tremendous hope to our patients for the future of cancer treatment. If I were to imagine a patient of the future, it starts with understanding their tumor.
Perhaps we could get a liquid biopsy from a blood sample to study the circulating tumor cells and learn the unique features of their tumor’s microenvironment. If their tumor has a particular mutation, we know that we can use a targeted therapy designed for that mutation.
We can also learn, for example, if their tumor has high numbers of myeloid cells, which can weaken an immune response. Then, we know that we need to combine our targeted therapy with a drug to block myeloid cells. Perhaps we then incorporate an immunotherapy to boost T cell activity and eliminate the tumor.
The idea is to give these treatments in synergy, with the right combination for an individual patient and the unique features of their cancer. It’s not a treatment for breast cancer or for prostate cancer, per se. It’s a treatment strategy for a specific tumor and immune environment.
Culture and innovation are key to advancing immunotherapy research
Within the Allison Institute, we are committed to making this future a reality. Exceptional research is key to that, but we also are focused on building an inclusive and innovative culture.
We want a brilliant future generation of scientists to lead the field one day. I want them to have confidence in proposing new ideas and testing their hypotheses. We must focus on training them and giving them opportunities to learn and grow.
Diversity is key to our approach as well. We all think in different ways and have unique perspectives based on where and how we were raised. Those unique insights can turn an idea upside down or understand findings in a new way, leading to the next breakthrough. We can’t know where the next great idea will come from, so we must enable great research across all backgrounds.
The Allison Institute will provide funds and resources to empower these young scientists as well as the more established researchers we plan to recruit. We will establish a culture of collaboration across all disciplines, including basic, translational and clinical researchers. We have to include everyone working together so that we can realize our vision.
Hope for cancer patients and their families
I want patients to know that we are making advances every day. There are treatments that can offer cures, and we plan to deliver more.
I encourage patients to talk with their physicians about innovative treatment options and consider participating in clinical trials so we can move the field forward. Together, we can unlock the promise of immunotherapy.
Padmanee Sharma, M.D., Ph.D., is professor of Genitourinary Medical Oncology and Immunology and director of scientific programs for the James P. Allison Institute.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
Immunotherapy represents a new paradigm in cancer care. It’s really an entirely new mechanism for treating cancer. We're not targeting the tumor cells; instead, we're targeting the immune system. This approach has had tremendous success and has allowed us to think of the word ‘cure’ more often for patients with metastatic cancers
However, we’re not curing every patient yet. We know there’s room for improvement. Now, with the launch of MD Anderson’s James P. Allison Institute[NR1] [BR2] , we will be focused on learning how we can fully bring the immune system into play and bring the benefits of immunotherapy to all patients.
Building immunotherapy from a foundation of basic science
The benefits we’re now seeing with immunotherapy are possible because of basic scientific discoveries. We’ve wanted to incorporate the immune system into cancer care for more than 100 years. But we couldn’t do it successfully because we didn’t have the basic understanding.
It wasn’t until we understood how T cells are regulated by positive and negative stimulatory molecules that we had our “Aha!” moment — that we could block the inhibitory pathways. That came from discovery science by Nobel Laureate James Allison, Ph.D. Only with that strong foundation will we have success in the clinic.
So far, we’ve been focused on T cells, but there are other immune cell types that also play important roles. We need to figure out how to target different immune cell subsets, each of which has its own set of regulatory mechanisms and potential therapeutic targets.
That is our vision for the Allison Institute: to conduct exceptional science that leads us to a deeper understanding of immunobiology. This will enable us not only to develop new immunotherapy treatments, but also allow us to develop combination treatments that synergize immunotherapy with other cancer treatment approaches.
Developing synergetic therapies to improve cancer treatment
Combination strategies are essential to our future success. Traditional cancer therapies — surgery, chemotherapy, radiation therapy and targeted therapies — work to target the cancer cells directly. Immunotherapy targets the immune cells. These different treatments all work very differently, but when we learn how to effectively combine them, we can weaken the tumor and prime the immune system to eliminate cancer permanently.
If you think about the different components of a tumor, it is much more than just cancer cells. The tumor microenvironment, as we call it, has immune cells, stromal cells, fibroblasts, etc. All these different pieces play a role, and they play different roles in different cancer types. With the right combination strategy matched to a particular tumor, we can target all of these components of the microenvironment to bring long-term benefit to our patients.
Envisioning the future of cancer care
This work should give tremendous hope to our patients for the future of cancer treatment. If I were to imagine a patient of the future, it starts with understanding their tumor.
Perhaps we could get a liquid biopsy from a blood sample to study the circulating tumor cells and learn the unique features of their tumor’s microenvironment. If their tumor has a particular mutation, we know that we can use a targeted therapy designed for that mutation.
We can also learn, for example, if their tumor has high numbers of myeloid cells, which can weaken an immune response. Then, we know that we need to combine our targeted therapy with a drug to block myeloid cells. Perhaps we then incorporate an immunotherapy to boost T cell activity and eliminate the tumor.
The idea is to give these treatments in synergy, with the right combination for an individual patient and the unique features of their cancer. It’s not a treatment for breast cancer or for prostate cancer, per se. It’s a treatment strategy for a specific tumor and immune environment.
Culture and innovation are key to advancing immunotherapy research
Within the Allison Institute, we are committed to making this future a reality. Exceptional research is key to that, but we also are focused on building an inclusive and innovative culture.
We want a brilliant future generation of scientists to lead the field one day. I want them to have confidence in proposing new ideas and testing their hypotheses. We must focus on training them and giving them opportunities to learn and grow.
Diversity is key to our approach as well. We all think in different ways and have unique perspectives based on where and how we were raised. Those unique insights can turn an idea upside down or understand findings in a new way, leading to the next breakthrough. We can’t know where the next great idea will come from, so we must enable great research across all backgrounds.
The Allison Institute will provide funds and resources to empower these young scientists as well as the more established researchers we plan to recruit. We will establish a culture of collaboration across all disciplines, including basic, translational and clinical researchers. We have to include everyone working together so that we can realize our vision.
Hope for cancer patients and their families
I want patients to know that we are making advances every day. [NR3] [BR4] There are treatments that can offer cures, and we plan to deliver more.
I encourage patients to talk with their physicians about innovative treatment options and consider participating in clinical trials so we can move the field forward. Together, we can unlock the promise of immunotherapy.
Padmanee Sharma, M.D., Ph.D., is professor of Genitourinary Medical Oncology and Immunology, and scientific director of the James P. Allison Institute.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
Topics
ImmunotherapyPadmanee Sharma, M.D., Ph.D.
If I were to imagine a patient of the future, it starts with understanding their tumor.
Padmanee Sharma, M.D., Ph.D.
Physician & Researcher