Q&A with SITC Vice Presidential Candidate Sandra Demaria, MD

In celebration of Cancer Immunotherapy Month™, we’ve asked SITC leaders to participate in a Q&A series for The Sentinel. We’ve asked them to briefly share why they entered the field, advice they’d share with early career scientists considering a career in cancer immunotherapy and more.

Please see below the Q&A from Sandra Demaria, MD, of Weill Cornell Medical College. Dr. Demaria is a 2018 candidate for SITC Vice President. Learn more about her candidacy here. Voting for the 2018 SITC Election takes place June 14–28, 2018.

1. What initially excited or intrigued you about the cancer immunotherapy field to choose this as your career focus?

I have been fascinated by the immune system since the beginning of medical school when I started volunteering in a research lab working on immunology. Several years later, during my residency in pathology, I matured the decision to devote my research career to study how the immune system interacts with cancer, and how cancer treatment can alter that interaction. Basic immunology had progressed tremendously and after attending a tumor immunology meeting I became really enthusiastic about the possibilities to make progress in cancer treatment. My enthusiasm was further boosted when Jim Allison came to give a lecture and spoke about blocking CTLA-4. It was somewhere in early 2001, before antibodies against CTLA-4 were tested in the clinic, but his vision about the role CTLA-4 blockade in cancer treatment, and how it could be combined with other treatments contributed to shape the direction of my own work.

2. What advice would you share to an early career scientist contemplating a career in cancer immunotherapy?

There is a lot of enthusiasm for the things that work, but you should not be afraid to venture into an area of research that is met with skepticism. Tumor immunology was met with skepticism for a long time. The pioneers who believed in it did not abandon it to work on a more mainstream topic. On the contrary, they worked harder and generated the knowledge that made possible the current revolution in cancer care, with cancer immunotherapy becoming a new treatment strategy that has already saved many lives. There are many critical questions that need to be answered to enhance the effectiveness of cancer immunotherapy. So, think outside the box, do good science, believe in your data, and remember that the value of your work is not really measured by the impact factor of the journals you publish in, but by the impact that it will have on fostering real progress in the field. 

3. What are three of the biggest hurdles facing researchers in the field, and how do you think they can be solved?

Progress can be made only if there is substantial and continuous investment in science at multiple levels (basic, translational and clinical). Scientists and clinicians need to work with patient advocacy groups and other stake holders to leverage public support. Professional societies like SITC are instrumental in leading such efforts. 

Addressing the complexity of tumor-host interactions and understanding how to overcome resistance to immunotherapy requires a multi-disciplinary approach, and a team effort. The current academic structure is still largely based on older paradigms, and is at risk of losing talent that is essential for the research. New types of positions and reward systems that recognize the value of team contributions will help make faster progress and retain the best minds in research.

The bar for success is higher for upcoming and future immunotherapy agents. With increased life expectancy chronic toxicities of immunotherapy may become more important and less acceptable to patients. Improved model systems need to be developed to predict and study the mechanisms of toxicity. 

4. What area of research has you most excited for the future of the field, and why?

I believe that there is a huge potential in leveraging the effects of combination therapies that target different compartments to achieve a synergy with immunotherapy, if done in the context of a system biology approach. I work with radiotherapy, which has the advantage of being a broadly applicable and widely available treatment. But we need to understand how to tailor radiotherapy (and in fact any treatment) the right way for each individual patient. I like to think that there is a combination of specific interventions that will unlock the power of the immune system to reject cancer in every patient, it is just waiting to be discovered!