The Sentinel


Thursday, September 19, 2019

Reflections of SITC Cancer Immunotherapy Winter School

The following is a blog post authored by Andy Kah Ping Tay, PhD (Stanford University), a recipient of a 2019 SITC Cancer Immunotherapy Winter School Travel Award. In this blog, Dr. Tay describes his experience of attending the Winter School program, a comprehensive education program for early-to-mid-career scientists and clinicians. Click here to learn more about the 2020 SITC Cancer Immunotherapy Winter School scheduled for Jan. 13–17, 2020, in Houston, Texas.

By Andy Tay

A confidence booster

Trained as a biomedical engineer, I stumbled into cancer immunology research without much prior knowledge and continually worried that I might be too late going into this popular field. The SITC Winter School, however, changed my view. It provided me with sufficient knowledge on the basics of immunology and the clinical side of cell therapy. At the same time, there was appreciable amount of content on the industrial and technological aspects of immunotherapies. This arrangement was unique and helpful to the broad audience coming from academic institutions, clinics and industries. In fact, after the Winter School, I realized that despite the need for better assessment of cell quality for cancer immunotherapy, the current metrics to measure critical biological attribute are lacking. Building on this idea, I recently published an original article proposing a framework to rigorously assess cell quality after DNA delivery. The Winter School is a fertile ground to get new ideas to work on!

Immunotherapy for ALL

The SITC Winter School is also the first time where I met patient partners in a conference. It was a humbling experience because as a researcher, I hardly had any interaction with patients and yet, my technologies are meant to accelerate biomedicine for them. Through conversing with patient partners, I realized that there is insufficient information to educate patients about cancer immunotherapy as it is a relatively new therapy compared to chemo- and radio-therapies. This is especially true for children patients who are young and learn better through toys. Motivated by this, I went on to design a toy kit with the Stanford Design School to educate children aged 5-10 fighting cancer about immunotherapy (see figure below). I am extremely grateful that the SITC Winter School gave me an additional perspective about research which is that as researchers strive for biomedical breakthroughs, there should be sufficient communications with the larger society to explain what these breakthroughs will mean for them. 

Integrating into the SITC family

During the Winter School, I also got plenty of opportunities to learn about the various initiatives of SITC. One particularly useful take-away was an invitation to join the SITC Big Data and Data Sharing Task Force. Despite the promise of bioinformatics to improve cancer and immunological research, there is insufficient student trained in this area. Furthermore, the data that the community generates from analyses such as RNA transcriptomics are often under-utilized. The task force I am in aims to create training opportunities for students in computational cancer immunology, and to create workshops during conferences to introduce researchers to bioinformatics.

Whether you are looking to learn more about cancer immunology, or trying to find new ideas to work on, the SITC Winter School is a great platform for that!

Wednesday, September 18, 2019

JITC Letter from the Editor - September 2019

pedro-romero_1__1_.jpgDear JITC Readers,

There are several recent articles I would like to highlight in this September issue of the JITC digest, pointing to the progress we’ve been making toward understanding the immune system and cancer.

First, “PD-1 silencing impairs the anti-tumor function of chimeric antigen receptor modified T cells by inhibiting proliferation activity” by Jianshu Wang et al demonstrates yet another function of PD-1 in T cells. In this case, knock-down of PD-1 does not lead to increased anti-tumor activity; rather, silencing of PD-1 in CAR T cells inhibits their proliferation capability and differentiation, and impairs their anti-tumor effects.

“Development of a new fusion-enhanced oncolytic immunotherapy platform based on herpes simplex virus type 1” by Suzanne Thomas et al outlines the potential of a novel HSV-1-based oncolytic platform, whereby the engineered virus is armed with various modifications to increase its therapeutic effects, essentially allowing effective combination therapy through a single administered agent.

In the article, “Concurrent therapy with immune checkpoint inhibitors and TNF-alpha blockade in patients with gastrointestinal immune-related adverse events”, Yousef R. Badran and co-authors provide insight into management of one of the most common immune-related adverse events, enterocolitis. They describe five patients treated concurrently with checkpoint inhibitors and infliximab, all of whom had symptom resolution and disease control, providing physicians an example for management or severe cases of this common side effect. While the efficacy of this combination to control immune related enterocolitis awaits formal confirmation in controlled clinical trials, the results are indeed in line with recent observations in pre-clinical studies (Perez-Ruiz et al. Prophylactic TNF blockade uncouples efficacy and toxicity in dual CTLA-4 and PD-1 immunotherapy, Nature 2019).

Daruka Mahadevan et al describe a novel immune checkpoint inhibitor in “Phase I study of samalizumab in chronic lymphocytic leukemia and multiple myeloma: blockade of the immune checkpoint CD200”. In this first-in-human study, the authors observed encouraging efficacy through blockade of CD200 in hematologic malignancies, recommending further dosing optimization for future investigations.

Finally, “Characterization of a whole blood assay for quantifying myeloid-derived suppressor cells” by Minjun C. Apodaca et al addresses a pressing issue with a promising biomarker: quantification of circulating myeloid-derived suppressor cells. They identify a common pathway to their quantification using flow cytometry, and also point out a few pre-analytical variables that have significant impact on MDSC levels as well.

With best regards,

Pedro J. Romero, MD
Editor-in-Chief, Journal for ImmunoTherapy of Cancer

To view the entire September 2019 JITC Digest, please click here

Monday, September 16, 2019

President's Message - September 2019

Dear Colleagues,

I’d like to begin this month’s President’s Message honoring Stan Collender (1951-2019). Stan, an immunotherapy pioneer and advocate, was a cancer patient of past SITC President Michael B. Atkins, MD. Dr. Atkins first met Stan in 2012 when he presented with Merkel Cell Carcinoma. From there, they developed a close relationship as Stan courageously fought his disease with immunotherapy for many years. Their experience and efforts together taught us much about the impact and limitations of immunotherapy. Read more about Stan’s life and contributions to our field in the heartfelt memorial posted by Dr. Atkins to The Sentinel, SITC’s official blog.

As you know, breakthroughs in research and the advent of new cancer immunotherapy treatments this century spurred an explosion of interest and investment in our field. Through offerings like the Annual Meeting & Pre-Conference Programs, the Society for Immunotherapy of Cancer (SITC) brings together the most accomplished and innovative researchers in the field to spark new collaborations and force consideration of new ideas that prompt discovery of new targets and approaches.

While the SITC Annual Meeting is perhaps our most important and visible effort to advance science and improve patient outcomes, many other SITC activities contribute to our core mission. SITC’s Advances in Cancer Immunotherapy™ (ACI) regional education series is an example of how SITC leverages its member’s clinical and science expertise to inform patient care, particularly safe and effective treatment administration. At the other end of the spectrum of SITC programs, the society seeks to expand research and knowledge in our field through the professional development of early career scientists. Young investigators are the future of cancer immunotherapy research. SITC is investing in their future through a variety of programs that provide education and professional development and promote community and collaboration.

One of our most effective programs aimed at young investigators is the SITC Meet-the-Experts – an annual luncheon at the SITC Annual Meeting (Thursday, Nov. 7, 2019, at 12:05 p.m.) organized by the Early Career Scientist Committee that connects young investigators with leaders in the field. It has now grown to a year-round initiative featuring regular, free webinars. These online events focus on various topics that are pertinent to an early career scientist’s professional development. Most recently, Tullia Bruno, PhD (University of Pittsburgh), moderated our Aug. 22 webinar focused on Careers in Science Away from the Bench, which you can view on-demand here.

SITC will once again host a Cancer Immunotherapy Winter School on Jan. 13-17, 2020, at the Hilton Houston Post Oak in Houston, Texas. Led by program organizers Lisa H. Butterfield, PhD (Parker Institute for Cancer Immunotherapy/University of California San Francisco), and Leisha A. Emens, MD, PhD (UPMC Hillman Cancer Center), this program provides intensive instruction on the core principles of tumor immunology and cancer immunotherapy. These programs also foster connections among peers which is critical component to their future success.

SITC also strengthens the support network for young scientists through the Professional Interest Communities. These digital discussion forums connect individuals of similar professional and personal backgrounds to share career development needs, address professional hurdles and more.

Beyond the basic education and professional development offered by SITC, SITC Fellowships provide funding to support the early careers of the most talented scientists. Supported through the Forward Fund, SITC has awarded more than $2 million in Fellowship Awards since 2014. Stay tuned later this year for information about 2020 SITC Fellowships.

SITC offers an affordable membership rate of $50 for students and scientists-in-training. Joining our society provides discounted access to vital SITC in-person programs and reduced fees on articles accepted to the Journal for ImmunoTherapy of Cancer (JITC). It also places young investigators in a professional network of the most influential basic scientists, translational researchers and clinicians in the field. Click here to become a SITC member and join the world’s leading organization dedicated solely to cancer immunotherapy research.

Finally, I would like to recognize and thank the countless number of women who organized, facilitated and attended SITC’s Women in Cancer Immunotherapy Network Leadership Institute in Seattle last month. This exciting new program from SITC, championed by immediate Past President Lisa H. Butterfield, PhD, was a rousing success. I look forward to seeing our society continue its effort to support, advance and celebrate the success of women in our field.


Mario Sznol, MD
SITC President

Tuesday, September 3, 2019

A Tribute to Stan Collender: The Budget Guy, Immunotherapy Pioneer (Patient #1), Colleague and Friend (1951-2019)

By Michael B. Atkins, MD

Stan Collender was a man of many remarkable talents. Among his many achievements, he was widely recognized as one of the foremost authorities on the federal budget earning himself the moniker, “The Budget Guy,” and in 2012 receiving both the prestigious Howard Award for lifetime achievement in federal budgeting from the American Society for Public Administration and the James L. Blum Award from the American Association for Budget and Program Analysis. Stan was also my longstanding patient- an immunotherapy pioneer and an advocate whose experience and efforts taught us much about the impact and limitations of immunotherapy. Stan died May 3, 2019. Below is his cancer story from my perspective.

Stan Collender
I first met Stan in 2012 when he presented to my oncology practice status post resection of a Merkel Cell Carcinoma (MCC) on the bridge of his nose. We reviewed his history and the pathology and recommended a wide local excision and a sentinel lymph node biopsy. On hearing this recommendation, he joked that he was a local television celebrity so needed to protect his looks. I assured him that the plastic surgeon was up to the challenge.

After the successful surgery, we followed Stan at regular intervals. About 1 year later we noted he had developed an enlarged neck lymph node. Upon hearing this news Stan became diaphoretic, pale and promptly fainted. While he was out cold lying on an exam table and then gradually regaining consciousness, I remember thinking, “this is not going to be easy.”  But I never anticipated the novel, groundbreaking twists and turns Stan’s case would take, nor the heroic role he would assume as a patient advocate, or that I would be writing this posthumous tribute to a man I came to admire and care deeply about as a courageous colleague and friend.

Despite Stan’s tremulous start, he was an absolute rock thereafter. He underwent lymph node dissection and post-operative radiation therapy without a hitch. He subsequently developed a solitary brain lesion, which was also resected and treated with adjuvant stereotactic radiation to the resection bed. Unfortunately he developed widespread systemic disease six months later. In weighing treatment options available at the time, I recommended he participate in a clinical trial involving a then experimental immunotherapy, pembrolizumab, that we’d had good experience with in patients with melanoma, but had yet to test in patients with MCC. He volunteered for the clinical trial without hesitation, despite it being conducted in Seattle. He was literally Patient # 1 - a pioneer- on this important Cancer Immunotherapy Network (CITN) trial led by Drs. Paul Nghiem and Shailender Bhatia. Every 3 weeks he flew from DC to Seattle to receive his experimental treatment.  The pembrolizumab worked well: after two years of treatment his disease there was no visible signs of residual disease on imaging studies- his disease was apparently gone.  Not only did this treatment help Stan, but based on the results of this groundbreaking clinical trial, pembrolizumab receive FDA approval and is now the standard of care for patients with treatment na├»ve advanced MCC, providing benefit to countless patients with this disease.

Stan embraced this treatment success and his new lease on life with his typical gusto. He wrote an OpEd in the New York Times where he described his clinical trial experience. Rejecting the concept of being a guinea pig, he wrote he felt more like Chuck Yeager breaking the sound barrier and going where no one else had gone before. He encouraged others to participate in clinical trials and became a leading spokesman and a tireless advocate for the immunotherapy, MCC and cancer clinical trials communities. Just like Chuck Yeager in aviation, in MCC and immunotherapy circles, he became a national hero.

With his cancer in remission, Stan and I moved beyond our traditional patient-physician relationship: we became collaborators and friends. When Stan joined the Georgetown faculty, teaching public relations and public policy classes, we officially became colleagues.  Over lunches we strategized on how we could best represent the value of immunotherapy relative to other cancer treatments, as well as how to encourage cancer clinical trials participation and more public private partnerships such as the CITN trial he’d participated in.

Stan was frequently in attendance when I gave educational briefings to Congressional staffers, and welcomed me singling him out as Patient #1 on the MCC CITN trial. We served together on SITC committees focusing on measuring the value of immunotherapy, where Stan’s personal experience and budget expertise were both unique and invaluable. When I received my endowed chair, I was honored to have Stan and his beloved wife Maura, join me at the dinner ceremony and celebration.

In 2017, Stan was invited to give the Keynote lecture at the annual American Association of Cancer Institute’s meeting in DC. He talked about his views of the upcoming federal budget and its potential impact on cancer research funding, but he also described his personal battle with cancer, his experience as a survivor, and thanked me publicly for having encouraged him to pursue the CITN trial. Sitting in the audience, I felt both like a proud teacher witnessing my prized pupil excel, and grateful to see him healthy and choosing to apply his experience, talent and renewed health to benefit others.

Over lunches, we talked about his potentially running for Congress in the Virginia 6th in 2018 and how wonderful it would be to have a vocal cancer survivor and immunotherapy and clinical research advocate in Congress. He ultimately withdrew this pursuit, but came to my house for a gathering of concerned voters in his ex-candidate’s capacity to discuss the race and promote the candidacy of Jennifer Wexton - who ultimately was elected to serve the district.

And so it went. Stan and I had developed a shared mission and fought together on several fronts for its success. I thought we’d be doing this together for the rest of our careers.

Then all hell broke loose. Stan was almost 2 years out from his last therapy, a time when we usually consider patients who have responded to immunotherapy to be cured. So it was a shock when he presented in December 2018 with hand weakness, headaches and difficulty swallowing and a head MRI which showed that his lateral ventricles were packed with tumor. I had never seen anything like this presentation before and had no idea that MCC could do this. His tumor had recurred exclusively in one of the few places where the immune system doesn’t reach.

The word spread like wildfire through the MCC and immunotherapy communities. It was devastating. The pioneer/ hero- MCC patient # 1 - had relapsed. I was once again thrust into action as his physician, proposing a variety of approaches all focused on trying to get his immune system re-activated and into his ventricles where the tumor was hiding. A lot of my proposed treatments were quite involved and associated with considerable risk, but Stan was always positive. He would respond to my carefully chosen words of encouragement such as,  “I hope this works” or “This could work” with an optimistic “It is going to work” and a courageous “Let’s do it!”  Although Maura was more attuned to the uncertainty in my recommendations, Stan’s optimism usually prevailed.

Ultimately, the tumor could not be controlled and we ran out of both treatment options and optimism. Maura and Stan decided to focus on comfort measures. Stan passed away peacefully at home on May 3rd, 2019.

At his memorial celebration a few weeks later, person after person spoke about how they knew Stan, each describing a unique contribution he had made during his remarkable careers in Government, public policy, public relations, as well as in intramural football and as a family man. Clearly Stan was a true “mensch” with his many interests, passions and strong commitment to both his family and the world around him. His impact on the MCC, immunotherapy and cancer clinical trials communities was profound and enduring. Even in death, Stan remains a teacher and an advocate: his cancer taught us about potential new obstacles to effective immune therapy and like Chuck Yeager, his legacy as “Patient Number 1” will undoubtedly inspire research efforts to overcome them. I will miss this remarkable man- rest in peace my friend.