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“Our cell processing facility at Fred Hutchinson Cancer Research Center in Seattle produces 200-600 million engineered cells per day.” - Gary Gilliland, M.D., Ph.D., President & Director at Fred Hutchinson Cancer Research Center. Seattle, Washington, USA. Photo courtesy of Gary Gilliland

LinkedIn Pulse – February 01, 2018

By Gary Gilliland, M.D., Ph.D.
President and Director at Fred Hutchinson Cancer Research Center

I’ve gone on record to say that by 2025, cancer researchers will have developed curative therapeutic approaches for most if not all cancers.

I took some flak for putting that stake in the ground. But we in the cancer research field are making incredible strides toward better and safer, potentially curative treatments for cancer and I’m excited for what’s next.
I believe that we must set a high bar, execute and implement — that there should be no excuses for not advancing the field at that pace.

Gary Gilliland, M.D., Ph.D.
President & Director at Fred Hutchinson Cancer Research Center.
Seattle, Washington, USA.
Photo courtesy of LinkedIn

2017 was a landmark year for accelerating cancer cures, ushering in a spate of new FDA approvals for cancer drugs.

https://www.forbes.com/sites/matthewherper/2017/10/18/fda-approves-another-amazing-and-costly-cancer-killing-gene-therapy

These include approval of two different CAR T-cell therapies — a type of cancer immunotherapy that uses a patient’s own engineered immune cells to attack and kill cancer cells.

All of us at Fred Hutchinson Cancer Research Center were thrilled to see those announcements.
They are an initial validation of what we and our colleagues around the world have been working toward for decades.
More importantly, they offer potentially lifesaving therapies for some cancer patients with historically limited options for treatment.

Microsoft co-founder Bill Gates speaks to the BBI’s strengths in advancing precision medicine for people around the world: a strong, unique collaboration; the power of big data; and visionary philanthropy.
Photo courtesy of brotmanbatyinstitute.org

The key phrase in that sentence, by the way, is some patients.

The cellular immunotherapies Kymriah and Yescarta were approved to treat a type of advanced pediatric leukemia and aggressive non-Hodgkin lymphoma, respectively.
And we know that while these two therapies are a great advance over previously available treatments, not all patients will respond to them.
And of those who do respond, some experience serious side effects.

That leaves many more patients and cancers to treat and cure safely. Immunotherapy holds promise to tackle many of these other cancer types, but one approach is not enough to cure cancer.
We will need a convergence of different expertise, new research methods and strong data science to reach the goal of cures for more patients.

Juno CEO Hans Bishop (left) speaking to VP of Research and Receptor Discovery Francois Vigneault inside his lab.
Photo courtesy of GeekWire / Kurt Schlosser

At Fred Hutch, our researchers are testing tomorrow’s cancer treatments at the laboratory bench or in clinical trials today.
Last year, we saw some remarkable research advances from our own labs that hint at what’s next on the horizon.

As 2018 kicks off, my colleagues and I are keeping a close eye on a few promising areas of cancer research and treatment — and of course, doing our part to help usher in these advances as swiftly as we can.


Courtesy of Gary Gilliland

Next-Generation Immunotherapy

The recent news of Celgene’s acquisition of Juno Therapeutics is a great example of how the field of immunotherapy is advancing.

https://www.geekwire.com/2018/juno-therapeutics-acquired-celgene-9b-dramatic-deal-rising-biotech-star/

The science behind Juno’s immunotherapy cancer treatments traces back to decades of preclinical studies at Fred Hutch, where our scientists discovered how particular types of immune cells have potent and sustained anti-tumor activities.

Photo courtesy of Gary Gilliland

With the goal of making cancer immunotherapy safer, we’re taking the most comprehensive look yet at certain serious side effects and infections that can happen after treatment with CAR T cells.

http://www.fredhutch.org/en/news/center-news/2017/10/car-t-cell-side-effects-study.html

http://www.fredhutch.org/en/news/center-news/2017/11/infections-cd19-car-immunotherapy.html

Understanding — and combatting — the unique toxicities associated with CAR T-cell therapy will be key to delivering on the promise of these therapies for more patients.

As we continue to refine our current immunotherapy approaches, we’re also broadening our cellular immunotherapy efforts to new clinical trials and more cancer types to help bring the promise of this powerful technique to more patients in need.

Our focus has been on various forms of blood cancers, although we recently launched a trial that includes patients with lung cancer and triple negative breast cancer, and another trial for patients with melanoma.

In 2018, we’ll be broadening our focus to include many more solid tumors and more blood cancer types, including ovarian, lung, head and neck, and gastric cancers, and multiple myeloma.

Dr. Cameron Turtle and his colleagues led detailed studies of the potential side effects of a Fred Hutch-developed CAR T-cell therapy, a type of immunotherapy in which immune cells are engineered to target a patient's cancer.
Photo courtesy of Robert Hood / Fred Hutch News Service

Right now, we have 12 cellular immunotherapy clinical trials ongoing with 21 more cellular therapy trials in the pipeline slated to open soon.

We’re working with 11 industry partners in immunotherapy, from global manufacturers such as Eli Lilly and Company to biotech companies such as Minerva Biotechnologies, and, of course, our startup partners in the immunotherapy space, Juno Therapeutics and Adaptive Biotechnologies.

As our trials ramp up, and to keep up with the urgency of patient need, our dedicated cell processing facility is producing on average 200 million to 600 million engineered cells in a single day.

As immunotherapy matures, extending its early successes from blood cancers to solid tumors will be one of the field’s most challenging but most important hurdles to clear.

A team led by the Hutch's Drs. Cameron Turtle and Joshua Hill was the first in-depth look at the infections that can strike patients who receive an emerging form of cancer immunotherapy.
Photo courtesy of Robert Hood / Fred Hutch News Service

Fred Hutch researchers are making headway applying immunotherapies to solid tumors such as breast and lung cancer.

One of the developments I’m most excited about comes from several recent milestone advances in a rare solid tumor known as Merkel cell carcinoma, studies that led to the first FDA approval of an immunotherapy drug for this cancer and which also showed promising early hints of the power of combination immunotherapy.

http://www.fredhutch.org/en/news/center-news/2017/03/immunotherapy-fda-approved-merkel-cell-carcinoma.html

http://www.fredhutch.org/en/news/center-news/2017/05/triple-therapy-merkel-cell-carcinoma-small-trial.html

Studies in this unique tumor lay the groundwork for advances in other, more common cancers that we are also gearing up to tackle with new clinical trials.


Courtesy of Gary Gilliland

Can the Cloud Cure Cancer?

Cloud computing has infinitely expanded the ways and means of cancer research.

From real-time scientific collaboration across countries and continents to unprecedented scale of data management, cloud technology will support key efforts like precision oncology, enhanced data visualization and other advanced research that will bring us closer to cures.

Photo courtesy of Gary Gilliland

As we continue to draw new connections between genes and tumor types, precision oncology approaches to treating cancer will become increasingly important and will require at least a terabyte or more of data per patient - enough to fill the storage capacity of eight of the newest smartphones.

Last year, Fred Hutch research led to the launch of a new clinical trial for a precision medicine approach against advanced prostate cancer and uncovered a certain genetic alteration that may breathe new life into an old leukemia drug.

http://www.fredhutch.org/en/news/center-news/2017/10/gentlemen-study-aims-to-remove-barriers-to-genetic-testing-counseling-for-advanced-prostate-cancer.html

http://www.fredhutch.org/en/news/center-news/2017/06/mylotarg-precision-medicine.html

Researchers at Fred Hutch and around the world are zooming in on a specific group of patients who could benefit from a leukemia drug, called gemtuzumab ozogamicin (Mylotarg), that was pulled from the market seven years ago.
Photo courtesy of Kimberly Carney / Fred Hutch News Service

In December, with our partners at UW Medicine, we launched the Brotman Baty Institute for Precision Medicine that we at Fred Hutch are delighted to take part in.

https://brotmanbatyinstitute.org/

As I noted at the launch, this institute is one more example of Seattle’s new role as epicenter of the effort to cure cancer.

Both the National Cancer Institute and the National Institutes of Health recently initiated data commons projects to bring together data scientists, cloud technologists and bioinformatics experts to drive collaborative efforts in harnessing the cloud and data tools for large-scale projects.

We expect these efforts to gather momentum in 2018, and we are working with the top cloud providers on several data-intensive projects at Fred Hutch that leverage machine learning and cloud computing to accelerate research and improve patient outcomes.

Tom Judd saw his advanced Merkel cell carcinoma shrink by more than 90 percent on an immunotherapy trial.
Photo courtesy of Bo Jungmayer / Fred Hutch

For example, we’re leveraging deep learning techniques to analyze magnetic resonance images that identify markers for breast cancer.

We’re also leveraging artificial intelligence to improve outcomes in patients who receive chemotherapy and building a next-generation patient engagement platform for blood stem cell transplant survivors.

Look for advances in these areas, and others, as we leverage the cloud to help cure cancer.

Fred Hutch immunotherapy researcher Dr. Kelly Paulson is seeing promising results in a small, ongoing trial for patients with advanced Merkel cell carcinoma.
Photo courtesy of Robert Hood / Fred Hutch News Service

A recent exciting development has been the announcement of a partnership between Adaptive Biotechnologies and Microsoft that will focus on use of artificial intelligence to analyze T-cell receptor sequences in patients with a spectrum of diseases, including cancer, that engage the immune system.

T cells provide a lens on what our immune system “sees.”
But we need artificial intelligence to provide a virtual reality to enable us, through T-cell receptor sequencing, to see what they see, and devise diagnostics and patient-specific therapeutics based on those insights.

Dr. Heather Cheng counsels a patient with prostate cancer.
Photo courtesy of Robert Hood / Fred Hutch News Service

So the answer to the question “can the cloud help us cure cancer” is “yes” — and nowhere are we better positioned to leverage the nexus between biosciences and cloud-based technologies than in Seattle.

Infectious Disease - Ties to Cancer and Beyond

As many as one in five cancers worldwide may be tied to an infectious disease.

At the Hutch, we have long understood the intricate connections between infection and cancer; this past year, we launched an integrated research center dedicated to exploring those connections with the aim of preventing many of these cancers that carry a heavy global burden.

We are also exploring new partnerships in public and private sectors to further delve into the cross-sections of infectious disease and cancer.

Photo courtesy of Gary Gilliland

In the world of HIV prevention, the last two years have been banner years for the Fred Hutch-based HIV Vaccine Trials Network, which launched an unprecedented four efficacy prevention trials in 2016 and 2017.

The studies, which are testing new vaccines and other ways to prevent HIV infection, will collectively enroll 12,200 volunteers around the globe.

We’re all anxiously awaiting the studies’ final results in 2020 and 2021.

I’ve been a cancer researcher for my entire career.
And I’ve seen more progress in the field in the last few years than in the previous five decades.
I can’t wait to see what 2018 will bring.

I look forward to communicating with you all in the coming year and welcome your thoughts.

Sincerely,

Gary Gilliland, M.D., Ph.D.
President and Director, Fred Hutchinson Cancer Research Center

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