Archive for July, 2015

 

Jul 27 2015

The Future of Immunotherapy

by at 9:34 am

Greetings on a warm midsummer’s evening. I have spent the last four days at a fabulous immunotherapy meeting in Florida that brought together leaders and some emerging stars in the field, many of whom have helped to establish new standards of care. Georgetown was well represented by me, Mike Atkins and Suthee Rapisuwon, who presented an interesting poster at the meeting. This is such an exciting era for the field of immunotherapy. In the four days of presentations, stunning advances were described for the management of virtually every major malignancy, as well as many fairly rare ones. By one measure, targeting the PD1: PDL1 axis has had significant clinical success in at least 17 distinct malignancies. Mike mentioned that such a meeting would have been unimaginable even five years ago. In fact, an immunotherapy meeting with 100+ attendees was unheard of 20 years ago. By the way, in case you didn’t know it, Mike really is one of the rock stars in the field, as many speakers referred back to his work and expressed enormous respect for his insights and suggestions.

Interestingly, two of the areas where immunotherapy has yet to have any meaningful impact are ER+ breast cancer and pancreatic cancer – two of the areas of historical interest to Lombardi investigators. In fact, I was the only invited speaker who was not able to speak about promising clinical results, since I was asked to speak about pancreatic cancer. There are significant issues in pancreatic cancer, where T cell infiltrates are uncommon, almost certainly because of the inhospitable stromal microenvironment, and nobody knows why ER+ breast cancer is insensitive to available immunotherapies. However, these challenges represent important research opportunities for all of us.

I’ll be back in the office on Tuesday and look forward to a busy week of work. We’ll be spending most of the following week in Philadelphia, on a working vacation (i.e., babysitting). However, I’ll be back in town a week from Friday to participate in an all-day teaching program on our campus hosted by Mike, Geoff Gibney and me for the Society of Immunotherapy of Cancer (SITC). This primer is designed to get anybody who is interested up to speed. So, check it out if you are interested.

Have a great week.

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Jul 20 2015

A New Perspective

by at 9:36 am

We have entered a time when folks are on vacation and things move a bit more slowly. And in the middle of a ferocious heat wave, moving slowly makes a lot of sense!  However, that doesn’t mean our work stops. I started off the week at a meeting of the Board of Scientific Counselors of the NCI, and was pleased to get a detailed legislative update, the contents of which were confirmed later in a conference call of the AACR Legislative Affairs Committee. While much remains to be done, there is definitely momentum towards improved funding of the NCI. I don’t need to explain to any of you why that would be important. So, fingers crossed…

Speaking of crossed fingers, we had a bit of a health scare this past week involving our daughter-in-law Sarah, who is married to our oldest son Ken. She just had a baby on May 29th and noticed a breast mass that appeared to grow fairly rapidly. An ultrasound suggested it was solid, raising the possibility that it was a tumor. Now, in my rational brain I knew that the vast majority of breast masses in this setting are benign, or simply cysts, but as an oncologist, I only see or know of the people for whom the outcome was not as happy. Since Sarah and Ken live in Philadelphia I was able to call my old colleagues and friends at Fox Chase Cancer Center, who sprang into action so she could be seen virtually immediately and evaluated. Sarah was seen on Friday morning, and thankfully it seems to be nothing more than a cyst. But in the terrible hours while we waited for a call, all sorts of crazy ideas and nightmare scenarios ran through our heads. Sarah is so special to us – we worried for Ella and Eli, and of course for Ken, but most of all we worried about her. She has become every bit as much a child of ours as any of our own kids, and we are so lucky to have her in our lives. The thought of her possibly not being able to live out the wonderful life she has made for herself and those she loves, and to fully realize her vast potential, was simply unbearable. And our own sense of potential loss was acute and very painful. How lucky we are to have wasted all that angst on a simple cyst, yet to have a heightened sense of appreciation for Sarah and for the joy she brings to our lives.

Had it not been for Sarah, we would have lost our son years ago. I may have mentioned this before in a blog, but over a decade ago, Sarah was with Ken when he accidentally smashed his left leg with an axe while trying to clear a trail. He very nearly bled to death, and only her incredible composure and competence enabled him to get safely off the trail to meet an ambulance that sped him to a hospital where he could be fluid resuscitated and have repair of a torn artery. When we got to the hospital the next morning he was in the ICU,  alert but enmeshed by a maze of IV lines and catheters. I remember telling him, “I don’t know what you plan to do with Sarah, but as far as we’re concerned, she’s a keeper.” Fortunately, this was one piece of advice from us that he took quite seriously, and we simply could not be happier.

I took another lesson away from this little scare. While we were fortunate, many people were not so lucky. Last week nearly 31,000 Americans learned that they have cancer, and they and their loved ones faced all the anguish we imagined but never had to face. And, for more than 10,000 of these people, there will be no happy endings. It was good for me to be transported, if only in my fevered imagination, into the lives of those who hear those words they never want to hear, and to remember that the work we do is not just about genetics, cell biology, statistical methodology or even clinical care. It is about people’s lives, and ending the suffering and loss that cancer causes, once and for all.

I wish nothing but happy endings for all of you too, and also hope your air conditioning works these next few days!

Have a wonderful week.

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Jul 13 2015

Back in the Blogosphere!

by at 10:53 am

Hello again! After a six week hiatus, our website capacity has been restored by the hiring of Meghan Lasswell, who is Lombardi’s new communications associate. Welcome Meghan, I look forward to working with you. Meghan is a recent graduate of Vanderbilt University and has considerable relevant experience that makes her exceptionally well-suited for her responsibilities.

Too much has happened over the past six weeks to possibly summarize them in a brief blog post. On the GUMC side, we bade farewell to Howard Federoff and welcomed Ed Healton as our new Executive Vice President. Ed is ideally suited to continue to advance the substantial gains that have been made in the relationship of Georgetown and MedStar Health, and he has hit the ground running. Some of you may have met him when he toured Lombardi’s research and clinical spaces a couple of weeks ago. He “gets” the Lombardi mission and views it as being a centerpiece of the medical center. I very much look forward to working with him to advance the Cancer Center’s mission and the work of the Lombardi Sector.

On a personal note, we welcomed our fourth grandchild, Elijah (Eli) Arthur Weiner into the world on May 29, so Ella now has a little brother. We have spent a lot of time on I-95 over the past six weeks, particularly since our younger son David just started his orthopedics internship at Union Memorial Hospital in Baltimore, and we helped he and his wife Kelly set up a place near the hospital where he can crash after a night on call.

I’ll be at the NCI on Monday chairing a meeting of the Board of Scientific Counselors for Clinical Sciences and Epidemiology, and will be spending the rest of the week finalizing our FY ’16 budgets, engaging in a variety of research planning activities and seeing a few patients.

Have a great week.

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