Bay Area Edition | June 2022

SCIENCE

2022 HEALTH CARE EDITION

ALL ABOUT IMMUNOTHERAPY

How is it dierent from other treatments? Unlike other forms of cancer treatment, immunotherapy does not directly target the tumor, but empowers the immune system.

The Allison Institute

What is it?

TREATMENT NO. 1: Immune checkpoint inhibitors

The Allison Institute is led by Dr. James Allison , who won the 2018 Nobel Prize in physiology or medicine for his research into T-cell biology.

1 Checkpoint proteins naturally limit T-cells to prevent them from attacking healthy cells.

2 Immune checkpoint inhibitors block checkpoints allowing T-cells to more actively target cancer cells.

Immunotherapy is a broad term used to describe the process by which the immune system is boosted by external means to ght o infection or diseases, in this case cancer. While there are several types of immunotherapy treatment, the Allison Institute includes immune checkpoint inhibitors and T-cell activation.

Healthy cell

used depending on the circumstances, and multiple can be used in conjunc- tion with each other. Traditional methods can have down- sides that researchers said may be avoidable with the new treatment. Chemotherapy is a drug treatment in which chemicals are introduced to kill fast-growing cells in the body. Because it is not targeted, chemotherapy can signicantly aect the rest of the body, according to the Mayo Clinic. “You can’t even hardly do anything,” said Speidel, who underwent che- motherapy for a year. “You’re so sick; you’re nauseated; you have blisters in your mouth. It’s terrible.” Radiation therapy is the use of high-powered beams of energy to directly kill cancer. “[Radiation] sometimes also targets normal tissues that are in the way, … and this can create side eects that sometimes are self-limited and resolve after treatment but in some situations can be long standing and part of the survivorship experience,” Pisters said. Immunotherapy is not without side eects, Speidel said. Checkpoint ther- apies have a 5%-10% chance of causing side eects, the most common being fatigue, according to MD Anderson. The types and severity of illness cre- ate a wide range in how much individ- uals are expected to pay toward care. A year after treatment, Speidel’s thy- roid shut down. However, Speidel said the downsides of immunotherapy he experienced are nothing compared to the years of life he gained by undergo- ing experimental treatments. “All I do now is take a little pink pill in the morning for my hormones, and that’s it,” he said. Chemotherapy: a chemical treatment that kills fast-growing cells within the body Radiation: highly concentrated doses of radiation meant to kill/ shrink tumors Targeted therapy: the use of drugs or other substances to attack cancer cells, similar to antibiotics Surgery: used in conjunction with other treatments after a tumor has become small enough to operate on and remove

Cancer cell

TREATMENT NO. 2: T-cell activation

Opened in March Located in the A MD Anderson campus with plans to move to B TMC3's life science campus in 2023

1 A T-cell interacts with an antigen containing a cancer cell’s information.

2 The T-cell is injected

T-cell: a type of white blood cell that targets specic foreign material in the body Antigen: a toxin or foreign particle

into the patient.

HOLCOMBE BLVD.

3 The T-cell instructs other T-cells in the body to attack cancer cells.

$15M initially invested into research center

Plans to employ 125 faculty and sta by 2027

Cancer cell

SOURCES: MD ANDERSON, AMERICAN CANCER SOCIETYCOMMUNITY IMPACT NEWSPAPER

MD Anderson unveils new cancer research center BY GEORGE WIEBE

supercharge the immune system ... to ght the cancer,” he said. The hospital made an initial invest- ment of $15 million to the institute, and philanthropy will be an essential driver for progress moving forward, ocials said. The institute plans to recruit 125 faculty and sta members over the next ve years; that number is expected to double by 2032. New kind of treatment Cancer is the second-leading cause of death for Texans. An estimated 46,353 people statewide reportedly died of cancer-related illness in 2021, 10,827 of them in the Greater Houston area, according to the Texas Depart- ment of State Health Services. Around 66% of Texans diagnosed with cancer survive ve years or more after diagnosis, according to a 2020 report by the Texas Cancer Registry. Preemptive action is the most impactful way to ght cancer, Pisters said, noting one-third of all cancer cases are preventable. Diminishing tobacco smoking limits cases of lung cancer; reducing ultraviolet light expo- sure limits cases of melanoma; and proper weight control, diet and exer- cise fend o a host of diseases, he said. Historically, the three primary ways of treating cancer have been chemo- therapy, radiation therapy and surgery, according to Pisters. Each method is

The research hub is designed to further study new ways to treat cancer through the science of immunotherapy, said immunologist Dr. James Allison, for whom the institute is named. “Immunotherapy has transformed cancer care over the past decade, but unfortunately, not all patients bene- t equally. Our goal is to change that,” Allison said at the institute’s launch. Making a dierence Between September 2020 and August 2021, MD Anderson Cancer Center conducted 1,600 clinical trials with 9,684 patients, according to its annual report. Allison—who won the 2018 Nobel Prize in physiology or medicine in conjunction with Dr. Tasuku Honjo for work in immunotherapy as a means to treat cancer—leads the new institute with Dr. Padmanee Sharma and Dr. Raghu Kalluri. The institute is expected to move to the TMC3 Collaborative Building upon its opening with additional lab space to be added to its southern campus. Immunotherapy emerged as a means of treating cancer over the last two decades, said Dr. Peter Pisters, presi- dent of MD Anderson Cancer Center. “[Immunotherapy] is a broad term that really involves a series of strate- gies, based in science, that are designed to harness the immune system or to

Ron Speidel was diagnosed with bladder cancer in 2013. By 2015, fol- lowing chemotherapy and surgery, the cancer had spread to the bone. With all conventional treatment options exhausted, Speidel was told he had six months to live. In April 2015, Speidel was approved for immunotherapy clinical trials at The University of Texas MD Ander- son Cancer Center in the Texas Med- ical Center, where every 10 days over the next ve months, he and 14 other cancer patients received experimental treatment. Immunotherapy consists of a series of drug infusions that take sev- eral hours each appointment. The U.S. Food and Drug Administra- tion approved the rst immunother- apy drug in 2014 to treat melanoma. It was not easy, but Speidel said he is still going strong seven years later—6 1/2 years longer than doctors gave him. “It’s been a heck of a journey,” said Speidel, a retired Missouri police o- cer, in a phone interview with Commu- nity Impact Newspaper . “All the trials and tribulations I’ve had as a police ocer, … this has been a battle. This has been something I’ve never experi- enced in my life.” Key to the research eort in Houston is the opening of the new Allison Insti- tute in March, run by MD Anderson and located in its medical center campus.

BAY AREA EDITION • JUNE 2022