The future of cancer therapy looks “incredibly promising,” Dr. D. Gary Gilliland, president and director of Fred Hutchinson Cancer Research Center, said Tuesday.
“It’s actually plausible that in 10 years we’ll have curative therapies for most if not all human cancers,” Gilliland told hundreds of industry and research leaders from around the world who were gathered in Seattle at the 2015 Life Science Innovation Northwest conference, an event hosted by the Washington Biotechnology & Biomedical Association.
“We are on the threshold of amazing advances in the treatment of cancer,” he said.
Gilliland’s keynote address, and the question-and-answer session that followed, centered on immuno-oncology — or cancer immunotherapy — a family of cancer treatments that harnesses the disease-fighting power of a patient’s own immune system.
“Immuno-oncology is especially exciting for us. This looks to me like a tsunami on the horizon. Cancer can see that tsunami coming … and cancer’s running scared.
“Our mantra is Cures Start Here. We’re not looking simply to treat cancer — we’re looking to cure cancer.”
The epicenter of immunotherapy
Gilliland called Fred Hutch the “epicenter” for immunotherapy. “This is where it all started,” he said. The Hutch’s pioneering work in bone marrow transplantation — for which Dr. E. Donnall Thomas won a Nobel Prize — provided the first definitive and reproducible evidence of the idea that the immune system can fight cancer. The discovery that it was the healthy donor’s immune cells that were curing transplant recipients of leukemia and other blood cancers — not the high-dose chemo and radiation — has helped usher in the modern era of cancer immunotherapy.
“We didn’t understand how that worked decades ago. We have a much better understanding of that now,” Gilliland said. “We’re able to train our immune cells to destroy cancer. That’s what Juno [Therapeutics] does,” he said, referring to the company launched in December 2013 by Fred Hutch, Memorial Sloan Kettering Cancer Center and Seattle Children’s to develop T-cell therapy and other cancer immunotherapies.
“And I’ve never seen anything like this in my life,” Gilliland continued. “You give this cell-based therapy that was developed by [Drs.] Stan Riddell and Phil Greenberg at the Hutch, and these tumors just melt away. People go into continuous, complete remission. You don’t need to keep giving the drug, you give it once. One infusion — that’s it.”
The potential for extending this powerful approach into other types of cancer, especially solid tumors, has created a sense of urgency among researchers at Fred Hutch and elsewhere. “We have treatments that can cure patients, but it doesn’t work in everybody, and we don’t understand that.”
Work is now underway to figure it out and then use that knowledge to design new, more effective approaches. Making those improvements and bringing them to patients will require continued innovation and partnership across the life science industries.
The challenge is to realize the next scientific breakthroughs amid the resource constraints that currently exist around biomedical research and drug development. That is where Gilliland hopes to bring his experience in both academia and industry to bear.
‘The right drug for the right patient’
Gilliland spent four years as the senior vice president and global oncology franchise head at Merck Research Laboratories. There, he said, he had the “opportunity to learn both the business of drug development and also the challenges around managing drug development with limited resources … I’m very happy to be able to bring some of that experience into the Hutch to help us better understand how we can bring our mechanisms forward for the benefit of patients.”
Among the strategies he’s pursuing to make the Hutch even more successful are philanthropic and business development opportunities. To help with the latter, Fred Hutch has recruited Dr. Nicole Robinson as Vice President of Industry Relations and Business Development.
Finding more and better ways to leverage intellectual property, including through commercialization, will be essential. “We’re a 501c3 so this is not about profit,” Gilliland said. “This is about investing the returns from intellectual property to try to move this forward more rapidly.”
Gilliland also spoke about the emerging potential of using an in-depth understanding of genetic differences to determine how individual patients will respond to specific therapies. “We call that precision medicine: trying to find the right drug for the right patient,” he said.
Refining these approaches is one-way researchers can help address the problem of soaring cancer care costs, Gilliland said, “but the data that it generates is almost incomprehensible. And when you think about that, you think, ‘Where better in the world would you want to be than in a city and state that has Amazon and Microsoft?’ We’re right in their backyard, or as I like to say, they’re in our backyard. We have an opportunity to integrate more effectively with them to understand how to manage big data.”
Another new addition to the Fred Hutch team, Matthew Trunnell, will help to spearhead that effort. As vice president and chief information officer, Trunnell will be responsible for linking more efficient computing power with research that increasingly relies on high-performance computing, data analysis and data storage.
Northwest roots, global reach
Asked to highlight Hutch research that excites him, Gilliland pointed to the work being done by the Hutchinson Institute for Cancer Outcomes Research, which brings together providers, patients and other organizations to understand how to make cancer care most effective in terms of both outcomes and cost.
He also mentioned the Women’s Health Initiative, a long-term research program headquartered at the Hutch and involving more than 160,000 women nationwide, which released findings in 2002 that prompted millions of women to stop taking combined hormone therapy. That WHI study is estimated to have saved hundreds of thousands of lives and $37.1 billion in the first decade after the results were published. Gilliland said the work of the WHI underscores the wide reach of Fred Hutch research: “We’re having impacts in ways that aren’t simply wet bench science but extend out into other arenas.”
That reach also extends geographically, and Gilliland noted as one example the Hutch’s recent opening, in partnership with the Uganda Cancer Institute, of a new cancer center in Kampala, Uganda. Fred Hutch and the life science sectors in general need to think globally when it comes to helping cancer patients, he said.
“The impact we can have on world health is potentially stunning,” Gilliland said, including in the area of immunotherapies. “You can give these medicines … in a very short course, no chemo that requires blood product support, no radiation therapy that requires a machine, and these are potentially curative. You give those treatments and somebody can walk out of the clinic and they’re done. So if we can get the price point right, we can cure diseases worldwide based on those types of insights in a way that we can’t do [with chemotherapy].”
A thriving life sciences community
Gilliland highlighted the “thriving life sciences community that’s developing here in Washington state. Innovation continues at a very rapid pace.”
He noted the construction that continues unabated in the South Lake Union neighborhood of Seattle, where Fred Hutch, Juno, the WBBA and so many other biotech, research, and health care leaders are based. The plethora of cranes poking up above so much of the skyline is just one measure of growth.
WBBA President and CEO Chris E. Rivera noted that when the organization first began keeping track in 2013, there were just under $800 million in business-to-business transactions in the local biotech community. In 2014, that total ballooned to $1.6 billion, and 2015 is well on its way to a new high. With Celgene’s recent announcement of its $1 billion investment in Juno, the WBBA counts more than $2 billion in deals just through the end of June.
“It’s spectacular to see the progress that’s been made [in South Lake Union],” Gilliland said. “It’s becoming the epicenter of not only for immuno-oncology but for big data, big science and research.”
One thing Gilliland said the regional life sciences community could collectively work on is awareness. “The West Coast tends to get left out a little bit of the media streams that come out of the space. We can do a much better job of raising awareness … The [Northwest’s] life sciences shouldn’t be considered a well-kept secret anymore.”
Andrea Detter is the deputy editor at Fred Hutchinson Cancer Research Center. Reach her at adetter@fredhutch.org.
