Gene therapy has the potential to change how we treat diseases such as cancer and HIV, but it’s only available in high-tech clean rooms. Why isn’t it more widely available?
“It’s complicated and expensive,” said Dr. Jennifer Adair during her recent talk at a TEDxNashville event focused on health.
In “Bringing Gene Therapy to the Table,” Adair, an assistant member of the Clinical Research Division at Fred Hutch, described a series of pivotal moments working with patients and scientists like Fred Hutch’s Dr. Hans-Peter Kiem that fueled her passion to make gene therapy a treatment that is more accessible and affordable.
She spoke of a glioblastoma patient from Alaska — the first patient to whom she and Kiem ever gave gene therapy, who survived an astounding six and a half years after treatment — and the gamble he took in taking the time to repeatedly come to Seattle for treatment.
“If you had been given a diagnosis with a prognosis of 11 months, would you be willing to leave your community, your family, your friends, your co-workers and take a chance on something like this?” Adair asked the audience, adding that for nine out of 11 months the patient had to travel back and forth to Seattle.
That was the first time Adair thought that gene therapy should be simplified. The rest of her 14-minute talk, which Adair gave Aug. 4, described how gene therapy could be used to treat HIV and how she’s working to prove that moving the therapy to more clinics around the world is possible with existing technologies.
In her TEDxNashville bio, Adair gave more detail on how her scrappy point of view comes from her everyday experience, which included getting through school as a newly married young mom with the help of a corporate scholarship and the U.S. welfare system.
“It’s a proof of concept; hasn’t left Fred Hutch yet,” Adair said. But by getting the word out that gene therapy can be made accessible, she and her colleagues hope barriers to getting it to more people will be overcome and that scientists will discover how people with even more diseases can benefit from this approach.
— Molly McElroy | Fred Hutch News Service
Drs. Edus H. “Hootie” Warren and Warren Phipps of Fred Hutch Global Oncology have received a five-year, $2.9 million grant from the National Cancer Institute’s Provocative Questions Initiative to study immune responses to Kaposi sarcoma. The research potentially could lead to new treatments — inc ircs/pathogen-associated-malignancies-integrated-re luding immunotherapies — for one of the most common cancers in sub-Saharan Africa.
“We want to try to understand what an effective immune response against Kaposi sarcoma looks like so we could then figure out ways to potentially harness that response and improve it in people who do not respond to chemotherapy,” Phipps said. “We are in the midst of an exciting revolution of our understanding of immune responses as a way to treat cancer, which is what created the vision for this study.”
Kaposi sarcoma is one of up to 20 percent of cancers worldwide caused by infectious pathogens, in this case, human herpesvirus 8. Kaposi sarcoma begins in the lymphatic system or in blood vessels and can appear as lesions on the skin, in the mouth, nose or throat and in the lungs and gastrointestinal tract. In Uganda, where Fred Hutch has a research alliance with the Uganda Cancer Institute, it is the second most common cancer, after prostate cancer, in adult men. It is also a common cancer among women, after cervical and breast cancers.
Driving the high numbers is the HIV/AIDS epidemic. HIV attacks the immune system, leaving those infected less able to fight off other infections. In the United States in the 1980s and early 1990s, the once-rare cancer became a hallmark of the AIDS epidemic. It has become rare again in the U.S. since the rollout of antiretroviral therapies that keep HIV in check. But in Uganda, despite efforts to scale up antiretroviral treatments, many still lack access to care or start therapy late.
Only about 50 percent of Kaposi sarcoma patients survive beyond one year and just 10 percent survive beyond five years.
“Novel treatments are urgently needed,” Phipps said.
A research exchange that goes both ways
The NCI’s Provocative Questions Initiative rewards “effective and imaginative ways” to improve cancer prevention, detection, diagnosis and treatment. Several features of Kaposi sarcoma — including its occurrence in people with suppressed immune systems — suggest the new immunotherapies that have begun to revolutionize cancer treatment may be effective against it.
The grant will allow Fred Hutch researchers to study the range of responses in patients who receive antiretroviral therapy for their HIV and chemotherapy for their cancers and compare them with Kaposi sarcoma patients who do not have HIV. Uganda is one of the few places where such a study can take place because it also has an endemic, or local, form of Kaposi sarcoma; about 10 percent of patients with the cancer seen at the UCI are HIV-negative, Phipps said.
“We’re particularly interested in those who respond well and have tumor regression or a complete response,” he said. “What are their T cells [a type of immune cell] doing? This will guide future work to either augment that response or lay the foundation for new immunotherapies or new strategies such as immune-checkpoint drugs or a therapeutic vaccine to mimic that response.”
The urgent need for new therapies; Fred Hutch’s longstanding collaboration with the UCI in the country’s capital, Kampala; and the infrastructure it has helped develop there, including trained researchers and a state-of-the-art facility with laboratories; makes Uganda the ideal place to do such a project, Phipps added. The study will make use of tumor specimens he has collected as part of an ongoing Kaposi sarcoma study at the UCI. The only Fred Hutch faculty member currently living in Kampala, Phipps has been working in Uganda for nearly 10 years, building Fred Hutch’s research operations, developing its training programs and conducting his own research, with a particular focus on Kaposi sarcoma.
T cell genetic sequencing for the project will be done in the Seattle lab of immunotherapy researcher and oncologist Hootie Warren, who pioneered the process to be used. Named head of Global Oncology in July, Warren’s goals include using what is being learned at the Hutch and elsewhere about immunotherapies to improve cancer treatment worldwide.
Both Warren and Phipps anticipate that the exchange will go in both directions. Although Kaposi sarcoma does not occur in the United States at the levels it did 20 years ago, it still exists, but in numbers too scattered to do large study. Such a study can be done in Uganda — and the lessons applied to U.S. patients.
“Anything we can learn about the impact of HIV on T-cell responses to cancer will be significant for our HIV population with other cancers,” Phipps said.
In a recent Fred Hutch talk about the project, Warren went one step further.
“We will learn important principles from our studies of Kaposi’s that will clearly benefit how we approach treatment,” he said. “But the research and what we learn in our studies will have enormous implications for all cancer biology.”
— Mary Engel / Fred Hutch News Service
Raquel Sanchez of Fred Hutchinson Cancer Research Center is one of 40 young Seattle-area leaders who were honored today by the Puget Sound Business Journal for their impact on the business community. She received the “40 Under 40” award today at a luncheon hosted by PSBJ at Seattle’s Benaroya Hall.
Sanchez is the senior operations director of the Hutch’s Human Biology Division and the Seattle Translational Tumor Research group. She directs the management of the division’s operations, finances and human resources. She was honored for her key role in the recruiting and diversity efforts of the division as well as her impact on its day-to-day management and long-term strategic planning.
“Creating a diverse team had been a goal of mine from the moment I stepped into my position four years ago,” said Sanchez in a profile posted Wednesday by the journal. “At that time, the team was fairly homogenous in race and age and, by and large, in how they approached challenges. To increase creativity, innovation, and energy for change, I worked closely with recruiting and questioned where ads were being placed, what community work fairs were we attending, and what relationships were we building to create pipelines of talent, requiring a diverse pool before making every hire.”
As a result of Sanchez’s efforts, the division now includes a more diverse mix of employees and has a dedicated pipeline for new employees from minority groups. Among her other successes, Sanchez facilitated the development of new information-technology solutions for researchers across the Hutch.
Sanchez is also a member of Fred Hutch’s Institutional Review Board and Diversity Council, and she sits on the advisory board of Hutch United, a grassroots organization dedicated to promoting the success of Fred Hutch scientists from underrepresented groups.
The journal’s “40 Under 40” program began in 1999. Its goal, according to PSBJ’s website, is to “identify people under the age of 40 who were center stage in our business community, working hard to drive the economy and demonstrating dynamic leadership.” In addition to celebrating these young leaders, the program also aims to build a cross-sector leadership network among honorees, who now number 760.
This year’s “40 Under 40” list includes regional leaders in diverse industries, from biomedical research to law to environmental consulting to transportation. The last Fred Hutch employee to be included among the “40 Under 40” was oncologist and health economist Dr. Veena Shankaran in 2014.
Prior to coming to the Hutch, Sanchez spent more than a decade in an operations leadership role at Memorial Sloan Kettering Cancer Center in New York City. A native Brooklynite, Sanchez grew up in a Dominican immigrant family and became a first-generation college graduate.
“My parents came to New York in their early 20s to give their children a better future,” Sanchez said. “That they sacrificed so much is a built-in motivation for me to do for others as well. In our family, you’re just supposed to help.”
— Susan Keown / Fred Hutch News Service