Pioneering Perspective

The Future of Cellular Cancer Immunotherapy at Winship

CAR-T immunotherapy illustration
CAR-T immunotherapy illustration
Illustration by Keith Chambers/Science Photo Library

In 2013, Science Magazine named cancer immunotherapy as the breakthrough of the year.

This strategy has already led to impressive and durable responses in patients with hematologic (blood) cancers, and is poised to transform care and yield cures in several other cancers.

Madhav Dhodapkar, MBBS

The past decade has established immune therapy as one of the major pillars of modern cancer therapy, alongside surgery, radiation, chemotherapy and targeted therapy. Investigators at Winship have played a major role in this immune revolution, which in several cancers has led to substantial improvements in survival and served as a source of hope and inspiration for patients and researchers alike. Most current immune approaches against cancer involve two broad strategies. One involves "checkpoint inhibitors," therapies aimed at removing the natural brakes against immune cells and allowing them to unleash their effects against cancer. The other, my focus here, involves infusing immune cells into cancer patients. This strategy has already led to impressive and durable responses in patients with hematologic (blood) cancers, and it is poised to transform care and yield cures in several other cancers.

Why Winship?

As Georgia’s only Comprehensive Cancer Center and a prolific contributor to cancer immunology research, Winship is poised to help lead this revolutionary new way to treat cancers. Winship investigators have already been engaged in seminal studies that led to the approval of engineered T cell therapies called chimeric antigen receptor (CAR) T cells. Several Winship researchers are actively studying and developing new methods to improve these therapies.

It takes a village

Renowned cancer immunologist Madhav Dhodapkar, MBBS.

A noted immunobiologist, Dhodapkar is working to harness the immune system’s properties to detect, prevent and treat cancer, particularly multiple myeloma.

Photo: Jack Kearse

While cell-based therapies such as CAR-T cells or other immune cells, offer considerable promise, safely collecting and administering them require infrastructure and a team with specialized expertise. This is particularly important for optimally managing early toxicities in patients receiving therapies. Winship has created dedicated teams of researchers, clinicians, nurses and other staff who specialize in caring for patients before and after immune cell infusion.

Home-grown and personalized therapies are the future

Several opportunities for improvement have become clear as the cell therapy revolution in cancer takes shape. T cell-based therapies, including CAR-T cells, may benefit from advanced genetic engineering to improve their function. Winship researchers are also exploring new ways to help such cells persist longer and more effectively kill cancer cells. Others are exploring new ways to target tumors, use immune cells to deliver drugs to the tumor site or engineer cells to target specific mutations or proteins within tumor cells. Improving scalability and reducing costs associated with cellular therapy are additional unmet needs. This is why it is likely that advances in cell-based therapies would occur through personalized approaches and may benefit from "on-site" manufacturing to help rapidly test innovative approaches and reduce costs.

Academic centers of excellence and new partnership models involving industry, regulatory and funding agencies are critical to delivering on this promise. The National Cancer Institute in 2020 chose Winship as one of a limited number of cancer centers to form a consortium focused on cell therapy. Winship also is actively engaged in partnerships with other centers involved in cell therapy.

In the past year, Winship has invested in a new cell manufacturing laboratory, Emory Cellular and ImmunoTherapy Core (ExCITE) lab, which we expect to begin manufacturing CAR-Ts for cancer patients in 2022. We anticipate this facility will help translate preclinical studies from several Winship labs to test new cell-based therapies in the clinic and will be central to recruiting additional cell therapy researchers to enhance the critical mass of cell-therapy research at Winship.

In spite of the remarkable progress and promising clinical results in recent years, the best for cell therapy in cancer is yet to come, and I encourage you to stay tuned.