For many decades, chemotherapy and radiation were the chief therapies to treat cancer. Today, at major medical centers like the Hadassah Medical Organization, cancer specialists are focusing their efforts on the biology of an individual’s cancer and immunological approaches to eradicating the disease.
In a July 6 Hadassah International webinar “Transformation and Innovation in Cancer Research and Treatments,” three of Hadassah’s trailblazers in cancer treatment spoke about the latest innovations and what transformations they see on the horizon in caring for cancer patients.
Prof. Aron Popovtzer, head of Hadassah’s Sharett Institute of Oncology, reported that “our main focus in cancer now is personalized treatment.” Hadassah, he said, “is going to be the first hospital in Israel and one of the first in the world” to sequence a specific tumor’s genome and tailor treatment for each patient accordingly.
Prof. Michal Lotem, head of both Hadassah’s Center for Melanoma and Cancer Immunotherapy and of its newly created Cancer Research Center, emphasized the importance of providing medical treatment that is “rich in science.” Noting that “data is power,” she talked of the many growing databases Hadassah has, which will offer insights into the nature of various cancers and enable physicians to discover the behavior of these diseases. For example, Hadassah’s databases can reveal biomarkers in cancer that tell physicians who among their patients are most likely to respond to a specific treatment and who should not receive it.
Prof. Lotem pointed out that Hadassah, situated in close proximity to the Hebrew University, has the unique advantage of many research collaborations with academic colleagues. “Not many cancer centers,” she said, “enjoy this synergy.” As a result, discoveries can move more quickly from basic science to translational medicine. With more and more treatments today taking into consideration the molecular basis of a person’s cancer, Prof. Lotem reported that “a main pillar of the new Cancer Research Center will be to encourage and nourish many of its youngest doctors to become physician/researchers.”
Some of the most cutting-edge work is being spearheaded by Prof. Polina Stepensky, head of Hadassah’s Bone Marrow Transplantation Department. She is at the forefront of a treatment based on genetic engineering called CAR-T-cell therapy, which involves editing the t cells of a cancer patient’s immune system to enable those cells to attack the cancer more effectively. Prof. Stepensky has already treated 27 patients suffering from either lymphoma or leukemia with CAR-T cell therapy. The majority, she reports, are in remission.
Working with Prof. Lotem, Prof. Stepensky is developing a “homemade CAR-T-cell therapy,” which involves creating Hadassah’s own CAR-T cells. Her vision is to begin clinical trials by the end of the year.
Hadassah is also capitalizing on the knowledge artificial intelligence (AI) can provide. For example, Prof. Popovtzer related that AI helps them understand how a patient’s tumor is reacting to radiation treatments. This understanding enables physicians to modify the standard dose of radiation according to the patient’s level of response. “We can learn a lot from the computer,” he said. As a result of this additional knowledge, Prof. Popovtzer explained, physicians can not only prolong their patients’ survival but also lower the toxicity of treatments, enhancing their quality of life.
While each of the presenters emphasized the importance of having an appetite for science and for taking advantage of the power of computers and the data they generate to tell them what is happening in real time, Prof. Lotem noted that success is “augmented by patients who inspire you.” As she said, “I learned a lot about bravery, courage, conviction, and perseverance from Stewart Greenberg,” one of her long-time patients whom she saved from stage 4 melanoma.
Looking to the future, Prof. Lotem stressed the need to discover new ways to manipulate the immune system to cure cancer. “We have not yet seen more than a small proportion of what immunotherapy will be able to do,” she said, “and we must pursue its potential. We cannot let Pharma completely control treatment. Hospitals should initiate the search for innovation.”