Aude G. Chapuis, MD, is a medical oncologist and adult hematopoietic stem cell transplant physician with a background in immunology and adoptive T-cell transfer studies in humans. She is an assistant member of the Fred Hutchinson Cancer Research Center and an assistant professor at the University of Washington School of Medicine in Seattle, Washington.
Dr Chapuis spoke to Cancer Therapy Advisor about the state of vaccine-based immunotherapy and the potential impacts the National Cancer Moonshot Initiative will have on this field and on community oncologists.
Cancer Therapy Advisor (CTA): The field of vaccine-based immunotherapy is rapidly developing. Where do you see it going in the next 5 to 10 years?
Dr Chapuis: The challenge with vaccine-based immunotherapy is that many vaccines have been geared to boost a pre-existing dysfunctional immune response. With the advent of novel vaccine strategies that engage de novo responses and oncolytic viruses, we may see a rapid revival of this approach—especially if they can be administered with checkpoint inhibitors and agents that stimulate immune cells, such as the stimulating antibody-targeting CD40.
Adoptive immunotherapy strategies may also be useful in this context to determine which tumor antigens need to be targeted and how many and what kind of cells need to be present for tumor control, thus determining the type of immune responses that vaccine strategies need to generate.
CTA: How durable are some of the recent breakthroughs?
Dr Chapuis: These breakthroughs are going to be durable for CD19-expressing tumors. The current data might change the landscape, and we may be treating patients with certain lymphomas and acute lymphoblastic leukemia with chimeric antigen receptor (CAR) T cells up front instead of when patients have exhausted all other options. In fact, companies are now trying to find ways to deliver T-cell products to smaller hospitals to accommodate this treatment modality.
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CTA: What are some of the most promising immunotherapies being implemented?
Dr Chapuis: In my opinion, gene-modified cells that express a T-cell receptor (TCR) or a CAR are going to be promising. Many targets are being sought both in the solid tumor and liquid tumor worlds, and it might be that combinations of CARs and TCRs are necessary to obtain complete responses. The combination of these cells with checkpoint inhibitors is also exciting.