CTA: Are we on the cusp of any new discoveries that you’re particularly excited about?
Dr Chapuis: For immunotherapy to control tumors and prevent their growth for as long as the patient is alive, we need a reservoir of cells that specifically recognize the tumor and leave other tissues untouched. These cells must persist for years and give rise to effector cells that can react to putative tumor growth instantly.
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All research to obtain such cells is exciting, including trials that look at what type of native cells should be used to insert TCR and CAR genes, trials that look at different tumor targets, and trials that assess whether combinations of the cells with checkpoint inhibitors can enhance survival of the cells and migration into the tumor microenvironment. In particular, I would look out for trials that examine tumor tissue after immunotherapy to provide the most relevant data.
CTA: Can immunotherapy offer anything in terms of preventing cancer?
Dr Chapuis: Once these therapies have a proven effect and safety in the therapeutic setting, it is plausible that certain high-risk patient populations could receive them as prevention. Although if they work as well as we think they will, immunotherapy for prevention might not be necessary. Instead, patients could receive immunotherapy as soon as they are diagnosed with a minimal disease burden.
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CTA: How will the National Cancer Moonshot Initiative most affect the daily practice of community oncologists?
Dr Chapuis: Hopefully the Moonshot Initiative will allow more patients—especially those outside big urban centers—to have access to clinical trials that include immunotherapy. Currently, it is difficult to implement phase 1 clinical trials outside tertiary cancer centers, so hopefully the Moonshot Initiative will allow for modification of regulations to allow just that. The sharing of data through the Moonshot Initiative should also allow development of new therapeutics more rapidly upstream of trial implementation.
