November-December 2016 | Health

Six Cutting Edge Medical Procedures Happening in the Bethesda Area

Thanks in large part to the National Institutes of Health our backyard is an international hub for medical innovation

“We are building on the understanding that every person’s cancer is unique,” says Dr. Steven Rosenberg, chief of surgery at the National Cancer Institute. Photo by Skip Brown

The Cancer Research Pioneer

More than 100 signed photos of researchers line the corridor leading to the office of Dr. Steven Rosenberg, chief of surgery at the National Cancer Institute (NCI), which is part of NIH.
“It has been a privilege to work closely with you and to be part of this ‘scientific paradise’ that you have created,” wrote Alena Gros, Ph.D. Gros left NIH in September after a seven-year fellowship and returned to her native Spain, where she is an investigator at Barcelona’s Vall d’Hebron Institute of Oncology.

Gros will be sharing with her colleagues what she learned from Rosenberg, a pioneer in immunotherapy. The most promising recent advance in cancer treatment, immunotherapy spurs an individual’s immune system to fight the disease.

“The research done here with Dr. Rosenberg is very special,” says Gros. “It’s how the field advances. He trains fellows, and we spread the knowledge.”
In 1985, Rosenberg was one of the first researchers to demonstrate how immunology could cure a patient with advanced metastatic melanoma. The patient, a former Navy commander who had been told she had just months to live, was treated by Rosenberg at NIH’s hospital. The treatment involved using a drug called interleukin-2 to stimulate the patient’s immune system.

“She was the 67th patient treated,” says Rosenberg, who lives in Potomac. “All the patients I treated before her, all went on to die. [She] showed, for the first time, that it was possible to stimulate the body’s own immune system to let it attack the cancer. It was an enormous boost.”

Thirty years later, Rosenberg, 76, heads one of the key research labs on the NCI campus in Bethesda, where he continues to lead advances in immunotherapy. He has trained about 300 American and international scientists and physicians on immunology techniques.

“Surgery, radiation and chemotherapy can cure just over half of people who develop cancer, but that still leaves 580,000 Americans who die a year,” Rosenberg says. “The advantage of immunotherapy is that it is using a body’s own internal forces. We think this may be the way to get metastatic cancers.”

Currently, the most developed immune therapies are called checkpoint inhibitors, which disable cancer cells’ immune suppressing signals. The Food and Drug Administration (FDA) has approved four checkpoint inhibitors, including one given to President Jimmy Carter in 2015 that led to his cancer’s remission. However, research shows that these checkpoint inhibitors only work on about 20 percent to 40 percent of adult patients with some advanced lung and melanoma cancers.

Rosenberg has been relentlessly focusing on what are called cell therapy approaches. One of them, CAR T-cell therapy, involves removing some of a cancer patient’s T cells—the body’s warriors that kill foreign invaders—and then genetically engineering them to recognize and attack the patient’s cancer. Another approach involves identifying naturally occurring T cells in a patient’s body that could attack their cancer, and growing more of them.

“We are building on the understanding that every person’s cancer is unique,” Rosenberg says. “And it is ironic. The mutations that cause cancer are likely to be the Achilles heel of cancer because those mutations aren’t in healthy tissue.”

Dedication to his research drives Rosenberg to the lab and hospital six days a week and most Sundays. “Just ask my wife, I have no hobbies,” he says. “This is what I do. I work here. I spend time with my family. That is it.”

Rosenberg has published papers showing success in the use of cell therapy to shrink tumors in lymphoma, sarcoma, metastatic melanoma and a bile duct cancer. Still, CAR T-cell therapy remains experimental, and there is no FDA-approved CAR T-cell therapy on the market—yet.  

Rosenberg, through the NIH, is working with Kite Pharma, a small drug company based in Santa Monica, California, to commercialize the NCI’s T-cell technology. He says Kite could begin producing a therapy for lymphoma within the next year or two.

“We are on the verge of some really important advances,” Rosenberg says.