Working Together on Cancer Research
From Popular Mechanics- It’ll Take an Army to Kill the Emperor
The men and women who are trying to bring down cancer are starting to join forces rather than work alone. Together, they are winning a few of the battles against the world’s fiercest disease. For this unprecedented special report, we visited elite cancer research centers around the country to find out where we are in the war.
Future. A tricky word for a cancer patient. Who gets to have one is still a function of blind fortune. But all these ideas are starting to come together, and progress is suddenly accelerating.
This article is a bit of a long read, but worth the time. The latest in cancer treatment is interspersed with personal vignettes and observations by the reporter. Here are the sections of the report:
I. Precision Medicine: What Is Cancer, Really? – This section focuses on St. Jude’s in Memphis, Memorial Sloan Kettering Cancer Center in New York City and Brooks Brothers Computational Biology Center
It took thirteen years and cost $2.7 billion to sequence the first genome, which was completed in 2003. Today, it costs $1,000 and takes less than a week. Over the last two decades, as researchers like Newman have uncovered more and more of the individual genetic malfunctions that cause cancer, teams of researchers have begun to tinker with those mutations, trying to reverse the chaos they cause.
II. Checkpoint Inhibitor Therapy: You Have the Power Within You! – The focus is on work being done at MD Anderson Cancer Center in Houston.
“That’s the first patient I met,” Allison says. “She was about twenty-four years old. She had metastatic melanoma. It was in her brain, her lungs, her liver. She had failed everything. She had just graduated from college, just gotten married. They gave her a month.”
The woman, Sharon Belvin, enrolled in a phase-two trial of ipilimumab at Memorial Sloan Kettering, where Allison worked at the time. Today, Belvin is thirty-five, cancer- free, and the mother of two children. When Allison won the Lasker prize, in 2015, the committee flew Belvin to New York City with her husband and her parents to see him receive it. “She picked me up and started squeezing me,” Allison says. “I walked back to my lab and thought, Wow, I cure mice of tumors and all they do is bite me.” He adds, dryly, “Of course, we gave them the tumors in the first place.”
III. CAR-T Cells: Tiny Machines – Stanford University in Palo Alto, California, Novartis, Hospital of the University of Pennsylvania and City of Hope National Medical Center in Los Angeles are highlighted in this section.
Slowly, though, the successes are mounting. At City of Hope National Medical Center just outside Los Angeles, Behnam Badie, an Iranian-born brain surgeon who has the kind of bedside manner you’d dream of if you ever required a brain surgeon, is developing a surgical device that can continuously infuse CAR-T cells into the brain tumors of cancer patients while he operates. For a while, he was working with the California Institute of Technology to build a magnetic helmet that could move the cells to the correct places, but the project ran out of money.
IV. Postmodern Radiation: Any Other Ideas? – Los Alamos National Laboratory in New Mexico and isotopes are covered in this section.
To get to the Los Alamos National Laboratory in New Mexico, you drive from Santa Fe through peach-parfait mesas and off into the sunset. Even on the public roads, there are checkpoints where security officers will ask to see your driver’s license. The deeper you go, the more intense the screening gets, until finally you end up in a place employees just call “behind the fence.”
After the public roads but before “behind the fence,” are the hot cells: four-foot by three-and-a-half-foot boxes where employees use robot hands controlled by joysticks to process non-weapons-grade isotopes. The isotopes are made on another mesa, by a linear particle accelerator that shoots rare metals with proton beams.
V. Policy Reform: Divided We Fall – Joe Biden, The Cancer Moonshot and policy are the focus in this section.
The fragmentation in medical research—the lone ships out on the ocean—doesn’t exist as much in other sciences, says Simon, because scientists in other disciplines have no choice but to share equipment: telescopes or seismology sensors or space shuttles. Industries that have managed to work together have sent humans to the moon. “We don’t even know how much progress we could make in our cancer enterprise because we’ve never had it up and running at a level that would be optimal,” he says.
VI. Silicon Valley: The Brain – And of course, we’re in Northern California now. The Parker Institute for Cancer Immunotherapy in San Francisco and six academic research institutions signed on to work together under the Parker Institute’s umbrella: Memorial Sloan Kettering; MD Anderson; Penn Medicine; Stanford Medicine; University of California, Los Angeles; and University of California, San Francisco.
The six, along with independent investigators at a few other research institutions, agree to share research data and work together on goals and projects without getting hung up on institutional constraints, such as intellectual property. In return, they get two things: money, which every cancer researcher needs; and guidance, which is equally pressing but not necessarily as obvious.
“I spend a lot of time trying to develop relationships between people who might not always do so on their own.” Some of those relationships are between researchers themselves. Others are between M.D.’s and Ph.D.’s, or between researchers and drug companies, or engineering companies, or the U.S. Patent Office. It doesn’t really matter, so long as the arrangement furthers knowledge.
VII. Hope – MD Anderson, Materialise in Plymouth, Michigan
This type of surgery is called microvascular reconstruction surgery. It drastically improves life for patients who would otherwise, like late film critic Roger Ebert, no longer be able to eat or talk without support. When it fails, however, it fails impressively: The transferred bone must have the correct blood supply or the body will simply reabsorb it, leaving only the bare metal scaffold the doctor implanted. Human bone is far better suited to the long-term mechanics of chewing and talking than metal is, and a plate without bone to protect it will eventually snap, like a paper clip bent back and forth over and over. Garvey has had to reconstruct jaws that have failed before, leaving patients disfigured and unable to chew properly. For a patient who has already undergone treatment for cancer, the impact of having to have multiple reconstructive face surgeries is harrowing.
Future. A tricky word for a cancer patient. Who gets to have one is still a function of blind fortune. But all these ideas are starting to come together, and progress is suddenly accelerating. We are at what Crystal Mackall calls “the end of the beginning,” and the hope is that one day soon, the miracles will no longer be miracles. They will just be what happens. Until then, we pin our hopes on the incremental or unpredictable improvements—the half measures, the better outcomes. It will always be true that once a person has had that most frightening of conversations with chance, life will be split into two parts—the time before cancer, and the time after it. But for a fortunate few, perhaps the second part can be as good, and even as rich and wonderful and as great as the first.
You can find the full article in the June issue of Popular Mechanics.