Janus was the Roman god of beginnings and transitions. It is depicted as a two-faced image that looks to the future and the past. As first pointed out by Dr. Olivera Finn, the Janus principle can be used to illustrate the past accomplishments and future opportunities in Immunotherapy of Cancer. In this case, immune function/tumor rejection and immune dysfunction/tumor progression. Ann Oncol 2012 Sep 23 (Suppl 8).
About Cancer Biology and Immunotherapy-2020
To date, the passive immunotherapeutic approaches which have been FDA-approved clearly provide clinical benefit to a proportion of advanced disease patients. While these treatments have been heralded as much needed improvements, the nearly 600,000 Americans who died of cancer last year did not gain the level of benefit we would have hoped from modern cancer care. As the frontiers of cancer immunotherapy are pushing forward, we need to concentrate on integrative translational medicine. We are proposing to have an outlet for a comprehensive discussion, which will simultaneously integrate a deep understanding of the biology of cancer along with the development of future treatment concepts to ultimately realize the full potential of this clinical revolution.
To this end, together with the United Scientific Group (USG) and under the auspices of the Mercer Medical School, Savannah Campus is organizing a Cancer Biology and Immunotherapy (CBI) meeting in Savannah, Georgia in March 30 to April 1, 2020. USG has successfully organized four Vaccine Research and Development meetings and during these events it has become apparent the cancer vaccine and immunotherapy research portions need to be expanded to their own conference.
Cancer has clearly thwarted many treatment approaches, including oncogene-driven targeted agents, monoclonal antibodies, as well as immune-modulatory agents like interferons, lymphokines, and cytokines, and various anti-angiogenic agents. With this checkered past, one has to ask the hard questions: were the concepts incorrect or were the treatments used without a full understanding of the biology of the disease? Was a complete accounting made of the host-tumor interactions? Did we fully understand the complex mechanisms inherent to the tumor microenvironment, which could render many of these treatments ineffective?
All too often pragmatic decisions, such as manufacturing requirements or financial decisions, have driven cancer R&D development and clinical trial design. Commercial strategy was crafted based on these limitations, such as ignoring early-stage or minimal residual disease patients to focus on late-stage or recurrent tumors which would achieve a clinical readout on a faster timescale. Furthermore, using cancer vaccines as a monotherapy in advanced disease patients, which flies in the face of the conventional tenets of vaccinology. Furthermore, targeting our treatments of various tumors while ignoring the magnitude and consequences of near limitless intra- and inter-tumoral genomic heterogeneity has been a major challenge. Also, in many cases, malignant progression is accompanied by major immune suppression. While successful treatments of passive immunotherapy are being heralded, the immune suppressive state of advanced disease is clinically limited. Possible combinatorial treatments of active and passive immunotherapy are warranted. These discussions will be topics of this first CBI meeting.