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Q&A With Dr. Jonathan Bramson — Thoughts on Future of Immunotherapy

jonathan bramson
jonathan bramson

Dr. Jonathan Bramson, Vice Dean Research and Professor of Medicine for the Faculty of Health Sciences at McMaster University discusses his current research and the potential of innovative immunotherapy treatments for cancer patients.

What got you interested in cancer research?

Throughout my academic career, I worked in labs that do cancer research. I like to see direct applications of my research and cancer was an area where I knew I could see the direct consequences of the work that I was doing. Finding a cure for cancer struck my sensibilities the right way, and I’ve stuck with it ever since.

Can you explain your current research?

In 1994, I started working in immunotherapy, which is based on the idea that you can use your body’s immune system to fight cancer. We were focused on using modified viruses to deliver immune-activating proteins to the tumour site so that we could convert the local state, where the tumour lives, from one that suppresses immunity to one that’s susceptible to immunity. Over time, my research shifted from trying to modify local environments to directly modifying the white blood cells that are responsible for the immune response to cancer.

My lab performs immune cell engineering — we take white blood cells from cancer patients and genetically reprogram them to give them the ability to see the tumour and to avoid being shut down by it. The biggest challenge we face is educating the immune cells to only go after the tumour. Choosing the best target on the tumour is the big trick right now! Only through clinical trials will we know if our therapies will work.

Is there anything in your personal pipeline that you’re excited about?

We just opened a human trial that’s tackling solid tumours. It’s exciting for us to see that a technology developed in 2015 is now being tested in humans. We’re also working on an off-the-shelf solution where the white blood cells will be produced en masse and placed in the hospital pharmacy, and the pharmacist will pull them off the shelf based on a patient’s profile and infuse them into the patient as needed.

Is there a gap in the research space?

There are two big gaps. First, in the Canadian landscape, it is challenging to secure funding and support for trials. Clinical trials cost money but it is money well spent because you can’t know if anything is useful until you test it in humans. The other challenge is manufacturing. We work with customized viruses and human cells. Canadian scientists have built consortia with the capacity to manufacture these customized biological agents at pilot scale, but we don’t have the capacity to produce them at full scale — at least, not yet. We are hopeful that new investments in Canadian manufacturing will open opportunities for domestic manufacturing of these powerful agents.

The ultimate value of immunotherapy comes from its potential to cure cancer. Human studies have shown that, when we do this right, we can cure people who had no other treatment options. Some of these investments in clinical trials and biological manufacturing might sound expensive initially, but there’s a long-term payoff. We must recognize that if we want a health research enterprise that benefits Canadians, it takes investment so that we ourselves, are reaping the rewards of our own discoveries, rather than seeing exciting new treatment technologies being developed in other jurisdictions, like the United States, who then sell it back to us at a premium.

What’s the hope for the future of immunotherapy?

It’s fantastic. We’re learning so much and patients are already seeing their lives change. Individuals who previously had no options will get immunotherapy and they’ll never see cancer again. That’s incredibly exciting. The trick for us is figuring out how we can go from those 20 to 30 percent who have had this fantastic response, to 100 percent.

We have an incredibly vibrant research community in Canada and young people should be thinking about being a part of that community for their future. People should be aware that amazing discoveries in immunotherapy are being made in Canada, that Canadian scientists are among the best in the world — across all biomedical sciences — and that you can make a life out of biomedical research.

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