TEDMED: In your TEDMED 2018 Talk, you mentioned that cancer researchers had essentially given up on using the immune system to fight cancer, with the exception of cancers like cervical cancer and liver cancer. What motivated you to look at the immune system differently, and even build your own synthetic immune system, to fight cancer cells? Did you receive skepticism from the medical community before your research was proven fruitful?
Carl June: I have mentioned that I did my initial research while a medical research officer in the United States Navy. I was basically “conscripted” to do research in HIV even though my medical training was as an oncologist with specialization in leukemia. I was simply not permitted to do research in cancer. This turned out to be very fortunate turn of events because I learned how to use the HIV virus to engineer the immune system for people with HIV/AIDS. This gave me a completely different perspective when I moved to the University of Pennsylvania and began working on leukemia and lymphoma.
And yes, there was skepticism. You better believe it! And it was well-deserved because for more than a hundred years people had tried to use the immune system to fight cancer with very disappointing results. In fact 10 years ago, there were less than five scientists working actively to make CAR T cells for cancer, and now there are hundreds of laboratories around the world working on this problem. It is rare in science and medicine to see a shift of that magnitude in that time scale.
TM: CAR T cell infusions are the “first living drug in medicine,” as they stay alive and on patrol in the body for decades. Have other drugs followed this path?
CJ: As it happens, last week I got an email from the very first patient that we treated with CAR T cells for leukemia. The occasion of his email was that it was the nine-year anniversary since he had had his CAR T cell infusion and he wrote me to say how grateful he is for the remission. At this time I think we are safe to conclude that he is in fact cured. So that’s a very rewarding email to get! Scientifically we know from lab tests that his CAR T cells are still on patrol and in fact they are the first “living drugs”. I am confident that with the technologies we have today, including genome-editing, that there will be many more examples of living drugs created over the coming years.
TM: At TEDMED, we like to think about each talk as sharing a “gift” with the community— a single idea that the audience takes away with them, that can change the way they think about a key issue or an “idea worth spreading”. What is the gift you’d like people to receive when watching your TEDMED Talk?
CJ: I have mentioned that I had many unplanned detours in my career. The gift I would like to leave with the community is that these twists and turns can be huge opportunities, and in my case, they led to the discovery of a cure for leukemia. Sometimes creativity can emerge when you are forced to change your mindset.