Unlocking the mysteries of cancer
[6 min read]
In this article:
- Swedish experts are in the vanguard of applying technology to cancer research and are leading advances in the detection and treatment of blood, lung and brain cancers.
- Spatial multiplex immunohistochemistry is helping researchers understand how immunotherapy works in the body and develop tailor treatments for patients with cancer.
- Your generous support for the Swedish Foundation makes this lifesaving work possible.
The pace of research has picked up at Providence Swedish, due in part to the headway at the Paul G. Allen Research Center at Swedish Cancer Institute. With new clinical trials underway in the Phase 1 lab, a next-generation lab in the works and investigator funds being awarded, the Center—which opened in 2021 thanks to the generosity of the Allen Cornerstone Gift—is gaining momentum.
With a focus on physician-led clinical research, the Center has a single goal— to revolutionize cancer care but not just for our community, for patients everywhere. Using a collaborative model, the Center was created around three pillars of discovery: the Initiative for Molecular and Genomic Evaluation of Cancer, the Center for Immuno-oncology and the Initiative for Cancer Prevention and Early Detection. Together, these pillars work to better understand, treat and prevent cancers.
Kelly Paulson, M.D., heads the Center for Immuno-oncology (CIO). The CIO’s mission is to help develop and test leading-edge immunotherapies to improve cancer treatment. Immunotherapy treatments can teach the body’s immune system to attack cancer and supercharge the ability of the immune system to fight the disease. Advances in immunotherapy are key to developing long-lasting treatments for advanced cancers.
In 2022, Dr. Paulson and her team opened the CIO and began seeing patients at First Hill. As part of its role with the Swedish Cancer Institute, the CIO provides patients with greater access to specialized and personalized leading-edge care.
“At the CIO, our goal is to use the immune system to cure cancers in more patients,” said Dr. Paulson, “We know we can cure certain cancers in some patients, but it’s not nearly enough.”
Understanding who an immunotherapy works for and who it doesn’t work for and then how to improve that treatment for patients is crucial. Thanks to your support, we continue to uncover cancer’s secrets. A few of the studies the immuno-oncology team is currently shepherding include:
- Krish Patel, M.D., Director of Lymphoma Program and Director of Hematologic Malignancies and Cellular Therapy at Swedish Cancer Institute is studying the response of the immune system to two different conditioning regimens used to treat blood cancers such as leukemia, lymphoma and multiple myeloma. Dr. Patel has made major contributions to new therapies and treatment standards in recent years and is looking to expand that knowledge with this study.
- Adam Bograd, M.D., thoracic surgeon, is examining the relationship between neoadjuvant immunotherapy response and the microbiome in treating lung cancer.
- Charles Cobbs, M.D., neurosurgeon at the Ben & Catherine Ivy Center for Advanced Brain Tumor Treatment, is using CIO support to study the impact of novel immunotherapy approaches on glioblastoma, the most aggressive brain cancer. This trial is using a novel glioblastoma cell culture developed by the Ivy Center.
Across the CIO, we are running multiple active phase I immunotherapy trials including studies of bispecific antibodies (“BiTe”s) for advanced lung cancers, and studies of novel immune checkpoint inhibitors for gastrointestinal, gynecologic, breast, ovarian, and advanced skin cancers. This work builds on Swedish Cancer Institute’s rich clinical trials portfolio, led by Philip Gold M.D., Director of Clinical Research and Program Leader for the Gastrointestinal Oncology Program, with more than 60 active therapeutic trials.
Spatial multiplex immunohistochemistry
To effectively study a disease, it’s critical to see as clear a picture of what’s happening in the body as possible. Spatial multiplex immunohistochemistry (smlHC) is bringing researchers one step closer to that big picture view.
smIHC is a new method that can simultaneously detect and visualize many proteins within the same tissue sample. This technique uses different colored fluorescent tags that bind to specific proteins. By using different colors, scientists can see which proteins are present and where they are located within the tissue sample.
“With these technologies, we are no longer just looking at a part of the problem. We are seeing all of the interactions of all of the immune cells together as they work to fight the cancer. We are seeing what is working and what isn’t so that we can understand successful immune responses.”
Why does this matter to cancer research? When smlHC is applied to cancer immunotherapy research, it allows researchers to study the immune response within tumor tissues in a more comprehensive way. By analyzing multiple proteins simultaneously, researchers can identify immune cells, checkpoints, and other factors involved in the immune response to cancer.
This information helps us understand why some patients respond well to immunotherapies while others do not. Information that will help us develop personalized and more effective treatments that harness the power of each patient’s immune system to fight their cancer.
Advances in technology and advances in medicine are inextricably linked. Take, for example, something as simple as storage. The Center’s lab is now equipped with the latest generation of liquid nitrogen fed vapor phase cryogenic freezers. These freezers allow Providence Swedish researchers to store tumor tissues more efficiently so that they can be studied over time. Long term study of tumor tissues provides greater insight into the efficacy of treatments.
Leading-edge technology is also available to study cells in new, more comprehensive ways. As Dr. Paulson looks to deepen our knowledge of solid tumor cancers, she is exploring how cells within the body interact. Until recently, this type of study has been painstaking and time consuming as the traditional technologies used to examine cells had limited capabilities.
Thanks to the generosity of our Swedish Foundation donors, we now have a spectral flow cytometer that is in use at the Center’s lab. The addition of this machine has ushered in a more effective and efficient method of studying tissue samples. The machine uses fluorescence to analyze individual cancer cells, looking for biomarkers that help identify cancer cells and other cells in the tumor. This new technology allows researchers to look for dozens of markers in the same sample, saving time, money and precious tissue samples.
Our next goal is to add spatial multiplex immunohistochemistry (IHC) capabilities to the lab, a mouthful of a term that will complement the spectral flow research already happening. IHC helps researchers study cancer cells within tissue samples more efficiently. It allows them to look at multiple proteins or molecules in the cells simultaneously to better understand the characteristics and behavior of cancer cells within the tissue and how different cells interact with each other. IHC also allows us to see the tumor as an ecosystem of cells living together. Including understanding which cells are next to each other and how they might be using these proteins to influence the behavior of another cell nearby.
As cancer grows, it accumulates mutations and other alterations that change how genes are expressed. These changes can be seen in tumor proteins that are slightly different from their counterparts in healthy tissue. It is these proteins (cytokines), both cancerous and healthy, that Dr. Paulson is tracking with florescent markers.
Cytokines are the signals that cells use to talk to each other and observing them allows us to understand how the immune system is shifting. Is it shifting to fight the cancer cells? Is it shifting in the direction of inflammation? By applying IHC, researchers can study cytokines in cells and tissues, gaining insights into their role and impact on immune responses and disease processes.
Both technologies provide valuable information about cancer cells by focusing on different pieces of the puzzle. Spatial multiplex IHC allows researchers to see the location and relationships of molecules within tissue samples, while spectral flow cytometry focuses on analyzing individual cells and measuring the presence of specific molecules on their surface.
“With these technologies, we are no longer just looking at a part of the problem,” said Dr. Paulson. “We are seeing all of the interactions of all of the immune cells together as they work to fight the cancer. We are seeing what is working and what isn’t so that we can understand successful immune responses.”
Together, these methods will help propel Dr. Paulson’s work. Allowing her to develop new insights into solid tumor growth and treatment with a particular eye on how immunotherapies can be created to effectively combat cancers for more patients. This knowledge will help her refine immunotherapies for large populations of patients and eventually, specific individuals.
“The grief we feel as physicians having a treatment that we know can cure, like immunotherapy, but right now can only cure some people—it’s painful. But that pain also propels us forward.” said Dr. Paulson.
Thanks to the ongoing support for the Swedish Foundation, and the Paul G. Allen Research Center at Swedish Cancer Institute, Dr. Paulson and her colleagues continue to push the boundaries of immuno-oncology in the hopes of providing every patient with the ability to use their own immune systems to fight, prevent and cure cancers.
Learn more and find a provider
If you or a loved one have questions about cancer diagnosis, treatment or care, the experts at Swedish Cancer Institute are here for you. We can accommodate both in-person and virtual visits. To talk to someone or make an appointment, call 1-855-XCANCER.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.