Immunology at the University of Virginia About me….. PhD Biochemistry University of Illinois Postdoc Immunology Harvard University At UVA since 1980 Professor of Microbiology, Immunology, and Cancer Biology Director, Carter Immunology Center Co-Leader, Cancer Immunology and Immunotherapy Program, UVA Cancer Center Director, Immunology Training Program Trained 32 PhD graduate students, 27 postdoc fellows vhe@virginia.edu Doing science – graduate school and beyond Curiosity – what do you want to know? Motivation – what drives/focuses your curiosity? The best graduate training gives you a chance to practice being relentlessly curious find out what truly motivates you There are no stupid questions……. What do you think of when you think of ….. Immunology The Immune Response The Immune System So what do you want to know? Immunology Research at UVA Immune System Function and Dysfunction What kinds of immune responses are necessary to control bacteria, viruses, parasites, and tumors? How can they be regulated and improved? How can we make better vaccines for malaria, tuberculosis, and cancer? How do autoimmune diseases develop? How is self-tolerance established and maintained? What kinds of immune responses cause allergies? Why do allergic responses develop against innocuous substances? What’s the basis for immune deficiencies, leukemias, lymphomas? What processes control the development of lymphocytes? What’s all the excitement about? Checkpoint blockade inhibitors Ipilumumab (Yervoy) – 10-20% overall response rate in melanoma Pembrolizumab (Keytruda) and nivolumumab (Opdivo) – 30-40% overall response rate in melanoma; 20-30% in lung, renal cancers, mesothelioma, TN breast cancer Combination greater that 80% tumor shrinkage in 30% of melanoma patients CAR-T - >80% response in B cell leukemias Being curious about the immune response to cancer Is there an immune response to cancer? What does the immune system recognize on cancer cells? What kind of immune response is needed to control or cure cancer? How do we improve that immune response in cancer patients? Cellular and molecular players in anti-tumor immunity Mellman et al. (2011) Nature. 480: 480-489 Tumor infiltrating lymphocytes predict survival in colorectal cancer better than Duke’s staging Galon et al, Science 313 1960 (06) Why do induced specific immune responses fail to control tumors? • Minimal infiltration of immune cells • Immunosuppressive microenvironment with similarities to “wound healing” • Adaptation based on a “persistent pathogen” Acute inflammatory response Typical for pathogens Type II inflammatory response Typical for wound healing Cancer Immunotherapies Old and New Anti-cancer antibodies Therapeutic vaccines Adoptive T cell therapy Checkpoint blockade inhibitors Cancer vaccines Therapeutic, not prophylactic – treating people who already have a disease Stimulate an already developed but suboptimal or moribund response Stimulate a new response not already induced by the tumor What does the immune system recognize on tumor cells? Patient-specific neoantigens Tissue-specific, cancer-testis antigens Phosphopeptides Phosphopeptides: a better class of tumor antigen Cancer Cell Normal Cell Overactive Kinase Kinase Proteasome Inhibited Phosphatase Proteasome Reverse Immunology Approach: Identify MHC-associated peptides modified by intracellular phosphorylation using mass spectrometry Qualify peptides as recognizable by T lymphocytes Making Better Vaccines by Targeting the Dendritic Cell Combining immunotherapies with one another and with other approaches Adoptive cell therapy Chemotherapy (and radiation) can induce “Immunogenic Cell Death” that primes the immune response The big picture Cancer immunotherapy approaches are based on discoveries by scientists who were not necessarily interested in either cancer or immunology Immunotherapies are only effective for certain kinds of cancer, and then only in a subset of patients – why? Understanding how to regulate the immune response to cancer also creates opportunities to regulate other kinds of immune responses – pathogens, autoimmunity, and allergy Immunology Centers and Programs at UVA Department of Microbiology, Immunology, and Cancer Biology Carter Immunology Center Center for Immunology, Inflammation and Regenerative Medicine Immunology and Immunotherapy Program of the UVA Cancer Center Activities and funds to support research Increased breadth of immunologically-related activities Networking and collaboration Collaboration and Connection Other UVA Centers of Excellence Infectious Disease and Biodefense Host-pathogen interactions Vaccines and immunotherapeutics Cancer Biology Immune regulation in the tumor microenvironment Vaccines and immunotherapeutics Inflammation and Vascular Biology Inflammation (danger) is as important as foreignness Blood vessels are the immunological highway Cardiovascular disease is caused by the immune system Models in Immunology Research Basic to Clinical Cell culture - inside and out Mice – manipulated and otherwise People – source and subject Technology – flow cytometry, mass spectrometry, imaging, genomics, etc Summer Research Internship Program http://www.medicine.virginia.edu/education/phd/g po/srip/home-page Biomedical Sciences Training Program http://bims.virginia.edu Immunology Training Program http://research.med.virginia.edu/itp/ Immunology Training Program http://research.med.virginia.edu/itp/ 31 mentors NIH sponsored training grant Stipend/tuition for 2nd, 3rd year students Specialized coursework in Immunology Research in Progress Series Immunology Seminar Program Student invited speakers Anderson and Carter Lectureships Immunology Training Program http://research.med.virginia.edu/itp/ Year 1 BIMS or MSTP coursework and lab rotations Choose mentor Two Fundamental Immunology modules in spring Year 2 Two Advanced Topic Modules in Fall Writing course in Fall Qualifying Exam in Spring Year 3 1 Advanced Topic Module All years Research-In-Progress Student run summer journal club RESEARCH The graduate experience Goal: To prepare you to be among the next generation of biomedical researchers Bench Research: How to formulate a hypothesis you can test How to design, conduct, interpret a well-controlled experiment How to do it again – developing a line of investigation Oral Presentations Journal clubs, Research presentations, lab meetings Organizing your thoughts, anticipating questions, thinking on your feet, teaching Writing Papers, grant applications, thesis Why Immunology at UVA? Outstanding science First class technical facilities Opportunities from basic to clinical Strong support for graduate student development Collaborative and collegial environment Success in future career – academia, biotech, big pharma, and others Making Better Vaccines – Targeting the Dendritic Cell Patient cancer specific mutations – tumor neoantigens – as the basis for personalized immunotherapy Checkpoint blockade inhibitors release the brakes on immune responses T cell targets for immunoregulatory antibody therapy I Mellman et al. Nature 480, 480-489 (2011) doi:10.1038/nature10673 Adoptive T-cell transfer immunotherapy Treatment of B-cell leukemia using CAR-T cells Klebanoff, C. A. et al. (2014) Nat. Rev. Clin. Oncol. doi:10.1038/nrclinonc.2014.190 Chemotherapy and Radiation Work by Augmenting the Immune Response Where do we go from here? The majority of patients with melanoma, lung cancer, and renal cancer do not respond to checkpoint blockade inhibitors Responses are correlated with mutation load and presence of T cells in the tumor before treatment Responses in patients with prostate, breast, colorectal, and pancreatic cancers are very low The microenvironments of these tumors may activate distinct immunosuppressive pathways Where do we go from here? CAR-T and TIL therapies are effective in the majority of B-cell leukemia and melanoma patients Expansion of these approaches is limited by: Identification of appropriate antigens Understanding how to improve T cell entry into tumors The Immune System Lymphocytes Myeloid cells – dendritic cells, macrophages, etc - How are these cells generated? How do cells get activated? How is the expression of different functions controlled? How do cells ? Lymphoid Organs Antibodies, receptors, cytokines, and chemokines