The European Society for Medical Oncology (ESMO) has selected Thomas Gajewski, MD, PhD, to receive the 2019 ESMO Award for Immuno-Oncology. The award is given in recognition of his groundbreaking work elucidating why some patients are resistant to immunotherapy and how to restore the anticancer immune response. The award will be presented during this year’s ESMO Immuno-Oncology Congress in Geneva on December 11–14, 2019.
Thomas Gajewski, MD, PhD
Dr. Gajewski is AbbVie Foundation Professor of Cancer Immunotherapy in the Ben May Department for Cancer Research and Professor of Pathology and Medicine at the University of Chicago, where he has worked for more than 2 decades furthering our understanding of fundamental aspects of antitumor immunity and translating this into new treatment strategies.
Although immunotherapy represents a huge breakthrough for many patients with cancer, some patients do not respond to immunotherapy, and Dr. Gajewski focused on finding out why. To do this, he explored the tumor microenvironment to tease out how it influences tumor responses to the immune system.
Dr. Gajewski’s research group found that patients whose T cells recognize tumor cells have what they called a “hot” or “T-cell–inflamed” tumor microenvironment. These T cells are suppressed but can fight cancer cells if supported by immunotherapies. In contrast, other patients have “cold” tumors that lack T cells, making them unresponsive to immunotherapy. The next step was to find out how to give T cells access to these “cold” tumor cells.
The group identified a protein complex called STING (stimulator of interferon genes) that reacts to DNA that is damaged or has drifted outside the cell nucleus and recruits T cells into the area. The discovery led to the development of STING agonists that proved effective in laboratory models of cancer, and clinical trials of STING agonists are underway. Dr. Gajweski and co-researchers also found that “cold” tumor cells cloak themselves from T cells by expressing active beta-catenin, which prevents the entry of dendritic cells. The group is now using this understanding to develop new therapeutic approaches.
A further major breakthrough was the finding that the presence of certain types of “good” bacteria in the gut flora may improve response to immunotherapy. The presence of these bacteria appeared to increase T-cell infiltration into the tumor environment, switching the tumor cells from “cold” to “hot” and boosting the response to immunotherapy in patients being treated for advanced melanoma. ■