However, Miller and Kaumaya acknowledge that it’s asking a lot of vaccines, which typically prevent disease, to halt aggressive cancer. Their longer-term goal is creating vaccines that are given when cancer is found early and focusing on checkpoint inhibitors, proteins used by cancer to cloak itself from immune cells. Kaumaya is already putting those peptides through rigorous lab testing, while Miller plans to draft a protocol for clinical testing.
“We’re also talking about microscopic disease,” Miller said. “The immune system still has a fighting chance to help eliminate it.”
Kaumaya’s ambition doesn’t stop there. He aspires to make a “vaccine platform” that would act like a socket wrench to different types of cancer. Chemists like him could swap out peptides to create different combinations, substantially speeding up the time it takes to fashion new therapies.
That potential for efficiency, adaptability and scalability appeals deeply to Salman. “What I love about this work is the platforms,” she said. “That’s what I want the Brown Center to be.”
Salman’s search for talent didn’t stop at Kaumaya. Leng Han, PhD, the David Brown Professor of Genomic Medicine, uses computational biology to parse terabytes of data in search of biomarkers, targets and therapeutic approaches. Lionel Apetoh, PhD, the Christopher Brown Professor of Immunology, brings expertise that can help improve the function of CAR T cells. And Yaoqi Alan Wang, PhD, explores why cancer might prove resistant to some forms of immunotherapy.
They covet targets that span multiple cancers and, as Kaumaya’s work shows, devise treatments that are “adaptable,” Salman said. That’s a marked shift from traditional classifications of cancer based on tissue type or the organ where it originates. “It doesn’t matter if the tumor is called solid or liquid,” Salman noted. “We can use the same strategy to treat both.”
Researchers are also investigating how natural killer cells, which destroy diseased and infected cells, may help thwart lung cancer. There’s potential for CAR T cells to be valuable tools in the treatment of colorectal cancer and glioblastoma.
Salman and Apetoh, for example, are exploring the potential of a protein expressed in acute myeloid leukemia and pancreatic cancer. They’ve even designed a vector, which helps CAR-T cells zero in on cancer cells and begun testing its performance in animal models. Eventually, the data they amass could be the backbone of an application to the FDA for a clinical trial.
“Chances are high it’s going to work,” Salman said.
KAUMAYA AND MILLER’S collaboration is a fleeting example.
Salman’s staffing assessment is blunt. The Brown Center is stocked with basic scientists, but IU faces a shortage of faculty skilled at smoothly managing clinical trials. That has the potential to create a bottleneck at the end of the Brown Center’s pipeline. The need is particularly acute in lung, pancreatic and colon cancers.
Spinning up more trials would maximize the infrastructure investment made by IU to build a cell and gene manufacturing facility. It made the first CAR T-cell therapy for a patient in October 2023, but the current tally is just 15 patients. Three years ago, Emily Hopewell, PhD, who oversees the facility, estimated that her staff could annually treat 70 patients.
“We’re not anywhere near that capacity,” she said this summer.
For her part, Salman has tried to fill the void, launching a trio of clinical trials with Rita Assi, MD, whom she recruited from Stony Brook University, for CAR T-cell therapies in rare forms of blood cancer. Yet those diseases feature small pools of patients — one of the cancers has just 1,000 new cases annually — who have also endured multiple rounds of treatments. Because their immune systems are already battered, a potential enrollee might not be eligible after a rigorous screening procedure featuring blood tests, imaging and other clinical procedures. Given that the trials are vetting safety, only one new patient can be treated each month.
