Oncology Central

Changing the philosophy of stem cell transplantation for cancer cure not treatment

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Cancer immunotherapy is currently at the forefront of emerging therapies for the effective treatment of multiple types of malignancy. Many immunotherapy agents such as checkpoint inhibitors (nivolumab, ipilimumab etc.) have been demonstrated to promote reductions in both tumor burden and disease recurrence, and many results from the recent ASCO meeting continue to support the notion that cancer immunotherapy has ‘come of age’.

We recently talked to Professor Shimon Slavin from the International Center for Cell Therapy & Cancer Immunotherapy (Tel Aviv, Israel) about the other side of cancer immunotherapy, discussing his innovative work in stem cell transplantation and donor lymphocyte infusion, with the ultimate aim of curing cancer patients.

What first sparked your interest in cell therapies?

For many years I was interested in the topic of stem cells because they can be a source of different subsets of cells. By using stem cells you can therefore treat and even cure a very large number of malignant and nonmalignant diseases that are otherwise incurable.

Can you tell us a little about your career and what led you to where you are today?

First of all I started to work with hematopoietic stem cells, investigating their use in curing otherwise lethal diseases through stem cell transplantation. These include diseases caused by deficiency of bone marrow products like aplastic anemia, ‘bubble babies’ who are born without an immune system, genetic diseases, autoimmune diseases and the largest use in cancer – predominantly in hematologic malignancies but also occasionally in solid tumors such as neuroblastoma in children, and breast cancer and renal cell cancer in adults. All you have to do is prevent rejection of the bone marrow cells, and if you can do that successfully then the patient will incorporate the stem cells of the donor and will start producing normal cells.

In cancer cases there are two possibilities for cure. One is to give patients very high doses of chemotherapy and radiation therapy in an attempt to kill all the malignant cells, which you cannot do with conventional doses of either, and then rescue the patient with stem cells. If the treatment was good enough to kill all the cancer the patient may be cured. However, this is not an intelligent way to cure cancer, because in order to do that you have to use lethal doses of chemotherapy or radiation. This of course is a very risky procedure and it cannot be applied to elderly or very sick patients. When applied for treatment of children, sterility, bone growth impairment and multiple endocrinopathies are unavoidable. Even then, recurrent disease continues to be the single cause of failure, while in parallel procedure-related toxicity and mortality is also unescapable. That is the way things used to be before we changed the whole philosophy of stem cell transplantation.

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