Clear up tumors by giving the patient’s own immune system a boost? John Haanen remembers it well when almost no one believed in immunotherapy twenty years ago. “As soon as I started speaking about it at the major American and European conferences, the halls emptied. Only a number of diehards thought that you could actually clear cancer with the immune system.”
Nowadays, most hospitals offer immunotherapy to treat metastatic cancer, and immuno-oncology regularly achieves new breakthroughs. On November 21, Haanen will receive the Bob Pinedo Cancer Care Award for his contribution to these innovations.
CV Immuno-oncologist
John Haanen (1959, Sittard) is professor at the LUMC in Leiden and head of the melanoma clinic at the Center Hospitalier Universitaire Vaudois in Lausanne. Since 1997, he has been working at the AVL/NKI on how the immune system can be used against cancer. This year he received the ESMO Lifetime Achievement Award and the Bob Pinedo Cancer Care Award for his work, in particular for his research into TIL therapy for metastatic skin cancer.
The KNAW, which awards the prize every two years, calls Haanen a pioneer, especially because of his commitment to the so-called TIL therapy. As professor of translational immunology at the LUMC and research leader at the Antoni van Leeuwenhoek/Netherlands Cancer Institute (AVL/NKI), he has been working for more than fifteen years on this new form of treatment, in which the body’s own immune cells are grown to clear up metastatic tumors.
TIL is the first cell therapy that can cure patients of solid tumors and has been reimbursed since last year for treatment against metastatic skin cancer. Haanen led a large clinical study and will soon submit the results to the EMA for possible approval of the drug. No academic institution has yet achieved this without private investors. “This would demonstrate that our product is effective and make it available to other European hospitals. Moreover, we could do this a lot cheaper than the commercial parties.”
The study found that almost half of patients respond to TIL therapy. “That is more than double compared to regular treatment for skin cancer. These are patients for whom chemotherapy and other forms of immunotherapy no longer work, so that is a good result.”
Did you initially encounter resistance when researching immunotherapy?
“Yes, also here in the AVL/NKI. At the time, the focus was mainly on optimizing chemotherapy and some targeted treatments. As we became increasingly better at unraveling DNA, it also became clear which DNA errors are responsible for the behavior of malignant tumors. If you can find a ‘brake’ for these errors, you have the solution, most researchers thought. But cancer is adaptive and well able to evade these types of targeted treatments. As a result, our research into immunotherapy such as TIL was tolerated – even though few thought it would really work.”
After five to six weeks, the cultivation is complete and there are approximately 10 to 50 billion cells
And yet TIL therapy works. Can you explain that?
“TIL stands for tumor-infiltrating lymphocytes [lymfocyten zijn een groep witte bloedcellen]. Tumors are incredibly good at evading our immune system, for example by making the surrounding tissue hostile to immune cells. Some immune cells still manage to reach the tumor, but are then paralyzed by their environment. By taking these cells from the patient, reactivating them in the laboratory and growing them, we can give them back to the patient to clear up the tumors.
“We first look for a metastasis between two and four centimeters, which we remove surgically. In one clean room we cut this into pieces and soak cells in a solution, to which we then add growth factors. After five to six weeks, the culture is complete and there are approximately 10 to 50 billion cells that we grow together with additional growth factors. [eiwitten die de celgroei bevorderen] administered via an infusion.
“When you return so many cells, you cannot do this in a system that is already full of lymphocytes. By temporarily removing them with chemotherapy, space is created and growth factors remain available for the returned cells.”
I would like to continue with my work for a while. It’s varied and I think it’s fantastic
Does this therapy also work for other types of cancer?
“More indications have recently been found for TIL treatment. For example, a study is now underway in patients with lung cancer and a study has been conducted in cervical cancer. But due to the activating effect of the growth factors, the treatment has serious side effects and is not suitable for every patient. For example, most lung cancer patients have smoked a lot, which means they are not optimal cardiovascularly, and many other patients are old or have had intensive chemotherapy.
“When you grow lymphocytes, other immune cells also grow along with them. If we learn how to better select the right TIL and filter out other cells, we could create a purer product that may require less chemotherapy and growth factors. Hopefully we can treat more vulnerable groups of patients with TIL.”
So you don’t plan to stop yet?
“Well, I would like to continue with my work for a while. It’s varied and I think it’s fantastic. I treat sick patients and at the same time have a large research group with which we think about the future of these types of cellular treatments.
“I also really enjoy ensuring that the research and the knowledge I have acquired does not disappear when I leave. So I also train doctors and researchers who can take over my work. Of course you build up a fantastic network with colleagues and companies with whom you study together, but ultimately you have to transfer that. For example, how do you ensure that a company wants to work with us?”
When you receive such an award, you naturally think back to what led to receiving such an award
Besides TIL therapy, which scientific contribution stands out to you?
“I have put a lot of effort into education. When immune checkpoint inhibitors emerged, managing their side effects was a challenge. Checkpoint molecules are inhibitory molecules on immune cells that ensure that the immune system does not go off the rails and cause an autoimmune reaction. By blocking this, immune cells become more active against cancer, but you often also cause a severe autoimmune reaction. Together with colleagues, we have written a practical guideline for how to deal with these side effects.” It is widely used worldwide.
How do you actually feel receiving these awards?
“When you receive such an award, you naturally think back to what led to receiving such an award. And that is not just a coincidence. It is a result of the effort you have put in and being very dedicated. Long before the first immunotherapy proved successful, I was strongly convinced that we can use the immune system against cancer. Ultimately, that turned out to be true during my period. Of course it plays a role that you go to the right places and work with the right people, but you also contribute a part of your life.”
What sacrifices have you made?
“Long days and working weeks of sixty to seventy hours are not unusual. There is therefore little time for many things. I love listening to music and going to the theater, but when you choose to devote your life to science, you have to make choices.”
Share Email the editor
Immunotherapy: A Comedy of Tumors and Triumphs
Well, isn’t it hilarious how only two decades ago, if you mentioned immunotherapy at a conference, you might as well have been talking about your new line of socks? “I can cure cancer with my immune system!” they’d say, and the halls would empty faster than a free buffet at a restaurant. John Haanen remembers those days fondly—when the concept was about as welcome as a bad joke at a wake.
Fast-forward to today, though, and you’ll find immunotherapy shaking hands with cancer treatments in hospitals worldwide. Now, people can’t stop talking about it! In fact, on November 21, Haanen will be handed the Bob Pinedo Cancer Care Award for his trailblazing contributions. Honestly, it’s like going from ‘who’s that?’ to ‘hey, can I get your autograph?!’ overnight!
Meet the Immuno-oncologist: John Haanen
John Haanen is not just any immuno-oncologist; he’s practically the *Rock Star* of TIL therapy—or “tumor-infiltrating lymphocytes” for those who like long names. I mean, wouldn’t it be great if you could just walk into a bar and say, “Hey, I work with TIL!” and have people nod in awe?
This year alone, he’s snagged the ESMO Lifetime Achievement Award while working like he’s training for the Olympics—all centered around teaching your own body to fight off cancer like it’s an ex from high school.
“After five to six weeks, the cultivation is complete and there are approximately 10 to 50 billion cells!”
Just to clarify, that’s not a party in a Petri dish; that’s science! Haanen’s breakthrough TIL therapy isn’t just some academic jargon. This is the first cell therapy that actually gives a chance to patients having trouble with pesky solid tumors. And it’s been all the rage since it became reimbursed last year! Apparently, giving cancer the boot just got a whole lot cheaper than your last date night.
Now, I can hear your thoughts, “But wait, doesn’t that mean misery-for-a-moment when treating patients?” Well, hold onto your stethoscopes because Haanen made it clear: almost half of the patients respond to TIL therapy. That’s double the success rate compared to regular treatments! It’s the kind of statistic that makes you feel like a proud parent watching their kid score a goal at their first soccer game—beautiful, majestic, like poetry in motion! Who knew a body could be so good at crowd control?
TIL Therapy Explained: The Lab’s Culinary Adventure
So, what is TIL therapy? Basically, we’re taking immune cells out for a bit of “self-care”—that’s right. They take a break, get pampered, and then return to work, bursting with enthusiasm, ready to kick some cancer butt! If only we could all sign up for that kind of self-care treatment, right?
The process begins with the removal of a lovely little metastasis at just the right size—2-4 centimeters, if you’re looking to impress. The researchers then engage in a bit of lab cookery, slicing with precision and tossing in some “growth factors,” which sounds like some sort of health supplement! Add five to six weeks of TLC, and voilà! You have 10 to 50 billion excited immune cells, all eager to ruin a tumor’s party!
“When you return so many cells, you cannot do this in a system that is already full of lymphocytes…”
Haanen likens this process to preparing a space for returning guests—an immunological housewarming party, if you will. It’s a balanced formula between reactiveness and growth factors—kind of like mixing cocktails. But let’s hope no one takes it too far; we don’t need our immune cells waking up the neighbors with all their partying!
Looking Ahead: Expanding Horizons in Cancer Treatment
Alongside his groundbreaking TIL therapy, Haanen has been involved in extending the applications to other types of cancer. He’s aiming for lung cancer and even cervical cancer. Whoa! Talk about expansion plans! But all this is not without its challenges, especially when you have to navigate your patients’ pre-existing health conditions. But, I must say, if Haanen can help grow immune cells for lung cancer patients adjusting to the aftereffects of smoking, I’d say he’s playing doctor at a whole new level!
“I treat sick patients and at the same time have a large research group with which we think about the future of these types of cellular treatments.”
The man is pulling double duty—treating cancer and training the next generation of doctors! Quite generous indeed! Some may even call him the “Stan Lee of Immunology,” creating a whole universe where doctors and researchers work together to battle through the villains of the medical realm.
A Poignant Reflection on Dedication
And awards? Well, they bring that warm fuzzy feeling, right? Haanen reflected saying, “When you receive such an award, you naturally think back to what led to receiving such an award.” It’s the kind of moment that makes you ask yourself, “Was it all this hard work? All those late nights?”
Indeed, this pioneering figure, much like a determined secret agent taking on bad guys, has sacrificed weeks filled with *sixty to seventy hours* of work, giving up less glamorous pastimes like listening to music and going to the theater. Now, I don’t know about you, but that’s a tough trade-off! However, with an award in hand, that hard work seems to pay off in dividends, making those sacrifices worthwhile.
Conclusion: The Future Looks Bright
Despite the hurdles, Haanen doesn’t plan to stop anytime soon. With a spark in his eye, he’s ready to make sure that the knowledge he’s garnered doesn’t fade into the fog of time but gets passed into new hands. It’s a delightful twist to think we’re not just left with “once upon a time” but rather “here’s how to continue the tale!”
So, next time you hear about immunotherapy, don’t just nod along—remember the journey of individuals like John Haanen, who fought against skepticism and emerged victorious. After all, a good pun is worth a thousand words, and a good immune system? Well, that’s priceless!
What impact is John Haanen’s research expected to have on the future of TIL therapy in oncology?
D advancing the science behind it! It’s a true testament to his dedication and passion for making a difference in the world of oncology.
To put it simply, John Haanen isn’t just playing around in the lab; he’s shaping the future of cancer treatments one breakthrough at a time. With aspirations to enhance TIL therapy for even more cancer types and empower the next generation of researchers, he stands poised to lead the charge in immunotherapy—a field that is rapidly evolving and