Tag: immunotherapy

Major gift accelerates transformation of old mall into UCLA research hub

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The reincarnation of a shuttered Los Angeles retail mecca as a sprawling UCLA research center has received a major boost from billionaire philanthropist Dr. Gary Michelson and his wife, Alya, who will give $120 million to ramp up the project.

Michelson, a spine surgeon and inventor, said the money will help launch the California Institute for Immunology and Immunotherapy, which aims to create breakthrough discoveries that prevent and cure diseases including cancer, heart disease and Alzheimer’s.

The institute will be a tenant in UCLA Research Park, which is under construction in the former Westside Pavilion. The indoor mall two miles south of the university at Pico and Westwood boulevards was a 1980s icon popular with shoppers and filmmakers before falling out of favor. Most of its stores closed by 2019.

The shopping center was being converted to offices when the UC Regents bought it for $700 million in January to create the research park. Along with the California Institute for Immunology and Immunotherapy, it will house the UCLA Center for Quantum Science and Engineering, as well as other science and medicine programs.

By purchasing the former shopping center, UCLA saved years of toil to build such a facility on its campus, which is the smallest of the nine UC undergraduate campuses and has very little room for growth.

A courtyard view of the UCLA research center now under construction in the former Westside Pavilion shopping center.

(Brian van der Brug / Los Angeles Times)

“That building would have gone on the last available piece of property on the UCLA campus,” Michelson said, “and it would have been extraordinarily expensive to build there. As a real estate matter, this was just an extraordinary opportunity.”

The immunology institute had been planned for years, while a full-scale research park was something “we’ve always dreamed of having … but we always recognized we could never find a piece of property that big close to campus. We had sort of given up on the idea many years ago — and it came alive,” said former UCLA Chancellor Gene Block, who was instrumental in the purchase of the former Westside Pavilion.

An earlier plan to build the institute on the campus called for tearing down a parking garage, digging a hole deep enough to replace the parking and erecting a new building on top, Block said.

The gift, through the Michelson Medical Research Foundation, designates $100 million to establish two research entities within the institute, each funded with $50 million; one will focus on rapid vaccine development and the other on harnessing the body’s microbiome to advance human health. The microbiome research will be conducted in collaboration with the new UCLA Goodman-Luskin Microbiome Center, placing it among the largest microbiome research enterprises in the world, the foundation said.

The foundation is also funding a $20-million endowment to provide research grants to young scientists using novel processes to advance immunotherapy research, human immunology and vaccine discovery.

The institute will have labs of different sizes meant to serve biotech researchers who can start with small teams that can grow into larger labs if they find success.

“We’re going to create an entire ecosystem of biotech startups and they’re going to stay right here” and attract other players to the neighborhood, Michelson said. “We’re going to build out an entire ecosystem of biotech all through Westwood.”

He envisions 5,000 people, including 500 research scientists, working in the institute. Gov. Gavin Newsom estimated in January that it would take more than three years to fully transform the 700,000-square-foot complex, but Michelson hopes to have a large portion of the immunology institute operating in half that time, he said. At 360,000 square feet, the institute will be the research park’s primary tenant.

The former mall’s 12-screen multiplex movie theater may be converted into lecture halls or performance spaces offering programming across the arts, humanities, sciences and social sciences, the chancellor’s office said.

An interior view of the UCLA research center now under construction in the former Westside Pavilion shopping center.

(Brian van der Brug / Los Angeles Times)

The gift is the Michelsons’ largest single donation in 30 years of philanthropy that includes $50 million to build Michelson Hall at the University of Southern California, which is home to the Michelson Center for Convergent Bioscience. The Michelson name will not be attached to the new UCLA complex, he said, because other philanthropists — perhaps one who donates more than he did — may want the recognition.

“The gift will change countless lives here and across the globe,” UCLA interim Chancellor Darnell Hunt said.

The institute will operate as a nonprofit medical research organization funded by a public-private partnership and governed by an independent board that includes UCLA representatives, according to a UC Regents document. The institute will pay UCLA 7.5% of the net revenues generated by the sale of new medicines and other inventions its scientists create, the document said.

Los Angeles Mayor Karen Bass said the project “has the potential to fundamentally change health outcomes around the world and create good jobs in Los Angeles.”

The purchase of the former Westside Pavilion marked the third major acquisition for the public university system in Los Angeles in less than two years.

Seeking to expand its footprint, UCLA announced in June 2023 that it had acquired the Art Deco-style Trust Building in downtown Los Angeles and renamed it UCLA Downtown.

Nine months prior, the school spent $80 million to buy two other major properties owned by Marymount California University, a small Catholic university that was shuttered last year. The purchase included Marymount’s 24.5-acre campus in Rancho Palos Verdes and an 11-acre residential site in nearby San Pedro.

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August 27, 2024
Alzheimer’s disease “game changer” as progression slowed with immunotherapy

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Hope is on the horizon for millions of Alzheimer’s disease patients as scientists develop a new target for Alzheimer’s treatment: the immune system.

Alzheimer’s affects roughly 5.8 million Americans, according to the Centers for Disease Control and Prevention (CDC). The progressive disease is the most common form of dementia and is associated with memory loss and cognitive decline in regions of the brain involved in thought, memory and language.

Scientists believe that Alzheimer’s is caused by the abnormal buildup of proteins in and around the brain cells, but exactly what triggers this is still unclear.

Today, there is no known cure for Alzheimer’s. However, new medications may offer relief to patients and slow the disease’s progression. And our body’s immune system can help with this.

“There are many approaches that are in various stages of development that target the immune system, which is now known to play a key role in Alzheimer’s disease,” Todd Golde, a professor of pharmacology, chemical biology and neurology at Emory University, told Newsweek.

One particularly exciting approach involves the use of antibodies that can target and bind to the abnormal protein clumps that form in the brain. “This results in clearance or reduction of [the protein clumps],” Golde said.

Golde and colleague Allan Levey have summarized this approach in a recently published perspective in the journal Science.

Precisely what mediates this interaction is still unknown, but Golde said that the brain’s private squad of immune cells may play an important role. These cells, called microglia, are found exclusively in the brain and central nervous system and can engulf problematic proteins and infectious particles like bacteria. Therefore, researchers believe that the antibodies may act as little molecular flags to signal to the microglial cells that a mess needs cleaning up—a mess in the form of an Alzheimer ‘s-associated protein clump.

Based on clinical trials, these antibodies offer a very promising avenue for future treatments.

“These treatments slow decline in the very earliest symptomatic stages of Alzheimer’s disease on average by about 25 to 30 percent over 18 months of treatment,” Golde said. “Notably, the antibodies show quite remarkable impacts on amyloid deposits [aka the protein clumps] themselves.”

Unlike previous therapies designed to ease symptoms and boost cognitive function, Golde said that these antibodies represent the first therapies capable of altering the course of the disease.

“Having a disease-modifying therapy (like this) is in some ways a game changer for Alzheimer’s disease, as it says that we can alter the course of this devastating disease and slow it down,” Golde said. “This is just a start, and that either improved versions of these therapies, other types of disease-modifying therapies, or combination therapies will likely in the future lead to treatments with bigger impacts, halting or preventing disease.”

Artist’s impression of a nerve cell surrounded by antibodies. Antibody treatments may be the future of Alzheimer’s therapy.
peterschreiber.media/Getty

Two of the antibodies used in these trials have already been FDA approved; the third is expected to be approved in 2024. However, care still needs to be taken over their use.

“Because of potential for side effects, the need to treat patients early in the symptomatic phase of the disease in individuals [and] the fact that they are currently given through multiple IV infusions and require careful monitoring, there are some barriers to widespread use [of these antibodies],” Golde said. “Indeed, there is appropriate caution among most clinicians to ensure that the right patients most likely to benefit from these therapies are treated.”

Golde stresses that, while these results are fascinating, we are still a long way from effectively treating Alzheimer’s.

“Though this represents an initial success, huge unmet medical need remains,” he said. “We need continuing investment in the public and private sectors to ensure that we can meet that need and build off this initial, but limited, success.”

Is there a health issue that’s worrying you? Do you have a question about Alzheimer’s? Let us know via health@newsweek.com. We can ask experts for advice, and your story could be featured on Newsweek.

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Newsweek is committed to challenging conventional wisdom and finding connections in the search for common ground.

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December 14, 2023
NSCLC: Advances in Treatment

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Doctors once thought non-small-cell lung cancer (NSCLC) was one disease. Most people got the same treatment — chemotherapy (chemo) — especially if their cancer had spread to other parts of the body.

Now, doctors know there are many different types of NSCLC, with “more coming down the pike,” says Nathan Pennell, MD, a medical oncologist specializing in thoracic cancer at the Cleveland Clinic’s Taussig Cancer Institute.

That means treatment plans are no longer once-size-fits-all. Instead, treatments like targeted therapies and immunotherapy are tailored to each person’s tumor.

Targeted Therapies

Some cancer cells have gene changes (also called mutations) that help them grow and spread. The goal of several targeted therapies is to block those changes. The FDA has approved medicines to treat eleven different gene mutations that can drive NSCLC:

EGFR

ALK

BRAF

ROS1

RET

MET

KRAS

PIK3CA

HER2

NTRK

MEK1

One drug targets the growth of tumors on blood vessels:

Epidermal growth factor receptor — or EGFR — is the most common. It’s a protein on the surface of cells that helps them grow and divide. If you have too much EGFR, your cells grow faster than normal. Medicines called EGFR inhibitors stop this growth.

Karen Reckamp, MD, co-directs the lung cancer and thoracic oncology program at City of Hope in Duarte, CA. She says targeted therapy has completely changed the way doctors manage lung cancer. Now, before you start treatment for advanced NSCLC, you’re likely to have genetic testing to see if you have a mutation that might help guide your treatment.

Reckamp says this new way of doing things has changed the game for many people with advanced NSCLC.

“We don’t talk about a cure,” Reckamp says. “But the tumor shrinks, people feel better, go back to work, and have a better quality of life.”

Targeted therapies also have drawbacks. Some only work for the small number of people who have gene mutations that respond to a certain targeted therapy. About 15% of people with lung cancer have EGFR-positive lung cancer. The numbers are much smaller for other gene changes.

The medicines also have side effects, like:

Skin rash

Diarrhea

Liver damage

Bone marrow problems

Reckamp says these usually aren’t as severe as side effects from chemotherapy.

“For most people, the side effects are pretty tolerable, and they do pretty well.”

Another problem is that targeted medicines often stop working, eventually.

“Cancer cells find ways to survive and overcome the toxic treatments we’re giving them,” Reckamp says. “When that happens, you have to try a different treatment.”

Still, she says targeted therapies have greatly improved the odds for people with NSCLC.

“With chemotherapy alone, [extending life] by 1 year was as good as we could get. Now, with these therapies in addition to chemo, it’s not uncommon for patients to live 2, or even 5 years.”

Immunotherapy

Your immune system normally destroys cancer cells. But tumor cells are sneaky and can find ways to evade your body’s best defenses. If you have NSCLC, some cancer cells may churn out a protein called PD-L1. It attaches to another protein, PD-1, on important immune T cells. This is called an immune checkpoint, and it tells your T cells to leave the tumor alone.

One way to get around this is with medicines called checkpoint inhibitors. They prevent PD-L1 and PD-1 from getting together. This unleashes your immune system, so it’ll be at full power against cancer cells. But healthy cells get caught in the crossfire.

“Immunotherapy can cause inflammation anywhere in your body from head to toe,” Reckamp says. “When your immune system never turns off, you can get something resembling an autoimmune disease like rheumatoid arthritis. Or you can have problems with your thyroid, liver, bladder, kidneys, and heart.

“And this can happen anytime — even after you’ve stopped treatment. But most symptoms can be well-controlled with high-dose steroids.”

Your doctor won’t suggest immunotherapy unless your tumor tests positive for high levels of PD-L1. The test isn’t always correct, though, and some tumors that test positive for PD-L1 may not respond to immunotherapy.

Still, Reckamp says immunotherapy is a better choice than chemo for most people who have it, despite the severe side effects and hefty price tag. It may even keep working after you stop taking it.

In the Pipeline

Reckamp says to look for improvements in targeted medicines and smarter drugs that can outwit and outlast cancer cells.

“There are lots of clinical trials focused on overcoming resistance to targeted medicines and immunotherapy, and combining these with chemotherapy to improve not just the length of a [person’s] life, but also the quality,” she says.

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December 14, 2022
NSCLC: Advances in Treatment

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NSCLC: Advances in Treatment

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December 14, 2022
NSCLC: When You Need More Than One Treatment

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NSCLC: When You Need More Than One Treatment

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December 14, 2022
NSCLC: When You Need More Than One Treatment

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Standard chemotherapy (chemo) was once the only treatment for advanced non-small-cell lung cancer (NSCLC). Now, you’re likely to get chemo plus a targeted medicine or immunotherapy, says Karen Reckamp, MD, co-director of the lung cancer and thoracic oncology program at City of Hope in Duarte, CA.

She says most people need more than one therapy, and often, they get all three at some time during their treatment. Combined treatments may work better because they attack cancer in different ways. And while they aren’t likely to cure advanced NSCLC, they may help you live longer with fewer symptoms.

Targeted Therapies

These block gene changes that cause tumors to grow and spread. The meds are more precise in targeting tumors than chemo, so side effects may not be as tough to deal with.

The problem is they often work for a while and then stop. This may be because the gene changes again, so it’s no longer a good target. Or, cancer might find a way around the therapy. Either way, you’ll probably need to add another medicine — usually chemo or a different targeted drug.

Immunotherapy

This treatment works in a different way. It triggers your immune system to attack your cancer. If your tumor has a high level of the protein PD-L1, immunotherapy medicines called checkpoint inhibitors may be your best treatment. These often work better when combined with chemo.

You May Still Need Chemo

If you don’t have the PD-L1 protein or a gene target, immunotherapy plus chemo is likely to be your main treatment. Reckamp says that fact disappoints some people.

“But we’re not at the point where we can do without [chemo],” she says. “In an era where we have all these new therapies, chemo is still helpful and will be part of most people’s treatment.”

That’s because chemotherapy can mop up cancer cells that other treatments leave behind.

“Metastatic cancer has spread through the lymph and blood to other places in the body,” Reckamp says. “That’s billions of cells. There’s always some cancer left, no matter what the treatment.”

Dealing With Side Effects

Cancer medicines can have serious side effects. What happens when you get two at the same time, or one right after the other? It can be tough, Reckamp says, especially since therapies can cause so many different problems.

For example, platinum-based chemo — the kind used for advanced NSCLC — damages all your fast-growing cells, even the healthy ones. Common side effects are:

Nausea

Diarrhea

Hair loss

Anemia

Bleeding

Chemo also can cause liver and kidney damage. If your side effects are severe, you may need a lower dose, or to stop treatment completely. Reckamp says many people can predict how they’re going to feel on certain days and plan around it. And since chemo is given in cycles, you have a chance to rest during the breaks.

You may not get a break from certain targeted medicine, though. Many targeted medicines are taken every day. That makes you more likely to have constant, but manageable symptoms, like rashes and diarrhea.

“You might have one really bad day of diarrhea with chemo and mild diarrhea every day with a targeted therapy,” Reckamp says.

Targeted medicines usually won’t make you as tired as chemo. Other side effects are usually easier on your body, too, but they still need to be dealt with.

“All these drugs are attacking cancer, so there is a level of not feeling like yourself,” Reckamp says. “Most people get used to that feeling. When they stop treatment, they remember what they’re supposed to feel like.”

What about side effects from immunotherapy, which can be pretty unpredictable?

“That’s anyone’s guess,” Reckamp says. “It can cause inflammation anywhere in your body at any time, even after you stop treatment. You can get inflammation in the brain, colon, thyroid gland, liver, bladder, kidneys, or heart.

“We can predict when you’ll feel bad with chemotherapy, but with immunotherapy, we can’t.”

She says people who get both immunotherapy and chemo need to be on high alert. The number of possible side effects is high, and some can come without warning.

“If you’re not feeling like yourself, call your doctor, and they can help guide you what to do next,” she advises. “Also, [very serious] problems like colitis and pneumonitis [lung inflammation] can happen quickly and suddenly. We need to hear about that right away.”

Scott Gettinger, MD, an expert in immunotherapy and targeted therapy at Yale Cancer Center in New Haven, CT, also warns about pneumonitis. It’s inflammation of lung tissue that can cause cough and shortness of breath. For people with NSCLC, it can be deadly.

“When you suspect pneumonitis, you need to start steroids right away,” he says.

High-dose steroids can bring down life-threatening inflammation. Lower doses may help treat less serious symptoms.

Despite the intense side effects, Reckamp says most people do pretty well with combined treatments.

“You can work, travel, and live a fairly normal life, but you need to adjust for days when you don’t feel well,” she explains. “Hospitals and treatment centers have social workers and many other resources to help you get back into life.”

But, Reckamp says, you’ll also need help you can’t get from a hospital.

“You also need strong social support from your family,” she says. “And it can be helpful to join a group of like-minded people or talk to a therapist or counselor.

“Patients are living longer, so it’s important to help them figure out how to frame what they want for their lives and how to do what they want to do.”

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December 14, 2022
Treating Inoperable Lung Cancer: A Nurse’s Perspective

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By Alison Massey, as told to Susan Bernstein

There is a perception that chemotherapy is like treatments from 20 or 30 years ago. They think it will have side effects that are not tolerable, but we have made significant advances in managing the toxicities that come with these cancer medications. People think chemo will make them sick, but that’s not the case. Each individual treatment regimen has its own side effect profile. If you look at the list of possible side effects, people can be overwhelmed. Most people will experience a side effect, but no one gets every possible side effect.

Generally, people will be a little tired or have a dip in energy level for a few days. But between your treatments, we hope that you’ll be able to live your normal life. We have many people who continue to work between their treatments.

Nausea is another common side effect, but we’ve made advances in how to manage nausea you may experience around your treatments as well. We can offer patients a range of anti-nausea medications. Some treatments do cause hair loss, and if that’s the case, we let you know that up front. It’s important to note that the vast majority do not cause hair loss, although some may cause hair thinning. We definitely have ways to help you manage these issues, including offering a prescription for wigs or other resources. With hair thinning, we can also check certain labs or get our dermatology colleagues involved to help you.

Fatigue is the main thing you may experience with radiation. Radiation can cause inflammation in your body as it kills the cancer. It’s the inflammation that causes the side effects. Depending on what is being radiated, you may have pain. For example, if you are receiving lung radiation, your esophagus can be involved because the radiation may be close to that area of your body. If so, you may have pain with swallowing or difficulty swallowing. You may even feel like food gets stuck after you swallow it. People who are having radiation may not realize that it could affect swallowing food.

Sometimes people will need radiation to a painful lesion. While receiving radiation at a particular spot for people with advanced lung cancer, you may have a flare-up of that pain. Ultimately, the hope is that pain will disappear. During this time, we can also treat you with pain medications or steroids like dexamethasone to minimize the inflammation that causes pain.

Checkpoint inhibitors [immunotherapy medications for lung cancer] can have side effects, but they are different than chemo because they act on your immune system. These medications can overactivate your immune system, which leads to the side effects. Sometimes, we see patients develop dermatitis, which appears as a rash, or experience colitis that causes diarrhea, or pneumonitis of your lungs, which may cause shortness of breath or a cough. Checkpoint inhibitors may also cause arthritis or myositis, which is inflammation of your muscles. Sometimes, we can even see swelling of your joints. It’s important that if patients notice any new symptoms while taking a checkpoint inhibitor, they let us know about it so we can initiate treatment. The quicker you tell us about these side effects, the sooner we can treat and reverse them.

Anxiety and depression are two things we deal with very often during cancer treatment. In my experience, people may feel lost when they are first diagnosed. But once you have found your oncologist and your whole cancer support team, and you know you have a plan of attack to treat your cancer, most people feel better. Many have a fear of cancer treatments and the potential impact of treatment on your quality of life. We let people know that they can still live their life and they should continue to do the things that they enjoy.

Your mood and outlook may depend on where you are in your cancer treatment course or disease progression. Early on, most people are more functional and have less fatigue. Some people may still be able to work. Others may need to hang out at home for a few days after each treatment. Our goal is that you don’t stay in bed the whole time you’re being treated for cancer. Keep an active schedule as much as you can. Realize that you will be tired after your treatment and plan for those days. And don’t forget to ask for help if you need it!

Sleeping well can also affect your mood and quality of life. A lot of our patients have insomnia. Often anxiety may be causing that insomnia. Your mind is racing, so you can’t sleep. Also, some of the meds you take for nausea or steroids for inflammation can rev you up and cause insomnia. And sometimes an annoying cough can disrupt your sleep.

Some people with lung cancer may need to use supplemental oxygen. In my experience, people struggle with the idea of wearing oxygen because, like the association with hair loss, now people on the outside are able to see that they are sick. But from a medical perspective, it’s important to wear it if you need it.

Loss of sexual function is something we can see in both men and women. In my experience, men are more vocal about this, so speak up, ladies, if you have any concerns! Erectile dysfunction can affect men during cancer treatment. Women may experience vaginal dryness or pain during intercourse. If that happens and you let us know, we can refer you to a sexual health doctor. Treatments can also affect women’s menstrual cycles. If you’re someone who could get pregnant, you should be careful to use contraception while you’re being treated for cancer.

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November 22, 2022
Inoperable Lung Cancer: Innovations That Are Changing the Outlook

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By David Tom Cooke, MD, as told to Susan Bernstein

The term is “inoperable lung cancer.” It means that the risk of surgery to remove the lung cancer exceeds the benefits of the surgery for a patient. However, it is hard to tell if someone is “inoperable.”

Age is one factor that can slightly increase your risk, but it’s not necessarily prohibitive. I’ve operated on 90-year-olds. Other health problems you have can be a factor, such as impaired lung function. If we remove a lung tumor in a person who already has minimal lung function due to severe COPD or emphysema, that can make surgery risky, for example. There is a growing population of people who fit that description. To be determined that your lung cancer is “inoperable,” you really need to be seen by a thoracic surgeon.

The gold standard for treatment of early-stage, inoperable lung cancer is something we call SBRT, or stereotactic body radiation therapy. It’s high-dose, focused radiation. SBRT is used to try to destroy the tumor. It’s very targeted, and we use special imaging to be very precise with this treatment, typically CT scans. It’s different from traditional, high-dose radiation therapy to shrink or kill tumors. SBRT has potential to cure lung cancer, but it’s not known if it has the same cure rate for patients as surgery. We usually perform one or two SBRT treatments, and then you have routine follow-up for 5 years.

There are some newer experiments going on in this area. It’s thought that radiation can cause the release of antigens, small proteins that activate your immune system. There are studies to see if the combination of SBRT with immunotherapy drugs called checkpoint inhibitors can increase the likelihood of killing and eliminating lung tumors. Checkpoint inhibitors activate one’s own immune system — to remove the “checkpoints” that slow down the immune system — to fight cancer.

Researchers are studying not only the effects of this combination therapy, but how long patients would have to take these drugs. Right now, there have been phase I studies to look at the safety of this SBRT/checkpoint inhibitor combination, as well as clinical trials underway to look at the results of the combination therapy.

Another treatment used in early stages is the use of [local scopes to treat the tumor], such as navigational bronchoscopy. For this treatment, we take a camera attached to the end of a catheter and insert it into the patient’s trachea, or windpipe. Then, either using high-tech guidance tools or combined with a CT scan, we aim the catheter toward the tumor. This is also being done with robotic technology combined with a CT scan to guide the catheter to the tumor, followed by microwaves to kill the tumor, or to locally inject chemotherapy directly into the tumor. There are animal studies being done now to test this type of technique.

There have been recent advances in surgery, so people whose lung cancer was once considered inoperable may become operable. One key factor here is robotic surgery. We can make smaller incisions for less stress on the body. Robotic surgery also allows us to take less lung tissue out to remove your tumor.

There are other new technologies on the horizon for lung cancer treatment. One may be a combination of robotic surgical technology with 3D imaging and heads-up displays in the operating room to carefully guide the surgery. I always use this comparison: If your child is going to the prom, do you want them going in a 1992 Ford Taurus or a 2022 Toyota Camry with all the latest safety innovations, such as blind spot assist, airbags on all sides, and a backup camera? We can use these technologies to greatly increase safety during surgery.

There is another point that is important for the big picture of lung cancer treatment. According to the American Lung Association’s 2021 “State of Lung Cancer” report, over 20% of patients diagnosed with lung cancer did not receive any treatment whatsoever. In addition, Black patients with lung cancer are 23% less likely to receive surgical treatment and 9% less likely to receive any treatment compared with white patients.

Before you have any treatment for lung cancer, it is best to discuss it with a team of doctors, including a thoracic surgeon, because we have so many different options to fight your disease.

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November 22, 2022

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