Q and A with Cell Therapy Expert Damian Green
Bringing the future of cell therapy to Sylvester Comprehensive Cancer Center, with 20 years of expertise as a stem cell transplant physician, oncologist and immunotherapy researcher.
A little more than a year into his tenure as chief of the Division of Transplantation and Cellular Therapy at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, Damian Green, M.D., is already getting his hands dirty building out the cellular therapy program.
As the Ron and Nedra Kalish Family Endowed Chair in Stem Cell Transplantation and assistant director of translational research at Sylvester, Dr. Green leads the charge in developing new approaches to cell therapies for blood and solid cancers. He is committed to growing the division and building the infrastructure to deliver new therapies to patients.
Dr. Green talks about his research and developing cellular therapy treatments at Sylvester in the following interview, which we’ve edited for length and clarity.
How did you become interested in cellular therapies?
As a high school research intern, I learned how difficult it was to get neurology treatments from the laboratory to patients. But when I started working with blood cancer patients, I realized the situation was unique. The stakes and the demand to do something are much higher.
That environment allows me to push science forward more quickly in a way that matches my drive to help people. I became interested in cellular therapies because they harness the remarkable power of the immune system. I have had the good fortune to see these treatments save the lives of individuals who otherwise had no hope, and my interest stems from wanting to make that happen more often.
How has your first year at Sylvester been going?
As chief of the Division of Transplantation and Cellular Therapy, I’ve spent my first year becoming very familiar with the many outstanding features of the institution.
We’re uniquely positioned here at Sylvester to be on the leading edge of clinical trials exploring new therapies. Beyond that, we have the capacity to bridge the clinic and laboratory in ways designed to make the treatments better.
Dr. Damian Green
Our clinicians, laboratory scientists and the people in my division running trials are a remarkable team. My focus is on bringing the laboratory and the clinic closer together to help turn research into real treatments. I have found people with energy and tenacity at Sylvester. I seek to leverage these strengths, push boundaries and use the most cutting-edge technologies to develop innovative cell therapies for patients in South Florida and beyond.
How does cellular therapy work?
Modern cell therapy harnesses the power of the immune system. This system has been refined in living organisms over hundreds of millions of years. It is remarkably sophisticated.
In the case of chimeric antigen receptor (CAR) T cells, or CAR T cells, we first find markers, which are ideally unique to the tumor cell, since we don’t want our therapy to attack normal cells. Then, we take a patient’s own T cells and modify them to see those markers as the enemy. When we infuse them, they expand in the patient’s body and target the tumor cells for destruction. There are other types of cellular therapy and we are actively exploring many avenues.
How are you working to improve cell therapies for blood cancers in your own research?
I’ve been developing new CAR T technologies for multiple myeloma, focused on increasing the number of tumor markers on a myeloma cell. In a recent paper in the journal Blood, we published the results of this novel approach. We were able to enhance the visibility of cancer cells to the immune system, which we hope will lead to better outcomes. The approach is very promising. At the same time, there’s still a lot of work to do to understand CAR T and tumor cell interactions.
For example, we’ve learned that when CAR T cells “eat” the tumor cells, they can also display on their surface the very targets from the cells they attacked — a process called trogocytosis. We discovered a way to increase the density of targets on tumor cells, but when we do that, the CAR T cells may have a greater propensity to attack each other. That’s not what we want. So, we’re trying to understand what we can do to prevent it.
We’re also very interested in developing armored CAR T cells that don’t just express the target but also carry machinery to stimulate a robust immune response around the malignant cells to get a better tumor cell kill rate. We are building that out as a treatment for acute myeloid leukemia.
When you took this role at Sylvester, your goal was to expand our cell therapy work. What on the horizon gets you excited?
A lot is happening very fast in the cell therapy space, and we want to leverage exciting developments. Certain cancers are harder to treat with immunotherapy. I am excited about our research to make CAR T cells work better. This includes going after multiple targets on the same cell and finding ways to penetrate deeper into the tumors to destroy every remaining cancer cell.
These advances will allow us to bring cellular therapy technologies to solid tumors like breast cancer, lung cancer and colon cancer. And in the non-cancer space, I am excited about using what we have learned to treat autoimmune diseases like lupus and rheumatoid arthritis.
We’re uniquely positioned here at Sylvester to be on the leading edge of clinical trials exploring new therapies. Beyond that, we have the capacity to bridge the clinic and laboratory in ways designed to make the treatments better.
The cross-pollination of ideas between the folks who are seeing patients daily and those who are in the laboratory is happening all the time. When you bring our experts together, they can float concepts, troubleshoot and elevate the best ideas. Part of my role and commitment is to be the catalyst that connects these people. That’s where the magic of science happens.
Tags: Acute Myeloid Leukemia, blood cancers, breast cancer, cancer research, CAR T cells, colon cancer, Dr. Damian Green, immunotherapy, living cell therapy, lung cancer, Sylvester Comprehensive Cancer Center