Lawrence Fong, MD’s research has focused on immunotherapy for more than 30 years. For many of those years, the new scientific director of the Immunotherapy Integrated Research Center at Fred Hutch Cancer Center considered immunotherapy — the practice of harnessing the body’s own immune system to fight cancer and other diseases — an idea whose time had not yet come.

Fong, who previously founded and led the University of California, San Francisco’s Cancer Immunotherapy Program, assumed his new role July 1. When he started his career, he was told by some mentors that immunotherapy was “a great lab experiment but it wasn’t something that would change clinical practice.” He now feels vindicated for having stayed the course.

Lawrence Fong, MD, is the scientific director of Fred Hutch's Immunotherapy Integrated Research Center.

Lawrence Fong, MD, is the scientific director of Fred Hutch’s Immunotherapy Integrated Research Center.Courtesy of Robert Hood / Fred Hutch News Service

Fong replaces Geoffrey Hill, MD, FRACP, FRCPA, who is senior vice president and director of Fred Hutch’s Translational Science and Therapeutics Division, where Fong is a full professor. Fong, the Bezos Family Distinguished Scholar in Immunotherapy, also has an appointment in the Clinical Research Division at Fred Hutch and serves as a professor in the University of Washington Department of Medicine.

A genitourinary oncologist, Fong is no newcomer to Seattle. During his internship and residency in internal medicine at the University of Washington, Fong was involved with Fred Hutch clinical care in bone marrow transplantation. At the UCSF Department of Medicine’s Division of Hematology/Oncology, Fong contributed to the pre-clinical and clinical development of several FDA-approved immunotherapies including immune checkpoint inhibitors. In 2021, he received a seven-year, $4.2 million National Cancer Institute Outstanding Investigator Award for his project, “Determinants of Response to Cancer Immunotherapy.”

In this Q&A, Fong talks about how immunotherapy has transformed clinical practice and shares his vision for the IIRC.

What drew you to Fred Hutch? 

Fred Hutch has been at the center of immunotherapy having pioneered bone marrow transplantation. Success with this approach did not come overnight; it took decades. While we have had some great successes in immunotherapy, I believe that progress will require iteration and refining our approaches as we see how they work in our patients. This is a concept ingrained at Fred Hutch. While we have had success with CAR T cells in hematologic malignancies, this approach in solid tumors has been very challenging. But we are now starting to see responses in these patients too. The challenge is to increase the rates of response, improve durability of response and reduce side effects. These are areas where our foot is in the door in terms of getting new treatment approaches to work. Through iteration, our goal is to get over barriers that prevent us from having durable clinical responses.

What are some of the most significant immunotherapy discoveries?

 

Checkpoint inhibitors have transformed a lot of cancers. Yet the majority of patients who receive those therapies don’t benefit. Take lung cancer: We give checkpoint inhibitors as a frontline therapy, but the majority of patients go on to progress. So there’s a huge opportunity to improve outcomes on that front.

Other areas where we’ve made huge strides are cell-based therapies for leukemia, lymphoma and multiple myeloma. Most successes are in the context of B-cell malignancies where we target specific proteins like CD-19 and BCMA. For solid tumors, we now have targets too and are starting to see successes with T-cell engagers, CAR T cells, and T-cell receptor-engineered T cells. We also now have an approved tumor infiltrating lymphocyte treatment.

How do you see the relationship between research and the clinic? 

I believe the lab and clinic must be tightly integrated. In addition to leading my own lab, I will be leading the IIRC. I will also be leading the Bezos Family Immunotherapy Clinic. We always talk about translational research, but the goal is really integrating laboratory and clinical research. Think about this as an iterative loop: We rapidly use learnings in the lab or clinic to inform the development of the next generation of treatment. That rapid iteration is what we’re striving for at Fred Hutch.

Fred Hutch historically has been strong in malignant hematology including immunotherapy and bone marrow transplantation. Fred Hutch now has developed great strengths in solid tumor. All the pieces of the puzzle are there, but we want to leverage our existing infrastructure, immunologic expertise and clinical prowess to help transform more cancers like prostate, pancreatic and colorectal cancers, where we haven’t made as much progress as we would like.

What’s the best way to inspire that type of progress?

We are launching a few specific initiatives to accelerate advances. We just announced the Catalyst Grant Program, which will help support the forward translation of discoveries at Fred Hutch into actual immunotherapy products rather than spinning ideas out into companies to accomplish this. Catalyst grants will offer funding for therapies from the manufacturing stage to the clinical trial stage. We are also launching the Innovation Grant program that will provide seed funding for novel concepts.

This network is designed to get Fred Hutch discoveries in the lab into actual clinical trials. In academia, it can be hard to get grants to show there’s no toxicity or to make actual cells that we’re going to use to treat patients. That has required investigators to create companies to accomplish these goals. But this network will act like a research sandbox supporting translational research on patients participating in clinical trials at Fred Hutch.

Historically, clinical investigators rely on lab collaborators to do correlative research on patients getting treatment. This sandbox will enable clinical investigators to initiate research trials and perform mechanistic studies to understand how the treatment actually works without having their own research labs to do the work. We will leverage existing infrastructure at Fred Hutch that includes acquiring samples from patients.

The questions we can ask in this day and age are much more sophisticated than what we asked even five years ago. This network will allow us to make more progress, faster.

Read more about new leadership at the Bezos Family Immunotherapy Clinic, part of the Immunotherapy Integrated Research Center. 

This article was originally published August 15, 2024, by Fred Hutch News Service. It is republished with permission.