A year in review – CIRM’s 2017 Annual Report focuses on a year of accelerating stem cell treatments to patients

Facebook-AR-2017[3]

At CIRM we have our focus very clearly on the future, on accelerating stem cell therapies to patients with unmet medical needs. But every once in a while, it’s a good idea to look back at what you have already done. Knowing where you came from can help you get to where you are heading.

So, it’s with a sense of accomplishment that we are unveiling our 2017 Annual Report. It’s a look back at another banner year for the stem cell agency, the research we funded, the partnerships we created and, most importantly, the lives we touched.

It features profiles of several people who received stem cell therapies in CIRM-funded clinical trials and the impact those therapies are having on them. But it also looks at some of the other individuals who are such a vital part of the work we do: patient advocates, researchers and a member of our Grants Working Group which reviews applications for funding. Each one, in their own way, contributes to advancing the field.

The report also highlights some of the less obvious ways that our funding is benefitting California. For example, the additional $1.9 billion dollars our funding has helped generate through co-funding and partnerships, or the number of projects we are funding that have been awarded Regenerative Medicine Advanced Therapy Designation from the Food and Drug Administration (FDA), making them eligible for accelerated review if their results continue to be promising.

It’s a look back at a successful year.

But we are not resting on our laurels. We are already hard at work, determined to make 2018 even better.

 

 

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CIRM-Funded Scientist is Developing a Stem Cell Therapy that Could Cure HIV

Photo Illustration by the Daily Beast

This week, UCLA scientist Scott Kitchen made the news for his efforts to develop a CIRM-funded stem cell gene therapy that could potentially cure patients infected with HIV. Kitchen’s work was profiled in the Daily Beast, which argued that his “research could significantly up survival rates from the virus.”

Scott Kitchen, UCLA Medicine

Kitchen and a team of scientists at the UCLA David Geffen School of Medicine are genetically modifying blood-forming, hematopoietic stem cells (HSCs) to express chimeric antigen receptors (CARs) that target HIV-infected cells. CARs are protein complexes on the surface of cells that are designed to recognize specific types of cells and are being developed as powerful immunotherapies to fight cancer and HIV infection.

These CAR-expressing HSCs can be transplanted into patients where they develop into immune cells called T cells and natural killer (NK) cells that will destroy cells harboring HIV. This strategy also aims to make patients resistant to HIV because the engineered immune cells will stick around to prevent further HIV infection.

By engineering a patient’s own blood-forming stem cells to produce an unlimited supply of HIV-resistant immune cells that can also eradicate HIV in other cells, Kitchen and his team are creating the possibility for a life-long, functional cure.

Dr. Kelly Shepard, Senior Science Officer of Discovery and Translation Research at CIRM, reflected on significance of Kitchen’s research in an interview:

Kelly Shepard

“This unique approach represents a two-pronged strategy whereby a patient’s own stem cells are engineered not only to be protected from new HIV infection, but also to produce HIV-specific CAR T cells that will seek out and destroy existing and new pools of HIV infection in that patient, ideally leading to a lifelong cure.”

Kitchen and his team are currently testing this stem cell-based CAR-T therapy against HIV in a large-animal model. Their latest findings, which were published recently in the journal PLOS Pathogens, showed that stem cell-derived human CAR T cells were effective at reducing the amount of HIV virus (called the viral load) in their animal-model. They also saw that the CAR T cells survived for more than two years without causing any toxic side effects. This work was funded by an earlier CIRM award led by another CIRM grantee, Dr. Jerome Zack, who is research collaborator of Kitchen’s.

In December 2017, Kitchen received a $1.7 million CIRM Discovery Stage Quest award so that the team can continue to optimize their stem cell CAR T therapy in animal models. Ultimately, they hope to gain insights into how this treatment could be further developed to treat patients with HIV.

Currently, there is no widely available cure for HIV and standard antiretroviral therapies are expensive, difficult for patients to manage and have serious side effects that reduce life expectancy. CIRM has awarded almost $75 million in funding to California scientists focused on developing novel stem cell-based therapies for HIV to address this unmet medical need. Three of these awards support early stage clinical trials, while the rest support earlier stage research projects like Kitchen’s.

CIRM Communications Director, Kevin McCormack, was quoted at the end Daily Beast article explaining CIRM’s strategy for tackling HIV:

“There are a lot of researchers working on developing stem cell therapies for HIV. We fund different approaches because at this stage we don’t know which approach will be most effective, and it may turn out that it’s ultimately a combination of these approaches, or others, that works.”

Taking a new approach to fighting a deadly brain cancer

Christine Brown DSC_3794

Christine Brown, Ph.D., City of Hope researcher

CIRM’s 2017 Annual Report will be going live online very soon. In anticipation of that we are highlighting some of the key elements from the report here on the Stem Cellar.

One of the most exciting new approaches in targeting deadly cancers is chimeric antigen receptor (CAR) T-cell therapy, using the patient’s own immune system cells that have been re-engineered to help them fight back against the tumor.

Today we are profiling City of Hope’s Christine Brown, Ph.D., who is using CAR-T cells in a CIRM-funded Phase 1 clinical trial for an aggressive brain cancer called malignant glioma.

“Brain tumors are the hardest to treat solid tumors. This is a project that CIRM has supported from an early, pre-clinical stage. What was exciting was we finished our first milestone in record time and were able to translate that research out of the lab and into the clinic. That really allowed us to accelerate treatment to glioblastoma patients.

I think there are glimmers of hope that immune based therapies and CAR-T based therapies will revolutionize therapy for patients with brain tumors. We’ve seen evidence that these cells can travel to the central nervous system and eliminate tumors in the brain.

We now have evidence that this approach produces a powerful, therapeutic response in one group of patients. We are looking at why other patients don’t respond as well and the CIRM funding enables us to ask the questions that will, we hope, provide the answers.

Because our clinical trial is a being carried out at the CIRM-supported City of Hope Alpha Stem Cell Clinic this is a great example of how CIRM supports all the different ways of advancing therapy from early stage research through translation and into clinical trials in the CIRM Alpha Clinic network.

There are lots of ways the tumor tries to evade the immune system and we are looking at different approaches to combine this therapy with different approaches to see which combination will be best.

It’s a challenging problem and it’s not going to be solved with one approach. If it were easy we’d have solved it by now. That’s why I love science, it’s one big puzzle about how do we understand this and how do we make this work.

I don’t think we would be where we are at without CIRM’s support, it really gave the funding to bring this to the next level.”

Dr. Brown’s work is also creating interest among investors. She recently partnered with Mustang Bio in a $94.5 million agreement to help advance this therapy.

Stem Cell RoundUp: CIRM Clinical Trial Updates & Mapping Human Brain

It was a very CIRMy news week on both the clinical trial and discovery research fronts. Here are some the highlights:

Stanford cancer-fighting spinout to Genentech: ‘Don’t eat me’San Francisco Business Times

Ron Leuty, of the San Francisco Business Times, reported this week on not one, but two news releases from CIRM grantee Forty Seven, Inc. The company, which originated from discoveries made in the Stanford University lab of Irv Weissman, partnered with Genentech and Merck KGaA to launch clinical trials testing their drug, Hu5F9-G4, in combination with cancer immunotherapies. The drug is a protein antibody that blocks a “don’t eat me” signal that cancer stem cells hijack into order to evade destruction by a cancer patient’s immune system.

Genentech will sponsor two clinical trials using its FDA-approved cancer drug, atezolizumab (TECENTRIQ®), in combination with Forty Seven, Inc’s product in patients with acute myeloid leukemia (AML) and bladder cancer. CIRM has invested $5 million in another Phase 1 trial testing Hu5F9-G4 in AML patients. Merck KGaA will test a combination treatment of its drug avelumab, or Bavencio, with Forty-Seven’s Hu5F9-G4 in ovarian cancer patients.

In total, CIRM has awarded Forty Seven $40.5 million in funding to support the development of their Hu5F9-G4 therapy product.


Novel regenerative drug for osteoarthritis entering clinical trialsThe Scripps Research Institute

The California Institute for Biomedical Research (Calibr), a nonprofit affiliate of The Scripps Research Institute, announced on Tuesday that its CIRM-funded trial for the treatment of osteoarthritis will start treating patients in March. The trial is testing a drug called KA34 which prompts adult stem cells in joints to specialize into cartilage-producing cells. It’s hoped that therapy will regenerate the cartilage that’s lost in OA, a degenerative joint disease that causes the cartilage that cushions joints to break down, leading to debilitating pain, stiffness and swelling. This news is particularly gratifying for CIRM because we helped fund the early, preclinical stage research that led to the US Food and Drug Administration’s go-ahead for this current trial which is supported by a $8.4 million investment from CIRM.


And finally, for our Cool Stem Cell Image of the Week….

Genetic ‘switches’ behind human brain evolutionScience Daily

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This artsy scientific imagery was produced by UCLA researcher Luis del la Torre-Ubieta, the first author of a CIRM-funded studied published this week in the journal, Cell. The image shows slices of the mouse (bottom middle), macaque monkey (center middle), and human (top middle) brain to scale.

The dramatic differences in brain size highlights what sets us humans apart from those animals: our very large cerebral cortex, a region of the brain responsible for thinking and complex communication. Torre-Ubieta and colleagues in Dr. Daniel Geschwind’s laboratory for the first time mapped out the genetic on/off switches that regulate the growth of our brains. Their results reveal, among other things, that psychiatric disorders like schizophrenia, depression and Attention-Deficit/Hyperactivity Disorder (ADHD) have their origins in gene activity occurring in the very earliest stages of brain development in the fetus. The swirling strings running diagonally across the brain slices in the image depict DNA structures, called chromatin, that play a direct role in the genetic on/off switches.

UCLA scientists make sensory nerves from human stem cells for the first time

Being able to tell the difference between hot and cold or feeling the embrace of a loved one are experiences that many of us take for granted in our daily lives. But paralyzed patients who have lost their sense of touch don’t have this luxury.

Sensory nerves are cells in the spinal cord that send signals from outside of the body to the brain where they are translated into senses like touch, temperature and smell. When someone is paralyzed, their sensory nerves can be damaged, preventing these sensory signals from reaching the brain and leaving patients at risk for severe burns or not knowing when they’ve cut themselves because they can’t feel the pain.

A Journey to Restore Touch

A group of scientists led by Dr. Samantha Butler at the  Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA are on a research journey to restore the sense of touch in paralyzed patients and people with sensory neuron damage. In their earlier work, which we blogged about back in September, the team discovered that signaling proteins called BMPs played an important role in the development of sensory nerve cells in chicken embryos.

With the help of CIRM-funding, Butler and her team have made significant progress since this earlier study, and today, we bring you an exciting update on their latest findings published in the journal Stem Cell Reports.

Using a similar strategy to their previous study, Butler and her team attempted to make sensory nerve cells from human stem cells in a dish. They exposed human pluripotent stem cells to a specific BMP protein, BMP4, and a chemical called retinoic acid. This combination treatment created two types of sensory nerve cells: Dl1 cells, which allow you to sense your body’s position and movement, and Dl3 cells, which allow you to feel pressure.

Human embryonic stem cell-derived neurons (green) showing nuclei in blue. Left: with retinoic acid added. Right: with retinoic acid and BMP4 added, creating proprioceptive sensory nerve cells (pink). (Image source: UCLA Broad Stem Cell Research Center/Stem Cell Reports)

This is the first time that researchers have reported the ability to make sensory nerve cells from human stem cells. Another important finding was that the UCLA team was able to make sensory nerve cells from both human embryonic stem cells and human induced pluripotent stem cells (iPSCs), which are pluripotent stem cells derived from a patient’s own cells. The latter finding suggests a future where paralyzed patients can be treated with personalized cell-based therapies without the need for immune suppressing drugs.

Feeling the Future

This study, while still in its early stages, is an important step towards a future where paralyzed patients can regain feeling and their sense of touch. Restoring a patient’s ability to move their limbs or walk has dominated the field’s focus, but Butler argues in a UCLA news release that restoring touch is just as important:

Samantha Butler

“The field has for a long time focused on making people walk again. Making people feel again doesn’t have quite the same ring. But to walk, you need to be able to feel and to sense your body in space; the two processes really go hand in glove.”

 

Butler and her team are continuing on their journey to restore touch by transplanting the human sensory nerve cells into the spinal cords of mice to determine whether they can incorporate into the spine and function properly. If the transplanted cells show promise in animal models, the team will further develop this cell-based therapy for clinical trials.

Butler concluded,

“This is a long path. We haven’t solved how to restore touch but we’ve made a major first step by working out some of these protocols to create sensory interneurons.”

How CIRM funding creates additional financial support for stem cell research in California

CIRM’s 2017 Annual Report will be going live online very soon. In anticipation of that we are highlighting some of the key elements from the report here on the Stem Cellar.

Two businessman shaking hands

Partnerships that help advance stem cell research

CIRM funds stem cell research.  We all know that.  What you may not know is that CIRM funds also help bring in additional funding and investments to these projects, and as a result, to the state of California.  CIRM’s investment can also be seen as helping validate the credibility of a particular project, taking some of the risk out of investing in it.

We call this second wave of support “Leveraged Funding”. Since we were created in 2004 we have brought in $1.5 billion in Leveraged Funds.

We break that down into three main categories:

  1. Co-Funding– This is funding that was specifically committed to help co-fund a CIRM project. For example, if we fund a for-profit company to do a Phase 1 clinical trial we expect them to co-fund 30% of the cost of the trial. If it’s a Phase 3 clinical trial the co-funding amount rises to 50%.  To date we have received $911 million in co-funding.
  2. Partnership Funding– Partnership Funding – This is non-CIRM funding committed by partners, not already captured by Co-Funding. For example, our Board’s decision to invest in a project can sometimes be seen as a kind of “Good Housekeeping Seal of Approval” because it shows this project has been reviewed by experts and recommended for funding.  Our funding allows investigators to do the early work and get data that helps attract funding from outside investors. These funds can be committed or spent at the same time as CIRM funds or to further the project after the CIRM award expires. Since 2004, we have helped generate $528 million in partnership funding.
  3. Additional Leverage– This is everything not covered by the first two categories but is mainly non-CIRM funding reported in the “Outcomes Survey”, which the lead investigator on the project completes at the end of the award. This lets us know about any non-CIRM funding they received as a result of their CIRM project (such as money from the National Institutes of Health or other agency grants). More than $395 million in additional leverage funding has been raised because of CIRM.

In 2017, we saw eight projects that we support attract additional support, almost $390 million, from outside investors.

  Disease Area  Industry Partner 2017 Funding
1. Adenosine deaminase-deficient Severe Combined Immunodeficiency Orchard Therapeutics $110,000,000
2. X-Linked Chronic Granulomatous Disease Orchard Therapeutics Not disclosed
3. Acute Myeloid Leukemia Forty Seven, Inc. $75,000,000
4. Pediatrics Genetic Disorder AVROBIO, Inc. Not disclosed
5. HIV/AIDS CSL Behring $91,000,000
6. Chronic Lymphocytic Leukemia Oncternal, Inc. $18,400,000
7. Brain Cancer Mustang Bio, Inc. $94,500,000
8. Age-related Macular Degeneration Santen Pharmaceutical Not disclosed
  Total   $388,900,000

Our goal is to do all we can to support the best science and move it out of the lab and into clinical trials in people. Obviously, providing funding is a key step, but it’s far from the only step. For us, it’s really just the first step.

On Wednesday, we’ll profile one of the CIRM-funded researchers whose work is attracting support from outside investors, work that is taking a whole new approach to fighting a deadly brain cancer.

How Tom Howing turned to stem cells to battle back against a deadly cancer

As we enter the new year, CIRM’s 2017 Annual Report will be posted in less than two weeks!  Here’s one of the people we are profiling in the report, a patient who took part in a CIRM-funded clinical trial.

Tom Howing

In March of 2015, Tom Howing was diagnosed with stage 4 cancer. Over the next 18 months, he underwent two rounds of surgery and chemotherapy. Each time the treatments held the cancer at bay for a while. But each time the cancer returned. Tom was running out of options and hope when he heard about a CIRM-funded clinical trial using a new approach.

The clinical trial uses a therapy that blocks a protein called CD47 that is found on the surface of cancer cells, including cancer stem cells which can evade traditional therapies. CD47 acts as a ‘don’t eat me’ signal that tells immune cells not to kill off the cancer cells. When this ‘don’t eat me’ signal is blocked by the antibody, the patient’s immune system is able to identify, target and kill the cancer stem cells.

“When I was diagnosed with cancer I knew I had battle ahead of me. After the cancer came back again they recommended I try this CD47 clinical trial. I said absolutely, let’s give it a spin.

“I guess one is always a bit concerned whenever you put the adjective “experimental” in front of anything. But I’ve always been a very optimistic and positive person and have great trust and faith in my caregivers.

“Whenever you are dealing with a Phase 1 clinical trial (the earliest stage where the goal is first to make sure it is safe), there are lots of unknowns.  Scans and blood tests came back showing that the cancer appears to be held in check. My energy level is fantastic. The treatment that I had is so much less aggressive than chemo, my quality of life is just outstanding.”

Tom says he feels fortunate to be part of the clinical trial because it is helping advance research, and could ultimately help many others like him.

“The most important thing I would say is, I want people to know there is always hope and to stay positive.”

He says he feels grateful to the people of California who created CIRM and the funding behind this project: “I say a very heartfelt thank you, that this was a good investment and a good use of public funds.”

He also wants the researchers, who spent many years developing this approach, to know that they are making a difference.

“To all those people who are putting in all the hours at the bench and microscope, it’s important for them to know that they are making a huge impact on the lives of real people and they should celebrate it and revel in it and take great pride in it.”

The 10 Most Popular Stem Cellar Stories of 2017

As the New Year fast approaches, it’s time for us to reflect on our accomplishments these past 12 months. 2017 was an exciting and successful year for California’s Stem Cell Agency. We welcomed Dr. Maria Millan as the new President and CEO of CIRM. We also funded 16 new clinical trials and added two new medical centers (UCSF and UC Davis) to our CIRM Alpha Stem Cell Clinics Network. These are just a few examples of the significant progress that our Agency has made towards accelerating stem cell treatments to patients with unmet medical needs.

As you can imagine, these advances as well as the steady stream of new discoveries in the stem cell field, have kept our communications team very busy. In fact, I took a quick look at how many blogs we published in 2017 and the number is an impressive 242. That translates to blogging about stem cell research 66% of the year! How’s that for dedication?

Todd, Kevin and I love (and I truly mean that) writing for the Stem Cellar. All of the studies, trials, scientists and patients we feature are fascinating, but there are certain stories that steal the spotlight. It’s always fun to see which blogs are the most popular with our readers. So, let’s take a look at the 10 Stem Cellar stories caught your eye in 2017.

  1. Can stem cell therapies help ALS patients?
  2. jCyte gets FDA go-ahead for fast track review process of retinitis pigmentosa stem cell therapy
  3. A stem cell clinical trial for blindness: watch Rosie’s story
  4. Could stem cells help beat multiple sclerosis?
  5. Bye bye bubble baby disease: promising results from the stem cell gene therapy trial for SCID
  6. A clinical trial network focused on stem cell treatments is expanding
  7. Have scientists discovered a natural way to boost muscle regeneration?
  8. Three people left blind by Florida clinic’s unproven stem cell therapy
  9. Good news from Asterias’ CIRM-funded spinal cord injury trial
  10. Scientists make stem cell-derived nerve cells damaged in spinal cord injury

Honorable Mentions (underdog blogs that deserve a second look)

  1. 4 things to know about stem cell clinical trials [Video]
  2. ViaCyte treats first patients in PEC-Direct stem cell trial for type 1 diabetes
  3. Family, faith and funding from CIRM inspire one patient to plan for his future
  4. Texas tries to go it alone in offering unproven stem cell therapies to patients
  5. Has the promise of stem cells been overstated?

See you in January!

From all of us at CIRM, we wish you the happiest of holidays and good luck in the New Year. We’ll see you back here in January with exciting new content from our 2018 Annual Report. Stay tuned and stay curious my friends!

Making beating heart cells from stem cells just got easier

Here’s a heartwarming story for the holidays. Scientists from the Salk Institute in La Jolla, California have figured out a simple, easy way to make beating heart cells from human stem cells that will aid research and therapy development for heart disease. Their study, which received funding support from CIRM, was published last week in the journal Genes & Development.

The Salk team discovered that making beating heart tissue from human stem cells is as simple as turning off a single gene called YAP. You might be wondering how the team settled on this gene and no, it doesn’t involve pulling a random gene name out of a hat.

In previous studies, the researchers found that two cell signaling pathways, Wnt and Activin, are crucial for the development of embryonic stem cells into specialized cells like cardiomyocytes (beating heart cells). This research led to the discovery of a third pathway, controlled by YAP, which sets up a road block for cell specialization and keeps stem cells in their undifferentiated state.

Only hESCs without YAP (right panel) make heart cells (green) in one step. Blue dye marks cell nuclei. (Salk Institute)

The team deleted YAP from these stem cells using CRISPR gene editing technology, and then treated the stem cells to the Activin signaling molecule. Without YAP, exposure to Activin prompted the stem cells to develop immediately into beating cardiomyocytes that you can see beating away in the Salk video below.

Dr. Kathy Jones, Salk professor and senior author on the study, explained why this discovery is important to the field in a news release:

“This discovery is really exciting because it means we can potentially create a reliable protocol for taking normal cells and moving them very efficiently from stem cells to heart cells. Researchers and commercial companies want to easily generate cardiomyocytes to study their capacity for repair in heart attacks and disease—this brings us one step closer to being able to do that.”

First author, Conchi Estarás, emphasized how their new method for making cardiomyocytes is attractive not only for its simplicity, but also for its cost-effectiveness in enabling large-scale manufacturing of these cells for treatment.

“Instead of requiring two steps to achieve specialization, removing YAP cut it to just one step. That would mean a huge savings for industry in terms of reagent materials and expense.”

Looking ahead, Jones and her team do not plan on deleting the YAP gene from stem cells because of the potential side effects cause by the loss of YAP’s other cellular functions. Instead, they will be using commercially available molecules that can temporarily inhibit the function of YAP in hopes that this less permanent action will still readily produce beating heart cells from stem cells.

Kathy Jones and Conchi Estarás. (Image courtesy of Salk Institute)

Harnessing the body’s immune system to tackle cancer

Often on the Stem Cellar we write about work that is in a clinical trial. But getting research to that stage takes years and years of dedicated work. Over the next few months, we are profiling some of the scientists we fund who are doing Discovery (early stage) and Translational (pre-clinical) research, to highlight the importance of this work in developing the treatments that could ultimately save lives. 

This second profile in the series is by Ross Okamura, Ph.D., a science officer in CIRM’s Discovery & Translation Program.

Your immune system is your body’s main protection against disease; harnessing this powerful defense system to target a given disorder is known as immunotherapy.  There are different types of immunotherapies that have been developed over the years. These include vaccines to help generate antibodies against viruses, drugs to direct immune cell function and most recently, the engineering of immune cells to fight cancer.

Understanding How Immunotherapies Work

One of the more recent immunotherapy approaches to fight cancer that has seen rapid development is equipping a subset of immune cells (T cells) with a chimeric antigen receptor (CAR). In brief, CAR T ceIls are first removed from the patient and then engineered to recognize a specific feature of the targeted cancer cells.  This direct targeting of T cells to the cancer allows for an effective anti-cancer therapy made from your own immune system.

Simplified explanation of how CAR T cell therapies fight cancer. (Memorial Sloan Kettering)

For the first time this fall, two therapeutics employing CAR T cells targeting different types of blood cancers were approved for use by the US Food and Drug Administration (FDA) based on remarkable results found during the clinical trials. Specifically, Kymriah (developed by Novartis) was approved for treatment of acute lymphoblastic leukemia and Yescarta (developed by Kite Pharma) was approved for treatment of non-Hodgkin lymphoma.

There are drawbacks to the CAR T approach, however. Revving up the immune system to attack tumors can cause dangerous side effects. When CAR T cells enter the body, they trigger the release of proteins called cytokines, which join in the attack on the tumors. But this can also create what’s referred to as a cytokine storm or cytokine release syndrome (CRS), which can lead to a range of responses, from a mild fever to multi-organ failure and death. Balancing treatments to resolve CRS after it’s detected while still maintaining the treatment’s cancer-killing abilities is a significant challenge that remains to be overcome.  A second issue is that cancer cells can evade the immune system by no longer producing the target that the CAR-T therapy was designed to recognize. When this happens, the patient subsequently experiences a cancer relapse that is no longer treatable by the same cell therapy.

Natural Killer (NK) T cells represent another type of anti-cancer immunotherapy that is also being tested in clinical trials. NK cells are part of the innate immune system responsible for defending your body against both infection and tumor formation.  NK cells target stressed cells by releasing cell-penetrating proteins that poke holes in the cells leading to induced cell death.  As an immunotherapy, NK cells have the potential to avoid both the issues of CRS and cancer cell immune evasion as they release a more limited array of cytokines and do not rely on a specific single target to recognize tumors.  NK cells instead selectively target tumor cells due to the presence of stress-induced proteins on the cancer cells. In addition, the cancer cells lack other proteins that would normally send out a “I’m a healthy cell you can ignore me” message to NK cells. Without that message, NK cells target and kill those cancer cells.

Developing new immunotherapies against cancer

Dan Kaufman, UCSD

Dr. Dan Kaufman of the University of California at San Diego is a physician-scientist whose research group developed a method to produce functional NK cells from human pluripotent stem cells (PSC).  In order to overcome a major hurdle in the use of NK cells as an anti-cancer therapeutic, Dr. Kaufman is exploring using stem cells as a limitless source to produce a scalable, standardized, off-the-shelf product that could treat thousands of patients.  CIRM is currently funding Dr. Kaufman’s work under both a Discovery Quest award and a just recently funded Translational research award in order to try to advance this candidate approach.

In the CIRM Translational award, Dr. Kaufman is looking to cure acute myelogenous leukemia (AML) which in the US has a 5-year survival rate of 27% (National Cancer Institute, 2017) and is estimated to kill over 10,000 individuals this year (American Cancer Society, 2017).  He has previously shown that his stem cell-derived NK cells can kill human cancer cells in a dish and in mouse models, and his goals are to perform preliminary safety studies and to develop a process to scale his production of NK cells to support a clinical trial in people.  Since NK cells don’t require the patient and the donor to be a genetic match to be effective, a bank of PSC-derived NK cells derived from a single donor could potentially treat thousands of patients.

Looking forward, CIRM is also providing Discovery funding to Dr. Kaufman to explore ways to improve his existing approach against leukemia as well as expand the potential of his stem cell-derived NK cell therapeutic by engineering his cells to directly target solid tumors like ovarian cancer.

The field of pluripotent stem cell-based immunotherapies is full of game-changing potential and important innovations like Dr. Kaufman’s are still in the early stages.  CIRM recognizes the importance of supporting early stage research and is currently investing $27.9 million to fund 8 active Discovery and Translation awards in the cancer immunotherapy area.