Robert L. Ferris, MD, PhD is Hillman Professor of Oncology and Director, UPMC Hillman Cancer Center and Co-Director of the Tumor Microenvironment Center. Since 2007 he was Co-Leader of the Cancer Immunology Program and Associate Director for Translational Research at the University of Pittsburgh Cancer Institute (UPCI). Dr. Ferris received his medical and graduate training in Immunology at Johns Hopkins, then completed his residency and subspecialty training in head and neck surgical oncology in 2001. In 2006, he received the Excellence in Clinical Investigations award at UPCI and was elected to the American Society for Clinical Investigation (ASCI) in 2008.
Dr. Ferris has been active in SITC for 15 years. He served on the 2009 SITC Annual Meeting Program Committee and currently serves as Vice-Chair of the SITC Membership Committee and SITC Champion at UPCI. Dr. Ferris participated in multiple SITC strategic leadership retreats, co-directed the SITC Advances in Cancer Immunotherapy™ (ACI) meeting in Pittsburgh in 2013 and will again in September 2017. He is also a Section Editor of the Journal of ImmunoTherapy of Cancer (JITC), and serves on the Editorial Boards of the Journal of Clinical Oncology, Clinical Cancer Research and Cancer Immunology Research and as Associate Editor for JNCI.
Dr. Ferris' external service includes Co-Chair of the NCI Head and Neck Steering Committee and Chair of the NIH Tumor Microenvironment (TME) study section. Dr. Ferris is national co-chair of several ongoing phase II and phase III immunotherapy trials investigating anti-PD1 or anti-CTLA-4 immunotherapy, having led the phase III trial leading to FDA approval of nivolumab for recurrent head and neck cancer in 2016. Dr. Ferris is a site PI for the Cancer Immunotherapy Network (CITN) representing the Hillman Cancer Center.
Dr. Ferris’ laboratory investigates mechanisms of tumor antigen processing and immune evasion used by cancer cells. Using his surgical practice to run phase I and phase II trials studying reversal of immunosuppression through mAb and vaccine therapy, Dr. Ferris bridges basic, translational and clinical immunotherapy. He has published over 280 scientific articles. Dr. Ferris has a successful track record of mentoring MD and PhD graduate students in Immunology. He is PI of an NCI T32 training grant for translational head and neck oncologists. Dr. Ferris’s laboratory is funded by an R01 grant to study the phenotype and function of Tim-3+ tumor infiltrating lymphocytes and resistance to treatment with therapeutic anti-PD-1 mAb in the microenvironment. He is also PI for the Head and Neck SPORE and Leader of Project 3, comparing suppressive regulatory T cells (Treg) after mAb therapy using cetuximab. He has run several phase I clinical trials of DC-based vaccination as well as oncolytic viral therapy for HNC.
What are the two or three critical issues facing the field of cancer immunotherapy?
1. Translational biomarker development for selection of appropriate patients and combinations.
SITC has always promoted a deeper understanding of patients and their cancer biology, to refine understanding of the tumor microenvironment, which will be the basis for personalized immunotherapy. Clinical evidence emerging from the treatment of cancer patients with new immunotherapeutic agents clearly indicates the need to identify predictive biomarkers to guide patient selection. Moreover, the multitude of immunotherapeutic modalities targeting immune stimulating as well as immunosuppressive mechanisms has paved the way for extensive testing of combinatorial approaches. This must be guided by science and adaptive designs rather than convenience.
Given the exquisite specificity of the immune system, there is probably no better way to personalize cancer care than through cancer immunotherapy. Recent data have revealed that some tumors may lack T cell infiltrates and be immunologically, “cold,” while other tumors may harbor significant numbers of immune cells and be immunologically, “hot,” (inflamed) and still other tumors may induce T cells that cannot enter the tumor microenvironment. Each of these immunologic phenotypes will likely demand a separate strategy for effective combination immunotherapy. In addition, emerging technologies provide the opportunity for mapping the unique mutational and transcriptional landscape of a patient’s tumor, and drive selection of neo- vs shared antigens. In addition, host factors such as the immunoregulatory microbiome appear to shape the immune response to cancer.
SITC can promote the tools for gathering and integrating this information and developing the infrastructure for supporting personalized cancer immunotherapy, a key priority for the field. These tools will elucidate the most promising treatment strategies that integrate novel immuno-oncology agents into combination immunotherapy regimens. Judiciously applying scientifically rigorous adaptive trial designs, identifying predictive biomarkers of response, and characterizing biomarkers of both primary and acquired resistance to immunotherapy are key for the effective clinical development. This strategy will help prioritize the most promising agents and combinations to test, facilitating nimble and effective drug development. SITC can promote both grant writing and trial design tool for trainees to enhance biomarker use and novel discovery efforts.
2. Education of Practitioners.
One of SITC’s primary goals is to educate scientists and practitioners. This effort has now shifted to non-immunologists who manage adverse events, refer patients for cancer immunotherapy, or may have begun integrating this new type of therapy into their oncology practice. We need to expand our educational outreach to physicians and researchers in other medical specialties who will encounter patients receiving cancer immunotherapy and who may collaborate in the management of the immune-related side effects associated with this modality. It is essential for us to capitalize on the breadth and depth of the immunotherapeutic targets and agents by continuing to integrate and coordinate the talents, efforts and resources of stakeholders in diverse disciplines in academia, early phase discovery, biotechnology/pharma and regulatory agencies. SITC’s many novel relationships with partner societies and other agencies enable us to help control the quality of the science, potentially generate new sources of funding support and new members, and retain our leadership and direction of the field.
3. Measuring and promoting the value of cancer immunotherapy.
With the success of cancer immunotherapy, the need for cost effectiveness research and demonstration of the value proposition is a rapidly emerging challenge for the field, which SITC can lead. There are many immuno-oncology agents in development and these are often quite expensive once approved. It is very clear that the rising cost of medical care poses substantial challenges for society as a whole and that the current path is not sustainable. Developing innovative models for assessment of, “value,” and methods of reimbursement will also be critical for the optimal application and establishment of cancer immunotherapy strategies in the clinic. We must continue to develop consensus guidelines for optimally implementing immuno-oncology in patients as the efficacy of immunotherapy extends to additional tumor types. This includes developing novel endpoints for drug approval that reflect the unique mechanisms of action and patterns of response and building new integrated models for scientific, clinical, regulatory and payor collaboration in therapeutic development for dissemination into practice. SITC must play an important role in this area.
What is your vision for SITC?
This is a pivotal time for cancer immunotherapy, which is now emerging from adolescence and is established as a standard of care for an increasing number of tumor types. Thus, a new set of challenges have arisen for SITC than we have encountered in the past 15 years beyond just promoting science to show that cancer immunotherapy is an effective modality. The potential to transform cancer into a chronic medical condition, or in a subset of patients to cure previously incurable cancer patients, is transformative. Indeed, these are very exciting times for our field which SITC must anticipate and lead. SITC is a unique organization, interdigitating with academics, industry, regulatory and educational societies, advancing the field of immunotherapy in these exciting but challenging times of today’s funding environment and medical practice. It is great to be part of such a progressive organization. As a long-time contributor for various aspects of SITC functions (Membership Committee, SITC Champion, Annual and Regional Meeting Organizer, Board of Directors), I now add the perspective of a Cancer Center Director with a strong commitment to immunotherapy as one of the founding areas of our mission, just like it was for SITC. I outline three key areas below for our continued leadership, two of which play to SITC's strengths (biomarkers and education) and one in which we need to grow and design, to continue to develop and lead the field. Accelerating progress in immuno-oncology will require continued attention to the most critical issues facing our field today. Three of the most important challenges facing cancer immunotherapy are 1) biomarker development for selection of appropriate patients and combinations, 2) education of practitioners, and 3) measuring the value of cancer immunotherapy.