Carlo Bifulco, MD • 2019 SITC Election

Bifulco__Carlo_MD.jpgBiography

Dr. Bifulco is a Surgical Pathologist with additional fellowship subspecialty training, expertise, and board certification in Molecular Genetic Pathology and Hematopathology. Dr. Bifulco serves on the Global Colon Cancer Immunoscore Task Force led by the Society for Immunotherapy of Cancer (SITC), and is Chair of the SITC Pathology Task convened to establish multiplexed immunohistochemistry/immunofluorescence (mIHC/IF) standards.

Prior to joining Providence, Dr. Bifulco served on the Pathology faculty at the National Cancer Center in Milan/Italy, at the University of Florida and at Yale University, and completed fellowships in Hematopathology at Yale and in Oncologic Surgical Pathology and Molecular Genetic Pathology at Memorial Sloan Kettering Cancer Center. Dr. Bifulco currently serves as the Director of Molecular Pathology and Pathology Informatics at Providence St. Joseph Health, and as the Director of Translational Molecular Pathology and Molecular Genomics at the Earle A. Chiles Research Institute in Portland, Oregon, a division of the Providence Cancer Institute. He oversees the PSJH Molecular Genomics Laboratory, one of the largest clinical genomics labs in the Pacific Northwest, which provides state-of-the-art genomic sequencing to cancer patients across the seven state PSJH system.

His current translational research is focused on supporting the characterization of the tumor immune microenvironment through immunohistochemical and image analysis techniques, and on the integration of genomics with immunotherapies.

SITC Election Platform Statement

What are the two or three critical issues facing the field of cancer immunotherapy?

The majority of cancer patients treated with immuno-oncology (I-O) therapies will ultimately fail to respond to these agents. Primary and secondary resistance underlying mechanisms of immune escape are actively been explored and elucidated, but we currenlty lack a framework that systematically investigates them and translates that knowledge into personalized IO therapeutic strategies. In particular: a) existing biomarkers, such as PD-L1, TMB, Immune Gene Expression signatures, and Tumor Mutational Burden, can enrich for populations of IO responders, but their predictive value is limited, and significant improvements will be required to enable responses in larger patient populations; b) better biomarkers will be required to empower the development for optimal strategies to rationally select combination IO therapies, an area that is currently driven by simplistic assumptions and heuristics and not by a personalized understanding of the patient's tumor biology.

What is your vision for SITC?

SITC has played a crucial role in enabling major achievements in I-O and in transforming the therapy of cancer. The field is however now facing significant challenges in further improving upon these recent successes. By fostering a systematic assessment of the antitumoral immune response, rooted in the morphological features of the tumor microenvironment, and based not only of tumor biomarkers (currently TMB, MSI, and typically PD-L1) but also on an assessment of the patient’s own immune system; such as immunoscore, multiplexed immunohistochemisty/immunofluorescence, seromics, TCRseq, etc., SITC will enable the development of a novel framework that could provide the foundation required for the overcoming of the current challenges faced by the field. Such an approach, building on the pioneering and SITC supported work of Jerome Galon enhanced by novel multiplexed immunofluorence technologies, will highlight the centrality of the immune response to patient outcomes across different tumor types and I-O approaches and has the potential to synergize with other strategic priorities of the society.