Eduardo M. Sotomayor, a leader in lymphoma and immunotherapy research, will serve as the inaugural director of the new George Washington University Cancer Center beginning in July.
The center’s mission will be to provide the most advanced, compassionate care to cancer patients in the Washington, D.C., region. It also will have a strong focus on personalized medicine—an emerging type of care that uses patients’ genetic makeup to uncover the specific biology of their tumors, which guides more targeted therapy.
One of Dr. Sotomayor’s top priorities is for the center to attain a prestigious National Cancer Institute (NCI) designation within the next decade. There are currently 68 NCI-designated Cancer Centers in the United States, which are funded by the National Institutes of Health. They combine basic, clinical and population-based research in an effort to translate laboratory discoveries into new treatments.
The GW Cancer Center will be an umbrella for all cancer-related activities, clinical services and research in the School of Medicine and Health Sciences, GW Hospital and the GW Medical Faculty Associates. The center will also work in collaboration with other schools, such as the Milken Institute School of Public Health. Science and Engineering Hall will house the center’s research arm when the eighth floor of the building is completed in 2016.
“For an NCI-designation, a center must show collaboration, integration and outreach. That requires leaders who can bring basic researchers, clinicians and population scientists together,” Dr. Sotomayor said. “What impressed me most about GW is that everyone is committed to that goal. And they know the investment and effort that needs to be made in order to reach it.”
Dr. Sotomayor joins GW after serving as the scientific director of the DeBartolo Family Personalized Medicine Institute at Moffitt Cancer Center in Tampa, Fla. The medical oncologist also chaired the center’s Department of Malignant Hematology and was a professor at the University of South Florida College of Medicine.
Originally from Peru, Dr. Sotomayor first became interested in medicine at 7 years old, after an infection landed him in the hospital. He went on to the University of Miami after completing medical school in his home country. There he studied a field that was largely unchartered territory at the time called cancer immunotherapy.
Dr. Sotomayor has dedicated his career to studying immune responses (or lack thereof) to cancer and designing novel immunotherapeutic approaches, particularly for patients with aggressive forms of lymphomas that attack the immune system.
He is also a member of the NCI subcommittee that reviews the performance of all NCI-designated Cancer Centers in the country. He hopes to bring his observations and expertise from this position as he guides GW toward becoming an NCI Center.
“Such exposure gave me a better view of what was happening in the cancer field,” he said. “I knew I wanted to build a cancer center from scratch.”
Breakthroughs in Immunotherapy
In the early ‘90s, when Dr. Sotomayor began to focus on cancer immunotherapy—an approach that harnesses the immune system to battle tumors—the new effort was considered a “road to nowhere,” he said.
“People told me, ‘Immunology will never become a treatment for cancer patients. You’re wasting your time.’ But I continued,” he said.
Dr. Sotomayor next joined a research group at Johns Hopkins University that was the first to describe a phenomenon called T-cell tolerance. T cells, essential for human immunity, fight infections and are able to destroy cancer cells. Dr. Sotomayor, working at that time in Hyam Levitsky’s lab at Hopkins, discovered how cancer cells, and lymphomas in particular, block T cells from fighting back, leading to uncontrolled tumor growth.
“The immune system recognizes and tries to attack the cancer cells, but then the cancer cells tell them to stop,” Dr. Sotomayor said.
It was a big leap in cancer immunotherapy, and since then, Dr. Sotomayor has been researching ways to break this state of unresponsiveness to cancer cells.
“A few years ago I would say, ‘You need to put all your things in order because there is nothing else to offer you.’ Now, with these immunotherapeutic approaches and others under development, there is hope.”
Several research groups have tried since then to identify the mechanisms by which cancer cells block a patient’s T-cell responses. One of the major advances in the field was the discovery of “brakes” or “checkpoints” in T cells that if properly blocked can unleash the full destructive potential of T cells and allow them to do their job against malignant cells.
After a series of successful clinical trials using antibodies to block these “checkpoints,” the results finally convinced even skeptics in the scientific community that the approach could save lives. In 2013, Science Magazine named cancer immunotherapy its “Breakthrough of the Year.”
“For someone who was told, ‘Don’t devote your scientific career to cancer immunotherapy, you have no future,’ to see that change during my professional lifespan is of course very satisfying,” Dr. Sotomayor said.
The full potential of cancer immunotherapy remains to be uncovered. Doctors are rushing to figure out why these new therapeutic approaches shrink some tumors and don’t help others. But for a clinician accustomed to telling cancer patients that they had only a few months to live, the trajectory of immunotherapy offers Dr. Sotomayor much reassurance about the direction in which cancer research is headed.
“It’s the difference between being alive or dead,” he said. “A few years ago I would say, ‘You need to put all your things in order because there is nothing else to offer you.’ Now, with these immunotherapeutic approaches and others under development, there is hope.”
Advancing Personalized Medicine
The next breakthrough in cancer research, Dr. Sotomayor believes, will be personalized medicine, and that is how he is hoping to make an impact at GW.
Trying to detect abnormalities or mutations in the DNA of a cancer cell was an expensive, complex undertaking less than a decade ago. But with recent advances in genomics, researchers now are able to genetically test the tumors of cancer patients to determine their very specific molecular and genetic makeup.
This new frontier, Dr. Sotomayor said, will lead in the near future to big databases that will include both genomic analyses and phenotypic data (lifestyle, diet, demographics) from a large number of cancer patients. Doctors will then be able to reference that information in order to provide future patients with more individualized, effective treatment.
“Twenty years ago, the computer didn’t have that capacity to store that amount of data. But now, the tools are there,” he said. “We are going to see exponential growth in precision medicine as we keep collecting more and more interpretable data. And we are going to be making better decisions based on that information.”
Dr. Sotomayor’s aim for the GW Cancer Center is to provide scientists and clinicians with the tools to help them make advancements in personalized medicine for local patients, as well as discoveries that will have an impact far beyond the region.
“The rapid advances in genomics and immunotherapy are revealing to us cancer’s best kept secrets and weaknesses,” he said, “which we should take advantage of as a first step to ultimately reach a cure.”