UNC Oncologist William Kim Highlights Immunotherapy’s Role In Cancer Conquest

(ChosunBiz, Lee Yong-Seong) — The results of various types of “immune anticancer drug” treatments on patients with melanoma (a skin cancer caused by the malignant transformation of melanocytes) and kidney cancer, along with follow-up observations on patients with blood cancers such as lymphoma after receiving “chimeric antigen receptor T (CAR-T)” cell therapy, show that many have survived for a long time. Personally, I view these individuals as having “conquered” cancer.

William Y. Kim, a Korean American oncologist and professor at the University of North Carolina at Chapel Hill (UNC) School of Medicine, noted in a written interview, “The emergence of ‘immunotherapy’ that uses patients’ own immune systems to fight cancer has made the goal of conquering cancer more realistic. As immunotherapy is applied at earlier stages with less treatment burden, I expect that we will be able to conquer even more cancers in the future.”

Professor Kim studied economics and biology at Wesleyan University in the U.S. and received his medical degree from the Ivy League institution Brown University. He then completed both residency and oncology fellowship at Beth Israel Hospital affiliated with Harvard Medical School and Dana-Farber Cancer Institute, respectively. He currently co-leads the ‘GU Cancer Research Program’ at the UNC Lineberger Comprehensive Cancer Center, specializing in treating bladder and kidney cancer patients. Here is a Q&A with Professor Kim.

I am curious if there is anything in the anticancer drug market that could be called a ‘game changer.’

Having worked as an oncology specialist and cancer researcher for just over 20 years, I want to include several drugs in the ‘game changer’ category, such as (protein) kinase inhibitors, CAR-T cell therapies, immune checkpoint inhibitors, and antibody-drug conjugates (ADCs). Although they have been around for a bit longer, vaccines that prevent infections related to human papillomavirus (HPV) closely associated with cervical cancer also seem to have the potential to be called game changers.

Protein kinases are essential enzymes that regulate cell growth, division, and survival. When they become abnormally activated, they induce the proliferation of cancer cells. Therefore, by inhibiting them, we can stop cancer cell growth and enhance treatment efficacy. CAR-T cell therapy is a technology that extracts T cells, a type of immune cell from the patient’s body, modifies their genes to attack specific cancer cells, and then reinjects them into the patient. It is highly effective for treating certain leukemias and other blood cancers, but has limitations for solid tumors such as lung cancer.

How close do you think we are to ‘conquering cancer’?

The emergence of immune anticancer drugs that utilize patients’ own immune systems to fight cancer has made the goal of conquering cancer a more realistic one. The results of various types of immune anticancer drug treatments on patients with melanoma and kidney cancer, along with follow-up observations on blood cancer patients after receiving CAR-T therapy, show that many have survived for a long time. Personally, I view these individuals as having “conquered” cancer.

This sounds like you’re saying we are not far from conquering cancer.

I expect that as immunotherapy is applied at earlier stages with less treatment burden, we will be able to conquer more cancers in the future. Additionally, with auxiliary technologies developed to detect minimal residual disease (MRD) that is a very small number of cancer cells remaining after treatment, we will be able to prevent overtreatment of patients who can be cured with only surgery or radiation therapy. However, we must not forget that cancer is not a single entity (monolith) and that there is considerable heterogeneity within each cancer type. Providing personalized treatment that optimally delivers the most effective drugs to all cancer patients while minimizing side effects is the most important thing.

Will advancements in artificial intelligence (AI) technology also help in conquering cancer?

As in many other fields, the expectations for AI’s role in new drug development have greatly increased. I believe one of the areas where AI will have a significant impact is in predicting treatment responses and discovering biomarkers for prognosis. The capacity to build massive data with “multi-modal AI” has become possible, and as machine learning technology rapidly advances, it is expected that biomarker-based therapies will soon be commonplace.

Multi-modal AI refers to AI that comprehensively utilizes various types of data modalities such as text, image, audio, and video. Its learning and processing targets are not limited to text, as it can handle visual and auditory information, allowing for human-like thinking. Biomarkers are indicators that can detect changes occurring in the body using proteins, DNA, RNA, and metabolites. Utilizing biomarkers allows for objective measurement of the normal or pathological state of organisms, as well as their responses to drugs.

What technology seems most promising in the anticancer drug market?

In the near future, I believe immune anticancer drugs will be the most promising. The logic of using one’s own immune cells to seek out and attack cancer cells is indisputable. The remarkable effects and durability following the administration of immune anticancer drugs have been proven through the patients I treated. I was also impressed that the patients coped well with treatment, provided there were no immune-related side effects. As protein science advances rapidly, I trust that innovations will continue and the risks of side effects will further decrease.

What about ADC and gene editing therapies?

It has been proven that ADC treatments that target PD-1 (a protein known to interfere with cancer treatment) or HER2 proteins that induce cancer cell growth are highly effective in cancers with a high tumor mutation burden (TMB). While it is not yet established, combining immune anticancer drugs with ADCs could potentially enhance treatment efficacy. Although interest in cancer treatment using gene editing technology has grown, it has not yet resulted in clinical success. Still, I believe it is too early to make judgments at this time.

What other technologies will lead the anticancer drug market?

Personally, I am very interested in the field of protein science, as I believe it will lead the next generation of anticancer drug research. The decision to award the 2024 Nobel Prize in Chemistry to David Baker, Demis Hassabis, and John M. Jumper for their innovative contributions through AI in protein research is not unrelated to this. Early evidence already shows that protein science can bring advancements to cancer treatment. Technologies related to bispecific T-cell engagers (BiTE) that target two antigens and enable new mechanisms of action demonstrate that protein science can enhance the efficacy of immunotherapy and antibody targeting.