The Center for Data Innovation spoke with Aude Chapuis, assistant member of the Fred Hutchinson Cancer Research Center and assistant professor at the University of Washington Medical Center. Dr. Chapuis discussed her work on precision medicine and immunotherapy, as well as obstacles to using data in medicine.
This interview has been edited.
Joshua New: Can you define what precision medicine means in your field? Most people have heard the term used as a buzzword and likely understand that it means more personalized treatments for diseases, but that is probably where their knowledge ends.
Aude Chapuis: Precision medicine is a broad term that encompasses many types of therapy, including immunotherapy for cancer. Immunotherapy can be divided into therapies that broadly lower the threshold of activation of T cells, a type of white blood cell important in the immune response, called “checkpoint blockade,” and adoptive transfer, the transfer of cells to a patient of T cells that are specific to both the patient and their tumor.
New: Why is it that precision medicine is most often discussed in relation to cancer treatments? Is it just because of the seriousness of the disease, or something different?
Chapuis: Cancer is very heterogeneous and different types of cancer require different therapeutic approaches. Even in one patient, the cancer can have different subtypes that will respond to treatment differently. I think “precision medicine” for cancer developed from coming to terms with this challenge. Instead of using the same approach for anybody with one type of tumor regardless of its genetic aspects, clinicians are looking into what proteins are expressed across tumors and then targeting those with their treatments. This requires a much more precise knowledge of the proteins expressed by tumor and the patient.
New: You published research in February that has been described as “barcoding” certain kinds of cells involved in the immune response to better understand how they can be used to fight cancer. Is this an accurate description? What does “barcoding” a cell mean?
Chapuis: T cells can mediate tumor killing as part of the immune response. All the T cells that circulate in the blood have a specific natural “barcode.” This comes the fact that they rearrange or modify their DNA to carry a unique T cell receptor—the structure that recognizes the “bad” protein in the tumor. We can use this barcode as a way to track thousands of cells in the blood, including the ones we infused, and study whether they reach the tumor to destroy it.
New: Could this approach be applied to tackle other kinds of diseases?
Chapuis: Yes. For example T cells can also target cells that have been hijacked by certain types of viruses, specifically seek those cells out, and eliminate them.
New: What’s the biggest data-related barrier to your research?
Chapuis: Since I work in a big academic center, data storage and access to information is facilitated. What is more difficult is the manpower required to generate and access the data or extract what is meaningful from the data. Training people to give them the specializations to do this takes a long time and we usually have limited funds to support them appropriately.