So what happens when a researcher does some soul searching? As an immunologist, Dr. Tuohy was known for – and good at – directing the immune system to destroy entire organs. In fact, it was his laboratory that generated a now commonly used model of multiple sclerosis, which has been instrumental in advancing that field. This success led him to collaborate with ear researchers, for whom he developed a model where the inner ear was the object of his targeted destruction. But destroying organs was more negative than Dr. Tuohy's personality could sustain, and frankly, it got a bit boring. That prompted the thought that if he could direct the immune system to kill organs, why not target the immune system to kill the tumors derived from them?
As a step in this direction, he chose to focus on ovarian and breast cancers, since these involve organs that are routinely removed as part of therapy (i.e., if the organs were destroyed, it would not be life-threatening). Eight years of subsequent research birthed the striking data recently published in Nature Medicine, announced in our last issue. Interestingly, since Dr. Tuohy is not a cancer biologist by trade, 2 of those 8 years were spent verifying and re-verifying the results in a number of different breast cancer models to prove he knew what he was doing.
Previous research on using vaccines to fight cancer has focused on targeting the virus that causes the cancer (those cancers for which this is the case) or on a therapeutic vaccine application. To Dr. Tuohy, using a vaccine therapeutically (i.e., after the individual has cancer) sounded egregiously inefficient – kind of like waiting for an accident to happen in a high risk zone before taking action to prevent it in the first place. "Our immune system has a great capacity to protect us from many things, but we fail to take full advantage of it, particularly after receiving our initial childhood vaccines," says Dr. Tuohy. So the challenge became one of developing a prophylactic vaccine against the tumor itself … vaccine that could actually prevent breast cancer. This is what his article in Nature Medicine demonstrates in animal models.
The news has been widely received: A recent tally shows that 1400 media outlets have carried the story to over 484 million people in 17 countries around the globe.
Where does the research go from here, and is this the beginning of the end for breast cancer? The process from the lab to humans is in its earliest stages, and many details are far too premature to discuss. Now it's a matter of moving into clinical trials in order to see what type and magnitude of tweaking might be necessary to apply the strategy to women. Undoubtedly, this will mark the beginning of the cyclical iterations between lab bench and bedside that characterize medical advances. According to Dr. Tuohy, though, if similar results are seen in clinical trials, the impact on human health will be monumental.
Recognizing humble beginnings, Dr. Tuohy concedes, "It's DOS - it's not Windows," and adds with a smile, "But we went to the moon with DOS." Currently, Dr. Tuohy's group is proactively working on the "next generation" vaccine, which he calls "Terminator 2." (And additional research in his lab is continuing to develop similar vaccine strategies against other cancers.)
Whether aiming for the moon or wishing on a star, the prototype in animal models provides the "proof-of-concept" encouragement that "it can be done." This soul-searching immunologist may well have found a frontier-blasting application for his organ-destroying talent - with no boredom in sight!