A cutting edge approach to stimulate the immune system: immunotherapy, a cornerstone in the treatment of advanced melanoma.

Prof. Michal Lotem, M.D. Head, Center for Melanoma and Cancer Immunotherapy. Sharett Institute of Oncology

Melanomas (skin cancer) are among the most aggressive and life-threatening cancers worldwide. In the United States alone for 2017, about 87,110 new melanomas will be diagnosed (about 52,170 in men and 34,940 in women) and about 9,730 people are expected to die of melanoma (about 6,380 men and 3,350 women). Unfortunately, the incidence of melanoma is on the rise in the U.S. and around the globe. One of the risk factors for melanoma is exposure to natural/artificial ultraviolet light which elicits DNA photo- damage. Despite improvement in melanoma therapy over the last decade, metastatic melanoma remains deadly.

Prof. Michal Lotem, Head of the Center for Melanoma and Cancer Immunotherapy, and her research team are at the forefront of anti-cancer therapies to harness the body’s own immune system and using it to eradicate cancer. This treatment, called immunotherapy, boosts the body’s natural defenses to fight cancer. It uses substances made by the body or in a laboratory setting to improve/restore the immune system function and inhibit the malignant activity of cancer cells, while leaving healthy cells unaffected. In general, most scientists working at the laboratory bench are not well connected to clinical teams and this disconnection significantly obstructs the translation of novel basic science discoveries to clinical practice. The uniqueness in Prof. Lotem’s work is the intrinsic connection between the clinicians involved and the basic scientists, thus bridging the gap between basic science and clinical practice. The clinicians involved at the Center for Melanoma are the same ones engaged in basic research for the direct benefit of patients.

The Center for Melanoma and Cancer Immunotherapy uses two different vaccines that are having a significant impact in patients with advanced melanoma stages III and IV. 1) The Autologous Vaccine, which is prepared from the patient’s own tumor cells obtained from a biopsy during surgery is custom made for each patient. For the past 16 years, a clinical study in patients with advanced melanoma receiving the autologous vaccine has shown a higher proportion of surviving patients after treatment as compared to lower survival rates of non-vaccinated patients. 2) The Modified Allogeneic Vaccine for melanoma and other tumors, which is prepared from a tumor cell line with improved activity. This vaccine is suitable for a large percentage of patients and consists of a tumor cell line that has undergone changes to improve its recognition by the immune system, and enhances the response it elicits in the patient. In addition, in her pursuit to identify a novel and efficient melanoma treatment, Prof. Lotem has identified in human and animal studies a highly relevant, albeit unexplored, target for optimizing melanoma immunotherapy (a molecule termed SLAMF6). This actively ongoing basic research investigation could lead to clinical application within a relatively short period. The different treatment options used at the Melanoma Center offer a new lease on life in those patients with advanced melanoma.

Prof. Lotem represents an exciting breed of scientists with cutting-edge scientific thinking who contribute to the field of cancer by looking into reprogramming/triggering the body's own immune system to home in on cancerous tumor cells and attack in a more natural fashion, unlike treatment with chemotherapy and radiation. This novel approach to cancer treatment is an exciting area of medicine, which aims at exploiting the patient’s own immune cells to achieve a medical benefit.

Prof Lotem is an international expert in skin cancer and clinical oncology, who combines innovative basic research with treatment of her patients with a personalized protocol that only a handful of oncology centers around the globe are able to offer.