Milestones and a mission
Former President George H.W. and Barbara Bush are all about celebrating milestones. From fundraising birthday bashes to co-chairing MD Anderson’s 60th anniversary, they’ve been involved in raising money to help others for decades.
Their philanthropic activities often involve world leaders and major entertainers. They sometimes include a bit of thrill seeking on the part of President Bush. In 1999 and 2004, he found himself jumping out of a “perfectly good airplane” (according to Mrs. Bush) during fundraising events to help those dealing with cancer and other challenges.
Now, MD Anderson celebrates a milestone made possible by the Bushes’ commitment to cancer care. June 2009 marked the 10th anniversary of the George and Barbara Bush Endowment for Innovative Cancer Research — a fund that has been instrumental in helping MD Anderson scientists provide proof that their creative ideas work and move their findings from the laboratory bench to patient care.
Approximately 3,300 people helped launch the Bush Endowment at a June 1999 gala celebrating President and Mrs. Bush’s 75th and 74th birthdays, respectively. MD Anderson continued raising funds for the Bush Endowment through the institution’s 60th anniversary event in November 2001 and 41@80, a celebration of President Bush’s 80th birthday in June 2004. The three efforts raised more than $50 million for the Bush Endowment and have helped fund the work of 16 physicians and scientists.
By primarily supporting basic science, the Bush Endowment fills a critical gap in the research funding process. Before making a grant, agencies such as the National Institutes of Health require a kind of evidence called “proof of concept.” With Bush Endowment “seed funding,” MD Anderson scientists can develop that evidence and press on with their investigations. Such innovative research has produced a tremendous amount of information about the genetic and molecular abnormalities that lead to cancer. Using this information, scientists are working to determine which is the driving force in an individual’s cancer and then develop a personalized treatment that targets that abnormality.
Four of the 16 Bush Endowment recipients are focusing on immunological approaches that harness the patient’s immune system to fight the disease. To develop powerful immunotherapies, these researchers and their colleagues are forming collaborations to translate findings from basic immunology research into clinical trials for such cancers as melanoma, lymphoma and leukemia. The Department of Immunology also plans to expand this research to treatments for sarcoma, prostate and breast cancers. Immunotherapy has the potential not only for treatment of disease, but also for prevention of recurrences due to the immune system’s ability to “remember” the antigen. In addition, it could be used as a preventive measure for healthy people who are at high risk of developing certain cancers.
Nicho Bourque is proof that personalized cancer medicine holds tremendous promise. Bourque visited her dermatologist in Lake Charles, La., in August 2007, when a mole on her right hand under her middle fingernail began to grow larger. When the biopsy came back positive for a rare type of melanoma, her dermatologist strongly suggested she go to MD Anderson.
Merrick Ross, M.D., professor of surgical oncology, performed surgery, working closely with plastic surgeons to save Bourque’s finger. But one month later, tests found that the melanoma had grown deeper than thought, and Ross amputated her finger to the first joint.
Bourque and her husband, Trent, returned to MD Anderson every four months for scans to determine whether the melanoma had spread. In August 2008, tumors were found in her lungs.
Her oncologist, Nicholas Papadopoulos, M.D., professor of melanoma medical oncology, gave her several options for treatment. Bourque asked, “If I were your daughter, what would you choose for me?”
Bourque had two rounds of interleukin-2, a natural protein that stimulates T cells in the body, but that alone did not work. Papadopoulos asked if she’d be part of a clinical trial using her body’s T cells to fight her cancer. Bourque agreed.
Some T cells (tumor infiltrating lymphocytes, or TIL) have the ability to specifically recognize melanoma antigens, or markers. That discovery has led to the development of adoptive cell transfer (ACT) protocols for patients with metastatic melanoma, enabling a patient’s immune system to fight tumors. While these TIL heroically attempt an attack on tumors, in most cases the tumors win out because the tumor environment suppresses the efforts of the TIL. Scientists have found that if they harvest T cells inside a patient’s melanoma tumor after surgery and grow them to great quantities, they can boost the individual’s immunological army enough to overpower the tumor.
Following Bourque’s lung surgery, investigators from the Department of Melanoma grew T cells removed from her tumor for six weeks. The T cell count had to reach 40 million in the first stage before she could receive the treatment. It doesn’t always happen.
“For the first few weeks, we prayed and prayed for the T cells to reach the minimum number. When we finally reached that milestone, we were overjoyed,” says Bourque.
Bourque spent two and a half weeks at MD Anderson receiving T cells, chemotherapy, high dose interleukin-2 and dendritic cell therapy — another milestone. “The addition of a vaccination step to existing ACT therapy in humans has been shown to significantly enhance anti-tumor responses,” says Patrick Hwu, M.D., chair of the Department of Melanoma Medical Oncology and a recipient of Bush Endowment funds. “Nicho is the first human to receive her own dendritic cells, mixed with a melanoma antigen, in combination with the T cells. Dendritic cells are the most potent antigen-presenting cells known and have a great capacity for activating TIL. When they come in contact with T cells, they activate the cells and induce their proliferation. We’re thrilled about the potential this combination therapy holds for patients.”
Bourque was thrilled as well at the scans taken after her T cell treatment.
“Our results were amazing,” she says. “The tumors had shrunk dramatically.”
From the start, Bourque told her husband that it was important to “do this so that I can help others.
“I know I’m going through all of this for a reason,” she says. “The message I want others to know is that they can beat this. It’s doable. And it is important to live every day like it’s your last.”
Maybe that’s why jumping out of a perfectly good airplane can make sense.