UVA School of Medicine

VIRGINIA MEDICINE Fall 2022

University of Virginia School of Medicine Vitals magazine published by the UVA Medical Alumni Association and Medical School Foundation (MAA MSF)

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Fall 2022 11 In a perfect world, that would be the end of the story. Unfortunately, it's not. Some cancers are more immunogenic than others, researchers have found. The immune system recognizes melanoma cells more readily than many other cancers, and it tries to mount a systemic response against melanoma to remove those cells. Breast, pancreatic, and many other common cancers, however, are not so immunogenic. "Solid tumors are fairly adept at evading immune recognition, so there's a lot of interest in trying to disrupt that environment within the tumor," says surgical oncologist and immunologist Craig Slingluff, MD, who serves as director of UVA Cancer Center's Human Immune Therapy Center as well as another co-director of the Focused Ultrasound Cancer Immunotherapy Center. His work developing therapeutic In the last decade, cancer immunotherapy has revolutionized treatment for some malignancies by harnessing the human immune response to detect and remove cancer cells from the body. Unfortunately, that breakout success only extends to certain tumors that have, by nature, the ability to induce an immune response. Now scientists at the University of Virginia want to take those advances to a new level by adding focused ultrasound (FUS) to their armamentarium. The establishment of the world's first Focused Ultrasound Cancer Immunotherapy Center at UVA is providing a significant boost to that effort. With the expertise and support of the Charlottesville- based Focused Ultrasound Foundation, this new center unites UVA's strengths in cancer immunotherapy, focused ultrasound applications and medical imaging in the quest to develop new technologies to improve outcomes for patients with cancer. Enhancing the Immune Response The groundbreaking work of neurosurgeon Jeff Elias, MD '94, led UVA's clinical innovations in FUS more than a decade ago, developing treatments for essential tremor, Parkinson's disease, epilepsy and other conditions. UVA's chief of breast and melanoma surgeon David Brenin, MD, who serves as one of three co-directors of this new center, was among the first researchers at UVA to explore the value of this image-guided technology for treating conditions outside the brain. He has used FUS ablation to treat both benign and malignant breast tumors for almost ten years. What Brenin and others hope to find is that FUS treatment of a tumor in one area of the body will generate an immune response that will also destroy tumor cells that have metastasized to other areas of the body. "That abscopal effect is key because very few people die from the tumor in the breast," Brenin says. "The thing we worry about is metastasis. We hope that treatment of the tumor in the breast with FUS will induce a cellular immune response to the damaged tumor cells in the breast. When this happens, the body can create T cells that are sensitized to the tumor and have the ability to circulate around the body, trafficking to metastatic sites where they can attack the tumor cells and kill them, or at least keep them under control." The thing we worry about is metastasis. We hope that treatment of the tumor in the breast with FUS will induce a cellular immune response to the damaged tumor cells in the breast." D A V I D B R E N I N , M D C O - D I R E C T O R , F O C U S E D U L T R A S O U N D C A N C E R I M M U N O T H E R A P Y C E N T E R A T U V A

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