Bold vision: Q&A with George Coukos

What advice would you give to your younger self?
Be bold and be courageous in the choices you make—both are key ingredients in a successful career. Dare to follow untraveled paths and don’t be afraid of failure. If you don’t try, you’ve already failed. Success is not a given. You have to have the audacity to fly on your own and be willing to take risks.

How did you become interested in ovarian cancer research?
After completing a clinical fellowship in gynecologic oncology, it became very evident to me that it was the side of gynecology that needed the most help. Ovarian cancer is the deadliest form of gynecologic cancer and a particularly challenging problem, and we needed to improve our understanding of this disease and its underlying biology, and the methods to improve prevention and early detection, if we were ever going to attempt to reduce its burden.

In the area of translational research, one of our most important efforts is to develop better ways to interrogate tumors so that we can begin to really understand and learn what happens in patients when things go right and when things go wrong. Our bioengineering research programs will develop the next generation of immune engineering technologies.

What do you consider to be the most exciting development in cancer research today?
For me and for many others, it has to be the immune therapy revolution. Unlocking the immune system is the big new hope for cancer treatment because in recent years we’ve seen some truly promising advances in treating certain types of cancer. Along with surgery, radiation and chemotherapy, immunotherapy is becoming a viable avenue of treatment and offers hope to people with cancers that are otherwise difficult to treat. With immunotherapy, we’ve entered a new era of cancer therapy by enabling the immune system to continuously monitor against the reappearance of ‘foreign’ cancer cells. So the ability to reprogram the immune system is changing the paradigm in cancer treatment. Harnessing the natural ability of our immune system
to eliminate malignant cells represents the most promising anti-ovarian cancer strategy since the development of chemotherapy. We now have the tools to shape the way we treat cancers in a way we haven’t before. I think there is no doubt in the oncology community that immunotherapy is here to stay and will continue to make a significant impact—in much the same way that chemotherapy, molecular targeted therapies, radiation therapy or surgery have done—as we optimize the technology and the medical science behind it.

Can you tell us about the research you’ll be pursuing at the Lausanne Branch?
We will continue to study the human tumor microenvironment and develop a variety of new immunotherapeutic strategies, including more personalized approaches using cell-based technologies. We know that immune-based approaches have succeeded in other lethal cancers, such as melanoma. I believe that successful immunotherapy approaches will depend on the ability of re-engineered T cells to travel into the tumor environment, and we are developing ways to engineer immune cells to better recognize tumor cells and then to kill them. Our ultimate goal is to translate these discoveries to the clinic.

What made you decide to assume the leadership role at the new Ludwig Lausanne Branch? Why did you decide take on this challenge?
My passion for immunotherapy and Ludwig’s long history in Lausanne and its expertise in cancer immunology made my decision easy. Ludwig has invested more than 200 million Swiss francs in its research efforts in Lausanne, and there is a cadre of experienced cancer immunologists on the ground. This puts the new Branch in an unparalleled position to guide the field in bringing the next generation of cancer immunotherapies to patients.

What are you hoping to achieve in Lausanne?
We aspire to be one of the world’s leading programs in cancer immunotherapies. I think we can achieve this by creating a vibrant environment within the Branch that offers our researchers access to the clinical pathway as well as cutting-edge technology and engineering. This will ultimately give patients access to innovation. The most important goal is
to foster the creation of groundbreaking translational research programs and accelerate our discoveries into results
that will have a positive impact on the future treatment of human cancer.

This is a big, bold vision—and one I deeply believe we can achieve. We have a common and unified goal for the organization and we’re going to work very hard to ensure a collaborative, open environment and leverage the talent of our scientists and clinicians in order to avoid the ‘silo’ culture that tends to hinder progress in cancer innovation.

Critical to our success is the government and multi-institutional support from the Lausanne University Hospital (also known as the CHUV), University of Lausanne, the ISREC Foundation and the Swiss Federal Institute of Technology. We’ll be based at the University of Lausanne and the CHUV and operate in close collaboration with the new Swiss Cancer Center Lausanne.

You have been grappling with ovarian cancer for almost 25 years. Are we making any headway in detecting or preventing it?
Persistence is in my DNA. Worldwide, ovarian cancer is the seventh most common cancer in women and the five-year survival rates haven’t changed much in the past 30 years. Right now, we don’t have any ovarian cancer screenings that have been proven accurate enough to use in the general population. Nor do we have guaranteed ways to detect it or to prevent it other than surgical removal of the ovaries and the fallopian tubes.

Since our ultimate goal is to prevent cancer, it’s very important we focus our efforts in detecting tumors early enough to save lives by finding ways to train the body’s own immune system to kill cancer cells. With immune-based approaches, we’re finally making progress and getting some momentum going.

You’ve been quoted as saying that you always set yourself five-year goals. What are they now?
Make the promise of immunotherapy a reality for more patients. I’m very optimistic that treatment advances in immunotherapy will mean that cancer cure rates could rise from 50% to 75%. We’re going to achieve this by developing innovative and transformative approaches and moving them as rapidly as possible into the clinic.

Translational research is interpreted many ways, but true translational research has a direct impact on the way we manage patients. The key word is “impact.” The eyes have to be really focused on a specific problem, and we need to assemble the teams and approaches that will make a dent in this problem. So it’s imperative that we work closely with our partner institutions to ensure that both the research environment and the clinical environment are completely integrated, which will allow us to achieve these ambitious goals.