The vaccine specialist: Q&A with Lana Kandalaft

Can you tell us about what excites you most in your work right now?
We’re pretty unique here at the Ludwig Lausanne Branch, in that there are not many translational programs around the world like ours. I have an amazing team to work with in developing cancer vaccines and other immunotherapy products for our patients. And right now, we are in an excellent position to deliver some innovative products to them. Our work is very gratifying because we are able to see our technologies being implemented in clinical protocols and witness first-hand how a treatment is working and whether it is benefitting an individual patient.

You’ve done a lot of research on ovarian cancer. How optimistic are you about near-term opportunities for immunotherapy treatments for this kind of cancer?
While we don’t have immunotherapy for ovarian cancer as yet, we have a lot of promising leads. I think the challenge is going to be defining exactly which patients may get the best results from different approaches. There are a couple of studies out whose results are encouraging and indicate we need combination therapies along with chemotherapy to produce a better response. Chemotherapy and PARP inhibitors are viable combination partners for immunotherapy and combining checkpoint inhibition with other drugs may lead to some new options for patients. But none of these combinations are standard of care right now. Now the more that we understand the tumor microenvironment and its influence on a patient’s response to therapy, the more we’ll be able to understand how various combination therapies work and which ones might work best.

My interest is in vaccines, and I have a paper out right now with my colleagues here Alexandre Harari and Cheryl Chiang at the Ludwig Lausanne Branch on a personalized cancer vaccine strategy that recognizes the importance of T cells for controlling ovarian cancer. Some interesting early data have come out that may lead us in directions that we want to go, but larger studies need to be done to validate the findings. Vaccines are not the cure, however. It’s my hope that they will eventually be integrated into the standard of care, but they will not be the definitive cure for ovarian cancer.

What worries you the most about developing these therapies?
First of all, they are difficult to develop, and the difficulty is the technology—choosing the right antigen, choosing the right TCR (T cell receptor). The T cells themselves are difficult to handle. Number two, in order to ramp up production, you have to have the infrastructure to actually manufacture these products. Producing them and getting them to patients is complex and very challenging. While it took us quite a few years to build, the Center of Experimental Therapeutics (CTE) has two GMP manufacturing facilities: the Tumor Processing Facility and the Cellular Manufacturing Facility. Just as CAR T-cell therapy has been approved for standard of care for some cancers, I believe these new immunotherapies will be as well. And third, once we’ve developed these therapies there are some big questions to answer. How will the world adapt? Will pharma make use of all the good technology we’ve developed and run with it? Will every hospital in every country and in every city have the infrastructure in-house to treat its patients? Will these therapies eventually become part of the standard of care? We have a lot of hurdles to overcome, but I’m confident they are all doable.

Given all these challenges, what is it about ovarian cancer that drives you?
It’s what’s called the silent killer because it’s a very tough cancer to detect and by the time a woman receives a diagnosis, the disease is quite advanced, at either Stage III or IV. I started working on it at the Ovarian Cancer Research Center at the University of Pennsylvania with George Coukos and found it very challenging to treat. The disease landscape is such that the cancer bounces back in 85% of women who undergo the standard of care, which is surgery followed by chemotherapy. I think there is a watchful waiting period with this disease where a vaccine could be given to women in remission to prevent recurrence.

But it might have been my exposure to patients when I was at Penn that changed my mentality and the way I approach this disease. It’s a different ballgame when you interact with patients and their husbands or mothers or sisters or other close relatives. And I think part of my attachment to ovarian cancer stems from my personal experience with patients, many of whom have become friends.

Can you tell us what you find most stimulating about the research environment at Ludwig Lausanne?
At Ludwig we are really very lucky. The leadership has set a specific direction for the organization, and everyone on the team has a shared sense of purpose, and we are all working towards one goal. Or, as I like to say, we’re all drumming to the same beat. Our focus is on translational science—primarily tumor immunology and the design and development of novel immunotherapies. I admit it can be daunting in terms of career development because not every member can become their own PI or have their own lab or run their own Branch. But at the end of the day, we’re all working on something that will eventually get to our patients and hopefully make a difference.

What has it enabled you to do that you could not do previously?
Prior to coming here, I worked with George at Penn developing immune therapies for ovarian cancer patients. It was a small operation focused on vaccines. It was difficult because we didn’t have a Good Manufacturing Practice (GMP) facility and had to outsource everything. Here in Lausanne, we built a department that has it all. We’re one of the largest immunotherapy centers in Europe, and we have it all right here—the researchers, the doctors and the patients. Within the CHUV’s Department of Oncology, we created the CTE, which I run with a staff of 140. We have a clinical investigation unit to run our clinical trials and two GMP manufacturing facilities for cancer immunotherapies. Without these resources, we could not have achieved what we are achieving right now.

Your training has been very international. What perspective does that provide for you?
That you can be whoever you want to be wherever you are. It doesn’t matter if you’re in India, Spain, the U.S. or Switzerland. All it takes is the right mindset and the right attitude. Every new venue presents a different challenge. Each institution has a lot to offer. You have to adapt, as each has its own mission and its own way of doing things. There are new languages to learn, new cultures to embrace and new techniques to learn. But since I left home at such a young age, I was able to adapt quite easily and absorb everything around me like a sponge. And bottom line, science is science, whether you are working in the U.S. or Switzerland.

What is the most effective/best way for scientists to use social media to engage, communicate and interact?
Honestly, I don’t know. It’s very important to communicate about your work and share it with others, but I have to admit I lack the time right now to even think about using social media. I would need the support of a very good communications team to even start.

What would our readers be surprised to know about you?
I’m aware that people perceive me as a workaholic, and I know they think that I have no private life. But I do. I am a mother with two amazing boys. I’m a very good cook and have even mastered a Lebanese lamb dish that my dad said was even better than my mother’s. Music is a big part of my life. I wrote my entire PhD thesis to Jon Bon Jovi’s music—played very loud. And since moving to Switzerland, I have fallen in love with the mountains and ski touring. It’s my new passion. Exhausting, but so beautiful.

Would you share a story that led to you choosing your field of work?
It was in Cardiff, Wales, where I was working on my PhD in pharmaceutical drug delivery. I had just started a course in pharmaceutical biology that was interesting, but I couldn’t see a real-world application. One evening when I was sitting at the bench next to my computer, I came across a paper written by Doug Hanahan and Bob Weinberg entitled The Hallmarks of Cancer. I said to myself, “Ah, Lana, this is what you need to do. You need to deliver drugs to cancer. This is what you must do.” So I immediately started looking into postdoc opportunities at the National Cancer Institute in Bethesda. That was a turning point in my life. When I came to Lausanne in 2012, and first saw Doug Hanahan, I was so excited and thrilled to actually meet him that I know my face turned completely red. I kept saying to myself, Doug Hanahan is here, and it was his amazing paper that really touched me and changed my life.

When you’re not wearing your many science hats, what other activities are you involved in?
I’m at a stage in my life where my role as a mother has changed. I have a different connection with my two sons, who are now 10 and five years old, than I did when they were younger. While I encourage them to be independent, they will often bike alongside me when I run. I still play a lot of tennis and in winter we ski a lot on the weekends. Opera is not my thing, sports are. And I watch a lot of movies with the boys and, of course, listen to music.

What kind of music do you listen to?
I’m into French rap because it’s what my kids are listening to, and I want to be cool. I also listen to a lot of oldies because growing up, my dad was always playing them. But it’s definitely the music from the 80’s that gets me pumped up. It’s great music to run to.

There has been a lot of discussion in the media lately about women in science. What has been your experience as a female scientist? How do you see your role in helping to mentor women?
Again, I have been very lucky in that I have always worked in an environment where the leadership has been nothing but supportive of women. The field of science is challenging as it is, and it doesn’t really matter whether you are male or female, everyone is working towards the same goal. Here at the CHUV, women are well represented as 69% of the employees are female, and many are in leadership positions.

My role as a mentor is very important to me, and I often wish I had more time to devote to it. I am often approached by young women who want to know how I was able to achieve what I did, what my life is like, and ask whether a life outside the lab possible. Mentoring the younger generation is key to helping them reach the next level. I had one very talented female postdoc who came to work for me and over the years received a number of promotions, and ultimately became a key member in our department here at the CHUV. She now works in the pharmaceutical industry. One day, she came to me and said, “Lana, you didn’t just give me a job, you gave me a career.” That touched me deeply and reinforced how important it is to mentor and inspire the next generation.