#177 - Steven Rosenberg, M.D., Ph.D.: The development of cancer immunotherapy and its promise for treating advanced cancers

Sep 27, 2021 2h 6m 14 insights

Steve Rosenberg is the Chief of Surgery at the National Cancer Institute, a position he has held continuously for the past 47 years. Steve is a pioneer in the field of immunotherapies for cancer and a recipient of nearly every major award in science. In this episode, Steve discusses his inspiration for devoting his career to cancer research and describes his keen observation of two cases of spontaneous cancer remission, driving him to learn how to harness the immune system to treat cancer. Steve's personal story essentially serves as a roadmap for the field of immunotherapy, from the very non-specific therapies such as interleukin-2, the discovery of tumor-infiltrating lymphocytes, checkpoint inhibitors, CAR T-cells, and adoptive cell therapy. Perhaps most importantly, Steve expresses his optimism for what lies ahead, especially in the face of some of the more recent discoveries with respect to tumor antigenicity. Finally, Steve discusses the human side of cancer which helps him to never lose sight of why he chose to become a physician. We discuss: <ul> <li>Steve's childhood and inspiration to become a physician and medical researcher [3:15]; </li> <li>Patients that influenced Steve's thinking about cancer and altered the course of his career [13:15]; </li> <li>The discovery of antigen presentation, Steve's first job, and why he knew he wanted to study cancer [19:30]; </li> <li>Cancer treatment in the early 1970's and Steve's intuition to utilize lymphocytes [26:45]; </li> <li>Cancer cells versus non-cancer cells, and why metastatic cancer is so deadly [31:45]; </li> <li>The problem with chemotherapy and promise of immunotherapy [38:30]; </li> <li>How the immune system works and why it seems to allow cancer to proliferate [43:15]; </li> <li>Steve discovers how to use interleukin-2 to mediate cancer regression [52:00]; </li> <li>The immunogenic nature of certain cancers and the role of mutations in cancer [1:03:45]; </li> <li>The improbable story of how CAR T cell therapy was developed [1:16:30]; </li> <li>The discovery of tumor infiltrating lymphocytes (TIL) and engineering of T cells to recognize specific antigens [1:28:00]; </li> <li>Steve's experience treating President Ronald Reagan's colon cancer [1:36:00]; </li> <li>Why Steve has turned down many tempting job offers to focus on his research at the National Cancer Institute [1:41:00]; </li> <li>The role of checkpoint inhibitors in cancer therapy and the promise of adoptive cell therapy [1:43:00]; </li> <li>Optimism for using immunotherapy to cure all cancers [1:48:00]; </li> <li>The human side of cancer and the important lessons Peter learned from working with Steve [1:52:15]; and </li> <li>More</li> </ul> Learn more: https://peterattiamd.com/ Show notes page for this episode: <a href="https://peterattiamd.com/StevenRosenberg">https://peterattiamd.com/StevenRosenberg</a> Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

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Actionable Insights

1. Cultivate Purpose to Alleviate Suffering

Develop an almost spiritual desire to become a doctor and do research, focusing on making progress in helping people and alleviating suffering rather than causing it.

2. Maintain Unwavering Life Focus

Once a core purpose is identified, stick with it diligently throughout your education and career to achieve your long-term goals.

3. Innovate, Create Tomorrow’s Medicine

From the outset of your career, aim to create the medicine of tomorrow rather than merely practicing today’s science or medicine.

4. Acquire Broad Foundational Knowledge

To avoid intimidation by the unknown and effectively tackle diverse scientific problems, acquire a broad background in foundational sciences like physical chemistry, quantum mechanics, and thermodynamics.

5. Seek Inspiring, Knowledgeable Mentors

To foster a good education and personal growth, surround yourself with people who possess extensive knowledge and can inspire you.

6. Commit to Tireless Work Ethic

To achieve significant progress, commit to working tirelessly and consistently, including weekends, often being present in your workplace almost every day.

7. Sustain Enthusiasm Despite Failures

Embrace the philosophy that success involves moving from failure to failure without losing enthusiasm, always maintaining belief that your efforts will eventually work.

8. Secure Strong Family Support

To sustain a high level of professional commitment, secure strong personal and family support that understands your work and actively helps by managing daily life burdens.

Actively combat secrecy in science by openly sharing all knowledge, experimental results, and future plans with others to accelerate progress and help those suffering.

10. Persevere with Challenging Patients

Even when facing high rates of failure with critically ill patients, maintain a commitment to their care and use the profound suffering as motivation to work harder and innovate for improved treatments.

11. Appreciate Privilege of Helping

Acknowledge the unique and unbelievable privilege of being a doctor, using developed skills and wisdom to alleviate the suffering of others.

12. Read “The Transformed Cell”

For anyone wanting to understand how biomedical research is conducted, including the process of scientific discovery and the journey of failures and successes, read “The Transformed Cell” by Steve Rosenberg and John Barry.

13. Engage with Longevity Science Content

To translate the science of longevity into accessible knowledge, utilize Peter Attia’s podcast, website, and weekly newsletter.

14. Deepen Health Knowledge via Membership

To take your knowledge of health and wellness to the next level, consider joining Peter Attia’s membership program for in-depth content by visiting peteratiyahmd.com/subscribe.