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[Interview] Cancer Researcher Steven Powell on This Year’s Nobel Prize in Medicine

Oct 24, 2018 06:00AM ● By MED Magazine

Last month, this year’s Nobel Prize in Physiology or Medicine was awarded jointly to James Allison of the US and Tasuku Honjo of Japan for conducting the research that helped give rise to immunotherapy. The two are credited with paving the way for the first checkpoint inhibitors that are now routinely used in cancer immunotherapy.

But as Sanford researcher Steven Powell, MD, observes in a recent interview with MED, their work, pivotal as it is, has only scratched the surface of what might be possible in this quickly evolving medical field.

MED: Is cancer immunotherapy a new field?

SP: Not entirely. We have known that the immune system is important in cancer for over 100 years. The first work in cancer immunotherapy was done by a researcher and physician who was injecting patients with puss in the hope of spurring an infection and causing a massive immune response. That was a crude way of using immunotherapy and it was not very successful.

MED: What is the significance of Allison and Honjo’s work?

SP: These guys found a piece of the puzzle that was integral to making immunotherapy work. They discovered how checkpoints, these immune system braking mechanisms in the body, can be turned off so that cancer can’t use that to survive. Their work has led to a massive interest and discovery of other aspects of the immune system. My personal feeling is that they absolutely deserve the Nobel Prize.

MED: And yet immune checkpoint inhibitors are not a cure for cancer. Why not?

SP: The problem is that not all cancers use these mechanisms to survive. Some use different mechanisms. In my lab, we look for biomarkers to help identify which patients are likely to benefit from immunotherapy and which aren’t.

MED: Why isn’t a “strong immune system” the most important factor is warding off cancer?

SP: The immune system is incredibly complex. It is like the body’s military. It has to attack when it is supposed to but it also has to recognize when it needs to back off. People talk about taking supplements to “strengthen immunity.” But you don’t need your immune system to be overly active; you need it to be specifically active.

MED: What is next for cancer immunotherapy?

SP: We now have about a half dozen trials looking at other immune checkpoints, besides the ones identified by Allison and Honjo. In addition, some of our trials involve combinations of drugs, because sometimes the immune system needs a little bit of a push and sometimes it needs a brake. We are also trying to learn how to use immunotherapy with chemotherapy, radiotherapy and other treatments to get the most out of it. The only way it is going to happen is to get more people involved in clinical trials. That is what we hope to do.

Raad about Dr. Powell’s involvement in the KEYNOTE immunotherapy trial.

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