Dr. June: We are in the midst of a revolution in the understanding and treatment of cancer. Precision therapies targeting each person’s cancer have the potential to replace toxic and non-specific therapies such as chemotherapy. My team at the University of Pennsylvania has been working for more than 20 years to engineer the human immune system to fight cancer with chimeric antigen receptor CAR T cells. We’ll discuss the emerging industry of CAR T cell therapies.

Slone Partners: You were named one of Time Magazine’s 100 Most Influential People in the World in 2018, which was presented with an anecdote by a former 7-year old pediatric patient who credited you with saving her life. What was it like seeing yourself and your scientific work presented alongside pop icons Xi Jinping, Cardi B and Robert Mueller?

Dr. June: It was of course a huge honor to be listed side-by-side with Elon Musk and Nancy Pelosi, but to be honest, my teenage children were more impressed than I was. The list was published by Time in April 2018, and what impressed my children was that I was listed 6th, ahead of Jennifer Lopez and Rihanna! I am most humbled that the former “7-year old pediatric patient” (Emily Whitehead) is now 14 years old and cancer-free. What greater reward in one’s career could possibly happen?

Slone Partners: Your visionary, award-winning work developing chimeric antigen receptor CAR T-cell therapy represents an exciting breakthrough utilizing cell engineering. Tell us about CAR T-cell therapy, your team, and the University of Pennsylvania’s place in the pantheon of cancer discoveries.

Dr. June: CAR T cells are a form of gene therapy that trains a patient’s immune system to recognize and destroy their cancer in the same way it dispatches bacteria and viruses. My laboratory began working on understanding how T cells can be activated to fight cancer in the 1980’s. In 1992, Bruce Levine, Ph.D. (now a colleague of mine and Professor at the Perelman School of Medicine) joined my lab as a postdoc where he invented a method to grow CAR T cells that is now used worldwide. What makes immune-based therapies like CAR T cell therapy so promising – and so powerful – is that they are a living drug churned out by the patients themselves. The treatment isn’t a pill or a liquid that has to be taken regularly, but a one-hit-wonder that when given a single time, trains the body to continue treating, ideally for a lifetime. They are the first “living drug.”

Slone Partners: You’ve said that it is vitally important that the research, medical and pharmaceutical communities collaborate to maintain momentum in personalized medicine. With shared research databases, the life sciences industry exploding, and academic medicine institutions seemingly flush with cash gifts, what barriers still exist for curing cancer?

Dr. June: It is only recently that cancer became the number one cause of death in the US, now that medicine has made major inroads into preventing and treating atherosclerosis and cardiovascular disease. However, the job of eradicating cancer is not close to being completed. At this point, most patients still die from metastatic cancer, with perhaps 20-30% cured by today’s immunotherapies. I’m optimistic that the combined efforts of academia along with the biotechnology and pharmaceutical industries will solve the cancer epidemic.

Slone Partners: There have been many vital milestones in oncology over almost 250 years of research, therapies, and policy, beginning with Percivall Pott’s first writing about an outbreak of squamous cell carcinoma of the scrotum in chimney sweepers in 1775, to gene cloning advancements in the 1990’s. When you look at the dozens of oncology breakthroughs identified on the National Cancer Institute website, what stands out as the most important, and where does personalized medicine rank as a breakthrough?

Dr. June: I had to look up the list of milestones! One major milestone was in 1909 when the German physician-scientist Paul Ehrlich proposed that the immune system usually suppresses tumor formation, a concept that became known as the “immune surveillance” hypothesis. I was privileged to share the Paul Ehrlich award with Jim Allison a few years ago in Germany, for developing immunotherapies for cancer that Ehrlich had foreseen a century previously. The Nobel prize in Medicine or Physiology was awarded to Jim in 2018 for the discovery of checkpoint therapy, and perhaps there will be recognition for CAR T cells in the future!

Slone Partners: How, when and why did oncology become your life’s work? Was there a specific “aha” moment where you consciously made the decision to help solve one of humanity’s grandest challenges?

Dr. June: Lisa Rosenbaum, M.D. wrote about the strange quirks of fate that led to CAR T cells (New England J Medicine, 377(14), 1313, 2017). To quote from her article “So many times, I almost had to quit. June spent his early career developing a technique to boost immune function in patients with HIV by modifying their T cells and inducing proliferation ex vivo. Though he and his colleague Bruce Levine would later build on this technique to engineer patients’ T cells to attack leukemia, June might have continued focusing solely on the basic science. But in 1996, his 41-year-old wife was diagnosed with ovarian cancer.” When my first wife Cindy was diagnosed with metastatic cancer, it galvanized me to turn from basic science research and I then placed the translational science of developing CAR T cells on the front burner. I’ve discussed this in more detail in a recent TED talk. I am forever grateful to my colleagues Bruce Levine, Jim Riley, Anne Chew, Yangbing Zhao, and Michael Milone, and many others, including my second wife Lisa Speicher who helped get me through that tragedy and turn CAR T cells into a reality. It is not unrealistic to expect that one day CAR T cells will cure ovarian cancer.

Slone Partners: What makes you personally happy?

Dr. June: I’d have to say that the answer to this question changes with the passing years. Early in my career I was intensely devoted with 24×7 attention to bench scientific research. I have some regrets that this maniacal focus, which eventually resulted in cancer breakthroughs, came at some costs to my success as a father and spouse at home. However, now what is most personally rewarding to me is teaching in my laboratory and at home. I am basically a “coach” for a large team of scientists and students at work. At home, I’m blessed with 5 children and 4 grandchildren, and I try to divide my time equally amongst them. I enjoy long hikes in the mountains with my wife Lisa. Some of my best ideas come to me on long bike rides. Work-life balance is surely the hardest issue that faces me.