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The Peter Attia Drive

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

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.77.3K Ratings

🗓️ 27 September 2021

⏱️ 126 minutes

🧾️ Download transcript

Summary

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:

  • Steve’s childhood and inspiration to become a physician and medical researcher [3:15];
  • Patients that influenced Steve’s thinking about cancer and altered the course of his career [13:15];
  • The discovery of antigen presentation, Steve’s first job, and why he knew he wanted to study cancer [19:30];
  • Cancer treatment in the early 1970’s and Steve’s intuition to utilize lymphocytes [26:45];
  • Cancer cells versus non-cancer cells, and why metastatic cancer is so deadly [31:45];
  • The problem with chemotherapy and promise of immunotherapy [38:30];
  • How the immune system works and why it seems to allow cancer to proliferate [43:15];
  • Steve discovers how to use interleukin-2 to mediate cancer regression [52:00];
  • The immunogenic nature of certain cancers and the role of mutations in cancer [1:03:45];
  • The improbable story of how CAR T cell therapy was developed [1:16:30];
  • The discovery of tumor infiltrating lymphocytes (TIL) and engineering of T cells to recognize specific antigens [1:28:00];
  • Steve’s experience treating President Ronald Reagan’s colon cancer [1:36:00];
  • Why Steve has turned down many tempting job offers to focus on his research at the National Cancer Institute [1:41:00];
  • The role of checkpoint inhibitors in cancer therapy and the promise of adoptive cell therapy [1:43:00];
  • Optimism for using immunotherapy to cure all cancers [1:48:00];
  • The human side of cancer and the important lessons Peter learned from working with Steve [1:52:15]; and
  • More

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Transcript

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0:00.0

Hey everyone, welcome to the Drive Podcast.

0:13.0

I'm your host, Peter Atia.

0:14.8

This podcast, my website, and my weekly newsletter all focus on the goal of translating

0:18.7

the science of longevity into something accessible for everyone.

0:22.4

Our goal is to provide the best content in health and wellness, full stop, and we've assembled

0:27.0

a great team of analysts to make this happen.

0:29.5

If you enjoy this podcast, we've created a membership program that brings you far more

0:33.3

in-depth content if you want to take your knowledge of the space to the next level.

0:37.3

At the end of this episode, I'll explain what those benefits are, or if you want to learn

0:41.1

more now, head over to peteratiamd.com forward slash subscribe.

0:46.3

Now, without further delay, here's today's episode.

0:48.9

I guess this week is Dr. Steve Rosenberg.

0:53.1

Steve is the chief of the surgery branch of the National Cancer Institute.

0:56.4

As a physician, he has held continuously for the past 47 years.

1:02.0

Some of you may have heard of me talk about Steve Rosenberg in the past.

1:05.8

He is unquestionably the most important mentor I've ever had.

1:10.9

Steve has received numerous awards.

1:12.9

In fact, really too many to name.

1:14.6

So it's probably easier to explain it this way.

1:16.8

He has received essentially every major award in science, except for the Nobel Prize.

1:22.8

He is one of the pioneers in the field of immunotherapy dating back to his early work

1:28.1

in the 1970s and 80s with the discovery of interleukin 2 and its effect on lymphocytes

...

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