Zena Werb is a professor in the UCSF Department of Anatomy and associate director for basic science at UCSF's Helen Diller Family Comprehensive Cancer Center. Photo: Sonya Yruel
from UCSF Magazine Winter 2020
The Future // Visions for 2050
New treatments like immunotherapy are producing astonishing outcomes for some cancer patients. Five-year survival rates have increased dramatically since the early 1960s. And novel therapies that target specific genetic mutations are prolonging and saving lives while causing fewer side effects than radiation and chemotherapy.
But cancer is not a single disease, which is why finding a single cure is so elusive. Basic scientist Zena Werb, PhD, has been studying cancer cells in UCSF labs for more than four decades. Here, she shares her take on the future of cancer medicine.
Where do you think cancer research is headed?
We’ve mostly studied the nasty things about cancer – oncogenes and suppressor genes that propel cancers forward. What we haven’t looked at adequately is what keeps a cell in a non-cancer state. By 2050, I believe scientists will be addressing the neighborhood, or microenvironment, around a tumor and better understanding its role in keeping cancer cells under wraps.
How does that fit in with new treatments like immunotherapy?
Recent breakthroughs in immunotherapy and precision medicine have the potential to drive increased interest in the tumor microenvironment. People don’t realize the immune system is broader than just T cells and CAR T cells. The whole neighborhood, or matrix, around a tumor – not just the tumor itself – is important, and specifically how genes, microbes, organisms, and proteins all interconnect. Understanding this process, known as “biological crosstalk,” could uncover a great deal about the mechanisms that lead to cancer metastasis. Research directed at how the many disparate pieces of this complex biological system work together and influence health will become increasingly important.
Why have we seen so many breakthroughs recently?
New technologies have allowed us to image and sequence the genomes of tumors and cancers in ways that were never possible before. Targeting specific tumor pathology and genetic mutations with personalized therapies has produced incredible results for some patients. It’s really remarkable. But at the same time, we have to continue developing models of care and therapies that impact populations and not just individuals. Big-data analytics will play a huge role in that effort.