Tavis: Dr. Vincent Tuohy is a noted immunologist at the Lerner Research Institute at the Cleveland Clinic. He’s also the principal investigator in this new study on what could be a watershed moment in the fight against breast cancer. He joins us tonight from Cleveland. Dr. Tuohy, an honor to have you on the program, sir.
Dr. Vincent Tuohy: Well, it’s my pleasure; I’m delighted to be here. Thank you.
Tavis: You are, as I mentioned, an immunologist, not a cancer specialist. So how did you end up being the guy at the center of this kind of breakthrough?
Tuohy: Yeah, that’s a – (laughter) This is my first manuscript on cancer. I’m really not known as a cancer researcher and I’m certainly not a breast cancer expert. But I’ve spent my whole career targeting and harnessing the immune response against very highly specific targets and created several mouse models for human diseases that include heart failure, multiple sclerosis, deafness, in fertility and so forth.
I just thought that it would be a nice opportunity as I’m entering this stage of my career to try not only to destroy organs and create these animal models for testing new therapies and understanding disease mechanisms but also to actually destroy the tumors derived from these organs, and a good start, I thought, would be the breast and breast cancer.
Tavis: Tell me more, then, about the study involving these mice.
Tuohy: Yeah, well, this goes back about eight years or so, when we realized from the – just examining the mortality and morbidity of a variety of different childhood diseases that we had a wonderful childhood vaccination program that protected us in a magnificent way from the development of childhood diseases like measles and polio, and yet it stops at age 13 with a vaccination against the human papilloma virus in the teens.
It just ended – there was no more vaccinations scheduled until the ’60s with Herpes Zoster for shingles pneumococcus. So there was this giant gap, a real deficiency, I thought, in our healthcare in that we had no vaccine, we did not attempt to try any protective immune therapy against adult diseases that we encounter when we reach our forties, like breast cancer and prostate cancer and colon cancer and so forth.
So this was a very big deficiency, I thought, in healthcare, and I thought that the model to approach protective therapy or protection against these diseases was the childhood vaccination program, which is really what we call a prophylactic vaccination – a protective vaccination that’s given before you get the disease so that you don’t get the disease, and that’s what the motivation was for my research.
Tavis: So that’s the motivation. Tell me now more specifically about what you have discovered in the lab.
Tuohy: Well, the big obstacle in developing a prophylactic or protective vaccine against breast cancer, the giant hurdle that had to be overcome was that when you vaccinate you must vaccinate against self. There are no viruses that are known to really cause the majority of breast cancer.
So we have to vaccinate against self. That means that we actually have to vaccinate against a protein that’s found in normal breast tissues and normal tissues. That would cause what we call autoimmune complications or inflammation and damage to those tissues. That would be an undesirable and inappropriate outcome in order to protect ourselves from breast cancer.
Breast cancer is really an overgrowth, an unregulated overgrowth of normal cells that just lose their ability to stop multiplying and they no longer are normal but they do make normal proteins that are found and over-expressed in the tumor and that are also found in the breast.
However, we found that they also make some proteins that are not over-expressed in the normal, non-lactating, healthy, normal breast tissue but only in the lactating breast tissue. So this, I thought, gave us an opportunity to target these lactation-dependent proteins that are over-expressed in the tumors but not expressed in the normal breast tissue.
The reason we did this is because there are two events that take place, I think, as women age in their forties. One is an increasing risk for breast cancer, an increasing need to be protected from it, and at the same time a decreased need to use the breast for lactation, for breastfeeding and really for survival of the species. That’s what the breastfeeding and lactation is all about.
So we thought we’d take advantage of this aging process, the natural aging process in a woman, and target a lactation protein over-expressed in the breast tumor but not really expressed in the majority of women as they age and go through their forties and fifties with increasing risk for breast cancer.
It turned out that it worked really well. All the mice that we vaccinated were protected against breast cancer, but showed absolutely no sign of inflammation in the normal breast tissue, and so we were delighted to see this finding. I think what it does now, it opens up the opportunity to be very careful in selecting the targets but in targeting self in such a way that we’re protected against a variety of different illnesses that are really I think quite extensive. It’s just open to our imagination.
Tavis: So how hopeful, then – I hear the delight. I note your use of the word delighted, so let me ask you, given that you’re being cautious about this, how hopeful women should be about what’s happening in your lab.
Tuohy: Well, I think hope is a very good thing, don’t you think?
Tuohy: It’s a very good thing. We all need hope. But we also need a bit of reality, and I think we have to understand that this is a very embryonic shape that we’re in, very embryonic form of this prototypic vaccine. We have a long, long way to go. There are lots of obstacles to overcome. We have about 10 years before we can get this to a healthy patient population that’s cancer-free, so we have quite a ways to go and there’s a concern that it may not directly translate from mouse to human.
That’s always a concern. But at the same time my feeling is if we can do it in mice, we can do it in humans.
Tavis: In short order and in terms that we can understand, what’s your concern about why it might not translate from mice to humans?
Tuohy: Well, there’s a lot of species variations in terms of protein expression. The inflammatory changes that we fail to see in mice may occur in normal women. We’re not sure of that yet. We’re going to look very carefully and that’s why it’s going to take a long time.
We have to approach this very safely, very carefully. However, all the concerns that we have, that everyone has, are certainly legitimate. At the same time, I don’t think they should be – we should be too skeptical, so skeptical that we don’t even try this.
I think this is an exciting opportunity for us to explore a new way of protecting us from adult diseases.
Tavis: Fair to say in closing here that you and your team are encouraged to work even harder now to figure this out?
Tuohy: We’re working very hard and we’re determined to carry this through until we see whether or not either this or something like this, an evolving variation of this, could also work.
We’re not finished by a long shot. We have a long way to go and there are many, many diseases before us. I’m hoping that the medical community takes up this initiative and also tries to apply the criteria for target selection to a variety of other diseases.
I think the possibilities to me seemed I wouldn’t say endless; I’m always accused of exaggerating, but quite extensive.
Tavis: Well, I can tell you this – there are a whole lot of people who are hopeful now, given these results, a lot of folk who feel a sense of urgency and excitement about what you and your team have done, and for any of us who have lost a loved one to breast cancer, we can’t support you and cheerlead you enough to keep moving forward.
So it’s a great breakthrough and I’m glad you had time to talk to us about it tonight, Dr. Tuohy. I’m going to let you get back in the lab and get back to work. You’ve got stuff to do, so thanks for talking to me.
Tuohy: Yeah, I’ve got a lot of work to do.
Tavis: I appreciate having you on.
Tuohy: Thanks a lot. It was great talking to you. Thank you very much.
Tavis: My pleasure.
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