Eric Grewal. Image: Aaron Washington
This essay was written for the 2017-2018 HMS Dean's Report in answer to the question "What is the promise of biomedicine to me?"
Diphtheria. Measles. Polio. Just a few decades ago, these diseases were death sentences for patients across the globe. Yet today, they often escape our attention completely, quelled by vaccines that cost less than a smartphone and take a minute to administer.
This stark contrast between worlds—one of illness and one of unparalleled health—has only been made possible through massive strides of progress in biomedicine. To me, however, the promise of biomedicine is still in the process of delivery.
Just as patients in the 20th century anticipated a cure for infectious diseases, I look forward to a future where conditions as complex as cancer and autoimmunity can be ameliorated with a treatment as simple as a vaccine.
I look forward to a future where conditions as complex as cancer and autoimmunity can be ameliorated with a treatment as simple as a vaccine.
My faith in the promise of biomedicine was seeded early in my life. While other kids enjoyed shooting hoops on the playground, I was the type of kid who’d rather puncture my basketball and use the shell to make a model of a eukaryotic cell. But beyond my childhood antics, I also witnessed a key event during my youth that changed my view of biomedicine forever. When my dad was diagnosed with aggressive lymphoma, my family and I assumed the worst. His oncologists confirmed the often terminal nature of his disease, uncertain if standard chemotherapy would be curative.
Luckily, my dad was a scientist—an immunologist, in fact. He understood exactly the nature of his disease. As a researcher, he was also aware of experimental therapeutics that were being tested in clinical trials. One of those drugs, rituximab, had the potential to treat cancers such as his, and his oncologists saw the perfect opportunity to incorporate this novel therapeutic into his treatment regimen. Over a decade later, my dad remains cancer-free, and this I believe can only be described as a feat of modern medicine. Moreover, rituximab has gone on to be approved as a standard treatment for numerous other conditions. Today it’s listed on the World Health Organization’s List of Essential Medications. I was inspired by this triumph. Even at a young age, I knew that I wanted to develop novel therapeutics as a biomedical researcher in the future.
I soon got my chance to do so. I began my exploration of research at Amgen Inc. and the Institute for Systems Biology, getting a taste of what working in a laboratory was like. These experiences allowed me to hit the ground running when I enrolled at the University of California, Berkeley. As an undergraduate, I worked extensively as a researcher at Aduro Biotech, a company that’s developing therapies to unleash a patient’s own immune system against cancer.
Notably, our scientists pioneered a technology that transforms Listeria monocytogenes, a seemingly deadly bacterium, into an innocuous vaccine vehicle for tumor antigens. My research also involved a protein called STING, which can be targeted to promote an antitumor immune response. Many of the drug candidates I worked on as an undergraduate are currently being used to treat patients in human clinical trials. Watching a theoretical drug idea be translated into a potentially life-saving medicine, in just a matter of a few years, confirmed my belief in the power of drug development.
After graduating from UC Berkeley in just two years, I knew I needed to further my education to keep working on new therapies. I chose the Immunology Program at Harvard Medical School because of the unparalleled access it provides to a world-class community of translational researchers. In the classroom, I would hear from celebrated professors such as Shiv Pillai, who pushed us to think beyond the constraints of basic biology. What is memory? How does one differentiate self from nonself? Can tolerance be learned? As philosophical as these questions may sound, they actually inform some of the most pressing issues we contemplate as immunologists—memory responses to pathogens, self/nonself discrimination during allergy, and tolerance from autoimmunity.
This philosophical mindset also comes in handy in the lab, where I’m working on another new immunotherapy for cancer. Under the supervision of HMS associate professor Catherine Wu at the Dana-Farber Cancer Institute, I’m investigating a class of personalized cancer vaccines that actually target the deceptive mutations that cancers use to evade detection. By targeting these so-called “neo-antigens,” we’ve been able to induce encouraging responses in a small number of patients with advanced tumors.
To be sure, not every experimental drug will be a magic bullet. For every cancer medicine that gets approved, numerous others fail to show efficacy in clinical trials. But despite this fact, researchers like me and my colleagues at HMS remain committed to the cause of translational therapeutics. We strive to keep developing new therapies until the day that diseases like cancer are just as distant in our memory as measles. And to me, that’s the real promise of biomedicine.
