Echoes from the Past: Frederick’s Flagship Immunotherapy Program, Part 1

Editor’s note: This is the fifth installment of a series about the history of the National Cancer Institute at Frederick and the Frederick National Laboratory for Cancer Research, and the first installment in a five-part miniseries about the Biological Response Modifiers Program.

It was a party of international stature. More than 300 scientists from 27 countries dined and rubbed elbows in the J. Harper Poor Mansion in Manhattan, a three-story abode that in past years had welcomed the likes of President John F. Kennedy, comedian Jack Benny, and actress Marilyn Monroe.

At the center of it all were the Krims, the owners of the opulent stone rowhouse on East 69th Street. Mathilde Krim, Ph.D., codirector of the Interferon Laboratories at Memorial Sloan-Kettering Cancer Center, and her husband Arthur, the prominent lawyer, political advisor, and chairman of Orion Pictures, had invited the droves of researchers into their home for a celebration to kick off an international workshop at Rockefeller University. The subject was interferon, a class of natural proteins associated with the immune system.

The grandiose event captured the growing scientific and public enthusiasm about interferon in the late 1970s. Data from early studies suggested that the proteins might be effective against several diseases, including cancer. (Krim, however, was careful to note that they were not “a magic bullet” while speaking with Life magazine’s Albert Rosenfeld at the party.)

The time seemed to be right for large-scale scientific action. Throughout the late 1970s, Krim and Mary Lasker, the nationally renowned philanthropist, activist, and National Cancer Advisory Board member, lobbied Congress and prodded the National Cancer Advisory Board to establish a federal effort to study interferon for cancer treatment.

Under pressure from politician and public alike, the National Cancer Institute yielded to the fanfare. However, no party ushered in its plunge into the world of compounds like interferon—called “biologicals”—in 1978. Instead, the move came at a conference table. The NCI Division of Cancer Treatment Board of Scientific Counselors established a subcommittee, led by Enrico “Henry” Mihich, M.D., of Roswell Park Cancer Institute, to explore the viability of a biologicals initiative.

Mihich’s team wasted no time, holding several workshops to assess the idea. In 1979, they presented their recommendations to NCI. The institute accepted, NCI Director Vince DeVita Jr., M.D., telling Congress that NCI would “provide a skeleton” for investigator-initiated research in biologicals.

Then NCI looked north to Frederick.

‘What Do We Need to Run a Clinic?’

The Frederick Cancer Research Center (FCRC, a forerunner to Frederick National Laboratory and NCI at Frederick) had the space to accommodate the program, the immunological expertise to offer a solid foundation, and the good fortune of being just a few blocks away from a regional hospital.

Michael Hanna Jr., Ph.D., FCRC director at the time, recalls answering the ring of his office phone one day to hear DeVita’s voice on the other end of the line.

“He said, ‘Go ahead and do it,’” Hanna said.

FCRC and NCI partnered with Frederick Memorial Hospital (now Frederick Health Hospital) in 1980 to begin setting up the biologicals initiative, which was soon dubbed “the Biological Response Modifiers Program” (BRMP). It would be a combined effort, headquartered in Frederick and led by NCI, between government, contractor, and community health system.

Under the program, scientists at FCRC would conduct clinical trials with immunotherapies, approaches that used immune system compounds like interferon to attack tumors or stimulate patients’ immune systems to do so. Patients’ physicians would refer them to a trial. The patients would travel to Frederick for a physical examination and—if they were deemed eligible to participate—enrollment in either the inpatient or outpatient clinic at the hospital.

“I can remember literally sitting around a table like this and saying, ‘What do we need to run a clinic? What do we need to run a small hospital or a suite in a hospital?’ … We made about four pages of things we needed to buy,” said Dave Bufter, who was a financial analyst at FCRC at the time. (He retired as chief operating officer at Frederick National Laboratory in 2016.)

There was a problem, however. Frederick didn’t have one of the critical diagnostic tools: a computed tomography (called “CAT” at the time) scanner. The nearest one was in Hagerstown, Maryland, over 20 miles away.

“I said [to DeVita], ‘There’s only one thing you got to give me. You got to give me the money to buy a CAT scanner. … We can’t have a clinic where we have to send people to Hagerstown every day to get a CAT scan, or periodically to get a CAT scan,’” Hanna said.

The request was approved, and the scanner was added to the list of necessary purchases, alongside everything from hospital beds to blood pressure cuffs. NCI purchased the device for Frederick Memorial Hospital. FCRC subcontracting staff arranged renovations to the hospital’s basement for its installation. It was a large effort—the hospital’s elevator shafts even had to be extended to the basement so patients could be transported down on beds and gurneys.

FCRC, NCI, and the hospital agreed that BRMP patients would have priority for scans, with any leftover capacity open to other patients at the hospital. A separate billing arrangement allowed NCI to recoup some of the cost of the purchase.

“And so, it worked out well for the community, it worked out well for us, and it increased the quality of health care in Frederick,” Bufter said. The scanner was the first such device in the county.

Program Prepares for Patients

Meanwhile, other preparations were well underway. FCRC staff coordinated the establishment of the four-bed inpatient clinic on the second floor of the hospital, along with the 10-bed outpatient clinic in the Medical Pavilion next door. NCI spent approximately $4 million on interferon in 1980. That summer, the institute also recruited Robert Oldham, M.D., director of the Division of Oncology at Vanderbilt University, as the inaugural BRMP director. He assumed his duties in October.

The BRMP began sponsoring trials at universities and research centers as satellite or partner clinics. These groups would cooperate with BRMP researchers in Frederick to study biologicals against cancer, particularly interferon, thymosin, and MVE-2.

At the same time, Oldham, a growing cadre of BRMP staff in Frederick, and NCI had begun selecting the first biologicals that the BRMP would study. Interferon was top of the list.

“We were able to get that program up and running very quickly,” Bufter said.

As 1980 turned to 1981, staff maneuvered the final pieces into place. The BRMP would soon welcome its first patients.

To be continued. You can read the other parts in our archive.

 

Samuel Lopez is a technical editor in Scientific Publications, Graphics & Media (SPGM), where he writes for NCI at Frederick and Frederick National Laboratory’s news outlets; manages the day-to-day operations of the Poster newsletter; informally serves as an institutional historian; and edits scientific manuscripts, corporate documentation, and a slew of other written media. SPGM is the facilities’ creative services department and hub for editing, illustration, graphic design, formatting, and multimedia training and support.