A summer in Boston, a new cancer therapy and the rantings of a Southampton medical student

Last year, as I approached my medical school end-of-year exams in June 2013, I couldn’t stop the butterflies in my stomach. I had a lot riding on this. Apart from passing and staying on the course, obviously. I had managed to line-up a research internship at Boston University for the summer, but if I failed the opportunity would disappear.

Perhaps before I continue further I should introduce myself to the readers. I am currently now a final year medical student at the University of Southampton. I am an international student from Bangladesh who came over to the UK back in 2008 to study Biomedical Sciences at UCL. Throughout my undergraduate degree I learnt two things: firstly, you have to actually work in a lab, rather than sitting in lectures and scoring top grades in exams, to become a good scientist and secondly, that scientists are currently amongst the most underpaid and under-recognised professions in the world. Following graduation, being in the same boat as most people regarding not knowing exactly what to do career-wise, I decided to go into medicine for both a career as a clinical research scientist (a concept which is fairly new to the NHS) and to avoid committing to a PhD project at that point without knowing what research field I was interested in.

Before I started medical school, over the preceding summer I participated in the iGEM (International Genetically Engineered Machine) competition organised by MIT, representing UCL. This introduced me to the concept of synthetic biology and I realised my true passion following this competition. Our project for the competition involved creating a new manufacturing platform for DNA vaccines and we had to come up with novel genetic circuits, which would automate the entire process of vaccine production to bring both greater efficiency and quality. I was fascinated by the concept of being able to take bits and pieces of useful DNA from different sources and putting them together in the right order to create a new component, which had a novel function that did not exist before in nature. This was both science and engineering and I straightaway recognised this as a new emerging field which could be utilised in multiple areas, ranging from new therapeutics to providing biofuels. Starting medical school after this was quite a different experience compared to studying for a science degree and doing research. However I saw it as a good opportunity to see how scientific research into new therapeutics was perceived by healthcare professionals and the red tape that was involved in transitioning basic research from the lab bench to an effective therapy at the bedside in the hospital. Besides, learning about the pathophysiology of a large range of diseases and witnessing patient experiences is quite beneficial in identifying key areas that require more research and also to see what sort of negative effects patients and doctors had to put up with regarding new therapies. This I found to be quite useful as scientists working solely in a lab lack this perspective and I believe we need more professionals trained in both fields to bridge the gap between medical research and healthcare.

While in medical school the field of immunology caught my eye as I saw it was a rapidly expanding field with new therapies like monoclonal antibodies etc. emerging with increasing frequency. I saw the immune system as a part of human physiology with vast untapped potential, which could be harnessed to both prevent and cure many of the illnesses we deal with every day.So by my second year I was already looking for a summer internship that combined synthetic biology with immunology. I discovered this was a very niche topic and only very few labs in the world specialise in this area. I came across the Wong Laboratory (wilsonwonglab.org) by pure chance on the internet and saw they were a new lab that focused on applying synthetic biology principles in “training” immune cells to fight-off cancer in innovative ways. Obviously I was intrigued and I emailed the professor, Wilson Wong, at once. After a few emails back and forth and reviewing my CV he was happy to accept me, which left me to sort-out the funding. After trying several places, I was eventually lucky to have the British Society for Immunology offer their generous financial support, seeing my enthusiasm for the project. Thankfully, I passed my course exams and was soon on my way to Boston. I was very excited as it was a new city and I would be working on something new and cutting-edge. I met my supervisor on the first day and he assigned me to a new gene-silencing technology (CRISPR) project that came-out in February 2013, and also asked me to shadow the lab postdoc before I moved onto further projects. Now I must admit there is a huge difference between the US and UK education systems that I noticed in my first few weeks. Science moves really fast in the States and the graduate students are constantly under pressure, working round the clock, to get data and publish as many articles as they can, and not just focus on their PhD thesis. Once I got the hang of things in the new lab, soon I was taking on new projects and before I knew it I literally had no free time. Once I proved my competence, I was assigned a solo project to design an existing therapeutic platform (chimeric antigen receptor) towards a new cancer antigen, Axl, that no other lab has tried before. This was quite challenging, especially as I started the work quite late into my internship, but luckily I managed to construct the therapeutic receptors in time and after one failed pilot run, the new receptors started showing functional efficacy. Everyone was thrilled at that point, none more than me!

To describe my time in Boston, I must admit I did not have much free-time outside the lab to explore the city as much I wished to. But luckily, Boston University is in a fantastic location near to the city centre and Fenway Park stadium and we did manage to get tickets for a Red Sox and Yankees game (which the Red Sox lost unfortunately!). I also visited Harvard University and Cambridge Square across the river. Boston seemed to me a nice ‘transition’ between England and America, as some of the streets appear to resemble certain areas in London.

My typical day in the lab would start at 9am usually with a team briefing in our supervisor’s office. I would then continue to set-up my experiments and spend any free time either troubleshooting current problems and negative results, or planning the next phase of my experiments. A part of my time was spent in the tissue-culture room, where we grew our cancer cell lines, and we used the HIV virus to transfer our genetic circuits into these cells in order to test their function (which sounded very cool at the beginning, but became quite routine for me later on). Since we were a small lab we had a lot of work to share between us and we would be lucky to grab a quick lunch. I remember quite a few times when one of our team members (including me) would ‘lose their mind’ from the sheer volume of work, and we would have to drag ourselves out of the lab for a quick drink before coming back (this was quite normal apparently). I even saw many people work throughout the night and over the weekends.

The main thing that I got out of this placement, other than learning new lab techniques and protocols, was the work ethic and planning strategy that our supervisor instilled in us, as I learnt to carry out batches of experiments with a faster turnover period and also to plan ahead for expected contingencies even before getting my data. The idea was efficiency and to get rid of any bottlenecks in the workflow and to me this was a very valuable lesson.

On my last week, my supervisor took me out for lunch and we chatted about things in general. I jokingly told him that after working in his lab, going back to med school this year was going to be a breeze. He replied saying that, since we were a new lab, he had been actually taking it easy on us so far! I hope he was joking… at least for the sake of the permanent lab members. At any rate, I did enjoy my time in Boston and had no complaints from my end as it gave me a great career building opportunity. I now know more about the type of research I want to do in the future and how to run a lab efficiently. In the future, I hope to work on more cellular therapies as I believe it’s is going to replace small-molecule inhibitor research at some point.

On top of this, I have a keen interest on the entrepreneurial side of things, as many researchers do not recognise the value of their research and get exploited by Big Pharma. The idea of scientists forming spin-off companies or forging business partnerships is starting to become a growing trend, especially at Southampton. I believe this is an exciting time in life sciences and any of us working in this field are quite lucky as there is so much to be done and new ground-breaking advances are bound to happen. I sincerely hope any student who reads this article finds it inspiring and I wish them all the best in their careers!

Ejaj Intisar, University of Southampton, UK

The details of the funding scheme and information about Ejaj’s time in Boston and plans for the future are available at this link: https://www.immunology.org/membership/membership-benefits/--bsi-med-elect--summer-placement-awards

Ejaj successfully created a new cancer immunotherapy (cellular) against mesothelioma within 6 weeks during his internship, which is going to further studies later this year as it proved effective in in-vitro studies.

Ejaj also presented his work at the AAI Immunology 2014 conference, in Pittsburgh, Pennsylvania, USA (the biggest immunology conference in the world). He was the only undergraduate at his symposium and his work was well received and applauded by the chair and audience. This conference trip was funded by the Faculty of Medicine (the alumni donations), thanks to Dr. Chris Stephens.

At the conference Ejaj won the AAI Trainee Abstract Award Bursary due to the scientific merit of his work. The abstract is available at this link - http://jimmunol.org/gca?gca=jimmunol%3B192%2F1_Supplement%2F205.8

Mesothelioma is a type of lung cancer commonly caused by exposure to asbestos and it’s prevalence is expected to increase rapidly in UK over the next few years. It’s a very aggressive cancer with poor prognosis and limited treatment options.