The 8th annual Scholar re-treat featured presentations by Scholars and Mentors in each of the topics of the four most recent annual forums: the Biology and Treatment of Primary Brain Tumors, immunotherapy and Breaking Tolerance, Cancer genomics, and Epigenetics. One extremely heartening theme that was common to all of these sessions was that it was clear that our ability to study human tumors directly has increased vastly. no longer is it necessary to study only models and cells that are remote approximations of patients’ own tumors. now the trip between patient tumor, hypothesis generation and testing in the laboratory, and back to the patient is occurring nearly continuously, a vast improvement in recent years.

This retreat was fortunate to benefit from the experience of Forbeck stalwart Chuck Sherr (St. Jude’s, Memphis) who kicked off the retreat with a fascinating discussion of why if one particular type of mutation is selected in a cancer cell, another is not, and how this can teach you about the cancer’s cell of origin. The Brain Tumor session that followed, chaired by Martine Roussel (St. Jude’s, Memphis), was characterized by the type of bedside-to-bench investigation that is providing information so much more rapidly today, even in the challenging disease of glioma.

The Dinner was accompanied by an exciting keynote address by Tom Gajewski (University of Chicago), who shared recent advances in manipulating the immune system to recognize and destroy cancers. He particularly described how a certain type of immune cell, the T cell, can be directed against cancer cells. Most interestingly, his talk was not merely describing immunology theory, but also presented results of testing in patients, some of which showed strikingly encouraging responses. The lesson that came across was that the immune system can be recruited as a powerful ally in the search for durable remissions in even very challenging cancers.

The final day was a combination of genomics and Epigenetics. Cancer genomics is the study of the changes in the genetic code of cancer cells. This type of study has been tremendously advanced by the speed and economy of genome sequencing, so that now it is possible to sequence all the DNA in a tumor so efficiently that one can compare sequences among many tumors simultaneously. it is a challenge to manage the huge amount of information produced, but we learned that the payoff is that one can potentially use this information to identify new targets for cancer therapy and perhaps also to individualize cancer therapy based on the tumor’s individual genome.

However, the genome does not tell the whole story. For example, the cells of your eyeball, your skin, and your heart have the identical genome but look and function very differently. It is Epigenetics that creates these critical differences. Epigenetics is the study of all the extra chemical marks on the genome that influence how the genetic code is read. if the genome contains the genetic letters, the epigenome provides the punctuation. We heard about modern techniques to read how a cancer cell’s entire epigenome differs from that of normal cells and about how these differences might arise. Particularly excitingly, Jay Bradner (Dana-Farber, Boston) told us about how drugs can be developed to alter the epigenome of cancer cells, perhaps forcing them to misread their altered DNA and forget they are cancer cells, with some stunning examples of the effects on tumors. it was made clear that manipulation of the epigenome by drugs is laden with ample, unexploited potential in cancer.

A summary of the content of the presentations does not do justice to the amount of interaction that takes place during a retreat. The format of the meeting is more conducive to rapid learning and immediate response than the vast majority of cancer meetings elsewhere, and it permits dissemination of ideas in a way not possible at larger meetings. While some of this interaction takes place in the meeting rooms, it continues at the relaxed social events made possible by the organizers, and even after the meeting in collaboration via email. As always, the setting was most conducive to discussing science and the setting most con-genial to the scientists themselves, all one could want from a retreat.