Nobel Prize

Was pioneering Chinese scientist Chen Lieping ‘unfairly overlooked’ for Nobel Medicine Prize?

Scientists and state media complain immunotherapy pioneer’s work should have been recognised alongside US and Japanese prizewinners

PUBLISHED : Friday, 05 October, 2018, 9:02pm
UPDATED : Friday, 05 October, 2018, 9:07pm

Chinese scientists and state media have complained that the renowned immunologist Chen Lieping has been “unfairly overlooked” in the award of this year’s Nobel Medicine Prize, which went to American and Japanese scientists.

Chen, based at Yale University, has been researching the same area of medicine for years and is also considered a “crucial contributor” to a novel cancer treatment.

James Allison, from the MD Anderson Cancer Centre in the US, and Tasuku Honjo, from Kyoto University in Japan, shared this year’s Nobel Prize for their contribution to cancer immunotherapy, a treatment that uses the human body’s immune system to attack tumour cells.

China’s first drug-coated heart stent passes clinical trials in Europe

The novel method, which has fewer side-effects than traditional treatments like chemotherapy, has led to the development an entirely new class of drugs.

“Chen is the one who really translated the discovery into clinical practice,” said Tony Mok Shu-kam, chairman of the department of clinical oncology at the Chinese University of Hong Kong, “whereas Honjo and Allison are the discoverers”.

Mok explained that cancer immunotherapy scientists could be divided into two types – discoverers who “basically discover something new from fundamental research” and translational scientists who “move it along toward clinical practice” – along with the doctors who actually run the trials in hospitals.

He also pointed out that Nobel committees often prefer to focus on discoverers when awarding the prize.

Allison was awarded the prize for discovering the CTLA-4 molecule that acts as a biological brake on the immune system’s T cells, which can identify and destroy invaders such as bacteria, viruses and parasites.

Tumour cells often deceive such checkpoint inhibitors by appearing to be normal cells. Working out ways to unleash the T cells to fight the tumours allowed scientists to develop immunotherapy treatments that were more effective at targeting tumour radiation.

Allison also coined he term “checkpoint inhibitor” to describe the brake that prevents T cells from killing healthy cells.

As the Nobel citation put it, he “realised the potential of releasing the brake and thereby unleashing our immune cells to attack tumours”.

Around the same time Honjo discovered another such checkpoint, called PD-1, which also keeps T cells from attacking cancer cells.

James Allison and Tasuku Honjo win the 2018 Nobel Medicine Prize for cancer research

Mok, a clinical oncologist who led immunotherapy trials for lung cancer treatments in Hong Kong, said: “They are the general discoverers and I think they are definitely worth it,” he continued. “But whether there are additional worthwhile names, [for the list of winners] it’s always debatable.”

He also pointed out that Chen “does not run clinical trials. He is kind of in between. He is the major force behind the translational research”.

Some sections of the Chinese media and scientific community argued that his role should have been enough to win a Nobel Prize.

“Finding the molecules matters, so does knowing how to use them,” a report from Science and Technology Daily, the official newspaper of China’s Ministry of Science and Technology, said. “Honjo deserves the award. But Chen should be on the laureate list if Honjo is.”

“It’s Western prejudice against China,” one comment under the article read. “We should keep our heads down and focus on development.”

“Honjo first cloned PD-1 in 1992, but he did not realise that it could be used in cancer treatment,” one unnamed scientist from the Chinese Academy of Medical Sciences was quoted as saying in the article.

“It was Chen who made the first breakthrough towards applying the molecule in immunotherapy in 1999.”

Last year Chen, who is also a professor at Fujian Medical University in Fuzhou, China, said in interview that Chinese scientists or Chinese-American scientists should be more outspoken so that their work could be noticed and recognised.

He was speaking after he was overlooked in science award that went to Allison and Honjo for their work on immunotherapy – but in this instance it was a Chinese university, Fudan in Shanghai, that had made the decision.

The Fudan-Zhongzhi Award was set up in 2015 to honour outstanding scientists in mathematics, physics, biology and medicine.

“I feel disappointed about the results,” Chen told Chinese science blog The Intellectual in January 2017.

“Honjo’s contribution is more in fundamental immunology than in cancer immunotherapy,” he said.

Chen did not reply to emails or calls from South China Morning Post this week.

How one man’s resignation sparked debate over China’s poorly paid talents

Nobel prize committees do Other specialists have also played an important role in the development of immunotherapy.

A 2000 study carried out on mice, subsequently published in the Journal of Experimental Medicine, saw Honjo’s team collaborating with immunologist Gordon Freeman to confirm the hypothesis that PD-1 acted as a biological brake.

But the previous year Chen and his team at the Mayo Clinic in the US discovered the human version of that molecule, work that led to clinical trials focusing on PD-1.

Freeman, an oncology scientist at the Dana-Farber Cancer Institute of Harvard Medical School is considered by scientists a critical contributor in the field of immunotherapy, along with other US-based academics such as Geoffrey Bluestone of the University of California, San Francisco, Jedd Wolchok of Memorial Sloan-Kettering Cancer Centre and F Stephen Hodi of Harvard Medical School,

Wolchok and Hodi used Allison’s work on CTLA-4 to carry out the first clinical immunotherapy trials, which helped save patients’ lives.

They published the results in Proceedings of the National Academy of Sciences in the US.

“Freeman is both a discoverer and a clinical scientist who moves new findings to treatment,” said CUHK’s Mok. “His work is critical to the field.”

Mok continued that the question of whether the Nobel committee’s decision was fair “can be debated”.

He said: “Every award has its own criteria, depending on what kind of people it wants to honour. “Nobel tends to award the discoverer instead of the translational and clinical trial spectrum.”