A ‘Matchmaker’ Between the Lab and the Clinic: At Work With Ivan Maillard

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Ivan Maillard

A passion for both science and the humanities has informed the life and career of Ivan Maillard, MD, PhD, who was recently selected to lead the Division of Hematologic Malignancies at Memorial Sloan Kettering Cancer Center (MSK), which is dedicated to treating patients with blood cancers.

Dr. Maillard is a practicing clinician with experience treating lymphoma and leukemia, a researcher focused on reducing the side effects of bone marrow transplantation, and an experienced administrator who most recently served as Vice-Chief for Research in the Division of Hematology/Oncology at the University of Pennsylvania, where he was a member of the Abramson Family Cancer Research Institute and Co-Scientific Director of the Cell Therapy and Transplantation Program.

A native of Lausanne, Switzerland, who received a classical European education steeped in Latin and Greek (and English), Dr. Maillard was still nursing a passion for French literature and studying the flute at Lausanne Conservatory into his third year of medical school.

And while the humanities and a deep curiosity about the world served as a springboard to medicine, Dr. Maillard’s interest in scientific research developed later.

“The initial spark actually came during a six-month period that I spent as a medical student in Cameroon,” he says. “They had about 400 beds, and I found myself in the middle of a measles outbreak.”

After caring for many children with measles and seeing the toll of the disease firsthand, Dr. Maillard wanted better answers about how viruses interacted with the immune system and what could be done to reduce the heavy burden of viral diseases.

A Career in Cancer Research Is Born

After medical school, Dr. Maillard enrolled in a doctoral program at the University of Lausanne, where his thesis work investigated a retrovirus that causes breast cancer in mice. This was in the mid-1990s, when the HIV epidemic was grabbing nightly headlines.

“My plan at the time was to train as an infectious diseases specialist and then work on HIV, take care of HIV patients, and to work on virology and immunology in the lab,” he says. “But when I was a resident, I started seeing cancer patients clinically, and it completely changed my mind.”

Dr. Maillard pursued fellowship training in hematology/oncology at the University of Pennsylvania before launching an independent career, in 2007, at the University of Michigan — where he was a physician and headed a research lab at the U-M Life Sciences Institute, a hub for basic and translational research similar to MSK’s Sloan Kettering Institute.

Lab Findings Suggest New Approach to Graft-Versus-Host Disease

As an investigator at U-M and later at the University of Pennsylvania, Dr. Maillard and his group made significant contributions to the understanding of blood-forming stem cells (hematopoietic stem cells) and to Notch signaling in the immune system (a cell-to-cell signaling system that regulates many processes). The findings are paving the way toward better treatments for patients with graft-versus-host disease — a serious complication of stem cell and bone marrow transplantation — as well as for other T cell-mediated immune disorders.

“In graft-versus-host disease, the immune cells in the graft end up attacking the organs of the recipient,” he says. “At the same time, they also attack cancer cells. So you need to find a careful balance between the two, because you want to be able to suppress this dangerous immune response, which can be life-threatening, while preserving the beneficial aspects of the immune response that attacks and eliminates cancer cells.

“What we discovered is that if you block the Notch pathway in T cells, which are a type of immune cell that mediates graft-versus-host disease, you can really provide a very high degree of protection. And you can block this signaling in a way that doesn’t cause immunosuppression throughout the body but redirects these immune cells to be less likely to cause damage while still being able to perform their beneficial functions,” Dr. Maillard adds.

The team is now working on translating the discoveries they made in mice to human patients.

Mentoring Physician-Scientists

Meanwhile, as a lab head and administrator, Dr. Maillard has focused on developing and mentoring physician-scientists — those who, like himself, dedicate themselves both to providing care to patients as well improving care through laboratory research.

“Many important discoveries that have changed patient care and that are going to continue to change patient care have come from physician-scientists,” he says. “I think there’s something to be said about making observations in the clinic with your own eyes that inspire you to try to better understand disease mechanisms and what can be done about it.”

There are some practical challenges for physician-scientists as well, given the long years of training required, he adds.

“And the fact that training typically happens at a time when many people are building families,” he says, means that “there is this intersection of professional training and life that happens and that, in parallel, needs to be supported.”

A Scientific Matchmaker

At MSK, Dr. Maillard plans to continue his support for physician-scientists and for clinical researchers, along with serving as a “scientific matchmaker” who can speak the language of both the bench and the bedside.

“Perhaps, this diverse range of interests that I had early on — in music, literature, the sciences, and the arts — is similar in that you have feet in different worlds and yet also see how they could communicate,” he says. “And maybe speaking multiple languages, too, is also part of it.”

Throughout his career, Dr. Maillard has developed an intimate knowledge of his institutions’ research departments through scientific collaborations, serving on thesis committees and immersing himself in the research community. Meanwhile, he maintains a significant presence on the clinical side where he sees patients and interacts with clinical colleagues.

“I enjoy being someone who can help see a potential link between a researcher I know is doing something interesting but needs to find a clinical partner, or vice versa — a clinician who has interesting ideas and is trying to find a partner in the lab,” he says.

MSK Department of Medicine Chair Deb Schrag, MD, MPH, notes that Dr. Maillard has approached his clinical care and research in exactly this holistic manner.

“The combination of his career-long focus on mentorship, basic and translational investigation, and patient care makes him the optimal person to lead MSK’s Division of Hematologic Malignancies into the future,” she says. “We are confident that he will serve as a staunch ally and supporter of our faculty members, working with them to identify paths to career development, address roadblocks, and maximize the creativity and potential of those within the division.”

All About the People

Outside of work, Dr. Maillard is excited about New York’s cultural offerings, especially music and the arts. (At U-M, he even served on the thesis committees for several student musicians.)

“But what drew me to MSK the most was actually the people,” he says. “There are six different services within the Division of Hematology/Oncology, and I have a connection to each of them, either through science or the clinic, or both. And there’s also a great opportunity to make connections between the division and other units at MSK where amazing work is being done — in basic science, in immunology, in solid tumors, and so forth. I couldn’t be more enthusiastic about joining the MSK family.”