«In a few years, artificial intelligence (AI) and immunotherapies will help us cure cancer, better than any other therapy. Chemotherapy will disappear. The new frontier is here.” Fabio Luciani, professor of Immunology and Machine learning at the UNSW University (University of New South Wales), in Sydney, one of the top 50 universities in the world, has no doubts. He has spent 21 years of his life doing experimental and theoretical research, dedicating much of his time to AI applied to immunology. And now, at 49, he’s launching a startup from Australia. He creates digital twins, a sort of avatar of patients, and thanks to artificial intelligence he manages to predict who may benefit from immunotherapy and who may not. He pioneered personalized medicine and tailor-made therapies. «And the nice thing is that from Sydney I am collaborating with an Italian artificial intelligence startup, ASC27, whose CEO Nicola Grandis is from Abruzzo like me».
Predictive models have always been his passion.
«I have built much of my career trying to apply artificial intelligence to immunology to treat autoimmune diseases and cancer. Immunotherapies, i.e. therapies based on manipulating the natural immune response and redirecting it towards tumors, are revolutionizing medicine. Some immunotherapies, such as the one against advanced melanoma, allow the number of patients who respond to therapy to be increased from 3 to 40%. Our approach aims to provide a therapy tailored to the individual, prevent side effects, warning him in advance of the necessary changes in his treatment. This application will be used in patients involved in Clinical Trials and in the future in all patients. An approach that will not only help those who suffer but will also improve knowledge on these new therapies.”
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Starting from a small town in Abruzzo, Luciani arrived in Sydney, first crossing Italy, then Europe.
Theoretical physicist, the same discipline as Nobel Prize winner Giorgio Parisi, in life he approached various disciplines and followed a thousand passions. «I have always traveled a lot. For me, doing research meant travelling. Follow my intuitions.” Naples, Rome, Bologna, Dresden, Berlin, Utrecht. His first interest is in engineering. He studies for two years. Then he graduated in theoretical physics. Meanwhile he falls in love with medicine. He takes a year off and goes to Bologna to study immunology with a luminary: Claudio Franceschi. «He was my mentor, he called me crazy horse». He returns to physics, doctorate in Germany. His thesis on mathematical models of immunology. “I was already making prediction models of how the immune system works.” Then he goes to Holland. In 2005 he arrived in Sydney. «I started working on tuberculosis: thanks to artificial intelligence we were able to predict patients who had forms resistant to antibiotics. I worked on hepatitis C: we used genomics, sequencing the virus. We have studied how this virus spreads in prisons, where there is a very large community of drug addicts at risk of infection. We took blood samples and found out who was infected. Then, thanks to genomics, we were able to trace, based on the similarity of two virus genomes taken from two different people, the origin of the infections and the risk factors, then giving important information to the competent authorities to minimize the risk of future infections” .
Intuition, curiosity, humility: these are the three key words of his career. «Curiosity is the underlying theme of my life. It’s what always pushed me forward. I never stopped asking myself why. I still do it, 24 hours a day. I do it especially when things go wrong. I arrived in Australia as an epidemiology “modeller”, then I worked in genomics, then I finally returned to immunology. Which is basically my first love.”
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A sportsman, Professor Luciani swims 8-10 kilometers in the ocean every week. He left Italy because it was too tight for him. «Even today I look at our country and see people like me who want to do something and can’t. Take Abruzzo. There are many scientists and scholars who have fled. There is a real brain drain. The CEO of ACS7, Nicola Grandis, was introduced to me by a mutual friend, the scientist Carlo Corona. We are all three from Lanciano. I look at Abruzzo and see a large oven. We make a lot of bread, a lot of desserts. Everything of the highest quality. But then we sell everything. We have nothing left. An empty oven.”
As a boy, Luciani was a rebel. «I played with the naughtiest children, I didn’t want to go to school, I was restless. Then, at 14, a girl said to me: why don’t you start studying instead of just partying? I remember that sentence as if it were now. She changed my life.”
In Milan it is 8.30 in the morning, in Sydney it is 6.30 in the afternoon. Luciani is married to an Australian and has two children. He has been away from Italy for more than 20 years, he only returns to Abruzzo on holiday. Yet he still retains the accent. «I am a full-blooded Italian». Passionate about communication, he hangs out with kids, goes to schools, explains what immunology is. «I tell it with a graph, I draw a large ball that touches all the other balls. It touches oncology, it touches neuroscience, it touches everything. The immune system is not localized to a specific point, it is spread everywhere. It’s in the stomach, in the liver, in the brain. It is the peripheral system that defends us. Two-thirds of the drugs approved by the Food and Drug Administration are immunotherapies.”
How do they work? «Immunotherapies are therapies that use the immune system. To kill cancer, we take the brakes off it. In English we say “release the brakes”. While in the case of autoimmune diseases, we try to greatly reduce the unwanted immune response.”
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Luciani was among the first scientists in the world to do single cell genomics, which is the analysis of a single cell, a very advanced technology for studying the human body in detail.
«What life has taught me is to never give up. It’s continuing to follow your instincts, your curiosity. Your own passions. Look what Sinner’s example teaches us. Look at all the people who have been successful, they tell you the same things. You must never give up especially in times of difficulty, be passionate, humble. Those who attack, those who are overbearing, those who are arrogant, do so because they feel at fault. Watch animals when they are under pressure. The reaction is Fight or flight: attack or escape. The same happens to us humans.”
Are we born curious? “I do not know. I know that many people keep their curiosity locked in a drawer. I teach kids to be curious. April 29 is World Immunology Day. Initiatives are being carried out all over the world to raise awareness of the goals of this new frontier. In Sydney we open our museum to schools. We hold teacher training courses and teach children curiosity. And artificial intelligence.
«Artificial intelligence is nothing more than a different way of making predictions. Today it is dominated by the world we live in. Where we always talk too much and without knowing much. There is a lot of communication that is not based on true or reproducible arguments. And this is a problem. In my opinion, AI needs reproducibility. To make robust, stable things that work and are reproducible. Artificial intelligence is truly changing medicine. The way we treat patients, talk to them, do diagnostics. Thanks to this technology we will be able to personalize the treatment. And maybe one day beat cancer. This is why I continue to do research…”.
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