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The Promise of a New Year: A Look at Medicine in 2018

CAR-T-flash-mob-2017

Physicians, patients, and friends of the Penn Medicine converged in a “flash mob” at the Perelman Center for Advanced Medicine in August to celebrate the FDA approval of Kymriah™, the first personalized cellular therapy to treat cancer.

From the U.S. Food and Drug Administration’s approval of the first ever gene therapy, which brings new hope to cancer patients with very few options for treatment, to the approval of another gene therapy that can treat a rare and inherited form of blindness, 2017 saw great achievements in the field of medicine. Penn pioneered both therapies and remains at the forefront of some of the most exciting and historic innovations anywhere in the medical world. While those landmark achievements made headlines, last year also saw advancements in clinics and revelations in labs that are already changing practices and could lead to new discoveries for years to come. As Penn continues to incubate the next generation of breakthroughs, here’s what Penn doctors say they’re excited about now that we’ve turned the calendar to 2018.

David A. Mankoff, MD, PhD, Radiology: We’re excited to continue our work using big data analytics for imaging, which will better guide tissue sampling and treatment. That will be crucial as we build advanced instrumentation looking at whole-body systems biology through our Explorer PET scanner. We’ll also be integrating imaging and pathology informatics to improve diagnoses. And we’re working on functional neuroimaging to help guide neuro-oncology treatments and to study the basis of neuropsychiatric disorders.

Justin E. Bekelman, MD, Radiation Oncology/Leonard Davis Institute: Spending on drugs for cancer in the United States has surged. The remarkable national commitment to cancer research, and the promise, expense, and projected growth of targeted cancer drugs call for solutions to address access, affordability and innovation. The Gant Family Precision Cancer Medicine Consortium will be releasing its recommendations in 2018.

Susan Domchek, MD, Basser Center for BRCA: We anticipate FDA approval of Olaparib for BRCA-associated metastatic breast cancer. Penn and the Basser Center were very involved in this work. The important part of this is that Olaparib works in BRCA triple negative breast cancer and is better than chemo in that setting. So this would be the first targeted therapy for a subset of triple negative breast cancer.

Richard L. Doty, PhD, Otorhinolaryngology: We have a number of projects ongoing. One relates to new ways of detecting early Parkinson’s disease. The other relates to better understanding why older people who have smell loss have a higher risk for mortality.

James M. Metz, MD, Radiation Oncology: We’re thrilled to move ahead with the plan to bring proton therapy to South Jersey through our partnership with Virtua. We’re also anticipating exciting developments from our proton research room as we continue to ramp up discovery in that facility.

David L. Porter, MD, Hematology Oncology: We will treat our first patient with commercial CAR T cells. We gave the first patient experimental cells in 2010 and within seven years it became an FDA product that we will be able to use for the benefit of patients.

Robert Schnoll, PhD, Psychiatry: We continue to look for ways to personalize tobacco cessation work, especially in light of our study on the use of the nicotine metabolite ratio as a biomarker of response to nicotine patches or varenicline. We’re hoping to examine the impact of translating this biomarker into primary care.

Lynn M. Schuchter, MD, Hematology Oncology: While I am so excited about the new development in treatment for patients with melanoma, I am most excited about the work we are doing in implementing the Serious Illness Conversation Guide for all of our Hematology Oncology practitioners. This is a framework for clinicians to explain serious illness, like cancer, to patients so that they have a good understanding of their illness. It also ensures that the clinicians know the goals, values, and priorities of their patients. The goal is to have more, better, and earlier conversations about illness. This is hard work but so important.

Heather Shaeffer, DSW, LCSW, Patient and Family Services: In 2018, the Writing a Life program will include caregivers to expand the scope of the work. The nurse navigators developed educational sessions designed to give clinical staff an introduction to cancer from diagnosis to treatment to survivorship and end of life care. In 2018, the program will expand to offer sessions to non-clinical staff as well.

Sunil Singhal, MD, Center for Precision Surgery: 2018 should be an exciting year as we continue to develop TumorGlow, an agent that makes tumors glow during surgery and helps surgeons remove more cancer. Not only will we be presenting more data to show the effectiveness of this approach, we’ll also be taking part in global clinical trials bringing this approach to an even greater number of cancer types in humans.

Joseph F. Sobanko, MD, Dermatology: We’ve been examining the way patient quality of life evolves with our skin cancer treatments as well as our facial rejuvenation treatments. Our team is excited to finally be able to share the studies’ results. Additionally, we’ve closely examined how clinicians and patients uniquely view and judge the final aesthetic results of these procedures and the factors that determine how close or far apart patient-clinician assessments may be. Finally, we’re thrilled to pilot a patient-to-patient peer support program for high-risk and complex oncologic and reconstructive cases in the Mohs clinic called BRIDGES – Buddy Relationships In DermatoloGic Excisions for Skin cancer.

Colleen Tewksbury, MPH, RD, LDN, Bariatric Surgery: We just had our launch of the Apple CareKit app for bariatric patients, so we’re excited to actually start using it and collecting data.

Robert H. Vonderheide, MD, DPhil, Abramson Cancer Center Director: We’re hopeful 2018 will bring FDA approval for the CAR T therapy Kymriah in non-Hodgkin’s lymphoma patients. We’re also looking forward to presenting final results of our study evaluating a DNA vaccine that targets TERT and IL-12 in hopes of preventing recurrence in patients who are in remission after surgery but who are at high risk of relapse.

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