Using patient-derived antibodies to fight COVID-19: research at Main Line Health

Researchers at Lankenau Institute for Medical Research (LIMR), the research division of Main Line Health, are conducting a clinical research study examining the protective antibodies generated in patients who have recovered from COVID-19 infection. Using a unique technology pioneered at LIMR, they are capturing and replicating these antibodies from blood samples retrieved by Lankenau pathologists.

The researchers — led by LIMR Professor Scott Dessain, MD, PhD, who holds The Joseph and Ray Gordon Chair in Clinical Oncology and Research — are applying their knowledge and technology to take advantage of the ability of certain patients’ immune systems to naturally overcome the infection.

Using these antibodies, they seek to quickly translate their findings into a blood test that can identify people who have already acquired immunity to COVID-19, because they have survived the infection. (Recent investigations suggest that only about half of those who are infected actually become sick.)

Once a blood test is developed, Dr. Dessain and his team will make it available to Main Line Health patients and staff members. This is critical because it identifies, for example, clinical staff who are immune to the virus, and thus would be safe to care for COVID-19 patients without need of personal protective equipment, because they are no risk to themselves or others.

These antibodies may also point to an effective route to treat COVID-19, based on their natural development by the immune system in patients who have recovered from the disease.

Dr. Dessain notes that, while researchers elsewhere also are working in this area, LIMR’s unique technology may provide a much faster platform for identifying and generating large amounts of the best antibodies needed for blood tests and immunotherapies.

This technology uses a revolutionary antibody discovery method invented at LIMR, called On-Cell mAb Screening™, or OCMS (ock-ems) for short. OCMS can rapidly identify and isolate antibodies from patients for mass production that have the most highly desired properties.

Dr. Dessain’s team has extensive experience in this work. Illustrating the power of their OCMS method, they isolated the best patient-derived antibodies ever obtained against polio virus. In fact, these antibodies recently were designated as the International Reference Standard by the World Health Organization (WHO) and other global authorities for quality control of Sabin polio vaccines used worldwide.

Dr. Dessain’s team has received glowing and growing attention, with funding of their projects by the Bill & Melinda Gates Foundation, WHO, and the National Institutes of Health.

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The Physician Wellness Committee: “You are not alone”

 

The ongoing COVID-19 pandemic has been and will continue to be a challenging and difficult time for all healthcare providers particularly those on the medical staff who are on the front lines in the ER, ICU, and COVID-19 designated floors.  There are also many physician practices that are financially struggling due to the curtailment of elective visits and procedures.   The physician wellness committee would like to express our utmost appreciation and gratitude to all of you who are working so tirelessly and selflessly during these unprecedented times.

We know all this can be physically and mentally exhausting.  Please reach out to your colleagues and site/campus chiefs to share any concerns you may have.  Also, we encourage anyone who is struggling to take advantage of the employee assistance program First Call.  This is available to anyone on the medical staff whether or not you are employed by MLH.  The link for that is www.firstcalleap.org or 800.382.2377.

Our committee’s work on physician burnout will continue but at the moment our concerns are with you during this pandemic.  We are here to support you in any way we can.

Walter Klein, MD Chair

Susan Gregory, MD Vice Chair

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National Doctors’ Day

Colleagues:

Today, March 30, is National Doctor’s Day and, while this year we are not able to celebrate in the usual way, I hope you know that I and the rest of the senior leadership team are more grateful now than ever that we have such a highly skilled and compassionate medical staff.

It cannot be said enough how unprecedented our current situation is, but I have confidence in our ability to successfully navigate this challenging time. This is due, in large part, to the resilience and willingness to help that I’ve seen from those in the MLH family, especially from our medical staff. Not only are you all continuing to care for patients, but many of you have also offered your own resources to help with the potential surge of patients that may come through our System in the coming days and weeks.

I am thankful for all of you, our senior leadership team is thankful for all of you, and most importantly, I know our patients are thankful for all of you. I ask that you also extend our thanks to your loved ones for sharing you with us. As the son of a physician, I know the sacrifices made by family members in support of your dedication to patients, and that is especially true now.

On behalf of MLH senior leadership as well as all of your colleagues, please accept our sincere gratitude, with great respect and admiration.

With appreciation,

Jack Lynch

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Welcome Jonathan Buckley, MD to Collegeville

Main Line HealthCare physician network welcomes Jonathan Buckley, MD to Collegeville.

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2019-2020 MLH Medical Staff Meetings

Attendance at 50% (1) Hospital Staff meeting per Calendar Year is required for Active Staff members by the MLH Medical Staff Bylaws.

You may attend any ONE of the following meetings, at the hospital of your choice, whether that hospital is/is not your primary facility.

THERE ARE NO EXCUSED ABSENCES.

Spring 2020 Meetings

Tuesday, April 21, 2020 6:00PM Go To Meeting- more information to come
Tuesday, May 5, 2020 6:00PM Riddle Hospital – Springfield Country Club
Thursday, May 14, 2020 5:30PM Bryn Mawr Hospital – Pennypacker Auditorium
Tuesday, June 2, 2020 5:00PM Lankenau Medical Center – Center Pew

Auditorium

 

Questions? Contact the Medical Staff Affairs Office at 484-337-8031

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Clinical Trial of the Week: Treatment trial for patients with a certain type of colorectal cancer

By Donna Loyle, communications specialist, LIMR

March is Colorectal Cancer Awareness Month, which makes this an ideal time to spotlight trial #S1613, which is ongoing at all Main Line Health acute care hospitals.

This trial is for patients who’ve been diagnosed with locally advanced or metastatic HER2/Neu colorectal cancer and whose tumors cannot be surgically removed.

Participants are grouped into two treatment arms:

  • Those in Arm 1 receive the chemotherapy drug Herceptin® (trastuzumab) IV and the monoclonal antibody pertuzumab IV on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
  • Those in Arm 2 receive the monoclonal antibody cetuximab IV and the drug irinotecan hydrochloride IV on day 1. Courses repeat every 14 days. Patients with documented disease progression may optionally cross over to Arm I.

Patients must be willing to undergo follow-up care for up to three years. Other inclusion/exclusion criteria may apply.

The principal investigators are Albert DeNittis, MD, and Paul Gilman, MD. For more information, visit https://www.mainlinehealth.org/research/clinical-trials/s1613

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A clinical research study is seeking people who test positive for COVID-19

Doctors at the Lankenau Medical Center are running a clinical research study of patients who have recovered from COVID-19 infection. We want to learn how the immune system overcomes

COVID-19 infection. We hope to use this information to create a diagnostic test to identify patients who have a protective immune response to COVID-19.

This information would be useful for our care of patients and staff. For example, it would help identify patients who are immune but did not get sick from the virus, as well as those who are still vulnerable to the virus. If you have COVID-19, we would like to study a sample of your blood after you have recovered from the infection.

At the Lankenau Institute for Medical Research, we have created a revolutionary antibody discovery method, called OCMS™, which will be used to quickly and efficiently isolate antibodies that you have made against the virus. This method requires only a small blood sample (about 3 tablespoons).

Study Details:

  • The study requires that you provide a single blood sample
  • We collect the blood after you have recovered from your COVID-19 infection
  • Four tubes of blood will be drawn (about 3 tablespoons)
  • Blood will be drawn at the Outpatient Laboratory at the Lankenau Medical Center
  • Blood will be processed and studied in the Center for Human Antibody Technology at the
  • Lankenau Institute for Medical Research
  • Participation is entirely voluntary; no payments or compensation will be provided

If you test positive for COVID-19, and are interested in learning more about the clinical research study, please contact Dr. Scott Dessain at the Lankenau Medical Center by phone or email.

Dr. Scott Dessain

Lankenau Medical Center

100 E. Lancaster Ave.

Wynnewood, PA 19096

484-343-1799

Email: dessains@mlhs.org

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Be alert: New COVID-19 related phishing scheme

Sent on behalf of Don Klingen, MD, CMIO and Interim CIO
All,

Today we received an alert from the FBI that phishers are using fake CDC websites to gather information. At Main Line Health, we’ve already started to see these emails come through our servers. Below is an example of an email that we were able to quarantine from an employee’s inbox.  This is an example of a class “A” spoofing email, which means that if you read it quickly, the text of the URL looks legitimate.

**Pro Tip – always mouse over any link in an external email to see where the link is sending you to.**  In this case, doing so would have shown you the link it was directing you to did not match the link in the email.

MLH Example Email

Subject: [EXTERNAL] HIGH ALERT: COVID-19 cases surpassed 300,000 globally

If you were to click the link in the email, it would take you to an Outlook credential harvesting site:

Remember: If you receive an email that you have ANY concern about, IT IS IMPERATIVE that you click on the “Report Phishing” button in your Outlook toolbar.

This will send the message to be re-examined by our email security platform as well as send a copy to the Information Security team for further analysis.

If you would like to speak with someone directly, you can also call the Service Desk (484-596-HELP) 24 hours a day.

 

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Clinical Trial of the Week: Study to determine if DNA testing can predict appropriate treatment in patients with early-stage colon cancer

By Donna Loyle, communications specialist, LIMR

Researchers seek to understand how well circulating tumor DNA (ctDNA) testing in the blood works in predicting appropriate treatment options for patients with stage IIA colon cancer after surgery. Testing for ctDNA levels may help identify patients who do and do not benefit from chemotherapy.

Participants are randomized into two study groups. One group undergoes active surveillance, which is the current standard of care for resected stage IIA colon cancer.

Those in the other cohort are split into two groups: Those in whom ctDNA has been detected in their blood undergo a chemotherapy regimen; those in whom ctDNA is not detected undergo active surveillance.

The primary objectives of this trial are to compare the rate of ctDNA clearance and recurrence-free survival in ctDNA-detected patients treated with or without adjuvant chemotherapy following resection of stage IIA colon cancer.

Study #NRG-GI-005 is approved for all Main Line Health acute care hospitals. The principal investigators are Albert DeNittis, MD, and Paul Gilman, MD. For more, email cancertrials@mlhs.org or visit www.mainlinehealth.org/research/clinical-trials/nrg-gi005

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Blood conservation during COVID-19

Submitted by: Pradeep K. Bhagat, M.D. and Ila Peterson, M.D.

We received a communication from the Penn-Jersey American Red Cross on 3-16-2020 that, in part said the following: “Dear Transfusion Service Partner, Already the American Red Cross is experiencing the adverse effects of the coronavirus pandemic (COVID-19) on our blood collection operations. With a rapidly increasing number of blood drive collections across the country, the impact to the national blood supply is inevitable. We are steadfast in our efforts to recruit and collect blood despite these ongoing challenges; however, the volatility of the situation requires that we act now to safeguard the anticipated limited supplies.”

At MLH the Blood Banks will take the following steps to insure the continued access to blood to those most in need. We believe that delaying elective surgeries when possible particularly on the Cardiovascular and Orthopedic Surgical Services until after the coronavirus crisis has subsided and blood product inventories are normalized will be of greatest help. Other measures include:

  1. Verifying that the patient is ready to be transfused before the blood product is picked up or sent by pneumatic tube. RBCs, platelets and plasma are wasted when a patient has a fever, no IV access or has not consented to transfusion and there is a delay in returning product to the blood bank once issued.
  2. For stable non-emergent patients with orders for 2 or more units of RBCs to be issued, units will be issued one at a time; the patient should be reassessed to see if an additional is required.
  3. We will be moving products between hospitals to limit outdating. We will not be stocking blood products on the shelf for “just in case” scenarios.
  4. ASAP we will switch from type O RBCs to type specific RBCs in emergent or massive transfusions.
  5. Expect out of type platelets. We will be ordering “any type” platelets from the Red Cross. PAS and 100% plasma platelets will be used interchangeably.
  6. We will be utilizing the one unit rather than 2 unit platelet transfusion strategy for non-bleeding adult oncology patients (Gehrie et al. Vox Sang 2019; 114: 517-22)
  7. For any coolers that go out and are returned with product to the Blood Banks, the Medical Director will be notified immediately to get permission to return the RBCs with white “safe t vues” and cold plasma into the refrigerated inventory. Platelets are to be returned at room temperature. It is paramount that coolers with product be returned ASAP once it has been determined that the product is not needed for transfusion.

8. Reduce products for holds e.g in OR setting.

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