2020-2021 MLH Medical Staff Meetings

Mark your calendars!

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.

Fall 2020 Meetings

Tuesday, October 6, 2020               6:00PM          Paoli Hospital

Tuesday, October 13, 2020               5:00PM          Lankenau Medical Center

Thursday, October 15, 2020               6:00PM           Riddle Hospital

Thursday, October 22, 2020               5:30PM          Bryn Mawr Hospital

Spring 2021 Meetings

Tuesday, April 6, 2021                     6:00PM            Paoli Hospital

Thursday, May 6, 2021                     6:00PM            Riddle Hospital

Wednesday, May 12, 2021                 5:30PM            Bryn Mawr Hospital

Tuesday, June 8, 2021                       5:00PM            Lankenau Medical Center

The meetings will be held virtually due to the MLH meeting restrictions associated with the COVID-19 pandemic.  There will be no on-site in-person meeting.  The link and phone number to access the meetings will be emailed prior to each meeting.

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

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Clinical Trial of the Week: Radiotherapy trial for patients with certain types of breast cancer

By Donna Loyle, communications specialist, LIMR

 

Tailor RT is a multicenter, randomized, non-inferiority phase III trial evaluating outcomes among certain breast cancer patients treated with regional radiotherapy (RT), that is, RT to regional nodes following breast-conserving surgery (BCS) or RT to the chest wall and regional nodes following mastectomy.

Inclusion criteria:

  • Eligible patients must have been diagnosed with biomarker low-risk, node-positive breast cancer and no evidence of metastases
  • Must already have been treated with BCS or mastectomy and will receive endocrine therapy for five years
  • Must be willing to undergo the treatment protocol as specified for the study arm into which the patient has been randomized

Each patient is grouped into one of four study arms:

  • Arm 1A: receives whole breast irradiation following BCS
  • Arm 1B: no radiotherapy following mastectomy
  • Arm 2A: receives whole breast irradiation plus regional RT following BCS
  • Arm 2B: radiotherapy to the chest wall and regional nodes following mastectomy

The Main Line Health principal investigators for the Tailor RT study are Albert DeNittis, MD, and Paul Gilman, MD. For more, visit www.mainlinehealth.org/research/clinical-trials/tailor-rt

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COVID-19 Town Hall Medical Staff

The next Town Hall for Medical Staff will be held on Wednesday September 2 at 5:00pm. An invitation will be sent the day of the event.

 

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Update to Cloth Mask Restrictions at MLH

Colleagues,

As we continue to navigate through this ever-changing COVID-19 environment, we remain committed to updating our policies, guidance and procedures to reflect relevant research and recommendations from the CDC and PA Department of Health. Effective Tuesday, August 25, Main Line Health will be restricting the use of bandanas and neck gaiters, in addition to the already-restricted valve masks, while on our campuses. Each of these masks are pictured below. This decision is based on advisement from infection prevention and in alignment with the latest research of the effectiveness of these face masks.

Should you see a colleague, patient or visitor arrive with one of these masks, please provide them with an isolation mask, stating “Since you are joining us at MLH, we would appreciate it if you would use this mask today.”

On rare occasions, patients/visitors cannot wear or tolerate an isolation mask. Please contact your campus command for guidance in these situations.

If you have questions about these changes, please reach out to your campus command center. These updated masking guidelines can be found on Wellspring.

Thank you for your continued dedication to ensuring the safety of our employees, patients and visitors.

Paul Yakulis

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Clinical Trial of the Week: Treatment-dosage study for patients with atrial fibrillation

By Donna Loyle, communications manager, LIMR

 

A new multicenter, randomized, dose-ranging clinical trial is evaluating the safety, tolerability, pharmacokinetic and pharmacodynamic effects of the experimental medication MAA868. Eligible patients are those with atrial fibrillation or atrial flutter and at low risk of thromboembolic stroke or peripheral embolism.

 

MAA868 is a fully human antibody that binds the catalytic domain of zymogen and activated reducing factor XI. Participants are randomized into two study arms. Those in Arm 1 receive injection of MAA868 on the first day and then two subsequent monthly injections. Within this group:

  • Cohort 1 receives a low dose of MAA868
  • Cohort 2 receives a high dose
  • Cohort 3 receives a dose to be determined by the clinician

Participants who are randomized into Arm 2 receive a placebo.

 

Eligible participants must not have had a stroke, transient ischemic attack or systemic embolism. They must not have a history of major bleeding during treatment with an anticoagulant or antiplatelet therapy, or a family history of a bleeding disorder. Other inclusion and exclusion criteria apply.

 

This trial is approved for Lankenau Medical Center. The Main Line Health principal investigator is Douglas Esberg, MD. For more, visit www.mainlinehealth.org/research/clinical-trials/maa868.

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New approach for a cancer vaccine reported by LIMR investigators and colleagues

Preclinical proof of concept for a novel cancer vaccine methodology was provided in a recently published study that was conducted by investigators at the Lankenau Institute for Medical Research (LIMR), in collaboration with IO Biotech. In the study, animals treated with the experimental methodology not only had total remission of their cancers, but also showed complete protection against re-introduction of tumor cells.

 

The vaccine, developed by IO Biotech which owns the intellectual property, was designed to attack cells expressing IDO1 (indoleamine 2,3-dioxygenase), an enzyme that LIMR scientists discovered limits the cancer-fighting activity of chemotherapy by thwarting the immune system’s ability to eradicate tumors. Based on earlier work from LIMR, several pharmaceutical companies developed medications to block the IDO1 enzyme in order to help unleash the immune system to destroy cancer cells, but effective use of these agents in the clinic has proven to be challenging.

 

IDO1 is not a conventional candidate for vaccine-directed attack, because it is a “host” protein that, according to the textbooks, should be ignored by the immune system. But earlier work by LIMR’s collaborators uncovered the presence of IDO1-reactive immune cells in patients. This finding fostered the idea that stimulating IDO1-reactive immune cells with a vaccine could result in effective anti-tumor immune responses — an idea now validated by the current study.

 

Several peptides (short stretches of amino acids from the entire IDO1 protein) were evaluated, and peptides activating different aspects of the immune response — referred to as class I-directed and class II-directed — were both shown to have anti-tumor activity. Furthermore, the researchers in the current study found that the most effective treatment included three agents: a class I-directed IDO1 peptide, a class II-directed IDO1 peptide, and an anti-PD1 antibody.

 

When the investigators combined all three agents, they observed a complete elimination of tumors that could not be eradicated by individual treatments. Moreover, animals that responded to the combination of three treatments showed durable resistance to subsequent re-introduction of tumor cells. This finding was encouraging because it suggested that the immune system was activated properly to prevent relapse.

 

Additionally, the researchers found that this immunological resistance could be transferred to a naïve tumor-bearing animal simply by transplanting immune cells from a therapy-treated subject to an untreated subject. The researchers credited this effect to the treatment regimen’s ability to induce T-cells, a component of the immune system critical for thwarting cancer growth.

 

“While some patients experience long-term benefits from immune checkpoint inhibitors, most patients eventually experience disease progression,” said Alexander Muller, PhD, associate professor at LIMR, who is a cancer researcher and one of the authors of the new study. “Responsiveness to anti-PD1 antibodies also varies widely among different types of tumors. So identifying interventional strategies — such as this combination of three treatments — that can overcome the limitations of immune checkpoint inhibitors given alone, and unleash the immune system to fight cancer in both the short and long term, is clearly of the utmost importance.”

 

The study’s results are described in the peer-reviewed manuscript “Peptide vaccination directed against IDO1-expressing immune cells elicits CD8+ and CD4+ T-cell-mediated antitumor immunity and enhanced anti-PD1 responses” published in Journal for ImmunoTherapy of Cancer.

 

Other LIMR investigators on the study included Souvik Dey, PhD; Erika Sutanto-Ward; James DuHadaway; Arpita Mondal, PhD; Lauren Merlo, PhD; and Laura Mandik-Nayak, PhD. The team worked with colleagues from Drexel University’s College of Medicine, the National Center for Cancer Immune Therapy at the University of Copenhagen, and IO Biotech, a Copenhagen-based biotech firm developing this approach in clinical oncology trials.

 

The research was funded by IO Biotech, with additional laboratory support through the Lankenau Medical Center Foundation and Main Line Health.

IO Biotech’s proprietary T-win® technology platform, the technology evaluated by LIMR, enables identification of compounds with dual mechanism of action targeting and directly killing immunosuppressive cells and tumor cells while indirectly activating other T-effectors, leading to strong anti-tumor responses.  The company’s compounds are administered as “off-the-shelf” subcutaneous injections, distinguishing these treatments from many immuno-oncology therapies.

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RAS-ACS Awards Mentor of the Year

On behalf of the Resident and Associate Society of the American College of Surgeons, we are so pleased to congratulate Dr. Ned Z Carp on being awarded the RAS-ACS Outstanding Mentor of the Year Award!

 

The RAS Outstanding Mentor of the Year Award was created to honor an outstanding Fellow of the American College of Surgeons who has had a marked impact on the engagement of a resident or associate member in the College and has offered the support and encouragement necessary to build the strong foundation for a surgical career. Dr. Carp was nominated by Dr. Austin Williams for this award, and his nomination letter was indeed compelling. While there were other excellent nominees, Dr. Carp epitomizes the characteristics for which this award was created. The Executive Committee of the RAS felt that it was time to recognize those surgeons who have made a great impact on our careers through their encouragement of our participation in the College (as well as in many other aspects of surgery).

Again, our sincere congratulations and our sincere thanks for all that Dr. Carp has done to support surgical trainees! Congratulations!

Sincerely,

Naveen F. Sangji, MD, on behalf of the RAS-ACS Executive Committee

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Epic Updates 2020

The new storyboard feature is coming in September. The ‘new’ storyboard feature, is an upgraded version of the patient header which provides much more information as well as useful links to documentation. There will be more information provided as we get closer to the upgrade date. No need to wait, access it now!

https://pivot.mainlinehealth.org/news/new-storyboard-feature-coming-in-september-epic-upgrade-no-need-to-wait-access-it-now/

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Clinical Trial of the Week: Treatment trial for patients with ovarian or peritoneal cancer

By Donna Loyle, communications specialist, LIMR

Researchers are studying how well the FDA-approved medication letrozole, given with or without paclitaxel and carboplatin, works in treating patients with stage 2, 3 or 4 cancer of the ovary or peritoneum.

Prior to enrollment in this phase III randomized clinical trial, patients must have undergone surgical removal of both ovaries and the fallopian tube, and, at minimum, an attempt at surgical removal of their tumors. Eligible participants must not have concomitant invasive malignancy and must not have received prior chemotherapy or radiotherapy to treat their disease.

Eligible participants are divided into two study arms. One group receives paclitaxel, carboplatin and letrozole. The other group receives letrozole alone.

Study #NRG-GY019 is approved for Lankenau and Paoli. 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-gy019

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Pre-Procedural COVID Testing Update

Please see this flow diagram describing the most recent ordering process for any Pre-Procedural COVID tests.  It provides guidelines for locations, days sites are open and the scheduling process.  Please call the COVID Command Center with questions at 484 580-1919.

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