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Archive for February, 2018

CAR T-cell Therapy Moves from Trial to Treatment

Amy Cheese (center) shares her story about how CAR T-cell therapy helped her get in remission and back to her job as a third-grade teacher. Cheese was joined by Julie Vose, MD, chief of Hematology/Oncology and Matthew Lunning, DO, Hematology/Oncology.

New Therapy Offers Another Chance for Patients with Blood Cancers

A promising therapy for people with recurring non-Hodgkin lymphoma and pediatric/young adult acute lymphoblastic leukemia was recently approved by the Food and Drug Administration (FDA) and is now available for commercial use at Nebraska Medicine.

“This is a big home run for patients who have failed every other type of cancer treatment,” says Julie Vose, MD, chief of Hematology/Oncology.

Nebraska Medicine, which has a nationally recognized lymphoma program, was one of the first centers in the Midwest that provided chimeric antigen receptor (CAR) T-cell therapy through clinical trials. The therapy is part of growing treatment options in cancer that harness the body’s own immune system to attack a tumor.

“T cells are white blood cells that help our bodies fight infection and cancer,” explains Dr. Vose. “In some patients with lymphomas and leukemias, their T cells don’t recognize the cancer as being abnormal and this allows the cancers to grow. This new therapy allows us to take the patient’s own T cells outside the body and re-stimulate them to fight their own cancer.”

Amy Cheese of Fort Collins, Colorado, was out of options before coming to Nebraska Medicine in November 2016. The third-grade teacher was battling non-Hodgkin lymphoma and had a grapefruit-sized tumor in her chest. After receiving CAR T-cell therapy, Cheese is now in remission and back to teaching.

“I can’t stop smiling,” she says. “Knowing CAR T-cell therapy is commercially available makes me think of all the people who will not have to hear the words, ‘there is nothing else we can do.’”

Amy Cheese came to Nebraska Medicine in November 2016. to undergo CAR T-cell therapy for non-Hodgkin lymphoma. She is now in remission.

“We are really excited about offering this new therapy to our patients,” says Matthew Lunning, DO. “Nebraska Medicine has been involved from the ground floor in developing this therapy and we are now able to offer it on a large scale. Nationwide, patients with non-Hodgkin lymphoma who have received this therapy have had a complete remission rate of nearly 40 percent after six months. This is significant as these are patients who have failed other possible therapies available.”

Treatment for newly diagnosed non-Hodgkin lymphoma and acute lymphoblastic leukemia patients typically starts with chemotherapy. The relapse rate for first time treatment of non-Hodgkin lymphoma is 30 percent and 40 percent for acute lymphoblastic leukemia. The majority of these patients will then go on to receive a blood or bone marrow transplant, of which about half of patients will relapse. Patients who relapse after the transplant or are not candidates for a transplant may be potential candidates for CAR T-cell therapy.

During the first phase of CAR T-cell therapy, the patient’s T cells are collected at an outpatient procedure at the hospital. The cells are then sent to a pharmaceutical company lab where they are genetically modified and grown until there are millions of them. The process in the lab takes about two to six weeks. When the cells are returned to Nebraska Medicine, they are placed in a specialized processing center to complete the procedure. In the meantime, the patient receives several days of chemotherapy. The modified CAR T cells are then infused into the patient where they multiply, attack and kill the cancerous cells. The CAR T cells, which remain in the body long after the infusion has been completed, help to prevent the lymphoma or leukemia from relapsing.

“The selection of candidates for this therapy needs to be rigorous,” says Dr. Lunning, “and the process needs to be done at a center that has specific expertise in this area due to the potential for severe side effects and toxicities that can be harmful to the patient unless monitored and treated appropriately.”

All Nebraska Medicine staff involved in the therapy have had to undergo and pass a training program before Nebraska Medicine could be approved to administer the treatment. We are the only health care network in Nebraska to offer CAR T-cell therapy.

“The good news is that we are getting better at treating, detecting and managing toxicities and we will continue to improve with more experience. The potential for this new therapy is very promising. We hope to be able to expand it to the treatment of other cancers like multiple myeloma and solid tumors eventually,” says Dr. Lunning.

Omaha Firefighter in Remission with CAR T-Cell therapy

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

New Therapy Offers Another Chance for People with Blood Cancers

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Nick Howe, lymphoma survivor who received CAR T-Cell Therapy, converses with Philip Bierman, MD, hematologist and medical oncologist and Susan Blumel, BSN, RN, lymphoma clinical research coordinator

A promising therapy for people with recurring non-Hodgkin lymphoma and pediatric/young adult acute lymphoblastic leukemia has recently been approved for commercial use at Nebraska Medicine.

Nebraska Medicine, which has a nationally recognized lymphoma program that specializes in research and clinical trials, was one of the selected centers in the country that provided this new option, called Chimeric Antigen Receptor (CAR) T-Cell Therapy, through clinical trials. The therapy is part of growing treatment options in cancer that harnesses the body’s own immune system to attack a tumor.

Schedule an Evaluation!
To find out if you are a candidate for this new therapy, please call us at 402.559.5600 to schedule an evaluation.

The  CAR T-Cell therapy showed so much success in clinical trials that it was fast-tracked by the Food and Drug Administration (FDA) for rapid submission and early approval.

“We are really excited about offering this new therapy to our patients,” says Matthew Lunning, DO, Nebraska Medicine

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The Nebraska Medicine hematology and medical oncology lymphoma team pictured from left to right: Philip Bierman, MD, Matthew Lunning, DO, James Armitage, MD, Gregory Bociek, MD, Julie Vose, MD, and Katherine Byar, APRN-NP

hematologist and medical oncologist. “Nebraska Medicine has been involved from the ground floor in developing this therapy and we are now able to offer it on a large scale. Nationwide, patients with non-Hodgkin lymphoma who have received this therapy have had a complete remission rate of nearly 40 percent after six months. This is significant as these are patients who have failed other possible therapies available.”

Treatment for newly diagnosed non-Hodgkin lymphoma and acute lymphoblastic leukemia typically starts with chemotherapy. The relapse rate for first time treatment of non-Hodgkin lymphoma is 30 percent and 40 percent for acute lymphoblastic leukemia. The majority of these patients with relapsed non-Hodgkin lymphoma and acute lymphoblastic leukemia will then go on to receive a blood or bone marrow transplant, of which about half of patients will relapse. Patients who relapse after the transplant or are not candidates for a transplant may be potential candidates for CAR T-Cell therapy.

“T cells are white blood cells that help our bodies fight infection and cancer,” explains Julie M. Vose, MD, Nebraska Medicine hematologist and medical oncologist, chief of the Division of Hematology/Oncology at the University of Nebraska Medical Center (UNMC). “In some patients with lymphomas and leukemias, their T-cells don’t recognize the cancer as being abnormal and this allows the cancers to grow. This new therapy allows us to take the patient’s own T-cells outside the body and re-stimulate them to fight their own cancer.”

During the first phase, the patient’s T-cells are collected at an outpatient procedure at the hospital. The cells are then sent to a lab where they are genetically modified and grown until there are millions of them. The process in the lab takes about two to six weeks. When the cells are returned to Nebraska Medicine, they are placed in a specialized processing center to complete the procedure. In the meantime, the patient receives several days of chemotherapy. The modified CAR T-cells are then infused into the patient where they multiply, attack and kill the cancerous cells. The CAR T-cells, which remain in the body long after the infusion has been completed, help to prevent the lymphoma or leukemia from relapsing.

“The selection of candidates for this therapy needs to be rigorous,” says Dr. Lunning, “and the process needs to be done at a center that has specific expertise in this area due to the potential for severe side effects and toxicities that can be harmful to the patient unless monitored and treated appropriately. All Nebraska Medicine staff involved in the therapy have had to undergo and pass a training program before the hospital could be approved to administer the treatment.

“The good news is that we are getting better at treating, detecting and managing toxicities and we will continue to improve with more experience. The potential for this new therapy is very promising. We hope to be able to expand it to the treatment of other cancers like multiple myeloma and solid tumors.”

Nebraska Medical Center First Hospital in Omaha to Implant Heart Device

Jessica Delaney, MD, cardiac electrophysiologist, and Andrew Goldsweig, MD, interventional cardiologist, work together to implant the new WATCHMAN device.

New Device Reduces Stroke Risk in Irregular Heartbeat Patients

Nebraska Medical Center is the first hospital in Omaha to offer patients with a type of irregular heartbeat, also known as atrial fibrillation (afib), an alternative to long-term blood thinners with a newly approved device called WATCHMAN.

The WATCHMAN implant reduces the risk of stroke by closing off an area of the heart called the left atrial appendage. Doing that keeps harmful blood clots from forming in the left atrial appendage, entering the bloodstream and potentially causing a stroke. By closing off the left atrial appendage, the risk of stroke is reduced and, over time, patients will be able to stop taking blood thinners. Reasons that someone may be unable to take long-term blood thinners include prior bleeding while on a blood thinner, mediation side effects or interactions or an occupation where long-term blood thinners would be hazardous.

“This new device provides doctors with a breakthrough stroke risk-reduction option for patients,” says Andrew Goldsweig, MD, interventional cardiologist. “For patients with non-valvular atrial fibrillation, the WATCHMAN implant offers a potentially life-changing remedy which could free them from long-term blood thinners while offering equivalent stroke protection.”

People with atrial fibrillation are five times more likely to have a stroke than the general population. Atrial fibrillation can cause blood to pool and form clots in the left atrial appendage. If a clot forms there, it can increase stroke risk. Blood clots can break loose and travel in the blood stream to the brain, lungs, and other parts of the body.

“We are extremely happy to be able to provide this option,” says Jessica Delaney, MD, cardiac electrophysiologist. “We have already implanted our first three devices and have a specialized clinic established to evaluate if WATCHMAN is the right course of treatment for certain patients. It certainly gives us another tool to elevate our already high level of care.”

To implant the device, the doctor inserts a small needle in the upper leg, followed by a narrow tube, similar to a standard stent procedure. The doctor then guides the device into the left atrial appendage of the heart. The procedure is done under general anesthesia and takes about an hour. Patients commonly stay in the hospital overnight and leave the next day.

To hear more about the WATCHMAN, click on the KETV story below.

http://www.ketv.com/article/device-to-prevent-strokes-eliminate-blood-thinners-available/15930264
To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

New Technology Results in Faster Treatment for Stroke Patients

Nebraska Medicine’s telestroke program is designed to improve stroke care in Nebraska.

Telestroke is the use of electronic audio and video communication in order to provide care for stroke patients, not only at Nebraska Medicine, but for other hospitals throughout the region that do not have a stroke-experienced neurologist available 24/7. Telestroke provides real-time expert neurological assessment and recommendation of treatment for patients presenting with stroke-like symptoms at other hospitals.

Marco Gonzalez Castellon, MD, neurologist and telestroke medical director, is seen demonstrating how the telestroke software works. At his desk, he can view the patient’s CT scan on his laptop and utilizes his iPad to assess and speak to the patient. Both tasks can also be performed on one computer.

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

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