The cast of Of Medicine and Miracles gathered last month with director Ross Kauffman and producer Robin Honan to celebrate Emily Whitehead’s 10-year anniversary of being cancer-free.
Penn Medicine’s new Pavilion is a massive 1.5 million square feet of advanced clinical space. This spring, Penn’s transplant team performed its 1,500th lung transplant – among the largest number of these complex surgeries at any hospital in the country. More than 562 million doses of COVID-19 vaccines based on mRNA technology developed at Penn Medicine have been administered in the U.S. to date, in addition to vaccines given in over 200 other countries spanning the globe. In so many examples of efforts across Penn Medicine, there is proof of complex medicine making a big impact.
Penn Medicine is also a place where people see the value and power of starting small and starting simple. In this issue’s cover story, we explore the Perelman School of Medicine’s unique emphasis on teaching medical students how, when, and why to use ultrasound throughout their training. As a result, time and again, medical students on their clerkship rotations, as well as PSOM graduates beginning their careers, find themselves picking up a point-of-care ultrasound device when other clinicians might not, giving them the power see what’s happening inside their patient’s body — an ectopic pregnancy in one example, fluid in the heart in another. Through a relatively simple act of looking, using an established and noninvasive technology, they learn and alter the course of a patient’s treatment.
Simple things can be an important start on the road to something more. Just look at the feature story in this issue about an outreach initiative in Philadelphia’s Kensington neighborhood. Three members of Penn Medicine’s hospital and research staff, who hadn’t worked together directly before the COVID-19 pandemic, came together early in the spring of 2020 to help a community in need. With very little initial funding, they created a free COVID testing program, every week for two years, for a community that otherwise wouldn’t have been tested. As the story details, too, offerings like this are a simple start in another way – as harm reduction, helping instill trust between people who use drugs and the medical system that often doesn’t treat them well. As McFadden noted, a positive interaction can be a good first step toward getting more medical care when they need it, including for substance use disorder.
Penn is a place where tackling the biggest challenges – like curing cancer – often start small, with bold ideas that are too risky and too complex to scale up out of the gate. That lesson is clear this year as we’ve passed some remarkable milestones for the cellular therapy treatment for cancer, which was first tested at Penn Medicine over a decade ago. The initial trial of this chimeric antigen receptor (CAR) T cell therapy was tiny – just three patients. Patient number one was Bill Ludwig, a retired corrections officer who had been battling chronic leukemia for 10 years. Then Doug Olson, a scientist, who likewise found his cancer was no longer responding to standard treatments. Both of these first two patients, after being infused with engineered versions of their own bodies’ T cells, went into rapid remission and made international headlines. That success was followed a year later by a pediatric trial at Children’s Hospital of Philadelphia (CHOP), and another patient number one: Emily Whitehead, then just turning seven years old.
Today, the impact of those three individual volunteers is enormous. Both Ludwig and Olson still had sustained remissions and persistent populations of CAR T cells in their bodies 10 years after their treatments, Penn researchers reported in Nature earlier this year, a result so remarkable that they used a word around which that they usually hedge: These patients were cured. Olson recently celebrated his 75th birthday surrounded by family. Ludwig, sadly, passed away due to COVID-19 in 2021, but not before touring the country with his wife in an RV, enjoying a healthy retirement that cancer nearly took from him. Emily Whitehead, now a teenager with a driver’s license who is looking toward college, just celebrated 10 years cancer-free.
The impact of the work is up in lights this spring – a major documentary film, “Of Medicine and Miracles” covering CAR T cell pioneer Carl June, MD, and his team’s work to develop this new approach and the Whitehead family’s emotional journey through treatment and beyond, will debut in June at the Tribeca Film Festival, with a wider release to follow. And the impact is reaching across the globe, with at least 15,000 patients worldwide having received CAR T therapy so far. Most recently, Penn and CHOP signed research agreements with the government of Costa Rica to help facilitate access to new investigative CAR T treatments for patients in Central America. And the therapy received its third FDA approval, this time for the treatment of adults with relapsed or refractory follicular lymphoma.
There is one big lesson in all of this, and it’s a simple one: In science, medicine, and life itself, whatever is worth doing, small steps matter.