What if, within the next few years, patients with lung or blood cancer could sit in a chair, be infused with their own modified cells to kill their cancer, and go home?
Cancer researchers and doctors across the country are working on it, not only replacing cycles of toxic chemotherapy with the most advanced immunotherapies, but also making cutting-edge treatments more easily accessible and even comfortable.
Much of the local effort begins to come together on Friday when the University of Maryland Medical Center opens a new $219 million cancer center.
The Roslyn and Leonard Stoler Center for Advanced Medicine will rise in front of the Baltimore City Center Hospital and house the Marlene and Stewart Greenebaum Comprehensive Cancer Center. Its opening is scheduled for 2025.
Dr. Kevin Cullen, director of the Greenebaum Cancer Center, said the new center was designed in anticipation of medical advances and patient needs.
“We will be able to offer a bone marrow transplant, for example, in an extended stay environment. You stay for the treatment and go home and come back the next day,” Cullen said before the inauguration. “We don’t have that capability now.”
Cullen said the center is already among the first in the region to offer immunotherapy treatments that will only grow.
Construction and research at the University of Maryland School of Medicine, which will jointly operate the center with the hospital, is made possible in part by state and federal “moonshot” investments and funding from the American Cancer Society and others in a bid to develop better therapies, and even cures, for more types of cancer – the No. 2 killer in the United States with 600,000 deaths expected this year.
Fundraising for Central Maryland began in 2018 when Baltimore auto dealer Len Stoler and his wife, Roslyn, donated $25 million for the 198,000-square-foot building to enable the treatment of thousands of patients per year.
The 9-story metal and glass building designed by Nebraska-based architectural firm HDR will double the center’s capacity from the current building and accommodate patient visits that are expected to increase by more than 50% by 2028.
Officials plan to serve patients with increasingly complex cancers that require multidisciplinary treatment and extended follow-up care. Most of the space will be dedicated to inpatient and outpatient care with a new entrance and lobby for the hospital. An additional 42,000 square feet will be renovated in the existing medical center.
Much of the new center’s start-up funding will come from a $216 million “moonshot” initiative launched by Governor Larry Hogan, whose cancer was treated at the center. Hogan accelerated $100 million in funding for the center in next year’s budget.
At the federal level, cancer research nationwide stands to gain from an initiative by President Joe Biden to halve cancer deaths over the next 25 years and improve the lives of survivors.
Congress has already allocated approximately $1.6 billion to expand research into genetic mutations found in different cancers, develop vaccines to prevent cancer, deploy new diagnostic tools to detect cancers earlier, and reduce disparities in disease rates.
An important and promising front in these treatments focuses on immunotherapies, which train people’s immune systems to target and kill cancer cells.
Maintaining the momentum will require more funding and attention, said Dr. Arif Kamal, an oncologist and chief patient officer at the American Cancer Society.
The National Cancer Institute, the largest funder of cancer research, can only accept one in 10 research requests it receives, Kamal said.
“When receiving funding has a 90% chance of not working, promising scientists may be deterred, and we face the threat that they will leave the field and their potential breakthrough discoveries will never be revealed,” did he declare.
The Cancer Society has given more than $133 million to Maryland for research over the years, with University of Maryland hospitals and the University receiving $23.8 million.
Kamal said it was an “exciting and promising time” in cancer care, and doctors had an increased ability to treat more types of cancers in less damaging ways.
He cited several types of immunotherapies, such as checkpoint inhibitors, which block proteins that prevent the immune system from attacking cancer. There is also CAR T-cell therapy, which involves taking T cells from a patient’s blood and training them to attach to tumor cells before being returned to patients via viruses.
The Maryland Cancer Center was the first in the Maryland-Washington, DC-Virginia region to offer CAR T-cell therapy to treat lymphoma, a blood cancer, after participating in trials to show its effectiveness.
The FDA recently approved it to treat lymphoma in patients whose chemotherapy failed once rather than multiple times, giving patients faster access, said Dr. Aaron Rapoport, director of the transplant and cell therapy program. at the Maryland Cancer Center.
In total, the University of Maryland center is using the treatment on 250 patients.
“More than half of these patients had no other choice and are likely cured of their cancer,” Rapoport said. “It’s proven to be very effective for patients, and we were one of the leading centers to demonstrate it.”
Rapoport said there are many other advances in the work in Maryland and elsewhere, and some will likely be available when the new cancer center opens in 2025. They can also be administered on an outpatient basis rather than in involve hospital stays.
To prepare for this, the new center will include an expanded outpatient center for bone marrow transplants and other immunotherapies. A cell processing lab that handles patient blood will be on site. There will also be an urgent care area where cancer patients can go instead of the emergency room.
These additions were part of changes made with input from medical and other staff and the community, said Cullen, director of the center.
The expanded patient care areas will complement the research areas largely located close to the hospital.
This research will continue during construction and will involve collaborations with other institutions, including Johns Hopkins Medicine.
Dr. William Nelson, director of the Sidney Kimmel Comprehensive Cancer Center at Hopkins, said the institutions have long shared their work to make progress.
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In the 1970s, researchers looked at what could kill cancer in a lab dish and figured out “how much of these things we could get into a person without too much collateral damage,” Nelson said.
It has cured some cancers, but also damaged other organs, caused hair loss and made people sick, he said.
Today, doctors have and are developing new tools: they can map genetic defects in cancer patients, target specific genetic defects with therapies, improve technology to better diagnose cancer, and determine which drugs will or will not work. on specific patients. And this is in addition to new immunotherapies.
Nelson said Hopkins, Maryland and other institutions must figure out how to seize opportunities like the government moonshot and private dollars to capitalize on progress. Collaboration is a great way.
Hopkins scientists recently announced that they have received $8 million for new cancer research. It’s part of a $50 million award from the Break Through Cancer Research Foundation to five leading cancer centers that will work together on cures for pancreatic, ovarian and brain cancers.
They hope to accelerate research like scientists did with mRNA vaccines against COVID-19 in less than a year. Then they need to make sure that any new treatment is given as comfortably and fairly as possible.
“Take a disease like breast cancer. You never need to be in the hospital overnight, for a mammogram, biopsy, lumpectomy, chemo, hormone therapy,” Nelson mentioned. “People have lives to live. Come in, get seen, and get back to work or home. It’s the future.