Kansas City, Kan- Key points from today’s guests:

Morning Rounds – Updates on the Latest News

Dr. Joseph McGuirk, division director, HMCT, The University of Kansas Cancer Center

• The FDA has approved a new CAR-T cell therapy for leukemia.
• In clinical trials, it achieved a 63 percent complete remission in relapsed, refractory acute myeloid patients.
• CAR-T cell therapy leverages our understanding of how the immune system, specifically cells called T cells, fight not only infection, but also help prevent cancer, or if a cancer develops, eradicate that cancer.
• When patients have cancers that progress and our T cells let us down, this therapy involves taking patient T cells out of their blood to the laboratory, genetically rewiring them to again recognize the cancer cells, expanding them into hundreds of millions of cells, and infusing them like a blood transfusion back into the patient.
• They then sweep around the body, identify the cancer cells, attach to them, punch a hole in them, and release proteins that go through and chop up their chromosomes, their DNA, and kill the cell.
• This has been really a paradigm shift for patients with number of different types of blood cancers, lymphomas, multiple myeloma, and acute mobility of leukemia.
• This is the third approved CAR-T cell therapy to treat leukemia.

Morning Rounds – Updates on the Latest News

Tom Hult, stroke survivor

• Tom had to go through a baseline assessment to see if he was eligible for a first-in-the-region implant to help stroke victims.
• It is called paired vagus nerve stimulation, or VNS.
• He had a stroke eight years ago and has had some issues with dexterity.
• His hope is that the implant can rewire the brain to get motion back in his hand.
• Tom wants people to know that having a stroke is not the end – it’s just a challenge in life. He said you have to face it head-on, stay positive and work hard.

Karen Hult, Tom’s wife

• She said Tom’s condition has changed the way they do things, and it takes some more planning in advance sometimes.
• Karen knows he is such a hard worker and is dedicated to improving.
• She is grateful for the support from family, friends, and the medical team.

Dr. Colleen Lechtenberg, M.D., medical director, Comprehensive Stroke Center, The University of Kansas Health System

• Tom is a good candidate because he had an ischemic stroke and not a hemorrhagic stroke or a bleeding kind of stroke and has upper extremity weakness. This is not FDA approved for lower extremity weakness.
• He's in the chronic phase of stroke, so that means his recovery has either slowed down or totally leveled off, and really importantly, he's willing to work really hard to do intensive therapy.
• Stroke patients can start with their primary care physician or their physical therapist to determine if they're eligible.
• And then from there, approved providers and therapists in the community can screen the patient to see if they're eligible and can be referred to the neurosurgery clinic for a consultation.

Dr. Sandra Billinger, Ph.D, vice chair, Translational Stroke Research, The University of Kansas Medical Center

• The implant itself is well-known. It has been successfully used in epilepsy and to treat depression and so this is really exciting to move it into this chronic ischemic stroke phase.
• We're very excited that we're able to see these differences in people post stroke. The research has shown that when you pair this vagal nerve stimulation with intensive rehabilitation, we see a lot of improvements in the upper extremity.
• This mean patients get to do the activities they want to do. It gives people hope, especially for people who are living with chronic stroke years after they suffered one.
• I've heard some anecdotal success stories from my colleagues, where people are seeing these improvements and getting back to their lives and doing the things that they want to. And so that's a really exciting opportunity.

Dr. Jeremy Peterson, M.D., endovascular neurosurgeon, The University of Kansas Health System

• The implant will be placed along the nerve that runs right between the carotid artery and the jugular vein.
• We’ll wrap this little pigtail electrode around the nerve itself, and then tunnel the system down to the battery pack, which is right under the clavicle, like most cardiac implants.
• This is an outpatient procedure, so compared to many of the other procedures, this is less invasive.
• Patients will be able to activate the implant to send electrical pulses to the brain.
• This procedure is in high demand.

Monday, Nov. 18 at 8 a.m. is the next Morning Medical Update. One man wanted an expert and specific surgery to treat his prostate cancer, so he traveled from Washington state to Kansas to find the care he needed at The University of Kansas Cancer Center.

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