National Hospital Week is an opportunity to highlight hospitals, health systems and health care workers and the innovative ways they are supporting and connected to patients and the community.
As we faced the ups and downs of the coronavirus pandemic for another year, caring experts at City of Hope gave their all, day after day, to ensure patients received safe, top-quality cancer care. Researchers continued to act with urgency and agility to fight not only a new disease that posed special danger to their patient population, but to continue groundbreaking studies in cancer, diabetes and rare diseases. City of Hope physicians went above and beyond as they sought to extend clinical trial participation to diverse populations, serve underrepresented groups, expand genetic testing and even provide patients with financial assistance.
Everyday heroes abound across the City of Hope community. What follows is a description of the efforts of just a few whose dedication to their patients and the community knows no bounds. To all of our health care workers, we say thank you.
A Covid-19 Vaccine for Cancer Patients
With the knowledge that mRNA-based COVID-19 vaccines may not offer the same level of protection to cancer patients and other immunocompromised individuals, City of Hope scientist Don Diamond, Ph.D., professor in the Department of Hematology & Hematopoietic Transplantation, and John Zaia, M.D., Aaron D. Miller and Edith Miller Chair for Gene Therapy, immediately sought to create and test a vaccine geared toward immunocompromised individuals.
The vaccine, COH04S1, is uniquely different than the many vaccines that have been developed because it targets both the spike and nucleocapsid proteins, in contrast to the current U.S. Food and Drug Administration-approved COVID-19 vaccines, which only target the spike protein.
It has been licensed by Geovax Labs Inc., and a recently published study showed it produced a robust neutralizing antibody and T cell (an immune cell) response against SARS-CoV-2 with no significant side effects in a Phase 1 clinical trial. It is now being studied in a first-of-its-kind Phase 2 clinical trial for immunocompromised cancer patients, who have difficulty producing antibodies and largely depend on T cells to protect against the virus responsible for COVID-19.
A proud Pacific Islander who grew up in Hawaii, Raynald Samoa, M.D., an assistant clinical professor in the Department of Diabetes, Endocrinology & Metabolism, advocates passionately for his community. So much so that he garnered the attention of a president. On Feb. 3, Samoa was named a member of President Joe Biden’s Advisory Commission on Asian Americans, Native Hawaiians and Pacific Islanders. According to the White House, the goal of the commission is to “advise the President on ways the public, private and nonprofit sectors can work together to advance equity and opportunity for every Asian American, Native Hawaiian and Pacific Islander community.”
At City of Hope since 2008, Samoa exudes empathy the way others use a stethoscope: it’s an essential tool. When he realized early on in the pandemic that the coronavirus was having an outsized impact on the Pacific Islander community (he himself caught the virus — twice), he co-founded the Pacific Islander COVID-19 Response Team. The group aims to increase the amount of available data specific to the Pacific Islander population, develop and train more health care providers for the community, and provide reliable COVID-19 information, resources and support. “Getting COVID-19 taught me to ask questions about access [to health care] for all,” he said.
His work attracted attention. In May 2020, Samoa appeared before the U.S. House Ways and Means Committee during a session on “The Disproportionate Impact of COVID-19 on Communities of Color”; he believes this is how he landed on the White House radar. In his testimony, he urged lawmakers to recognize that many Pacific Islanders are essential workers who suffer disproportionally from COVID-19 and other illnesses because of, in his words, “less money, less education and more suspicion” of vaccines.
“We’re not all going to be equal tomorrow,” he says. “So I have to figure out how to fill those gaps. That’s how I deliver care. I know what these folks go through, and I know it’s not their fault.”
Crusading for More Genetic Testing
Ever since 2003, when scientists successfully mapped the human genome, personalized therapy based on a patient’s genetic information has become the holy grail of cancer treatment. Where once doctors depended on chemotherapy, surgery and radiation, now it is possible to analyze the DNA of a person’s tumor and use therapies designed to target the specific mutations found. In addition, by analyzing the person’s individual DNA, they may identify mutations that put that person at high risk for certain kinds of cancer. They then can be placed on screening and treatment protocols aimed at prevention.
Much of this effort depends on screening patients and their families for genetic mutations and anomalies. City of Hope leads the way here, aiming to test every new patient — more than 4,000 of them last year. “We aspire to provide universal access to sequencing patients and their tumors, here in Duarte and across our entire enterprise,” said Stephen Gruber, M.D., Ph.D., M.P.H., director of City of Hope’s Center for Precision Medicine.
Such screenings can make a tremendous difference in people’s lives, making “untreatable” cancers highly treatable, if not curable, and preventing others in the first place.
Championing Diversity in Clinical Trials
People of different races, ethnicities, ages and sexual orientations have varying physical, genetic and environmental factors and vulnerabilities that come into play with diseases. A medication, for example, may affect patients of different races or even ages differently. If this is not researched and tested during clinical trials, crucial information may be missed.
City of Hope’s health equities program directs funds provided by the Beckman Endowment for pilot projects that address health disparities research. These projects include investigations and interventions that address health conditions disproportionately affecting certain ethnic groups or medically underserved populations, such as lung cancer among Black people. The goal for these funded projects is to increase the number of clinical trials that target these diverse populations to address their disease and inform the science.
Edward Kim, M.D., M.B.A., physician-in-chief of City of Hope Orange County and vice physician-in-chief of City of Hope National Medical Center, has advocated for years for expansion of clinical trial inclusivity. His work has reduced barriers to clinical trials.
“For too long, cancer studies have followed rigid eligibility requirements that overlooked real-world cancer patients' diversity,” he said. “Now, by ensuring trial participants look more like those we treat, we can reverse this age-old and dangerous blind spot. Most importantly, our clinical findings will be more applicable to our patient populations, implemented sooner and reach more people.”
Helping Patients Pay for Care
City of Hope’s Department of Radiation Oncology created the Radiation Oncology Patient Assistance Fund to provide financial assistance to patients who are unable to afford much-needed over-the-counter products not covered by insurance. It’s making a profound difference to patients and their families.
Patients who undergo radiation often have burning, itching skin and develop mouth sores, depending on the site of radiation. Lotions, ointments and supplements created specifically for radiation patients are available at most pharmacies and drug stores. These items are not covered by insurance and can be expensive, costing several hundred dollars over the course of treatment, making them cost-prohibitive for some patients.
The fund has also been made available to patients who need to pay for gas or rideshare services for their long commute to and from Duarte for what are often daily treatments that can last weeks.
Without assistance, some would forego the products and recuperate without them, or potentially either decide against radiation treatment or not finish their treatment, which could hurt their chances of survival.
Jennifer Novak, M.D., a clinical resident in radiation oncology, created the fund after hearing from some of her patients that they would not be able to afford the products. “This patient assistance fund eases the financial burden for patients who have to go through radiation therapy.”
“Undergoing treatment for cancer can be stressful as it is,” she said. “Financial concerns are often an added source of anxiety that we are addressing for the good of patients’ health and peace of mind.”