Smilow and Yale Cancer Center Clinical and Research Town Hall | June 3, 2021

Transcript

• 00:00All right, welcome everybody to town hall.
• 00:04Summer is finally here and I want
• 00:06to thank everybody for joining in.
• 00:08So before we get started I thought
• 00:10it be helpful to sort of stress
• 00:12that these town halls are monthly
• 00:14and they are going to be on the 1st
• 00:16Thursdays of the month at 5:00 PM.
• 00:19I'm going to remind everybody at the
• 00:20end that there is a survey at the end,
• 00:22so hopefully can connect in
• 00:24and the other part.
• 00:25I hope you'll see that from tonight,
• 00:27and if you were here last month is
• 00:29that we are hoping that this really
• 00:32reflects our broader mission of the
• 00:34of our all of our entity that we want
• 00:36to be an academic cancer system,
• 00:38and that means looking at both sides,
• 00:40both smilow cancer hospital or care
• 00:43centers and then Yale Cancer Center,
• 00:45which has all the basic signs and
• 00:47the research and clinical trials.
• 00:49So as you as we go along,
• 00:50I hope we can see that we're going to
• 00:53obviously talk about urgent issues,
• 00:54but also reflect all the wonderful
• 00:57things that happen in this large
• 00:59and wonderful organization that is.
• 01:01Us together,
• 01:02so hopefully you'll see as part of this,
• 01:05it's a busy agenda and I want us to keep
• 01:07going so we can have time at the end for Q&A.
• 01:10With that Renee next slide please.
• 01:12So reminder,
• 01:14ASCO,
• 01:15virtue Alaska starts tomorrow,
• 01:18and I know that there's lots of
• 01:20symposium in our faculty participating.
• 01:22It has both.
• 01:24Plenary sessions,
• 01:25educational poster presentation and for
• 01:27many of our there's lots of participants,
• 01:31I can tell you that an it's an
• 01:33opportunity for us to showcase the work.
• 01:35The fabulous work that's going
• 01:37on to a global audience,
• 01:39including all the innovative clinical trials,
• 01:42the basic science research that's
• 01:43going all the clinical research,
• 01:45so I want to wish everyone who's
• 01:47presenting good luck and best wishes.
• 01:49And it really is wonderful to sort
• 01:52of have all of you participating I.
• 01:55Hopefully next year will be in person.
• 01:58And this is the asko badge
• 01:59that to share on social media.
• 02:02If you go and tag and and tweet
• 02:04out something along the lines
• 02:06of this next time please.
• 02:07OK,
• 02:08this is all more further good news
• 02:10this the top docs came issue came
• 02:13out from Connecticut magazines.
• 02:14An 90 physicians from smilow
• 02:16cancer hospitals were named
• 02:18to the best doctors list.
• 02:20I mean this is amazing.
• 02:22It's an impressive accomplishment
• 02:23and it's nice to have that
• 02:26recognized by by the magazine.
• 02:27So congratulations to all of the
• 02:29people who are named on this next.
• 02:34OK, so also more good news.
• 02:37It's it's like an evening of good news,
• 02:39right? So more good news.
• 02:40I think all of you know that our
• 02:43COVID numbers are really coming down
• 02:45and that reflects all of the great
• 02:47work for all of us collectively.
• 02:49An also the vaccination rates that
• 02:52Connecticut is really leading
• 02:54in the nation simultaneously.
• 02:56It's nice to see that clinical volume
• 02:58so you can see alongside April of last
• 03:01spring if you can remember how we shut
• 03:03down a lot of our ambulatory operations.
• 03:06And so a big gift.
• 03:07An in dark blue is in person visits,
• 03:09and we picked up a lot of
• 03:12telehealth video visits.
• 03:13And then as you look in the fall,
• 03:14we really kept working across even
• 03:16though we had a late fall surge.
• 03:19As you know which I want to remind
• 03:21everyone that the fall surge
• 03:23was actually total numbers of
• 03:24patients as it was much longer.
• 03:26The total number of patients we
• 03:28treated through that was much
• 03:29higher than the spring surge.
• 03:30But then you can see in March
• 03:33and April the numbers have just
• 03:35skyrocketed along side.
• 03:36In in that reflects probably pent up
• 03:38needs of our patients as the long
• 03:41delayed cares and people are coming to us,
• 03:43and we've seen it.
• 03:44And I think you all are seeing that,
• 03:46and we're seeing that on both an
• 03:49inpatient and ambulatory site. Kate.
• 03:52Alright, moving to the next one.
• 03:54OK, this is perhaps not so good news,
• 03:57so I think some of you have seen
• 04:00the notices on that bread cross is
• 04:03experiencing a severe blood short.
• 04:05Short shortages on O blood type.
• 04:08It's all both positive and negative.
• 04:11It is affecting some beer beer
• 04:13managing this very well.
• 04:14Red Cross has been very helpful in managing,
• 04:17but there are some upcoming blood drives.
• 04:19You can see that and their local.
• 04:21So if you want wish to participate
• 04:22I think where.
• 04:23We would encourage that in there
• 04:25really on our site, so thank you,
• 04:27Renee for that and then moving
• 04:29on to the next slide.
• 04:31OK, so agenda, as I mentioned packed agenda.
• 04:33We have doctor Dan Dimaio who's going to
• 04:36lead us on some good news very quickly.
• 04:38And then Akiko Osaki is here along
• 04:42with Nathan. What's in Nathan?
• 04:45Doctor Nathan Growball to talk
• 04:47about all the stuff that they
• 04:48have been doing in COVID and.
• 04:50And if you don't know doctor,
• 04:52I was even sakis known as Doctor
• 04:54viral immunity on the in his
• 04:56been teaching the world about
• 04:57COVID and then clinical trials.
• 04:59Update by Rock Dr Roy Herbst,
• 05:01Radiation Oncology update clinical
• 05:02update by Kevin Dr Billingslea
• 05:05and Kim Slusser and then this
• 05:07is cancer survivorship month.
• 05:08Interesante will end off,
• 05:09so I'm going to remind our presenters.
• 05:12It's a tight agenda.
• 05:13I'm going to keep you on a.
• 05:145 minute times and don't let me
• 05:16kick you off the presenter menu,
• 05:18but with that I'm going to turn
• 05:20it over over
• 05:20to Doctor Tamayo.
• 05:22Thank you Anita.
• 05:23It's a pleasure to give again a
• 05:25little more good news than him.
• 05:27The podium quickly over to our
• 05:30speakers again the next slide please.
• 05:33The Cancer Center membership
• 05:34has been garnering awards.
• 05:36Jones Stites once again is gotten major
• 05:39national award for her work on RNA and
• 05:41two of our younger faculty member,
• 05:43Lillian Kobashi and City Chen,
• 05:46both at the West Campus,
• 05:47have received Pershing Square, so no prizes,
• 05:51and he this is to support their research.
• 05:52This is very nice.
• 05:54Ignition for them.
• 05:56Also, the next slide shows that
• 05:59our clinical work has been
• 06:01recognized by Yale Medicine.
• 06:02Both Delacy and Ron Salem have
• 06:05gotten distinguished career awards.
• 06:06It's a wonderful recognition for
• 06:08them for the long careers and Ruth
• 06:10Taliban have gotten an award from
• 06:12the Melanoma Research Alliance.
• 06:14So so congratulations to all these
• 06:18wonderful investigators and clinicians.
• 06:20But what I really want to talk about today,
• 06:22or to have you here today is about COVID-19.
• 06:26We all know the terrible toll it
• 06:28took on our patients and also how
• 06:31it disrupted our clinical service
• 06:33and disrupted research at Yale.
• 06:35You might not be so weird that
• 06:37that the yield is actually a real
• 06:39Center for COVID-19 research has
• 06:41made tremendous contributions to
• 06:43keep this pandemic under control.
• 06:45So we have two speakers to tell
• 06:46us a little bit about their work.
• 06:47First mate, Grubaugh, who tell us about.
• 06:50The emergence and spread of the
• 06:52virus that causes this disease.
• 06:54Then,
• 06:55Akiko is Saki will talk more about
• 06:57the disease aspects and further
• 06:58attempts to try to control it
• 07:00and understand it going forward.
• 07:02So Nate, if you can share your screen.
• 07:07Thank you.
• 07:10Thank you Dan and thanks for the invitation
• 07:14to present this work with you all.
• 07:16This is especially important for me
• 07:19because this has been a really close
• 07:22collaboration with the hospital,
• 07:23and in doing this work to enhance
• 07:26our Scooby to genomic surveillance
• 07:28for a community across the state.
• 07:30It helps with a lot of research objectives,
• 07:33but it's also just been a really
• 07:35important public health service
• 07:36that we've been able to provide.
• 07:40So this figure shows kind of our
• 07:46journey with with genomic surveillance,
• 07:48so the yellow bars are the number of
• 07:51weekly COVID-19 cases from the state
• 07:54of Connecticut and the purple lines
• 07:56represent the percentage of those cases
• 07:59that have been sequenced per week.
• 08:02And it shows that we went through
• 08:04a lot of different phases.
• 08:06So at the at the beginning we had
• 08:09this really amazing collaboration
• 08:10that Akiko is a big part of,
• 08:13but also many people in the hospital
• 08:15and the School of Medicine and the
• 08:17school public health called the
• 08:19Impact in that list to establish
• 08:21COVID-19 research here at Yale.
• 08:23And what my group did is during
• 08:25this this early period,
• 08:27our researchers focus on sequencing of
• 08:29the genome to understand the emergence
• 08:31of starts could be two in the state
• 08:33and we published this paper really
• 08:35early on that was that was surprising
• 08:37to many because that we found that
• 08:40the viruses that started the outbreak
• 08:42and Connecticut weren't from primarily
• 08:45from international introductions,
• 08:47that these were.
• 08:48This is the result of domestic spread
• 08:50and of course now we look back.
• 08:51And of course there's a
• 08:52lot of domestic spread,
• 08:53but when you think back to.
• 08:54It was from like March 2020 that
• 08:57that was really unknown at the time.
• 09:01And then there was a period from
• 09:04late summer two to fall where we
• 09:06didn't really do a lot of sequencing.
• 09:09A lot of routine sequencing at the time
• 09:10because there was a lot of interest
• 09:12from it in terms of a surveillance program.
• 09:14Then at this time that my lab was
• 09:16primarily working on diagnostics and
• 09:17on the sequencing front we were just
• 09:19working with the Department of Public
• 09:21Health on doing a lot of outbreak
• 09:24investigations to understand different
• 09:25outbreaks might be connected and related
• 09:28to things that the state we're interested in.
• 09:31Of course,
• 09:32the the interest in an sequencing
• 09:34changed a lot in December,
• 09:37and in the early part of 2021,
• 09:39with the emergence of stars,
• 09:40Kobe 2 variants,
• 09:41I think that we all saw then the importance
• 09:43of the work and the need to enhance this.
• 09:45So we were able to really quickly
• 09:48start working with the hospital
• 09:49in the diagnostic lab specifically
• 09:52David Paper and re Landrian with
• 09:53pathology as well and the Department
• 09:55of Public Health to start increasing
• 09:57our sequencing capacity to really
• 09:59understand what was happening.
• 10:01With with variants across the country
• 10:04and some of the work that we've been
• 10:06able to do with this in connection
• 10:08with collaborators across the country
• 10:09as they were able to show where a
• 10:11lot of the early B 117 outbreaks
• 10:13happened in the United States.
• 10:18And now we've. We've transitioned to
• 10:20this other space, which I'm calling,
• 10:22you know high definition SARS Co V2
• 10:24Genomic surveillance and I have this other
• 10:26symbol up here which is the symbol for
• 10:29our Yale genomic surveillance starts kovi,
• 10:31two genomic surveillance initiative that is
• 10:34really a big partnership with the hospital.
• 10:36The School of Medicine,
• 10:38the Yale Center for Genomic Analysis,
• 10:40the School Public health,
• 10:41but also some external partners
• 10:43in Jackson Laboratory and the
• 10:46state and and also now UConn.
• 10:48And we've been able for
• 10:50the last several months,
• 10:51sequence between 5 and 12%
• 10:53of the cases in this.
• 10:56These data allowed us to really
• 10:58build a track.
• 10:59The emergence and spread of a
• 11:00lot of different variants,
• 11:01so we're no longer caught off guard.
• 11:03We have a pretty good handle on what is what
• 11:06is being introduced here and importantly,
• 11:08now we're able to transition a lot
• 11:11of that work to help understand
• 11:13vaccine breakthroughs and
• 11:14sort of other future threat.
• 11:16We publish our data every
• 11:18Thursday at 4:10 PM.
• 11:20So just over an hour ago we had a new report.
• 11:23You can find it on COVID tracker.
• 11:25See t.com or you can follow us on Twitter.
• 11:27I'll have a little Twitter thread
• 11:29explaining all of this right after
• 11:31this is this is over and thank you.
• 11:36Thank you Nate.
• 11:36This is a tremendous amount of work.
• 11:38Pickup mobilized very quickly.
• 11:40Very appreciative and I think
• 11:42it's had national impact.
• 11:43So Akiko, if you share,
• 11:45you can tell us what you been
• 11:47up to over the last year.
• 11:50Thank you so much for this opportunity to
• 11:53share some of our just kind of a summary
• 11:56of what we've been doing and another is
• 11:58that you and so I'm going to pick up on
• 12:00what Nate was saying about this impact
• 12:03study that we collaboratively did and
• 12:06basically back in March of last year,
• 12:11some of us got together and created
• 12:14a biorepository called impact.
• 12:16It stands for implementing medical and
• 12:19public health action against coronavirus.
• 12:21Connecticut and it's a really a kind
• 12:25of became one of the most successful
• 12:28study group in the country to really
• 12:32tackle COVID-19 both viral infection
• 12:34as well as immune response.
• 12:36And obviously the surveillance.
• 12:39And you know,
• 12:40diagnosis and everything else
• 12:41just followed from this as well.
• 12:44So we wanted to really make this
• 12:47an inclusive effort and so we
• 12:50really wanted fellows and students
• 12:52and healthcare professionals.
• 12:53To get together and implement some of
• 12:57these very important research and also
• 12:59kind of really making elevation of
• 13:01the career of early stage faculty and
• 13:04trainees as as a key target.
• 13:06And I think we've been able to do that,
• 13:08and so I'm going to show
• 13:09you some of the results.
• 13:11This was our first impact meeting.
• 13:14Here's Nate you can see as well as
• 13:18Doctor Co from the school public health.
• 13:20He was the Pi of this repository.
• 13:24Doctor Saad Omer from the Institute
• 13:27for Global Health myself Ellen
• 13:29Foxman and Marine Laundry we all got
• 13:32together and started to you know,
• 13:34really think about how we can
• 13:37form this repository so everyone
• 13:40can benefit and study COVID.
• 13:43So we had a large number of
• 13:46people who had different roles
• 13:48by repository data management,
• 13:50impatient recruitment.
• 13:54Health care worker cohort outpatients,
• 13:57translational and viral efforts and
• 14:00you can see this is just a tip of
• 14:04the iceberg of who was involved,
• 14:06but it was also governed by the
• 14:09Board of Governors who oversaw all
• 14:13the requests for the buy repository.
• 14:16And what this allows us to do is to
• 14:18collect you know every three to four
• 14:21days biospecimen from patients who
• 14:23are in the hospital in the cohort,
• 14:26one who we collected, blood,
• 14:29saliva, oral, pharyngeal,
• 14:31nasopharyngeal swabs,
• 14:33feces,
• 14:33urine and in some patients mini ball
• 14:36so that we can start to look at immune
• 14:39responses and viral replication in real time.
• 14:42And this has really led to a lot
• 14:44of insights that helped us.
• 14:46Kind of try to tackle this infection.
• 14:48We also have an outpatient cohort as
• 14:50well as the health care worker cohort,
• 14:52which served as a uninfected control
• 14:58and using this impact cohort we
• 15:00tackled a large number of questions.
• 15:03We meaning a lot of people involved,
• 15:05I'm just here to as a messenger,
• 15:08so one of the key issues with kovit is
• 15:11that it's a very heterogeneous disease
• 15:14really, really varies between people,
• 15:15how they respond and how
• 15:17they recover and how they.
• 15:18Suffer from this infection and so we
• 15:21focused on different immune responses
• 15:23that occur in people with asymptomatic
• 15:25all the way to fatal infection.
• 15:28And we published several papers on this
• 15:31front looking at how the immune system
• 15:34fails in the severe and fatal COVID,
• 15:37and in addition it's we also saw
• 15:40signatures of the immune response
• 15:42that's contributing to disease.
• 15:44So in the late phase severe COVID.
• 15:47Basically we found out that.
• 15:49Immune responses goes awry.
• 15:50An all kinds of arms that the
• 15:53immune system gets engaged in.
• 15:55It's really the immunopathology
• 15:56that may be driving the disease,
• 15:58whereas earlier phase of the disease
• 16:01is caused by the virus itself,
• 16:04and we've also been looking at
• 16:06differences in immune system.
• 16:08Immune response in male and female
• 16:10patients identified one of the first
• 16:13differences in COVID and that may
• 16:15explain some of the differences
• 16:17we see with risk for severe and.
• 16:20Fatal disease in the male cohort.
• 16:23We've also been looking at long
• 16:25haul or disease.
• 16:26In particular,
• 16:27antibodies that develop against
• 16:29their own cells.
• 16:31They autoantibodies we published
• 16:33with Doctor Aaron Ring.
• 16:35Diverse array of autoantibodies
• 16:37that occur in COVID patients.
• 16:39It's almost sort of.
• 16:41You can consider some of these
• 16:43disease features as autoimmune.
• 16:46We've also been with Doctor Shelly
• 16:48for Hardy and been looking at the
• 16:51impact of COVID-19 in pregnancy,
• 16:53causing both severe impact as
• 16:56well as some more subtle impact
• 16:59that occur within the placenta.
• 17:02Doctor Carrie Lucas and Doctor Kevin
• 17:05Harreld have been looking at children.
• 17:07How they respond differently to COVID
• 17:09and how they can recover versus
• 17:12some of the Missy kind of features
• 17:14that are occurring in some children.
• 17:17So yellow has done a lot of investigation
• 17:19in this heterogeneity of disease
• 17:22in the last couple of minutes.
• 17:23I just want to kind of think
• 17:26about what's next and so we are
• 17:29very interested in figuring out
• 17:31what Long Cove it is all about.
• 17:33And especially we are hearing from
• 17:36patient based groups that about
• 17:3730 to 40% of the long haulers.
• 17:40Are feeling better after vaccination
• 17:42and this provides us a window into
• 17:44which we can understand the disease
• 17:47itself as well as potential therapy.
• 17:49So we are now recruiting people who
• 17:52have long hauler disease prior to
• 17:55their vaccination and also after the
• 17:58vaccination in we're following how
• 18:00their immune responses differ and how
• 18:03that relates to symptom improvement.
• 18:06And we're measuring a lot of different
• 18:08immune features so we can understand.
• 18:10Both the disease process itself as
• 18:12well as therapy, and so just briefly,
• 18:14we think that are a couple of reasons why
• 18:17people are having long hauler disease first.
• 18:20It may be that there is a persistent
• 18:22virus infection that's somewhere in
• 18:24the body causing chronic infection,
• 18:26chronic inflammation, and that can be
• 18:28dealt with by vaccine induced antibodies,
• 18:31which can potentially clear
• 18:32these kinds of reservoir.
• 18:34Second possibility,
• 18:35as I mentioned,
• 18:36is the autoimmune disease that's
• 18:37occurring in some of these patients,
• 18:39an immune.
• 18:40Vaccine induced induced immune
• 18:43cytokines can temporarily dampen
• 18:45these kinds of autoreactive cells,
• 18:48and so we're looking into
• 18:50these kinds of possibilities.
• 18:52And we have a great team here
• 18:54at Yale COVID Recovery study.
• 18:57So Dr Harlan Krumholz is the Pi
• 19:00of this study and I'm a copy.
• 19:02I'm and Daisy Massey.
• 19:04A postcard is really kind of
• 19:06spearheading all the efforts in
• 19:08this front and many a wonderful
• 19:10collaborators listed here are
• 19:12helping out with this study,
• 19:14so I don't want to go over time.
• 19:17I'm going to just desktop share here.
• 19:19Thank
• 19:19you. Doctor Masaki and thank you dad Trueba.
• 19:23Next up we have Doctor Roy Herbst
• 19:25giving us a clinical trials update.
• 19:34Thank you Anita,
• 19:36and it's really a pleasure to be here.
• 19:39Unfortunately, I'm here.
• 19:40I'm taking this role as Roy
• 19:42Decker recovers from his illness,
• 19:44but it was my pleasure to help out.
• 19:45And as you'll see,
• 19:47we're making some progress.
• 19:48Much of it that was begun
• 19:50with Roy and the entire team.
• 19:54Well, I want to start with just
• 19:56a quick patient story and why
• 19:57clinical trials are so important.
• 19:59So this is Maureen Marine
• 20:01was on a clinical trial.
• 20:03She came to Yale 11 years ago.
• 20:06This is before there were any.
• 20:08I mean our therapy trials, by the way,
• 20:09going on in Indiana's and I know that
• 20:11'cause I was at MD Anderson back then,
• 20:13but she was getting a trial of a
• 20:15drug that's now known as Nemo Mab,
• 20:16with Scott Gettinger,
• 20:18Mario Small and Hairy Cougar
• 20:21and she had wonderful response.
• 20:22She had refractory disease.
• 20:24She wouldn't have very much time at all,
• 20:26less than a year,
• 20:27and she's now alive and strong.
• 20:29Eleven years later.
• 20:30That was a clinical trial here at Yale.
• 20:33So we have a couple of things
• 20:35we're doing right now.
• 20:36We really want to have the most
• 20:38safe and efficient clinical trials
• 20:39network we possibly can have.
• 20:41We're modernizing where we were getting
• 20:43a great deal of help from the YCC.
• 20:46I much appreciated from an
• 20:48outside consultant you're on and
• 20:50together with our current team,
• 20:52we're really building a
• 20:54clinical trials office.
• 20:56It's going to be even better than
• 20:57it was before we're improving our
• 20:59standard operating procedures. Why?
• 21:01Because this is an electronic age.
• 21:03We need processes.
• 21:04Where we can sign off on regulatory
• 21:06documents electronically,
• 21:08we want the investigators to have
• 21:10increased responsibility and oversight.
• 21:12We're all working together as a team
• 21:13and we've been working very closely
• 21:15with one of my other hats with the
• 21:17DART leaders to make that happen.
• 21:18We're recruiting staff.
• 21:19We got somewhat low in staff during COVID.
• 21:22It's been a tough 14 months.
• 21:24We've seen that and thank you to all that.
• 21:26All the work that was done here at yeah,
• 21:28but now we're recruiting an A
• 21:30lot of recruiting is going on and
• 21:32just this week we've made eight
• 21:33or nine offers for really good.
• 21:36Staff were focusing on education
• 21:37and training of the staff,
• 21:39were bringing on a younger and newer staff,
• 21:41so we want to make sure that
• 21:43they are supported and trained,
• 21:44and we're doing that.
• 21:45And then we want to activate more trials,
• 21:47but to make room for the new trials
• 21:49we have to close them all trials.
• 21:50So that's something I've been very
• 21:53involved with with the entire team care
• 21:56Pavlik Sarah Boynton the entire team.
• 21:58So just to give you an exact some
• 22:00some sense of the magnitude of
• 22:02the task you can see here trials
• 22:04that are open to accrual.
• 22:06There are 238 trials open to
• 22:08accrual at Yale and 622 translator.
• 22:11Active doesn't translator still open
• 22:13because there are some patients being
• 22:15filed but no one has is currently going on.
• 22:18And then if you look open since March 1st,
• 22:2031 trials of open,
• 22:21so where we've gotten things cranking again,
• 22:23we're opening trials.
• 22:25We're prioritizing trials,
• 22:26and we've closed 38.
• 22:28Really proud of that and then none
• 22:30of them have been closed completely,
• 22:33so we've closed them.
• 22:34You know,
• 22:34to accrual, but then we
• 22:36close them completely,
• 22:37making room for the newer the better.
• 22:39Science, the science coming
• 22:40out of the labs like Leaping,
• 22:42Shine, Ehrenring, Akiko,
• 22:44all people you've just heard.
• 22:46So look at patients on trial.
• 22:48So we had a newsletter.
• 22:49I hope everyone got it,
• 22:50and I think Nita and Renee and
• 22:53and everyone for their help on
• 22:55this and you can see that we
• 22:57put 47 patients on trial in May.
• 23:00Would we have liked more?
• 23:01Sure, but we could have had less.
• 23:03We're keeping our momentum going
• 23:04and I'll show you in a moment
• 23:06that the curve is heading up.
• 23:08312 patients are still on treatment
• 23:10at the main campus, New Haven,
• 23:12but 122 at the care centers.
• 23:15So we have a number of patients
• 23:16that are under treatment,
• 23:17so we're pretty busy.
• 23:21Now if you look at the types of trash,
• 23:23this is important about half
• 23:25of them are industry trials,
• 23:26but actually quite nice.
• 23:27About half of them are either cooperative
• 23:29group trials where there's been a lot
• 23:31of input you know from from our team.
• 23:33We're one of the leading sites
• 23:34in the Southwest oncology group,
• 23:35the SWOG through the National
• 23:37Clinical Trials Network,
• 23:38and you can see 15% of these or
• 23:40investigator initiated meaning they've
• 23:42directly come from a real science.
• 23:44So this is good.
• 23:45I'd love to see this piece a little
• 23:46bit bigger and we're working on that.
• 23:48There's enough signs here to make this
• 23:50at least a quarter or even a third.
• 23:53And here I I told you you can
• 23:55see back from last January and
• 23:57we were already a little bit low.
• 23:59We were already trying to fix
• 24:00things a bit back then,
• 24:01but then we took this dip we
• 24:03actually had to close trials for a
• 24:05month or two because of the virus,
• 24:07but we've gotten back up there and look.
• 24:09We're beginning to get to those levels,
• 24:11so a positive trajectory.
• 24:12Do I want to do better?
• 24:14Absolutely we will,
• 24:15but thank you to everyone at the
• 24:17entire team for all they've done.
• 24:20So we have a work stream activation team.
• 24:22We just took this picture today so
• 24:24we're meeting at multiple times a
• 24:26week to try to open more trials,
• 24:28use the You're on team.
• 24:29The YCC team find ways to identify
• 24:32the trials closer to opening.
• 24:33Unless the gateman's been working
• 24:35very closely with us on this,
• 24:37Mallory of course works.
• 24:38Here she's one of our regulatory
• 24:40team by Jesse Ragna announce
• 24:42and they're all with urine.
• 24:44Sarah is is our is our leader right
• 24:47now and they've got me to join.
• 24:49But we opened four trials last week.
• 24:51And we closed.
• 24:52One doesn't seem like a lot,
• 24:53but it's really good progress and
• 24:55the momentum is is moving forward
• 24:58really making some progress.
• 25:00So I just wanna show you an example of
• 25:01what we're opening their their varied.
• 25:03Here's a trial of Marriag Ocean.
• 25:04So this is a surgical trial in breast cancer,
• 25:07so you can see surgery versus
• 25:09active monitoring.
• 25:10Here you can see Andrea Silver a
• 25:12try for triple negative breast
• 25:14cancer immunotherapy and adding a
• 25:16vaccine and neoantigen vaccine.
• 25:18This is a little bit of a rare population,
• 25:19but it's an important population,
• 25:21so this is open.
• 25:22This trial, Barbara Burtness.
• 25:24I think this is going to be very popular.
• 25:26Very high accrual because it's
• 25:28a drug lab at Neb.
• 25:29That's a multitype tyrosine kinase
• 25:31inhibitor targets vascular in
• 25:32affiliate growth factor being added
• 25:34to pembrolizumab in patients who
• 25:36are resistant to immunotherapy.
• 25:37This trial is now up in accruing
• 25:39both on the main campus and the care
• 25:42centers and then actually by coincidence,
• 25:44one of my trousers in the queue
• 25:46just by coincidence.
• 25:47And this is a trial of another
• 25:49checkpoint inhibitor known as ticket
• 25:50anti TIGIT and this is this is actually
• 25:52on going. And we're accruing as well.
• 25:55I just want to say that you just saw
• 25:57it from Akiko the impact program,
• 25:59and, you know, Wade Schultz here was
• 26:01very involved in that. You know,
• 26:03creating the whole computational database.
• 26:05On Ed, Captain Ann Wade and the team
• 26:07here Christina Weiss Big shout out.
• 26:09She's the CTM for the GI team working
• 26:11with Pam Neal at the care center.
• 26:13They are now doing a clinical
• 26:15trials matching project.
• 26:16How amazing, in real time they're going
• 26:18to use the database linked to Epic
• 26:20that tell us who Ann where patients
• 26:22are eligible for clinical trials.
• 26:24This will help us both in our feasibility
• 26:26planning but also to find those
• 26:28patients who can go on trials with all
• 26:30the different eligibility criteria.
• 26:32I'm not going to say too much of this
• 26:33time mentioned in her grand rounds.
• 26:35Two weeks ago, but good things are happening.
• 26:37Where and we also want to find
• 26:39more diverse patients.
• 26:40We want to put more minority
• 26:41patients on trials.
• 26:42This will help us to find
• 26:44them throughout the network.
• 26:46Finally, I hope you saw the newsletter.
• 26:48We highlighted some of our staff here
• 26:49are two I'd love for people to send me.
• 26:51Emails were going to put this out
• 26:53monthly with staff they recommend for
• 26:55highlights will get them out there.
• 26:56I just want to give a shout out to Heather.
• 26:58She's on the lung team Heather.
• 26:59I actually one of my first actions in
• 27:01this role was to send her to help the Q team.
• 27:04I wasn't that popular with my own team,
• 27:06but she did it with a smile and
• 27:08she's just a great nurse research
• 27:09nurse and has done a wonderful job.
• 27:11And Christine Lee,
• 27:13who is a regulatory manager who's
• 27:15just an amazing job.
• 27:16So finally I just want to tell everyone
• 27:19we're moving in the right direction.
• 27:20We do have a ways to go we're hiring.
• 27:23This is some outings we've had just in
• 27:24the last few weeks of the lung team.
• 27:26I happen to be there so I had some pictures,
• 27:28but I'd love to see every team
• 27:30getting together supporting each
• 27:31other and then just the other day
• 27:32in the clinic I met a patient.
• 27:34Scott Gettinger had me come into a
• 27:35room and he said Doctor Herbst it
• 27:37was a pleasure meeting you yesterday
• 27:39during during my visit with Doctor
• 27:41getting here it was very quick and
• 27:42actually if I showed you my sincere
• 27:44appreciation to everyone that smile,
• 27:46I've been going there since I
• 27:47got into the clinical trial.
• 27:48Four is now active out in 2012.
• 27:51We help this man.
• 27:52He's alive only because of
• 27:54our clinical trials office.
• 27:55It's been nine years and my scans
• 27:57are still clear and all that time.
• 27:59I can't remember one time that I was not
• 28:01treated with the utmost kindest by everyone.
• 28:03The nurses the clinical trial staff,
• 28:05volunteers and doctors smiles
• 28:07and good words go along way when
• 28:09you're dealing with an illness.
• 28:10So I just want to stress we're doing
• 28:12important work where pulling together,
• 28:13we hope for the best that Roy
• 28:15Decker will come back soon.
• 28:16Thank you very much.
• 28:19Thank you Doctor Herbs
• 28:20for that fabulous update,
• 28:22and I want to publicly state my gratitude
• 28:25for stepping in as our acting chief.
• 28:27You stepped in with both feet
• 28:29and graciousness and really have
• 28:32been doing huge amount of work.
• 28:33I think is all of us can see
• 28:35obviously a lot of it was built with
• 28:38Doctor Decker and that our support
• 28:39teams and also I think what draw.
• 28:41So seeing is we want to be
• 28:43transparent and share all the data.
• 28:44So the newsletter I felt was
• 28:46fabulous and then just to see this
• 28:48data so will continue to do this.
• 28:50Monthly, this is important work you
• 28:51showed some why it is important
• 28:53with those great patient stories.
• 28:55So thank you Roy.
• 28:56Next step,
• 28:57I think is Doctor Wilson to give
• 28:59us a radiation oncology update.
• 29:02Thanks nita. This will be brief and
• 29:05much more uplifting and less stressful
• 29:07for this group compared to last month.
• 29:10And I say that because as most of
• 29:13you know we were in the throes
• 29:15of managing the resultant.
• 29:17Challenges that were associated with
• 29:20the third party vendor cyber attack,
• 29:23which brought all of our systems down
• 29:25across the network for several weeks,
• 29:28so we were forced to.
• 29:31Develop and put into play
• 29:33alternative modes of treatment for
• 29:35our patients which worked well.
• 29:37So the news today is good.
• 29:39In fact, this week we're treating
• 29:41approximately 300 patients a
• 29:42day throughout the network,
• 29:44which is very close to the highest daily
• 29:48numbers that we've ever seen in the
• 29:52program and within the next two weeks.
• 29:55All of our patients will be back and
• 29:59managed in the standard clinical record
• 30:01and verify mode prior to the cyberattack.
• 30:04There aren't very many patients
• 30:06left in the file mode technique,
• 30:09but there are a few,
• 30:10but they'll be coming off that
• 30:11mode soon as soon as they finish
• 30:14their treatment program.
• 30:15So things are going very,
• 30:16very well and very efficiently,
• 30:20so that's excellent news.
• 30:23We have some.
• 30:24Nice equipment changes.
• 30:26We have a we have two CT
• 30:29simulators in New Haven.
• 30:31One of them has been decommissioned
• 30:34is actually I believe being removed
• 30:37tonight and will be replaced by a
• 30:39wide bore CT to match the other wide
• 30:42bore CT that we currently have,
• 30:44which will be a great addition
• 30:46to the program.
• 30:47In addition it will have some
• 30:49other nice technical upgrades.
• 30:51The downside on that is since these are.
• 30:54Complicated installations with
• 30:56commissioning associated with them.
• 30:58It will take a couple of months to have
• 31:02this up and running, but that's OK.
• 31:04The other CT can handle the load.
• 31:06Of course there is some scheduling
• 31:08inconvenience because of that,
• 31:10but there will not be any delays
• 31:12in the management of our patients
• 31:14because of this. So that's good news.
• 31:17Also,
• 31:17our CT simulator in Guilford is
• 31:20also being replaced,
• 31:21which is good news in those patients.
• 31:25Again,
• 31:25are all being seen and treated
• 31:27in a timely fashion,
• 31:28and we've worked out a program where
• 31:30they undergo their CT simulation.
• 31:32Most of those patients anyway
• 31:33at our Hamden facility,
• 31:35so that's been moving very, very nicely.
• 31:38A bigger piece of equipment,
• 31:40news is we have four linear
• 31:42accelerator's in New Haven.
• 31:44One of them has just been decommissioned
• 31:47very recently and will be replaced.
• 31:51A very in Truebeam device we already
• 31:53have one of those linear accelerators,
• 31:57so this will be a very nice
• 31:59replacement device.
• 32:00But again it takes a long time
• 32:02for the removal installation.
• 32:04These are big pieces of equipment,
• 32:06highly technically complicated
• 32:07with a lot of radiation therapy,
• 32:10safety commissioning associated with
• 32:12it so that device will not be up
• 32:15and running probably until October.
• 32:17The downside of this is in all
• 32:19departments face this all the time
• 32:21whenever they have to replace equipment.
• 32:23So we're used to this,
• 32:25but we're on extended hours.
• 32:26We do not believe in waiting lists
• 32:28for our patients, so we take care
• 32:31of everyone by extending the hours.
• 32:33So we're basically treating patients
• 32:35from 6:45 or 7:00 in the morning,
• 32:37which is typically when we start.
• 32:40But now instead of being
• 32:42done around 5:00 or 5:30,
• 32:44there are patients being treated up
• 32:46until about 7:00 o'clock in the evening,
• 32:48which of course is inconvenient
• 32:49for some patients.
• 32:50But remarkably, there are.
• 32:51We always encounter patients who prefer that.
• 32:53Because that makes it easier for them to get
• 32:55their treatment after they're done with work,
• 32:58so it's not as bad as it sounds,
• 32:59and our staff is used to
• 33:01doing this sort of thing,
• 33:02so it's another good piece of good news,
• 33:05but it will take a couple of months,
• 33:07but in general, things are going very well.
• 33:09We have emerged successfully
• 33:12from the cyberattack challenges,
• 33:14so morale is much better.
• 33:17Efficiency is much better.
• 33:19There are a few pieces in
• 33:22terms of historical data.
• 33:24That we have garnered from the cloud,
• 33:27which will allow us access to all of
• 33:29the history on all of our patients.
• 33:32We're not quite there yet,
• 33:33but should be in the next couple of weeks.
• 33:34That's also another piece of good news.
• 33:36We were concerned that those date of may
• 33:38have been corrupted during the cyber attack,
• 33:40but indeed they were not.
• 33:42So that's good news in the last
• 33:44piece of information dovetailing.
• 33:46Often his comments regarding ASCO Astro,
• 33:49the Radiation Oncology International
• 33:51meeting will be taking place this year.
• 33:53The end of October in Chicago Live,
• 33:56which will be exciting.
• 33:57So thanks very much for the time.
• 33:59Well,
• 34:00that was really great news.
• 34:01And as you said lot,
• 34:02you know what your team had to go through
• 34:05and I'm really excited that that all
• 34:07our patients are being taken care of.
• 34:08And also, more importantly,
• 34:09you're also getting some state
• 34:11of the art machine.
• 34:12So congratulations to all of you.
• 34:14Thank you Lynn.
• 34:16Next, I think we have a clinical update
• 34:19with Doctor Billingslea and Kim Slusser.
• 34:21I don't know who's going first.
• 34:24Alright tag team are dynamic dual.
• 34:29Thank you Nita. You know,
• 34:33I will say that this is been a truly
• 34:37gratifying week for Kim for myself,
• 34:40for our all of our clinical teams.
• 34:43I think many in the audience know that we
• 34:47had the the pleasure of moving our surgical
• 34:51oncology team back in to NP 15 this week.
• 34:55And as much as it was enormously
• 34:59gratifying to bring that team home,
• 35:02it was also a difficult and poignant
• 35:06team a poignant moment as we consider.
• 35:10The history of COVID care
• 35:13in this institution, and.
• 35:17And the fact that NP 15 was really
• 35:20Ground Zero for caring for hundreds
• 35:23of patients for COVID at Yale,
• 35:25New Haven Hospital over the past 14 months.
• 35:29There was a wonderful ruin remembrance
• 35:33ceremony yesterday in the morning with
• 35:36many of our staff as well as our leaders and.
• 35:40And I think it was a fitting tribute
• 35:42to the dedication, compassion and
• 35:45excellence of the mini physicians, nurses,
• 35:49and staff that work tires tirelessly
• 35:52for for days, weeks and months on end.
• 35:56Take care for patients
• 35:57through the pandemic there.
• 35:59But we are.
• 36:00We're enormously happy to be back on it.
• 36:03MP15 and.
• 36:04We will be moving the women's oncology
• 36:09program back to NP 14 next week.
• 36:13I have some some.
• 36:16Some gratitudes to share,
• 36:17but Kim,
• 36:18let me ask if you want to
• 36:19jump in at this point.
• 36:23I mean, the only thing
• 36:24I I just want to also echo what Kevin said
• 36:28around the remembrance ceremony it was.
• 36:31It was quite touching and it was also pretty.
• 36:35It it really brought back
• 36:36I think to a lot of people.
• 36:38Some of those early day memories and you
• 36:41know they shared what that MCU team had
• 36:44to experience over these past 14 months.
• 36:47And you know they mentioned that they had to
• 36:52witness 300 deaths just on that unit alone.
• 36:55And but they were able to also
• 36:57witness Four Weddings, and it was
• 37:00just a really great reflection time.
• 37:02And it was.
• 37:03Then especially great to know that
• 37:06we no longer need a 28 bed COVID ICU
• 37:10unit at Yale New Haven Hospital.
• 37:13I think that that is what we celebrated
• 37:15and then to be able to bring our surgical
• 37:18oncology unit back to their home on MP15.
• 37:21And it was great to walk around the unit
• 37:24in the evening and see our team members
• 37:26back up there and we can't wait to
• 37:29welcome women's oncology back next week.
• 37:31Go ahead, Kevin.
• 37:34So I do want to say
• 37:36a special note of thanks to our
• 37:39multidisciplinary teams who have
• 37:42cared for patients with women's
• 37:44cancers at the Saint Berryfields
• 37:46campus for the past 14 months.
• 37:49The work of the nurses under the
• 37:52leadership of Sarah Infantino
• 37:54has been absolutely brilliant.
• 37:57And you know, we often talk about
• 38:00heroism and we think of it is is
• 38:03singular dramatic activities.
• 38:05But what I think is often most
• 38:09to me most impressive is,
• 38:11is that quiet heroism of everyday service.
• 38:15In this group of nurses came to work every
• 38:19day under challenging circumstances,
• 38:22caring for a difficult group of
• 38:26patients in a challenging environment.
• 38:28With patients undergoing surgery
• 38:30here at the York Street campus.
• 38:32Transferring by ambulance to
• 38:35Saint Braves without their usual
• 38:37support structure around them.
• 38:40So I, I just can't.
• 38:43Can't say enough for all deeply grateful.
• 38:46This same gratitude extends to Vanna.
• 38:50Dest and her team of Aips that
• 38:52worked hand in hand with the nurse,
• 38:54is providing outstanding around the
• 38:57clock care for patients over there.
• 39:00We had wonderful support from our
• 39:03hospitalist colleagues under the
• 39:05direction of Laramidia and will pushing,
• 39:07providing some additional support.
• 39:09And, of course,
• 39:11our G1 GYN Oncology service surgeons.
• 39:14Providing care at both campuses,
• 39:18sometimes operating at two campuses
• 39:20in one day.
• 39:21Covering centrical emergencies on
• 39:24York Street while rounding at SRC.
• 39:27Doctor Ratner and her team,
• 39:29including doctors and sodium
• 39:31and eras santine,
• 39:32all Twigger Clark weighing and icky.
• 39:34And we're all deeply grateful.
• 39:37I know there are probably
• 39:38people I'm leaving out,
• 39:39but I will just say this was
• 39:43truly a Herculean effort on behalf
• 39:45of all of our our patients.
• 39:48Thank you.
• 39:54And then another milestone for us is,
• 39:57you know, on March 9th we formed
• 40:00a smile COVID-19 response team.
• 40:03But then after a few months turned
• 40:06into a monitoring and transformation
• 40:09team and we had hundreds of meetings
• 40:13of this team and we are May 28th.
• 40:16We sunsetted this team again.
• 40:18Another just amazing milestone for us.
• 40:22We do recognize that there is still
• 40:25disruption and there is still displacement
• 40:27and there is still a lot of work we
• 40:30have to do throughout this pandemic,
• 40:32but the fact that we are at a
• 40:34place where we no longer have to
• 40:37bring this large group together,
• 40:38it really gave us also another time of
• 40:41reflection to see everything that was
• 40:44accomplished over the last 14-15 months.
• 40:48An really came out of this group of
• 40:52over 60 multidisciplinary team members
• 40:54across Yale Cancer Center and Smilow.
• 40:57An other department's in the hospital,
• 41:00and again,
• 41:01it wasn't those 60 individuals
• 41:03that did all this work.
• 41:05It was every single person within
• 41:07our community across Yale Cancer
• 41:10Center and Smile.
• 41:11Oh, but the fact that we were able
• 41:13to create over 30 working groups,
• 41:16an accomplished over 100 what
• 41:17we call just do it.
• 41:19Action items that stand across relocations,
• 41:24changing clinical pathways.
• 41:26Creating new protocols.
• 41:28Opening up a new clinic and a new
• 41:32monitoring call program for our patients
• 41:35that experienced COVID transitioning
• 41:37hundreds of staff to remote to remote
• 41:41work and successfully care for patients.
• 41:43It's just amazing to see what our
• 41:46entire enterprise had accomplished
• 41:48while still delivering excellent
• 41:51clinical care to our cancer patients and
• 41:54ensuring a safe workplace for our teams.
• 41:57And I just.
• 42:00Was.
• 42:01Very grateful to be part of this team.
• 42:05Throughout all of this and continue
• 42:06to be proud every day to come to
• 42:08work and work with this amazing team.
• 42:12And I think also some of the things
• 42:15we can really take away from this
• 42:17team is that now we have a playbook.
• 42:20We have all of the work that we did
• 42:23previously and I think if we ever had
• 42:26to go through something like this again
• 42:28we're just more prepared and we're
• 42:31also more prepared now and how we.
• 42:34Look at our clinical operations again.
• 42:37This group moved into a transformation team.
• 42:39We formed forward transformation teams
• 42:42inpatient ambulatory clinical trials,
• 42:45and supportive care services.
• 42:48Ann are ambulatory transformation
• 42:50team and are supportive care services.
• 42:53Transformation team are still very,
• 42:56very active with many,
• 42:58many initiatives that is transforming
• 43:00care across our enterprise,
• 43:02and that work will continue.
• 43:04So just by sunsetting this,
• 43:06it doesn't mean that the work is done,
• 43:08but it is a milestone where we no longer
• 43:10have to bring this group together as
• 43:13frequently as we had in the past.
• 43:15And we are able to sunset.
• 43:17And with that we're also able to look ahead.
• 43:20So one of the things we really learned
• 43:22about this whole process that we went
• 43:25through is that we really valued the
• 43:27forum of bringing so many different
• 43:29people from our enterprise together
• 43:32to talk about clinical care
• 43:34delivery in our clinical operations,
• 43:36an with the launch of our disease centers,
• 43:39it's going to be critically important
• 43:41to have some type of forum where
• 43:44we bring again our diverse group of
• 43:46team members together to talk about.
• 43:49Clinical activities so we will be
• 43:51forming a Yale Cancer Smith Center
• 43:54Smilow Clinical Council that Kevin
• 43:56and I will Co chair and it will really
• 43:59serve as a form for this continued
• 44:01work of our transformation teams,
• 44:03and it will also provide a venue for
• 44:05disease center clinical leaders and
• 44:08smiling multidisciplinary leadership
• 44:09to exchange best practices and be a
• 44:13setting where we can discuss innovation
• 44:15and can can ensure our care signature
• 44:18across all of smilow So we're really
• 44:21looking forward to the launch of that.
• 44:22There will be more to come in more
• 44:25specifics about this and future town halls.
• 44:27We hope to have this Council up and
• 44:29running sometime this summer, but again,
• 44:32just a very significant milestone.
• 44:38In our work through this pandemic and Kevin,
• 44:40I'll just let you close out.
• 44:43Thanks
• 44:44Kim, I have very little
• 44:45to add except powerful
• 44:47lessons learned an I think.
• 44:49We do have an opportunity to take the the.
• 44:56The lessons that we've learned
• 44:57in our knowledge that we can work
• 45:00quickly and effectively as a nimble,
• 45:03cross functional team that spans
• 45:05this entire organization and and
• 45:07we're going to carry that forward.
• 45:10The Clinical Council is going
• 45:11to be a great venue for that,
• 45:13and I know we're all looking.
• 45:15Forward to.
• 45:16Continued growth in our organization.
• 45:19Thank you Kim and Kevin for that
• 45:21nice update and also for announcing
• 45:23the news that I think a lot of
• 45:25percent look forward to severely.
• 45:27Great to hear this.
• 45:29Next up is Doctor Terrasanta.
• 45:31Give us an update on survivorship.
• 45:35Thank you doctor Hooja.
• 45:41I'd like to just remind everyone
• 45:44that we have a very large.
• 45:47Survivorship network,
• 45:48here at throughout the Smilow Cancer
• 45:52network we have survivorship programs
• 45:54not just in Smilow New Haven,
• 45:58but also at L&M.
• 46:01Bridgeport Hospital Greenwich Hospital
• 46:04an multiple survivorship support staff
• 46:07and providers all across our network.
• 46:10We also have supportive care services as
• 46:13mentioned by Kim and Kevin and some that are,
• 46:16you know, highly utilized by our survivors
• 46:20like the sexuality and Intimacy Clinic.
• 46:23The cardio oncology clinic.
• 46:26Oncology rehab and we have a new
• 46:29cancer and cognition clinic.
• 46:31Anna supplements clinic and we work
• 46:33very closely with our palliative
• 46:35care and integrative medicine
• 46:36colleagues so I just want to call
• 46:39out all of you on the call today.
• 46:41You were involved in the
• 46:43survivorship network and thank you.
• 46:45National Cancer Survivors
• 46:46Day is an annual event,
• 46:48usually the first Sunday in June and
• 46:51last year we converted to a virtual event
• 46:54and it was actually wildly successful.
• 46:58We had thousands of views on our website.
• 47:02And what we are doing again this
• 47:05year is something similar and I
• 47:07hope that with a little bit more
• 47:09preparation all of you can participate.
• 47:12So what we're doing is a sort of a
• 47:16month of June theme of myth busting
• 47:21different survivorship type myths,
• 47:23and we're hoping to have many
• 47:28people contribute short videos
• 47:30celebratory messages to survivors,
• 47:33messages of gratitude or tips and tricks
• 47:37that reflect your area of expertise.
• 47:41Really,
• 47:41it's a it can be anything.
• 47:44That you wanted to submit short
• 47:46videos from yourself or your team.
• 47:48You can email cancer answers at
• 47:52yale.edu and Renee or Emily will send
• 47:55you a link to upload your video.
• 47:58Well,
• 47:58there's also room for testimonials from
• 48:01survivors if you're interested in that,
• 48:03you can also email cancer answers
• 48:05at yale.edu.
• 48:06We're sharing through social media
• 48:09under the hashtag smilow celebrates.
• 48:12And then we're posting these sprinkled
• 48:15throughout the next few weeks in June,
• 48:18in various different themed weeks,
• 48:22and then we'll sprinkle in
• 48:23the messages of gratitude.
• 48:24So please, if you're on this, call Ann.
• 48:27You're at all interested.
• 48:29Send a video through cancer
• 48:31answers at yale.edu,
• 48:32or patients really want to see you and
• 48:35they feel very close to their teams
• 48:38when they see these videos posted.
• 48:40In addition,
• 48:41we thought would be really fun to
• 48:43capitalize on the Smiler shares
• 48:45format that I was born out of,
• 48:47COVID that patients are able to respond
• 48:50to and and tune into in real time.
• 48:53So every Tuesday at 7:00 PM
• 48:55we will have a smile,
• 48:57oh shares and we are highlighting
• 49:00these various programs all across
• 49:02our network with experts again from
• 49:05top to bottom of our geographic area.
• 49:08So next week we will talk about.
• 49:10Exercise and strength for cancer
• 49:13survivors and then June 15th sexuality
• 49:16intimacy and menopause in cancer survivors.
• 49:19June 22nd supplements and Nutrition and
• 49:23June 29th holistic coping strategies.
• 49:26This will be a mix of experts talking
• 49:29about myths within these topics,
• 49:32and then some panelists to answer questions.
• 49:35You're welcome to join us as well,
• 49:37but please feel free to pass
• 49:39this along to your patients.
• 49:43I wanna just take this one last
• 49:45moment to put in a plug for our
• 49:48series on emotional intelligence.
• 49:49This is open to all members of the cancer
• 49:54community and it's been very popular.
• 49:57It's hosted by Marc Brackett and
• 49:59Robin Stern from the center of
• 50:01Emotional Intelligence here at Yale,
• 50:03we've had two sessions an our
• 50:05next session will be Monday,
• 50:08June 21st at noon and this is
• 50:11more about our own health.
• 50:13And taking care of ourselves and
• 50:15each other an I think we've learned
• 50:18a lot in the pandemic on how
• 50:20important that is now more than ever.
• 50:23So if you're interested in this,
• 50:25please feel free to email me if
• 50:27you're not already on the distribution
• 50:28list and we'll get you the invite.
• 50:30Thank you.
• 50:32Thanks Doctor Sampson, I love the
• 50:34idea of uploading those little videos.
• 50:36That is phenomenal.
• 50:37We have a V amazingly finished.
• 50:40We have a few minutes so you all did
• 50:43great and we have a few minutes for Q&A,
• 50:46so hopefully all folks can
• 50:49time in their questions.
• 50:52Come to our panelists,
• 50:53'cause I think in the other piece I
• 50:55wanted to mention is we do have a
• 50:57patient symposium in our last one had
• 50:59a really nice turn out to be continued.
• 51:02This based on the events during
• 51:05COVID and had nice sort of
• 51:08interactions with our patients.
• 51:10Perhaps as folks are
• 51:12typing in their questions,
• 51:13I'm going to ask something to either
• 51:15Doctor Gruber, doctor Eva sake.
• 51:16One of the questions that came up and
• 51:19I have to say Kevin Billingsley did
• 51:21a really nice job, but I'm not sure.
• 51:23I'm convinced that I knew the answer, but.
• 51:25Our immuno suppressed patients
• 51:27who get vaccinated.
• 51:28There seems to be even on CNN this morning.
• 51:32There's a lot that are be
• 51:34producing enough antibodies.
• 51:35What should we be sort of thinking about?
• 51:37What's the current state of affairs on that?
• 51:42And I knew if it's like I'm not
• 51:43going to give you the easy ones.
• 51:47Yeah Kevin, do you wanna go well?
• 51:51Capital. In front of
• 51:54a world class immunologist.
• 51:59What I think we're counseling
• 52:00patients is that for.
• 52:04People who were on lymphocyte
• 52:07depleting therapies,
• 52:08and we know that their the their immunity,
• 52:13immunological response to vaccination
• 52:15is going to be blunted related either to
• 52:19the disease process or to the treatment
• 52:22that it is prudent to work closely with.
• 52:26Your treating oncologist and potentially
• 52:29delay vaccination until there has
• 52:32been some immune system recovery.
• 52:35For people who were heading into bone
• 52:37marrow transplant stem cell transplant,
• 52:39we're obviously trying to get them vaccinated
• 52:42before they embark on that treatment.
• 52:45Unless they're having a rapidly
• 52:48progressive acute leukemia or some
• 52:51hematol other haematological malignancy.
• 52:54What I am kind of trying to
• 52:56communicate to the public is that
• 52:58that is a really actually relative,
• 53:01quite quite a small population
• 53:03of cancer patients.
• 53:04Given the broad pool of people
• 53:07that we treat and smilow,
• 53:09and for the vast majority of our patients.
• 53:13Vaccination is perfectly safe.
• 53:15They should be vaccinated, and they will.
• 53:19They'll mount a protective immune response,
• 53:22but. I think akeel let me have you.
• 53:26You can fill us in on the real science
• 53:27you passed or not.
• 53:32No, I think that's a perfect answer.
• 53:35I was also going to add,
• 53:36you know if it's possible to use
• 53:40monoclonal antibody cocktails on some of
• 53:42the patients who are very vulnerable.
• 53:44You know, I don't know if that's
• 53:45going to be approved for use,
• 53:47but that's something to be
• 53:49thinking about in the future,
• 53:51because these monoclonals they can last for,
• 53:53you, know sometime at least,
• 53:55to prevent infection of these
• 53:57email compromised people.
• 54:01This is Ken. I was just gonna
• 54:02say last week we did host
• 54:04Milo hosted a town hall.
• 54:06I'm hoping maybe we can check with
• 54:08Renee to see if it was recorded
• 54:10and maybe we can follow up with
• 54:12our community on where that's at.
• 54:13'cause we did host a immuno vaccination
• 54:17and immuno compromised patients
• 54:20town hall last week with with
• 54:23several several faculty members from
• 54:27infectious disease and and smile oh so.
• 54:31Renee saying yes,
• 54:32it was recorded show host in the link.
• 54:35There was great discussion in
• 54:37that town hall last week as well.
• 54:39Thank you Doctor Grubaugh a
• 54:42question for you in the chat.
• 54:45Have you seen vaccine breakthroughs
• 54:46yet in Connecticut or New Haven?
• 54:50Yeah, there's been hundreds of vaccine
• 54:52breakthroughs than Connecticut so far,
• 54:55and I think you know,
• 54:56that should have been expected going in
• 54:58that it's the the vaccine is not 100%.
• 55:02What we're finding in?
• 55:03We're finding this from, you know,
• 55:05other individuals from or other groups
• 55:07from all over the country is that we're
• 55:10not really seeing a over representation
• 55:12of 1 variant in the vaccine breakthroughs
• 55:15versus the unvaccinated population.
• 55:16Not saying it it may not stay that way.
• 55:19There may be things that emerge or with
• 55:21more data, we end up finding things,
• 55:23but so far it seems to be what what people,
• 55:26what causes?
• 55:27Vaccine breakthroughs are just.
• 55:30The same things that caused
• 55:31all other infections,
• 55:32and it probably means that it has
• 55:34more to do with the host response
• 55:35than it does the virus itself.
• 55:38Thank you so much and I
• 55:40think that's reassuring.
• 55:41I mean, some are expected,
• 55:42but I'm glad to see that that you know,
• 55:45we're not seeing a particular
• 55:47variant breakthrough.
• 55:47The next question I have here is,
• 55:50and perhaps because we sit on two sides,
• 55:54maybe Kim and Kevin.
• 55:55You can tackle this.
• 55:56What are the panelists?
• 55:58Thoughts on getting back to
• 55:59small in person meetings versus
• 56:01zoom in regards to connection,
• 56:03communication and productivity?
• 56:11I.
• 56:13I guess I will say that I think we are
• 56:16at a juncture in our evolution through
• 56:19this that we do have support from,
• 56:22at least on the health system side.
• 56:26To gather in small meetings.
• 56:31And in our workspaces,
• 56:33not in clinical care spaces.
• 56:38For for business related activity.
• 56:42Ink. And those of us who are
• 56:45on the leadership team are
• 56:47starting to do that.
• 56:47And I do think that it.
• 56:50Is is productive?
• 56:51I will say that I don't.
• 56:54I have not heard where the
• 56:56School of Medicine sits.
• 56:58On that policy directly.
• 57:05Kim, do you want to add anything else or no?
• 57:08I agree with Kevin.
• 57:09I mean I think we I saw Roy's
• 57:12pictures of some outings and so forth.
• 57:14So it looks like there's.
• 57:15I think you know the outdoors.
• 57:17If we can utilize the warmer weather and but,
• 57:20but I know that connection is so important.
• 57:24So I think as long as we start
• 57:26small and as Kevin said,
• 57:27there are some health system guide
• 57:29guidelines that have allowed us to start
• 57:32coming together a little bit, not in.
• 57:34Big groups, but in small meetings and
• 57:38non clinical areas and I think I I
• 57:41think we should be supporting our teams
• 57:43together like that when when we can.
• 57:46I think we have learned that zoom
• 57:49really helps us as well so I think we'll
• 57:52probably just like Tele health, right?
• 57:53Well, always live in this hybrid
• 57:56world but I think all of us would
• 57:59love to see more in person.
• 58:03Time together
• 58:04and I know Roy you have your
• 58:05hand up from the university.
• 58:07As you know the guidelines still
• 58:09stand in terms of yes you can
• 58:11meet its their size limitations.
• 58:12You need approval for certain events
• 58:15and then the most biggest caveat
• 58:17is consumption of food is still not
• 58:20allowed on the university campus.
• 58:22So again that may change and I
• 58:23know they are looking to change
• 58:25as you're seeing that from the
• 58:27Provost Doctor Hurts you.
• 58:28Had your hand up.
• 58:29Yeah, I just wanted to say that we
• 58:30found all the rules and we're meeting
• 58:33that we are. Paying for it ourselves,
• 58:34and we're not doing any official events.
• 58:36We have to follow the guidelines, but you
• 58:39know there's nothing wrong with someone
• 58:40having a party and you go to it.
• 58:44OK, well it's the top of the hour,
• 58:46so I think Renee wanted me to remind Renee.
• 58:49Do you have one?
• 58:50Thank you to all our panelists for
• 58:51presenting and for keeping to the time limit.
• 58:53I really, truly appreciate it.
• 58:55We made it. And then there's going
• 58:57to be a brief survey at the end
• 58:59of today's town hall webinar.
• 59:00I think it pops up as as the web and
• 59:03R finishes and then the other part is
• 59:06if you have other ideas or questions.
• 59:09Cancer answers at yale.edu just submit
• 59:11them and we will try to address those.
• 59:14So again, same same time next
• 59:16month first Thursdays, 5:00 PM.
• 59:18See you then thank you everybody
• 59:19have a good evening.
• 59:23Thank you.