Notes from Neil

Dear Friends and Colleagues,

This week marked the 2-year anniversary of our community’s first known case of COVID-19. As we start to reconnect with family and friends, we find ourselves reflecting on the experience. Some things will never be recaptured because of the pandemic, like my son’s senior year in high school or his final season on the baseball mound. On the other hand, the pandemic has helped us grow and become stronger. I proudly witness his, and others, enhanced ability to deal with unpredictability, greater accommodations for rapid change and a resilience that young people rarely possess. 

So, this morning I asked him what the best thing was to come out of the pandemic.  As a business major studying for exams, he immediately shared the stats on the skyrocketing number of startups in the last 2 years.  As a scientist, I can also attest that these have been banner years for science and for research at MedStar Health.

While our main priority is caring for our community while ensuring the safety of our associates, patients, and research participants, science has not slowed down. As an academic health system, we have stepped up to address the greatest challenges COVID-19 has presented. 
Our goal has always been to advance health through research to help our patients of today and tomorrow:

• We’ve grown our portfolio of research related to COVID-19 from 50 studies in May of 2020 to more than 200 current active clinical studies today.
   
• In the fall of 2020, MedStar Health was a leader in the national consortium for the COVID Community Research Project (CCRP), an at-home research study to help us better understand the best ways to treat and prevent COVID-19, enrolling more than 14,000 participants in our region.
   
• Researchers at MedStar Health led an international team that used artificial intelligence to evaluate cardiac images from patients across the globe who had COVID-19 to predict who is at greatest likelihood to die from COVID-19.  
   
• The Research Institute brings a community based, health equity lens to all of the work that we do, including disparities of COVID-19 care, vaccine hesitancy and accessibility.  As an example, MHRI researchers are applying artificial intelligence techniques to develop a tool in the emergency department that supports safe discharges of COVID-19 patients and can address disparities in care.

As we continue in our fight to end the pandemic, we remain committed to better understand this virus and improve our therapeutic approaches and its long-term consequences.  In this month’s newsletter, we highlight collaborative work we’re doing with NIH to improve COVID-19 research to better treat and care for our patients. In this edition, you’ll also see how we were able to gain knowledge to help others as we rapidly built-out two monoclonal infusion centers for outpatient management of COVID-19.

The rain has cleared and the sun came out to a glorious 75 degrees today! I am grateful for the hints of spring and the falling COVID-19 numbers.  However, I am even more grateful to work with such wonderful people, demonstrating their resilience to accomplish such meaningful and impactful work. As One MedStar, there’s nothing we can’t accomplish together. And for me, that is why its been a banner two years!

Thank you for your contributions to advancing health.

The MedStar Health Research Institute Early Stage Investigator Grant is a funding opportunity available to support early stage investigators at MedStar Health to help launch impactful research careers in any discipline or specialty that will advance health and create new knowledge. 

The goal of the grant is to support scientific research by a MedStar Health employed investigator that will advance health for patients in the communities we serve. Also, this opportunity provides seed funding that has a high likelihood of leading to external funding which ultimately contributes to the successful launch of a productive research career at MedStar Health.

I am pleased to announce the following MedStar Health early stage investigators to receive funding for their research.  This is the first round of funding with others likely to be funded later this year. 

We are MedStar Health Proud of our grantees and excited to see them take their research career to the next stage and support our mission to advance how we treat our patients today and tomorrow.

Investigator: Erica Coates, PhD

Research Project: Preschooler’s Adjustment to In-Person Learning Following COVID-19-Related School Closures in Black Families: A Mixed Methods Approach

The purpose of this study is to draw attention to the experiences of Black families with young children during the pandemic and identify parent and teacher protective factors associated with children’s adjustment during the return to in-person learning 2021-2022 school year. This is especially important given the public health, economic, educational, and racial injustices Black Americans have endured during the pandemic, and for hundreds of years.

The proposed study will provide valuable insight about the inequities experienced by Black children and caregivers and will lead to improved methods for addressing health disparities. This work will support the efforts of the MedStar Health Research Institute’s Health Equity Plan to promote justice for marginalized communities and to dismantle structural racism across the spectrum of bias and discrimination

Investigator: Charlotte Gamble, MD, MPH

Research Project: Racial Inequity in Endometrial Cancer Diagnosis, Treatment, and Outcomes in Washington, D.C.- A Mixed Methods Study

Endometrial cancer has the second widest Black/White racial disparity in 5 year mortality of all cancers affecting people in the United States at 20% -- second only to Melanoma at 26%. Rates of endometrial cancers are increasing, yet the mortality gap remains unchanged. In order to design successful multi-level interventions that eliminate the systematic inequity that culminates in this massive survival gap, it is essential that both the patient experience as well as community and local health system resources are leveraged appropriately.

The aims of this study are to: 1) determine experience of black patients during diagnosis and treatment, using semi-structured interviews; 2) quantify disparity in receipt of surgery, chemotherapy, or radiation therapy within a single healthcare system; and 3) map regional (DC area) disparity in diagnosis and treatment by patient neighborhood to assess role of racial segregation in determining referral patterns and access to cancer care.

This study will lay the necessary groundwork for designing tailored interventions that address inequity in diagnosis and treatment of Black women with endometrial cancer. It will also leverage the patient experience to prioritize identified gaps in provision of care that should be targeted.

Investigator: Joshua Reuss, MD

Research Project: Comprehensive Assessment of the Immunobiology of Immunotherapy-Refractory NSCLC Patients Treated on a Phase II Trial of Anti-PD-L1 Plus Anti-TIGIT Immunotherapy with VEGF Inhibition

Anti-PD(L)1 immune checkpoint blockade (ICB) has revolutionized the frontline management of patients with advanced non-small cell lung cancer (NSCLC) who lack actionable driver mutations. Despite this, the majority of patients develop resistance, at which point effective treatments are limited. The aims of this proposal are to analyze tumor and blood specimens collected from patients prior to and during study treatment in order to illuminate: (1) what factors in the pre-treatment tumor microenvironment (TME) and periphery promote immune checkpoint blockade resistance, and (2) how tiragolumab plus atezolizumab and bevacizumab (TAB) therapy acts on the TME and peripheral immune repertoire to enhance an effective antitumor immune response.

Not only would these analyses illuminate the underlying mechanisms of ICB resistance in advanced NSCLC, but they would also provide supporting data to evaluate potential biomarkers of response, as well as additional candidate treatment targets that further invigorate an effective anti-tumor immune response. Critically, pilot data generated from this proposal will serve as the backbone for career development proposals that incorporate additional innovative analyses which seek to explore the functional evolution of the anti-tumor immune response including: T-cell receptor sequencing, neoantigen prediction, and single-cell RNA sequencing.