Inspired - Summer 2015 - University of Chicago Medicine

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Inspired SUMMER 2015

A PHYSICIAN PUBLICATION

ALSO IN THIS ISSUE PAGE 1

ESD: Alternative to surgery for en bloc removal of GI tumors PAGE 7

Bronchial thermoplasty for refractory asthma in adults PAGE 8

INNOVATIONS IN

ENDOSCOPY COVER STORY: PAGE 4 Diagnosis and treatment of complex GI disorders at the Center for Endoscopic Research and Therapeutics (CERT)

New technology in pediatric cardiac cath lab reduces radiation exposure


The University of Chicago Medicine & Biological Sciences has been at the forefront of medical care, research and teaching for more than 90 years. Located in historic Hyde Park on the South Side of Chicago, the University of Chicago

®

AT T H E F O R E F R O N T O F M E D I C I N E

Medicine & Biological Sciences includes: Patient Care » Center for Care and Discovery » Comer Children’s Hospital » Bernard A. Mitchell Hospital » Duchossois Center for Advanced Medicine » Numerous outpatient locations throughout the Chicago area Teaching Programs » Pritzker School of Medicine » Master’s and doctoral degree programs » Postdoctoral programs Research » Medical and basic science units Among our many honors and acknowledgments: 12 Nobel laureates; ranked 10th of all U.S. medical schools; one of only 41 National Cancer

We look forward to partnering with you to improve the health of your patients.

Institute–designated comprehensive cancer centers; ranked third in nation for National Institutes of Health grant support per researcher. University of Chicago Medicine & Biological

DEAR COLLEAGUES,

Sciences Executive Leadership Kenneth S. Polonsky, MD, Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine, and executive vice president for Medical Affairs for the University of Chicago Sharon O’Keefe, president of the University of Chicago Medical Center Jeffrey Glassroth, MD, dean for clinical affairs, University of Chicago Medicine

Patients with

CERT team looks forward to partnering

challenging gastro-

with you to improve the health of your

intestinal conditions

patients. You can read more about the

often need care

team and the program on page 4.

beyond standard endoscopy. The

Some of the diagnostic and interventional

physicians in the Center for Endoscopic

endoscopic procedures we offer were

Research and Therapeutics (CERT) at the

developed and perfected as a result of

education, Pritzker School of Medicine

University of Chicago Medicine specialize

clinical trials. At UChicago Medicine,

INSPIRED IS PUBLISHED THREE TIMES

in advanced diagnostic and interventional

we offer a wide range of clinical trials

procedures, including several offered at

for your patients. In cancer alone, we are

only a few centers in the U.S.

participating in more than 350 clinical

T. Conrad Gilliam, PhD, dean for basic science, Biological Sciences Division Holly J. Humphrey, MD, dean for medical

A YEAR BY THE UNIVERSITY OF CHICAGO MEDICINE & BIOLOGICAL SCIENCES. Editor: Anna Madrzyk Assistant Editor: Gretchen Rubin Email us at: inspirededitor@uchospitals.edu Design: TOKY Branding + Design Contributing writers Thea Grendahl Christou, Tanya Cochran, John Easton, Sarah Fell, Kathleen Goss, PhD, Kevin Jiang, Patricia Nedeau, Lisa Spengler,

trials. Two studies that offer great promise In many cases, endoscopic techniques can

for cancer patients are featured on page 3.

spare patients the risks associated with surgery. And the list of clinical applications

As always, thank you for your interest

for advanced interventional endoscopy

in the University of Chicago Medicine.

expands each year. The multidisciplinary

Anne Stein, Tiffani Washington and Matt Wood Contributing photographers David Christopher, Bob Coscarelli, Robert Kozloff, Jean Lachat, Victor Powell and Nancy Wong ADDRESS The University of Chicago Medicine 5841 S. Maryland Ave., Chicago, IL 60637 The University of Chicago Medicine Comer Children’s Hospital 5721 S. Maryland Ave., Chicago, IL 60637 Telephone 1-773-702-1000 Appointments 1-888-824-0200 Follow the University of Chicago Medicine on Twitter at twitter.com/UChicagoMed or visit our Facebook page at facebook.com/ UChicagoMed. You can read more about our news and research at uchospitals.edu/news and at sciencelife.uchospitals.edu. This publication does not provide medical advice or treatment suggestions. If you have medical problems or concerns, contact a physician, who will determine your treatment. Do not delay seeking medical advice because of something you read here. For urgent needs, call 911 right away. Read Inspired online at uchospitals.edu/inspired.

KENNETH S. POLONSKY, MD Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine, and executive vice president for Medical Affairs for the University of Chicago


AT THE FOREFRONT OF GI ENDOSCOPY ENDOSCOPIC SUBMUCOSAL DISSECTION

A step closer to natural orifice endoscopic surgery Endoscopic submucosal dissection (ESD) is an alternative to surgical resection for en bloc removal of gastrointestinal tumors. The University of Chicago Medicine Center for Endoscopic Research and Therapeutics (CERT) is one of only a few selected quaternary care centers in the U.S. to offer the procedure, which can be considered minimally invasive intraluminal endoscopic surgery. En bloc resection is vital because it allows detailed histopathological evaluation of the entire resected neoplasm and is associated with lower recurrence rates when compared to the loop-snare piecemeal technique, including traditional endoscopic mucosal resection. The ESD technique utilizes an electrosurgical knife to mark the margins of the lesion, mucosally incise around it and cut through the submucosal layer underneath the lesion.

Endoluminal resection is a major research focus at CERT.

Current indications for ESD include: » Superficial esophageal cancer (both squamous or adenocarcinoma in Barrett’s)

» Early gastric cancer » Early colorectal cancer (limited to the superficial submucosa)

» Non-lifting colorectal lesions

Our team was one of the first groups in the U.S. to perform endoscopic mucosal resection (EMR), and our experience spans 15 years and thousands of cases.

PHOTODYNAMIC THERAPY

Innovative treatment for unresectable cholangiocarcinoma Cholangiocarcinoma is a relatively rare cancer of the bile ducts with approximately 5,000 cases annually in the U.S. Five-year survival rates average 5 to 10 percent. For more than 80 percent of patients, the disease is unresectable. Therapy options traditionally have been limited to chemotherapy and palliative bile duct stenting to relieve jaundice. In photodynamic therapy (PDT), the patient receives an IV porphyrin sensitizer 48 hours prior to endoscopic application of light to the tumor with the purpose of causing cell death. The light is delivered via a flexible fiber during endoscopic retrograde cholangiopancreatography (ERCP) at the time of biliary stent placement or exchange. Although data on the use of PDT in cholangiocarcinoma is limited, initial studies in

patients with unresectable disease have suggested the treatment not only aids biliary decompression, but also improves survival through actual tumor destruction. The main side effect of this therapy is severe photosensitivity for 30 days, for which the patient must be counseled.

Studies suggest that treatment not only aids biliary decompression, but also improves survival. The University of Chicago Medicine Center for Endoscopic Research and Therapeutics (CERT) started a program in 2014 for the endoscopic palliation of cholangiocarcinoma including PDT and radiofrequency ablation. CERT is one of only a few centers nationwide invited to participate in an international, FDA-approved PDT study.

To request a consultation or make a referral, call the Center for Endoscopic Research and Therapeutics directly at 773-702-1459.

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Research News UNEXPECTED CONSEQUENCE

TALLYING LETHAL MUTATIONS

Humans carry, on average, one to two genetic mutations that, if inherited from both parents, can cause severe disorders or death before reaching reproductive age, according to a University of Chicago and Columbia University study. For two decades, Carole Ober, PhD, chair of the University of Chicago’s Department of Human Genetics, has worked closely with the Hutterite community, an isolated founder population with more than 1,500 living descendants. An analysis of data, including a 13-generation family tree and comprehensive disease information, concluded that each Hutterite founder carried approximately one to two recessive mutations that cause sterility or death before adolescence. “The records offered a fantastic opportunity to estimate mutations while disentangling genetic and socioeconomic factors,” said Ziyue Gao, University of Chicago graduate student and lead author of the study reported in Genetics.

Patients are almost seven times more likely to suffer a scratched cornea when undergoing a robotic hysterectomy than an open hysterectomy, according to a two-year analysis of nearly 1 million cases. The steep, headdown positioning of patients during surgery contributes to eye swelling, which could alter tear duct flow and lead to dryness, causing corneal abrasion, said senior author Steven

READ MORE AT

ScienceLife.uchospitals.edu ASPIRIN EN ROUTE

Nearly half of all heart attack patients in the United States may not be receiving a recommended, potentially life-saving dose of aspirin on their way to the hospital. University of Chicago Medicine researchers examined more than 14 million incidents in a national emergency medical services (EMS) database. They focused on 198,231 ambulance runs involving people age 40 or older who reported chest pain unrelated to injury and who had an electronic cardiogram or heart rate monitoring in the ambulance. Paramedics recorded giving aspirin to 45.4 percent of these patients. Early use of aspirin reduces deaths from acute coronary syndrome by 23 percent. Katie Tataris, MD, emergency medicine physician and University of Chicago Medicine EMS medical director, is lead author of the study published in Emergency Medicine Journal.

Roth, MD, director of neuroanesthesia at the University of Chicago Medicine. Roth and his fellow researchers from the University of Chicago Institute for Translational Medicine next want to analyze tear flow and tear film barriers of patients while they are under anesthesia to pinpoint the cause of this unexpected consequence. The study was published in the journal Anesthesiology.

PROMISING DRUG FOR MS

An FDA-approved drug for hypertension prevents myelin loss and alleviates clinical symptoms of multiple sclerosis in animal models, according to a new study by University of Chicago Medicine researchers. “Guanabenz appears to enhance the cell’s own protective machinery to diminish the loss of myelin,” said neurobiologist Brian Popko, PhD, senior author of the study published in Nature Communications. Current treatments reduce the immune response that causes myelin damage, but none protect or repair myelin. Researchers treated mice to induce an immune response against myelin similar to MS in humans. Clinical symptoms developed, but guanabenz significantly delayed their onset and reduced peak severity. Treatment also prevented around 20 percent of mice from developing symptoms. MS patients are now being enrolled in a guanabenz clinical trial, a collaboration between the Myelin Repair Foundation and the National Institute of Neurological Disorders and Stroke at the National Institutes of Health.

FOLLOW US ON TWITTER @ScienceLife

2 » THE UNIVERSITY OF CHICAGO MEDICINE INSPIRED MAGAZINE | SUMMER 2015


Study adds diabetes drug to ovarian cancer treatment

CANCER CLINICAL TRIALS

The University of Chicago Medicine is leading a three-center clinical trial that will compare the most effective current therapy for patients with stage 3 or stage 4 ovarian cancer against that same therapy plus metformin.

Pembrolizumab shows promise against head and neck cancer Immunotherapy with the anti-PD-1 antibody pembrolizumab (Keytruda®) was effective in one out of four patients with recurrent or metastatic head and neck cancer, according to results presented at the 2015 meeting of the American Society of Clinical Oncology (ASCO) by University of Chicago Medicine researcher Tanguy Seiwert, MD, and colleagues. READ MORE about the 2015 ASCO meeting in Conference Digest on page 9.

Pembrolizumab decreased the size of tumors by 30 percent or more in 24.8 percent of 132 patients, making it nearly twice as effective as the current preferred treatment using platinumbased chemotherapy plus cetuximab, an epidermal growth factor inhibitor. The results suggest that pembrolizumab, a checkpoint blocker, may soon begin to fill a large, unmet need for better treatments of this common form of cancer. “The efficacy was remarkable,” said Seiwert, associate program leader for head and neck cancer at UChicago Medicine, “roughly twice as good as any drug combination in our arsenal.” In this study, he added, pembrolizumab was active across a wide range of patient

| A B O V E | Head and neck cancer under

the microscope: The cancer (red and blue) is infiltrated with immune cells (green), which can attack and kill cancer. Pembrolizumab makes the cancer cells visible to the immune system. This can lead to lasting control of the cancer with few side effects.

subgroups, including HPV-associated and HPV-negative tumors. Overall, 56 percent of patients experienced a measurable decrease in the size of their tumors. “This may have the potential to prolong survival for a large proportion of our patients,” Seiwert said. “Immunotherapy has been very well tolerated by our patients, and serious side effects have been quite uncommon. We hope this approach will change the way we treat head and neck cancer.” Two ongoing phase 3 studies are evaluating pembrolizumab vs. standard treatment in patients with recurrent or metastatic head and neck cancer.

MORE THAN 350 CANCER CLINICAL TRIALS

Several recent studies have suggested that metformin, an established drug developed to treat type 2 diabetes, may provide significant benefits — including increased survival — to patients being treated for advanced cancers. An analysis of combined results from these earlier studies associated metformin use with a considerable decrease in cancer risk, tumor burden and cancer mortality. “This is the first study of its kind in ovarian cancer,” said trial director S. Diane Yamada, MD, a gynecologic oncologist at UChicago Medicine. “We think this is an exciting opportunity to find out if a safe, well-tested and inexpensive drug can significantly improve on our best current therapy. There is a strong biological rationale, a series of consistently encouraging results from observational studies and a real need for better, cost-effective therapies for this type of cancer.” To enroll in the trial, volunteers must have a diagnosis of ovarian, fallopian tube or primary peritoneal carcinoma, but not diabetes.

For more information or to enroll a patient in this study, email the care team at OvCaClinicalTrial @bsd.uchicago.edu.

AT THE UNIVERSITY OF CHICAGO MEDICINE COMPREHENSIVE CANCER CENTER Visit cancer.uchicago.edu/trials.

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ADVANCING PATIENT CARE THROUGH

ENDOSCOPIC DISCOVERY AND INNOVATION

Uzma D. Siddiqui, MD, is an authority on endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). She teaches advanced endoscopic techniques at the University of Chicago Medicine and throughout the U.S.


The Center for Endoscopic Research and Therapeutics (CERT) at the University of Chicago Medicine uses innovative endoscopic techniques to provide minimally invasive solutions to a range of gastrointestinal problems.

Endoscopic techniques and technology are constantly advancing, and we treat more complex cases here than anywhere in the region.

Our team diagnoses and treats a wide variety of complex gastrointestinal disorders, including esophageal and pancreatic cancer, large colon polyps, pancreatic and bile duct stones, pancreatitis and Barrett’s esophagus.

IRVING WAXMAN, MD

Director, Center for Endoscopic Research and Therapeutics

OUR DEDICATED, MULTIDISCIPLINARY TEAM PERFORMS:

» Advanced imaging techniques to identify precancerous conditions, sometimes even before they can be found with standard endoscopy. » Endoscopic treatment of malignancies and obstruction of the GI tract and other complicated conditions, sparing patients the risks of surgery. » Precise endoscopic diagnosis and staging of cancer, enabling referring physicians to plan the most appropriate and effective surgical and oncological care.

PANCREATIC DISEASE CENTER

AT THE FOREFRONT

2,500 Advanced endoscopic procedures performed each year

IRVING WAXMAN, MD

Director, Center for Endoscopic Research and Therapeutics (CERT) UZMA D. SIDDIQUI, MD

20 ACTIVE CLINICAL TRIALS

We are one of the only hospitals in the country to provide a comprehensive approach to treating benign pancreatic disease, including total pancreatectomy with autologous islet cell transplantation.

Center for Endoscopic Research and Therapeutics

Studies range from pilot and feasibility studies on novel technologies to randomized, multicenter clinical trials.

Associate Director, Center for Endoscopic Research and Therapeutics (CERT) ANDRES GELRUD, MD, MMSc

Director, Pancreatic Disease Center and Advanced Endoscopy VANI J. KONDA, MD

Director, Endoscopic Research and Education Programs

Probe-based confocal laser endomicroscopy (pCLE)

Clinical and interventional pancreatologist Andres Gelrud, MD, MMSc, directs the Pancreatic Disease Center.

Using a tiny, laser-scanning microscope, our physicians can visualize cellular detail with a resolution down to 1 micron. We can use this real-time microscopy to show cellular detail throughout the entire GI tract and even in less accessible organs, including the bile ducts and pancreas.

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Advanced interventional endoscopy procedures » Endoscopic ultrasound (EUS) with fine needle aspiration (FNA) » Celiac plexus nerve block » Endoscopic retrograde cholangiopancreatography (ERCP) » Cholangioscopy » Ablation of cholangiocarcinoma » Extracoporeal shock wave lithotripsy (ESWL) of large biliary and pancreatic duct stones » Ampullectomy

ADVANCED IMAGING Our center has the most advanced options for recognizing subtle or occult precancerous changes in patients with diseases such as Barrett’s esophagus and high-grade dysplasia. We often use two or three imaging modalities to examine the lining of the esophagus, beginning with a high-definition endoscope that produces images with a resolution in the range of a million pixels. We also regularly

use narrow-band imaging, which uses filtered blue light that enables us to see and interpret mucosal pit patterns and vascular patterns. Optical coherence-based technology allows us to see the superficial layers of the esophagus down to 3 mm deep with a resolution of 7 microns. | A B O V E | Vani J. Konda, MD, uses

advanced imaging techniques to diagnose and treat Barrett’s esophagus, gastroesophageal reflux disorders and other esophageal conditions.

WE KNOW HOW HARD IT IS FOR PATIENTS — AND DOCTORS — TO WAIT.

Our consultation or procedure turn-around time is typically fast — 24 to 36 hours. Call us directly at 773-702-1459.

» Endoscopic mucosal resection (EMR) » Endoscopic submucosal dissection (ESD) » Complex polypectomy » Radiofrequency ablation (RFA) of Barrett’s esophagus, radiation proctitis and gastric antral vascular ectasia (GAVE) » Confocal laser endomicroscopy (CLE) » Pancreatic pseudocyst drainage and necrosectomy » Photodynamic therapy (PDT) » Endoscopic suturing » Palliative stenting of GI tract and pancreaticobiliary malignancies AT THE FOREFRONT

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20th Annual Endoscopic Ultrasonography Live 2015 Center for Endoscopic Research and Therapeutics (CERT)

» A collaboration between the University of Chicago Medicine and Massachusetts General Hospital

» Two full days of live EUS procedures

State-of-the-art endoscopy suite On-site pathology and cytopathology allow results to be shared immediately with referring physicians — in most cases, we can develop a plan of care before your patient leaves the endoscopy suite. Procedures are performed under monitored anesthesia care by a member of CERT’s core anesthesiology group.

and an optional half-day hands-on lab

Join us at the University of Chicago Medicine Center for Care and Discovery

» International faculty For more information, visit cme.uchicago.edu.

6 » THE UNIVERSITY OF CHICAGO MEDICINE INSPIRED MAGAZINE | SUMMER 2015

To learn more about the Center for Endoscopic Research and Therapeutics, visit uchospitals.edu/cert.


Seventh straight “A” for hospital safety The University of Chicago Medicine was named one of the safest hospitals in the country for the seventh consecutive time by the prestigious and independent Leapfrog Group. In Leapfrog’s semi-annual Hospital Safety Score, UChicago Medicine garnered a “Straight As” designation from the nonprofit organization dedicated to measuring and driving improvements in hospital safety. UChicago Medicine is one of only 182 U.S. hospitals, out of about 5,000, to receive an A in all seven survey periods.

“We’re pleased to join the very small number of hospitals that have demonstrated consistent excellence in this nationally important measure of patient safety,” said Michael Howell, MD, MPH, associate chief medical officer for clinical quality. Leapfrog combined 28 publicly reported metrics to compile its spring 2015 Hospital Safety Score.

Bronchial thermoplasty for refractory asthma The largest insurance provider in Illinois is now covering bronchial thermoplasty (BT), an outpatient therapy for severe asthma refractory to maximal use of inhaled corticosteroids and long-acting beta-agonists. The minimally invasive bronchoscopic procedure reduces the excess smooth muscle in the airways of patients with persistent asthma. Anatomical manipulation of bronchial smooth muscle attenuates airway hyperresponsiveness. The most common treatment side effect — temporary worsening of respiratory-related symptoms, typically within a day of the procedure — usually resolves within a week. No longterm or new symptoms as a result of BT have been reported. The FDA approved the controlled radiofrequency energy therapy in 2010, following positive results from a clinical trial of 297 patients. In the nationwide placebocontrolled study, BT patients experienced 32 percent fewer severe asthma attacks, 84 percent fewer asthma-related emergency room visits and 66 percent fewer days away from work, school and daily activities than untreated patients. The University of Chicago Medicine was the only center in

| A B O V E | During bronchial thermoplasty (BT), pulmonologists insert a bronchoscope into the major airways of the lungs. The BT catheter delivers targeted heat (150 degrees F) to reduce excess airway smooth muscle tissue. Treatment involves three separate procedures, which target different lobes of the lung, spaced at least three weeks apart. Image courtesy of Boston Scientific Corporation.

Illinois that participated in the worldwide Asthma Interventional Research 2 (AIR2) trial. A five-year post-approval study reported that benefits of BT continue for at least five years after treatment. Patients who undergo BT continue to take prescribed asthma medications. “Bronchial thermoplasty is not a cure for asthma; it is a therapy added to the usual regimen of inhalers,” pulmonologist Kyle Hogarth, MD, said. “It helps bring the asthma under better control when medical management has failed.” Candidates for BT must be 18 or older and be nonsmokers.

The University of Chicago Medicine Comer Children’s Hospital is nationally ranked in three pediatric specialties — cancer (#34), diabetes and endocrinology (#47) and neurology and neurosurgery (#47). Only 83 of the nation’s children’s hospitals rank nationally in at least one pediatric specialty.

UChicago Medicine to lead prematurity research initiative The University of Chicago Medicine has joined forces with Northwestern University Feinberg School of Medicine, Duke University School of Medicine and the March of Dimes Foundation to establish a collaborative aimed at understanding the underlying causes of preterm birth. The new March of Dimes Prematurity Research Center will focus on identifying the regulatory genes responsible for ensuring a pregnancy continues to full term and how stress can influence those genes. The principal investigator is Carole Ober, PhD,

chair of the Department of Human Genetics at the University of Chicago. The March of Dimes will commit $10 million over the next five years toward the effort. The center is the fifth nationwide devoted to prematurity research. The Chicago collaborative will engage investigators from various disciplines, including genetics, bioinformatics, stem cell biology, obstetrics and gynecology, pediatrics, statistics, computer science and epidemiology, from across the three academic medical centers.

Ober anticipates that fresh insights from this multidisciplinary team of world-renowned experts could reveal new gene expression pathways and novel therapeutic strategies for altering the expression of relevant genes, resulting in lower preterm birth rates.

To learn more about the new March of Dimes Prematurity Research Center, visit prematurityresearch.org/uchicagonorthwestern-duke.

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UChicago Medicine first in U.S. to implant smallest LVAD Physicians at the University of Chicago Medicine recently implanted a left ventricular assist device (LVAD) measuring 2.7 inches long and 1.2 inches wide and weighing 3.2 ounces into a 66-year-old Gary, Ind., woman with advanced heart failure. She was the first person in the country to receive the HeartAssist5®, an innovative mechanical heart device that is the smallest and lightest of its kind. The woman was the initial participant in a national clinical trial. Houston-based ReliantHeart, maker of the HeartAssist5, is conducting the study, expected to run through 2016. The device was approved in 2012 in Europe for patients awaiting a heart transplant or as a destination therapy.

New cardiology chief, cath lab at Comer Children’s

HEARTASSIST5

2.7 3.2 INCHES

OUNCES ® | A B O V E | HeartAssist5 , shown actual size, 71mm x 30mm, 92 grams

| L E F T | 1. Pre-sealed outflow cannula 2. Exclusive flow probe 3. Near silent pump 4. Rigid titanium inflow cannula

Images courtesy of ReliantHeart.com

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“Some novel features in this device have the potential to improve patient outcomes,” said Valluvan Jeevanandam, MD, chief of cardiac surgery at the University of Chicago Medicine. “The pump is designed to reduce the risk of blood clots, and the continuous built-in wireless monitor can promptly alert the team to address issues before they become complications.”

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4 3

Daniel H. Gruenstein, MD, chief of pediatric cardiology.

A $3.3 million pediatric hybrid catheterization lab with state-of-the-art capabilities and safety features is opening this summer at the University of Chicago Medicine Comer Children’s Hospital.

Exposure to multiple X-rays, CT scans and heart catheterizations puts a pediatric patient at risk not only for radiation burns, but also for long-term radiation-exposure cancers. The Society for Cardiovascular Angiography and Interventions has identified radiation reduction, particularly in the pediatric population, as a top priority.

The hybrid catheterization lab features the Toshiba Infinix™ Elite Bi-plane cardiovascular X-ray system, which allows real-time feedback on radiation dosage. Spot Fluoroscopy, a dose-reduction technology that makes it possible to zoom in on a small region, reduces the area of a child’s body exposed to radiation. Comer Children’s is the first hospital in Chicago to offer this advanced dose management and tracking system for cardiac catheterization.

Before joining Comer Children’s this year, Gruenstein was director of pediatric interventional cardiology at the University of Minnesota Masonic Children’s Hospital, where he performed the first hybrid procedure for HLHS in the upper Midwest. He has been involved in the preclinical and clinical trials of multiple minimally invasive cardiac devices and has trained several hundred physicians in the closing of ASDs, stenting techniques and device retrieval.

“We will be able to see how much radiation we’re giving as we’re giving it, and we can make adjustments in how we’re doing the case to reduce the risk to children,” said

Gruenstein stresses the importance of communication with families, primary care physicians and referring cardiologists.

8 » THE UNIVERSITY OF CHICAGO MEDICINE INSPIRED MAGAZINE | SUMMER 2015

The American Heart Association and American Stroke Association recognize the University of Chicago Medicine for achieving

85% or higher compliance with all Get With The Guidelines®-Stroke Achievement Measures for

12 consecutive months to improve quality of patient care and outcomes.


CONFERENCE DIGEST American Association for Cancer Research More than 45 researchers from the University of Chicago Medicine Comprehensive Cancer Center (UCCCC) presented oral or poster presentations at the 2015 annual meeting of the American Association for Cancer Research (AACR) in Philadelphia in April. They joined nearly 20,000 basic, translational, clinical and population-based cancer investigators from across the globe to share the latest advances aimed at understanding and ultimately conquering cancer. Thomas Gajewski, MD, PhD, chaired the session “Biomarkers for Immunotherapy Response” and presented findings from his laboratory aimed at understanding why some patients respond to immunotherapies and others do not. Yang-Xin Fu, MD, PhD, presented work on identifying mechanisms that contribute to the enhanced therapeutic benefit of combining immunotherapy with radiation therapy and the mechanisms underlying radiation resistance. In addition, several UCCCC scientists took center stage to present their latest findings on breast cancer, metastasis and clinical trials.

Dozens of University of Chicago Medicine Comprehensive Cancer Center (UCCCC) faculty presented work at the meeting, with many of our physicians and scientists leading scientific sessions, offering perspective on their colleagues’ research and providing state-of-the-field overviews. A study by Tanguy Seiwert, MD, and colleagues, which described early antitumor and safety data of pembrolizumab for advanced squamous cell carcinoma of the head and neck, garnered considerable media attention (read more about the study on page 3). Rena Conti, PhD, and Blase Polite, MD, both thought leaders in cancer economics and policy, participated in one of several sessions on payment reform in oncology care. Oral presentations were also given by the following UCCCC faculty: Thomas Gajewski, MD, PhD; Todd Zimmerman, MD; Wendy Stock, MD; Michael Bishop, MD; Peter O’Donnell, MD; Mark Ratain, MD; Walter Stadler, MD; Habibul Ahsan, MD; William Dale, MD, PhD; Olatoyosi Odenike, MD; Richard Larson, MD; John Renz, MD, PhD; and Gini Fleming, MD.

Prevent Chronic Rejection?” (Marco Patti, MD); “Dietary Fat, the Gut Microbiome and Metabolic Risk” (Eugene Chang, MD); and “Influences of Nutrition and the Microbiome on GI Cancers: Western Diet and EGFR Signaling” (Marc Bissonnette, MD).

Society of General Internal Medicine University of Chicago Medicine physicians and trainees led workshops, gave oral presentations and presented posters at the Society of General Internal Medicine (SGIM) 2015 Annual Meeting in Toronto in April. Topics at the international conference included health disparities research, diabetes care and outcomes, and innovations in clinical care and medical education. In one of the plenary sessions, Elizabeth Tung, MD; Monica Peek, MD, MPH; Jennifer Makelarski, PhD, MPH; and Stacy Tessler Lindau, MD, MA, presented a scientific abstract titled “The Built and Social Environment: Neighborhood Obesity in Vulnerable Populations.”

Digestive Disease Week

American Society of Clinical Oncology The theme of the 2015 American Society of Clinical Oncology (ASCO) Annual Meeting held in Chicago May 29–June 2 was “Illumination and Innovation: Transforming Data into Information.” One of the largest scientific conferences focused on oncology, with a reported 37,000 cancer experts in attendance, the meeting showcased the field’s latest discoveries and efforts to revolutionize cancer clinical care through the implementation of new information. Tumor immunotherapy and the value and economics of cancer care were emerging areas of focus that received considerable attention from the oncology community.

University of Chicago Medicine faculty led courses and presented their research and clinical updates during Digestive Disease Week (DDW) in Washington, DC, in May. DDW is the world’s largest gathering of physicians and researchers in gastroenterology, hepatology, endoscopy and gastrointestinal surgery. The more than two dozen presentations from UChicago Medicine included: “Histological Normalization Is Associated with Superior Relapse Free Survival Compared to Histological Activity and Histological Quiescence in Ulcerative Colitis” (Britt Christensen, MD, and David Rubin, MD); “Can Fundoplication Before or After Lung Transplantation

| A B O V E | University of Chicago Medicine oncologist Blase Polite, MD, presents at the 2015 American Society of Clinical Oncology (ASCO) Annual Meeting. Polite participated in a session on payment reform in oncology care.

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His gift for ingenuity gave her the gift of health. When Andrea Rosengarden’s multiple myeloma, a blood cancer, returned with a vengeance, she turned to Andrzej Jakubowiak, MD, PhD. With Andrea’s kidneys failing and all treatment options exhausted, Jakubowiak proposed a treatment not yet tried in the U.S. combined with new drug therapy for her underlying cancer. Now long in remission with fully functioning kidneys, Andrea, with her husband Michael, has made a generous donation to advance Jakubowiak’s research into promising new treatments for multiple myeloma. This is the kind of discovery that led to an Accelerator Award from the Multiple Myeloma Research Foundation for the University of Chicago Medicine. When you make a gift to the University of Chicago Campaign: Inquiry and Impact, you support groundbreaking research and patient care that leads to innovative treatments and improved results for patients.

Everybody has a gift. Imagine the impact yours could make. 10 » THE UNIVERSITY OF CHICAGO MEDICINE INSPIRED MAGAZINE | SUMMER 2015 Learn more at givetomedicine.uchicago.edu or call (773) 702-6565.


DANIEL H. GRUENSTEIN, MD , associate professor of pediatrics, is the new chief of pediatric cardiology. Gruenstein previously was director of pediatric interventional cardiology at the University of Minnesota Masonic Children’s Hospital. He has been involved in the preclinical and clinical trials of multiple minimally invasive cardiac devices. His numerous national honors include the Patients’ Choice Award and Compassionate Doctor Award. ARLENE CHAPMAN, MD , professor of

medicine, is the new chief of nephrology and director of the Clinical Resources Cluster of the Institute for Translational Medicine (ITM). She previously was a professor of medicine at Emory University and program director for the Clinical Research Network of the Atlanta Clinical and Translational Science Institute. THOMAS K. LEE, MD , joined the faculty as

a professor of surgery. An experienced pediatric general surgeon, he previously was a professor of surgery at Stony Brook Medicine in New York. He has received several teaching awards for surgical education and published more than 50 peer-reviewed articles, abstracts and book chapters on a range of topics, including small bowel transplantation and pediatric trauma care. CHRISTINA E. CIACCIO, MD, MSc , has been named an assistant professor of pediatrics. She joined the faculty from Children’s Mercy Hospital in Kansas City, Missouri. She was a 2011 recipient of the Young Faculty Award from the American College of Allergy, Asthma and Immunology and the 2013 recipient of the Paul Henson Clinical Scholar Award for research in immunology and inflammation.

New physicians have joined the University of Chicago Medicine Heart and Vascular Center. CEVHER OZCAN, MD, assistant professor of medicine, is an academic cardiac electrophysiologist. She previously was an assistant professor of medicine at the State University of New York and completed fellowships at Massachusetts General Hospital/Harvard Medical School and Yale University. SIRTAZ ADATYA, MD, assistant professor of medicine, formerly was an assistant professor in the advanced heart failure and transplant program and medical director of the heart failure clinic at the University of Minnesota. TRISSA A. BABROWSKI, MD, assistant professor of surgery, completed her vascular surgery fellowship at the University of Chicago Medicine.

INSPIRED TO DISCOVER, TEACH & GIVE BACK REMZI BAG, MD , associate professor of

medicine, joined the University of Chicago Medicine as medical director of the lung transplant program. Having directed Emory University and Baylor College of Medicine affiliated programs, Bag brings experience in lung transplantation, pulmonary hypertension and other advanced lung diseases. MITCHELL C. POSNER, MD , the Thomas D. Jones Professor of Surgery, has been appointed physician-in-chief of the University of Chicago Medicine Comprehensive Cancer Center. In this newly created position, Posner will work with leadership and faculty to implement strategies designed to further enhance clinical programs and research efforts. He continues to serve as chief of general surgery and surgical oncology. SUSAN L. COHN, MD , professor of pediatrics and dean for clinical research, is the new co-director of the University of Chicago Institute for Translational Medicine (ITM). Cohn also serves as a co-leader of the ITM’s Clinical Trials Cluster. A nationally recognized expert on neuroblastoma, she also is director of clinical sciences in the section of pediatric hematology/ oncology and acting section chief. SCOTT EGGENER, MD , associate professor of surgery, received the Society of Urologic Oncology’s 2015 Young Investigator Award for his past and anticipated future contributions to the field. He is co-director of the prostate cancer program at the University of Chicago Medicine and director of translational and outcomes research in the Section of Urology. NEIL H. HYMAN, MD , professor of surgery, has been appointed co-director of the University

LEARNING @ THE FOREFRONT

Learning @ the Forefront is our online education channel for medical professionals. Listen to University of Chicago Medicine specialists discuss the latest treatments, procedures and research findings at learning. uchospitals.edu.

of Chicago Medicine Digestive Diseases Center. Hyman, chief of colon and rectal surgery, is a recognized leader in the treatment of colon and rectal cancers, inflammatory bowel disease and complex colorectal problems. MARSHALL CHIN, MD, MPH , the Richard Parillo Family Professor in Healthcare Ethics, recently was installed as president of the Society of General Internal Medicine (SGIM) at the SGIM national meeting in Toronto. As president, Chin will lead the 18-member governing board and support and promote the work of its more than 80 member-driven committees, task forces and interest groups. Also at the meeting, VINEET ARORA, MD, MA , associate professor of medicine and assistant dean for scholarship and discovery at the University of Chicago Pritzker School of Medicine, received the Frederick L. Brancati Mentorship and Leadership Award; VALERIE PRESS, MD, MPH , assistant professor of medicine, was named the 2015 Brancati Leadership Scholar; and MILDA SAUNDERS, MD, MPH , assistant professor of medicine, received the ACLGIM Unified Leadership Training in Diversity Award. JESSICA J. KANDEL, MD , the Mary Campau

Ryerson Professor of Surgery, is a 2015-16 fellow in the Hedwig van Ameringen Executive Leadership in Academic Medicine Program for Women at Drexel University College of Medicine. The program is dedicated to developing the skills needed to lead and manage in today’s complex health care environment, with special attention to the challenges and opportunities affecting women leaders in academic medicine. Kandel is surgeon-in-chief at the University of Chicago Medicine Comer Children’s Hospital and chief of pediatric surgery. MONICA PEEK, MD, MPH , associate professor of medicine, has been named a Greenwall Faculty Scholar for the class of 2018. The Greenwall Foundation’s Faculty Scholars Program in Bioethics is a career development award to enable faculty members to carry out innovative bioethics research to help resolve pressing ethical issues in clinical care, biomedical research and public policy. Peek will further her work on shared decision-making among vulnerable populations. MARYELLEN GIGER, PHD , the A. N. Pritzker

Professor of Radiology, received the American Association of Physicists in Medicine’s William D. Coolidge Award. The Coolidge Award is the AAPM’s highest honor, denoting excellence and distinguished contributions to medical physics.

Continued on page 12

PHYSICIAN REFERRAL LINE 1-800-824-2282 | UCHOSPITALS.EDU | UCHICAGOKIDSHOSPITAL.ORG » 11


Continued from page 11 MARK SIEGLER, MD , the Lindy Bergman Distinguished Service Professor of Medicine and Surgery, was named a Master of the American College of Physicians (ACP). Notably, the ACP is celebrating its centennial, and Siegler joins 10 University of Chicago faculty members who have received this prestigious designation over the past 100 years. He also received the John Conley Foundation Award for Outstanding Contributions to Clinical Ethics and Clinical Ethics Education. He is the founder and director of the University of Chicago’s MacLean Center for Clinical Medical Ethics. DAVID MELTZER, MD, PHD , professor of

medicine and chief of hospital medicine, has been elected to the prestigious Association of American Physicians. This honor recognizes his contributions as a leader in the theoretical foundations of medical cost-effectiveness analysis and the cost and quality of hospital care. HABIBUL AHSAN, MD , Louis Block Professor in the Departments of Public Health Sciences and Medicine, and associate director for population research for the University of Chicago Medicine Comprehensive Cancer Center, has been named to the National Advisory Environmental Health Sciences Council. Ahsan is one of 18 council members who are leaders in the basic sciences, medical sciences, education and public affairs. ROBERTO M. LANG, MD , professor of

medicine and director of the noninvasive cardiac imaging laboratory, received the Meritorious Service Award from the American Society of Echocardiography. MARK J. RATAIN, MD , the Leon O. Jacobson

Professor of Medicine and director of the Center for Personalized Therapeutics, was honored with the 2015 Award of Excellence in Clinical Pharmacology from the Pharmaceutical Research and Manufacturers of America Foundation.

CME & EDUCATIONAL OPPORTUNITIES

6th Annual Pediatric Robotic Urology Update & Live Case Demonstration JULY 24 – 25

University of Chicago Medicine Center for Care and Discovery 5700 S. Maryland Ave., Chicago This educational program is designed to educate and transfer the techniques and technologies of the robotic system to pediatric urology fellows and practicing pediatric urologists for effective and safe use in clinical practice settings.

Chicago Breast & Lymphedema Symposium

Procedures include lymph node transfer and lymphovenous bypass; nipple-sparing mastectomy with direct to implant reconstruction; and bilateral upper gracilis (BUG) flaps for unilateral breast reconstruction. (Registration for the live-surgery event is not included in the symposium registration fee.)

29th Annual Challenges for Clinicians DECEMBER 4 – 7

The Drake Hotel 140 E. Walton Place, Chicago New techniques, drugs and evidence, and quality and safety concerns all play a role in the evolving landscape of perioperative medicine. The target audience includes anesthesiologists, certified registered nurse anesthetists and other health care professionals.

SEPTEMBER 18 – 20

The University of Chicago Biological Sciences Learning Center 924 E. 57th St., Chicago The Chicago Breast and Lymphedema Symposium will identify, discuss and demonstrate complex breast reconstruction and lymphedema therapies within the framework of creating and maintaining multidisciplinary relationships. In addition to the symposium, University of Chicago Medicine surgeons Julie E. Park, MD; Nora Jaskowiak, MD; David W. Chang, MD; and David H. Song, MD, will perform several procedures live on Friday, September 18, that will be streamed for registered guests to view in an auditorium setting and moderated by symposium faculty.

University of Chicago Medicine physicians are available to present in-office CME courses in greater Chicagoland and Northwest Indiana.

For information, please contact Uchenna Hicks, uchenna.hicks@ uchospitals.edu .

Register for CME events at cme.uchicago.edu .

P H YS I C I A N R E L AT I O N S Please contact your dedicated liaison by phone or email with any request. We are here to serve you.

New Pediatric Colorectal Reconstruction Center The Pediatric Colorectal Reconstruction Center at Comer Children’s Hospital offers comprehensive, multidisciplinary care for children who have complex

CAROL MARSHALL

DEMETRIA AVANT

Executive Director Referral Marketing, Customer Insights and Analytics 1-773-702-9205 carol.marshall@ uchospitals.edu

Regional and Western Suburbs 1-773-717-0458 demetria.avant@ uchospitals.edu

colorectal malformations.

MIKE DELAROSA

For more information or to refer a

Assistant Director Northwest Indiana 1-773-230-8496 michael.delarosa@ uchospitals.edu

patient, call UCM Physician Connect at 1-800-824-2282 or email the team at kids.colorectal@uchospitals.edu.

12 » THE UNIVERSITY OF CHICAGO MEDICINE INSPIRED MAGAZINE | SUMMER 2015

DIONNE MEEKINS-MICHAUD North and Northwest Suburbs 1-773-717-0457 dionne.michaud@ uchospitals.edu

BROOKE HERNANDEZ Pediatrics (all regions) 1-773-573-9500 brooke.hernandez@ uchospitals.edu

ANTHONY TURNER South and Southwest Suburbs 1-773-729-0822 anthony.turner@ uchospitals.edu


LEGENDARY CANCER RESEARCHER INSPIRES COUPLE’S GIFT Cynthia Chereskin is no stranger to the ills of cancer. Several years ago, her husband, Benjamin Chereskin, was diagnosed with tongue cancer, and 11 years ago, her father, Glen Johnson, had bladder cancer. Both cases required innovative treatment, which they found at the University of Chicago Medicine Comprehensive Cancer Center. Other hospitals treat oral cancers by removing portions of the tongue and surrounding tissues, but the University of Chicago Medicine’s approach involves a combination of chemotherapy and radiation therapy that is used to shrink the tumor. Fortunately, Benjamin’s cancer responded to therapy, and he did not need surgery.

The Janet D. Rowley Discovery Fund supports the most compelling ideas in cancer research. Cynthia’s father had been told by a physician at another hospital there was nothing their team could do for his bladder cancer. However, he found hope through surgeon Gary D. Steinberg, MD, director of urologic oncology, who removed Glen’s bladder and reconstructed a new one using intestinal tissue. “I feel incredibly lucky to live in Chicago and to have the University of Chicago in our backyard with these amazing doctors who have done so much in the name of research and medical science,” said Cynthia. | L E F T | Cynthia and

Benjamin Chereskin

The late Janet D. Rowley, MD, established that cancer is a genetic disease. Her discoveries opened the door to today’s targeted treatments.

In honor of her father, the Chereskins donated $1 million to the University of Chicago Medicine Comprehensive Cancer Center. Their founding gift established the Janet D. Rowley Discovery Fund, which supports the most compelling ideas in cancer research. “Our work is devoted to finding better ways to prevent, detect and treat cancer,” said Michelle M. Le Beau, PhD, director of the University of Chicago Medicine Comprehensive Cancer Center. “We are so grateful for this generous gift, which will facilitate the translation of new discoveries from the laboratory to the clinic that extend and improve lives affected by cancer.” The fund honors the late Janet D. Rowley, MD, whose pioneering discoveries in cancer genetics at the University of Chicago ushered in the current era of genome-guided research and treatment. It will support research that emulates her own legendary path: novel ideas and collaborative work that can lead to world-changing discoveries. This new fund gives the leadership of the University of Chicago Medicine Comprehensive Cancer Center the flexibility to invest in the most promising research. Cynthia, who serves as president of the University of Chicago Cancer Research Foundation Women’s Board, believes more comprehensive research is needed. “It is our hope that others will join us in supporting the University of Chicago Medicine Comprehensive Cancer Center to accelerate the pace of innovation and discovery in the fight against cancer.”

To make a gift to the Janet D. Rowley Discovery Fund, please visit givetomedicine.uchicago.edu/give.


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Introducing the Heart and Vascular Center The new Heart and Vascular Center at the University of Chicago Medicine integrates specialists in cardiology, cardiac surgery and vascular surgery in one highly coordinated setting.

For admissions, referrals and consultations, call UCM Physician Connect at 1-800-824-2282.

Heart and Vascular Center

Advanced care offered at the Heart and Vascular Center includes: » 3-D cardiovascular imaging » Mechanical circulatory support » Bloodless cardiac surgery » Complex valve replacement and cardiac reconstruction » Heart transplant and multi-organ transplant » Robotic cardiovascular surgery

» Medical and surgical treatment of complex arrhythmias » Endovascular treatment options for complex vascular and aortic conditions » Care for inherited cardiovascular diseases » Access to clinical trials of new therapies and procedures


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