Novel ways to prevent and treat Alzheimer’s disease, deploy immunotherapies to fight cancer, and train pediatricians to teach brain-building skills to new parents were among the topics discussed by experts from the Mount Sinai Health System at the 2019 Aspen Ideas Festival in June. For seven consecutive years, Mount Sinai’s leading doctors have participated in the Festival, which is a unique forum for the exchange of ideas held each summer in Aspen, Colorado.
“The Aspen Ideas Festival is a special place where innovation is showcased,” says Kenneth L. Davis, MD, President and Chief Executive Officer of the Mount Sinai Health System. “Mount Sinai is an academic medical system on the leading edge of discovery. We have a lot to share.” As a panelist and moderator, Dr. Davis participated in discussions on several topics, including ways to stem increasing drug prices that cost Americans an estimated $460 billion a year. “We want to ensure that patent laws favor innovative drugs and not just brand-name drugs with patents that extend their market exclusivity, even when there’s no additional benefit to patients,” Dr. Davis told an audience.
Kenneth L. Davis, MD, second from right, led a roundtable discussion in Aspen about the future of health care.
Dr. Davis also moderated a panel discussion titled “What Will it Take to Prevent Dementia?” which offered attendees a positive glimpse of future developments. The panel of experts said that within the next five years they expect to see new blood tests to predict Alzheimer’s disease and new drugs to slow its development in the brain, which can take 20 to 30 years.
Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and President for Academic Affairs, Mount Sinai Health System, discussed his role in co-inventing a patented method for treating patients with treatment-resistant depression, SPRAVATO™ (esketamine) nasal spray, which was approved by the U.S. Food and Drug Administration in early 2019. SPRAVATO uses the first new mechanism of action in decades to treat major depressive disorder (MDD). It is estimated that approximately one-third of U.S. adults with MDD have treatment-resistant depression. The discovery, Dr. Charney said, came from “a small group of researchers who met every week to share ideas. We also created a collaborative relationship with a pharmaceutical company to bring forth a treatment for a devastating disorder that has a profound impact on people’s lives.”
Three Mount Sinai cancer specialists participated in a panel discussion about the latest methods to harness the immune system to fight cancer: Steven Burakoff, MD, Dean for Cancer Innovation and Chief of Pediatric Oncology; Fred Hirsch, MD, PhD, Executive Director of the Center for Thoracic Oncology in The Tisch Cancer Institute; and Miriam Merad, MD, PhD, Director of the Precision Immunotherapy Institute, and Director of Mount Sinai’s Human Immune Monitoring Center. They said some of these immunotherapies are being used successfully in conjunction with traditional chemotherapy.
Free Skin Cancer Screening in Aspen Leads to Wake-Up Call
Click above to watch Maley Thompson tell her story.
Growing up in Aspen, Colorado, Maley Thompson enjoyed an active lifestyle, spending time outdoors in the summer and skiing in the winter. For years, Ms. Thompson routinely applied sunblock to her fair skin and believed it was providing her with adequate protection from the sun.
But her notion of safety changed abruptly at the 2018 Aspen Ideas Festival, when a complimentary skin cancer screening by doctors from the Mount Sinai Health System identified a small, but oddly shaped mole on Ms. Thompson’s neck. Each year, physicians and nurses from Mount Sinai’s Kimberly and Eric J. Waldman Department of Dermatology and Mount Sinai Heart perform hundreds of free screenings for skin, and blood pressure and cholesterol, onsite at the Aspen Ideas Festival.
“I was pretty cocky going into the Mount Sinai tent,” Ms. Thompson said during an interview at this year’s Aspen Ideas Festival. “But last year I was five months pregnant, and when they found something on my neck, I said, ‘is this something I need to treat immediately?’ And the doctor said, ‘yes.’”
Two days after returning home to Seattle last year, Ms. Thompson visited a dermatologist who biopsied the mole and found that it was precancerous. “I now know that I am at high risk because I grew up at high altitude, and I am so fair,” she said. “I have to get checked every six months rather than every year.” Ms. Thompson said she was grateful to Mount Sinai’s doctors for performing such a thorough screening and immediately zeroing in on the suspicious mole. “Without this service I would not have known that I had a precancerous mole in the middle of my neck,” she said. “I wouldn’t have had it taken care of. The problem would have exacerbated, and I would be dealing with it now as opposed to when it was easy to remove.
Lung cancer expert Dr. Hirsch told the audience that over the past decade there has been “tremendous progress in the treatment of patients with lung cancer, particularly those with metastatic disease.” This, he added, was due to the development of “molecular targeted therapies and most lately, immunotherapy,” which have extended survival rates to five years from seven to nine months, for certain patients. The targeted therapies require physicians to sequence the tumor mutations to find out which drug will work best for that tumor.
Dr. Burakoff urged cancer patients to get a full genomic panel review of their cancer. “Twenty-five years ago you would go to an oncologist who treats many cancers, but now everything is very specific,” Dr. Burakoff said. “It is important to go to a tertiary care center where the subspecialty expert will look at the tumor and the type of mutations you have to help identify or define the treatments.”
Dr. Merad, Mount Sinai Professor in Cancer Immunology, said that the development of immunotherapies to treat cancer represented a revolution in care and that these therapies would improve over time as researchers gained more knowledge. Her laboratory is currently investigating novel biological pathways and new clinical trials.
“We have never been as excited as we are now,” Dr. Merad said. “There has been success, but not 100 percent success, and my group focuses on those cases that resist this treatment.”
In a panel discussion on reinventing the pediatric visit, Carrie Quinn, MD, Executive Director of the Mount Sinai Parenting Center, discussed the Mount Sinai Health System’s collaboration with the nonprofit Bezos Family Foundation to enhance learning opportunities for children in their first years of life, when their brains are primed to learn. In addition to leading an eff ort to create upbeat messages that encourage enhanced communication between parents and their babies that will be placed throughout Mount Sinai’s labor and delivery and pediatric hospital units, Dr. Quinn has helped build and pilot a free and self-directed online curriculum to train pediatric residents about the science of early childhood development.
“How the parent responds to a child’s cues and emotions really builds those brain connections,” said Dr. Quinn. “It might be a baby turning their head away or crying, or arching their back. That’s a signal, that’s a sign of communication for an infant. So we want to help parents recognize those cues, the language of babies, and respond back and forth with them.”