Dr. Marius Geanta, the host and president of the Centre for Innovation in Medicine talks to Dr. Stephen K. Klasko, former President and Chief Executive Officer of Thomas Jefferson University and Jefferson Health and one of the most illustrious advocates for transformation in healthcare and the use of technological and social innovations for improving population health.

The title of the podcast is “Jefferson Health System” because it’s not just about health, it’s about transformation, education, vision, and the ability to think differently. In Stephen Klasko’s opinion, you should always start with a vision.

The AHA! moment

I love the word rethink and reimagine and rethink all the time because we can’t make incremental changes in health care. I had three Aha! Moments in the beginning. I started my career as a practicing obstetrician and back in the 80’, 97% of obstetricians in the United States were male. The most performed procedure in the country was a hysterectomy, followed by C-section. I hadn’t done anything academic at that point. I happened to be at a lecture by some old guy, probably my age now, I was only 30. And he said to the medical students that if you see a small fiber in the uterus, just take out the uterus because the woman doesn’t need it.

And then, I happened to be at Barnes & Noble (a bookstore), and the top ten nonfiction bestsellers were Hysterectomy Hoax – How Hysterectomy Ruined My Life. So I realized what we were teaching these kids was based on the past.
So then fast forward to the nineties. All doctors are complaining about the business of health care. And I said, look, I can deliver a baby. I could probably figure out the business. I got my MBA award and a $1,000,000 grant to look at what makes doctors different and how we handle change and recognize that we need to educate and select doctors differently, not just based on memorizing the Krebs cycle, but being ready for the future.

And the last Aha! was when I got to lead the Digital Health Initiative for Apple in pre iPhone era. Apple was a small computer company with 3% of the computer market and 4% of the operations. The Dell Gateway and Microsoft were the Kings. And if you asked any of those folks what’s going to be like in 2022, they talked about Windows 2025.
But Steve Jobs recognized that the whole piece was getting commoditized, the computers and operating systems. I didn’t want to spend the next ten years just incrementally changing. I wanted to create a digital lifestyle. So that’s what I took to health care.

Listen to the fourth episode of the #ReThinkHealth Podcast, powered by Centre for Innovation in Medicine. Dr. Marius Geanta, the host and president of the Centre for Innovation in Medicine talks to Professor Fatima Mechta-Grigoriou, Director of the Stress and Cancer Laboratory, Coordinator of the Breast Cancer Scientific and Medical Program, and Scientific Director of the Cancéropôle Île-de-France, Institut Curie, Paris, about breast cancer innovations and her recent research presented during the American Association for Cancer Research Annual Meeting.

Cancer immunotherapy has emerged as an effective therapy in oncology. However, despite encouraging results, many patients with advanced cancer do not respond to immune checkpoint inhibitors, and little is known about the mechanisms of primary resistance. Identification of biomarkers that may reliably discriminate between responder and non-responder patients before initiating therapy is hence needed to select patients who are likely to benefit from immuno-oncology drugs.

Professor Fatima Mechta-Grigoriou and her team show in their recent paper “Single-Cell Analysis Reveals Fibroblast Clusters Linked to Immunotherapy Resistance in Cancer” that several cancer-associated fibroblasts clusters could actually contribute to primary resistance to immunotherapy. In addition to well-known factors involved in immunotherapy resistance, such as lack of antigen presentation, tumor immunogenicity deficiency, T-cell exclusion, or defective tumor cell response, they identified specific cellular clusters as new key players in primary resistance to immunotherapy.

“Breast cancer represents an heterogenous pathology. There are many different physiological features which are already well known in being involved in this pathology. But in addition to known physiological and clinical aspects, clinicians and biologists have also now identified different molecular subtypes of breast cancer.

And these particular molecular breast cancer subtypes have been identified based on the expression of the receptors located at the surface of cancer cells. Currently we know about the luminal breast cancer subtype expressing the hormonal receptors which include both progesterone and estrogenic receptors. This is one class of breast cancer subtype, but the clinicians also identified the HER2 breast cancer subtype.

And finally, there is a third sub-group of patients who are referred to as the triple negative breast cancer patients, because these patients do not express hormonal receptors on the one hand, and on the other the tumor is not amplified for the ERBB2 oncogene.

So those three main molecular subtypes are currently included in breast cancer class. The luminal breast cancer patients represent the majority of patients – around 70% of cases, and the HER2 and triple negative breast cancers, around 15% of the cases.

We need now to consider more the tumor microenvironment, because the heterogeneity concerns not only the cancer cells, but the cells of the tumor microenvironment. Although these cells do not exhibit any genetic variation as the cancer cells, they directly participate to the tumor development and metastatic spread and promote consistent growth.”

Professor Fatima Mechta-Grigoriou

Listen to the third episode of the #ReThinkHealth Podcast powered by Centre for Innovation in Medicine. Dr. Marius Geanta, the host and president of the Centre for Innovation in Medicine talks to Dan Staner, vice president of Moderna, responsible for the markets across the EMEA region (Europe, Middle East and Africa). The story of Dan Staner begins in Bucharest, Romania, where he was born and raised to the age of 11.

Their discussion focuses on how the Moderna Covid-19 vaccine reached the market in record time, without making any compromise on safety and quality, as well as on what products are coming next using the mRNA technology.

“The Moderna world became reality from a company which was based on a ten years dream of our CEO, who believed to build a new mechanism of action, a new set of pharmaceuticals after the small molecules revolution, the biologics revolution. He believes that mRNA will be the third revolution. And I think his dream became reality at the end of 2020 in the US and at the beginning of 2021 in Europe”

Dan Staner

Moderna has recently published new clinical data on the mRNA-1273,214 vaccine, which contains the contents of the mRNA fragment from the original Spikevax vaccine, as well as a new mRNA fragment adapted for the Omicron variant. A booster dose of this vaccine results in a higher titer of neutralized antibodies against the Omicron variant one month after administration compared to the first version of the vaccine (mRNA-1273). The new data suggest the possibility of a longer protection and the mRNA-1273,214 vaccine meets all the characteristics to become the booster dose for the fall of 2022, with the intention of approving the bivalent vaccine until end of summer. In this context, a single booster dose per year would be needed.

Listen to the second episode of the ReThink Health podcast, hosted by Dr. Marius Geanta and powered by the Centre for Innovation in Medicine, a European research & innovation organisation, with interest in visionary health policies and civil society education.

Through this podcast and the ideas expressed by our guests, we want to build forward better and to set the stage for the European Health Union, one in which the Eastern voice is also heard.

Brian O’Connor is the Chair of the ECHAlliance, the European Connected Health Alliance. He is currently providing strategic advice to Governments, International organizations and companies on the challenges facing healthcare in general and specifically on the Connected Health opportunity. 

The functioning of the healthcare system during the war in Ukraine in the midst of hostilities and the Covid-19 pandemic, migration and its impact on the spread of diseases in the context of Eastern European realities – all this and much more in the first episode of the ReThink Health Podcast with Dr. Marius Geanta, President of the Centre for Innovation in Medicine, a European research & innovation organisation.

The first edition guest is Professor Richard Sullivan, Director of the Institute of Cancer Policy and Co-Director of the Center for Conflict & Health Research at King’s College London.

Through this podcast series and the ideas expressed we want to build forward better and to set the stage for the European Health Union, one in which the Eastern voice is also heard.

Together with experts, we aim to understand the depth and complexity of the problem facing the countries of Europe as a result of an unprecedented war in Ukraine. The destruction of medical infrastructure through attacks on medical facilities, hospitals, and convoys, as well as the constant changes the medical personnel is faced with, represent a turning point and created a whole new reality in Ukraine.

The Eastern European countries managed poorly the pandemic. During this war, millions of Ukrainians were forced to migrate. But primary recipient countries are still recovering after the fifth wave of the pandemic. By adding the burden of migrants and the threat of numerous infectious diseases, Eastern European health systems could be at the brink of collapse if they fail to work together to alleviate this burden.

It is difficult to even imagine the scale of losses and the necessary costs for the restoration of healthcare systems, especially Ukrainian. Funding is important, but not sufficient, says Prof. Sullivan. This complex task requires a plan and leaders should have already started the planning.