Dr. Crystal Mackall
Crystal Mackall, MD, professor of pediatrics (stem cell transplantation) and of medicine, is a physician scientist who has devoted her career to developing immune therapies to treat cancer. She played a leading role in the discovery of the major pathways by which T cells are replenished following cancer therapy and identi ed interleukin-7 as the protein that drives this process. Her group was among the rst to use genetically modi ed chimeric antigen receptors (CARs) to induce T cells to recognize and attack speci c cancer cells. This therapy achieved high remission rates when used to treat children with leukemia. Dr. Mackall is now working to prevent relapses after CAR therapy and create new CAR T cell therapies to treat solid tumors. She joined the Bass Center team in January as associate director of the Stanford Cancer Institute and co-medical director of the Stanford Laboratory for Cell and Gene Medicine. Dr. Mackall previously led the Immunology Section of the National Cancer Institute in Bethesda, Maryland, and served as chief of the Pediatric Oncology Branch.
Dr. Kara Davis
Kara Davis, DO, has discovered certain features of leukemia cells that put patients at a higher risk for relapse. She and her team are studying how the communication in cancer cells is different in children who are cured of acute lymphoblastic leukemia, from those whose disease returns. She has developed an outcome predictor that looks for these features in blood or bone marrow at the time of
diagnosis to determine who will respond well to certain treatments and who will not. This information can help physicians prescribe the most appropriate type and amount of treatment, leading to better outcomes.
Dr. Davis is also developing new technology for tumor diagnosis, using multiple tiny samples on the same slide. Currently, tumor tissue is sliced thin and placed on one slide at a time. But very small tumors or biopsies often do not provide enough tissue to get a good view of what is going on. The ability to run multiple tests on the same tissue enhances the ability to diagnose tumors and predict how a patient will respond to treatment.
Another part of Dr. Davis’s work involves developing immunotherapy clinical trials for children with leukemia. Immunotherapy enhances the body’s own immune cells to recognize and destroy tumors, and represents a revolutionary approach to oncology treatment. She works closely with Crystal Mackall, MD, director for the Cancer Immunotherapy Program, Department of Pediatrics, and the Parker Institute for Cancer Immunotherapy at Stanford. Their work includes a chimeric antigen receptor (CAR) T cell study, as well as an immune checkpoint inhibitor study. Chimeric antigen receptor T cells are the patient’s own T cells that have been removed, engineered to recognize and kill cancer cells, and reintroduced into the body. Immune checkpoint inhibitors are drugs, usually composed of antibodies, which spur the immune system to attack cancer cells. Both therapies have shown great promise in treating and curing blood cancers.
Dr. Sheri Spunt
Endowed Professor of Pediatric Cancer, division chief of hematology/ oncology and associate chair of the Department of Pediatrics. An internationally recognized expert on the treatment and biology of soft tissue sarcomas, Dr. Spunt joined Stanford in 2013 from St. Jude Children’s Research Hospital, where she was deputy clinical director.
Dr. Sheri Spunt is on a mission to ensure that every child who develops a rare sarcoma has theopportunity to heal, grow up, and live a long, full life. The creation of the Stanford Rare Sarcoma Program is the crucial first step on the road to that brighter future. Dr. Spunt sums up her commitment this way: “In the rare sarcoma world, we are far behind other forms of cancer because no one has taken the time to methodically study these diseases. When I retire, if that is no longer true, then I will have achieved what I was meant to achieve in this life.”
Cancer is fear. Cancer is a waiting room full of orange chairs with worn wooden arm-rests and a doctor with a white beard mouthing words that sound distant and muffled until you feel so hot and so cold that you run to the bathroom, where you kneel over the toilet. Cancer is pain in your bones and your eyes, pain so intense it makes you cry out. Cancer is the metronomic, mechanical grind of the small machine that pumps liquid food through a tube into your stomach. Cancer is watching the blue number on the heart-rate monitor, and checking the color of the urine, and wincing at the needle, and waiting for the results, and the incessant ringing of a phone at the nurses’ station in the hallway.
Cancer is two people looking up at each other over soup scraped from a vat in the café across the street because that’s the only place open at this hour….Cancer is the thing people say to each other: “What if the radiation doesn’t work?” “Nobody knows why children get cancer, sweetheart.” “They said this part should pass in a few days.” “It’s spread to the lymph nodes.” ‘It’s in remission!” “The neighbors left some food in the fridge.” “I can’t do this.” “You can do this.” “I love you.”
Editor in Chief
Recently, I was cleaning out the piles and piles of papers that have been collecting dust for the past year. There was barely time to be with family let alone sort through and organize papers. The last year has been spent in graduate school working to obtain my Pediatric Nurse Practitioner’s license to work in pediatric oncology. Papers, exams, quizzes, studying, reading through the never-ending barrage of articles that came at me, trying to tend to my children’s needs while taking a timed exam and not panic……and wondering at least once a day, “What the f*ck am I doing?” “Did I make the right decision?” “Is all of this worth all of the time away from my family?” I missed my girls. I missed my husband. I missed my friends. But it was only temporary. The end goal was the mission. The end goal of continuing to fight this battle against pediatric cancer armed with as much knowledge and experience as I could possibly take in. The end goal is to put myself on the front lines of pediatric cancer and to have my finger on the pulse. On the pulse.
I came across one of the hundreds of “Popular Mechanics” magazines that come through our house on a regular basis. I exaggerate of course. It’s really one a month. Most of these magazines get shoved in drawers or end up in the recycling bin (to my husband’s dismay) before they get read. But there was one in particular that caught my attention. As I glanced at it, of course the word “cancer” jumped out at me. I thought to myself, I’ll just put this aside and read it later. That was a few months ago. It wasn’t until just a few days ago that I got a chance to actually read the article.
“Cancer is not a single, well-defined disease. There are types and subtypes, and each type and subtype requires the energy and intelligence of whole teams of doctors and researchers. You hear about them sometimes- a breakthrough, a new drug trial. You hear about fundraisers and 5K runs, and about statistics that either show progress or stasis, depending on how you read them. What you don’t often hear is a lot of cancer researchers talking at once. Sharing. Cancer is a diffuse problem, but where are we in the overall fight? Will this ever end? Because, man, this is requiring a lot of time and money and patience, and people are dying.” ~ Ryan D’Agostine
After reading the introduction as some is quoted above, I started to delve into the article. As I was flipping through the pages, a picture jumped out at me. It was Dr. Crystal Mackall, who has been a pioneer in immunotherapy, has worked at the National Institute of Health, and who has been the recent recipient of some generous funding by Team G on behalf of The Bay Club
and our many supporters including the Berry Foundation and the Esther B Collishaw Foundation. I started to pay close attention to the article, feverously reading and taking notes while my arms were covered in goose bumps. This. Is. Exciting.
A few years back and with the help of the Vernacchia Family, we were able to fund $20,000 to a project at Lucile Packard through Dr. Kharbanda at LPCH. These funds were used to train the staff to deliver immunotherapy to patients in the unit in hopes of showing the efficacy of this therapy. This was one of the many projects for CAR T-Cell immunotherapy happening across the country for eventually obtaining FDA approval as a standard treatment for leukemia with overwhelming positive responses in each trial. To my knowledge, it has shown promise in one of the three patients that were treated at Lucile Packard. One study reported 60% of it’s patients went into remission. These patients would have otherwise died if they didn’t receive this treatment.
Dr. Kharbanda worked closely with Dr. Kara Davis and Dr. Crystal Mackall. Both on the cutting edge of immunotherapy treatment, these doctors are furthering immunotherapy to target not just one marker on the cancer cells but two markers. This gives the immune system another marker to attack cancer cells and destroy them. Without going into too much scientific detail, the process of immunotherapy is relatively simple. The patient’s own cells, specifically the T-cells are taken and sent to a lab. The lab modifies the T-cell by adding a receptor (this is where you hear of a modified form of the HIV virus being used) that matches a marker on the cancer cell. The modified T cells are returned to the patient where the cells then target the marker on the cancer cell in order to destroy it. (Detwiler, J. 2017. It’ll Take an Army to Destroy the Emperor. Popular Mechanics, 194. 80-81).
Fast forward two years later, a major pharmaceutical company called Novartis is currently working to make this therapy FDA approved and available for children with recurrent B-Cell ALL. It won’t be available as a first line treatment, not yet anyway. But if scientists continue to improve this therapy, it may possibly be used as the curative treatment over standard chemotherapy treatment. Furthermore, this same therapy may be developed for other cancers in hopes for more effective, less toxic treatment.
Last year, we were lucky enough to meet Gina Rodriguez and her beautiful family. Her daughter, Sofia is currently fighting ALL. Sofia, a 4 year old with cherub cheeks and soft curly locks recently growing out from her chemo induced hair loss, is a beautiful soul. She is soft spoken and has a smile that could brighten anyone’s day. Gina connected Team G with The Bay Club for one of the biggest fundraisers we have had to date. Between the family’s effort and the efforts that Bay Club put into fundraising for pediatric cancer last September 2016, they raised over $54,000!!! $40, 000 of this donation has gone to these incredible doctors, Dr. Davis and Dr. Mackell to further immunotherapy treatment and bring this promising treatment to the forefront for children battling ALL. (The remaining $14,000 is another story that we will bring to you soon!) Immunotherapy trials will be brought to Lucile Packard as a treatment option starting this coming fall. It is exciting to see the rewards of our hard work paying off with treatments other than the standard chemotherapy, radiation, and surgery (poison, cut and burn) coming to the bedside.
As the president of any foundation, it is important to understand where funding is donated. Individuals are trusting in us to place their hard earned donation in appropriate and capable hands. I take this task with great responsibility. Our foundation has been working with many scientists to find projects for donations, which we have been doing for almost 4 years. To date, Team G has donated over $188,000 to fund childhood cancer research. But this latest donation is the reason we started this foundation.
Kristin Cosner ~ President and Co-founder