september
2 017
The Triangle Physician T H E
M A G A Z I N E
F O R
H E A L T H
C A R E
P R O F E S S I O N A L S
Carolina Partners in Mental HealthCare Integrated Health Care Improves Patient Likelihood of Getting Well
Also in This Issue AID Helps Group Open Independent Surgery Center
Many Forms of Psoriasis Affect Quality of Life
Top 10 Proposed MACRA Changes Ahead
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From the Publisher
Dermatology
Forging Onward Carolina Partners in Mental Health, the
provides a thorough overview of changes to
cover story this issue, offers an ideal
the MACRA Quality Payment Program.
package for patients - not just one provider
On the medical front, physician assistant
but an integrated team of specialized
Tracy Cloninger gives an interesting
providers who work together to address
overview of psoriasis and its various forms.
an individual’s often complex health care
While advertisements about treatment for
needs. The article presents the case as to
plaque psoriasis are ubiquitous, there are
why this arrangement leads to improved
other forms that can impact one’s health
outcomes.
and quality of life in significant ways.
It’s always exciting to hear from physician
Despite great unknowns, medical progress
advocate Marni Jameson Carey. This month
forges onward, and each of us benefits. We
she reports on the successful effort to open
would like to hear about your contributions
an independent surgical center in Vermont
in uncertain times, so we can share them
and the support her organization provided
with the 9,000-plus readers within the
during a two-year odyssey.
Raleigh-Durham medical community.
Practice consultant Margie Satinsky is
Please contact us at
dedicated to providing wise counsel
info@trianglephysican.com.
on critical, complex and ever-changing governmental and agency regulations. It’s a volatile landscape, and she translates it with great editorial finesse. This month she
Publisher
John Teague
The Triangle Physician T H E
M A G A Z I N E
F O R
H E A L T H C A R E
P R O F E S S I O N A L S
Publisher - John Teague John@TTP2LC.com
Creative Director - Joseph Dally jdally13@gmail.com
Contributing Editors Marni Jameson Carey Tracey S. Cloninger, P.A.-C. Margie Satinsky, M.B.A.
News and Columns Please send to info@trianglephysician.com
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The Triangle Physician
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“After five gall bladder attacks that mimicked a heart attack, my family doctor said ‘It’s time to have this thing out!’ My surgeon said,’Let’s do this robotically at Johnston Health.’ sa it went Now I’m thankful to say, perfectly! No pain, no recovery issues, not even a red mark!” Charlotte Davis Smithfield, NC
For Charlotte’s complete story, visit johnstonhealth.org.
Expert Care. Close To Home!
daVinci Robotic Surgery
SMITHFIELD
www.johnstonhealth.org
CLAYTON
6
COVER STORY
Carolina Partners in Mental HealthCare Integrated Health Care Improves Patient Likelihood of Getting Well s e p t e m b e r 2 0 17
FEATURES
10
Physician Advocacy
AID Helps Group Open Independent Surgery Center After Two-Year Fight Marni Carey gives a play-by-play of the events leading up to a spectacular win for independent Vermont physicians.
11
Vol. 8, Issue 8
DEPARTMENTS 14 Research News Gold Nanostars and Immunotherapy Vaccinate Mice Against Cancer
15 News
Welcome to the Area
Dermatology
Understanding and Managing Psoriasis Flares Tracey Cloninger’s overview raises understanding of the many forms of psoriasis and its impact on quality of life. On the Cover: Meet the Carolina Partners Center for Interactive Care team. Back row: Jackie Camp, Ph.D.; Kelly Crenshaw, N.P.; Lisa Beresnyak, B.A.; Meagan Biggs; and Katie Godin, R.D., L.D.N. Front row: Sharon Wilkening, M.A., L.M.H.C.; John V. Yacono, M.D., F.A.C.P.; and Greg Carter, D.C.
september 2017
5
Category
Table of Contents
Category
Carolina Partners
Center for Integrative Care Integrated Health Care Improves Patient Likelihood of Getting Well Carolina Partners in Mental HealthCare’s Center for Integrative Care offers a holistic approach that expands patient care to an integrated health care team. It is led by a central mental health care provider who collaborates with the needed caregivers. “The goal is to make health care simpler and more effective by integrating traditional psychiatric health care into a broader spectrum of treatment modalities, including nutritional counseling, acupuncture, physical therapy, and primary care,” says the Center for Integrative Care (CIC) Care Coordinator Sharon Wilkening, L.P.C.
The Center for Integrative Care team.
6
The Triangle Physician
Katie Godin, a licensed dietitian, discusses nutritional options with a client.
The idea of integrative health care is not a new one. “A cursory Google search will turn up a large body of scientific research on the subject. Yet it is something we rarely get to see in practice,” says Wilkening. “By and large, in western society, health care has been compartmentalized between various public and private facilities that have little to do with one another. “Think about it: You go to the physician for annual checkups, the hospital for acute maladies and injuries, your therapist for counseling, perhaps a separate psychiatrist for medication management. You or someone you know may suffer from substance abuse or maybe an eating disorder, in which case, you or they have likely been directed to yet another specialized clinic to get help.” The list goes on, says Wilkening. “Throughout this elaborate, convoluted process, these myriad institutions rarely collaborate or communicate beyond the bare minimum, and they might therefore vastly differ in how they choose to treat a patient.” The American Journal of Managed Care writes, “Despite the robust literature demonstrating the benefits of integrated care models, behavioral and physical health care delivery have tradi-
The goal is to make health care simpler and more effective by integrating traditional psychiatric health care into a broader spectrum of treatment modalities, including nutritional counseling, acupuncture, physical therapy, and primary care
tionally operated in separate spheres.”1
september 2017
7
Lisa Beresnyak, medical assistant and health coach, works with a Center for Integrative Care client.
It makes sense to integrate health care, says Wilkening. “The argument is almost self-evident: You are more likely to get well, if your treatment plan is centralized and therefore tailored to your precise needs as an individual, particularly if you suffer from comorbid disorders that must be treated in tandem.” CIC Health Coach Lisa Beresnyak asks the reader to imagine he or she is suffering from insomnia and anxiety. “A foray into the insulated health care landscape as it stands now might very well yield a long, frustrating road to nowhere.” The patient may be seen by a psychiatrist who prescribes antianxiety medication and sleeping pills. Then, when the new medication regimen affects the patient’s energy levels and appetite, she starts to binge eat. The patient’s physical health then starts deteriorating, so she sees a dietician who recommends exercise. But her medical barriers make exercise difficult, and this affects her self esteem. The patient spirals into depression, so she goes back to the psychiatrist, who prescribes antidepressants as well as cognitive behavioral therapy with another therapist. “Before you know it, the patient is bouncing between three or four different specialists who each have a piece of the puzzle of her health, but none of whom have the whole picture. Worse, they are sabotaging one another’s treatment plans without even realizing it,” says Beresnyak. On top of it all, Beresnyak says, the various doctor visits are getting too expensive and emotionally draining. She points to a study that has shown a significant percentage of patients with substance abuse problems are unwilling to undertake the work required to go to numerous appointments and therefore stop going.2 CIC is solving this dilemma, says Beresnyak. She describes the scenario that occurs when a patient arrives at CIC with similar diagnoses of insomnia and anxiety.
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The Triangle Physician
“Your therapist, dietician, exercise counselor, and medication manager all exist on one personalized care team, and they can work together to give you the best treatment possible. The mounting expenses and complications disappear.”
“We believe in the power of treatment options that can
Wilkening says Carolina Partners has always been committed to innovation in health care. “Our practice philosophy has long disavowed a one-size-fits-all solution to health care. We believe in the power of treatment options that can be catered to the specific needs of each patient who walks through our doors. “The Center for Integrative Care is an important step in this direction, not just for the
be catered to the specific needs of each patient who walks through our doors.”
company, but for the American health care system in general. It’s time to move away from the chaos of segregated health care and in the direction of the integrative approach.” Carolina Partners has offices throughout the Raleigh-Durham region and across North Carolina. More information is available online at www.carolinapartners.com. References 1
Minkoff, Neil D. “Treating Behavioral Health Disorders in an Accountable
Care Organization.” AJMC. 16 Dec. 2016. Web. 16 July 2017. http://www.ajmc.com/journals/ajac/2016/2016-vol4-n4/treating-behavioralhealth-disorders-in- an-accountable-care-organization 2
“Common Reasons Why Those
Who Need Treatment Don’t Get It.” 16 Dec. 2016. Web. 16 July 2017. https://www.elementsbehavioralhealth. com/addiction-recovery/commonreasons-why-those- who-need-treatmentdont-get-it/ Greg Carter , DC
Katie Godin, RD, LDN
Kelly Crenshaw, NP
Lisa Beresnyak, BA
Steven Lambeth
Mary Tyrey, BSN, RN
Jakie Camp, PHD
Sharon Wilkening, MA
september 2017
9
Physician Advocacy
Dermatology
AID Helps Group Open Independent
Surgery Center After Two-Year Fight By Marni Jameson Carey
Helping independent doctors nationwide, the
FTC’s attention but also filed a letter during the
Florida-based Association of Independent Doc-
open comment period that got picked up by the
tors celebrated yet another victory for patients
media. That got the state’s legal authorities to
by helping doctors in Vermont open a freestand-
really take this seriously and let our regulators
ing surgical center they had had been fighting to
know that people nationally were watching this
build for two years.
case to see whether they would vote in favor of
The doctors, part of Health First, had been
Marni Jameson Carey is the executive director of the Association of Independent Doctors. You may reach her at (407) 571-9316 or marni@aid-us.org. Visit www.aid-us.org for more information.
competition.”
pleading with state regulators to get the certifi-
The decision allows independent doctors
cate of need to build the facility. Area hospitals,
to create the first independent multispecialty
worried about competition, opposed the center.
outpatient surgery center in the state, and break
Health First had even filed a lawsuit, but
into a general surgery market that has been
the controversy dragged on. Frustrated, Health
exclusively controlled by hospitals. Vermont’s
First Executive Director Amy Cooper, who had
only other freestanding surgical center is an eye
learned of AID’s success in working with the
clinic.
Federal Trade Commission to promote competi-
“By joining AID as a chapter, we sent a
tion and block monopolies, reached out to the
strong signal that we’re serious about maintain-
national nonprofit.
ing competition and put everyone on notice that we are not going away,” said Cooper. The addition of a Vermont AID chapter was crucial given the dynamics in the state, added Cooper. “By forming a state chapter, we reinforced Health First’s resolve to do what’s best for patients and help independent doctors maintain their small practices.” Members are also now part of AID’s online
In April, 15 Health First doctors joined
directory of independent doctors, a growing
AID, creating a Vermont Chapter. That gave AID
database designed to help patients and referral
enough horsepower to represent their interests
sources find independent doctors.
to both the FTC, the Green Mountain Care Board
Established in 2013, AID now has 1,000
responsible for issuing the approval and local
members in 33 states across the country and
media.
chapters in California, Florida, South Carolina,
In May, AID wrote a letter to the board argu-
Vermont, and soon Texas and Pennsylvania.
ing for approval of the new center. The letter got
The nonprofit trade association speaks out on
the attention of state and national media. In July,
behalf of independent doctors who don’t have
the doctors got the green light to build their sur-
the time, resources or clout to fight the forces
gical center. In 90 days, AID helped win a battle
facing them, and educates consumers, lawmak-
the doctors had been fighting for two years.
ers, businesses and the media about why saving
“AID played a key role in our victory,” said Cooper. “AID not only brought the matter to the
10
The Triangle Physician
America’s independent doctors matters.
Dermatology
Understanding and Managing
Psoriasis Flares By Tracey S. Cloninger, P.A.-C.
Psoriasis is a condition characterized by red
Inverse psoriasis forms in-between skin folds
scales and patches on the skin that can appear
in recessed areas of the body, such as the under-
anywhere on the body.
arms and groin, where skin makes continuous
The exact cause of psoriasis has not been
direct contact with other skin. Unlike other types
determined, but it is an autoimmune disease
of psoriasis, inverse psoriasis is characterized by
believed to be linked to genetic roots. Psoriasis
smooth rashes rather than raised bumps, and it
“flares” when skin cells in affected areas grow
is less scaly to the touch.
rapidly, creating a buildup of scaly tissue. Stress,
Guttate psoriasis appears as patches of
injury, bacterial infections and certain medica-
small red spots (papules) on the skin, usually
tions can trigger flares.
shaped like drops of water, smaller than 10 mil-
Psoriasis comes in a variety of types, each
limeters in size with a pink hue. Bacterial infec-
of which manifests slight differences in symp-
tions, such as strep throat, can trigger flares of
toms as well as triggers and affected regions of
guttate psoriasis. This is sometimes unexpected,
the body. No type of psoriasis is contagious or
as some types of bacterial infections do not
infectious, but it is often painful.
show obvious or easily recognizable symptoms.
Psoriasis vulgaris (plaque psoriasis)
Pustular psoriasis can be identified by
is the most common
the presence of pus-
type of psoriasis is
tules, or white pus-
plaque psoriasis, also
filled bumps most of-
known as psoriasis
ten on the hands and
vulgaris. Plaque psori-
feet. Pustules also
asis appears as raised
can appear between
patches (bumps) of
skin folds as well as
scaly,
silvery-white
on the tongue. Al-
skin, usually appear-
though pustular pso-
ing
riasis is sometimes
on
the
scalp,
knees, lower back and
accompanied
elbows. Most often,
such symptoms as
the bumps join into clusters.
by
fever, chills or headache, it is not infectious.
Erythrodermic psoriasis is the least com-
Nail psoriasis can appear underneath
mon but most serious form of psoriasis. Suffer-
surfaces of fingernails and toenails. This usually
ers often find bright red inflamed skin over the
causes pitting on the surface of the nail. It can
entire body, sometimes from head to toe. Eryth-
cause discoloration of the nail and/or separation
rodermic psoriasis adversely affects the overall
from the nail bed. It is common for an affected
function of the body’s systems by compromising
nail to darken and eventually fall off.
the skin’s ability to protect against temperature
Dermatology providers are specially trained
extremes and infections. As such, this type of
to identify the specific type of psoriasis and rec-
psoriasis can be life threatening. It most often ap-
ommend a treatment plan. Usually the type of
pears in patients who have already developed a
psoriasis is determined by a physical examina-
different type of psoriasis, but not always.
tion and/or a tissue biopsy of the affected area.
Physician assistant Tracey Cloninger of Southern Dermatology earned her bachelor’s degree in physical education from the University of North Carolina, her physician assistant degree from East Carolina University and her master of education degree in exercise physiology from the University of Georgia. As a physician assistant Cloninger collaborates with physicians on complex cases. She is a member of the American Academy of Physician Assistants, North Carolina Academy of Physician Assistants and Society of Dermatology Physician Assistants. “My passion is to help young patients make good lifestyle choices, so their healthy skin lasts a lifetime.” Cloninger can be reached at (919) 782-2152.
Blood tests are not an effective method.
september 2017
11
Physician Advocacy
Highlights of Proposed 2018 Changes to MACRA Quality Payment Program By Margie Satinsky, M.B.A.
The
Medicare
Access
and
CHIP
Reauthorization Act of 2015 brought many
For more information, visit www.satinskyconsulting.com.
All eligible clinicians in groups that choose
changes to reimbursement for Medicare patients.
the virtual group option must participate, and
It went into effect on Jan. 1, 2017, and this first year
the participation decision to choose this option
is considered to be a transition year.
must be made prior to the 2018 performance
One part of the program, the Quality Payment
Margie Satinsky is president of Satinsky Consulting L.L.C., a Durham consulting firm that specializes in medical practice management. She has helped many physicians start new practices, assess the wisdom of affiliating with a larger health care system and improve their current practices. Ms. Satinsky is the author of numerous books and articles, including Medical Practice Management in the 21st Century.
not qualify as MIPS eligible.
period.
Program (QPP), generated many questions
2. Easier low-threshold exemption. An increase
and concerns from small, independent and
in the 2017 low-volume threshold to $90,000 or
rural practices. In response to these concerns,
200 patients would enable more small practices
Centers for Medicare & Medicaid (CMS) issued
and eligible clinicians in rural and Health Pro-
a proposed rule on June 20 that would make
fessional Shortage Areas (HPSAs) to be exempt
changes to the QPP in 2018, Medicare Access and
from MIPS participation.
CHIP Reauthorization’s (MACRA’s) second year. Comments were due back to CMS by Aug. 18.
3. Facility-based measurement. The transitional 2017 transitional year has no provisions
The 2018 proposed rule for the QPP both
for facility-based measurement. The proposed
amends some of the existing requirements and
change would implement an optional, volun-
contains new policies for physicians, and other
tary, facility-based scoring mechanism based
clinicians who are participating in QPP in either
on the Hospital Value Based Purchasing Pro-
the Advanced Alternative Payment Models
gram. The option would be available only for
(APM) or Merit-based Incentive Payment System
facility-based clinicians who have at least 75
(MIPS) tracks.
percent of their covered professional services
This article identifies and explains 10 of the most important proposed changes, focusing on
supplied in the inpatient hospital or emergency room setting.
the MIPS track that most eligible clinicians are
4. New hardship category under Advancing
expected to select. For a complete explanation
Care Information: CMS has proposed adding
of the proposed changes to both the MIPS and
a new hardship category for clinicians in small
APM tracks, check the resources listed at the end
practices under the Advancing Care Information
of the newsletter.
(ACI), the new name for the meaningful-use performance category.
12
The Triangle Physician
1. New participation option. A new “virtual
5. More options for submission by MIPS-eligi-
groups” participation option would give solo
ble clinicians: Moving away from the 2017 re-
groups (i.e., solo practitioners and groups
quirement for one submission mechanism per
of 10 or fewer eligible clinicians) the option
performance category, the proposed rule would
of coming together “virtually” in order to
allow MIPS-eligible clinicians and groups to sub-
participate in MIPS for a year.
mit measures and activities through multiple
Solo practitioners that wish to join a vir-
submission mechanisms within a performance
tual group must meet the definition of MIPS
category as available and applicable to meet the
eligible. A group that wishes to join a virtual
requirements of the quality improvement activi-
group may include eligible clinicians that do
ties or ACI performance categories.
25 percent respective weights.
(PTNs), which support clinician
egory: Eligible clinicians would have
c. CMS’ future plans for changing
the option of continuing the use of 2014
weights remains at raising cost to 30
strategies: TCPI.ISC@TruvenHealth.
Edition Certified Electronic Health Re-
percent for the 2021 MIPS payment
com. Regionalized Quality Innova-
cord Technology (CEHRT) or using the
year (using 2019 data for reporting)
tion Network-Quality Improvement
and beyond.
Organizations provide assistance:
2015 edition. There’s an exception for
practices in quality improvement
http://quiprogram.org/contact-
eligible clinicians for whom the elec-
10. Improvement Scoring for Quality
tronic health record was decertified
and Cost: The proposed rule adds a
retroactively effective to performance
mechanism for rewarding improvement
periods in 2017.
in performance for these two catego-
Support for small, underserved and
ries. Higher improvement would trans-
rural areas provides direct and custom-
late to more points.
ized assistance to small practices. In North
7. Timeframe for reporting in ACI category: In response to input from the phy-
zones?map=qin.
Carolina, Alliant GMCG is the designated
sician community, CMS has proposed retaining the 90-day reporting period. 8. More ways to earn bonus points: a. Eligible clinicians could add bonus
antquality.org.
the resources below.
•N orth Carolina Medical Society
• CMS website: http://qpp.cms.gov.
points in the scoring methodology
•C MS Quality Payment Program Center.
for: (1) caring for complex patients;
Call (866) 288-8292 or send an email
(2) using the 2015 edition CEHRT
support organization: QPPsupport@Alli-
For more information, contact one of
website: www.ncmedsoc.org. • Major software vendors, who offer
to QPP@cms.hhs.gov.
guides, webinars and technical
exclusively; (3) incorporating MIPS
• CMS-approved local organizations
performance improvement in scor-
that support clinician practices in
ing quality performance; and (4)
quality improvement strategies.
(919) 383-5998 or
incorporating the option to use fa-
Practice Transformation Networks
Margie@satinskyconsulting.com.
support. • Satinsky Consulting L.L.C.:
cility-based scoring for facility-based clinicians. b. MIPS-eligible clinicians, groups, vir-
AC N E
•
MOHS SURGERY
•
SKIN CANCER
•
PSORIASIS
•
ECZEMA
tual groups and advanced Alternative Payment Models (APMs) with 15 or fewer clinicians could receive five additional bonus points in their final score by submitting data on at least one performance category in the 2018 MIPS performance period. c. Small practices but not larger ones could continue to receive three extra points for measures in the quality performance category that don’t meet data completeness requirements. 9. Weighting MIPS components: a. Contrary to expectations, for 2018 the quality component would be weighted at 60 percent and the cost
SHE WANTED HER DAUGHTER TO HAVE THE BEST CARE AVAILABLE I R E F E R R E D H E R T O S O U T H E R N D E R M AT O L O G Y
component at 0 percent, allowing FOR THE MOST ADVANCED SKIN CANCER TREATMENTS, REFER YOUR PATIENTS TODAY!
practices to continue developing their processes for procuring and interpreting cost data. b. Improvement activities and ACI would remain at their current 15 percent and
919-782-2152
southernderm.com ROSACEA • HIVES
•
VITILIGO
DER131_AD_Triangle Physican BEST CARE 1/3.indd 1
•
K E R AT O S I S • WA R T R E M O VA L 1/30/17 3:28 PM
september 2017
13
Physician Advocacy
6. Options for reporting in the ACI cat-
Research News
Gold Nanostars and Immunotherapy Vaccinate Mice Against Cancer By combining a Food and Drug Adminis-
deeper within a tissue, according to the
nothing to affect the tumor in the untreated
tration-approved cancer immunotherapy
advisory.
leg. While a few mice responded well to
with an emerging tumor-roasting nano-
“The nanostar spikes work like light-
the immunotherapy alone, with the drug
technology, Duke University researchers
ning rods, concentrating the electromag-
stalling both tumors, none survived more
improved the efficacy of both therapies in
netic energy at their tips,” said Vo-Dinh.
than 49 days.
a proof-of-concept study using mice.
“We’ve experimented with these gold na-
The group treated with both the im-
The potent combination also attacked
nostars to treat tumors before, but we want-
munotherapy and the gold nanostar photo-
satellite tumors and distant cancerous
ed to know if we could also treat tumors we
therapy fared much better, with two of the
cells, completely curing two mice and
didn’t even know were there or tumors that
five mice surviving more than 55 days.
effectively vaccinating one against the
have spread throughout the body.”
disease. The results appeared online in Scientific Reports on Aug. 17.
“When a tumor dies, it releases par-
To attack distant cancerous cells out-
ticles that trigger the immune system to
side of the treatment site, Vo-Dinh teamed
attack the remnants,” said Vo-Dinh. “By
“The ideal cancer treatment is non-
up with colleagues Brant Inman, M.D.,
destroying the primary tumor, we activated
invasive, safe and uses multiple approach-
M.S., and Gregory M. Palmer, Ph.D., in the
the immune system against the remaining
es,” said Tuan Vo-Dinh, the R. Eugene and
Departments of Surgery and Radiation On-
cancerous cells, and the immunotherapy
Susie E. Goodson Professor of Biomedical
cology at Duke University Medical Center,
prevented them from hiding.”
Engineering and director of the Fitzpatrick
and Paolo F. Maccarini, Ph.D., of Duke Bio-
The combined treatment worked so
Institute for Photonics at Duke University.
medical Engineering. They combined this
well that, in a bit of a surprise, one mouse
“We also aim at activating the patient’s own
gold nanostar therapy with a cancer immu-
is still alive nearly a year out with zero re-
immune system to eradicate residual meta-
notherapy recently cleared by the FDA and
currence of the cancer. Even a month later,
static tumors. If we can create a long-term
in clinical use.
when the researchers injected more can-
Normally, the body’s immune system
cerous cells, the mouse’s immune system
protects against the growth of cancerous
attacked and destroyed them without a
The new approach relies on a “pho-
cells. Many tumors, however, overproduce
problem indicating a vaccine effect in the
tothermal immunotherapy” technology
a molecule called PD-L1, which effectively
cured mouse.
developed by an interdisciplinary group of
disables T cells, the immune system’s main
Duke researchers that uses lasers and gold
soldiers, the Duke advisory said.
anticancer immunity, then we’d truly have a cure.”
“This is our goal – our dream,” said Vo-Dinh.
nanostars to heat up and destroy tumors in
Several pharmaceuticals are being
While researchers conducted this
combination with an immunotherapeutic
developed to attempt to block the action
proof-of-concept experiment with a small
drug, according to a Duke Health press
of PD-L1, allowing the immune system to
number of mice, the results are encour-
advisory.
destroy the cancerous cells. Inman has
aging. The Duke researchers now plan to
This photothermal therapy hinges on
been active in the early development and
follow up with larger cohorts and to work
the widely demonstrated fact that nanopar-
current clinical use of these drugs – which
with other clinical researchers to test the
ticles accumulate preferentially within a
were used in this study – to treat bladder
treatment on mouse models of brain,
tumor due to its leaky vasculature.
cancer.
breast and lung cancer.
While several researchers around the
In the experiment, the Duke research-
world are pursuing such techniques using
ers injected bladder cancer cells into both
Reference
nanoparticles, Vo-Dinh has pioneered the
hind legs of a group of mice. After waiting
“Synergistic Immuno Photothermal Nano-
development of a unique type of nanopar-
for the tumors to grow, the researchers
therapy (SYMPHONY) for the Treatment
ticles called gold nanostars, which have
began trying different types of treatments
of Unresectable and Metastatic Cancers.”
the advantage of geometry. Because gold
– but only on one of the legs.
Yang Liu, Paolo Maccarini, Gregory M.
nanostars have multiple sharp spikes, they
Those that received no treatments
Palmer, Wiguins Etienne, Yulin Zhao,
are able to capture the laser’s energy more
all quickly succumbed to the cancer, as
Chen-Ting Lee, Xiumei Ma, Brant A. Inman
efficiently. This allows them to work with
did those receiving only the gold nanostar
& Tuan Vo-Dinh. Scientific Reports, Aug. 17,
less exposure, making them more effective
phototherapy, because the treatment did
2017. DOI: 10.1038/s41598-017-09116-1.
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