For nearly thirty years, the New York Cardiac Center (NYCC) has contributed in critical ways to the development and maturation of Extracorporeal Photochemotherapy (ECP). From its introduction as the first FDA approved cellular immunotherapy for cancer to one that now treats thousands of patients daily in 300 of the leading university medical centers in the U.S. and Europe, ECP has been administered to more than 60,000 patients who, collectively, have received three million treatments during these past thirty years. While development and scientific analysis of ECP has also been supported by industry and National Institutes of Medicine funding, NYCC funding has been particularly productive. Indeed, association with the NYCC has provided researchers the most flexible, innovative, and leveraged advances. Utilizing these advances has led to ECP undergoing accelerated evolution as treatment for an ever expanding population of patients with potential in such wide ranging clinical applications as heart and lung transplant rejection, autoimmune diseases, graft-versus-host difficulties following stem cell transplantation, broad-based personal anti-cancer vaccination and immunization against viruses. NYCC association and support has been directed at both clinical analysis and deciphering of the scientific principles underlying the treatment’s efficacy. Now, with the finding of these previously unknown novel principles, opportunities to help many more patients are within reach. In association with the newly established, nationally endorsed, American Council on ECP (ACE), which is composed of 35 American ECP leaders, the NYCC and the FOUNDATION FOR A C E are helping to focus more attention on this important endeavor.
Beginning with the first association between NYCC and Yale School of Medicine in 1990, a fount of information has poured forth to contribute to improvements in the investigation and clinical treatment of diseases of the cardiovascular system. The first association was a project that involved the investigation of the use of ECP, then known as photopheresis, developed in the early 1980’s, by Dr. Richard L. Edelson , now Professor and Chairman of Dermatology at Yale and Past Director, Yale Comprehensive Cancer Center. The study was titled Photopheresis for the Therapy of Progressive Systemic Scleroderma: A disease affecting the Cardiovascular System. Impressive statistical evidence, gathered in that study, justified further clinical trials.
A second project involved the use of photopheresis to control the rejection of transplanted hearts. This study was so successful that it led to photopheresis being utilized in more than 150 cardiac treatment centers around the world where heart transplants are performed. A paper published in 1998 in The New England Journal of Medicine described how this new treatment protocol is more effective than conventional immunosuppression in preventing episodes of cardiac rejection. More importantly, further coronary artery disease in these transplanted hearts is markedly reduced.
A third project was a retrospective statistical study of sixty patients who had been treated with photopheresis for the treatment of cutaneous t-cell lymphoma, a common type of lymphoma. These patients, ranging in age from 55 to 80 were statistically compared to a group of patients who had not been treated with photopheresis. Evidence of disease including angina and myocardial infarction was looked for in these patients. Although statistics suggested that one in eight of these persons would have been expected to show evidence of cardiovascular disease, there were no such incidents present in the photopheresis treated group.
ECP scientific insights directly enabled by NYCC funds are broadly applicable to important cancer immunotherapy, anti-viral vaccination, tolerance of transplanted organs and stem cell reconstitution of damaged immune systems. Specifically, research sponsored by the NYCC identified the precise mechanism by which dendritic antigen presenting cells, the master-switch of the entire T cell immune system, are formed and controlled. This key discovery can now influence immune reactivity and therapy and will be tested in multiple clinical trials. Innovative medical advances, like those in other technology based endeavors, are commonly disruptive to existing thought and practice. ECP’s capacity to turn on beneficial immune responses in cancer, while shutting off destructive immune reactions in the transplantation setting, is now well accepted and widely used in many of the foremost medical centers. When this development began, many questioned how this therapy could be made bi-directional as needed. Now, this treatment is at the leading edge of immunotherapy. The NYCC is immensely pleased to have been associated with these outstanding advances and looks forward with anticipation and enthusiasm to participating in the coming investigations.