On this episode of Advances in Care, Erin Welsh is joined by Dr. Barbara Ma, a medical oncologist at NewYork-Presbyterian who leads Cellular Therapy for Solid Tumors at Weill-Cornell Medicine. Dr. Ma and her team are at the forefront of advancing cell-based treatments which include tumor-infiltrating lymphocyte therapy—or TIL—a groundbreaking cell therapy for metastatic melanoma that received FDA approval in 2024. Their program is one of only a handful in the United States with the expertise and infrastructure to offer TIL therapy to patients with advanced melanoma based on the complexity of this treatment approach.

The process for administering TIL is multi-step beginning with the surgical removal of a patient’s tumor, from which the potent TIL cells are isolated, and grown in large quantities in a lab. These enhanced immune cells are then infused back into the patient’s body, to attack the malignant tumor directly. This process requires close supervision of the patient due to the side effects of a drug called IL-2 that helps prepare their body to receive the infusion and stimulate the immune cells. Despite the intricacy of the treatment, patients have experienced significant tumor shrinkage, sometimes within weeks, of receiving TIL therapy providing a new option with lasting effects.

Dr. Ma and her team are now investigating ways to optimize TIL therapy by shortening the manufacturing process, which can take several weeks, and reducing the toxicity associated with IL-2 to improve the patient experience. NewYork-Presbyterian and Weill Cornell Medicine is one of the few medical centers to both administer and continue to research this groundbreaking therapeutic avenue, which will likely have future applications in other types of solid tumor cancers.

Chapters:

[00:00 - 6:40] A New Treatment for Melanoma

Dr. Barbara Ma talks about a new treatment option for melanoma – tumor-infiltrating lymphocyte therapy or TIL.

[6:40 – 9:02] The Challenges of Immunotherapy and Solid Tumor Cancers

Dr. Ma discusses the toxicity associated with some immunotherapies, and how TIL therapy is administered.

[9:02 - 12:55] Response Rates for TIL Therapy

Dr. Ma describes the timeline of response following TIL therapy.

[12:55 - 16:26] Future Applications of TIL

Dr. Ma shares how patients can benefit from TIL as a second-line therapy, and how her team is working to shorten the manufacturing time and reduce IL-2 associated toxicity.

[16:26 – 18:07] Cell Therapy as the Next Frontier

Dr. Ma talks about her outlook for cell therapy as the next frontier in cancer treatment.

[18:07 – 18:48] Credits

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Dr. Barbara Ma is an Assistant Professor of Medicine at Weill Cornell Medicine and a medical oncologist specializing in cellular therapy and immunotherapy for solid tumors. She serves as Head of the Phase I Unit and leads Cellular Therapy for Solid Tumors at WCM, where her work focuses on advancing Tumor-Infiltrating Lymphocyte (TIL) therapy and next-generation cell therapies for cancers including melanoma, lung cancer, head and neck cancer, gastrointestinal cancers, and cervical cancer. Her clinical and research efforts center on translating emerging cellular therapies from early-stage clinical trials into real-world patient care, while improving treatment safety, reducing toxicity, and expanding access for patients with advanced cancers.

For more information visit nyp.org/Advances

On this episode of Advances in Care, Erin Welsh is joined by Dr. Leonardo Lopez, a psychiatrist at NewYork-Presbyterian and vice chair for inpatient services in the Department of Psychiatry at Weill Cornell Medicine. Dr. Lopez and his team are at the forefront of electroconvulsive therapy (ECT), and have built one of the largest programs of its kind in the country dedicated to treating severe psychiatric illness through this revolutionary method. Though it is one of the most effective therapies available for certain psychiatric conditions like treatment resistant depression and schizophrenia, ECT isn’t widely adopted or accessible. However, Dr. Lopez hopes to change that. In the episode, he describes the history of this treatment, how it has evolved since its inception to become one of the safest procedures done under general anesthesia, and the dramatic response rates.

ECT works by restructuring neurotransmitter release and promoting neuronal growth. Patients with conditions like psychotic depression and catatonia can sometimes see upwards of 90-95% response rates. To illustrate the power of ECT, Dr. Lopez shares the story of a pediatric patient who was referred to his team after being diagnosed with catatonia caused by another condition. Although the other condition was treated, the catatonia persisted until she was entirely dependent and non-verbal. Following a 6-week ECT treatment plan, the catatonia resolved completely and the patient was able to return to a normal life.

The treatment is less than 5 minutes and administered while patients are under general anesthesia and muscle relaxants, resulting in some of the fastest-acting psychiatric treatment for certain conditions, with minimal side effects. Dr. Lopez hopes that as ECT becomes increasingly destigmatized and sees continued treatment success, there will be more access across the country to this transformative and life-saving therapy.

Chapters:

[00:00 – 5:12] Efficacy of Electroconvulsive Therapy

Dr. Leonardo Lopez describes a potentially fatal syndrome called catatonia and the remarkable results of electroconvulsive therapy (ECT) in catatonia and other psychiatric conditions.

[5:12 – 10:17] Electroconvulsive Therapy to Treat Severe Catatonia

Dr. Lopez recounts a recent case of a pediatric patient with catatonia whose syndrome resolved completely after receiving electroconvulsive therapy (ECT), and why ECT should not be considered a treatment of last resort.

[10:17 - 13:05] Destigmatizing the Treatment

Dr. Lopez talks about how ECT has been stigmatized by media portrayals despite modern advancements in application.

[13:05 - 15:26] Expanding Access to ECT

Dr. Lopez shares his role in developing NewYork-Presbyterian’s ECT program and his hopes for increased access in the future.

[15:26 – 15:55] Credits

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Dr. Leonardo Lopez is a psychiatrist and clinical leader who serves as Vice Chair for Inpatient Services in the Department of Psychiatry at Weill Cornell Medicine. In this role, he partners closely with leadership at NewYork-Presbyterian to oversee the development, implementation, and ongoing management of inpatient psychiatry services, including electroconvulsive therapy (ECT), across multiple sites, including Weill Cornell Medical Center, Westchester Behavioral Health, and Brooklyn Methodist Hospital, while also collaborating with Gracie Square Hospital to integrate clinical services and advance system-wide behavioral health policies and practices. In these roles, he oversees large-scale inpatient services caring for New York’s most vulnerable populations, including specialized units for co-occurring disorders and patients in Department of Corrections custody, while also expanding access to advanced treatments like ECT and intravenous ketamine for treatment-resistant depression and other disorders.

For more information visit nyp.org/Advances

On this episode of Advances in Care, Dr. Steven Lobritto, pediatric medical director for liver transplant at NewYork-Presbyterian and Columbia, joins host Erin Welsh to tell the story of a high-risk pediatric liver transplant that he and his team performed to save the life of a two month old baby, after the center where the baby was originally treated deemed her inoperable.

Dr. Lobritto describes how NewYork-Presbyterian and Columbia has been building their liver transplant center since 1998, allowing them to push forward innovative, and life-saving, surgical strategies, like living donor and partial liver transplants, in order to increase the odds of survival for pediatric patients on the organ waitlist.

Children under one year of age have the highest mortality rates while waiting for a transplantable organ. In the case of this infant, the optimal treatment required surgical expertise in partial liver transplant due to her uniquely small size. Dr. Lobritto explains how he and his team coordinated with the patient’s initial care team across the country to prepare the critically ill, 11-pound baby to fly to New York, and the intricacies of the surgical procedure.

Dr. Lobritto also explains his involvement with the STARZL Network, a consortium of hospitals that share protocols, best practices, and learnings to address knowledge and training gaps in pediatric organ transplantation. He advocates for partial liver transplantation to be universally taught as a requirement of surgical training, to increase access to organs and save the lives of more young patients.

Chapters:

[00:00 - 5:58] NewYork-Presbyterian and Columbia’s Liver Transplant Center

Dr. Lobritto describes the strengths of the NewYork-Presbyterian and Columbia Liver Transplant Center, including the cutting edge techniques that allowed them to coordinate a partial liver transplant in a critically ill baby.

[5:58 - 8:12] A Specialized Transport to New York

Dr. Lobritto outlines the challenges of transporting the baby, who needed a mobile ICU team for life-support to travel to New York City.

[8:12 - 12:50] Multidisciplinary Collaboration

Dr. Lobritto shares the considerations that went into preparing for the baby’s complex surgery and how they adapted care when a complication arose.

[12:10 - 14:41] The STARZL Network

Dr. Lobritto discusses his work with the STARZL Network, which strives to increase access to pediatric organ transplant.

[14:41 - 15: 31] Credits

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Dr. Steven Lobritto is a distinguished pediatric gastroenterologist and a professor of pediatrics and medicine at Columbia University Irving Medical Center (CUIMC). He has been instrumental in the development of the Pediatric Liver Transplantation Program at NewYork-Presbyterian/Columbia and is the Medical Director of the program. Dr. Lobritto has trained many leading physicians in transplant hepatology and has contributed significantly to pediatric liver transplantation through his research and clinical care. His expertise in pediatric gastroenterology and liver transplantation has made him a respected figure in the medical community.

For more information visit nyp.org/Advances