When asked about the ingredients that makes Hadassah Medical Center’s Oncology Department one of the best in the world, Hadassah Director General Prof. Yoram Weiss points first to the staff.
“Our priority is having the best clinicians, the best researchers and the best educators, which informs our financial decisions. This was true in the past, it is true in the present and from what I see, it will also be true in the future,” said Weiss.
Recently, Newsweek featured Hadassah’s Sharett Institute of Oncology among the best medical centers in the world – the only medical center in Israel that made it into their ranking.
According to Weiss, Hadassah’s achievements in the field perfectly embody Hadassah’s approach, combining medical care and research.
In order to maximize the potential offered by new technologies and Israeli innovation, Hadassah has also created tools to bridge the gap between physicians as well as between researchers and industry.
“Some 25 years ago, we established a tech transfer company which takes care of the treatments developed at Hadassah, and also deals with companies that come to us in order to try and advance their products,” Weiss said. “We have also developed an incubator, where we provide start-ups with access to the services and infrastructure that a hospital like ours can offer.”
The strong connection between the hospital, the Hebrew University of Jerusalem, and industry is crucial also according to Prof. Aron Popovtzer, director of the Sharett Institute of Oncology. To link the three, the Sharett Institute established the Hadassah Cancer Research Institute.
“This connection is what allows us to offer treatments that are not available in the vast majority of hospitals around the world, and definitely not in Israel,” he said.
“For example, we have established a Proton Center, the first in the Middle East, in cooperation with a start-up called P-Cure,” he added.
Regular radiation works through particles known as photons, he explained. A treatment based on photons is very powerful in curing the disease but at the same time causes many unwanted side effects because the radiation beam is not precise enough to target only the disease and not the healthy tissues.
“Protons work in a different way, thanks to a specific feature that they present called ‘Bragg peak’,” Popovtzer said. “This property allows the radiation beam to stop abruptly after it reaches its target, which means significantly limiting the toxicity of the treatment.”
Protons are particularly important for types of tumors where the impact on the areas surrounding the cancerous cells would be especially harmful.
“For example, if a tumor is sitting exactly near a patient’s optic nerve, which is responsible for their sight, a treatment with photons might risk causing the person to become blind, while with protons the problem is solved,” Popovtzer said.
In addition, Hadassah’s Proton Center, which is running several clinical trials sponsored by P-Cure, offers a unique feature: instead of receiving treatment while lying down, the patient sits up and this allows the physicians to angle the radiation beam even more accurately.
The hospital is also working on offering cancer patients the possibility to undergo Alpha radiation, as opposed to regular radiation, in partnership with a company called Alpha Tau.
“Compared to regular radiation through photons, Alpha radiation offers the advantage of being more powerful, but also presents the disadvantage of covering a much smaller area, risking having the tumor grow outside of it,” Popovtzer said.
Hadassah and Alpha Tau have already conducted a successful study using the company’s Alpha radiation technology to treat head, neck and skin cancers with Alpha particles (sponsored by the company itself). They are now working on a new study to use this treatment to target tumors that are not treatable with regular radiation.
“For example, there is a big unmet need to treat pancreas and lung tumors,” Popovtzer said.
Hadassah offers many other innovative projects, including a genomic-testing project, that employs artificial intelligence to identify mutations.
“We check all patients for genomic changes in their tumors, and we use artificial intelligence to identify the best treatment based on the results of these tests, finding answers that are not only relevant for them but also for future patients who might present similar characteristics,” Popovtzer said.
Still another innovation is in the field of immunotherapy.
“Immunotherapy means combatting cancer through the immune system,” explained Prof. Michal Lotem, head of Hadassah’s Center for Melanoma and Cancer Immunotherapy and Hadassah Cancer Research Institute.
“In many cases, cancer marks the failure of a person’s immune system to attack the disease,” she added. “In oncology, a large portion of the treatments that we administer focuses on strengthening the immune system with what we called ‘immune checkpoint inhibitors.”
The US National Cancer Institute describes immune checkpoint inhibitors as “a type of drug that blocks proteins called checkpoints that are made by some types of immune system cells, such as T cells, and some cancer cells.”
These checkpoints help keep immune responses from being too strong but sometimes can keep T cells from killing cancer cells.
According to Lotem, often, with current state-of-the-art treatments, the patient’s immune response remains too weak to be effective against cancer. The new technology developed by Hadassah, therefore, aims at offering patients additional and stronger immune cells grown in the lab.
“We take a sample of white blood cells from the patient’s own blood and we generate a large number of white blood cells,” she said. “Afterwards, by using genetic engineering techniques, we insert into these cells a synthetic gene that allows them to specifically recognize cancer. The process is obviously very complex.”
Among others, the initiative is supported by the Health Ministry. The hospital is already administering this innovative treatment to some cancer patients.
“We are currently giving them increasing dosages of engineered cells each time, and soon we will reach the highest dosage we have planned to try, to verify that the treatment is not only effective against cancer but also safe for healthy tissues,” Lotem said.
Even if the treatment has so far been administered only in lower dosages, physicians are already witnessing delays in the progression of the disease and a decrease in cancer markers in the patients’ blood.
Lotem noted that this technology can help patients whose cancer - no matter which type - expresses the specific protein that allows the engineered cells to target the tumor.
“I believe that in the next few years, we will develop even more types of immunotherapy, which will allow us to target cancers that today are not treated effectively enough,” she said.
The support of Hadassah, in collaboration with Dr. Miriam and Sheldon G. Adelson Medical Research Foundation (AMRF), has been essential for her work, Lotem said,
“Hadassah actively encourages research - which is something that other hospitals do not do,” she said.
“Our cell therapy project is the result of a strong collaboration among physicians at the Sharett Institute, pure researchers in our labs and the Bone Marrow Transplant Department,” she concluded. “It is an institutional project and it shows how many different partners are needed in order for such an ambitious and innovative treatment to be delivered to the patients.”
This article was written in cooperation with Hadassah.