A 1-year-old boy being treated with a novel gene therapy drug. “Usually, this type of injury with a hemophiliac patient would involve hours in the emergency room, with repeated doses of intravenous coagulation factors,” said Prof. Gili Kenet, director of the National Hemophilia Centre at Sheba Medical Centre. (photo from IMP)
From wearables that allow cardiac specialists at a hospital in Ramat Gan to monitor a patient’s cardiac performance thousands of miles away from home, to giving gravely ill patients a new lease on life with groundbreaking new therapies, Israeli medical innovators are almost literally thumbing their noses at the Angel of Death and changing the way we live.
According to start-up “ecosystem” sources, there are at least 6,000 active start-up companies operating in Israel. Within the realm of digital health, the number of active start-up companies engaged in this field has grown from 65 companies in 2005 to more than 400 in 2018. A significant number of these start-ups are being financially supported by global corporations such as Philips, GE Healthcare, Merck and IBM. Some of these companies have opened up offices close to start-up hubs in Haifa (near the Technion) and Metro Tel Aviv, the recognized “capital” of Israeli business and high-tech.
“Israel serves as a global incubator of innovative ideas for a variety of reasons,” said Dr. Eyal Zimlichman, deputy director general, chief medical officer and chief innovation officer at Sheba Medical Centre, which is located in Ramat Gan and is the largest facility of its kind in the Middle East. “First of all, it’s in our genes. Secondly, there is the military aspect, where we are taught to improvise when necessary in the field. These things allow us to be naturally innovative. This has trickled down into the medical field, where we are offering the highest level of medical care. I also believe unique innovations in medicine, that will impact the world for the next 100 years, will be developed in Israel.”
Prime examples of Sheba Medical Centre’s innovative efforts revolve around combating potentially fatal diseases such as cancer with immunotherapy, oncology’s new medical “magic bullet”; targeting hemophilia with a novel gene therapy drug; and creating an app for a wearable device used by people with serious heart and diabetes issues.
Immunotherapy is a treatment that uses our body’s own immune system to invade and destroy cancer. CAR-T (chimeric antigen receptor) and TIL (tumour-infiltrating lymphocytes) are not universal cancer cures at this stage. However, there are ongoing clinical trials being conducted for major pharmaceutical companies and America’s National Institutes of Health at Sheba Medical Centre’s oncology unit, where end-stage cancer patients are being treated with CAR-T, which specifically targets leukemia and lymphoma, and TIL, which zeroes in on melanoma and ovarian cancer patients.
Seventeen people with cancer were treated at Sheba during an initial CAR-T trial, after all of these patients had displayed zero improvement in the wake of traditional chemotherapy treatments and bone marrow transplants. Of the 17, 75% had a complete response to the CAR-T. One of those patients, an 8-year-old girl from Bnei Brak, was the first child to achieve complete remission from childhood leukemia. A Sheba centre oncologist said, “When we came to give her the CAR-T cells, she was very, very sick. She couldn’t even get out of bed. When we came back to visit her three weeks later, she was going back and forth on her rollerblades.”
A few weeks ago, a 1-year-old boy became the youngest patient in the world suffering from both severe hemophilia A and an unusual allergy to be treated with a gene therapy drug that only recently was approved for use in the United States. The new drug, developed by an American biopharmaceutical company, contained a “bispecific antibody” that was injected into the child at Sheba Medical Centre. According to clinical trial results published in The New England Journal of Medicine, the drug has shown a 90% reduction in bleeding in children and a 70% reduction in adults.
“This is a new, exciting era with many novel options for improved care and even complete cure of patients with hemophilia,” said Prof. Gili Kenet, director of the National Hemophilia Centre at Sheba. “The child’s mother is so happy with the new treatment. The child had experienced a head trauma, but required no further therapy at all. Usually, this type of injury with a hemophiliac patient would involve hours in the emergency room, with repeated doses of intravenous coagulation factors. However, there were no complications, as his hemostasis (blood factors) was completely normal.”
Within the realm of what is known as IoT (internet of things), Prof. Robert Klempfner is blazing a trail of what he has dubbed IoMT (internet of medical things), where heart patients are able to engage in cardiac care and rehabilitation using wearables (for example, a high-tech watch), without having to return to the hospital for treatment.
“Today, the challenge for both heart doctors and cardiac care patients is what happens after a coronary event (heart attack), intervention or heart surgery,” said Klempfner. “What kind of regimen can be created for someone who might have had surgery at Sheba but lives and works in faraway places such as the United States or other countries? Within the new world of telemedicine and digital health, we have the technology to create rehab programs that are a win-win experience for both the hospital and the patient.
“We give cardiac care patients a watch,” he explained, “that is equipped with an app developed by the Sheba medical team and Datos Health [an Israeli start-up company]. The app contains a care path specially designed for each patient, containing rehab regimens, education material and secure communication with our patients. The medical centre receives data from wherever he/she is located when they are walking, exercising, doing other physical activities. Our technicians then analyze the info and provide ongoing feedback, assisted by smart algorithms provided by the innovative system.
“The program is also primed,” he said, “for patients who suffer from hypertension and diabetes that are now able to transmit all their measurements automatically to our system. This not only saves the patient time, by not having him/her return to the hospital, it saves the hospital time and bed space, so we are able to treat more patients. This ushers in a new era in digital healthcare.”