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Creativity, Collaboration
& Community

Chapter 1

A Time of Impact

Chapter 2

Cancer & COVID-19

Chapter 3

Investing in Innovation

Chapter 4

Immunotherapy:
The Future of Medicine

Chapter 5

Reducing Disparities and Promoting Equity

Chapter 6

Abramson Cancer Center’s Cancer System

Chapter 7

Philanthropy:
Energizing Our Mission

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Chapters

Chapter 2

Cancer & COVID-19

The Abramson Cancer Center played a major role in generating solutions to address the COVID-19 pandemic, from vaccine development to understanding the role of our immune system. The deep immuno-profiling work conducted by our investigators is improving patient outcomes in ways that will have an impact now and into the future.

The center’s staff nimbly enacted innovative programs and randomized clinical trials to discover and provide lifesaving care to cancer patients across the healthcare system throughout the pandemic. All the while, these dedicated teams have continued to build their understanding of the most effective ways to keep patients and their families safe.

A masked medical worker sits across from a masked patient in a healthcare setting, preparing to administer an IV.

Cancer Care Adjusts to COVID

A red arrow pointing to the right

When the world came to a standstill in March 2020, Abramson Cancer Center staff knew they would need to find ways to continue serving their patients amid the pandemic. Fortunately, the cancer center had been piloting innovative care models on a small scale prior to the COVID-19 crisis, and was uniquely equipped to adapt to the new environment. Staff quickly scaled up these efforts to meet patient and community needs.

  • Telemedicine: Whenever possible, Abramson Cancer Center providers conducted patient visits using telehealth technology. Many appointments that did not require a physical exam or treatment that could only be administered at the center were conducted over phone or video.
  • Cancer Care @ Home: This program increased its patient load by 700% in the early days of the pandemic. Cancer Care @ Home allows patients to receive injections and infusions from credentialed nurses without having to travel to the center.
  • Neoadjuvant (pre-surgery) Therapy: In some cases, Abramson Cancer Center physicians had to rethink treatment plans when surgery was not an immediate option. They worked together to determine how long certain cancer patients could postpone surgery, if needed — and what treatments to provide in the interim.
  • Immunologists Pivot: Cancer patients were among the cohorts of patients being monitored for their immune response to COVID-19 vaccination and treatment. Immune profiling work continues to help us better prepare for the future and save lives.

Genetic Counseling
Embraces Telemedicine

Genetic counseling and testing could not be conducted in person for much of 2020. Yet, in cancer, genetic counseling is an integral part of healthcare — both for cancer patients and for those at high risk because genetic testing can aid in the prevention, early detection and treatment of hereditary cancers. In fact, through genetic testing, physicians can identify specific gene mutations that can help them determine which type of treatment is most likely to be successful. This is essential to our patients and families.

That’s why our genetic counseling teams quickly transitioned to telehealth just a few weeks after the start of the pandemic. In fact, these changes helped the Basser Center for BRCA reach 25% more people in 2020 than in 2019.

Turning to Technology

Telehealth, the use of technology to provide healthcare across any distance, is not new, and the pandemic certainly hastened its adoption by healthcare providers and patients alike. Though it took some adjustment, telehealth visits have become a smooth and reliable way to provide genetic counseling services. In the early weeks of the pandemic, clinicians and patients worked together to adapt, learning the technology and platforms required to make telehealth successful.

Prior to their appointments, patients receive an electronic questionnaire to complete that asks about their health and family histories — a practice that has been in place for several years. Genetic counselors can access this information via a HIPAA-compliant virtual private network. Additional records can be uploaded into patient portals, by email or by fax.

The nuts and bolts of what genetic counselors do-review each patient’s medical and family histories and personal risk assessments, facilitate genetic testing and counsel patients on their options — can be done via telehealth. If genetic testing is ordered, the patient can often provide a saliva sample via a laboratory mail-in test kit. Occasionally, patients are referred for in-person blood draws. Test results are then delivered over the phone, and patients can schedule a virtual follow-up consultation with a physician for further review and medical care recommendations, if desired.

Telehealth Is Here to Stay

While in-person visits have since resumed, some patients continue to opt for telehealth visits for genetic counseling for safety and convenience. For many patients, telehealth means not having to take time off work or arrange for transportation to and from an appointment.

The pandemic forced the proliferation of telehealth in many specialties but, in genetic counseling, this easy way of connecting with patients is undoubtedly here to stay. It is our hope that we will continue finding new uses for telehealth — such as enabling greater access to clinical trials — so all patients, no matter their location or ability to travel, can get the care they need.

Lisa Oney stands in her kitchen, holding her baby and talking with her young daughter. She wears a mask over her mouth and a backpack, which has a pump attached to it.

At Home Care

COVID-19 Propels
Cancer Care @ Home Program

A red arrow pointing to the right

A year before the pandemic, Stat published an article, senior-authored by Penn Center for Cancer Care Innovation (PC3I) Director Justin E. Bekelman, MD, titled "Cancer treatment at home is safe, effective and closer to happening than you think."

Even Dr. Bekelman had no idea just how close that would be.

Successful models for home infusion of cancer drugs existed internationally before COVID-19 — and the building blocks were in place at Penn Medicine. Yet, at the time, the at-home administration of cancer drugs was nearly unheard of in the United States. But in November 2019, under PC3I’s direction, Penn Medicine began planning for the Cancer Care @ Home program. Shortly after its launch in February 2020, the program’s value was made extraordinarily clear by the emergence of COVID-19. Suddenly, home care was needed, especially for immunocompromised cancer patients. Together with Penn Home Infusion, Dr. Bekelman and his staff implemented the program in three distinct ways:

  • They empowered a cross-functional team from the Abramson Cancer Center, Penn Home Infusion Therapy, and the Hospital of the University of Pennsylvania, to make change.
  • They reimagined the status quo, not allowing "the way it’s been done" to hold them back.
  • They selected appropriate treatments and patient populations to match the safety and quality of infusions in the clinic.

"Many cancer patients continue to need ongoing monthly therapies, sometimes for six to 10 years — a significant burden that often means taking time off from work," Dr. Bekelman explains. "Now, some can receive their therapies in their home at their convenience."

Lisa Oney (pictured above), 34, is one such patient. A backpack carries her chemotherapy medicine, and with the aid of a pump, she receives treatment while on the go and tending to her two small children. Traditionally, the lymphoma she has would have required days-long hospital stays every month for over a period of six months, which would have been extremely challenging for her and her family. But, with the Cancer Care @ Home program, she is able to live her daily life.

"I’m able to walk around, and take care of my kids," she told The Philadelphia Inquirer last year. "I can go places."

Speeding Up Operations

In the early days of the pandemic, patients across the country were forced to put off cancer treatment due to the dangers posed by COVID-19, delaying potentially lifesaving medicine. So, Penn Medicine accelerated the Cancer Care @ Home program and focused on helping immunocompromised patients continue their treatment from home. This, in turn, benefitted everybody — as it allowed patients not eligible for at-home treatment to get their treatments at Abramson Cancer Center in a less crowded infusion space.

Headshot of Dr. Justin E. Bekelman.

"Patients tell us how much this program has helped them handle their cancer treatments and focus on healing,"

Justin E. Bekelman, MD, Director, Penn Center for Cancer Care Innovation (PC3I)

Across the health system, doctors, nurses, pharmacists and innovators came together to effect change. The planning, innovation and stakeholder engagement invested in the program’s introductory phase allowed Cancer Care @ Home the flexibility to quickly scale up. In the seven-week period from late March to mid-April 2020, the Cancer Care @ Home program saw a nearly 800% increase in home infusion referrals, from 39 to 310 patients. Today, about 3,000 patients with cancer receive treatments at home annually at Penn Medicine.

What’s to Come

As Dr. Bekelman says, "Cancer care at home is here to stay." The program is now standard of care at Penn Medicine in certain situations and is growing in popularity across the United States.

There will be challenges ahead, of course. While the goal of the program is not to transfer all cancer care to the home setting, broader availability of cancer treatment at home would reshape the way health systems and insurance companies think about the cost and delivery of care.

"Patients tell us how much this program has helped them handle their cancer treatments and focus on healing," Dr. Bekelman says. "Penn’s Cancer Care @ Home program is a leading indicator of how health care innovation can transform cancer care in ways we never thought possible."

See How Abramson Cancer Center Reimagined Cancer Care

Lindsay Roberts, her fiance Ben and two children stand together and posed before a stopped train on a train track.

Patient Story

Finding Joy and Power
in the Unexpected

In August 2018, 36-year-old Lindsay Roberts’ life was full, happy and "normal."

Lindsay and her fiancé, Ben, were parents to a healthy 18-month-old daughter, Simone, with whom they had just returned home from a family trip to Europe. Lindsay was enjoying planning her fall wedding to Ben and refurbishing their new 150-year-old Germantown home, all the while preparing to return to the work she loved — being a preschool teacher.

Their lives became even happier when Lindsay learned she was pregnant with their second child, but everything changed a few weeks later when she suffered a seizure and was found unconscious in her car. After being rushed to a nearby hospital and enduring weeks of agonizing unknowns, a scan revealed Lindsay had an oligodendroglioma tumor: a slow-growing type of brain cancer that required extensive treatment.

Brain tumors are complex-as is undergoing cancer treatment while pregnant. Fortunately, Lindsay sought care at Penn’s Abramson Cancer Center, where she met with world-renowned neurosurgeon Donald M. O’Rourke, MD.

"From the moment I came to Penn, Dr. O’Rouke helped me gain control and feel safe," Lindsay recalls. "He said to me, ‘I’m going to get you through this. We can keep your baby safe and get you well. It’s going to be a tough few years, but we’ll be there the whole way.’"

And Dr. O’Rourke — as well as Lindsay’s entire care team — was indeed with her and her family throughout their entire ordeal.

"What got us through was that the team paid so much attention to me," Lindsay says. "I felt like they were my doctors, from the beginning. I just felt incredibly comfortable and confident with them."

"Dr. O’Rouke said to me, ‘I’m going to get you through this. We can keep your baby safe and get you well.’"

- Lindsay Roberts

Lindsay and her newborn baby snuggling with her just after birth.

A New Plan

Dr. O’Rourke, along with medical oncologist Arati S. Desai, MD, radiation oncologist Robert A. Lustig, MD, and specialists in Maternal Fetal Medicine, worked together to devise a plan that would see Lindsay through a healthy pregnancy and then surgically remove her tumor, following up with six weeks of radiation and eight rounds of chemotherapy.

"The Maternal Fetal Medicine team’s phenomenal care helped me begin to relish my pregnancy and envision my family’s future in a way I hadn’t been able to before," Lindsay says. "My fears of cancer were still there — for sure — but the way we were cared for made a big difference."

In 2019, Lindsay, Ben and Simone welcomed Isaac "Ziggy" Johnson to the family. Under the watchful care of OB/GYN Adi Hirshberg, MD, Ziggy came into the world healthy and strong. Lindsay’s care team allowed as much time as possible for her to take in these beautiful early moments as a mother of two — to have an opportunity to breastfeed, to be present with her family. Six weeks after Ziggy’s arrival, Dr. O’Rourke and his team performed brain surgery on Lindsay. Dr. O’Rourke opted for an awake craniotomy (during which the patient is in a twilight state of consciousness) to remove the tumor while being careful to preserve Lindsay’s speech.

"And while that surgery was the first step of fighting my illness, I am indebted to Dr. O’Rourke and his team, and to Drs. Desai and Lustig, for making me feel like my cancer was not the end of my world," she says. "I love being a preschool teacher, so imagining a world where I might not be able to communicate in the same way was terrifying. My team made sure I didn’t have to miss out on any of those precious moments."

Carrying Hope Forward

After healing from her surgery, Lindsay began radiation with Dr. Lustig and chemotherapy under the guidance of Dr. Desai, who had been with her and her family through every stage of her cancer from her initial diagnosis to this critical stage of treatment.

"Every time we met with Dr. Desai, it was a breath of fresh air," Lindsey says. "She figured out how to make my chemo easier, because what was so important was to return to some semblance of normalcy. I had a newborn, a toddler, a fiancé and all my preschool students. I love my life and what I do. I didn’t want this cancer to stop me. So, thanks to Dr. Desai, I worked through my pregnancy, I worked through radiation, through chemo and through the pandemic."

Today, Lindsay’s cancer is in remission, and she is settling into her new life.

"Looking back throughout this incredibly difficult journey, I always felt hopeful. I held so much hope and positivity because of my doctors and Penn Medicine. I’m carrying that hope forward — it’s coming with me wherever I go, no matter what."

Chapter 3

Investing in Innovation

We are proud to have passionate scientists of every career stage dedicated to collaboration and research. Together with philanthropic and industry partners who support their vital work, we have the expertise and potential to change the world.

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