The discovery and development of treatments for new diseases have traditionally occurred in academic settings or research departments of pharmaceutical or biomedical companies. While this approach to creating new therapies still exists, the scientists and team members at Hackensack Meridian Health’s Center for Discovery and Innovation (CDI) are adding a valuable twist to the traditional—moving research closer to the patients that it will ultimately help.

“One of the unique features of health network-based research is the perspective that includes not only the science but also the pragmatic issues facing health care and the economics of health care,” says Sol J. Barer, Ph.D., chairman of the CDI Board of Directors. “This perspective is invalu­able in developing new therapies and approaches to diagnosing and treating diseases with therapies that not only work in controlled conditions but also in real-life patient care.”

The CDI offers leading scientists and health researchers an opportunity to advance their work and enable Hackensack Meridian Health and its hospitals to better serve their communities, says Robert C. Garrett, CEO of Hackensack Meridian Health. “This helps us achieve something that has been elusive, curing significant numbers of patients.’’

The CDI is comprised of three institutes that focus on developing strategies to detect, prevent or treat:

Cancer and infectious diseases involving numerous cancer cell types and infections due to weakened immunity

Multiple myeloma, which is a specific cancer of plasma cells that are found in bone marrow and make up an important part of the immune system

Regenerative medicine solutions that can heal damaged tissues and organs that cannot be treated with current therapies

“This is a phenomenal time in science with tremendous opportunities for innovation,” says David S. Perlin, Ph.D., chief scientific officer and senior vice president of the CDI. “Years ago, patients had to tolerate therapies with serious side effects and low success rates. But today, innova­tions have made some diseases that used to be untreatable, such as melanoma, curable.”

Specific projects underway at the CDI include:

Understanding genetics and epigenetics. “Most people are familiar with genetics due to the popularity of family history-related products. But understanding how genes affect a person’s health can lead to specific therapies for an individual’s illness,” Dr. Perlin says. “Epigenetics is simply the study of the biological mechanisms that switch genes on and off, which can influence the development and progression of a disease, and its response to therapy.”

“A person may have a gene that can cause disease but never does. We want to find out what affects that gene—why does it lead to disease in some people and not in others?” Finding the answer to that question will help scientists and physicians better detect, prevent and treat disease, he adds.

Improving drug therapies. Effective treatment of an infection requires that a drug gets to the source of the disease, but this is often not the case. “One investigator is developing technology that will allow us to see if the drug gets to the right site and at the proper dosage level needed to effectively treat the infection. This will allow us to improve response to therapy,” Dr. Perlin says.

Every person can react differently to a medication for reasons that include the speed that the body metabolizes or absorbs the drug and different rates of blood flow to the infection site. So it is not easy to determine how much medication actually reaches the infection site, he explains. “The risks when the drug does not reach the infection with the most effective dose include poor response to the therapy and development of a resistance to the medication,” he adds.

Creating new classes of antibiotics. “There are 2 million drug-resistant infections, which are especially dangerous to patients with weak­ened immune systems, such as cancer patients,” says Dr. Perlin. “CDI scientists are working on the next generation of antibiotics that can treat these infections that current antibiotics cannot.”

The antibiotic research is approaching the point at which researchers can apply for Federal Drug Administration permission to begin a clinical trial of the new medication, says Dr. Perlin. Clinical trials are the first steps to testing a new therapy in people to determine effectiveness and safety before making it available to all patients. Trials are closely monitored by researchers and clinicians to identify benefits and side effects, and ensure the safety of people who choose to participate.

Using stem cells to repair the body system. One CDI laboratory envisions the use of endothelial stem cells found in the bone marrow to rebuild the hematopoietic system—the part of the bone that forms new blood cells—that is often destroyed by various blood diseases, injuries, aging and radiation. “Researchers are already testing their findings in this application in clinical trials,” says Dr. Perlin.

The potential use of stem cells in other applications includes regenerating damaged organs in other parts of the body, which can help people with a variety of diseases that require life-long medication therapies, potentially heal completely and eliminate the need for medication, he adds.

Modifying T cells to attack cancer cells. CAR T-cell therapy is a type of treatment that “reprograms” a patient’s T cells, a type of immune system cell, to attack cancer cells in the patient’s body. “Using a patient’s own cells to treat cancer is an important component of a number of new cancer therapies,” explains Dr. Perlin.

Setting up a center that focuses on developing lead­ing-edge therapies that will help patients recover from diseases that may not be curable today is a significant investment in time and resources. But the effort is vital, says Andrew L. Pecora, M.D., FACP, CPE, president physician enterprise and chief innovation officer. “Health care is undergoing a massive transfor­mation, and it is critical that health care providers be involved in solving tomorrow’s medical challenges.”

The CDI is not just about making new discoveries, points out Dr. Pecora. “The center focuses on innovation, but we also want to bring value to our patients by finding new therapies that improve outcomes, reduce costs and improve comfort of patients by moving more treatments from inpatient hospital settings to outpatient settings that allow people to recover at home.”

The relationship between the CDI and the hospitals in the Hackensack Meridian Health network is a real benefit to research, says Dr. Pecora. “Our patients are with us throughout diagnosis, treatment, recovery and follow-up, so physicians can share observations in real-time or researchers can see data on one patient that covers a long time. This provides much more information than with patients who fly in for treatment, then return home to another state,” he says.

Dr. Barer agrees that researchers can be more effective when working with clinicians caring for patients. “Individual researchers in academia and pharma generally work in isolation from the pragmatic aspects of health care,” he explains. “They are wonderful in developing the science but often miss key aspects in the application to real-world situations and unknown side effects.”

He adds, “CDI will impact New Jersey in many ways that include the development of new science and technology, the development of new therapeutics and diagnostics, the economic benefits of new companies in New Jersey, and the general well-being of the people of New Jersey and the world.”

Learn more about the work of the Center for Discovery and Innovation.