Life-saving CHOP Pediatric Oncologist Named Citizen Diplomat

Children’s Hospital of Philadelphia pediatric oncologist Dr. Stephan Grupp’s life-saving T-cell therapy for patients battling leukemia took his 7-year-old patient, Emily Whitehead, from relapse to remission in 2012. In the six years since, Dr. Grupp has traveled to various medical sites and hospitals around the world to educate doctors and researchers about CAR T-cell therapy, the first-ever FDA approved personalized, cellular gene therapy for advanced B cell leukemias in children and young adults.

Dr. Grupp, in collaboration with Penn’s Perelman School of Medicine and Novartis, led global clinical trials of a cancer immunotherapy called ‘CAR T-cell therapy’ for children with a type of leukemia not responding to treatment. His research and sharing of knowledge with doctors around the world helped propel FDA approval of Dr. Grupp’s chimeric antigen receptor (CAR) T-cell therapy in 2017, and, in doing so, enabled patients access to a medical breakthrough that Dr. Grupp and a team of researchers from University of Pennsylvania developed in the City of Brotherly Love.

Nonprofit organization Citizen Diplomacy International will recognize Dr. Grupp, MD, PhD director of the Cancer Immunotherapy Frontier Program, and chief of the Section of Cell Therapy and Transplant at Children’s Hospital of Philadelphia as its Citizen Diplomat during the organization’s second annual Citizen Soiree on June 7.

Siobhan Lyons, Citizen Diplomacy International of Philadelphia President and CEO, said Dr. Grupp was selected as this year’s honoree because of his efforts to “change the world” through new medical breakthroughs.

“Philadelphia has been the birthplace of many great inventions,” Lyons said, adding that Dr. Grupp’s understanding of international affairs helped him to stand out. “Dr. Grupp is a world leader in high-tech medical breakthroughs and innovation in the life sciences, one of the most important and growing sectors in Philadelphia.”

Beyond recognizing Dr. Grupp, Citizen Diplomacy stands behind his mission to provide cutting-edge cancer treatment to people all around the world.

“We’re very interested in adapting this to other kinds of cancer,” Dr. Grupp said. “The question is, can you take this outside of blood cancer and can you make it work for solid cancer? Right now, there’s no equivalent cell therapy approach.”

Research had begun on what Dr. Grupp deems a “brand-new class of treatment” in 2000. By 2011 three adult patients had undergone clinical trials with positive outcomes, paving the way for Emily’s clinical trial. Six years after the first patient was enrolled, the drug was commercially approved.

“It’s unbelievably fast,” Dr. Grupp said of the process.

Since Emily’s treatment and subsequent remission, Dr. Grupp has treated more than 200 other patients whose leukemia is resistant to chemotherapy with what he calls a “new standard of care.”

Novartis, the drug manufacturer that makes Kymriah, the CAR T-cell therapy, is researching to determine how to target hematologic malignancies and solid tumors.

"We are so proud to be part of this historic moment in cancer treatment and are deeply grateful to our researchers, collaborators, and the patients and families who participated in the Kymriah clinical program," Bruno Strigini, CEO of Novartis Oncology, said at the time of the drug’s approval. "As a breakthrough immunocellular therapy for children and young adults who desperately need new options, Kymriah truly embodies our mission to discover new ways to improve patient outcomes and the way cancer is treated."

Strides toward international diplomacy

The Citizens Soiree is a fundraiser for Citizen Diplomacy International. Charitable contributions from the gala, as well as year-round donations, help to fund the organization’s international relations programming.

Lyons said the expansion of the Sister Cities high school student exchange program is the newest fundraising initiative. In 2017, 71 Philadelphia students participated in a 10-day international exchange program as part of Citizen Diplomacy’s Sister Cities program. Philadelphia is linked with 11 Sister Cities, including Torun, Poland and Frankfurt, Germany, offering students a reciprocal opportunity to travel to another country, stay with a host family, attend school and participate in cultural activities during the exchange.

“There’s a real push to grow the high school exchange program,” Lyons said. “If we really want to support leadership development and global thinking in future business leaders, we want to start young.”

The goal is to raise $25,000 from the Citizens Soiree to help support the exchange program, as well as other initiatives, including the International Visitor Leadership Program, the U.S. Department of State’s premier professional exchange program.

In all, 1,211 international visitors from 133 countries took part in Citizen Diplomacy’s 96 programs and delegations in 2017.

“Citizen Diplomacy expands your perspective and viewpoints,” Citizen Diplomacy International of Philadelphia Board member William Daniels said. “In today’s world, it’s easy to reduce things to an ‘either/or’ rather than embracing the ambiguity, which is critical to being an effective citizen. As a Citizen Diplomat, I am an ambassador for the region, whether here or abroad.”

“The international face of cell therapy”

Dr. Grupp, whose parents immigrated to America from Germany and became U.S. citizens, has been involved in international diplomacy as well. While seeking FDA approval of Kymriah, Dr. Grupp traveled abroad, educating and demonstrating to doctors the benefits of the brand-new technology he had helped to develop.

“They were eager to learn about it,” Dr. Grupp said of other pediatric doctors. “The reception was terrific.”

After each presentation, Dr. Grupp said he would often “get pelted with questions,” which he thoroughly enjoyed.

“You get a sense for how they practice medicine,” he said of doctors he met internationally. “The whole experience was exhilarating.”

Citing Dr. Grupp’s work to educate doctors around the world, Lyons said he is “an innovative medical business leader engaged in international diplomacy.”

“Dr. Grupp’s work is an example of how to promote Philadelphia as a leader in science and tech entrepreneurship as well as a prime gateway to the United States,” Lyons said.

Dr. Grupp shared how critical it is to navigate cultural communication differences between countries to successfully share treatment. He recalled how at a meeting in Japan he was reviewing the process. Initially he was pleased the communication was going so smoothly, then it occurred to him and his colleague to circle back and ask about a specific hard-to-get drug that was critical to helping a child if an adverse reaction occurred. They answered no; they did not have that drug. Dr. Grupp realized that lives could be lost if he did not successfully build trust with his peers for honest sharing of knowledge.

The catalyst for the drug’s FDA approval came, in large part, from Emily Whitehead. When Emily came to CHOP in April 2012 following two leukemia relapses, her parents, Tom and Kari Whitehead, sought a new option.

In doing so, Emily became the first pediatric patient in the world to undergo a clinical trial of CAR T-cell therapy. According to CHOP, Emily’s T cells were collected from her blood, then reprogrammed in a lab to recognize and attach to a protein called CD19, which is found only on the surface of B cells. After this re-engineering, cells are called chimeric antigen receptor T cells. When the cells are put back into the patient, they disperse throughout the body to find and kill cancerous B cells.

Unbeknownst to the Whitehead family, 7-year-old Emily would become, as Dr. Grupp puts it, “the international face of cell therapy.”

A cancer journey

Dr. Grupp trained at Harvard, at Boston Children’s and the Dana Farber Cancer Institute, and came to CHOP, relocating to Havertown, in 1996.

He first began working in immunology, noting, “I started with the science and went to the people.”

“I realized what I really wanted to do was study cancer,” Dr. Grupp said. “In terms of the personal interaction with the patients and the families, I thought pediatrics was a great field.”

On a personal level, Dr. Grupp can speak to patients, and their families, from experience, sharing first-hand knowledge of symptom issues or complications. He battled widespread lymphoma in 2008 to 2009, seeking treatment from Penn Medicine.

“I always knew how challenging it could be to navigate the health system in a theoretical way,” Dr. Grupp said, adding that it gave him perspective and causes him to rethink complex medical directives for at-home care. “I had enough experience being at home and requiring nursing care and complicated nursing care.”

If you go

The Citizens Soiree will be held on June 7 from 5:30 p.m. to 9 p.m. at the National Museum of American Jewish History, 101 S. Independence Mall East Floor in Philadelphia. The gala features international cuisine and cocktails and live music, including a performance from the Philadelphia String Quartet. Event proceeds benefit Citizen Diplomacy International of Philadelphia’s international relations programming, primarily the high school student exchange program. A variety of event sponsorships are available as well as standard tickets, which cost $150 each. To purchase a ticket or sponsor the event, visit http://cdiphila.org/soiree. To learn more about Citizen Diplomacy International of Philadelphia, visit http://cdiphila.org/.