Chief of the Division of Hematology, Oncology and Blood and Marrow Transplant at Nationwide Children’s Hospital
Dr. Timothy P. Cripe
“I chose pediatric cancer because I love children and they always inspire me”
During Arab Health Show 2019, “Hospitals” magazine had the chance to interview Dr. Timothy Cripe, chief of division of Hematology, Oncology and BMT at Nationwide Children’s Hospital. Nationwide Children’s Hospital is ranked one of America’s Best Children’s Hospitals in the country by U.S. News & World Report and treats patients with the rarest cancers and blood disorders across the country and around the world. We discussed the latest treatments and what matters most when a child is in need of life-saving care.
Can you tell us more about your background? And why you chose pediatric cancer?
I received my undergraduate degree in Biochemistry from Princeton University, and my M.D. and Ph.D. in genetics from the University of Iowa.
I entered this field because I love kids and I don’t like seeing people suffer. The reason I chose pediatrics is because children are innocent and helpless and they get sick by chance, it is not like they lived a long unhealthy life and brought it upon themselves. Most of us think that when you deal with children with illnesses you will get depressed, but I find myself inspired by them every day. They tolerate treatments better than adults and for the most part have a positive attitude towards life and conquering their disease. I always find myself wanting to help them feel better, but even though we have had great success in children cancers especially leukemia, we still have a long way to go. In fact, brain cancers have taken over as the most common cause of death due to disease in childhood. As a scientist I find this very challenging yet I’m hopeful for the future.
Why do children get cancer? What are the risk factors and causes?
The good news is that childhood cancer makes up only around 1% of all the cancers diagnosed each year. But we really don’t know why they get cancer and the way to prevent it.
As we know most adult cancer is age-related, being much more frequent in older persons. With age, the adult cells and the mechanisms that the body uses to fight cancer cells deteriorate, and could be exposed throughout the life stages of an individual to toxins due to smoking, unhealthy lifestyle or environmental factors. On the other hand, childhood cancers are different from those seen in adults and we now know from all the genetic studies done previously that perhaps up to 30% of the cases are due to some combination of inherited genetic predispositions. A strong family history of cancer may increase a child’s risk of cancer.
What are the services that you offer in your department?
We offer advanced treatments for children with any type of cancer even the rarest ones. We also treat patients with benign tumors and all types of blood diseases. We perform blood and marrow transplantation and both T and NK cell-based cellular therapies. We deliver something called MIBG for patients with neuroblastoma, which requires a lead-lined hospital room. We offer genomic evaluation of a patient’s cancer cells. And we have one of the best, comprehensive, multidisciplinary pediatric brain tumor teams who offer the most advanced treatments to give the children the best outcome possible.
Our mission is to offer the child the best treatments that exist and we also offer guidance to the family to be able to cope with the situation socially, emotionally and psychologically. We also do a great deal of research both in the laboratory and in the clinic to help discover treatments of the future.
What are the latest treatments in pediatric cancer?
The latest, most exciting development is CAR T-cell treatment that was FDA approved for a certain type of leukemia, B cell lymphoblastic leukemia. The treatment consists of taking the patient’s own immune T cells, i.e. the infection fighting cells, which are genetically modified and put back into the patient to fight the cancer cells. And the results have been nothing short of stunning.
I used to sit at the bedside of a leukemia patient and tell him we have nothing more for you, but now 80% of the patients in that situation benefit from this new treatment.
I think immunotherapy is transforming the way we look at cancer, but more research is needed in this field to determine which patient will respond to a given therapy. We think a big benefit of immunotherapy resides in fewer long-term side effects compared to traditional treatments like chemotherapy and radiation.
Genomics is another huge field that is now enabling us to identify key molecular drivers of an individual’s cancer and can help guide the selection of personalized, so-called targeted, therapies. Definitely, we are on the cusp of a new generation of cellular and targeted therapies for pediatric cancer that will allow us to decrease the side effects of chemotherapy with a better treatment outcome.
Can you describe for us the vision of Nationwide Children’s Hospital?
Our vision is to be a world leader in providing access to the most innovative treatments not only for children with cancer and blood diseases but for those with any other disease. We have been able to grow in size and scope tremendously and create a research institute, where we collect information about diseases, test new therapies and bring them to our patients. One of the biggest challenges we faced was creating the infrastructure such recruiting talented scientists and clinical trialists, establishing a large staff with experience in conducting clinical trials, as well as building things like a manufacturing facility to produce the therapeutics. Over the last few years we have put all of these in place. We are committed to providing the highest quality of treatments and delivering the best healthcare services to all children. We always try to seek new innovations to improve the lives of children and their families.
To learn more about Nationwide Children’s Hospital and Dr. Cripe, please visit NationwideChildrens.org/Hematology-Oncology-BMT