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An article for InventUM | Sylvester Comprehensive Cancer Center

READ ON THE MILLER SCHOOL OF MEDICINE WEBSITE

BY ROCHELLE BRODER-SINGER

Spanish-language content for lung cancer patients helps break down barriers to care.

As a physician and a Latina, Estelamari Rodriguez, M.D., M.P.H., has seen firsthand the ways that language barriers often prevent Spanish-speaking patients from receiving optimal care.

Dr. Rodriguez, a bilingual thoracic oncologist at Sylvester Comprehensive Cancer Center, part of UHealth—University of Miami Health System, is breaking down those barriers by creating Spanish-language educational content about lung cancer for patients and caregivers.

Since 2020, Dr. Rodriguez has created Spanish-language video content and seminars for Cancer GRACE (Global Resource for Advancing Cancer Education), a nonprofit patient advocacy organization that offers expert-mediated information on cancer management to empower patients, caregivers and health care professionals to collaborate in cancer care.

She’s covered a wide range of lung cancer topics, including advances in targeted therapies and the newest research on biomarker testing, immunotherapy and emerging therapies. Her goal is to provide information that will help Spanish-speaking lung cancer patients communicate their concerns to health care providers and make better treatment decisions for themselves.

Educate and Empower Cancer Patients

For her work, GRACE honored Dr. Rodriguez with its Patient Educator of the Year award at its annual gathering on May 31 in Chicago.

“It is a great honor to receive this award from the GRACE patient advocacy group,” Dr. Rodriguez said. “Educated patients are the best self-advocates.”

GRACE has presented the Patient Educator of the Year award annually since 2018. It recognizes an oncologist who has gone above and beyond in educating and empowering patients with cancer.

“We chose Dr. Rodriguez because she exemplifies our mission of providing accurate and reliable cancer education to patients and their advocates,” said GRACE Program Manager Maria Christian. “She tries to participate in our recorded video libraries and live events as often as possible. And if she’s unable to work it into her schedule, then she will personally record a presentation on her own time and send it to GRACE for publication.”

A Driving Force in Lung Cancer Treatment

Dr. Rodriguez is a triple board-certified hematologist and oncologist who helped establish the multidisciplinary lung cancer care approach at Sylvester, South Florida’s only National Cancer Institute-designated center. The multidisciplinary approach incorporates clinicians from outside of oncology, creating a team that works with patients from initial screening through diagnosis, treatment and support.

Dr. Rodriguez is also a driving force behind Sylvester’s lung cancer screening program and has a particular interest in treating malignant mesothelioma. Stationed at the Sylvester at Aventura office, she treats patients from both Miami-Dade and Broward counties.

Throughout her career, Dr. Rodriguez has advocated for health equity. She is an active member of the ECOG/ACRIN Cancer Research Group Health Equity Committee and a American Society of Clinical Oncology’s Virtual Diversity Mentoring Program mentor for minority medical students and fellows. Her research has included studying methods to reduce disparities in mesothelioma outcomes related to social determinants of health, such as age, gender, race and income.

The Unique Perspective of a Latina Oncologist

Dr. Rodriguez uses her unique perspective as a Latina physician – only 2.4% of physicians in the U.S. are Latina – to improve outcomes and care for all of her patients.

“I have witnessed in my own family from Puerto Rico and in my medical training how our Spanish-speaking patients and caregivers are sometimes left out of the physician-patient conversation,” she said. “Many patients in our Latinx community are receiving suboptimal care because of lack of access and education about treatment options, risks and benefits and alternative treatments.”

Dr. Rodriguez also noted that caregivers and family members often play an integral role as members of the treatment team for Hispanic patients. She makes an extra effort to speak to them, as well as to patients, in her videos and seminars.

GRACE’s Christian praised Dr. Rodriguez’s understanding of how to communicate to overwhelmed caregivers and patients by being factual, professional and personable. Christian also underscored the importance of Dr. Rodriguez’s Spanish-language material, which, she noted, reaches “a vulnerable population that too often find a lack of materials when searching for information.”

An article for InventUM | University of Miami Miller School of Medicine

BY ROCHELLE BRODER-SINGER

Prurigo Nodularis Treatment Effective in Phase 3 Trial

Shortly after the FDA approved the first systemic therapy for the chronic severe itch of prurigo nodularis (PN), researchers have demonstrated the effectiveness of a second systemic treatment in a phase 3 clinical trial.

Gil Yosipovitch, M.D., professor in the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, led the studies that resulted in FDA approval of the first treatment and was a collaborator on the phase 3 trials for another treatment, nemolizumab.

“Until recently, PN patients – who also tend to have many comorbidities – were a very difficult-to-treat population,” said Dr. Yosipovitch, also Stiefel Chair of Medical Dermatology and director of the Miami Itch Center. “This targeted treatment, which has minimal side effects, should be another excellent treatment for PN patients.”

PN is a chronic inflammatory skin disease characterized by severe itching. Scratching leads to skin nodules across large areas. The intensity and frequency of PN itch is among the worst of all itch-causing diseases. The itching, pain, stinging and burning are so severe patients struggle to sleep and have higher rates of depression and anxiety than people without the disease.

In a phase 3, double-blind, randomized trial, nemolizumab, a monoclonal antibody that targets the Interleukin-31 receptor for the itchy cytokine IL-31, was shown to rapidly reduce itching. It also significantly diminished pain and reduced the number of firm skin nodules for moderate-to-severe PN patients.

Earlier this year, the FDA approved PN’s first systemic therapy, the monoclonal antibody dupilumab, based on trials led by Dr. Yosipovitch. This subsequent phase 3 trial of nemolizumab points toward another potential treatment that can bring substantial relief to patients who did not respond to existing treatments.

Calming the Immune System

Nemolizumab calms key parts of the immune response that play roles in itching and nodule formation. It blocks signaling of the cytokine interleukin-31—coined “the itchy cytokine”—the levels of which are increased in patients with PN.

Interleukin-31 is believed to be a primary culprit in patients’ itchiness. The higher the level of interleukin-31, the greater the intensity of itchiness. It promotes inflammation and can activate sensory neurons in the skin that make a person more prone to react to any itchy stimulus. It can also stimulate other immune cells, further increasing itchiness, nodule formation and inflammation.

“For the last two decades, our group has studied the role of interleukin-31 in many types of itch, including PN, stasis dermatitis, atopic dermatitis, cutaneous T-cell lymphoma itch, lichen amyloidosis and even COVID-19-related itchy toes,” Dr. Yosipovitch said. “Now that there is a drug targeting this cytokine, we predict it may also be able to help patients with other types of chronic itch.”