Joana M. Mack, MD, is an assistant professor at the University of Arkansas for Medical Sciences practicing at Arkansas Children's Hospital. She is a pediatric hematologist-oncologist and joined the group in 2018 after completing her residency and fellowship training at Arkansas Children's Hospital. She is also the Pediatric Hematology-Oncology Fellowship program director and is actively involved in educating trainees. She is a member of the Vascular Anomalies Center and provides care for these complex patients.
Dr. Mack leads several research studies in the treatment of patients with Vascular Anomalies. She is a member of the Consortium of iNvestigators of Vascular AnomalieS (CaNVAS) and leads a multi-institutional study evaluating the quality of life in patients with vascular malformations.
Dr. Mack is a site co-investigator for the Consortium of iNvestigators of Vascular AnomalieS (CaNVAS), which is a multi-institutional research consortium founded by a group of pediatric hematologists/oncologists and patients advocacy groups to further advance research in vascular anomalies. Dr. Mack’s received a Marion B. Lyon Award for conducting her research study “Anticoagulation Effects on Quality of Life in Patients with Slow-Flow Vascular Malformations.” Dr. Mack leads this multi-institutional prospective study and now has 9 other institutions where the study is open throughout the United States. She undertook this endeavor just prior to the beginning of the COVID-19 pandemic and has still been able to enroll half of the subject accrual.
Most notably, Dr. Mack has secured approval for an Investigational New Drug Application from the Food and Drug Administration in March 2022 for her Phase II clinical trial using Cobimetinib, a MEK inhibitor, in patients with extracranial arteriovenous malformations (AVM). Due to the infiltrative nature of AVM, normal tissue must be removed along with the malformation and patients are too often left with significant functional impairments, amputations, and the need for extensive reconstructive surgery. In the search for targets for alternative systemic therapies, research has identified underlying somatic mutations in AVM tissue in mitogen-activated protein kinase 1 (MAP2K1), the gene that encodes MAP-extracellular signal-regulated kinase 1 (MEK1). These mutations increase MEK1 activity and have also been found in cancers. MEK1, a protein product of the MAP2K1 gene, is involved in the RAS/MAPK pathway and controls cellular processes and development. Several studies support the potential efficacy of targeted MEK1 inhibition in tumors with MAP2K1 mutations. Given the success of MEK1 inhibition with neoplasms housing these mutations, it is thought that MEK1 inhibitors may have clinical benefits in patients with extracranial AVMs with RAS/MAPK mutations. This trial is the first of its kind in the Midwest and South, giving much-needed access to this population.
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