Personalized cancer treatment in Germany: University Hospital Dresden

The University Hospital Dresden is working intensively on personalized cancer treatment in Germany: in April and May 2019, several clinical studies start here.

The National Center for Tumor Diseases NCT Dresden (Das Nationale Centrum für Tumorerkrankungen Dresden) is going to test the latest targeted agents, including promising drugs for cancer immunotherapy.

"We know today that there are hundreds of cancers that can be distinguished from each other. Each of these individual diseases may also differ from patient to patient and continue to change as the disease progresses. The modern, so-called personalized cancer medicine optimizes the entire treatment to the individual patient ", says Professor Martin Bornhäuser, Managing Director at the NCT Dresden and the head of the Medical Clinic I of the University Hospital Carl Gustav Carus Dresden.

In addition to the use of tailor-made medical therapies, the NCT Dresden also develops corresponding concepts for the operating theater, in which patient data are used for planning and performing surgical interventions.

For example, innovative systems should be able to display the optimal cutting pattern and patient's vital structures in real time.

In order for patients to take advantage of the latest scientific advances, physicians and scientists of the University Hospital Dresden, the Faculty of Medicine, the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) and the German Cancer Research Center (DKFZ) are working together at the NCT Dresden.

Combining all forces in the fight against cancer is also the goal of the German federal government.

The Federal Ministry of Education and Science proclaimed the “National Decade against Cancer” on January 29.

“The cancer is as individual as the people who get it. The cancer medicine of the future therefore resembles a tailor-made suit, which is customized for each patient with the utmost precision. Because the enormous variety of cancers ensures that a therapy suit off the rack is not the best option for every patient", says Professor Mechthild Krause. The basis of personalized cancer therapy is innovative diagnostic methods, such as molecular genetic testing.

“We are looking for changes that are responsible for the development, growth or metastasis of tumors.

They are an important basis for individual treatment. Ideally, targeted therapy should target this modified part of the cell”, explains Professor Hanno Glim, Managing Director of NCT Dresden and Head of the Department of Translational Medical Oncology.

Personalized immunotherapy represents important progress

At NCT Dresden, doctors and scientists use the specific biological features of tumors to accurately target the immune system to a tumor. Since last year, patients of the University Hospital Dresden receive innovative CAR-T-cell therapy.

Immunotherapy, which is available only in a few centers throughout Germany, provides hope for patients with aggressive cancer of the lymphatic system (lymphoma) and certain types of blood cancer.

We are talking about tumor cells that have a very specific surface feature called CD19.

To overcome the ingenious mechanisms of cancer resistance, the body’s own immune cells are supplied with an artificial molecule that targets the patient's white blood cells to specific surface cancer antigens. Thus, the immune system restores the ability to recognize and kill tumor cells.

“In about 40% of patients who have not previously received traditional treatment, the cancer disappears for a long time. It was one of the biggest advances in cancer treatment”, says Dr. Martin Vermke.

German scientists are developing a special CAR-T bispecific antibodies technology to switch the activity of the modified immune cells and to direct them against different surface antigens.

"We can offer our patients an exceptionally wide range of personalized immunotherapies. In the context of studies, further therapies with receptor-modified T-cells, bispecific antibodies as well as tumor infiltrating lymphocytes will be tested since April", says Dr. Wermke.

However, targeted drugs can affect cancer without activating the immune system. They prevent chemical signals from growing and spreading to the tumor cell and stop the formation of blood vessels that supply the tumor cell with nutrients and oxygen. Professor Christian Thomas, director of the Department of Urology at the University Hospital Dresden, examines a protein that normally regulates cell division and growth. It is assumed that in prostate cancer patients the tumor uses the Stat5 protein and stimulates its own growth. A high level of Stat5 in the prostate tissue indicates the aggressiveness of the tumor and the late stage of the disease.

In several experimental studies, Professor Thomas also was able to demonstrate that some biological products effectively control Stat5 protein, slowing the development of prostate cancer.

Personalized cancer treatment in Germany with fewer side effects

Individual therapeutic approaches also play an important role in reducing side effects. In a new study, doctors and scientists from NCT Dresden and NCT Heidelberg are studying whether oral tumors and laryngeal cancer caused by human papillomaviruses (HPV) can be treated with the same efficiency, minimizing the radiation dose.



“We reduce the dose of radiation in a carefully controlled two-step procedure that guarantees the highest possible patient safety. Thus, we hope to be able to significantly reduce long-term serious side effects, such as dry mouth, dysphagia, as well as impaired sense of smell and taste”, explains Prof. Mechthild Krause.

Even in cancer surgery, more accurate interventions are possible with fewer side effects. NCT Dresden scientists are developing automated systems that assist the surgeon in planning surgical procedures for each individual patient.

Personalized cancer treatment in Germany, which is actively developing today, will become an increasingly common and successful practice in the coming years.

Currently, new methods are being studied and implemented as part of the NCT MASTER program. Thanks to this program, young patients and patients with very rare tumors have an opportunity to analyze the genome of their tumor. Based on the results obtained, interdisciplinary teams develop the most effective therapy for each case. To date, around 1,300 patients from the NCTs in Heidelberg and Dresden as well as the centers of the German Consortium for Translational Cancer Research (DKTK) have been included in the program.

"In many patients we can achieve remarkable results. Personalized therapy does not have to mean that a new drug is developed for each patient. Rather, the treatment is individually adapted to the biology of particular cancer. To make this possible, we need to embed detailed gene testing in routine cancer treatment", says Professor Hanno Glim.

© Analytical reviews and oncology news by K. Mokanov: clinical pharmacist and professional medical translator