How To Improve Cancer Care In Germany
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1 Deutsches Krebskonsortium (DKTK) und Nationales Centrum für Tumorerkrankungen Heidelberg (NCT) Ist Deutschland jetzt konkurrenzfähig? DGIM Opinion Leader Meeting, Eltville-Erbach, Januar 2014 Otmar D. Wiestler, M.D. Deutsches Krebsforschungszentrum, Heidelberg (DKFZ)
2 An Exciting Era for Cancer Research & Oncology 1/30/2014 Seite Page 2 Unravel basic mechanisms Focus on human biomaterials Molecular stratification Novel, targeted treatments Individualized cancer medicine Turning cancer into a chronic disease Risk assessment, early detection and prevention
3 1/30/2014 Seite Page 3 The German Cancer Research Center Established in 1964 National Biomedical Research Center Staff of approx Member of the Helmholtz Association Core located on the Heidelberg biomedical campus Basic funding from BMBF & Baden-Württemberg National consortium with seven partner sites Nobel Prize for Harald zur Hausen in 2008
4 1/30/2014 Seite Page 4 Translational DKFZ Molecular diagnosis: p16/hpv (mtm), IDH-1, B-raf Stem cell mobilization in CML (IFNα & Glivec) Metastatic cancer stem cells (HI-STEM) APG101 / Apocept R in gliomas (Apogenix) IDH-1 vaccination for WHO grade II & III gliomas IMRT, Multileaf collimator, Particle therapy Vaccination against HPV 16 & 18 Oncolytic parvovirus for glioma treatment (ParvOryx) Risk-adapted early detection of colon cancer
5 1/30/2014 Seite Page 5 Partnerships & Alliances Local DKFZ-ZMBH Alliance Hi-STEM (Cancer stem cells) DKFZ-HIPO (Personalized Oncology) National Center for Radiation Research in Oncology HIT (Ion-Beam Therapy) NCT (Comprehensive Cancer Center) Heidelberg University Medical Centers DKFZ & EMBL screening facility International Inserm MD Anderson Cancer Center, Houston Gustave Roussy Institute, Paris Karolinska Institute, Stockholm Israel (DKFZ-MOST, Helmholtz Research School in Cancer Biology, Alliance in Personalized Medicine) National Cancer Institute, Bethesda Internatl. Cancer Genome Consortium National National Cohort DKTK (Cancer Consortium) DZHK (Cardiovascular research) DZL (Lung research) DZIF (Infection research) Industry Alliance with Siemens Healthcare Alliance with Bayer HealthCare Alliance with Roche Alliance with SAP Alliance with IBM Successful spin offs (apogenix, mtm)
6 1/30/2014 Seite Page 6 The National Center for Tumor Diseases
7 1/30/2014 Seite Page 7 NCT
8 1/30/2014 Seite Page 8 NCT as Platform for Translation Cancer medicine based on tumor boards and SOPs Steady increase in patient numbers (> p.a.) Platform for translational cancer research Internationally recognized profile areas in neurooncology, radiooncology, genome sequencing Building generates corporate spirit Excellent basis for personalized oncology
9 1/30/2014 Seite Page 9 Expansion Plans for NCT Position NCT in individualized cancer medicine Fully explore cancer genome sequencing as diagnostic and research pool Establish additional profile areas (pancreas, myeloma, lung, immunotherapy ) Expand programs in preventive oncology Heidelberg School of Oncology Extension of the building
10 Whole Genome Sequencing (WGS, WES) as a Basis for Personalized Oncology 1/30/2014 Seite Page 10 Data-Storage Data-Analysis Petabyte Range Computer Cluster
11 1/30/2014 Seite Page 11 DKFZ-HIPO & Personalized Oncology DKFZ HIPO Heidelberg Center for Personalized Oncology Clinical Development HIPO gen Genome Analysis Program HIPO sys Systems Biology Bioinformatics Synthetic Biology Program HIPO med NCT Precision Oncology Program Peter Lichter Roland Eils Christof von Kalle Clinical Project Management Genome Sequencing Proteomics Microbiomics Applied Bioinformatics Next Generation Imaging
12 1/30/2014 Seite Page 12 Precision Oncology Program - Workflow Clinical Project Management Pathology Sample Processing (Lab) High-Throughput Molecular Analysis Data management / bioinformatics Molecular tumor board Clinical Implementation / Targeted Therapies
13 Cancer Genome Sequencing as an Option for Every Patient at the NCT 1/30/2014 Seite Page 13 DKFZ- HIPO Patient Stratification Treatment Response Trial Success Surprise Responders Targets / Pathways for Novel Therapies NCT Clinical Studies (IIT) e.g. Pancreas Glioma Multiple Myeloma Breast Lung Medulloblastoma Heavy Ion Radiation National Center for Tumor Diseases
14 1/30/2014 The German Cancer Consortium (DKTK) A national effort in Translational Cancer Research Otmar D. Wiestler German Cancer Research Center
15 1/30/2014 Seite Page 15 Rationale for a national consortium Translational research requires alliances between the best partners in cancer research and cancer medicine Individualized cancer medicine at the horizon Excellent research in German laboratories Individual sites often lack critical mass for bench to bedside to bench research Vivid international competition Need for training and education programs
16 1/30/2014 Seite Page 16 The German Cancer Consortium (DKTK)
17 1/30/2014 Seite Page 17 Major Goals of DKTK Development of novel approaches for diagnosis, therapy and prevention of oncological diseases Bridging basic and clinical cancer research in translation centers Significant investments into novel professorships and units based on long-term institutional funds Long-term partnership between DKFZ and University Medicine Training and education of scientists and physician scientists Partnership with German Cancer Aid Pursue novel models for public private partnerships (PPP) Strengthening of Germany s international competitiveness
18 1/30/2014 Seite Page 18 Translational Research Programs
19 1/30/2014 Seite Page 19 Translational Research Platforms
20 1/30/2014 Seite Page 20 DKTK Clinical Communication Platform Continuous recruitment of patients into DKTK Clinical data warehouse DKTK Biobank Molecular stratification of patients Platform for innovative trials & individualized oncology Initial focus on AML, GI cancer and neurooncology Hubert Serve, Ulrich Keilholz, Peter Schirmacher & Frank Ückert
21 O. D. Wiestler Autor Seite 21 1/30/2014 Page New professorships
22 1/30/2014 Seite Page 22 Joint Funding Program Multi-site projects and trials initiated in 2012 Project title Participating sites Principal investigator Molecular diagnostics of pediatric malignancies Development of therapeutic vaccines. Multipeptidebased phase I/II clinical study for biochemically relapsed prostate carcinoma patients independent of HLA typing (MultiPro) Radiobiological profiling for biochemically stratified radiochemotherapy of HNSCC: A DKTK multicenter retrospective/prospective trial. Identification and molecular characterization of resistance mechanisms to cytotoxic chemotherapies in lung cancer *Funding in the order of 500 K p.a. for 3 yrs Berlin, Essen/Düsseldorf, Frankfurt/Mainz, Freiburg, Heidelberg, München, Tübingen Tübingen, Heidelberg, München, Tübingen Berlin, Essen/Düsseldorf, Frankfurt/Mainz, Freiburg, Heidelberg, München, Tübingen Essen/Düsseldorf, Frankfurt/Mainz, Freiburg, Heidelberg, Tübingen, Affil. Partner Köln Peter Lichter (HD) Stefan Pfister (HD) Hans-Georg Rammensee (TÜ) Michael Baumann (DD) Martin Schuler (E/D)
23 1/30/2014 Seite Page 23 Joint Funding Program Multi-site projects and trials initiated in 2013 Project title Participating sites Principal investigators Next generation molecular diagnostics of gliomas Elucidating the basis of primary resistance to first-line combined anti-egfr /chemotherapy and establishment of a tumor repository for analysis of secondary resistance in metastatic colorectal cancer Novel tools for dissection of oncogenic pathways Evaluation of new therapeutic concepts in relapsed AML *Funding in the order of 500 K p.a. for 3 yrs Dresden, Essen/Düsseldorf, Frankfurt/Mainz, Heidelberg, München, Affil. Universität Leipzig, Universitätsspital Zürich Berlin, Dresden, Essen/Düsseldorf, Frankfurt/Mainz, Heidelberg, München Berlin, Dresden, Frankfurt/Mainz, Freiburg, Heidelberg, München, Tübingen Berlin, Dresden, Frankfurt/Mainz, Freiburg, München Guido Reifenberger (E/D) Reinhold Schäfer (B) Volker Heinemann (M) Roland Schmid (M) Clemens Schmitt (B) Cornelius Miething (FR) Christoph Peters (FR) Karsten Spiekermann (M) Christian Thiede (DD)
24 1/30/2014 Seite Page 24 INFORM: Individualized treatment of pediatric cancers S. Pfister, O. Witt, P. Lichter & all of the GPOH
25 1/30/2014 Seite Page 25 Imaging & Radiooncology
26 68 GA-PSMA for Theranostics 1/30/2014 Seite Page 26 Small molecule ligands for PSMA Ga-PSMA ligand FECH
27 68 GA-PSMA Imaging 1/30/2014 Seite Page 27 PIRADS 4 T1w fs PET/MR PIRADS 3 PIRADS 4
28 1/30/2014 Seite Page 28 What do we want to achieve? Set up joint translation centers at all DKTK sites Recruitment of professors and talented junior scientists at all sites Continuous recruitment of stratified patients Establishment of the DKTK School of Oncology Establishment of a competitive funding program for DKTK sponsored by the German Cancer Aid DKTK as prime partner for industry cooperation DKTK as prime partner for international networks
29 1/30/2014 Seite Page 29 What do we want to achieve? International leadership in personalized oncology of pediatric tumors, glioma, and other cancer entities Completion of innovative IITs in cancer immunology RadPlanBio-Platform fully operational; Early radiooncology and particle therapy trials Expand translational research on AML, GI cancers and glioma Pipeline of innovative translational trials in the areas of diagnosis, treatment and prevention (5 each at any given time)
30 1/30/2014 Seite Page 30 DKH Oncology Centers of Excellence Comprehensive cancer centers with rigid quality control National coverage with currently 12 centers (approx. 15 % of patients with systemic disease) National network Strong outreach element DKH Translational Oncology Program
31 1/30/2014 Seite Page 31 Important future developments Fully exploit the DKTK Cancer Consortium Extend NCT into a center of excellence for individualized cancer medicine Establish strong links between DKTK and the DKH Comprehensive Cancer Centers (OSZ) Establish links between DKTK, OSZ and Study Groups Funding programs for projects at additional sites Foster PPP and international relationships
32 1/30/2014 Seite Page 32 Towards Personalized Oncology Molecular diagnosis & stratification Pathway-specific (targeted) treatments Agents interfering with migration & metastasis Cancer immunotherapy Innovative radiooncology Individualized combinations Cancer as chronic disease Cancer prevention
33 Welcome to the DKFZ!
34 Willkommen im DKFZ!
35 1/30/2014 Seite Page 35 Expansion Plans for NCT Strengthen research pipeline towards IITs Strengthen NCT as training & education platfprm Position NCT as prime partner for PPP contracts Strengthen the NCT position within DKTK Establish and exploit international interactions
36 1/30/2014 Seite Page 36 Allocation of the Budget
37 1/30/2014 Seite Page 37 Research DKFZ Neurooncology (profile area) Cancer Immunotherapies Innovative Radiooncology Cancer Prevention Metabolic Syndrome and Cancer Personalized Oncology
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