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Review – ‘20 - ‘21 – Outlook

An unusual year

Dear reader,

2020 is characterized by the exceptional situation caused by the corona pandemic. A situation that also poses a particular challenge to the National Center for Tumor Diseases (NCT) Heidelberg and its supporters, the German Cancer Research Center (DKFZ) and the Heidelberg University Hospital (UKHD).

Patient care and research activities had to be reorganized within a few weeks. In order to protect cancer patients and medical specialists, the processes at the NCT have been continuously adapted to the risk of infection and personal contacts have been reduced.

Thanks to the good interaction of all departments and interdisciplinary teams involved, it was nevertheless possible to maintain the supply at the highest level. Clinical trials could be continued or in some cases only had to pause briefly. A hotline for the social services at UKHD and NCT Heidelberg was set up at short notice, to which patients could turn with questions about further treatment or care.
We look ahead. The crisis was also a time to rethink or develop things. Training events and even the NCT run took place virtually. New research findings and innovative approaches are evidence of our tireless commitment to interdisciplinary patient care and excellent cancer research at the Heidelberg site. On this page you will find some selected topics that have occupied the NCT Heidelberg in this unusual year and we would like to take you with us to an outlook for 2021.

We thank you for the trust you have placed in us, your commitment to the NCT and its patients and the good solidarity in this difficult time!

We wish you a Merry Christmas and a Happy New Year 2021!


Your managing directorate at NCT Heidelberg

Picture (f.l.t.r.:) Prof. Peter Lichter, Prof. Jürgen Debus, Prof. Stefan Fröhling, Prof. Dirk Jäger

Managing directorate at NCT Heidelberg

The photo was taken before the corona pandemic.



#Personalia

Since February 1st, Prof. Stefan Fröhling has been a permanent member of the managing directorate at NCT Heidelberg, after having been acting as head of NCT Heidelberg together with Prof. Jürgen Debus, Prof. Dirk Jäger and Prof. Peter Lichter for almost two years.

#Expansion

The expansion of the NCT Heidelberg, which takes place while patient and research operations continue, will increase the usable area from today's 5,565 to 8,131 square meters. With the completion of the structural work in August 2020, an important milestone in the expansion phase has been reached.

Architect building drawing
Network
NCT new building
 

As part of the National Decade Against Cancer, four new locations for the National Center for Tumor Diseases (NCT) are being built nationwide. In a competitive application process, the locations Berlin, Cologne/Essen, Tübingen/Stuttgart-Ulm and Würzburg with the partners Erlangen, Regensburg and Augsburg prevailed as new locations.

The expansion is intended to create a network that will radiate all over Germany, which will enable highly competitive translational cancer research on an international level and provide appropriate research platforms. The aim is to translate promising results from cancer research into clinical application more quickly and to improve the care of cancer patients throughout Germany.



#Research

The NCT Heidelberg stands for personalized cancer medicine. For example, molecular or immunological examinations can identify changes in the tumor that are important for cancer development and treatment. Our goal is to use the latest knowledge to develop tailor-made, precise treatment methods for every patient.

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In order to optimize the translation of research results in academically driven clinical trials, so-called investigator-initiated trials (IITs), the managing directorate of the NCT Heidelberg has launched the two programs (i) Trial Infrastructure and (ii) Trial Pool. The Trial Infrastructure program aims to increase patient recruitment in IITs and support the development of novel designs for early clinical trials. The Trial Pool Program supports activities that go beyond routine patient care, with an emphasis on initiating and implementing innovative IITs. For this purpose, the Trial Pool supports selected IITs with employees (study nurses and data managers) on a rotation principle.

In addition to numerous national partners, the NCT Heidelberg participates in the newly established consortium of the German Human Genome Phenomenon Archive (GHGA). With this new initiative funded by the German Research Foundation, a national platform for the secure storage, provision and analysis of omics data (e.g. genomes, transcriptomes, epigenomes) is being set up within a uniform ethical and legal framework. GHGA is intended to enable the broad use of omics data in a responsible manner so that research knowledge reaches patient care more quickly.

The project group ‘Ethical and Legal Aspects of Whole Genome Sequencing’ (EURAT) has been working on the release of genomic raw data to adult and consenting patients and has developed a statement and a guideline for action shortly before the turn of the year, in December 2019. In addition to proposals for the procedure, the statement also contains a sample of written information material. The EURAT group includes scientists, who are also working at the NCT Heidelberg,

  • Eva Winkler, Irina Idler, Katja Beck, Benedikt Brors, Kai Cornelius, Nicola Dikow, Henrike Fleischer, Stefan Fröhling, Hanno Glimm, Esther Herpel, Jan Korbel, Peter Lichter, Daniela Richter, Christoph Schickhardt, Klaus Tanner, Stefan Wiemann. (2020). On the Release of Raw Genomic Data to Patients and Study Participants. Forum Marsilius-Kolleg, Bd. 17. https://doi.org/10.11588/fmk.2020.0.76125


Research has shown that cancer patients can benefit from targeted exercise therapy before, during and after oncological treatment to improve their fitness, restore physical function and improve quality of life. An international consortium involving the NCT Heidelberg has now evaluated all available data on the effectiveness of sport and exercise in cancer and published worldwide recommendations for patients. Country-specific representatives are now to integrate exercise offers in cancer aftercare.

  • Campbell, Kristin & Winters-Stone, Kerri & Wiskemann, Joachim & May, Anne & Schwartz, Anna & Courneya, Kerry & Zucker, David & Matthews, Charles & Ligibel, Jennifer & Gerber, Lynn & Morris, G & Patel, Alpa & Hue, Trisha & Perna, Frank & Schmitz, Kathryn. (2019). Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Medicine and science in sports and exercise. 51. 2375-2390. https://doi.org/10.1249/MSS.0000000000002116.


Immunomodulatory oncolytic viruses based on the measles vaccine strain (MV) are currently being developed as a new form of tumor immunotherapy. In this work two candidates for clinical development, MV IL-12 and MV IL5, were systematically tested. In immunocompetent mouse models it was shown that both the oncolytic activity and the immunotherapeutic effectiveness of MV IL-12 were superior. Accordingly, MV IL-12 is currently being optimized for clinical development.


In a multidisciplinary, transatlantic collaboration between the DKFZ Department of Translational Medical Oncology, the NCT Heidelberg, the Friedrich Miescher Institute for Biomedical Research in Basel, the Dana-Farber Cancer Institute in Boston and the Broad Institute in Cambridge, the mechanism of action of a new "molecular glue degraders" was discovered. The adhesive complex induced by the molecule CR8 inhibits the growth of cancer cells by coupling growth-promoting proteins to a disposal system of the cell.


Niels Grabe and cooperation partners developed a cloud-based "whole-slide" imaging platform using a deep-learning algorithm for the marker-based analysis of human papillomavirus (HPV) closely related to cervical carcinogenesis. The new method offers solutions in terms of both specificity and clinical infrastructure in HPV screening.

  • N.Wentzensen et.al (2020) Accuracy and Efficiency of Deep-Learning-Based Automation od Dual Stain Cytology in Cervical Cancer Screening; JNCI, https://doi.org/10.1093/jnci/djaa066


Jakob Kather and colleagues have developed a deep learning algorithm to predict genetic mutations, molecular tumor subtypes, gene expression signatures and standard biomarkers from routinely obtained histopathological tissue sections of tumor samples. This method can be implemented on mobile hardware, potentially enabling point-of-care diagnostics for personalized cancer treatment.


Juvenile myelomonocytic leukemia (JMML) is a rare blood cancer of early childhood. Previous research activities have shown that JMML patients can be divided into three groups based on certain genetic markers, DNA methylation. Depending on the subgroup, statements can be made about the course of the disease. Together with international colleagues from DKFZ, NCT Heidelberg and the University Hospital Freiburg, scientists have now defined a globally valid uniform methodology for the use of methylation status as a biomarker in JMML based on 255 patient data. The method for classification is designed to be used in everyday clinical practice. Among other things, it is intended to identify high-risk patients more quickly in order to give them access to innovative treatments in clinical studies.

  • M. Schönung, J. Meyer, P. Nöllke, A. Olshen, M. Hartmann, N. Murakami, M. Wakamatsu, Y. Okuno, C. Plass, M. Loh, C. M. Niemeyer, H. Muramatsu, C. Flotho, E. Stieglitz, D. B. Lipka: International consensus definition of DNA methylation subgroups in juvenile myelomonocytic leukemia. CCR, https://doi.org/10.1158/1078-0432.CCR-20-3184

The NCT-MASTER program develops individually adapted therapy options based on changes in the genetic material of individual tumors. In the MASTER program, the NCT Heidelberg and Dresden and all sites of the German Consortium for Translational Cancer Research (DKTK) work closely together. This year, the 2500th patient was included in the NCT MASTER program.


SarcBOP (Sarcoma Biology and Outcomes Project) is an interdisciplinary registry and biobank study for patients with bone and soft tissue sarcomas. The research activities generate a comprehensive database consisting of many different data, e.g. pathological and radiological data or results of broad molecular diagnostics. SarcBOP is therefore a continuously growing resource that serves as a basis and starting point for future studies. Since the start of the study in July 2019, 335 patients have already been enrolled in Heidelberg. The continuation of the study to other centers is in progress.


A multicenter study conducted by the German-speaking Multicenter Myeloma Group (GMMG) investigated the importance of a autologous stem cell transplantation in advanced multiple myeloma. The study shows that even treatment with novel drugs developed in recent years alone can achieve very good survival rates. Nevertheless, the patient group that additionally received a autologous stem cell transplantation benefited.

  • H. Goldschmidt, M.-A. Baertsch et al. (2020) Salvage Autologous Transplant and Lenalidomide Maintenance vs. Lenalidomide/Dexamethasone for Relapsed Multiple Myeloma: the Randomized GMMG Phase III Trial ReLApsE. Leukemia; https://doi.org/10.1038/s41375-020-0948-0.


For years, clinical studies have been trying to achieve an immune response of the patient against his tumor by means of cancer vaccines. Now, in a phase 1 first-in-human study of the sponsor BioNTech from Mainz with significant participation of the Dermatooncology Section of the Department of Dermatology at the NCT Heidelberg, the RNA vaccine FixVac was tested in patients with checkpoint-inhibitor-refractory metastatic melanoma. The RNA codes for 4 non-mutated tumor-associated antigens found in melanoma, namely NYESO1, MAGEA3, tyrosinase and TPTE. Recently, the exploratory interim analysis was published in Nature, which shows that FixVac alone or in combination with a PD-1 antibody can achieve sustained remissions in metastatic patients. Strong CD4+ and CD8+ T cell immune responses against the vaccine antigens are induced. A phase 2 study is planned.

HSO2 Logo

The two-year fellowship program of the Heidelberg School of Oncology (HSO²) has been restructured and is aimed at young doctors and scientists interested in a career in patient-oriented cancer research. The current call for tenders started in January 2020 and focuses on the - annually changing - priorities, in 2020 these were clinical studies and digital oncology. Four HSO² fellows were recruited in a competitive selection process. Anna-Elisa Heipertz, Lukas John, Nora Liebers and Johannes Heidbüchel have been pursuing their research at the NCT since autumn this year.

 

A virtual event was also held this year to replace the Cancer Core Europe (CCE) summer school that takes place annually in Portugal. Around 400 participants from all over the world took part in the virtual keynote session on translational cancer research.

Leere Stühle


The speakers Emile Voest (Netherlands Cancer Institute), Jean-Charles Soria (Gustave Roussy), Robert A. Weinberg (Whitehead Institute for Biomedical Research) and the speaker Núria Lopez-Bigas (Institute for Research in Biomedicine Barcelona) presented pioneering topics of Cancer research.

Keynote speakers Núria López-Bigas, Emile E. Voest, Robert A. Weinberg, Jean-Charles Soria




#Care

The NCT Heidelberg combines patient care and patient-related research under one roof. The special thing about the NCT is its comprehensive, interdisciplinary approach. The NCT Heidelberg acts as a central portal for all cancer patients, combines all oncological activities at the UKHD and translational research at the DKFZ and coordinates numerous oncological studies at the DKFZ and the UKHD.

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The best possible care for cancer patients is the top priority at NCT Heidelberg. In order to be able to ensure this in the future for patients with newly diagnosed and existing diabetes mellitus diseases, the NCT Heidelberg has developed a special care concept. The oncological nurse Gülhan Wacholder was in charge of developing the concept based on an observational study with 24 patients. The diabetes mellitus care concept is now the basis for further training for new specialists.

The aftercare app, which was developed by the Oncological Focus Stuttgart and the Cancer Association of Baden-Württemberg, supports cancer patients with the organization of doctor's appointments, provides useful addresses and information and now also contains an exercise program that was developed at NCT Heidelberg.

» Download the app (Android)
» Download the app (iOS)

The model project "AppDoc - Online Dermatologist", approved by the Baden-Württemberg State Medical Association and which has won several awards, has made it possible to obtain an initial assessment from qualified dermatologists from Baden-Württemberg for skin problems of all kinds since November 2018. Over 2,500 patients have now received online advice. With the approval of the State Medical Association, the model project is now open to those affected and to dermatological practices nationwide. In the Corona crisis, practices from all over Germany can care for their patients online and without the risk of infection. Employees of the UKHD, DKFZ and NCT Heidelberg developed the app.

In order to be able to continue treatments for cancer patients at the same high level despite the COVID-19 pandemic, the German Cancer Aid (DKH), the DKFZ and the German Cancer Society (DKG) set up a task force at the beginning of the crisis. With the participation of the NCT Heidelberg, the changes in the current supply situation are recorded. An early warning system helps to be able to give signals to decision-makers as quickly as possible in the event of possible cuts in the supply.



#Events

Since World Cancer Day on February 4, the regional self-help group “Treffpunkt Heidelberg” of the German Foundation for Young Adults with Cancer has been showing photos of young cancer patients on the 2nd and 3rd floors of the NCT building under the title “Show your face”. The photo exhibition is intended to show that young people can also be affected by cancer, with sometimes far-reaching consequences for their entire life, and at the same time, above all, to encourage other patients and relatives and offer support so that they can benefit from the experiences of the self-help group.

Bilder der Ausstellung
Gruppenfoto Treffpunkt Heidelberg

The NCT run also ran differently this year than usual. Under the motto “NCT RUNning against cancer: Alone. Together!” It was completely converted to a virtual format. Every runner self-selected a route and distance and ran alone or in small group according to the applicable Corona rules. 8,976 runners started alone from June 26th to 28th - but together with the idea of setting a sign against cancer. On all seven continents, people ran almost 120,000 kilometers for a good cause. Sponsors, supporters and donations raised almost 75,000 euros to support innovative projects at NCT Heidelberg.

NCT running shirt
NCT run poster
Runner
 

The first online charity event “Move against cancer”, organized by the Stiftung Leben mit Krebs and NCT Heidelberg, took place successfully this year from October 16-15, 2020. 14,282 hours of exercise were collected over four weeks by 183 teams and 1,108 participants for the benefit of the physical activity program for patients at NCT Heidelberg. Anyone could enter the activities in an app specially developed for the campaign and "convert" them into donations at the end. Further “move against cancer” campaigns are already planned for 2021.

Musicians at NCT Heidelberg

NCT Takte-gegen-Krebs (Bars Against Cancer): House Concerts. Under this title, three Christmas concerts were played this year and streamed live on the social media channels of NCT Heidelberg. The German Cancer Research Center kicked things off on December 9th, followed by University Hospital Heidelberg, and the finale was a concert evening at the NCT Heidelberg on December 11th. No audience members were allowed for the occasion. Through the fundraising campaign on the website www.nct-takte.de, bars could symbolically be acquired and viewers become part of the concerts. We cordially invite you to enjoy the concert recordings on our YouTube channel.

#Current

The NCT Heidelberg newsletter appears quarterly and provides information on selected current topics, dates and events relating to the NCT Heidelberg. Subscribe at: www.nct-heidelberg.de/newsletter

The NCT magazine Connect appears twice a year and provides an insight into all areas of the NCT Heidelberg. Subscribe free of charge at: www.nct-heidelberg.de/connect



#Outlook2021

In the coming year, the employees at NCT Heidelberg will continue to work on translating the latest research results into better treatment and prevention strategies as quickly as possible. New studies and innovative research projects will be launched and existing ones will be continued.

NCT run on July 2nd
On July 2, 2021, we will run again for a good cause, adjusted to the current situation.
»Current information at: www.nct-lauf.de

Summer School on 10-15. October
Since 2011, the "Summer School in Translational Oncology" has promoted the exchange between researchers from various areas of cancer research and cancer medicine. Lectures alternate with case studies, poster presentations and oral presentations by the participants.
»Current information at: https://www.cancercoreeurope.eu/our-summer-school

Interdisciplinary training of the NCT
The advanced training event "Interdisciplinary training of the NCT" for specialist audiences will continue to be offered weekly as an online seminar in 2021.
»Current information in the NCT event calendar: www.nct-heidelberg.de/veranstaltungen

NCT online retreat
The annual NCT retreat will take place online and at different times in 2021. From February 25 to April 29, 2021, there will be two thematic sessions on Thursdays. Interested employees at the NCT Heidelberg and NCT Dresden can register for the 1.5 hour sessions.

Conference of the NCT Scientific Advisory Board
During the conference in July 2021, the NCT directors will inform the Scientific Advisory Board about current developments and activities in clinical cancer research. Future perspectives are also discussed among the Scientific Advisory Board members, the management boards and the NCT directors. »Members of the Scientific Advisory Board

NCT network
The newly selected NCT locations in 2020 will now work together with the two existing locations of the NCT in a first funding stage to develop a strategic concept for the implementation of an overall NCT that will spread across Germany. This should be finalized in summer 2021. The four applicants then have the option of institutional funding as a later NCT location from the federal government and the host state.
»More on the website of the" Decade Against Cancer ".