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Comprehensive molecular profiling can significantly improve the treatment of patients with metastatic breast cancer. This has been demonstrated by researchers from the NCT Heidelberg, the German Cancer Research Center (DKFZ), the Heidelberg Medical Faculty of Heidelberg University, and Heidelberg University Hospital (UKHD) in an evaluation of the CATCH* study. Data from more than 400 patients show that personalized, biomarker-based therapy significantly increases response to treatment and progression-free survival – an important step toward precise, individually tailored cancer medicine.

The National Center for Tumor Diseases (NCT) Heidelberg is a joint institution of the German Cancer Research Center (DKFZ), Heidelberg University Hospital (UKHD), Heidelberg University Medical Faculty, and Heidelberg Thorax Clinic.

Breast cancer still has a poor prognosis in the metastatic stage. Current therapy can halt the disease in its advanced stages for some time. Nevertheless, with around 18,500 deaths per year in Germany, breast cancer is the most common cause of cancer death in women. Can the treatment of patients with advanced breast cancer be improved with drugs tailored to the individual genetic profile of their tumor? Heidelberg doctors and scientists aim to answer this question with the CATCH study. The prospective study included patients with metastatic breast cancer who were undergoing treatment at the NCT Heidelberg. In 412 of these women, the tumor genome was completely characterized at the molecular level, discussed in connection with their detailed medical history in the interdisciplinary molecular tumor board, and the course of the disease was followed up. To this end, the researchers analyzed, among other things, the entire genome of the tumor as well as the tumor RNA. This enabled them to identify relevant biomarkers that would not have been detected with simple panel tests limited to a few hundred genes. The analyses formed the basis for tailored therapy decisions.

Almost half of the patients (44 percent) were able to receive a therapy recommended by the tumor board because specifically targeted drugs were available for the genetic abnormalities of their disease. This treatment rate significantly exceeds the figures of other international precision oncology programs. Particularly noteworthy: in one-third of patients, molecularly targeted therapy led to at least a 50 percent longer progression-free survival time compared to standard therapy. The progression of the disease was thus prevented in some of the patients for a certain period of time.

86 percent of molecularly targeted drug therapies were off-label, i.e., outside the approved indications. In retrospect, it is clear that a significant proportion of these drugs are now approved for the treatment of breast cancer – a sign of CATCH's innovative strength.

Andreas Schneeweiss, Gynecological Oncology Section at NCT Heidelberg and UKHD, is the senior author of the recently published article. He says: “Our results show that a holistic molecular analysis can bring clinically relevant benefits for patients. We use it to identify and utilize treatment options that would otherwise remain undiscovered.” CATCH has succeeded in closely integrating molecular diagnostics with clinical decision-making. The study underscores that precision oncology is technically feasible and medically useful in routine care.

Peter Lichter, Department of Molecular Genetics at the DKFZ and Executive Director at NCT Heidelberg, is also a senior author of the study. He summarizes: “We show that a data-driven, individualized approach can lead to better treatment outcomes for patients with metastatic breast cancer. This gives us an important impetus for the further development of personalized cancer medicine.”

* CATCH: Comprehensive assessment of clinical features and biomarkers to identify patients with advanced or metastatic breast cancer for marker-driven trials in humans

Publication: Mario Hlevnjak°, Sabine Heublein°, Verena Thewes°, Lukas Wagener, Constantin Pixberg, Carlo Fremd, Laura Michel, Christian Maurer, Lars Buschhorn, Nicola Dikow, Fangyoumin Feng, Stefan Fröhling, Christel Herold-Mende, Steffen Hirsch, Chen Hong, Daniel Hübschmann, Lena Jassowicz, Polina Kozyulina, Katrin Pfütze, Richard F. Schlenk, Hans-Peter Sinn, Katharina Smetanay, Christoph Springfeld, Albrecht Stenzinger, Celina Wagner, Stephan Wolf, Andreas Trumpp, Dirk Jäger, Oliver Zivanovic, Marc Zapatka°, Andreas Schneeweiss°, Peter Lichter°: Delivering precision oncology in metastatic breast cancer: Clinical impact of comprehensive genomic profiling - The CATCH experience. International Journal of Cancer; doi.org/10.1002/ijc.70208

° These authors contributed equally to this study.

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The National Center for Tumor Diseases (NCT) Heidelberg
The National Center for Tumor Diseases (NCT) Heidelberg is a joint institution of the German Cancer Research Center (DKFZ), the University Hospital Heidelberg (UKHD), the Heidelberg Medical Faculty of the Heidelberg University and the Thoraxklinik Heidelberg. The aim of the NCT Heidelberg is to transfer promising approaches from cancer research into clinical practice as quickly as possible, and thus to benefit patients. This applies to both diagnosis and treatment, in aftercare or prevention. Participation in clinical studies opens up access to innovative therapies. The NCT Heidelberg is thus a leader in transferring new research results from the laboratory to the clinic The NCT Heidelberg, founded in 2004, is part of the NCT with further locations in Berlin, Dresden, SouthWest (Tübingen-Stuttgart/Ulm), WERA (Würzburg, Erlangen, Regensburg, Augsburg) and West (Essen/Cologne).
 

German Cancer Research Center (DKFZ)
With more than 3,000 employees, the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) is Germany’s largest biomedical research institute. DKFZ scientists identify cancer risk factors, investigate how cancer progresses and develop new cancer prevention strategies. They are also developing new methods to diagnose tumors more precisely and treat cancer patients more successfully. The DKFZ's Cancer Information Service (KID) provides patients, interested citizens and experts with individual answers to questions relating to cancer.

To transfer promising approaches from cancer research to the clinic and thus improve the prognosis of cancer patients, the DKFZ cooperates with excellent research institutions and university hospitals throughout Germany:

• National Center for Tumor Diseases (NCT, 6 sites)  
• German Cancer Consortium (DKTK, 8 sites)
• Hopp Children's Cancer Center (KiTZ) Heidelberg
• Helmholtz Institute for Translational Oncology (HI-TRON Mainz) - A Helmholtz Institute of the DKFZ
• DKFZ-Hector Cancer Institute at the University Medical Center Mannheim
• National Cancer Prevention Center (jointly with German Cancer Aid) 

The DKFZ is 90 percent financed by the Federal Ministry of Research, Technology and Space and 10 percent by the state of Baden-Württemberg. The DKFZ is a member of the Helmholtz Association of German Research Centers.

Heidelberg University Hospital and Faculty of Medicine: Internationally Renowned Patient Care, Research and Teaching

Heidelberg University Hospital (Universitätsklinikum Heidelberg, UKHD) is one of the largest and most prestigious medical centers in Germany. The Medical Faculty of Heidelberg University (Medizinische Fakultät Heidelberg, MFHD) belongs to the internationally renowned biomedical research institutions in Europe. Both institutions have the common goal of developing new therapies and implementing them rapidly for patients. Heidelberg University Hospital and the Medical Faculty of Heidelberg University employs around 14.500 employees and is committed to providing trainings and qualifications. Every year, around 86,000 patients and more than 1.100.000 outpatient cases are treated in more than 50 clinical departments with almost 2.500 beds.

Together with the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) and the German Cancer Aid, the UKHD established the first National Center for Tumor Diseases (NCT) in Heidelberg. The goal is to provide care at the highest level as an oncology center of excellence and to rapidly transfer promising approaches from cancer research to the hospital. In addition, the UKHD operates in partnership with the DKFZ and the University of Heidelberg the Hopp Children’s Cancer center Heidelberg (KiTZ), a unique and nationally known therapy and research center for oncological and hematological diseases in children and adolescents.

The Heidelberg Curriculum Medicinale (HeiCuMed) is one of the top medical training programs in Germany. Currently, there are about 4.000 future physicians studying in Heidelberg.