Partner Site Essen/Düsseldorf: Cutting-Edge Research in Germany's Far West

The Rhine-Ruhr area, formerly known for its coal and steel industries, has become a hub of highly skilled medical research in recent decades. At its center stand the cities of Essen and Düsseldorf with their university hospitals. Cancer research has long played an important role here: the Essen Tumor Clinic, established in 1967, which later became the West German Cancer Center (WTZ), was the first specialized cancer treatment center in Germany.

Martin Schuler, spokesman for the DKTK’s Essen/Düsseldorf location, is Director of Internal Medicine (tumor research) at Essen University Hospital and is a specialist in targeted cancer treatments and lung cancer. From his day-to-day clinical work he knows the importance of effective networks of clinics and research bodies: “WTZ physicians and researchers regularly exchange ideas in interdisciplinary expert groups. Particularly where there is a need for complex treatment and diagnostic strategies, we have access to a range of different treatment methods and can tailor the treatment to the patient.”

As well as surgery and chemotherapy, the partner institutions in Essen and Düsseldorf use immunotherapies and cutting-edge imaging diagnostics. In addition, the Essen medical campus has the largest clinic for bone marrow transplants in Europe and established the first proton therapy center in North Rhine-Westphalia a few years ago.

At Düsseldorf University Hospital, researchers are investigating, among other things, new treatment options for children with brain tumors. Marc Remke has been in charge of a DKTK junior research group there since the beginning of last year. Together with Guido Reifenberger and Arndt Borkhardt he hopes to improve treatment of malignant tumors in the cerebellum. The Düsseldorf researchers are also working with partners from other DKTK centers to develop a new classification for brain tumors under the patronage of the World Health Organization (WHO).

Targeted selection – targeted treatment

Researchers in Essen have tested at total of 58 new drugs and drug combinations in early-phase clinical trials in recent years – many of them in collaboration with the other DKTK centers. The aim is to translate new research findings into clinical practice. They have successfully focused on precision oncology. DNA analyses and molecular biomarkers can provide indications in advance of how effective a particular drug is likely to be for a particular patient. Physicians and researchers use this data to select the best trial treatment for the patient.

It is an approach that can speed up the development of new drugs considerably, as seen in the example of ceritinib. Ceritinib is a recently approved tyrosine kinase inhibitor that works in lung cancer patients whose tumors exhibit a particular genetic modification. Until now, the only treatment available for patients with advanced lung cancer was chemotherapy, and the chances of success were small. The effectiveness of ceritinib was immediately evident in the first clinical (phase I) trial. “The patients were selected according to their molecular profile,” explains Martin Schuler. “The treatment was so successful in the first group of 130 patients that the trial was quickly extended to larger groups of patients.” The drug was initially licensed for the US market, and was approved in Germany shortly afterwards.

Martin Schuler is convinced that close collaboration between basic researchers and physicians opens up brand new possibilities in the battle against cancer: “Even during a trial with a new drug we can investigate which genetic changes prevent the tumor from responding to treatment. Using these results, we can refine the treatment strategy and specifically target resistance.” In this way, the medical experts in Essen, working together with industrial partners, have already helped develop three new drugs that target resistance in lung cancer patients.

Reprogramming tumor cells

Jens Siveke is another physician who has been conducting research at WTZ since 2015. His focus is on pancreatic cancer. “This type of cancer produces symptoms late and spreads quickly to other sites in the body, which makes it extremely difficult to treat,” says Siveke, who has been appointed to one of the three new DKTK Chairs for Translational Oncology at Essen University Hospital. In pancreatic cancer, the tumor cells are also extremely adaptable and quickly develop resistance to the available drugs. “Until now there have been almost no effective drugs, and subsequent chemotherapy often achieves very little,” says Siveke, summing up the difficult situation. He is researching why pancreatic tumors often do not respond to treatment. Siveke and his team aim to reprogram certain of the tumor’s regulatory pathways to make it susceptible to drugs and immunotherapy treatments. Ultimately, this could also benefit patients with other types of cancer. “Many of the approaches developed within the DKTK can be applied to other types of cancer,” explains Siveke.

He appreciates the fact that cutting-edge technologies are shared within the DKTK and that colleagues from different fields can exchange ideas at the various centers. However, in his view, the key added value lies in the program’s long-term funding approach: “Within the DKTK, we can develop innovative, lasting solutions, free from commercial pressure, which will benefit patients all over Germany.”

Go to German Version of the article in the DKFZ magazine “Einblick”.