Most cancer-related deaths in the western world are linked to lung cancer. A fundamental problem is the resistance of lung cancer to chemotherapy, which continues to be the standard treatment for the vast majority of patients concerned. In this translational project, scientists are researching molecular mechanisms that lead to resistance to chemotherapy. They are analyzing tumor biopsies and blood samples from 130 lung cancer patients participating in a cross-regional clinical trial being run by the working group on internal oncology (AIO), which is testing an improved route of administration for chemotherapy. Tumor and blood samples from the treated patients are prepared centrally for the molecular trials at the DKTK site in Essen and are then analyzed by experts from several DKTK sites. In Essen, for instance, scientists are investigating whether signal molecules that are produced or modified in greater numbers in the tumors correlate with resistance or with a positive treatment outcome. They are analyzing tissue samples from the tumor and tumor cells detected in the blood. In Tübingen, scientists are checking whether characteristics of liquid blood components can be used to predict a patient’s response to chemotherapy. In Heidelberg, scientists are researching to what extent tumor cells in the blood contribute to tumor resistance and the development of metastases. In cooperation with the University of Cologne, complete cancer genomes are being analyzed for some patients using modern sequencing methods to detect previously unknown genome modifications that might influence a patient’s response to treatment.

This project will identify tumor characteristics at molecular and cellular level. In future, these findings can be used to help identify lung cancer patients who will respond particularly well to chemotherapy. The physicians are also hoping to develop improved treatment strategies for other tumors, including colon, stomach, breast and ovarian cancer, which are treated with the same or similar chemotherapies as lung cancer. Ultimately, this trial will also be able to identify individual lung cancer patients who could benefit from new targeted therapies because of specific molecular changes.