According to Statistik Austria, the number of people dying from cancer each year has been steadily declining over the last two decades. This is due to earlier diagnosis and improvements in treatment. According to the cancer experts from MedUni Vienna and Vienna General Hospital, the development of so-called "precision medicine" has played a major role in this trend. The term "precision medicine" encompasses a series of techniques, ranging from molecular biological analysis of cancer tissue and advances in imaging techniques through to the digital analysis of data using "machine learning", which all help to inform therapeutic decisions. In order to ensure that it can continue to provide state-of-the-art treatment to patients, MedUni Vienna is building a new Center for Precision Medicine.
The latest figures from Statistik Austria show that around 20,000 people died from cancer in Austria in 2017. This equates to approximately a quarter of all annual deaths in the country. Oncologists in Austria and throughout the world are therefore constantly working to refine strategies that can improve cancer treatment and ultimately even cure the disease.
The aim is to develop tailor-made treatment strategies that address specific and individual features of cancers. This ranges from the analysis of specific mutations in the cancer cell through to the use of Big Data in evaluation of imaging results through to the ability to adapt surgical and radiotherapy procedures to match a patient's individual anatomical or physiological characteristics or to draw up after-care strategies that are optimised to meet the patient's individual needs.
Speaking on the occasion of World Cancer Day on 04 February, Joachim Widder, Head of the Department of Radiotherapy of MedUni Vienna and Vienna General Hospital and Head of the Comprehensive Cancer Center (CCC) of the two institutions, commented: "In many cases, the advances in customised treatment, whether at the level of molecular biology or technology, bring direct advantages for patients: longer survival with fewer problems and better quality-of-life. It is now impossible to imagine doing without precision medicine in the diagnosis and treatment of cancer and even other diseases."
Oncology at the forefront
Oncology therefore leads the way for many other fields of medicine. This is clearly illustrated by the example of the mRNA vaccine that was developed against Covid-19. Cancer researchers have already been focussing on mRNA for several decades, as it provides a relatively short-lived blueprint for the production of protein molecules in the cell. Even genetically foreign blueprints can be introduced into the cell and converted into proteins. Since the immune system reacts to foreign protein structures on the cell surface, so-called antigens, cancer researchers are working on introducing blueprints for cancer antigens into dendritic cells, for example. These cells are responsible for presenting the antigens to the immune system, so that it can target them. This should trigger an immune response to the cancer cells. This principle was then adapted and applied in the development of the COVID-19 vaccine, which is why it was possible to produce it so quickly and efficiently.
Relieving the side-effects of antibody therapy
MedUni Vienna can also boast examples of the successful development of precision medicine concepts that have attracted international attention.
For example, researchers at MedUni Vienna (research group led by Maria Sibilia from the Institute of Cancer Research and Comprehensive Cancer Center) explained the causes of the painful inflammatory skin condition that occurs as a side-effect of blocking the EGF receptor. This treatment is successfully used to suppress cell division in cancer cells, thereby inhibiting tumour growth. On the basis of the study results, the researchers also discovered a way of preventing these side-effects. The study was published in the leading journal "Science Translational Medicine" at the end of 2019. The first author of the study, Thomas Bauer, was recently awarded the Science Prize 2020 by the Austrian Society of Dermatology and Venerology for this study.
Customized treatment of cervical cancer
Another example of developments based on precision medicine within the framework of the CCC is a refinement of a specific radiotherapy technique, image-guided adaptive brachytherapy, for cervical cancer, which led to a 15% improvement in local tumour control (meaning that cancer cells could no longer be detected in the region of the cervix in 92% of patients, even five years after treatment). The results were obtained in the context of the international, multi-centre EMBRACE I study, which was conducted under the supervision of a working group from the Department of Radio-Oncology of MedUni Vienna and Vienna General Hospital.
The researchers used an imaging technique (MRI) that allows extremely precise, individual adjustment of high doses of radiation to the tumour and its environment, thereby facilitating individualised and targeted treatment. The paper will be published in the leading journal "Lancet Oncology".
Center for Precision Medicine (zpm)
In order to create the conditions for more successes like this in the future, MedUni Vienna is building the Center for Precision Medicine, with construction work scheduled to start in 2022. The new Center will focus in particular on biomedical research, clinical trials, genome technology, bioinformatics, and IT. Its close proximity to University Hospital Vienna will be particularly advantageous to patients: clinicians and basic researchers will be working together on the same site to develop the very latest knowledge, so that patients can benefit from state-of-the-art medicine.