In Austria, there are around 40,000 new cases of cancer every year. If the cancer has reached the metastatic, incurable stage, the therapeutic aim is to improve quality-of-life and/or to prolong overall survival. However, in many cases, all conventional treatments fail, so that the disease can no longer be controlled, and the cancer progresses. Researchers from the Comprehensive Cancer Center (CCC) of MedUni Vienna and Vienna General Hospital have now found that precision medicine offers new avenues for treatment. They have now analysed the molecular biological characteristics of more than 500 cancer patients, for whom all standard palliative therapies had already been exhausted. Using the results, the experts offered 55% of the incurable patients a new targeted treatment option – based on their individual molecular profile.
A molecular biological analysis is done to determine the precise properties of the cancer cells, e.g. how the surface is made up and which signals cause cancer cells to proliferate or metastasise. These mechanisms are different for each tumour. If they are characterized, it is possible, under certain circumstances and conditions, to take targeted action against the tumour. This type of personalised therapeutic approach is known as precision medicine.
The researchers led by Gerald Prager, Department of Medicine I and Head of the CCC Platform for Molecular Diagnostics and Treatment in Oncology, studied the tumours of 519 patients using the very latest analytical techniques: Next Generation Sequencing, immunohistochemistry and cytogenetic analysis.
Hossein Taghizadeh, Department of Medicine I, member of the CCC and lead author of the study explains: "As well as the platform, the experts from the Medical University of Vienna and Vienna General Hospital also supervise the interdisciplinary tumour board for precision medicine. Every year, the tumour board discusses the cases of around 100 patients, for whom all standard treatments have been exhausted. Our study clearly shows that, in certain circumstances, precision medicine can offer experimental treatment approaches to control cancers, even in the metastatic, incurable stage."
Leaders in precision medicine
Precision medicine has been a known concept for some time now and its efficacy has been proven. However, it has so far only been practically established at a very few locations, because, apart from needing the appropriate infrastructure for molecular biological analyses and the expert know-how necessary for their interpretation, the everyday clinical structures must also be available, so that patients can be treated with the requisite speed. In the case of the Medical University of Vienna and Vienna General Hospital, a central role is played by the molecular pathological analysis of tumour biopsies by Leonhard Müllauer's team and the interdisciplinary case conference – the so-called tumour board, led by Gerald Prager assisted by Robert Mader. At this tumour board, an interdisciplinary team of experts develops customised treatment recommendations.
Center for Precision Medicine
Successes, such as those demonstrated in the present analysis, give us hope that precision medicine can help to improve or prolong the lives of even more people. In order to advance research and the development of new customised treatments, MedUni Vienna is therefore building the Center for Precision Medicine on the site of Vienna General Hospital – Medical University Campus – starting in 2022. Further information is available at: www.zpm.at
Prize for pioneering paper
Hossein Taghizadeh has now been awarded the ESMO's (European Society for Medical Oncology) Merit Award for young oncologists for his paper and the above-mentioned analysis. This prize is given in recognition of services to cancer research. At the same time, the prize underscores the expertise and international recognition that MedUni Vienna and Vienna General Hospital already enjoy in the field of precision medicine.
"Likelihood of targeted therapy recommendations for advanced solid tumors – data from the real-world precision cancer medicine platform MONDTI". Hossein Taghizadeh, Matthias Unseld, Robert Mader, Leonhard Müllauer, Thorsten Füreder, Markus Raderer, Maria Sibilia, Walter Berger, Philipp Staber, Hoda Mir Alireza, Stephan Polterauer, Matthias Preusser, Gerald W Prager.