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Lörsch AM, Jung J, Lange S, Pfarr N, Mogler C, Illert AL. [Personalized medicine in oncology]. PATHOLOGIE (HEIDELBERG, GERMANY) 2024; 45:180-189. [PMID: 38568256 DOI: 10.1007/s00292-024-01315-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/16/2024] [Indexed: 04/26/2024]
Abstract
Due to the considerable technological progress in molecular and genetic diagnostics as well as increasing insights into the molecular pathogenesis of diseases, there has been a fundamental paradigm shift in the past two decades from a "one-size-fits-all approach" to personalized, molecularly informed treatment strategies. Personalized medicine or precision medicine focuses on the genetic, physiological, molecular, and biochemical differences between individuals and considers their effects on the development, prevention, and treatment of diseases. As a pioneer of personalized medicine, the field of oncology is particularly noteworthy, where personalized diagnostics and treatment have led to lasting change in the treatment of cancer patients in recent years. In this article, the significant change towards personalized treatment concepts, especially in the field of personalized oncology, will be discussed and examined in more detail.
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Affiliation(s)
- Alisa Martina Lörsch
- Zentrum für Personalisierte Medizin (ZPM), Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
- Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
- Bayerisches Zentrum für Krebsforschung (BZKF), Standort Technische Universität München, München, Deutschland
| | - Johannes Jung
- Zentrum für Personalisierte Medizin (ZPM), Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
- Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
- Bayerisches Zentrum für Krebsforschung (BZKF), Standort Technische Universität München, München, Deutschland
- Deutsches Konsortium für Translationale Krebsforschung (DKTK), Standort München, München, Deutschland
| | - Sebastian Lange
- Zentrum für Personalisierte Medizin (ZPM), Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
- Bayerisches Zentrum für Krebsforschung (BZKF), Standort Technische Universität München, München, Deutschland
- Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
- Comprehensive Cancer Center München, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - Nicole Pfarr
- Zentrum für Personalisierte Medizin (ZPM), Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
- Bayerisches Zentrum für Krebsforschung (BZKF), Standort Technische Universität München, München, Deutschland
- Deutsches Konsortium für Translationale Krebsforschung (DKTK), Standort München, München, Deutschland
- Institut für Allgemeine Pathologie und Pathologische Anatomie, Technische Universität München, München, Deutschland
| | - Carolin Mogler
- Zentrum für Personalisierte Medizin (ZPM), Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
- Bayerisches Zentrum für Krebsforschung (BZKF), Standort Technische Universität München, München, Deutschland
- Deutsches Konsortium für Translationale Krebsforschung (DKTK), Standort München, München, Deutschland
- Comprehensive Cancer Center München, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
- Institut für Allgemeine Pathologie und Pathologische Anatomie, Technische Universität München, München, Deutschland
| | - Anna Lena Illert
- Zentrum für Personalisierte Medizin (ZPM), Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
- Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
- Bayerisches Zentrum für Krebsforschung (BZKF), Standort Technische Universität München, München, Deutschland.
- Deutsches Konsortium für Translationale Krebsforschung (DKTK), Standort München, München, Deutschland.
- Comprehensive Cancer Center München, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
- Klinik für Innere Medizin I, Abteilung für Hämatologie, Onkologie und Stammzelltransplantation, Universitätsklinikum Freiburg, Freiburg, Deutschland.
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Hönikl LS, Lange S, Butenschoen VM, Delbridge C, Meyer B, Combs SE, Illert AL, Schmidt-Graf F. The role of molecular tumor boards in neuro-oncology: a nationwide survey. BMC Cancer 2024; 24:108. [PMID: 38243190 PMCID: PMC10797778 DOI: 10.1186/s12885-024-11858-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/09/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND In neuro-oncology, the inclusion of tumor patients in the molecular tumor board has only become increasingly widespread in recent years, but so far there are no standards for indication, procedure, evaluation, therapy recommendations and therapy implementation of neuro-oncological patients. The present work examines the current handling of neuro-oncological patients included in molecular tumor boards in Germany. METHODS We created an online based survey with questions covering the handling of neuro-oncologic patient inclusion, annotation of genetic analyses, management of target therapies and the general role of molecular tumor boards in neuro-oncology in Germany. We contacted all members of the Neuro-Oncology working group (NOA) of the German Cancer Society (DKG) by e-mail. RESULTS 38 responses were collected. The majority of those who responded were specialists in neurosurgery or neurology with more than 10 years of professional experience working at a university hospital. Molecular tumor boards (MTB) regularly take place once a week and all treatment disciplines of neuro-oncology patients take part. The inclusions to the MTB are according to distinct tumors and predominantly in case of tumor recurrence. An independently MTB member mostly create the recommendations, which are regularly implemented in the tumor treatment. Recommendations are given for alteration classes 4 and 5. Problems exist mostly within the cost takeover of experimental therapies. The experimental therapies are mostly given in the department of medical oncology. CONCLUSIONS Molecular tumor boards for neuro-oncological patients, by now, are not standardized in Germany. Similarities exists for patient inclusion and interpretation of molecular alterations; the time point of inclusion and implementation during the patient treatment differ between the various hospitals. Further studies for standardization and harmonisation are needed. In summary, most of the interviewees envision great opportunities and possibilities for molecular-based neuro-oncological therapy in the future.
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Affiliation(s)
- Lisa S Hönikl
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany.
- Center for Personalized Medicine (ZPM), Klinikum rechts der Isar, Technical Universitiy of Munich (TUM), Munich, Germany.
| | - Sebastian Lange
- Center for Personalized Medicine (ZPM), Klinikum rechts der Isar, Technical Universitiy of Munich (TUM), Munich, Germany
- Department of Medicine II, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Vicki M Butenschoen
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Claire Delbridge
- Center for Personalized Medicine (ZPM), Klinikum rechts der Isar, Technical Universitiy of Munich (TUM), Munich, Germany
- Department of Neuropathology, Institute of Pathology, Technical University of Munich (TUM), Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Anna Lena Illert
- Center for Personalized Medicine (ZPM), Klinikum rechts der Isar, Technical Universitiy of Munich (TUM), Munich, Germany
- Department of Medicine III, Faculty of Medicine, Klinikum Rechts der Isar, Technical University Munich (TUM), Munich, Germany
| | - Friederike Schmidt-Graf
- Center for Personalized Medicine (ZPM), Klinikum rechts der Isar, Technical Universitiy of Munich (TUM), Munich, Germany
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
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Illert AL, Stenzinger A, Bitzer M, Horak P, Gaidzik VI, Möller Y, Beha J, Öner Ö, Schmitt F, Laßmann S, Ossowski S, Schaaf CP, Hallek M, Brümmendorf TH, Albers P, Fehm T, Brossart P, Glimm H, Schadendorf D, Bleckmann A, Brandts CH, Esposito I, Mack E, Peters C, Bokemeyer C, Fröhling S, Kindler T, Algül H, Heinemann V, Döhner H, Bargou R, Ellenrieder V, Hillemanns P, Lordick F, Hochhaus A, Beckmann MW, Pukrop T, Trepel M, Sundmacher L, Wesselmann S, Nettekoven G, Kohlhuber F, Heinze O, Budczies J, Werner M, Nikolaou K, Beer AJ, Tabatabai G, Weichert W, Keilholz U, Boerries M, Kohlbacher O, Duyster J, Thimme R, Seufferlein T, Schirmacher P, Malek NP. The German Network for Personalized Medicine to enhance patient care and translational research. Nat Med 2023:10.1038/s41591-023-02354-z. [PMID: 37280276 DOI: 10.1038/s41591-023-02354-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- A L Illert
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Medicine III, Faculty of Medicine, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
- Center for Personalized Medicine (ZPM), Freiburg, Germany
- Center for Personalized Medicine (ZPM), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Partner Site TU Munich, Munich, Germany
| | - A Stenzinger
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Center for Personalized Medicine (ZPM), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - M Bitzer
- Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany
- Center for Personalized Medicine (ZPM), Tübingen, Germany
| | - P Horak
- Center for Personalized Medicine (ZPM), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Division of Translational Medical Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - V I Gaidzik
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
- Center for Personalized Medicine (ZPM), Ulm, Germany
| | - Y Möller
- Center for Personalized Medicine (ZPM), Tübingen, Germany
- M3 Research Institute University Hospital Tübingen, Tübingen, Germany
| | - J Beha
- Center for Personalized Medicine (ZPM), Tübingen, Germany
| | - Ö Öner
- Center for Personalized Medicine (ZPM), Tübingen, Germany
| | - F Schmitt
- Center for Personalized Medicine (ZPM), Tübingen, Germany
| | - S Laßmann
- Center for Personalized Medicine (ZPM), Freiburg, Germany
- Institute for Surgical Pathology, Medical Center, University of Freiburg, Freiburg, Germany
| | - S Ossowski
- Center for Personalized Medicine (ZPM), Tübingen, Germany
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
- Institute for Bioinformatics and Medical Informatics (IBMI), University of Tübingen, Tübingen, Germany
| | - C P Schaaf
- Center for Personalized Medicine (ZPM), Heidelberg, Germany
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - M Hallek
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for integrated Oncology (CIO-ABCD), Aachen-Bonn-Cologne-Düsseldorf, Germany
| | - T H Brümmendorf
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Center for integrated Oncology (CIO-ABCD), Aachen-Bonn-Cologne-Düsseldorf, Germany
| | - P Albers
- Department of Urology, Heinrich-Heine University, Medical Faculty, Düsseldorf, Germany
- Center for integrated Oncology (CIO-ABCD), Aachen-Bonn-Cologne-Düsseldorf, Germany
| | - T Fehm
- Department of Gynecology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Center for integrated Oncology (CIO-ABCD), Aachen-Bonn-Cologne-Düsseldorf, Germany
| | - P Brossart
- Department of Oncology, Hematology, Stem Cell Transplantation, Cell- and Immunotherapies, Clinical Immunology and Rheumatology, University Hospital Bonn, Bonn, Germany
- Center for integrated Oncology (CIO-ABCD), Aachen-Bonn-Cologne-Düsseldorf, Germany
| | - H Glimm
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT), Dresden, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany
- German Cancer Consortium (DKTK), Dresden, Germany
| | - D Schadendorf
- Department of Dermatology, University Duisburg-Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK) Partner Site, Essen, Germany
- National Center for Tumor Diseases (NCT), NCT-West, Campus Essen, Essen, Germany
- Westdeutsches Tumorzentrum (WTZ), Essen, Germany
- Research Alliance Ruhr - Research Center One Health, University Duisburg-Essen, Essen, Germany
| | - A Bleckmann
- Department of Medicine A: Hematology, Oncology, and Pneumology, University Hospital Münster (UKM), Münster, Germany
- West German Cancer Center, University Hospital Münster, Münster, Germany
| | - C H Brandts
- University Cancer Center (UCT) Frankfurt-Marburg, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
- German Cancer Consortium (DKTK) Partner Site, Frankfurt, Germany
| | - I Esposito
- Institute of Pathology, Heinrich-Heine University and University Hospital, Düsseldorf, Germany
- Center for Personalized Medicine (ZPM), Düsseldorf, Germany
| | - E Mack
- Department of Hematology, Oncology and Immunology, University Hospital Marburg and Philipps-University, Marburg, Germany
| | - C Peters
- Institute of Molecular Medicine and Cell Research, University of Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK) Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Freiburg, Germany
- Comprehensive Cancer Center Freiburg (CCCF), Freiburg, Germany
| | - C Bokemeyer
- Department of Oncology, Hematology and BMT with section of Pneumology, University of Hamburg, Hamburg, Germany
| | - S Fröhling
- Center for Personalized Medicine (ZPM), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Division of Translational Medical Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - T Kindler
- University Cancer Center, University Medical Center Mainz, Johannes Gutenberg-University, Mainz, Germany
- German Cancer Consortium (DKTK) Partner Site Mainz, Mainz, Germany
| | - H Algül
- Institute for Tumor Metabolism, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Comprehensive Cancer Center Munich TUM, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - V Heinemann
- Comprehensive Cancer Center Munich, Klinikum Großhadern, Ludwig Maximilian University of Munich, Munich, Germany
- Department of Medicine III, Klinikum Großhadern, Ludwig Maximilian University of Munich, Munich, Germany
| | - H Döhner
- Department of Internal Medicine III, Ulm University Hospital, Ulm, Germany
| | - R Bargou
- Comprehensive Cancer Center Mainfranken, Uniklinikum Würzburg, Würzburg, Germany
- Bavarian Cancer Research Center (BZKF), Partner Site Würzburg, Würzburg, Germany
| | - V Ellenrieder
- Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany
| | - P Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - F Lordick
- Comprehensive Cancer Center Central Germany and University Cancer Center Leipzig,, University Medicine Leipzig, Leipzig, Germany
| | - A Hochhaus
- Comprehensive Cancer Center Central Germany and Department of Hematology and Internal Oncology, Universitätsklinikum Jena, Jena, Germany
| | - M W Beckmann
- University Hospital Erlangen, Department of Obstetrics and Gynecology, Friedrich-Alexander-Universität Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nuremberg, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Partner Site Erlangen, Erlangen, Germany
| | - T Pukrop
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
- Comprehensive Cancer Center Ostbayern, Regensburg, Germany
- Bavarian Cancer Research Center (BZKF), Partner Site Regensburg, Regensburg, Germany
| | - M Trepel
- Department of Hematology and Medical Oncology, Augsburg University Hospital, Augsburg, Germany
- Comprehensive Cancer Center Augsburg, CCC Alliance WERA, Augsburg, Germany
- Bavarian Cancer Research Center (BZKF), Partner Site Augsburg, Augsburg, Germany
| | - L Sundmacher
- Department of Health Services Management, Ludwig-Maximilians-Universität, Munich, Germany
| | - S Wesselmann
- Deutsche Krebsgesellschaft (DKG), Berlin, Germany
| | | | | | - O Heinze
- Department Medical Information Systems, University Hospital Heidelberg, Heidelberg, Germany
| | - J Budczies
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Center for Personalized Medicine (ZPM), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - M Werner
- Center for Personalized Medicine (ZPM), Freiburg, Germany
- Institute for Surgical Pathology, Medical Center, University of Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK) Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Freiburg, Germany
- Comprehensive Cancer Center Freiburg (CCCF), Freiburg, Germany
| | - K Nikolaou
- Department of Diagnostic and Interventional Radiology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - A J Beer
- Department of Nuclear Medicine, Ulm University Hospital, Ulm, Germany
| | - G Tabatabai
- Department of Neurology and Interdisciplinary Neuro-Oncology, Center for Neuro-Oncology, University Hospital Tübingen, Tübingen, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, Stuttgart, Germany
| | - W Weichert
- Center for Personalized Medicine (ZPM), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Institute of Pathology, Technische Universität München, Munich, Germany
- German Cancer Consortium (DKTK) Partner Site Munich, and German Cancer Research Center (DKFZ), Heidelberg, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Partner Site TU Munich, Munich, Germany
| | - U Keilholz
- Charité Comprehensive Cancer Center, Charité, Berlin, Germany
| | - M Boerries
- Center for Personalized Medicine (ZPM), Freiburg, Germany
- German Cancer Consortium (DKTK) Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Freiburg, Germany
- Institute of Medical Bioinformatics and Systems Medicine (IBSM), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Comprehensive Cancer Center Freiburg (CCCF), Freiburg, Germany
| | - O Kohlbacher
- Center for Personalized Medicine (ZPM), Tübingen, Germany
- Institute for Bioinformatics and Medical Informatics (IBMI), University of Tübingen, Tübingen, Germany
- Institute for Translational Bioinformatics, University Medical Center, Tübingen, Germany
- Department of Computer Science, Applied Bioinformatics, University of Tübingen, Tübingen, Germany
| | - J Duyster
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Personalized Medicine (ZPM), Freiburg, Germany
- German Cancer Consortium (DKTK) Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Freiburg, Germany
- Comprehensive Cancer Center Freiburg (CCCF), Freiburg, Germany
| | - R Thimme
- Center for Personalized Medicine (ZPM), Freiburg, Germany
- Comprehensive Cancer Center Freiburg (CCCF), Freiburg, Germany
- Department of Medicine II, Freiburg, University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - T Seufferlein
- Center for Personalized Medicine (ZPM), Ulm, Germany
- Department of Internal Medicine I, University Hospital, University of Ulm, Ulm, Germany
| | - P Schirmacher
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Center for Personalized Medicine (ZPM), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - N P Malek
- Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany.
- Center for Personalized Medicine (ZPM), Tübingen, Germany.
- M3 Research Institute University Hospital Tübingen, Tübingen, Germany.
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