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Guided Treatment in optimal Selected cancer patients - Translational and Clinical research in Oncology (GUTS)

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​​​​​​​​​​​​​The focus of the GUTS programme is to improve outcome of cancer treatment with better guided therapy in optimally selected cancer patients while reducing collateral damage and unintended late effects.

Current classification of cancer is still based largely on the morphology of tumor cells, while current cancer diagnostics (e.g. CT/MR/PET) are primarily based on visualization of the size and shape – and to a lesser extent – the molecular composition and heterogeneity of tumors. The identification of more cancer-specific dynamic cell biological changes in tumors and/or body fluids and their visualization will improve detection, classification, characterization and imaging of cancer. By combining current and novel state-of-the-art imaging and -omics modalities, tumor heterogeneity will be acknowledged and tackled. In addition, these cancer-specific cell biological changes can also be exploited to identify unique targets for innovative guided therapy, to better select cancer patients to be treated and to advance early identification of treatment efficacy, in order to adapt treatment to changing tumor characteristics. The ultimate aim is to improve the outcome. This will improve and support our strategy to personalize treatment of cancer for individual patients. Furthermore, if successful these interventions should result in the fewest possible harmful immediate and late side effects that would hamper quality of life and jeopardize healthy cancer survivorship.

Mission  

Mission of the GUTS programme is to establish and maintain an optimal collaborative multidisciplinary environment for principle investigators and researchers-in-training with the aim of improving cancer diagnosis and treatment outcome with better guided therapy in optimally selected cancer patients, with the fewest possible unintended early and late effects. This is accomplished through multidisciplinary collaboration – within the institution, nationally and internationally – on joint research projects and grant applications.

Programme Leaders   Principal Investigators   Description of the Programme  

A major challenge in current cancer research is the translation of promising preclinical data on more specific dynamic changes in cancer cells and its microenvironment into successful interventions. A particular challenge is tumor heterogeneity within and between patients. An important focus of research is therefore on the development and use of molecular imaging tools – both radioactive and optical – for drug development, patient and target selection and for monitoring treatment effects. For example, serial tumor biopsies result in spatiotemporal information on tumor heterogeneity.

Smart and small early clinical studies are considered to be the basis for successful translation. In addition, phase II studies followed by phase III studies will ultimately provide a credible evaluation of diagnostic accuracy of dynamic monitoring modalities and novel treatment options.

Often, more detailed cellular mechanistic information is required to understand the nature of the various early changes in tumor lesions, their microenvironment and the response patterns seen in patients. This requires studies with a broad variety of techniques to define pharmacodynamic behavior of a systemic treatment with more detail on tumor pathology, -omics, novel imaging techniques and pharmacokinetics.

Positioned in a horizontal matrix structure, this programme inherently interacts with and receives scientific input from the translational findings within the GUTS programme and from early translational results from the sister programmes DARE, TARGON, and SALL.

Due to the improving results of anti-cancer treatments and the increasing numbers of long-term survivors, the relevance of and knowledge about the pathogenesis of treatment induced long-term (and short-term) morbidity is also increasing. Improving knowledge about the occurrence of side-effects will provide opportunities for tailoring potentially toxic treatment and/or guiding primary and secondary strategies to prevent serious side effects of cancer treatment on an individual patient basis.

Relevance to Healthy Ageing  

Better staging and selection of patients prior to their treatment will improve outcome and reduce unwanted sequel. Adoption of a healthy lifestyle also during and after cancer treatment together with better handled multi-morbidity will lead to improved treatment outcome and thus contribute to healthy ageing and an active healthy cancer survivorship.

Therefore, important objectives of the research programme GUTS are the identification and evaluation of new targets for innovative cancer therapy, development of markers and tools for early detection of cancer therapy response, and development and exploration of  new tools for innovative classification, diagnosing and staging of cancer to tackle tumor heterogeneity. Furthermore,  the programme focusses on the evaluation of newly developed tools for innovative classification, diagnosing and staging of cancer in order to improve treatment outcome and understand treatment failure, and the development of prediction models for early and late effects of cancer treatment that can be used for primary and secondary prevention programmes.

Scientific and Societal output