2023-05-31 09:51:00
Cancer will probably remain a shock diagnosis for a long time to come. But new therapies and medicines from the Cancer Center CCC give cancer patients hope.
Munich scientists at the university clinics, united in the cancer center CCC, have developed some groundbreaking therapies that are of great interest to scientists and patients worldwide. In our large report, top experts from the Munich University Hospital of the LMU and from the Klinikum Rechts der Isar (TUM) present new therapies against cancer. For example, so-called theranostics, which combine diagnosis and therapy and destroy metastases directly in the body with radioactivity. At the end of 2022, an international pharmaceutical giant applied for worldwide approval for this novel prostate cancer therapy, which was significantly developed at the Munich university clinics. We explain six new weapons against cancer and how they work:
Theranostics as a novel prostate cancer therapy
Theranostics – this term stands for a combination of diagnosis and therapy in which tumors in the body are marked and destroyed. Here, the nuclear medicine specialists from the two Munich university hospitals have done pioneering work that has received worldwide attention. The scientists have identified molecules that are found in particularly high concentrations on tumors. These can be illuminated on PET/CT images. PET stands for Positional Emission Tomography and CT for Computer Tomography. A hybrid device combines the two methods. The CT analyzes the structure, the PET the function. The metastases glow because you inject a radioactively labeled surface molecule that binds to that on the tumors. You can get to them by irradiating them directly in the body. And with millimeter precision with radioactive substances, the radiation from which then hits the tumors directly in the body and destroys them. Sounds like science fiction. But it is precisely this treatment – called molecular radiotherapy – that has been largely developed in Germany. Fundamental research was carried out in Munich on the surface molecule CXCL4, which can be found on lymphomas (malignant tumors of the lymphatic system), among other things. The same applies to the surface molecule PSMA found on prostate carcinomas. “The relevant radiotherapy has been brought to product maturity in our company and is already being used successfully on hundreds of patients,” says Prof. Peter Bartenstein, Director of Nuclear Medicine at the LMUKlinikum.
Theranostik should also be used against bone marrow cancer and kidney cell cancer
Such therapies are also currently being developed in Munich for diseases such as multiple myeloma (a form of cooking marrow cancer) and renal cell cancer. “We did pioneering work here in Munich. Today we treat hundreds of patients from the USA here,” says Prof. Wolfgang Weber, Director of Nuclear Medicine at the Klinikum Rechts der Isar (TUM). The treatment is so successful that pharmaceutical giant Novartis has applied for international approval for it, which will happen in 2022. “We scientists are proud to have a treatment method here that was not developed by a large corporation but at German university hospitals,” says Prof. Bartenstein.
activate immune cells
“Cell therapy with so-called CAR-T cells is highly complex, expensive, but highly effective for lymph gland cancer, NonHodgkin’s lymphoma,” says Prof. Michael von Bergwelt, oncologist, intensive care physician and director of the Medical Clinic and Polyclinic II of the LMU Clinic. For this immunotherapy, blood is taken from the patient and sent to the USA, as there are not enough laboratories in Germany that specialize in this. In the USA, the immune cells are genetically reprogrammed in such a way that, when they are back in the patient’s body, they specifically attack the lymph gland cancer cells that are constantly being formed. Thanks to this new type of therapy, many patients who would have died sooner or later live for a long time. That’s a real miracle,” says Prof. von Bergwelt.
Immune to skin cancer
Black skin cancer (malignant melanoma) is an aggressive, very malignant skin tumor that spreads very quickly and early to other organs, where metastases then form. “Around ten years ago, the survival rate here was just over five percent. Now more than 50 percent of the patients survive longer than five years,” says Professor Dr. Angela Krackhardt, expert in immunotherapy at the Klinikum Rechts der Isar (TUM). So-called checkpoint inhibitors remove the blockages in the body’s immune system and allow the body’s own immune system to fight the cancer. But checkpoint inhibitors don’t always work that well. Unfortunately, only 20 to 30 percent of patients with lung cancer or other types of cancer affecting the stomach or intestines respond to the therapy.
See more thanks to artificial intelligence
Artificial intelligence (AI) can sometimes detect the smallest of strange tissue changes better than the human eye. For example, radiologists use AI in their analysis of images created by computer tomography, for example. “However, it is not the artificial intelligence that makes the diagnosis, rather it draws the experts’ attention to abnormalities that might otherwise not have been seen,” explains Prof. Marcus Makowski, Director of the Institute of Radiology at the Klinikum Rechts der Isar (TUM). Looking to the future, he sees a lot of potential here. A lot is expected from the AI, especially for lung carcinoma screening, which is to be introduced from 2023/2024. It is intended for people who are at particular risk of developing a lung tumor.
Deciphering cancer DNA
Slowing down the genetic material (DNA) of a cancer cell in the process of implementing its program of uncontrolled growth – this works if you know the weak points of the individual tumor in question. “We then attack precisely these weak points with medication,” explains Prof. Dr. Frederick Klauschen, Director of the LMU Institute of Pathology. It’s called precision oncology. The scientists use artificial intelligence (AI) to compare the thousands of mutations in the tumors and the effects of the drugs in hundreds of patients. In Munich, the universities are developing a large portal in order to track down lung cancer using millions of data sets and to find out whether a patient has had no more therapy or whether a recurrence, i.e. a recurrence of the tumor, is to be expected.
Shoot mini tumors
Today, radiation medicine specialists have mobile tumors well under control, explains Prof. Stephanie Combs, Head of Radiation Therapy at the Klinikum Rechts der Isar (TUM). When the patient breathes, for example, tumors can change their position in the body. Modern devices make it possible to only irradiate when the tumor is in focus. In addition, nuclear medicine can precisely mark metastases. This is why today, in the case of metastases after prostate cancer, only the affected lymph nodes are irradiated – and no longer the entire pelvis on suspicion. Prof. Claus Belka, Head of Radiation Therapy at the LMU Clinic: “Thanks to modern diagnostics, we can now see a lot more and can only irradiate the tumors with pinpoint accuracy.”
This article only contains general information on the respective health topic and is therefore not intended for self-diagnosis, treatment or medication. In no way does it replace a visit to the doctor. Unfortunately, our editorial team cannot answer individual questions about clinical pictures.
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