The research within our LUMC departments is conducted within departmental research programmes. The research programme below is embedded within the department of Urology.
- Research programme: Surgical Oncology
- Department: Surgery
- Programme leader: Prof. Dr. R.A.E.M. Tollenaar
- Principal investigators: Dr. P.J.K. Kuppen, Dr. W.E. Mesker, Dr. A.L. Vahrmeijer, Dr. G.J. Liefers, Dr. P.J. Voorham-van der Zalm, Dr. G. van der Pluijm
- Biomedical research profile: Cancer Pathogenesis and Therapy
- Generic research profile: Ageing, Innovation in Health Strategy and Quality of Care
Aim and focus
The Surgical Oncology research program from the Department of Surgery consists of translational research with a focus on colorectal, breast, urological and upper GI malignancies. The purpose of the research is 'personalized treatment', with objectives:
- Development of new, tumor-targeted therapy before or after surgery to prevent tumor recurrence.
- Improvement of surgical treatment and detection methods using new imaging agents for improved, intra- or peri-operative detection.
- Improvement of diagnostics for the identification of high-risk patients/(frail)elderly patients.
- Functional studies on the identification of pathophysiological mechanisms of tumor progression and therapy resistance.
- Analysis of dysfunctions due to damage of the pelvic nerves using electrostimulation.
To achieve these purposes research is performed on several levels: functional laboratory research, clinical trials and quality assessment programs. For this purpose the Surgical Oncology has available a datacenter, biobank and laboratories. The research group has at their disposal a very extensive database with patient information that is in many cases completed with biological patient material.
Position in international context
The research group feels very strongly about a multidisciplinary approach. There is a close collaboration with several local, national and international research groups and institutions, which has resulted in the acquisition of multiple, prestigious international (and national) research projects and the establishment of several multicentre research consortia.
Content / highlights / achievements
- Several local, national, and international phase I/II/III trials were organized by the Surgical Oncology research group for colorectal and breast cancer patients, among which TME and TEAM1. These trials have changed international guidelines for treatment of cancer. Trials concern type of surgery (TME), and pre-operative or adjuvant treatments using chemotherapy (NeoZotac), radiotherapy (Rapido), hormonal therapy (TEAM2; Ideal), aspirin or immunotherapy.
- Image-guided surgery using fluorescent probes to improve tumor resection while sparing vital tissues and to find residual disease was successfully developed.
- Early detection of colorectal, breast and pancreatic cancer using serum proteomics has grown to a new line of research. As a result the national TESTBREAST study was initiated. Furthermore tumor-stroma interactions are the basis of a new prognosticator with basic research for the unravelling of the involved cancer-related pathways and an international study SP to validate the parameter for implementation. Molecular signatures responsible for the stroma response in prostate cancer-induced osteoblastic bone metastasis were identified.
- Biomarkers are studied in panels of tumor tissue and other patient material and related to patho-clinical patient characteristics for their prognostic and predictive value. A research program is available with special focus on elderly cancer patients.
- For patients with urological malignancies novel candidate nanodrug compounds were developed for treatment of patients with advanced, therapy-resistant urological malignancies resulting in initiation of Phase I/IIa clinical studies.
- Drugs were developed for repurposing/repositioning of FDA-approved compounds for urological malignancies.
- The MAPLe (The Multiple Array Probe Leiden) has been developed at the department of Urology at the Leiden University Medical Center in collaboration with Medical Delta.
- Image guided surgery: This promising field of research aims at the intra-operative visualization of cancer. In the past few years our department has become one of the key players. Integration of molecular imaging techniques in the clinic has become a division broad initiative.
- Geriatric Oncology: Cancer in the elderly is worldwide recognized as one of the most important themes for the coming years. Since 2008 our group has steadily grown in this field. In collaborations with the Dutch society of geriatric oncology (GeriOnNe) and the patient advocacy group ‘Borstkanker Vereniging Nederland, (BVN) specific clinical trials for the elderly are being developed.
- Proteomics: Evaluation of the prognostic value of blood samples will have high-impact on the development of screening tests. This will be the emphasis of further research development.
- Tailored treatment: Prognostic and predictive profiling of colorectal cancer. A comprehensive program using state of the techniques at the level of DNA-RNA-protein is currently performed using patient-derived material. The prognostic evaluation of the stroma parameter will be internationally validated in collaboration with the European Society of Pathology.
- Cancer immunotherapy: New clinical immunotherapy trials are performed and further developed in colorectal cancer in which patients are vaccinated with p53-derived peptides.
- Biobank: Further improvement and extension of the serum bank is aimed at, by intensifying collaboration with our regional network of community hospitals.
- Detect and validate differences in EMG signals of the pelvic floor before and after surgery in the pelvis, gynaecology, neuro surgery and surgery to predict functional outcomes.
Cohesion within LUMC
This research is conducted in a close collaboration with many departments within the LUMC, especially with Pathology, Immunohematology and Bloodbank, Molecular Biology, Parasitology, Clinical Oncology, and Immuno-hematology. The research program is part of the LUMC research theme ‘Cancer Immunotherapy’ and the ‘LUMC Cancer Center’. The geriatric oncology program links two of the key LUMC themes: ‘Cancer’ and ‘Aging’ and is conducted in close collaboration with the department of Gerontology and Geriatrics and the department of Public Health and Primary Care.
The sub-programmes on urological malignancies (prostate, & bladder cancer) and dysfunctions of the pelvic are strongly embedded in LUMC, in particular in the field of cancer pathogenesis, therapy development (precision medicine) and biomedical imaging.