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New research into childhood cancer

The Princess Máxima Center and UMC Utrecht recently signed a new and promising collaboration agreement. This collaboration concerns three innovative research projects, directed by Elsken van der Wall (chair of the Strategic Program Cancer) and Peter Luijten (chair of the division Imaging & Oncology) of the UMC Utrecht and Laurens van der Flier and Frank Holstege on behalf of the Máxima.

The three projects are: 

Treating brain tumors better with sound vibrations
Immunotherapy: the translation of the tumor infiltrating immunological landscape into therapeutic concepts
Theranostics: image-driven, personalized cancer care

Treating brain tumors better with sound vibrations

Every year in the Netherlands, more than 800 adults and 20 children are diagnosed with high-grade glioma, a malignant brain tumor. Unfortunately, for many of these patients, no curative treatment is possible and less than 20% of patients are still alive after 2 years. For low-grade glioma (300 adults, 40 children), the survival is better but often severe symptoms such as epilepsy or visually impaired or even blindness are present. Low-grade gliomas can also degenerate malignantly. In addition to surgery and radiation, chemotherapy is often used to treat these brain tumors, but these therapies regularly have insufficient effect. A major obstacle seems to be the so-called "blood-brain barrier". The blood vessels in the brain are largely impervious to many medicines, so they do not work properly where they have to: in the brain, near the tumor.

This is why UMC Utrecht and Prinses Máxima Centrum have joined forces to open the brain for therapy using so-called innovative MRI-controlled 'Focused-Ultrasound' technology: The blood vessels in and around the blood vessels can be placed in and around the brain tumor is opened temporarily and locally, allowing effective anti-cancer drugs to work where they are needed. By applying this technology, we hope to improve the survival of adults and children with high-grade glioma in the future and to treat patients with low-grade glioma better with less epilepsy, problems with vision or malignant degeneration. It is planned that the first treatment studies will start in 2021. (UMC Utrecht researchers Mario Ries and Chrit Moonen together with Dannis van Vuurden, Princess Máxima Center).

Translating the tumor infiltrating immunological landscape into therapeutic concepts

Background: Immuno-oncology is a promising new area within the field of basic, translational and clinical cancer research and recent years have seen breakthroughs where (otherwise untreatable) patients have been cured by novel immunotherapies. Immuno-oncology focusses on understanding the relationship between the tumor and patients’ own immune system, with the aim to target the cancer cells with antibodies or immune cells. 

 To enhance immuno-oncology research in Utrecht, we will develop a program focusing on the analysis of the immune-microenvironment of different tumors. Which cells of the immune-system invade the different tumors? What are the targets that the immune cells recognize in the tumor? Are the immune cells switched off by the tumor and can we reactivate these cells to attack the tumor? Based on this research, we are going to develop novel cellular therapies and bring these into the clinic.(Josef Vormoor from  Princess Máxima Center with UMC Utrecht researchers internist-oncologist Karijn Suijkerbuijk, hematologist Jürgen Kuball and researcher Linde Meyaard).

Theranostics: image-driven, personalized cancer care

Theranostics is a combination of therapy en diagnostics. It implies the use of the same tumor characteristic for both imaging and nuclear therapy. The Theranostics program will focus on three issues:

1) In adult oncology theranostics has been successfully applied andcan be used in pediatric tumors as well. An example is a specific theranostics approach for neuroendocrine tumors in adults, which can be used in pediatric neuroblastoma.

2) Improving current theranostics via PET scanning. In the near future Lieve Tytgat and Bart de Keizer will start a clinical study in the Princess Máxima Centrum.

3) Improved therapeutics with nuclear isotopes are desired by the team. There are a lot of possibilities beyond neuroblastoma tumors. We want to use theranostics for instance also in i.e. sarcoma or other tumors. “There is a lot to study and improve for our patients!” says Max van Noesel, also on behalf of Alex Poot, radiochemist and Marnix Lam, head nuclear medicine department, UMC Utrecht. This team is ready!