van Laarhoven H.W.M.: Translational research in medical oncology

Important new targeted therapies are currently under development for the systemic treatment of cancer. However, only a subset of patients will respond to these treatments which are potentially toxic and expensive. In this research programme we aim to bridge preclinical and clinical approaches, to improve cancer treatment as well prediction of response to treatment, based on insights in tumor biology. Building on the knowledge acquired in our previous studies on growth factor receptor expression and tumor microenvironment of breast and colorectal cancer, we are extending our research efforts to oesophagogastric and pancreatic cancer. In preclinical studies we evaluate the the dynamics of growth factor receptor expression during systemic cancer treatment and cancer progression. Based on these studies are developing new strategies to combine and sequentially introduce targeted agents in the treatment of oesophagogastric cancer. New imaging modalities, including advanced diffusion weighted imaging techniques and PET-scans with a novel tracers, will be introduced to assess the tumor micro-environment – with a special emphasis on the visualization of tumor stroma, vascularization, and
oxygenation. Experiments to elucidate the identity of genes that are expressed in relation to the tumor microenvironment will be part of these studies. The potential of these techniques to serve as biomarkers will be evaluated. For the development of this research the collaboration with LEXOR and the departments of Pathology, Radiology and Nuclear Medicine in the AMC is indispensable.

As a second research line we focuss on the improvement of quality of life in oncological patients. We identified several new factors related to distress (e.g. the experience of time and future perspective), unravelled pathophysiological mechnisms related to severe fatigue after cancer treatment and developed new models of care for surveillance of women with a high genetic cancer risk and for the follow-up of patients after curative treatment of cancer. We have developed a support tool, focusing on ultimate life goals, for advanced cancer patients and currently assess its value in a randomized controlled trial in collaboration with the Department of Pastoral Care as well as the Department of Religious Studies of the Radboud University Nijmegen. Also, we are initiating studies to improve quality of life and functional outcome of patients with oesophageal cancer as well as compliance to oral cytotoxic treatment, in close collaboration with the department of Medical Psychology and Geriatrics.

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