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KiTZ: Hopp Children’s Tumour Center at NCT Heidelberg

The Heidelberg University Hospital and the DKFZ have established the "Hopp Children's Tumor Center at NCT Heidelberg" (KiTZ) where doctors, scientists, nursing staff and other specialists work side by side on new diagnostic and therapeutic options to help children with cancer.

Professors Stefan Pfister, Olaf Witt and Andreas Kulozik (from left to right) have joined forces at KiTZ to help children with cancer. © KiTZ / Philipp Benjamin

From a purely statistical point of view, the likelihood that children with cancer can be cured is quite high: nowadays, four out of five patients can be treated successfully. “But we cannot be contented with that,” is the unanimous opinion of Profs. Stefan Pfister, Olaf Witt and Andreas Kulozik, the directors of the Hopp Children’s Tumour Center at NCT Heidelberg (KiTZ) founded by Heidelberg University Hospital and the German Cancer Research Center (DKFZ). Together with nearly 200 other staff at KiTZ, Pfister, Witt and Kulozik are working hard to find new ways of treating children with cancer.

After traffic accidents, cancer is still the main cause of death in children in Germany. Every year, about 2000 children are newly diagnosed with cancer and every fifth child dies. These figures have remained unchanged for many years. The price paid by the children who survive is also high. In addition to acute adverse drug effects such as hair loss, nausea and mucosal bleeding, the long-term consequences can be severe: permanent organ damage, hormonal and neurological disorders, and the therapies can also be one of the factors likely to trigger future cancers.

Glossary

  • A gene is a hereditary unit which has effects on the traits and thus on the phenotype of an organism. Part on the DNA which contains genetic information for the synthesis of a protein or functional RNA (e.g. tRNA).
  • A hormone is an active regulatory chemical substance formed in one part of the body and carried by the blood to another part where it exerts a reaction in the cell. E.g., insulin is produced in the pancreas, passes to the muscles where it leads to a reduction of the blood glucose level.
  • Genetic sequences are successions of the bases adenine, thymine, guanine, and cytosine on the DNA (or uracil instead of thymine in the case of RNA).
  • Translation in a biological context is the process in which the base sequence of mRNA is translated into the amino acid sequence of a protein. This process takes place in the ribosomes. Based on a single mRNA molecule, many protein molecules can be synthesised.
  • Oncology is the science that deals with cancer. In a more restrictive meaning, oncology is a sector of medicine that attends to the prevention, diagnostics, therapy and aftercare of malignant diseases.
  • A tumour is a swelling of a tissue caused by abnormal cell growth, which can be benign or malignant. Benign tumours are local swellings, whereas malign tumours may seed off and spread into other tissues, causing secondary growths (metastases).
  • Neurooncology deals with the diagnostics and therapy of brain tumor diseases.
  • Computer tomography (CT) is a imaging technique to display the structures within the body. Therefore, radiograms are taken from different directions and are analysed by a computer to get a three-dimensional image.
  • Neurology is the study of the diseases of the nervous system.
  • Biomolecules which can bind active agents are called targets. They can be receptors, enzymes or ion channels. If agent and target interact with each other the term agent-target-specific effect is used. The identification of targets is very important in biomedical and pharmaceutical research because a specific interaction can help to understand basic biomolecular processes. This is essential to identify new points of application.

The search for new molecular keys for application in paediatric oncology

It is therefore essential to create new therapies that are better tolerated and that also offer a chance of cure for the 20 percent of children with cancer for whom no suitable therapy is yet available. Olaf Witt, head of the “Translational Paediatric Oncology” programme at KiTZ is counting on state-of-the-art technologies in the field of personalised medicine: “We are looking for the molecular keys in children with cancer recurrence that will make individualised therapies possible.”

This was for the case for four-year-old Emma who was diagnosed with a rare brain tumour two years ago. Emma underwent surgery and was subsequently treated with chemotherapy. However, treatment was ineffective and the brain tumour came back. A team of researchers from the INFORM (Individualised Treatment For Relapsed Malignancies in Childhood) registry in Heidelberg analysed the genetic material of the girl’s tumour. The scientists discovered two new potential therapeutic targets and developed a combination therapy that specifically targeted the two modifications, and was thus adapted to the girl's specific requirements. Emma now takes two drugs that were originally approved for treating leukaemia. Although it is still too soon to talk of treatment success, for Emma and her parents, the individualised treatment approach provides a glimmer of hope.

At KiTZ, research and clinical therapy are growing closer together

Donation of a cheque worth 20 million euros on the occasion of the inauguration of KiTZ. Prof. Dr. Andreas Kulozik, Prof. Dr. Olaf Witt, Dietmar Hopp, Annika, Prof. Dr. Michael Baumann, Prof. Dr. Stefan Pfister, Prof. Dr. Guido Adler (from left to right) © Heidelberg University Hospital

KiTZ was established in Heidelberg in November 2016. Since then, joint tumour boards have been set up, joint seminars have been held and scientific symposia like the “1st KiTZ Symposium on Paediatric Oncology and Haematology” ensure the excellent cooperation between research and clinical practice. What KiTZ still does not have is a separate building to house the research and clinical spaces under one roof. “We need our own therapy and research centre so that we can combine medical and scientific expertise on paediatric cancer and blood disorders in one place. At the moment, everything is scattered across the Heidelberg University campus,” explains Stefan Pfister, director of the “Preclinical Paediatric Oncology” programme at KiTZ.

At the end of 2016, the Dietmar Hopp Foundation announced that it will provide sponsorship of 20 million euros, around half of the estimated cost of the construction of the new centre. Other sponsors have also pledged their support, and 75% of construction costs are now covered. The KiTZ founders are confident of finding more supporters to enable building work to start in early 2018. The new building is expected to be finished in 2021.

The advantages of a new building for paediatric oncology are obvious. The close proximity of research and clinical spaces and the close ties with the neighbouring children’s hospital and other hospitals that work with the Heidelberg University Hospital enable experts from different medical disciplines to work closely together. Pathways are becoming shorter and processes more efficient. This is especially important when it comes to translating scientific findings into clinical applications, which is the special focus of the “Translational Paediatric Oncology” programme at KiTZ.

The new KiTZ building will also facilitate the flow of information. “I am convinced that casual chats in the corridor play their part in turning brilliant ideas into brilliant research approaches,” says Pfister who runs the Paedriatric Neurooncology department at the DKFZ. He plans to further expand the preclinical scientific research area at KiTZ in coming years.

A concept that meets the needs of children with cancer

As soon as the KiTZ building is ready, the Department of Oncology and Haematology of the University Children's Hospital will also be moved there. “Children and adolescents with oncological and haematological diseases already receive the highest quality outpatient, inpatient and day care,” says Andreas Kulozik, medical director of the Department of Paediatric Oncology and Haematology and head of the Clinical Paediatric Oncology programme at KiTZ. “In the new building, we will be able to pool all our services under one roof, and this means that we will also be able to look after the young patients’ natural desire to run around and participate in leisure activities. The architects are therefore planning to incorporate space for exercise and music therapy for distraction and recovery inside and outside the building. “We are currently working on a holistic concept that meets the needs of children with cancer,” says Kulozik.

The three KiTZ programmes

Programme 1, “Clinical Paediatric Oncology” (director: Prof. Dr. Andreas Kulozik), is focused on the outpatient, day care and inpatient clinical treatment of patients with cancer and severe blood disorders, often as part of clinical trials.

Programme 2, “Translational Paediatric Oncology” (director: Prof. Dr. Olaf Witt), combines innovative individualised treatment forms for increasing the chances of curing children with malignant diseases. The programme focuses on the translation of new research results into early clinical trials. This will be of particular benefit for patients who do not respond to established therapies.

Programme 3, “Preclinical Paediatric Oncology” (director: Prof. Dr. Stefan Pfister), brings together different experimental paediatric-oncological groups at the University Hospital and the DKFZ. The programme aims to develop new diagnostic methods for the classification of tumours, discover new mechanisms of tumour development and translate this into new therapeutic approaches.

The Hopp Children’s Tumour Center at NCT Heidelberg (KiTZ)

The Hopp Children’s Tumour Center at NCT Heidelberg (KiTZ) is a joint project between the University Hospital of Heidelberg and the German Cancer Research Center (DKFZ). As a therapy and research centre for oncology and haematology in children and adolescents, KiTZ aims to combine promising research approaches with patient treatment, from diagnosis to treatment and follow-up care. Children with cancer, including those who are no longer responding to established therapies, receive individualised treatment plans developed by a group of interdisciplinary experts on tumour boards. The participation of the young patients in clinical trials ensures access to new therapy options. KiTZ is therefore a directional platform for transferring research findings from the laboratory to the clinic.

The National Center for Tumor Diseases (NCT) is a cooperation of the German Cancer Research Center (DKFZ) and the Heidelberg University Hospital. As one of the leading Comprehensive Cancer Centers in Germany and oncological centre of the German Cancer Aid connects the NCT interdisciplinary patient care with excellent cancer research under one roof.

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