Molenaar applied for the grant with a project called iTHER2.0, which is short for individualized therapy 2.0 and is a continuation of a previous project. In iTHER1, tumors of patients for whom all treatment options are exhausted were subjected to elaborate diagnostic tests. A team of researchers and clinicians used the resulting RNA and DNA profile to advise about which medication might still bring about positive effects.
In ITHER2.0 the team will go a bit further. They aim to categorize the diagnoses, such that a treatment advice is directly apparent. ‘In about half of the tumors we find a genetic mutation which is associated with a positive outcome for a specific drug’, says Molenaar. ‘For these patients we can focus the treatment plan.’ This enhances the chance of effect. Moreover, it decreases side effects and therewith improves the quality of life.
In the other half of the patients the team could not find a mutation for which a medicine was known. The change this, the researchers will culture mini-tumors from patient tissue. With the organoid system, which was developed by the group of Hans Clevers, they can culture many types of tumors in the lab. These organoids are used to establish for which compounds the tumors are sensitive.
ZonMw Precision Medicine Program grants 1.4 million euro to the project. The group of applicants was considered strong, multidisciplinary and experienced. ‘It shows the strength of the Princess Máxima Center’, says Molenaar, ‘Máxima-colleagues Jarno Drost, Marc van de Wetering, Frank Holstege, Bastiaan Tops, Patrick Kemmeren and Emmy Dolman and also Jan Koster affiliated with the AMC are involved in the application and the project.’