Immunotherapy with laboratory-adapted T cells, a type of white blood cell, is a type of treatment that some children with blood cancer receive at Máxima. This involves their own immune system, in this case the modified T cells, attacking the tumor cells and clearing them out. Dr. Florijn Dekkers , senior researcher in Dr. Anne Rios' group, along with other researchers, developed a technology that provides three-dimensional (3D) imaging of cell activity. The audience in the room, wearing 3D glasses, watched breathlessly as a tumor cell was destroyed by a T cell right in front of them. Not only spectacular, but also a breakthrough for the scientific world, as it enables research into cell behavior and activity through images. 'We imaged how T cells from an immunotherapy attack an organoid, or mini-tumor, grown in the lab. We saw that some T cells were very active and others much less so. We learn a lot from that. In addition, it may also give us the opportunity to make a therapy more effective and thus better by combining the most active cells. We are now investigating this further with the ultimate goal of bringing this application from the lab to the clinic.
All tumors in view
Images, in this case scans, also play an important role in Prof. Dr. Max van Noesel's daily work. As a pediatric oncologist and researcher, he focuses on theranostics, a fusion of therapy and diagnostics, in the treatment and diagnosis of children with neuroblastoma. He explained how he uses specific proteins present on tumor cells to bind radioactive substances. The resulting charged proteins can then be made visible on a radioactive PET scan. A heavier radioactive substance can also be used as internal tumor irradiation. 'On several types of solid tumors, including neuroblastoma, we have found useful specific proteins and can get a lab-adapted radioactive antibody to bind them. With this, we use a PET scan to image the tumor cell or treat the child by attacking the tumor. This also allows us to visualize the success of the treatment: if the radiation is successful, the PET scan shows fewer tumor cells.' In adult oncology, this technology has been used for some time. Prof. Max van Noesel and his colleagues at Máxima and UMC Utrecht are investigating possible improvements and the translation of these methods to application in children.
Holograms and luminescent tumors
In 2021, 237 children, one-third of the total number of children with cancer that year, were diagnosed with solid tumors. They almost always start the treatment process with chemotherapy to control the tumor. This is often followed by surgery. Prof. Dr. Marc Wijnen is surgeon and research group leader and talked about how important images of the tumor and organ are during and prior to surgery. 'A solid tumor often interweaves with the organ. So during surgery we have to be very careful to cut away the tumor with as little damage to the organ and blood vessels as possible. A good preparation is very important here. Thanks to silicone models and Augmented Reality (AR) in which the organ with tumor floats in space in front of us, we have a much better picture of the situation compared to the scans we used before. As a result, we know better what to expect during surgery and can remove the tumor better and faster. As a result, the child is under anesthesia for less time and has less risk of complications.' New imaging techniques play a role not only prior to, but also during surgery. For example, surgeons can wear a so-called HoloLens, which allows them to project the tumor as a hologram on the organ. In addition, Prof. Marc Wijnen and his colleagues are investigating whether they can use fluorescence to light up tumor cells during surgery. For this they received funding earlier this year from the KWF .
It is possible to watch back the presentations by Florijn Dekkers and Max van Noesel via the links below (in Dutch!). Due to data protection it is not possible to watch back the presentation of Marc Wijnen.
Florijn Dekkers - Kankercellen onder de microscoop
Max van Noesel - Theranostics
Cancer in focus was the theme of the third and final science evening in 2022. In 2023, the Máxima will organize a new series. The announcement will be shared via the website and our social media channels.