“The Tumor in a targeted attack”
SPIEGEL ONLINE: Mr. Westphalen, cancers are often a combination of therapies treated. What is the molecular tumor therapy different?
Westphalen: In classical cancer therapy, we take a sample of the tumor and in the laboratory, to which disease it is. Then we recommend on the Basis of large clinical studies and our own experience with individual therapy. This can be a surgery, radiation or chemotherapy. Or a combination thereof. The molecular tumor therapy goes a step further. Because we now know that disease, the appearance under the microscope can be constructed from their molecular biology is very different. Therefore, we examine the cancer cells in highly specialized laboratories specifically on genetic modifications and mutations. These changes we can then attack in some cases, with the Tumor-adapted drug in a targeted manner.
SPIEGEL ONLINE: It is however, but not for each individual Tumor in an individual drug.
Westphalen: No. We use medicines, not only in the originally intended diseases, but increasingly across disease boundaries. We had, for example, a patient with a rapidly growing brain tumor that has already been operated on several times and irradiated. The classic therapy went slowly to the end. We have examined the Tumor molecular and a change detected, we know from lung cancer. The patient received a drug that is only approved for the treatment of lung cancer. It has the effect that the brain tumor grew for six months. That gave the patient time to recover from the last surgery and radiation therapy. In the connection it could be re-operated and irradiated.
SPIEGEL ONLINE: so It is not a cure?
Westphalen: at The present time we continue the therapy generally for the prolongation of life and relief of symptoms. The molecular diagnostics and therapy is not a panacea, but a tool that can offer some patients additional treatment options. You must say the patient also realistic.
SPIEGEL ONLINE: what are the criteria To decide which Patient this is out of the question?
Westphalen: Currently we use the molecular diagnosis, particularly in patients with rare tumor diseases. We are not sure that the health condition of the patient is too bad, because the diagnostics can take up to six weeks. In addition, the patient should feel physically and mentally able to take any further treatment options.
SPIEGEL ONLINE: Should all patients – whether advanced or in the early stage of molecular diagnostics to benefit?
Westphalen: In an ideal world, would I wish it to be. However, this is a question of cost and logistics. But there are already diseases in which the largest part of the Affected molecular is diagnosed. A pioneer of metastatic lung cancer. The influence of molecular therapy is here so pronounced that certain patients who would have died ten years ago, within a period of six to twelve months, can live for several years with her illness.
SPIEGEL ONLINE: What patients, in which the molecular diagnostics is carried out?
Westphalen: We are in need of tumor tissue, we are examining can. A new collection is not always necessary, because a part of the analyses can be archived tumor material. However, this may be too old. A relatively new possibility is the liquid biopsy, for which only a Blood sample is needed. This technique is not yet established in clinical practice, but will play a greater role in future.
SPIEGEL ONLINE: How is it, then?
Westphalen: The finding of tissue analysis, we discuss the molecular tumor Board. This is a panel of experts from the handlers of the respective patients as well as Physicians and scientists specializing in molecular biology and genetics. Together, we develop a recommendation for a therapy that…
SPIEGEL ONLINE: ;..which can then be immediately started?
Westphalen: no, we have yet to logistical and bureaucratic hurdles. If we want to use a drug that is not approved for the disease in question, actually, we need to ask the health insurance of the patient elaborate on the cost of acquisition. We also need to give thought to how we Fund the counselling, diagnosis and treatment in the future. This should be our goal, the molecular diagnostics available to as many cancer patients at the right time.
SPIEGEL ONLINE: Many patients don’t know anything about your possibilities and are overwhelmed in the search for the best diagnostic and treatment options. What would you advise them?
Westphalen: patients can contact the cancer information service. In addition, many cancer centers offer counselling. Here are Affected will be advised individually and, at appropriate clinics. In addition, most of the University have disease hospitals special consultation hours for the different cancer. I rate generally, to obtain information in several Places, and an escort to take to get as much information as possible about diagnosis and treatment options.