Leuven’s research powerhouse leads combined effort against cancer

Summary

Formed last year, the Leuven Cancer Institute has brought together KU Leuven’s pioneering researchers and UZ Leuven’s medical staff to find the most holistic approach to cancer treatment. But the first challenge is combining the worlds of theory and practice

Under one roof

Five years ago, Johan Swinnen’s son, Pieter, was diagnosed with an aggressive form of brain tumour. The 13-year-old model student and promising tennis player survived but now uses a wheelchair.

But Swinnen (pictured) embodies the other side of cancer treatment as well, serving as the vice-president of the Leuven Cancer Institute (LKI), a multidisciplinary centre dedicated to cancer research.

LKI was created last year from the merger of cancer divisions at the University of Leuven (KU Leuven) and the University Hospital of Leuven (UZ Leuven). The transition process involved hundreds of researchers, doctors, nurses, managers and other personnel, as well as more than 30,000 patients. “We’re actually not even done registering all of the personnel,” says Griet Van der Perre, who oversees communication.

Jo Van Lint, meanwhile, is the co-ordinator for translational research at LKI. Think of him as the proverbial concierge, whose task is to identify new developments and figure out their applicability in cancer patients. These can include latest findings in molecular biology, and new insights into hospital care and patient psychology.

The logistics of ‘together’

At LKI, Van Lint acts as a kind of matchmaker who brings together people of different medical backgrounds. “Scientists and clinicians often need to communicate with each other and be aware of each other’s work,” he says. “That sounds simple, but in a large institution like ours, it isn’t.”

With the merger of the cancer divisions, scientific researchers from KU Leuven joined up with doctors and nurses from the university hospital. So how do you connect people who are used to working in very distinct settings?

There’s a gap between clinicians and scientists. Many clinicians lack sufficient information about basic research subjects

- Jo Van Lint, translational research co-ordinator

“First of all, we have to know about each other,” explains Van Lint. “So we’ve created opportunities for people to meet and exchange ideas.”

Asking people to talk to one another is one thing, but how can they better understand each other? “There’s indeed a gap between clinicians and scientists,” he says. “Many clinicians lack sufficient information about basic research subjects. But scientists could also benefit from an expert clinical overview of specific tumours.”

So LKI created “mind the gap” sessions, in which speakers explain their work in terms that are understandable to the audience. “It sounds obvious, but all too often our talks become ‘good news shows’ that are geared towards impressing the public, when we should be trying to resolve any remaining unknowns, because they hinder potential and novel collaborations,” says Van Lint.

But the challenge of bringing together two different medical worlds doesn’t stop at scientists and clinicians. Swinnen, who, in addition to serving as LKI’s vice-president, is also a professor of oncology at KU Leuven, goes through the centre’s long list of staff.

Patient at the centre

“We employ fundamental and clinical researchers, plus doctors and nurses, who cover every aspect related to cancer and cancer patients, from genetics and immunology, to surgical work and psychology.”

Cancer tumours come with many signs and symptoms. They also attack different organs, requiring the involvement of a variety of specialists. Then there are the actual patients who need both physical and mental support throughout the process.

In treatment, everything revolves around fighting the growth, but we must not forget about the patient who’s frightened

- Johan Swinnen, vice-president of Leuven Cancer Institute

“Cancer involves more than just the tumour,” explains Swinnen. “In treatment, everything revolves around fighting the cancerous growth, and that is, of course, essential. But we must not forget about the patient who’s frightened and doesn’t want to feel or look ill all the time.”

When Swinnen’s son was diagnosed with brain cancer, the scientist realised first-hand that the illness doesn’t stop at treatment. While the surgery, combined with radio- and chemotherapy, was successful at treating the tumour, it confined Pieter to a wheelchair.

Because the treatment had hindered his cognitive abilities, he also had to leave school. “The dreams of becoming a tennis star made way for the struggle with everyday routines,” says Swinnen.

LKI is currently running some 200 clinical trials involving new or improved cancer drugs and treatments. “We’re definitely at the forefront of cancer research and therapy,” says Swinnen. But cancer research is a costly endeavour.

Power vs precision

“With the merger, LKI has modelled itself on some of the most successful cancer institutes in the world,” says Van der Perre. “But world class research and treatment methods come with a price tag. We are looking into fundraising, and there is a lot we can learn from institutes in the US and the UK.”

The way doctors and scientists look at cancer has changed radically over the past decades. For a long time, the three main treatments – surgery, radiation and chemotherapy – were applied in a very rigorous manner.

The treatments, often applied simultaneously, would result in a lot of collateral damage, killing healthy cells on top of the malignant ones. “The survival rates only started to increase when we began to view cancer as a complex, multifactorial disease, in which every tumour has distinct characteristics,” says Swinnen.

Cancer cells are true masters at manipulation. You could say that they bribe our immune cells to let them through

- Johan Swinnen

This change led to more personalised and precise treatment methods. “Cancer cells are very different from healthy ones,” continues Swinnen. “If we target a gene or a protein that’s only present in cancer cells, we can dramatically reduce the side effects.”

Furthermore, he says, every cancer patient is unique. “Two breast cancer patients might share the same diagnosis, but it’s very likely that their tumours have very distinct genetic make-ups. To find this out, we’d have to sequence the tumours’ DNA, which takes up a lot of time and resources.”

That’s the advantage of a multidisciplinary centre like LKI, he adds. “We have all this technology and expertise in-house and we are constantly setting up common technical platforms that are used by both fundamental researchers and clinical doctors.”

Swinnen is working on the development of a revolutionary cancer therapy that boosts the patient’s immune system, instead of weakening it. In 2013, his field, known as immunotherapy, was declared the “scientific breakthrough of the year” by the journal Science.

The golden cure?

“The problem with cancer,” says Swinnen, “is that the tumour cells are not regarded by our immune system as foreign or necessarily bad. That’s because cancer cells are true masters at manipulation. You could say that they bribe our immune cells to let them through.”

To promote immunotherapy, LKI will organise a special conference later this month, bringing national and international experts to discuss the treatment method’s various aspects. One of the key questions is how to restore the ability of post-cancer cells to trigger immune responses.

The huge advantage of immunotherapy, says scientists, is that it holds the promise of being very effective against metastasis – as our immune system is unmatched when it comes to tracking and tracing cancer cells in our body.

For now, however, the treatment method works on less than 30% of patients. Two drugs – one against lung cancer and another against melanoma – have already been approved by the European food and drug authority, but among the biggest hurdles is the absence of a reliable test that can predict if the patient would benefit from immunotherapy.

But this doesn't serve to dampen the enthusiasm of researchers like Swinnen. “From a purely scientific point of view, this is a very promising technique,” he says. “It yields an entirely new category of cancer drugs that we could have never dreamt of before.”

Photo top: Rob Stevens/KU Leuven
Photo above: Communicatie UZ Leuven