Patients and Cologne University Hospital work hand in hand on research

The focus is on a rare genetic change known as the ALK mutation. This mutation occurs in a subgroup of patients with non-small cell lung cancer (NSCLC). Overall, it affects only three to five percent of the 40,000 to 45,000 new cases in Germany each year. Due to its rarity, close international cooperation is crucial to finding patients with this characteristic and conducting meaningful research.

The Department of Internal Medicine I at Cologne University Hospital has launched the preclinical research project in collaboration with the two patient organizations - in other words, research that lays important foundations for future therapies before they are applied to humans. The focus is not only on science, but also on the active involvement of those affected - in project design, implementation, and the collection of patient samples.

Specifically, state-of-the-art single-cell sequencing will be used to identify which biological signatures (known as biomarkers) are associated with a response or non-response to immune checkpoint inhibitors. The aim is to identify patients who can benefit from immunotherapy – and at the same time to better understand why this is not the case for others.

“Targeted ALK therapy is currently the treatment of choice for ALK-positive lung cancer patients and is very effective. Unfortunately, resistance to ALK inhibitors often develops over the long term,” says PD Dr. Matthias Scheffler, lung cancer specialist at Department I for Internal Medicine. Prof. Dr. Dr. Roland Ullrich, senior physician, head of preclinical research at Clinic I for Internal Medicine and associated to the Center for Molecular Medicine Cologne (CMMC), adds: “If we better understand the mechanisms that influence response to immunotherapy, we could treat patients in a more targeted manner, for example by adjusting therapy at an early stage or by using combinations of different immunotherapies.”

The focus here is on investigating the tumor microenvironment (TME). Previous studies suggest that immune cells in the tumor environment, particularly myeloid cells, can significantly impact the effectiveness of immunotherapies. Some genetic changes result in a "hot," or immunologically active, TME that responds well to PD-1 blockade. Other changes, such as ALK, appear to be associated with a "cold," or more immunosuppressed, TME. Combining immunotherapeutic approaches could open up new possibilities in the future.

Representatives of patient organizations emphasize that affected individuals are not only study participants, but also active contributors. "It is encouraging to see that our experiences and perspectives are taken seriously from the outset, and that we are truly developing and implementing this project together," said Nicoline Ehrhardt and Sabine Hatzfeld, both of whom are members of the ZIELGENAU and ALK Positive Europe boards.

Access to biopsies from NSCLC patients with an ALK mutation is essential for the implementation of the project. Patients from all over Europe who would like to participate in this project can contact Cologne University Hospital directly. Participation can help to gain crucial insights for the future of personalized cancer therapy.

This message has been modified by the CMMC (K. Heber & D. Grosskopf-Kroiher) and is based on the text by the press and communications team of the University Hospital Cologne (original German version here).