To offer top-notch care for adult patients with soft tissue sarcomas (STS), to improve outcome for patients further by performing research and to educate and train the future generation of physician-scientists and scientists specialized in STS.
The scientific work within the STS center has as ultimate aim to improve the outcome of patients with sarcoma. The research varies from fundamental research (i.e. role of miRNA in STS and sensitivity to anti-tumor agents; identification of active signal transduction pathways in desmoids and STS), translational research (i.e. molecular characteristics of liposarcoma predicting local relapse; factors impacting imatinib pharmacokinetics), clinical studies (Phase I, II and III studies in GIST and STS), and topics in health science (i.e. value-based outcome measures).
Additionally, the clinical utility of novel strategies such as, but not limited to immunotherapy, radiogenomics, novel biological techniques (organoids / induced pluripotent stem cells / high-throughput drug screens) will be explored. For this research there is an intensive collaboration between the partners participating to this ACE, as exemplified by shared (co-)promotorships and regular joint research meetings.
The Center is an active member of the Soft-Tissue and Bone Sarcoma Group of the European Organization of Research and Treatment of Cancer (EORTC) and has multiple other international collaborations.
Given their rarity, not much attention is being paid to STS during the training of medical students. In contrast, during the resident training for surgical oncologists, medical oncologists, radiotherapists, and pathologists, STS are a regular component of the training these residents receive.
In the Erasmus MC Cancer Institute, there is a yearly course of multidisciplinary teams for all residents and fellows (Radiotherapy, Radiology, Surgery, Medical Oncology, Pathology) in the hospital to get an update in the state of art regarding diagnosis and treatment. CME and CME-like courses for registered medical specialists are provided. Prof Kees Verhoef is chairman of the "Nederlandse Vereniging van Chirurgische Oncologie (NVCO)", which is responsible for organizing national courses for surgical oncologists in training.
Each year a special course is being held for registered surgical oncologists on the topic "Sarcoma" with as learning objective to keep surgical oncologists up to date on the newest developments with respect to treatment. Given the relatively small size, there are no clear opportunities for innovation in this area of education. Apart from feedback on general activities such as approval of the training for Medical Oncologists and Radiotherapy, no specific feedback is available. There is currently 1 master student from Iran and 1 PhD student, also from Iran.
Societal Relevance to Research, Education and Patient Care
As mentioned, the contribution of research performed by the ACE in the context of (international) clinical studies on daily clinical care is substantial; examples include role of isolated limb perfusion in STS (Verhoef), first line treatment of metastatic GIST with imatinib (Verweij), first line chemotherapeutic treatment of advanced STS (Verweij), and second line treatment of advanced STS with pazopanib (Sleijfer).
Results from these studies have been incorporated in national and international guidelines such as those provided by ESMO and National Comprehensive Cancer Network.
Viability of Research, Education and Patient Care
Multidisciplinary tumor board meets weekly, which are also attended by residents from medical oncology, surgery, radiotherapy, pathology, and diverse PhD students. Furthermore, a multidisciplinary research group consisting of PhD students and supervisors meets every two months.
There are currently 2 master students and 3 PhD students doing fundamental/translational research. Two of these come from abroad. One PhD student has two promotores (one from surgery, one from med oncology) and two co-promotores (one from surgery, one from med oncology) underlining the collaborations across involved departments. There is no specific system for talent identification active within the ACE.
The Department of Medical Oncology has however a committee "Scout en Behoud", that aims to identify, monitor and evaluate talents actibve within the department. A bibliometric is not available, the reputation of some of the participants is however internationally recognized as exemplified by recent invited editorials by participants of this ACE (Ann Surg Oncol. 2016 Jul;23(7):2128-30 (Verhoef); Cancer 2016 May 1; 122 (9): 1346-8 (Sleijfer)) and by invitations to become chair/member of scientific committees for international meetings such as ESMO/ECCO (Sleijfer, Verhoef).
Key and relevant publications of the last five years
- Deroose JP, Eggermont AM, van Geel AN, Burger JW, den Bakker MA, de Wilt JH, Verhoef C. Long-term results of tumor necrosis factor alpha- and melphalan-based isolated limb perfusion in locally advanced extremity soft tissue sarcomas. J Clin Oncol. 2011 Oct 20;29(30):4036-44
- Eechoute K, Fransson MN, Reyners AK, de Jong FA, Sparreboom A, van der Graaf WT, Friberg LE, Schiavon G, Wiemer EA, Verweij J, Loos WJ, Mathijssen RH, De Giorgi U. A long-term prospective population pharmacokinetic study on imatinib plasma concentrations in GIST patients. Clin Cancer Res. 2012 Oct 15;18(20):5780-7
- Blay JY, Sleijfer S, Schöffski P, Kawai A, Brodowicz T, Demetri GD, Maki RG. International expert opinion on patient-tailored management of soft tissue sarcomas.Eur J Cancer. 2014 Mar;50(4):679-89
- Kasper B, Sleijfer S, Litière S, Marreaud S, Verweij J, Hodge RA, Bauer S, Kerst JM, van der Graaf WT. Long-term responders and survivors on pazopanib for advanced soft tissue sarcomas: subanalysis of two European Organisation for Research and Treatment of Cancer (EORTC) clinical trials 62043 and 62072.Ann Oncol. 2014 Mar;25(3):719-24.
- Judson I, Verweij J, Gelderblom H, Hartmann JT, Schöffski P, Blay JY, Kerst JM, Sufliarsky J, Whelan J, Hohenberger P, Krarup-Hansen A, Alcindor T, Marreaud S, Litière S, Hermans C, Fisher C, Hogendoorn PC, dei Tos AP, van der Graaf WT; European Organisation and Treatment of Cancer Soft Tissue and Bone Sarcoma Group. Doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft-tissue sarcoma: a randomised controlled phase 3 trial.Lancet Oncol. 2014 Apr;15(4):415-23.
- Le Cesne A, Ouali M, Leahy MG, Santoro A, Hoekstra HJ, Hohenberger P, Van Coevorden F, Rutkowski P, Van Hoesel R, Verweij J, Bonvalot S, Steward WP, Gronchi A, Hogendoorn PC, Litiere S, Marreaud S, Blay JY, Van Der Graaf WT. Doxorubicin-based adjuvant chemotherapy in soft tissue sarcoma: pooled analysis of two STBSG-EORTC phase III clinical trials.Ann Oncol. 2014 Dec;25(12):2425-32
- Woll PJ, Reichardt P, Le Cesne A, Bonvalot S, Azzarelli A, Hoekstra HJ, Leahy M, Van Coevorden F, Verweij J, Hogendoorn PC, Ouali M, Marreaud S, Bramwell VH, Hohenberger P; EORTC Soft Tissue and Bone Sarcoma Group and the NCIC Clinical Trials Group Sarcoma Disease Site Committee. Adjuvant chemotherapy with doxorubicin, ifosfamide, and lenograstim for resected soft-tissue Sarcoma (EORTC 62931): a multicentre randomised controlled trial.Lancet Oncol. 2012 Oct;13(10):1045-54
- Bellera CA, Penel N, Ouali M, Bonvalot S, Casali PG, Nielsen OS, Delannes M, Litière S, Bonnetain F, Dabakuyo TS, Benjamin RS, Blay JY, Bui BN, Collin F, Delaney TF, Duffaud F, Filleron T, Fiore M, Gelderblom H, George S, Grimer R, Grosclaude P, Gronchi A, Haas R, Hohenberger P, Issels R, Italiano A, Jooste V, Krarup-Hansen A, Le Péchoux C, Mussi C, Oberlin O, Patel S, Piperno-Neumann S, Raut C, Ray-Coquard I, Rutkowski P, Schuetze S, Sleijfer S, Stoeckle E, Van Glabbeke M, Woll P, Gourgou-Bourgade S, Mathoulin-Pélissier S; Definition for the Assessment of Time-to-event Endpoints in Cancer Trials Initiative. Guidelines for time-to-event end point definitions in sarcomas and gastrointestinal stromal tumors (GIST) trials: results of the DATECAN initiative (Definition for the Assessment of Time-to-event Endpoints in CANcer trials)†. Ann Oncol. 2015 May;26(5):865-72
- Gits CM, van Kuijk PF, Jonkers MB, Boersma AW, Smid M, van Ijcken WF, Coindre JM, Chibon F, Verhoef C, Mathijssen RH, den Bakker MA, Verweij J, Sleijfer S, Wiemer EA. MicroRNA expression profiles distinguish liposarcoma subtypes and implicate miR-145 and miR-451 as tumor suppressors. Int J Cancer. 2014 Jul 15;135(2):348-61
- Rutkowski P, Gronchi A, Hohenberger P, Bonvalot S, Schöffski P, Bauer S, Fumagalli E, Nyckowski P, Nguyen BP, Kerst JM, Fiore M, Bylina E, Hoiczyk M, Cats A, Casali PG, Le Cesne A, Treckmann J, Stoeckle E, de Wilt JH, Sleijfer S, Tielen R, van der Graaf W, Verhoef C, van Coevorden F. Neoadjuvant imatinib in locally advanced gastrointestinal stromal tumors (GIST): the EORTC STBSG experience. Ann Surg Oncol. 2013 Sep;20(9):2937-43
PhD theses of the last five years
- C. Gits. MicroRNAs in the Tumor Biology of Soft Tissue Sarcomas. 2013
- J.P. DeRoose. Two decades of Tumor Necrosis Factor-alpha and Melphalan Based Limb Perfusion. 2016