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Thoracic Oncology Group

Lung Cancer is predicted to cause about 249 000 deaths and to be the leading cause of cancer-related mortality in the European Union after 2020. More than half of lung cancer patients are diagnosed with distant metastases and thus require systemic antineoplastic treatment. This medical management of metastatic lung cancer has witnessed an unprecedented innovative boost in the last ten years. Every year, a plethora of novel compounds is introduced into clinical practice, which has already resulted in a substantial improvement in quality of life and survival. Our interdisciplinary Thoracic Oncology Group is dedicated to make these innovations available to all our patients as soon as possible. In addition, we aim at answering unmet clinical needs with academically driven innovative research projects.

Therapeutic improvements in lung cancer have been the result of a personalized oncology approach, where drugs are tailored to subgroups with common genetic and immunological features. Hence, pathologists have become even more important for making treatment decisions in medical oncology, as they assign tumors to these subgroups based on evermore demanding morphological, genetic, and immunological analyses. Ultimately, the increasing complexity of diagnosis and therapy in this field is only manageable with high-end software support. In this context, our research group has developed as an interdisciplinary hub of pathologists, software engineers, and medical oncologists that is rooted in our joint everyday patient care.

We believe that real and sustained progress in oncology can only be achieved by creating an interactive network around the patient including general oncologists, the local comprehensive cancer center, as well as national and international expert groups. Therefore, we decided to become a key contributor to the National Network Genomic Medicine Lung Cancer (nNGM), which defines the current state-of-the-art in molecular analysis and knowledge transfer for lung cancer in Germany. By following almost half of all advanced NSCLC patients in Germany, nNGM also allows for clinical studies and in-depth analyses of even the rarest molecular subtypes in lung cancer. 

Research

Treatment options for advanced lung cancer have tremendously improved during recent years. This progress is based on defining molecular subgroups and tailoring therapeutic interventions according to individual susceptibilities. As a result, lung cancer has ceased to exist as a single entity, but has broken up into an ever increasing number of small subgroups. This poses a significant challenge to scientific investigation, as many subgroups have become rare diseases of their own.

We try to further advance this successful development by characterizing individual subgroups with respect to biology and clinical outcome within the nNGM network and in close collaboration with the NCT/UCC Core Unit for Molecular Tumor Diagnostics. As an example, we characterized ERBB2 mutated NSCLC in terms of response to contemporary immunotherapy protocols. This study has significant implications for the current clinical management and the design of novel trials in this rare subgroup. It has been a great honor for our group that Felix has been awarded the Young Scientist Award 2021 by the Working Group Medical Oncology (AIO) of the German Cancer Society (DKG) for this retrospective study.

We are also dedicated to study novel therapeutic approaches in prospective interventional clinical trials.  Within the ALPINE trial (NCT05470595), we are currently investigating the efficacy of immunochemotherapy in the yet understudied rare subgroup of pulmonary large-cell neuroendocrine carcinoma (LCNEC).

In close collaboration with the NCT/UCC’s Early Clinical Trial Unit we are also running academic and industry sponsored phase I trials in lung cancer including advanced targeted and immune therapies.

As our understanding about genetic diversity of lung cancer advances, new challenges emerge. To predict therapeutic efficacy of targeted therapy for tumors with very rare genetic variants as well as combinations of multiple clinically relevant molecular alterations is difficult as clinical data is usually unavailable. Moreover, current preclinical models including cell lines are unable to address issues like individual tumor heterogeneity, which are of paramount importance for developing therapeutic resistance.

We therefore currently develop our own lung cancer organoid program in close collaboration with the NCT/UCC Preclinical Model Unit (Prof. Stange/Dr. Ball). Organoids are derived from different patient tumor samples and can be expanded as 3D-tissue model in vitro while maintaining genetic characteristics of the original tumor. These organoids can then be treated with a panel of antineoplastic agents. We currently prospectively validate the predictive value of in vitro-organoid response for clinical tumor response. Furthermore, our organoids will be integrated in the nNGM preclinical validation platform allowing on-demand functional characterization of tumors with rare genetic properties. We are very thankful that Carina can advance this project with the support of a scholarship by the Else Kröner Research School.

Advanced lung cancer care in Germany, in large part, lies in the trusted hands of general hematologists/oncologists and their private practices. This system allows high-quality cancer care close to the patients’ place of residence and optimal interdisciplinary interaction with other regional health care providers. In the light of the plethora of innovations not only in lung cancer, but in cancer therapy in general, the body of knowledge relevant to the general oncologist has been increasing year after year. In addition, more and more clinical trials have become available for patients with rare genetic alterations. These challenges require a closer collaboration between the patients’ treating oncologist and local comprehensive cancer centers.

Together with the NCT/UCCs’ Core Unit for Data Management and Analytics, we are working on software tools that interconnect private practice oncologists, regional hospital and comprehensive cancer centers for the purpose of exchanging knowledge and clinical experience, and promoting participation in clinical trials. Moreover, we try to make every patient’s data accessible for scientific analyses.  

As an example, we developed MURIEL/MURIPEDIA (MolecUlaRly Informed ThErapy in Lung Cancer), which serves as a knowledge management database harboring quality controlled biological and clinical information on genetic variants found in lung cancer. Text modules from MURIPEDIA summarize current treatment options in clinical trials, standard-of-care and potential off-label use as a ready-to-use guidance for the treating oncologist and accompany each molecular pathology report within the nNGM.

Within the Diginet consortium we try to further advance digital interconnection of patients, private practice oncologists, comprehensive cancer centers, health insurances and patient advocates. Within the model region Saxony, we and our local partners promote automated exchange of structured clinical and molecular data between our center and general oncologists.

Patient Care / nNGM center

To care for our patients with cancer of thoracic origin (lung cancer, thymoma, thymic carcinoma, mesothelioma, neuroendocrine tumors of the lung (carcinoid)) by antitumor drug therapy is at the heart of our work. We are strongly interconnected with the local experts from other NCT departments, including radiation oncology, thoracic surgery, and others, in the multidisciplinary thoracic tumor board. Furthermore, we very much value the collaboration with our regional nNGM partners in private oncology practices and hospitals, with whom we are united in the aim of providing state-of-the-art lung cancer treatment to every affected individual.

We are dedicated to offering innovative treatment options within clinical trials in the fields of molecularly targeted therapy, antibody-based immunotherapy, as well as cellular tumor therapy.
If you are a patient seeking second opinion, including advice about molecular testing (nNGM and others), please contact our outpatient clinic (see Contact).
If you are a colleague caring for a thoracic oncology patient, do not hesitate to contact us (see below). For atypical molecular situations in lung cancer and discussion of trial options, we invite you to our weekly molecular lung cancer tumor board, where we and our regional nNGM partners share our experiences on difficult cases every Thursday, 12:30 PM.

Contact

Patients: Appointment for Second Opinion
Please refer to our >>>online contact form

Molecular Lung Cancer Tumor Board, Thursday 12:30 PM
nNGM Center Management: nNGM-Tumorboard(at)uniklinikum-dresden.de

Colleagues/Researches/Industry:
Inquiry Regarding Treatment Options / Clinical Trials / Research Collaboration

Prof. Dr. Martin Wermke
E-Mail: nngminfo(at)ukdd.de

 

We are glad to welcome aspiring physicians from different disciplines who are interested in thoracic oncology and our approach to the current challenges in the management of lung cancer. As we all have different talents and interests ranging from clinical trials and retrospective analyses to preclinical models and digital oncology, we are looking forward to finding a way to integrate your skills in our group.

All of our residents pursue a specialty training in medical oncology or pathology in parallel to doing exciting science. We will discuss with you how to balance the two, using for example the structured clinician scientist programs available on campus.

We actively support networking beyond our own campus and have ourselves manifold experiences within existing national and international programs including the Young Thoracic Oncologists (AIO/POA), the AIO Mentoring Program, the Else-Kröner Clinician Scientist Program, and some ESMO opportunities.

We also regularly offer doctoral thesis projects for medical students. Contact us, if you are interested.

Medical Oncology Team

Prof. Dr. Martin Wermke, MD
Group leader – Thoracic Oncology Group
Professor for Experimental Cancer Therapy
Head – Early Clinical Trial Unit (ECTU)
Head – Trial Management NCT Clinical Trial Center (CTC)

Jingting Luan, MD
Resident Hematology/Oncology
Focus: Clinical Trials / Cohort Studies

Johanna Möller
Medical Student (cand. med.)

Dr. Felix Carl Saalfeld, MD
Resident Hematology/Oncology
Focus: Clinical Trials / Cohort Studies, Digital Oncology

Linna Sommer, MD
Resident Hematology/Oncology
Focus: Digital Oncology
 

 

Pathology Team

Prof. Dr. Daniela Aust, MD
Deputy Director – Institute for Pathology
Head – Molecular Pathology
Medical Coordinator – NCT Core Unit for Molecular Tumor Diagnostics
Focus: Molecular Pathology

Dr. Sascha Brückmann, MD
Consultant Pathology
Focus: Molecular Pathology, Lung-, Heart- and Vessel Pathology

Dr. Andreas Hartig, MD
Consultant Pathology
Focus: Molecular Tumor Board, Molecular Pathology

Dr. Carina Wenzel, MD
Resident Pathology / Molecular Pathology
Focus: Lung Cancer Organoids, Molecular Pathology, Digital Oncology
 

 

Data Management / Analytics

Heiko Böhme, Dipl-Inf. (FH)
Coordinator - Core Unit for Data Management and Analytics
Software Engineer
Focus: Digital Oncology

Katja Hoffmann, Dipl-Inf. (FH)
Software Engineer
Focus: Digital Oncology

Thoralf Stange, Dipl-Inf. (FH)
Software Engineer
Focus: Digital Oncology

Philipp Thöricht, Dipl-Inf.
Software Engineer
Focus: Digital Oncology

 

nNGM Center

Guergana Tritchkova, MD
nNGM Center Manager

Anne Zedlitz
Medical Documentation Specialist

2022

Janning, Melanie; […]; Saalfeld, Felix C.; Wermke, Martin; […];  Wolf, Jürgen; Loges, Sonja (2022). Treatment outcome of atypical EGFR mutations in the German National Network Genomic Medicine Lung Cancer (nNGM). Annals of Oncology. March 06, 2022 DOI: https://doi.org/10.1016/j.annonc.2022.02.225

Boch, Tobias, […], Sommer, Linna, […]; Wermke, Martin; Loges, Sonja (2022). Pathologic responses in oligometastatic NSCLC patients treated with neoadjuvant immune checkpoint blockade with and without chemotherapy followed by surgery. In Lung Cancer. https://doi.org/10.1016/j.lungcan.2021.11.009

2021

Saalfeld, Felix C.; Wenzel, Carina; […] Wolf, Jürgen; Thomas, Michael; Aust, Daniela E.; Wermke, Martin. (2021): Efficacy of Immune Checkpoint Inhibitors Alone or in Combination With Chemotherapy in NSCLC Harboring ERBB2 Mutations. In Journal of Thoracic Oncology. 16(11), pp. 1952-1958. DOI: 10.1016/j.jtho.2021.06.025.

Wenzel, Carina; Herold, Sylvia; Saalfeld, Felix C.; Aust, Daniela E.; Wermke, Martin (2021): The clinical benefit of molecular re-assessments in management of progressive lung cancer. In Transl Lung Cancer Res 10 (3), pp. 1582–1587. DOI: 10.21037/tlcr-20-9962020

Herbst RS, […], Wermke M, … Paz-Ares L. Phase 1 Expansion Cohort of Ramucirumab Plus Pembrolizumab in Advanced Treatment-Naive NSCLC. J Thorac Oncol. 2021 Feb;16(2):289-298

Wermke M, Kraus S, Ehninger A, … Cartellieri M. Proof-of-concept for Rapidly Switchable Universal CAR-T Platform with UniCAR-T-CD123 in Relapsed/Refractory AML. Blood. 2021 Jun 3;137(22):3145-3148

Budczies J, […], Wermke M, […], Stenzinger A. Deciphering the immunosuppressive tumor microen-vironment in ALK- and EGFR-positive lung adenocarcinoma. Cancer Immunol Immunother. 2021 Jun 14

2020

Saalfeld, Felix C.; Wenzel, Carina; Aust, Daniela E.; Wermke, Martin (2020): Targeted Therapy in BRAF p.K601E–Driven NSCLC: Case Report and Literature Review. In JCO Precision Oncology (4), pp. 1163–1166. DOI: 10.1200/PO.20.00187.

Christopoulos, P.; Kirchner, M.; Roeper, J.; Saalfeld, F.; […]; Wermke, Martin; […]; Thomas, Michael. (2020): Risk stratification of EGFR+ lung cancer diagnosed with panel-based next-generation sequencing. In Lung Cancer 148, pp. 105–112. DOI: 10.1016/j.lungcan.2020.08.007.

2019

Herbst RS, […], Wermke M, […], Chau I. Ramucirumab plus pembrolizumab in patients with previously treated advanced non-small-cell lung cancer, gastro-oesophageal cancer, or urothelial carcinomas (JVDF): a multicohort, non-randomised, open-label, phase 1a/b trial. Lancet Oncol. 2019 Aug;20(8):1109-1123.