DZL launches EMoLung trial on therapy monitoring of non-small-cell lung cancer
Has a cancer treatment been successful? How is the probability of a relapse? – These are questions, patients and clinicians are dealing with in post-operative care. Depending on the answers, a follow-up plan has to be made, sometimes including stressful procedures in hospital. In order to improve this process, DZL launched the EMoLung-Trial.
All five DZL sites are recruiting patients with early stage lung cancer for the EMoLung* trial. Clinical research teams continuously collect blood samples and exhaled breath condensates of all study subjects. The first sampling is done shortly before surgery, all others in the following two years. Scientists search for tumor DNA in the blood, while breath condensates are probed for ribonucleic acids (RNAs). Based on results of the first funding period of DZL, we are aiming at finding a ‘tumor signature’ that allows for discrimination of patients with early relapse from patients with late or no relapse art all. In EMoLung, we are focusing on epigenetic changes* that are triggered by environmental influences such as nutrition, way of life or pollutant exposure (e.g. smoking). The effect is a deregulation of a number of genes. We want to find out, which genes are affected.
Prof. Martin Reck (LungenClinic Grosshansdorf) is heading the study with Prof. Ole Ammerpohl (University Medical Center Ulm/University Medical Center Schleswig-Holstein, Campus Kiel) and PD Dr. Guillermo Barreto (Max Planck Institute for Heart and Lung Research Bad Nauheim). Ammerpohl and Barreto are responsible for epigenetic analyses. Patients are recruited at LungenClinic Grosshansdorf, Hannover Medical School, University Medical Centers Gießen, Munich and Heidelberg as well as Asklepios Clinic Gauting.
At present, the standard of post-operative care is CT. CT is stressful for the patient and also extensive. „If exhaled breath and blood analyses might complement CT in a meaningful way for a faster diagnosis of relapses, we would be a huge step forward“, says Martin Reck. A blood draw, a ‘liquid biopsy’, can be done fast and almost without any risk. For the collection of breath condensates the patient has to breathe in a tube for just ten minutes. If EMoLung is successful, it should be possible to predict the course of a disease more accurately and therefore adjust follow-up care and further therapies much better.
*EMoLung means „Epigenetic monitoring of patients with non-small-cell lung cancer“. Epigenetics can be regarded as an antonym of genetics. The latter is dealing with the subject of genes. Genes practically don’t change in the course of a human life. Only when exposed to radiation or toxic (carcinogenic) substances, genes can acquire changes (mutations). In contrast, epigenetic changes don’t alter the DNA sequences of the genes themselves. But they are responsible for gene regulation – the fine tuning. This physiological mechanism allows for adjustment to environmental conditions in case of unsteady food supply or psychic as well as physical stress.