Junior Clinical Cooperation Unit Translational Gastrointestinal Oncology and Preclinical Models
Prof. Dr. Johannes Betge
Carcinomas of the gastrointestinal tract are among the most common cancers. Despite recent advances in therapeutic options many cases cannot be cured, especially when the disease has spread and metastasized throughout the body. Our group therefore aims to develop novel, individualized therapies for patients with advanced gastrointestinal cancer and to analyze predictive markers, as well as mechanisms of resistance to therapies. For this, we are utilizing patient derived organoids (PDOs), up-to-date 3D cell culture models that we establish directly from our patients’ tumor or normal tissue biopsies. The organoids retain molecular characteristics of the original tissue and we can use them for functional analyses. We have established robotics-assisted high throughput-screening protocols that enable us to model drug response to hundreds of drugs simultaneously. We aim to translate these results of organoid-based drug screens back to bedside. Furthermore, we study tumor biology and the mechanisms of action and resistance of cancer drugs in tumors and organoids using high-throughput microscopy and single-cell sequencing. Thereby we aim to find markers for response and resistance that we further investigate in mechanistic studies. We are especially interested in the relevance of intracellular signaling pathways (most notably MAPK, IGF, PI3K/mTor) on tumor- and stem cell biology, drug response and development of drug resistance towards pharmacotherapies in colorectal cancer.
Prospectively, we aim to develop new treatments ex vivo in organoid models, most importantly using novel combinations of drugs, but also combining drugs and radiation therapy. Based on this, we will analyze their pertinent mechanisms of action and predictive markers. In a personalized approach using organoids and drug screening with clinically available anti-cancer drugs, we want to find individual therapeutic options for patients with advanced gastrointestinal cancer. We are currently testing this tailored approach in several clinical studies with our patients at the University Medical Center Mannheim (PROMISE studies).