“We have put the name of Vall d’Hebron on the map of world oncology”
Source: www.immedicohospitalario.es
Such a high percentage of participation in clinical research studies has no one. The Vall d’Hebron Institute of Oncology (VHIO) is a research institute focused on cancer that covers the preclinical, translational and clinical areas. Having access to a large hospital, with a large number of patients, has helped very importantly in their genomic efforts to subclassify the most frequent diseases such as breast cancer or colon cancer.
The Vall d’Hebron Institute of Oncology (VHIO) is a leading comprehensive cancer center of excellence where scientists and doctors adopt a purely translational research model, working together in multidisciplinary teams to accelerate and advance in the field of personalized and specific therapies against cancer.
We talked with Josep Tabernero (collegiate number 080824490), its director, about how they fight cancer. First, we ask how VHIO works. He emphasizes that it is “an oncology research institute”, which has become the “umbrella of preclinical, translational and clinical research of medical oncology areas” of Vall d´Hebron University Hospital. It clarifies that, in the clinical part, it is the institution that supports research in medical oncology, oncological hematology and radiotherapy. That is to say; “The VHIO is a research institute that covers these three areas: preclinical, translational and clinical.”
He adds that it is “an institute focused on cancer.” Note that this is very important “to be competitive” in a field of research as powerful as yours. The VHIO was established as such in 2007, so it has been in operation for twelve years. But, the idea of ??generating an independent institute focused on cancer was born before, in 2002.
What are the main achievements of the VHIO? “That we have put the name of Vall d’Hebron on the map of world oncology,” he replies. When they started designing this institute, apart from creating an exceptional clinical program, they thought about the areas in which they could excel. “We decided not to carry out basic research. There are very good basic cancer research centers in Catalonia and the rest of Spain, with which we collaborate. Our great opportunity is to be inside the hospital, which has access to a very important number of patients and tumor samples of patients, ”he says. They began to organize a collection of humanized preclinical models, what they call “avatars, organoids”, to study mechanisms of sensitivity and primary resistance acquired from different treatments. “Having access to a large hospital, with a large number of patients, with knowledge not only of clinical data but of genomic data, because we make a genomic study of all patients who have tumors, has contributed to very important genomic efforts to subclassify the most frequent diseases such as breast cancer or colon cancer, ”he says. They have participated in many publications characterizing these diseases. This is thanks to the Big Data and the molecular and clinical genetics data of each patient.
Development of new drugs
Another very priority area for VHIO is the development of new drugs. It also works to increase contributions to the development of new and better therapies for cancer treatment. With clinical studies, both in phase III or later phase, but especially in phase I and phase II, with more innovative agents. “This has made us have a great scientific impact in recent years. And that our institution is highly valued in different European consortia, ”says Tabernero. For example, they are part of the Cancer Core Europe, which is a consortium of cancer centers funded in part by the European Commission: Gustave Roussy Cancer Campus Grand Paris (Villejuif, France), Cambridge Cancer Center (Cambridge, United Kingdom), Karolinska Institute (Stockholm, Sweden), Netherlands Cancer Institute-NKI (Amsterdam, Netherlands), VHIO (Barcelona, ??Spain) and National Center for Tumor Diseases-DKFZ-NCT (Heidelberg, Germany).
The milestones in scientific production issues are very good. Last year they achieved an accumulated of 3,501 Impact Factor points (in 2017 it was 2,851). 65% of its publications are in the first quartile. In the field of clinical studies, they have made a very important effort to attract innovation. Last year, among the areas of medical oncology, hematology and radiotherapy, in 2018, they had 635 different open clinical studies. With a total of 1,500 patients included. In the area of ??medical oncology, there were 1,374, that this comes to be 30-35% of patients who see in the hospital and who need medical treatment. “Such a high percentage of participation in clinical research studies has no one,” he says. One in three oncology patients at this hospital participates in a clinical study of VHIO.
He suggests that, for an institute that was born in 2007, that such a high Impact Factor is already “demonstrates the commitment of all researchers to make innovation and to transfer it to patients quickly and their scientific contribution.” They have a total of 35 leading researchers and a team of about 400 professionals. Only 18 people are dedicated to management tasks. Tabernero recalls that, for clinical studies, a lot of monitoring staff is needed. Stresses that they have established a very transversal, very collaborative model.
At ASCO, they presented a study that demonstrates for the first time the efficacy of a personalized therapy against pancreatic cancer. Is immunotherapy the present or the future? Tabernero confirms that one of the two future medical treatment is in immunotherapy, in the attempt to make “more tumors are susceptible to immunotherapy.” Until now, immunotherapy only works well in those tumors that are called hot, that the immune system has already recognized the tumor as something abnormal, but then has fallen asleep and fails to eliminate it. What is done is to wake up the immune system. Although, the remaining 75% of tumors, those known as cold tumors, that the immune system has not recognized the disease as something abnormal to eliminate. “Therefore, we have to, through different treatments, educate the immune system to recognize the disease as something evil, and therefore to eliminate,” he reflects. The other future lies in personalized therapies aimed at alterations that have the malignant cell of that tumor. This year, in pancreatic cancer, they showed that in a population of 20% of patients it has an alteration in genes that are repairers of DNA, the BRCA1 and BRCAC2 gene, and benefited from a personalized treatment. It has been seen in ESMO, later this year, with the contribution of this center in ovarian cancer, prostate cancer and other tumors.
Regarding the future in oncology, he believes: “Number one, that detailed genetic analysis of tumors is here to stay. Number two, we think of the disease in a dynamic way. That is, the disease is evolving, both by spontaneous evolution and by the pressure we make for the different treatments. So you have to have a dynamic vision of the disease. In this, the liquid biopsy is helping a lot, and more that will help, as a tool that will be very important. Being able to diagnose how these genetic alterations evolve with a blood sample. Number three, precision medicine. In each patient you have to look at the particularities of each tumor and treat it in the best possible way. Number four, make the immune system increasingly effective to treat residual disease and to cure and chronify more patients. And number five, that we have it in the gutter, and we should all take it more seriously, prevention. Because 40% of tumors can be prevented and we are not doing everything we should do. ”
He claims that the latter is due to an education problem. Determine that it is vital to educate the population. From the anti-cancer decalogue, “seven measures are practically zero cost.” Screening or vaccination programs do; But quitting smoking, consuming little alcohol, taking care of yourself, exercising and eating a healthy diet have a very low cost.
Finally, from the international vision that confers him to be the president of ESMO between 2018 and 2019; Values scientific research in Catalonia and the rest of Spain as very positive. “10% of the presentations that were presented to ESMO had as a first or last author a Spanish. Actually, Spanish oncology is located on the map and well recognized, ”he says. It is true that Madrid, Barcelona and Valencia are the most powerful areas in this regard, although “there are emerging areas.” He admits that “this cannot be homogeneous” and that “theirs is to have very expert reference centers and then share the experience.”
