Each year, there are an estimated 3,000 new cases of cancer in Luxembourg, the most frequent being breast, prostate, colon and skin cancer.
1 in 8 deaths is caused by cancer
The disease is responsible for at least a quarter of all deaths in the country and remains one of today’s main health burdens, both in terms of pain and healthcare cost. This makes it ever more important that medical professionals, researchers, patients associations, politicians and the public work hand in hand to make a difference.
One major step in this effort is the National Cancer Plan, which was presented in 2014 by the Ministry of Health. This ambitious plan to fight cancer on multiple fronts gives a key role to IBBL in advancing cancer research. Indeed, since the creation of the biobank, we have been actively supporting several cancer research projects, some of which are run under the umbrella of the Personalised Medicine Consortium (PMC).
Personalising lung cancer therapy
Led by oncologist Dr Guy Berchem (Centre Hospitalier de Luxembourg & LIH), the main aim of this PMC’s flaship lung cancer programme is to discover and evaluate molecules in the blood or tumour tissue of cancer patients that could be used to improve diagnosis or treatment decision.
The study compares survival between patients that received targeted therapy, based on the presence of specific mutations in their tumour, and those patients that received standard therapy. To date, over 200 patients have been recruited for the study.
Publishing first results
Some of the cancer studies that we support have already generated significant results, such as the colorectal cancer study, funded by the Fondation Cancer and led by Prof. Serge Haan from the University of Luxembourg. The researchers on this project published their first findings in a prestigious scientific journal in 2014, following the discovery of 2 new molecules potentially suitable for early diagnosis of colorectal cancer. It is worth mentioning that colon cancer can be cured in 9 out of 10 cases when detected in time. The project has inspired two other publications since then, and the team continues looking at powerful markers that could help reduce cancer incidence.
To carry out their research, scientists rely on the support from the population. To date a total of 112 patients volunteered to donate part of their colon tumour for research. These samples were collected by surgeons in Luxembourgish hospitals and then immediately brought to the biobank, where our pathologists processed and analysed the tissues. We coordinated all of the steps involved in the collection, processing and quality control of these biological samples and their associated medical data.
This collection from the Luxembourgish population will also help researchers carry out three new pilot studies funded by the Fonds National de la Recherche and the PMC.
Enhancing the national fight against cancer
The scope of the collection is expected to be expended to all cancer types. Organised within the National Plan Cancer, the initiative relies on a joint effort between all of the actors in cancer research in Luxembourg: the hospitals, the Laboratoire National de Santé and the biobank. In future, any cancer patient that receives health care in Luxembourg will thereby have the opportunity to advance cancer research by donating a sample of tumour tissues. The collection will undoubtedly be a great asset to the national fight against cancer.
Our national projects
IBBL is involved in a number of national cancer research projects, in close collaboration with all major biomedical research and healthcare actors in Luxembourg. Below a selection of some of our latest projects.
Lung cancer is responsible for the most deaths due to cancer each year in both men and women worldwide, and once diagnosed, the 10 year survival rate is poor (<15%). This poor prognosis is based in large part on the absence of an effective diagnostic test for the disease. The main objective of this study is to discover and validate molecular biomarkers for lung cancer and develop a molecular-based diagnostic test specific for lung cancer. The study involves the collection of saliva, urine, blood and tissues from patients diagnosed with lung cancer, as well as a portion of the malignant fluid in the lungs. Patients who will undergo surgical resection of their tumor also donate a section of the tumor tissue and a piece of normal lung tissue adjacent to the tumor.
The goal of the project is to understand how disease develops and to use that knowledge to develop better diagnostic tests and treatments. The samples you will donate will be stored at the Integrated Biobank of Luxembourg (IBBL) for research studies. The first research study in the project is called “Discovery of new therapeutic targets for colorectal cancer”. This study is funded by the Fondation Cancer and the Integrated Biobank of Luxembourg (IBBL). This collaborative study is coordinated by the University of Luxembourg and the Laboratoire National de Santé (LNS) in partnership with IBBL.
This is a POC (Proof of Concept) where IBBL will be a partner of University of Luxembourg. IBBL will perform the Validation of Biomarker MYO5B, a prognostic biomarker for colorectal cancer discovered by the University of Luxembourg.
This research study is part of the development of personalised medicine for the treatment of cancer in Luxembourg. The objective of the “Pilot-PFP” study is to evaluate the setting up of a platform in Luxembourg to issue a treatment recommendation to physicians. In the long term, the goal of this platform will be to determine the best treatment for each tumour by mapping the functional profile and the genetic profile of the tumour. The pilot-PFP study is an initiative of the Luxembourg Institute of Health (LIH). The analysis platform will consist of the National Health Laboratory (LNS), IBBL, the Luxembourg Centre for Systems Biomedicine (LCSB) and the National Sequencing Centre (LuxGen). This platform aims to analyse the cancer cells of patients with metastatic gastro-intestinal cancer or recurrent glioblastoma; compare several available treatments; and identify the best potential treatment for the tumour. This study is a pilot study that should demonstrate LIH researchers the feasibility of the implementation of this analysis platform in Luxembourg. As a result, a small number of patients will be included in the study (20 patients at 2 sites in Luxembourg – the Centre Hospitalier de Luxembourg (CHL) and the Hôpital Robert Schuman (HRS).
In 2014, the government of Luxembourg initiated the first National Cancer Plan 2014-2018 in order to foster the interactions between the different actors fighting against cancer in Luxembourg. One of the proposed actions was to establish a national sample collection dedicated to research in oncology and oncology related fields, based on a close collaboration between the hospitals, the physicians, the LNS and the Integrated Biobank of Luxembourg (IBBL). This strategy allows a uniform forward-looking collection of biological resources to be prepared and stored at IBBL and opens opportunities for their use in future studies. Such a resource has the important advantage of providing larger sample collections, ready to use for research. Samples and clinical data of patients with suspected or diagnosed cancer are collected, processed and stored for future research purposes in the field of oncology or oncology related fields.
The research project project aims to identify the colorectal cancer (CRC) associated changes in the structure and function of the microbial community along the human gastrointestinal tract. Its higher objective is to implement a new, non-invasive model for the early detection of CRC based on the existing Faecal Occult Blood Test. IBBL is in charge of the collection, processing, transport, aliquoting and storage of the samples (blood, saliva, urine).
The project is aimed at the improvement of healthcare in Luxembourg, and more specifically at ameliorating the outcome of cancer treatment by assessing the value and feasibility of implementing molecular diagnostics tests as part of cancer care in Luxembourg. A set of standardised molecular diagnostic tests will be performed on tissue samples from each patient taking part in MDLUX2. The project is jointly funded by the National Cancer Institute (INC), the Integrated BioBank of Luxembourg (IBBL), the Fondation Cancer and the Fondatioun Kriibskrank Kanner. It is also supported by the Laboratoire national de santé (LNS), Luxembourg’s hospitals and other collaborating partners.
The project aims at understanding the formation of tumour Initiating Cells (TICs) in colorectal cancer and their contribution to metastasis. Specifically, it seeks to unveil the mechanisms underlying the acquisition of metastatic properties with the ultimate goal of providing novel molecular targets for the future development of therapeutics against CRC. The project is a collaboration between the University of Luxembourg and IBBL.
Malignant brain tumours are a highly heterogeneous disease with a very poor clinical outcome. In particular, Glioblastoma multiforme (GBM) displays very strong genetic heterogeneity. Despite aggressive therapy including surgical resection, radiation and chemotherapy, GBM patients show a very rapid disease progression with only a mean life expectancy of 12-15 months. The current clinical diagnostic still lacks reasonable resolution into tumour heterogeneity for optimized and personalized treatment strategies. The project aims to establish strategies for future clinical interrogation of intra-tumoral heterogeneity. We plan to analyse GBM patient specimens of initial and recurrent tumors at a single-cell level to reveal genetic and transcriptomic identities contributing to disease progression and therapy-related resistance. At the same time we will establish patient-derived xenografts (PDXs – tumor tissue that has been taken from a patient and implanted into mice for research purposes) from initial and relapse GBM samples of the same patients. These PDXs will enable pre-clinical personalized treatment approaches overcoming therapeutic resistance associated with heterogeneity.
We are regularly exposed to toxic products and these are accumulating in our body. Researchers in Luxembourg are now able to identify the level of exposure to certain toxic products through the analysis of blood or hair samples collected from healthy people. Weight loss is often observed during chemotherapy for patients with gastro-intestinal cancer disease. This weight loss may be a consequence of the surgery or may be due to the chemotherapy itself. A significant weight loss can lead to the release of toxic product residues from fat bodies. The researchers would like to understand (i) whether the weight loss induced by cancer treatments, either surgery or chemotherapy, leads to the release of toxic products to which the patient would have been exposed earlier, and (ii) if the release of these compounds would have an impact on the treatment efficiency. Hair and blood samples, as well as medical data, will be collected for the study and processed and stored at IBBL.
This project is a collaborative project between the CHL, IBBL, LNS and the University of Luxembourg. The main objective of this project is to investigate predictive or prognostic biomarkers for colon or rectal cancers. The biomarkers evaluated within this project have been either considered in individual studies as being statistically capable of predicting the outcome of the patient or not yet investigated for this purpose. The study will compare all these factors with the Dukes staging system, to see whether they would be able to complete the current clinical decision making tool.
SPRING is a clinical trial Phase I and II to test the safety and efficacy of a tri-therapy approach in advanced/metastatic Non-small cell lung cancer (NSCLC) and to retrospectively assess the ability of integrated genomics and transcriptomics to match patients to the combination. The ultimate goal is to improve advanced lung cancer treatment, enhance clinical benefit and increase survival. IBBL is responsible for providing tissue collection kits and processing the collected tissue samples. The project is a collaboration between CHL, the Clinical and Epidemiological Investigation Center of the LIH, and IBBL.
Cancer patients that would like to help advance cancer research, can ask their oncologist whether there are any ongoing research projects that they could participate in. IBBL has several ongoing collaborations with oncologists from Luxembourgish hospitals. Many of these projects are specific to a particular cancer type. However, within the Luxembourg National Cancer Plan, it is foreseen that eventually parts from all the tumour tissues that are surgically removed from cancer patients be included in the biobank for research purposes, if the patient has given his consent.
What about ethics ?
All of our biological samples are contributions from volunteers, both patients and healthy citizens, who have given specific consent for the collection of their sample. Every donor has the right to withdraw their consent at any time, in which case all of the unused samples will be destroyed and related data deleted.
We work with national and international authorities to ensure that the collection and use of samples and data conform to high ethical standards and safeguard the privacy of the donor. All of our donors’ identities are kept strictly confidential and our data secured. We have a rigorous process in place to remove all identifying information from samples and health records at the source, so no identifying information is known by the biobank staff or given to researchers.
Before receiving any samples, research organisations must submit an application to our sample access committee. To receive the approval of this committee, applicants must show that they have the expertise to perform their proposed research, that the proposed research has ethical clearance, and that they have sufficient funds to see the research through to completion.