Wir überwinden Grenzen

Enormous advances in cancer medicine, a revolution in gene therapy and research and the miniaturization of surgical procedures were key developments in the 2010s / Digitalization will be the driving force in the next decade

In just a few weeks, not only 2019 but an entire decade will come to an end. The 2010s were characterized by important advances in medicine. Diagnosis and treatment were significantly improved in numerous areas, such as imaging, radiotherapy and infection therapy. "The developments in cancer therapy, gene therapy and minimally invasive procedures are particularly noteworthy," says Prof. Dr. Frederik Wenz, Chief Medical Director of the University Medical Center Freiburg. "As a university hospital, it is part of our self-image to combine cutting-edge research and cutting-edge medicine in such a way that patients benefit as quickly as possible. We have succeeded in doing this very well over the past decade."

A new era of cancer therapy has begun

In 2011, the first immunomodulatory cancer drug was approved. Unlike conventional chemotherapies, the drug does not attack the cancer cell itself. Instead, it triggers a blockade that the cancer cells use to fend off an attack by the body's own immune cells. "The development of immuno-oncology therapies was a milestone in cancer treatment. We can now help many people who ten years ago would very probably have died of their cancer," says Prof. Dr. Justus Duyster, Medical Director of the Department of Internal Medicine I (specializing in hematology, oncology and stem cell transplantation) at the Freiburg University Medical Center. This development goes hand in hand with ever greater molecular genetic analysis of the tumor. "Ten years ago, we would hardly have dared to dream that we would be able to fight cancer in such a targeted way today," says Duyster.

A revolution in gene therapy

Developments in another field have also significantly changed the treatment of cancer and other serious diseases Very effective gene therapies are already approved today, for example against leukemia and hereditary diseases of the blood and immune system. In 2012, a new type of gene scissors, known as CRISPR-Cas, was scientifically described for the first time. "With the new gene scissors, we can modify the genetic material in cells very easily, precisely and in a targeted manner and thus correct certain genetic defects," says Prof. Dr. Toni Cathomen, Director of the Institute of Transfusion Medicine and Gene Therapy at the Freiburg University Medical Center. "CRISPR-Cas has given us an unprecedented dynamic in gene research and gene therapy. We are currently working very intensively on a gene therapy for HIV." Promising therapeutic approaches are currently being successfully tested in clinical trials, just eight years after CRISPR-Cas was first described. However, the molecular medicine expert also warns: "We need to gain a better understanding of the effects and side effects of gene scissors before they can be used on a broad scale," says Cathomen.

Minimally invasive cancer surgery: an old idea shows great potential

A few small incisions instead of one large one: The idea of performing minimally invasive surgical procedures is already more than 70 years old. However, after initial experience in the 1980s and 1990s, it was long reserved for simpler procedures. Thanks to new techniques and extensive studies, it also achieved a breakthrough in cancer surgery in the 2010s. "Ten years ago, the pioneers of minimally invasive surgery ventured into major tumor operations for the first time, including here in Freiburg. We can now remove tumors of any organ using minimally invasive techniques. Thanks to the smaller scars and the gentle technique, patients recover much faster," says Prof. Dr. Stefan Fichtner-Feigl, Medical Director of the Department of General and Visceral Surgery at the Freiburg University Medical Center. "With the help of robot-assisted procedures, we can make certain operations even gentler, for example for rectal cancer and liver cancer," says Fichtner-Feigl. In March 2020, experts in the field will meet in Freiburg for the 3rd European Congress for Minimally Invasive Tumor Surgery.

Exploiting the potential of digitalization

Digitalization in the healthcare sector is already in full swing and extends to all areas: from patient admission and imaging to the evaluation of treatment data. "How well we master the challenges of digitalization and exploit its potential will be crucial to our success in the coming years," says Wenz. "This is also particularly about the data treasures that exist at a university hospital like Freiburg and are collected on a daily basis. An important key to new therapies lies in the evaluation and combination of this data," says Wenz.

Contact: 
Prof. Dr. Justus Duyster
Medical Director
Department of Internal Medicine I
University Medical Center Freiburg
Phone: 0761 270-34060

Prof. Dr. Toni Cathomen
Director
Institute for Transfusion Medicine and Gene Therapy
Freiburg University Medical Center
Phone: 0761 270-34800

Prof. Dr. Stefan Fichtner-Feigl
Medical Director
Department of General and Visceral Surgery
Freiburg University Medical Center
Phone: 0761 270-28060