Projects / Programmes
Characteristics of Malignant Neoplasms Important for Diagnosis, Prognosis and Treatment Outcome
January 1, 2019
- December 31, 2027
| Code |
Science |
Field |
Subfield |
| 3.04.00 |
Medical sciences |
Oncology |
|
| 3.01.00 |
Medical sciences |
Microbiology and immunology |
|
| Code |
Science |
Field |
| B200 |
Biomedical sciences |
Cytology, oncology, cancerology |
| Code |
Science |
Field |
| 3.02 |
Medical and Health Sciences |
Clinical medicine |
| 3.01 |
Medical and Health Sciences |
Basic medicine |
cancer, cytology, pathology, flow-cytometry, cytogenetics, molecular genetics, geneticsa, radiology, micro RNA, next generation gene sequencing, therapy, targeted therapy, surgery
Data for the last 5 years (citations for the last 10 years) on
April 26, 2024;
A3 for period
2018-2022
| Database |
Linked records |
Citations |
Pure citations |
Average pure citations |
| WoS |
713 |
16,580 |
15,517 |
21.76 |
| Scopus |
613 |
19,200 |
18,107 |
29.54 |
Researchers (22)
Organisations (2)
Abstract
The main purpose of our research program is to develop a precise, individual patient-specific medicine. Precision medicine enables the improvement of routine diagnostic methods and the use of new methods for the diagnosis and treatment of cancer patients, so researchers and experts from laboratories, radiology, genetics and clinics are involved in the program. We investigate the significance of tumor markers in conjunction with established diagnostic methods: cytology, pathology, flow cytometry, cytogenetics, molecular genetics and radiological methods. In the field of leukemia in adult patients, in the past period, we found out which malignant clones of cancer cells are present before, during and after treatment and at the recurrence of the disease. The results help us in planning the appropriate treatment, or choosing the appropriate targeted therapy. In the field of Huerthle cell thyroid carcinoma (HCTC) we found out that micro RNAs are useful for distinction between HCTC and adenoma and can serve as predictive markers for metastases. In the field of cytology and pathomorphology of breast cancer we found out that prognostic factors MIB-1 and S-phase of the cell cycle in cytological samples are reliably measured in comparison with the results of histological material processed by automated immunohistochemistry staining instrument and this cytological method is now used as a routine investigation. In patients with lobular breast cancer we found out that use of preoperative ultrasound guided fine needle aspiration biopsy and imprint cytological investigation of sentinel lymph node biopsy enables only one instead of two surgical procedures in 43% of patients. In the next period, our research will be carried out in the field of leukemia, lymphatic neoplasms, melanoma, thyroid cancer, ovarian, colon, rectal and breast cancer. In the field of breast cancer, we will continue our research if using advanced magnetic resonance imaging (MR) methods, we can determine the effectiveness of neoadjuvant systemic treatment with cytostatics and / or biological agents and when we can omit axillary lymphadenectomy. In patients with hereditary breast and ovarian cancer, on the basis of cytogenetic markers, we will try to find out the predictive value for sensitivity to treatment with new antitumor drugs. In patients with neoplasms of the blood-forming organs, next generation sequencing will also be used to investigate the mechanisms of development and progression of the disease, enabling simultaneous analysis of genetic changes in a number of selected genes as well as the entire genome, identifying novel fused genes and quantifying the level of their expression and simultaneous analysis of mutations in analyzed RNA. With these approaches, we will investigate the typical "fingerprint" of an individual patient. The potential impact of all these studies is that the findings will help with the choice of the therapy to be as effective as possible, but also as non-toxic as possible.
Significance for science
Cancer represents one of the most common causes of morbidity and mortality in the developed world, and therefore its research is definitely a priority. Good laboratory and imaging diagnostics, multidisciplinary and interdisciplinary treatment and good collaboration between experts is crucial for the successful diagnostics and the patient's specific and its tumor-adjusted cancer treatment. The characteristic feature of modern research and science is the explicit subspecialisation of researchers and the emergence of new areas of science. Only the good cooperation of various subspecialists of researchers and experts in individual subsections allows discovering new findings. A brand new field in the field of cancer research opens the technology of "next generation sequencing", which allows simultaneous analysis of genetic changes in many selected genes or the entire genome. New methods also enable the identification of newly formed fusion genes and the quantification of the level of their expression, and the simultaneous analysis of mutations in the analyzed RNA. However, the results of these studies can only be used effectively for clinical use only if diagnostic methods are introduced into the laboratory and new knowledge is used in clinical medicine. In the meantime, we need to check their usefulness. There are extremely effective, but unfortunately exceptionally expensive medicines that can’t be afforded for all the inhabitants of the richest countries in the world. Therefore, it is a priority for researchers in the oncology field to develop diagnostic methods that will predict if treatment with these drugs can be effective at the individual tumor of the patient. Apart from laboratory tests, a more sophisticated radiological diagnostic can be of great help in assessing the effect of treatment for this purpose. The unexpected development of computer technology has allowed the emergence of new or improved radiological methods, which, in order to become clinically useful, require verification of efficacy in terms of sensitivity and specificity. For this reason, our research team expanded with researchers in the field of imaging, surgery, hematology and internist oncology in addition to pathologists and cytologists who comprised the core of researchers during previous period. The results of our research, carried out jointly, will be important for the international research public.
Our research will contribute to defining the significance of individual markers and their direct impact on clinical decision making in patients with leukemia, lymphatic neoplasms, melanoma, breast cancer, thyroid, ovary, colon and rectum. We expect a great contribution to knowledge in the development of methods for the determination of small malignant clones in adults with leukemia and lymphoma. Our findings on determining the minimum residual disease (MRD) in the treatment of malignant lymphomas will direct further research into the search for the basic biological and metabolic mechanisms of the cells of these clones and, consequently, the identification of new targets and target medicines. One of the areas of our research is ex-vivo testing of the sensitivity of malignant cells to various agents used in various therapeutic schemes, which provide information on the potential response of cancer cells to individual substances. In the past period, we have already studied the responsiveness of patients' plasmocytoma cells to arsenic trioxide and lymphoma cells of patients with chronic lymphatic leukemia to different combinations of active ingredients with monoclonal antibodies, but now we are researching and comparing different systems that evaluate the effectiveness of the substance by determining the intensity of apoptosis, either by flow cytometry or spectrometric techniques. The most current group of patients is AML patients with resistant disease or recurrence of disease, as well as patients with chronic lymphocytic leukemia, due to the extreme expan
Significance for the country
Investigations in the field of molecular biology and genetics are still relatively expensive and can not be provided to all patients in Slovenia. However, these investigations and other diagnostic tests (eg ultrasound or magnetic resonance imaging) are worth doing if results of these investigations confirm that these extremely expensive target medicinal products are only used when they are really effective and, according to the price and nature of the particular malignant disease, they are justified. Since many new treatments are available, in particular various targeted and immune drugs, the appropriate choice and later the assessment of the effectiveness of treatment with them is of key importance both from the point of view of the success of the treatment and from the economic point of view. Improving the overall effectiveness of oncological treatment of patients with sustainable treatment costs is a fundamental socio-economic goal that we follow in our research. With our knowledge and experience, we are extremely important for treating thousands of patients every year, and successful treatment of these patients contributes to the fact that the patients who have been cured for years and for many decades are fully active in their profession, the family and our society, which contributes to the welfare in our country.
Precise mechanisms for the action of new and already established methods of treatment can be evaluated by retrospective research. The characteristics of tumors are analyzed for patients who were previously treated. Patients' survival and course of disease is known on the basis of follow-up. Our research has a major impact on changing diagnostic and therapeutic algorithms. For example, an observation of our research group in which Dr. Bešič reported that 66% of patients with Huerthle cell thyroid cancer have an uptake of radioiodine in metastases is already included in the European Nuclear Medicine guidelines and the German guidelines for the treatment of thyroid cancer.
We are also very active in raising awareness of the professional and lay public about health, cancer treatment and a healthy lifestyle. We are organizers and co-organizers of numerous domestic and international professional and scientific meetings, we often have invited lectures for the professional, scientific and lay public. We are also active in the media, as we often engage in interviews. We are also authors and co-authors of the Slovenian guidelines for the treatment of patients with thyroid cancer, lymphoma, ovarian cancer, colon and rectal cancer. We have been active in the development of screening tests for breast cancer, cervical cancer, colon and rectal cancer, and we take care of the smooth functioning of these screening programs. In Slovenia, we have developed genetic counseling for cancer patients which was effectively implemented. We are the authors of publications for patients with thyroid cancer, lymphoma, ovarian cancer and genetic counseling and testing. We are active in a number of Extended Professional Colleagues at the Ministry of Health. We take care of transferring knowledge from abroad to Slovenia, and with our invited lectures and publications in professional and scientific literature, we take care of knowledge transfer.
The achievements of the research program are published in reputable journals and presented at international scientific or professional meetings, and in this way contribute to the recognition of Slovenia in the world. Our research enables even more intensive involvement of Slovenian researchers in the international scientific community and cooperation in bilateral and multicentric studies. In Slovenia, our research program ensures the early introduction of modern diagnostic methods into routine work and the upgrading of professional quality.
We also provide education and training for students, doctors and professional associates. Based on the research carried out in our program, in the last five-y
Most important scientific results
Interim report
Most important socioeconomically and culturally relevant results
Interim report
