Working groupOncological Breast & Gynecopathology

Tumor profiling - How (molecular) pathological predictive and prognostic biomarkers influence therapy stratification in invasive breast cancer and gynecological tumors

In order to provide cancer patients with both the most efficient, promising therapy, but also to avoid overtreatment, prognostic and predictive biomarkers are needed to guide therapy decisions. This is all the more important in the age of personalized medicine. For example, tissue analysis can be used to identify patients who will benefit from targeted therapy. Furthermore, the discovery of new targets can contribute to the development of new drugs or therapies. In our research group, we have therefore made it our goal to investigate tissue-based biomarkers with regard to their prognostic and predictive significance in oncology. The focus is on malignant tumors of the breast (invasive breast cancer) and female genitalia (e.g. endometrial cancer). In these tumors, we investigate molecular biological subtypes with regard to their prognosis and the expression of target structures suitable for new therapies. Furthermore, we try to optimize the determination of predictive biomarkers for the use of the latest drug therapies. This applies to both early and advanced stage cancer. Methodologically, we use immunohistochemical procedures, molecular pathological methods such as gene expression analyses or sequencing procedures and tissue microarrays in addition to classical histopathology. Our close cooperation partner is the Department of Gynecology and Obstetrics at the University Hospital Erlangen. We also want to integrate machine learning methods in cooperation with working groups of the Friedrich-Alexander-University Erlangen-Nürnberg or external cooperation partners in order to standardize or improve the evaluation of histopathological biomarkers.

Immuno-oncology in breast cancer

Furthermore, we are central study pathology for a currently recruiting randomized, multicenter phase II study [neoMono; Study to Compare a Mono Atezolizumab Window Followed by a Atezolizumab - CTX Therapy With Atezolizumab - CTX Therapy (neoMono); NCT04770272]. The neoMono trial is an ongoing clinical trial enrolling up to 458 (male and female) patients in the neoadjuvant setting with early, treatment-naïve triple-negative breast cancer (TNBC) or breast cancer with hormone receptor positivity of less than 10%, to analyze the effect of an additional monotherapy window with the immunotherapy agent atezolizumab before a combination of chemotherapy (initially carboplatin + paclitaxel, followed by epirubicin + cyclophosphamide) and atezolizumab. The benefit of the immunotherapy monotherapy window (test arm A) will be measured by treatment response, i.e. whether there is pathological complete remission (pCR) after completion of neoadjuvant therapy. As part of this clinical trial, a biobank of longitudinal tissue and fluid samples from all patients participating in the study is being established, i.e., all patients within neoMono undergo multiple on-treatment/post-treatment biopsies (tissue and fluid) to allow evaluation of static and dynamic biomarkers. This will allow translational research projects to investigate changes in the tumor biology and the immuno-oncological tumor microenvironment under immunotherapy.

In summary, the goal of our working group is to improve tissue-based diagnostics in pathology and thus therapy stratification for patients suffering from breast cancer or gynecological cancer. We achieve these goals more effectively in the research community, so requests for collaborations are encouraged. We would also like to integrate young scientists into our research efforts at an early stage. We would like to thank all study participants and patients for their trust.

Link to DZI Video Immunotherapy in Breast Cancer