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(C) Universitätsklinikum Heidelberg 2013 - Campus Neuenheimer FeldClose-up: National Center for Tumor Diseases Heidelberg

The NCT Nationales Centrum für Tumorerkrankungen (National Center for Tumor Diseases, www.nct-heidelberg.de) has been operating since 2004 and was established as a joint venture by Deutsches Krebsforschungszentrum (German Cancer Research Center, DKFZ), Universitätsklinikum Heidelberg and Deutsche Krebshilfe (German Cancer Aid) which funded it with €30m ($40m; £24m). Since 2008 it has been running a collaborative researcher exchange program with the Helmholtz Association of which the DKFZ is a member). With an investment of €29m NCT is located at the Neuenheimer Feld, the Heidelberg university campus. It houses a daycare unit, four outpatient clinics and research laboratories. In addition the NCT operates a tissue bank at the Pathology Department. Today 500 people are working for the NCT. The centre operates within a tightly woven network with departments of the medical faculty:  Translational Oncology (Christof von Kalle), Medical Oncology (Dirk Jäger), Preventive Oncology (Hermann Brenner, formerly Cornelia Ulrich) and cancer research consortia.

For its shareholders the NCT has three functions: First, it bundles cancer research activities at DKFZ and the university hospital at Heidelberg. These rely on a steady stream of medical cases, biological samples, or clinical data. In practice NCT serves as a central gateway for all tumour patients of the university hospital. Patients are welcomed at the NCT building and then channeled to interdisciplinary outpatient clinics on site, where visitors are attended by staff from different departments of the university hospital who rotate according to designated study projects. According to university figures more than 12,200 people were treated in the outpatient clinic in 2012. Of these visitors 10,000 were newly diagnosed cancer patients (+ 2/3 compared to 2007). About 40 percent of the patients are from outside the different regions and are actually from 45 foreign countries. NCT also links up biological research to the radiation therapy facility with protons and heavy ions where about 1,300 patients are currently treated at Heidelberg. A second function of the NCT is capacity building through strengthening patient education, pofessional training and informed medical referral. Since 2013 NCT has been expanding outside the city by setting up a pilot satellite offering cancer care and psycho-oncological advice in a community clinic at nearby Heppenheim. In addition to local activities NCT is assuming a major role in capacity building within the Deutsches Konsortium für Translationale Krebsforschung (DKTK, German Consortium for Translational Cancer Research). On initiative of the German government (Research Department, BMBF) DKTK was set up as a foundation in 2012. The DKFZ serves as the core centre with partner universities in Berlin, Dresden, Düsseldorf (left 2014), Essen, Freiburg/Breisgau, Frankfurt/Main, Mainz, München, and Tübingen. As large-scale network the DKTK attracts a larger portion of public funding, and intends to unite fragmented cancer research in partner institutions, as well as to incentivize the pooling of capacities in basic, translational and commercial clinical research. The DKTK (and within the NCT) is focused on seven areas: oncogenic pathways, molecular diagnostics, cancer immunology and immunotherapy, stem cells in oncology, integration of radiation therapy with protons/heavy ions and in-vivo electronics/molecular imaging, treatment resistance, and cancer preventive measures (e.g. nutrition, sports). A third function of the NCT is to serve as platform to develop business of shareholders and to be a one-stop shop for collaboration partners that are private practitioners in haematology-oncology and community hospitals, biobanking facilities, cancer research abroad (e.g. U.S. National Cancer Institute), and biotech SMEs (e.g. DKFZ spin-off Apogenix/Peter Krammer).

The NCT has several revenue streams to finance its operations. There are fees for its services (e.g. running(C) Universitätsklinikum Heidelberg 2013 - Entrance NCT National Center for Tumor Diseases Building an experiment on a laboratory instrument), charitable donations (e.g. German Cancer Aid for the construction of the NCT building), public research grants (e.g. HI-STEM grants currently €6.4m), reimbursement for medical treatments in the centre’s clinics (e.g. 4.286 paid treatments in 2009), and income from clinical trials. Because of its structure it is difficult to determine the NCT’s annual budget. Across the campus grants for oncology research sum up to €100m per year. People close to the NCT estimate that its budget makes up to about a fifth of the DKFZ, which would translate into €45m ($60m; £36m) in 2014.

Major scientific topics are in stem cells, tissue engineering, gene therapy (esp. vector development), as well as clinical studies of pharmaceutical substances (mono, combined) or of medical devices (e.g. clinical biomarkers, contrast agents for imaging). Currently one of its national flagship projects is HI-STEM (Andreas Trumpp) dedicated to metastasis-inducing cancer stem cells in pancreas carcinoma (PANC-STRAT grant). This project is currently operative as a non-profit organisation (HI-STEM gGmbH) and closely accompanied by asset managers of private investor, SAP-founder Dietmar Hopp. The NCT is also an active contributor to several EU projects contracted by the DKFZ. Current EU consortia are EU projects: AIPGene (Acute Intermittent Porphyria), DiaBil-2 (Diabetes Type 1), EuroFancoLen (Fanconi anaemia), Net4CGD (Chronic Granulomatous Disease), or Supersist aimed at immunotherapy of cancer, haematopoietic stem cells and gene targeting technologies for correcting inherited mutations. In the clinical studies line the center has registered eight ongoing clinical trials for the university hospital to date. These involve mainly drug substances. In six studies patient recruiting is ongoing for several cancer indications (colorectal, pancreatic, breast cancers, melanoma, paediatric tumors like leukaemia) and one allogeneic stem cell transplantation trial.

Caroline Olsen, B2Bioworld; contributed: Jasmin Rothacker

First published 9.2014; Updated 2.2015

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