Applied Research in Oncology

The research program consists of 10 main activities. Its implementation involves directly the specialized employees of the University Hospital Ostrava (FNO), and partially employees of the Faculty of Medicine, Ostrava University (LF OSU).

The main goal of the research program VP7 is to acquire top-notch research professionals and team leaders from both the Czech Republic and abroad, whose research activities will be focused on the field of experimental oncosurgery, preclinical and clinical laboratory diagnostics of tumor diseases, and diagnostic imaging methods in experimental oncology and internal diseases. As research support, a modern biobank will serve for the storage and experimental treatment of tumor diseases within clinical studies, in collaboration with commercial partners and research sponsors. The implementation of VP7 involves the Faculty Hospital Ostrava as well as the Medical Faculty of Ostrava University. The planned research program (VP7) will be closely connected with the planned construction of MSOC, the Moravian-Silesian Oncology Center at the Faculty Hospital Ostrava. The planned activities of VP7 and MSOC align with the long-term European and national plans for cancer treatment and currently comply with the National Recovery Plan (NPO) and the program for supporting Healthcare Applied Research for the years 2020-2026.

The execution of activities is led by the partner FNO, and the Medical Faculty of OU also contributes to specific tasks. FNO acts as the expert guarantor and ensures the integration of individual research activities into practical and clinical aspects. Staff from the Medical Faculty of OU participating in this research program will enable the integration of activities with the faculty's scientific and research background and the applicability of insights into the educational process of OU students and other research and development professionals from OU.

Task 1: Experimental Oncosurgery

The research endeavors within the domain of experimental oncosurgery will be focused on the development and innovation of medical devices and advanced technologies in oncological surgery. This collaborative effort will involve partnerships with commercial entities, concentrating on clinical trials and validation of medical instruments, as well as the assessment of contemporary software solutions. Collaboration will span across several research projects. Exploration in radiobiology has led to pivotal scientific insights, ranging from the revelation of stem cells to the delineation of signal transduction pathways activated by ionizing radiation, culminating in apoptosis. Radiobiological models serve as guiding principles for clinical studies that investigate radiation therapy in conjunction with inhibitors of DNA-dependent protein kinases (DNA-PK), Ataxia Telangiectasia Mutated (ATM), Ataxia Telangiectasia Related (ATR), as well as immune system inhibitors or cell cycle checkpoint inhibitors.

Over the past decades, hyperthermia (HTT) has gradually emerged as a promising strategy in combatting malignant tumors. This non-invasive treatment aims to deliver heat, which eradicates cancerous cells at clinically appropriate temperatures. Primarily, it aims to curtail the reparative capacity of tumor cells during both radiotherapy and chemotherapy. Furthermore, hyperthermia has shown promise in eliciting immune reactions, inducing immunogenic cell death, and overturning the immunosuppressive microenvironment of tumors. Besides microwave-induced hyperthermia, magnetically induced hyperthermia can also be employed, especially when combined with tissue-specific nanoparticles (typically Fe2O3). This approach exhibits the ability to precisely localize and intensely heat deep-seated tissues.

The specialized focus of Subtask 1 encompasses:

• Experimental oncosurgery, which will lead to the advancement and innovation of medical devices and advanced technologies in the field of oncosurgery.
• Diagnostic oncoradiology, yielding novel approaches in contemporary imaging techniques for oncological conditions.
• Experimental oncosurgery, yielding new educational models with suitable instructional environments.

Task 1: Experimental Surgery consists of four principal activities:

1. Novel Technologies in HepatOncology, Gastroenterology, and Biomedical Research
2. Research on Squamous Cell Carcinoma – Stomatosurgery
3. Telementoring, Teletracing, Virtual Reality, and 3D Modeling in Surgery
4. Experimental Onconeurosurgery, Anatomy, and Radiobiology

Task 2: Preclinical and Clinical Diagnostics in Modern Oncology

Oncology is a highly dynamic field that bridges various domains, including surgical and internal specialties. At the foundation of these disciplines lies laboratory diagnostics, which plays an indispensable role in comprehensive oncological patient care. The study of lifestyle-related and oncological diseases is closely intertwined. Therefore, the identification and study of new laboratory biomarkers are of paramount importance, enabling the tracking of dynamic developments in internal diseases, facilitating disease diagnosis, and significantly contributing to early diagnosis within the realm of comprehensive oncological care. This extends not only to biomarkers of internal diseases but also to oncological conditions.

One of the most dynamically evolving areas in the therapy of solid tumors is the immunotherapy of solid tumors, as well as hematological malignancies. Presently, definitive predictors that can reliably monitor the effects of immunotherapy or appropriately indicate immunotherapy for various types of solid tumors and hematological malignancies are lacking. We anticipate the emergence of new multicenter teams dedicated to conducting multicenter studies in this immensely crucial diagnostic area, with the potential for knowledge transfer into routine diagnostic and therapeutic practices.

The specialized focus of Task 2 encompasses:

• Study of novel predictors for targeted therapy in solid tumors and hematological malignancies
• Evaluation of the immune system status in patients with blood tumors treated with modern immunotherapy, known as immunomonitoring
• Identification and study of new laboratory biomarkers (HA10)
• Development and testing of three-dimensional navigation in oncosurgery and oncoradiology

Subtask 2: Preclinical and Clinical Diagnostics in Modern Oncology consists of four principal activities:

1. Real-time Three-dimensional Navigation, Utilization of VR and AR in Hepatosurgery, Oncosurgery, and Radiodiagnostics
2. Image Data Processing – Radiodiagnostics and Experimental Radiosurgery
3. Study of Predictors for Immunotherapy in Solid Tumors and Hematological Malignancies, Hematopathology, and Immunomonitoring
4. Identification and Study of New Laboratory Biomarkers of Internal Diseases – ULM and Internal Medicine

Task 3: Oncological Research Biobanking

Another realm of research within Research Project 7 (VP 7) will focus on new approaches in internal medicine, specifically targeting the area of enteral nutrition in both standard and intensive care settings. Additionally, it will address novel diagnostic methods and the implementation of existing diagnostic methods in new indications, such as electrogastrography in assessing enteral nutrition tolerance in intensive care. These insights will contribute to improved diagnostics and enhanced care for long-term chronically ill patients, particularly those with oncological conditions. Crucially, for comprehensive research, the establishment of infrastructure for the collection, preservation, processing, storage, and supply of biological samples from patients with internal diseases and associated comorbidities and oncological conditions is vital. This infrastructure would provide material not only for scientific and clinical use but also contribute to the standardization of operating procedures in this domain. This approach will ultimately facilitate the execution of high-quality multicenter studies, enriching the long-term integration of foreign research teams in our region.

The specialized focus of Task 3 is the biobanking of patient samples in oncological screening and for monitoring modern treatment of patients with a wide range of diseases (focusing on disease types based on the results of the activities of other subtasks in VP7, such as internal diseases, neurooncological conditions, craniofacial surgery, abdominal and thoracic surgery, oncological screening, etc.).

Task 3: Oncological Research Biobanking is realized through two principal activities:

1. Integrated Repository for Solid Tumor Research – the outcome is the establishment of a repository and the structuring of its utilization as a resource for other principal activities of all medical projects.
2. Biobanking of Patient Samples in Oncological Screening and Internal Diseases

Collaboration with Other Research Projects and Collaborating Entities

Due to the strong interdisciplinary connections, the research team of VP7 collaborates on certain partial activities with research teams from:

• VP9 subtask1 HA1 – VP7 and VP9 jointly develop newly proposed tools for liver tissue biopsy with the possibility of radiofrequency treatment of the puncture channel post-insertion. VP7 is responsible for defining input requirements and conditions, participating in the development of functional prototypes and in vivo testing, with VP9 handling technological development.
• VP9 subtask HA2 – VŠB provides developed software (VP9) based on FNO parameters, which (VP7) tests in a medical environment.
• VP9 subtask HA2 – VP7 defines basic parameters and ensures the robustness testing of algorithms on clinical data during the development of new software (VP9).
• VP6 – VP6 and VP7 together identify molecular changes in tumor cells of patients in resistant/aggressive stages of monoclonal gammopathies and validate and functionally characterize gene mutations.