Ahead of the 22nd ESUR meeting in Glasgow, Prof. Ellen Zwarthoff (Rotterdam, NL), biochemist and winner of this year’s Dominique Chopin Award for significant achievements in urological research, talks on the challenges in urological research and the importance of collaboration among various medical disciplines.In your field, particularly with regards to current urological research, what would you consider as the most important issues that researchers should focus on in the next few years?
Funding for bladder cancer research is low. If we want to improve survival for patients with bladder cancer, and I am sure this is the aim of the entire community, new therapies will have to be developed for patients with muscle-invasive bladder cancer (MIBC) and for those with high-risk non-muscle invasive cancer (NMIBC). However, regarding new therapies, bladder cancer research is still in the Middle Ages compared to active fi elds like colorectal, breast and lung cancer. This offers opportunities for young researchers.
Bladder cancer is heterogeneous molecularly with respect to different tumours from different patients, but also heterogeneous within one tumour or between tumour and metastases. The Cancer Genome Atlas (TCGA) initiative is now providing data on all mutations, copy number alterations, methylation, gene expression etc. in MIBCs. From these data new therapy targets are emerging. In the future every tumour will have to be analysed at multiple sites to identify the most important driver mutations that can be a target for therapy. A lot of basic research will also be needed to investigate signalling pathways, their crosstalk mechanisms and feedback loops and the way inhibitors of these pathways work.
Genetic and molecular studies play a crucial role in current medical diagnostics and treatment. What trends in urological research do you expect to see more in the coming years, and how will these developments impact on clinical practice?
Molecular assays will become more and more important in diagnostics and prediction of disease course as well in presenting predictive markers for therapy and as companion diagnostics for targeted therapy. Currently, many biomarkers have been and are being identifi ed. The crux is how to separate the wheat from the chaff. To enable this upfront, every study on a biomarker should include a test set of tumours and an independent validation set and a scientifi c journal should only accept papers that have adhered to this standard. Independent validation by other groups should then ensue. Once this has been achieved, the diagnostic and prognostic armamentarium will have been hugely expanded.
To societies and groups like the ESUR, what issues do you think should have top priority in their strategies or at least be given more attention in order to boost research goals in urology?
Research in my group focuses on urothelial cancer of the bladder and urinary tract. These cancers are associated with severe clinical problems and are expensive when compared to other cancers. In the Netherlands bladder cancer mortality is 2.9% of all cancer deaths. This is 7.6 and 5.8% for breast and prostate cancer, respectively. In addition, the prevalence of bladder cancer is high due to recurrent disease in 70% of patients presenting with an initial NMIBC who require long-term surveillance. Despite these figures funding for bladder cancer is low. Spending by the National Cancer Institute USA for breast and prostate cancer is 600 and 300 million per year, respectively, compared to only 20 million for bladder cancer (Cancer.gov).
Although these data are not easily obtained for the EU, I am convinced that this dismal picture is similar in Europe. Hence, I think that ESUR, EAU and other groups should bring this problem under the attention of the governments and funding agencies. It is time for a bladder cancer awareness campaign.
You are the recipient of the 2014 Dominique Chopin Award for significant achievements in urological research. How signifi cant is this award or similar honours to researchers?
I am very honoured having been nominated for the Dominique Chopin Award this year. I had the pleasure of meeting Dominique about 20 years ago when he came to Rotterdam for a visit together with Francois Radvanyi. I remember him as a dedicated urologist and a very nice person. In the Netherlands and Europe we do not have a strong tradition in giving awards and there are only a few awards that people are eligible for in general. Awards are certainly important for people’s careers. The EAU is doing very well in this regard with best poster prizes, best papers in different categories and so on.
The 22nd Meeting of the EAU Section for Urological Research will take place in Glasgow on 9-11 October, 2014. Abstract submission is open until 1 July.