The treatment of patients with oligometastatic tumors remains in the focus of the research activities in the second funding period. This patient collective presents with a controllable primary tumors and additionally one to five progressing metastatic lesions in liver and brain, which are the mainly responsible for the death of tumor patients. Half of the up to 20 mio people worldwide (500 000 in Germany), who will get cancer in 2020, will die. Liver metastasis can be detected in 70% of the deaths. Brain metastasis occur in approx. 20% of all tumor patients. Today oligometastatic patients are almost exclusively treated in palliative care. Molecular analysis of all metastasis does not take place despite better knowledge about tumor heterogeneity (differences in molecular genetics of the metastasis). Common treatment plans in these patients with solely manually assisted biopsy, histologic analysis and diagnosis of a single metastasis with a therapeutic decision made in the once weekly organized tumor board span over at least two weeks, frequently even longer and require inpatient stays for this period.
The M²OLIE closed loop concept aims at a curative therapy in these cancer patients. Within the first funding period several individual steps have been explored – electronic patient information, new image analysis techniques, automated robot assisted needle placement for biopsies and interventions, molecular classification of tumor entities by means of mass spectrometry and organization of ad-hoc tumor boards for therapeutic decisions. Aim of the second funding period is the integration and implementation of theses individual steps into a continuous, time and cost efficient closed loop process consequently using automated processes. Until the end of the second funding period this closed loop will be clinically evaluated in tumor patients with individualized, minimally invasive therapy of all metastasis within an one stop shop. This will be accomplished through close integration of the three joint projects with a multitude number of work packages: M²IBID with diagnostic and interventional imaging and molecular analysis, M²INT with automation and robot assisted biopsy and intervention, M²DATA with the conceptual design of a M²OLIE spanning data supply process. The M²OLIE closed loop process will lead to a paradigm shift in the whole diagnostic-therapeutic treatment process of cancer patients. f