Cure4PMP is a network of international collaborators working with Pseudomyxoma peritonei (PMP). PMP is a rare malignant disease (1-2 cases/million/year), characterized by gross accumulation of mucinous tumor in the abdominal cavity. The main treatment is cytoreductive surgery to remove all visible tumor, with the addition of intraperitoneal chemotherapy to kill microscopic disease. For patients who cannot be cured by surgery, no efficacious anticancer treatment exists, resulting in a chronic debilitating state which is ultimately life-threatening because of compression of abdominal organs.
Because of its rarity, the PMP therapeutic approach suffers from lack of standardization, and research efforts are typically fragmented and inadequately funded, hampering advances in the field. Cure4PMP addresses an unmet need for preclinical and translational research aiming to improve current treatment and bring new and better curative and palliative therapies to patients with PMP, through a broad international collaboration. The Cure4PMP network is particularly well suited to take on this challenge, being composed of high-volume clinical centres as well as advanced preclinical and translational research units across Europe.
Though a broadly based and clearly envisaged translational research pipeline established by the network partners, Cure4PMP will contribute to standardizing current therapy and aims to generate a common standard for effective biobanking and sample handling. Using -omics technologies and advanced bioinformatics, clinical samples will be analyzed to identify biomarkers and therapy targets, which will be validated in unique cell lines and animal models. The activities in Cure4PMP will forge strong international collaborative structures that will form a starting point for further implementation of results in subsequent clinical trials.
The Cure4PMP partners:
The partners of this network are headed by clinician-scientists, and are additionally composed of clinicians (surgeons, oncologists, pathologists, radiologists) and a broad spectrum of scientists from basic and translational cancer biology. All partners are contributing to work involving biobanking of clinical samples, standardization of procedures and evaluation of current therapy.
Oslo University Hospital (OUS) (Lead: Prof K. Flatmark) is the only treatment center for PMP in Norway, offering CRS and HIPEC to 5-10 PMP patients/year. Systematic patient registries of clinical information and biobanking of tumor tissue have been established since the late 1990s. A translational research program was established in 2004, focusing on development and use of animal models and cell lines, carried out at Institute for Cancer Research at the Norwegian Radium Hospital. This is a modern cancer research institute with excellent facilities, including a range of high-throughput analyses, advanced bioinformatics, an animal facility including a 7T high-resolution magnetic resonance imaging (MRI) scanner, in addition to a broad armamentarium of cell biology and biochemical methods.
Institut National de la Sante et de la Recherche Medicale (INSERM) (Lead Prof M. Pocard) The Carcinomatosis Angiogenesis and Translational (CART) research unit (INSERM-Paris7) specializes in development of animal models to mimic human disease for testing of drug efficacy, diagnostic and therapeutic strategies. This is the only INSERM research unit devoted to the peritoneal surface malignancy research in France. The first PMP program in the unit started in 2009 with a grant awarded by the NORD (National Organization of Rare Diseases) funding group, and this research has instigated changes in local therapy approaches, e.g. implementing MRI and peritoneoscopy in patient evaluation. Surgeons are members of the CART research unit, while also working at the associated clinical unit at Lariboisière hospital, which treats approximately 20 patients with PMP every year.
Centre Hospitalier Lyon Sud – RENAPE network group (RENAPE) (Lead: Prof François-Noël Gilly) As part of the French national Cancer Plan 2009-2013, and with the support of the National Cancer Institute and the French ministry of health, the National network for the treatment of rare peritoneal malignancies (RENAPE) was organized. Its main objective is to optimize the framework for healthcare management and treatment of rare peritoneal malignancies. RENAPE represents a network of more than 20 hospitals providing healthcare to patients affected by PMP, referring complex cases to the national treatment centers. One important priority has been to initiate biobanking of tumor tissues, and formalin-fixed samples from >1000 cases with PMP are available for analysis.
Universiteit Hasselt (UHasselt) (Lead: Prof K. Van Der Speeten) represents the Ziekenhuis Oost-Limburg hospital, which is one of two high volume treatment centers for PMP in Belgium, with extensive experience in CRS and HIPEC, treating 20-25 PMP cases annually. A particular research interest of the group is within investigations of pharmacologic aspects of intraperitoneal chemotherapy, and a pharmacologic research program for intraperitoneal treatment strategies has been established based on expertise gained both at the Washington Cancer Institute, USA and Uppsala University, Sweden.
Hampshire Hospitals NHS Foundation Trust (Lead: Prof A.H. Mirnezami) works across two institutions closely linked by common research interests. The clinical center is the Peritoneal Malignancy Institute Basingstoke, which with a track record extending over 20 years, has the largest international experience in PMP to date, treating 150 cases annually. Laboratory analyses including high throughput analyses, cell biology assays, development of cell lines, and prospective tumor banking are conducted at the Southampton Cancer Research UK Centre, which is a partnership between the University of Southampton, Southampton University Hospitals, and Cancer Research UK. The unit is a world-class centre of excellence with the goal of improving translational research for patient benefit with an established research pipeline from in vitro, through pre-clinical and translational studies to early and late phase clinical trials. Dedicated pathology is provided by Dr Norman Carr, who is an expert in PMP classification (from the WHO consensus) and takes part in the translational efforts. Molecular and gross pathology of PMP (with a specific focus on microRNAs and EMT pathways) are studied as part of a nationally supported study with over 300 patients prospectively recruited already by this group with a variety of clinical samples available for analysis.