MDLUX2: Drawing a Fuller Picture

MDLUX2 has a bold overall mission: to improve the treatment outcomes of cancer patients in Luxembourg, with a particular emphasis on rare and complex cancers (1). Continuing on from a previous initiative, the program also aims to determine whether or not molecular diagnostics are feasible and cost-effective as a routine part of cancer care; at the moment, such tests are not paid for by public health insurance, so MDLUX2 is vital in establishing their value to patients.

“Bringing small-scale local healthcare initiatives to the national level requires a lot of time, meticulous preparation, and the engagement of all possible stakeholders to ensure sufficient funding and the successful implementation of such projects,” explains Nikolai Goncharenko, Coordinator of the Institut National du Cancer. Goncharenko is enthusiastic about the new program because it will provide all patients with equal access to modern molecular cancer diagnostics. “The program will make cancer therapy in Luxembourg more personalized. Knowing the mutations and/or protein expression of particular molecules will help the tumor boards and treating physicians select the most appropriate treatment option for each individual cancer patient.” Additionally, by bringing the program to the national level with the support of private funding, the organizations involved – the Institut National du Cancer, the Fondatioun Kriibskrank Kanner, and the Integrated BioBank of Luxembourg – should be able to secure future public funding for further initiatives. At least, that’s the hope of Goncharenko and his colleagues.

The program’s diagnostic solution combines DNA and protein analyses. “It profiles solid tumor samples by sequencing 75 genes linked to approved targeted therapies,” says Goncharenko – but because sequencing analysis only partially reveals the identity of the tumor, proteins are also evaluated using IHC, microsatellite instability (MSI), and tumor mutational burden (TMB) to assess immunotherapy response. The testing even checks for unusual and damaging splicing in mRNAs and measures the methylation of gene promoters. By combining all of these analyses, investigators hope to establish a complete genetic profile of the tumor that can be used to predict response to targeted therapies, immunotherapies, and classic chemotherapies. Patients can also allow their samples and associated data to be biobanked for future research projects, supporting further advances in cancer research in Luxembourg and around the world.