Gentle, Personalised Treatment of Breast Cancer

Breast Cancer Cryotherapy

Breast Cancer Lasertherapy

Endogenous Vaccines: Target-Specific Stimulation of the Immune System

Immunotherapy

Kinase Inhibitors

The lab practice clinic GbR Dr. Kübler & Partner has a patented early recognition technology in order to isolate circulating tumour stem cells from the veins. Cancer is a disease of uncontrollable stem cells that developed years before a primary tumour or even metastases could be found. If treatment is necessary, it can commence at the earliest possible time thanks to this method. Monitoring of the reducing tumour stem cell number enables us to review success of the therapeutic measures.

How does the diagnosis method apheresis work?

Isolation of tumour stem cells circulating in the veins by apheresis takes place under standardised physical parameters. The apheresis machines are certified according to the TÜV and medical devices act. They are performed according to defined cycles. Collection takes about 1.5 hours during which the patient can lie down. A venous access is placed and the needle is connected to a tube system. The apheretically acquired cells are divided into various fractions by a density gradient. Thereafter, the relevant cells are washed several times until the desired degree of purity is achieved. A specially developed test that permits individual evidence, various molecular biomarkers is used to produce an expression profile of the character of the circulating tumour stem cells. By concurrent application of FISH analysis (fluorescence in situ hybridisation), it is possible to document the degree of damage of the amplification of genes, e.g. erb/B-2, C-Met of the tumour stem cells.
Diagnostic apheresis permits the acquisition of tumour stem cells from the blood without biopsy. These cells can then be examined for specific breast cancer antigens and their metastasis formation potential outside of the body.

The advantages of diagnostic apheresis:

• Gentle, biopsy-free, diagnostics
• Early recognition of breast cancer, in part before the primary tumour is visible in imaging procedures
• Molecular quantification and qualification of the circulating tumour stem cells
• Possible organ assignment of the tumour stem cells
• Recognition of the metastasis formation potential of the tumour stem cells

• Customised treatment planning according to the individual symptoms of the disease
• Progress review: Monitoring of the tumour stem cell count

Gentle Treatment of Breast Cancer

Laser- and cryotherapy New, minimally invasive tumour therapies

Cryotherapy and laser therapy are innovative methods to treat tumours. Both methods are minimally invasive and thereby open up the possibility of a gentle (and, for example, breast-preserving) treatment. They can be used in benign, and even as treatment of, malignant tumours – if it is desired and possible to deviate from the current traditional medical guidelines. Which of the two methods seems more suitable depends on the symptoms of the illness (e.g. on the position or size of the tumour).

How does cryotherapy work in breast cancer and benign tumours?

A cooling probe with a diameter of only 1.6 mm is introduced into the tumour under ultrasound observation. The probe tip cools down to minus 80 degrees which turns the tumour into a ball of ice very quickly (depending on its size. Then it thaws again, followed by new super-cooling. Shock-freezing and thawing twice breaks up the cells into very small, resorbable parts and immediately interrupts the blood flow in the supplying capillaries.

How does laser therapy work in breast cancer and benign tumours?

Laser therapy (or laser vaporisation) means that “coherent” light is applied to the tissue. This light beam has a very high energy density as a consequence of an extremely high physical bundling of photons. With the help of highly energetic laser energy, the tissue is vaporised (evaporated). The laser disassembles the cells into the smallest resorbable parts and interrupts the blood flow in the supplying capillaries. The interruption of the blood flow prevents washing out of tumour stem cells.
The laser probe is introduced through a small cut in the skin and placed on the tumour under permanent ultrasound control. Then, the tumour is taken apart step by step by vaporisations. The process is continually monitored on the ultrasound monitor.

What does cryotherapy and laser vaporisation do?

• The affected organ is preserved and scarring is usually minimal
• The risk of adverse effects and/or collateral damage is low
• The process can be repeated if necessary
• The tissue structure of the tumour is destroyed
• The disappearance of the tumour-typical structure (desmoplasia) can be followed by ultrasound
• Washing tumour stem cells into the circulation is mostly avoided

Endogenous Vaccines

Stem cell apheresis of producing endogenous vaccines
Stem cell apheresis of producing HSP

The vaccines support the natural killer cells (NK cells) in recognising their targets by individually specific endogenous tumour antigens of the respective patient. The immune response therefore is reinforced.

Endogenous vaccines

The method supports the immune system specifically in fighting tumours and metastases. It can be used in addition to immunotherapy, cryotherapy or laser vaporisation.
The natural killer cells (NK cells) of the immune system are responsible for removing tumour cells and tumour stem cells in the body, provided that they recognise their targets and are available at a sufficient amount. Vaccination supports the NK cells in recognition of their targets by individually-specific endogenous tumour antigens of the respective patient. The immune response is thereby reinforced.
Production of the vaccines.
The tumour stem cells circulating in a patient’s veins are needed to produce a vaccine. They are acquired by apheresis and isolated in the lab. The tumour stem cells are then exposed to extreme heat in order to destroy them. In this, they express cell-stabilising heat shock proteins/tumour antigens.

• Heat-shock proteins support the immune defence in managing cellular stress situations.
• Heat-shock proteins that we take from the destroyed tumour stem cells trigger a specific immune responsible for the tumour as an endogenous vaccine.

Why do tumour cells and tumour stem cells need to be removed?

Most cancers are caused and fed by uncontrollable tumour stem cells. It is not the differentiated tumour cells that are the most dangerous but the aggressive and invasive tumour stem cells that contain an unstable genome.
Tumour stem cells are cancer cells that have essential stem cell properties such as being able to renew themselves and differentiate to become different cells. Some tumour stem cells are enough for a continuous and numerous supply of tumour cells, which in turn are responsible for the growth of a tumour. Tumour stem cells are over-equipped with repair enzymes and membrane transporters. They are also disastrously mobile and can settle in tissues far from the primary tumour.
Targeting and destruction of the tumour stem cells is therefore the primary target of our breast cancer treatments.

Immunotherapy

Target-specific activation of the immune system.

If there is a large number of circulating tumour stem cells, target-specific activation of the immune system through immunotherapy is recommended. Immunotherapy means that the patient’s own natural killer cells (NK cells) are reproduced in the culture and returned to the patient in order to specifically strengthen the immune system, and to achieve immune competence against malignant cells. The NK cell perforates the tumour stem cell, injects cell-dissolving proteins and thereby forces it to dissolve into its components.

The immunotherapy works through increase of the endogenous natural killer cells.

The NK cells are a subgroup of white blood cells that are able to recognise and kill degenerated cells such as tumour cells, tumour stem cells and cells infected by viruses. NK cells are part of the congenital immune system. These cells are under-represented and have a reduced immune competence in immunocompromised patients and people with tumours.
We acquire the NK cells from the patients’ own blood using leucocyte apheresis. The apheretically acquired cells are divided into various fractions by a density gradient. Afterwards, the relevant cells are washed multiple times until the desired degree of purity is achieved. This method, called purging, ensures that no tumour cells/tumour stem cells are cultivated as well.
We reproduce the NK cells under ideal conditions in a cell culture and return them to the patient multiplied by way of infusion. We monitor the tumour cell number to verify effectiveness of the therapeutic measures.

What does immune therapy do?

• Targeted removal of the tumour stem cells (high potential of metastasis formation)

• Natural activation of the immune system: Mobilisation of the endogenous forces

• Can also be used for chemo- and radiation-resistant cells

• Patient-specific treatment based on a comprehensive diagnosis

• Gentle treatment and greatest possible presentation of quality of life

Kinase Inhibitors

Support of treatment by kinase-inhibiting medicines.

Kinases are enzymes, special proteins that transfer phosphate groups to other proteins . This phosphorylation has a similar effect like an on/off switch. Thus, a single kinase can activate many proteins. Only after activation will these proteins commence to complete their diverse tasks. This way, stimuli that arrive at the outside of a cell are transferred inside the cell and forwarded into the cell nucleus.

In this manner, kinases are involved in all fundamental processes such as growth, differentiation and self-destruction of the cell. These enzymes play a key role in the forwarding of growth signals. Failures in this system are therefore often disastrous and lead to massive pathophysiological consequences. The cause of many breast cancers is an overactivity of kinases and a lack of effectiveness of regulation mechanisms. These “over-eager” kinases cause uncontrolled growth of tissue, and are essentially involved in supplying tumours with new blood vessels (angiogenesis).

Kinase inhibitors, i.e. substances that inhibit the activity of kinases, are innovative targets for breast cancer treatment. Due to their specific affect, they are subject to drastically fewer adverse effects than conventional chemotherapy. It is also possible to find out in advance whether the treated patient suffers an impairment of the corresponding kinase. Treatment can therefore be individually adjusted to the kinase profile of the patient.

Hinweis:

This information does not replace a medical diagnosis of the individual clinical picture and is not yet a therapy recommendation.