Press release of "Hopp Children´s Cancer Center Heidelberg" (KiTZ). The KiTZ is a therapy and research center at the same time for oncological an hematological diseases in childhood and adolescents. The KiTZ is a joint institution of the Heidelberg University Hospital (UKHD), University of Heidelberg (Uni HD) and the German Cancer Research Center (DKFZ).

However, childhood tumors are unique in many ways. "Tumors in childhood and adolescence are fundamentally different from tumors in adults in terms of tumor types, causes of development, biology and therapeutic approaches," emphasizes Stefan Pfister, director of the Hopp Children's Cancer Center Heidelberg (KiTZ), department head at the German Cancer Research Center (DKFZ) and pediatric oncologist at Heidelberg University Hospital (UKHD), who is one of the lead authors of the current publication. Many childhood cancers are caused by a single genetic event that occurs in a cell during its developmental phase and subsequently leads to uncontrolled cell division. In contrast, malignancies in adults are usually due to multiple genetic events, often caused by external chronic influences such as smoking, alcohol, infections or UV light. In practice, this means that tumors whose tissues look similar under the microscope and which occur in the same organ can nevertheless have a completely different origin, a completely different biology and a different course of disease.

The new WHO classification of childhood tumors, which was jointly developed by scientists at KiTZ, UKHD and DKFZ and numerous other international experts, is therefore based on a modern, multi-layered approach that incorporates not only all microscopically visible but also numerous molecular features into the diagnosis. The book, now published as Volume 7 of the fifth edition of the WHO Classification of tumors, represents the first reference work to date of all tumor types that can occur in childhood and adolescence. "Until now, childhood tumors were only listed in the organ-specific WHO classifications among the numerous types of cancer that practically only occur in adulthood," says Andreas von Deimling, medical director of neuropathology at the UKHD and head of the Clinical Cooperation Unit Neuropathology at DKFZ. In addition to the usual classification by organ, a distinction is also made between cancers that typically occur in infants, older children and adolescents. "Finally, a holistic view should consider a child's tumor not only as a disease of an organ, but as a disease of an organ in a developing child," explains co-author Rita Alaggio, Head of the Department of Pathology at the Bambino Gesù Children's Hospital in Rome.

By adding genetic and other molecular tumor characteristics, it is also possible to identify entirely new tumor types, identify therapeutic targets and make assessments of the course of the disease, the authors say. For example, while tumors of the connective tissue are still classified mainly on the basis of tissue structures, tumors of the central nervous system and leukemia are nowadays mostly classified on the basis of recurrent molecular or epigenetic changes or patterns.

In the medium term, low- and middle-income countries could also benefit from the new, more precise diagnostic criteria for treating children with cancer, the experts hope. "An important prerequisite for this is the development of affordable tests and links to pathology and pediatric oncology networks," says Stefan Pfister. Especially in such countries, where there are often too few specialized pathologists to evaluate tumor samples, these methods could help to use more precise diagnostic approaches specifically for children with cancer as standard. Pfister is convinced that early precision diagnostics can already decisively improve the situation of many patients: "If we invest only two to three per cent of the costs of modern cancer therapy in an objective, precise and unambiguous diagnosis in which we bring together molecular tumor profiles, biomarkers for predicting the course of the disease and hereditary cancer predispositions, this is an extremely good investment for patients. To be able to recommend tailored treatments and avoid side effects. "
 

About the WHO tumor classifications

The World Health Organization (WHO) tumor classification classifies cancers based on defined criteria. Since 1956, the WHO has promoted the publication of the classification of tumours, better known as the WHO "Blue Books". Each book contains a state-of-the-art and scientific classification of tumors for each organ. Previously, pediatric tumors were included exclusively with adult tumors in organ-specific tumor classifications.

The Hopp Children's Cancer Center Heidelberg (KiTZ)

The „Hopp Children's Cancer Center Heidelberg” (KiTZ) is a joint institution of the German Cancer Research Center (DKFZ), Heidelberg University Hospital and Heidelberg University. As the National Center for Tumor Diseases (NCT), which focusses on adult oncology, the KiTZ is based on the US model of so-called “Comprehensive Cancer Centers” (CCC). As a therapy and research center for oncologic and hematologic diseases in children and adolescents, the KiTZ is committed to scientifically exploring the biology of childhood cancer and to closely linking promising research approaches with patient care– from diagnosis to treatment and aftercare. Children suffering from cancer, especially those with no established therapy options, are given an individual therapy plan in the KiTZ, which is created by interdisciplinary expert groups in so-called tumor boards. Many young patients can participate in clinical trials which ensures access to new therapy options. Thus, the KiTZ is a pioneering institution for transferring research knowledge from the laboratory to the clinic.

While the KiTZ focuses on pediatric oncology, the focus of the National Center for Tumor Diseases (NCT), founded in 2004, is adult oncology. Both facilities in Heidelberg are based on the US model of so-called "Comprehensive Cancer Centers" (CCC).
 

The German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ)

The German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) with its more than 3,000 employees is the largest biomedical research institution in Germany. At DKFZ, more than 1,300 scientists investigate how cancer develops, identify cancer risk factors and endeavor to find new strategies to prevent people from getting cancer. They develop novel approaches to make tumor diagnosis more precise and treatment of cancer patients more successful.

DKFZ’s Cancer Information Service (KID) provides individual answers to all questions about cancer for patients, the general public, and health care professionals.

Jointly with partners from Heidelberg University Hospital, DKFZ runs the National Center for Tumor Diseases (NCT) located in Heidelberg and Dresden, and, also in Heidelberg, the Hopp Children’s Cancer Center (KiTZ). In the German Cancer Consortium (DKTK), one of six German Centers for Health Research, DKFZ maintains translational centers at seven university partnering sites. Combining excellent university hospitals with high-profile research at a Helmholtz Center at the NCT and DKTK sites is an important contribution to the endeavor of translating promising approaches from cancer research into the clinic in order to improve the chances of cancer patients.

DKFZ is a member of the Helmholtz Association of National Research Centers, with ninety percent of its funding coming from the German Federal Ministry of Education and Research and the remaining ten percent from the State of Baden-Württemberg.
 

Heidelberg University Hospital and Faculty of Medicine

Internationally Renowned Patient Care, Research and Teaching

Heidelberg University Hospital (Universitätsklinikum Heidelberg, UKHD) is one of the largest and most prestigious medical centers in Germany. The Medical Faculty of Heidelberg University (Medizinische Fakultät Heidelberg, MFHD) belongs to the internationally renowned biomedical research institutions in Europe. Both institutions have the common goal of developing new therapies and implementing them rapidly for patients. Heidelberg University Hospital and the Medical Faculty of Heidelberg University employs around 14.000 employees and is committed to providing trainings and qualifications. Every year, around 84,000 patients and more than 1.000.000 outpatient cases are treated in more than 50 clinical departments with almost 2000 beds.

Together with the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) and the German Cancer Aid, the UKHD established the first National Center for Tumor Diseases (NCT) in Heidelberg. The goal is to provide care at the highest level as an oncology center of excellence and to rapidly transfer promising approaches from cancer research to the hospital. In addition, the UKHD operates in partnership with the DKFZ and the University of Heidelberg the Hopp Children’s Cancer center Heidelberg (KiTZ), a unique and nationally known therapy and research center for oncological and hematological diseases in children and adolescents.

The Heidelberg Curriculum Medicinale (HeiCuMed) is one of the top medical training programs in Germany. Currently, there are about 4,000 future physicians studying in Heidelberg.

Original publication

Pfister, S.M. et al. A summary of the inaugural WHO Classification of Pediatric Tumors:Transitioning from the optical into the molecular era. In: Cancer Discovery (Online Publication 17^th of December 2021) DOI: 10.1158/2159-8290.CD-21-1094

Further information

Press release of KiTZ
Hopp Children's Cancer Center Heidelberg - KiTZ

Press contact

Dr. Alexandra Moosmann
Head of communications KiTZ
Hopp Children’s Cancer Center Heidelberg (KiTZ)
Im Neuenheimer Feld 130.3 / 7.320
D-69120 Heidelberg
T: +49 (0) 6221 56 36434
a.moosmann@kitz-heidelberg.de
presse@kitz-heidelberg.de

Dr. Sibylle Kohlstädt
Strategic Communication and Public Relations
Press speaker
German Cancer Research Center
Im Neuenheimer Feld 280
D-69120 Heidelberg
T: +49 6221 42 2843
F: +49 6221 42 2968
S.Kohlstaedt@dkfz.de
presse@dkfz.de

Doris Rübsam-Brodkorb
Corporate Communications Heidelberg University Hospital and Medical Faculty
Im Neuenheimer Feld 672
D-69120 Heidelberg
T: +49 6221 56-5052
F: +49 6221 56-4544
doris.ruebsam-brodkorb@med.uni-heidelberg.de