Precision medicine for metastatic prostate cancer requires specialist expertise and resources, which are typically found in larger cities and centres of excellence.1-3 In 2020, the urology specialists at Charité – Universitätsmedizin Berlin hospital launched the Deutsche Netzwerk für angewandte Präzisionsmedizin (German Network for Applied Precision Medicine, DNA-Med), which improves access to precision medicine and supports clinical decision-making based on real-world data.4 As of 2021, the regional network had supported more than 1,000 people with metastatic prostate cancer. In 2022, it will expand to include other cancer types and become available to oncology specialists across Germany.2 4
In Germany, almost 68,000 men are diagnosed with prostate cancer every year.5 The five-year survival rate for prostate cancer is approximately 89%, but this drops to 52% for metastatic prostate cancer, which is when the cancer has spread to other parts of the body.
Recent advances in treatment have the potential to improve outcomes for people with metastatic prostate cancer.4 For example, precision medicine (also known as personalised medicines) allows healthcare professionals to tailor cancer treatment to the genetic characteristics of a tumour instead of adopting a standardised approach.1 6 These treatments are typically prescribed by specialists, as protocols continuously change to incorporate findings from on the latest cancer research1 7
The resources and expertise needed for precision medicine are often concentrated in centres of excellence and big cities.4 Specialists working in large university hospitals based in cities are also more likely to be aware of precision medicine trials, to which they can refer eligible people.2 As a result, people living in other parts of Germany may not be able to access the same care or benefit from taking part in clinical trials, potentially leading to worse outcomes.
In February 2020, the urology specialists at Charité – Universitätsmedizin Berlin hospital launched DNA-Med (formerly known as Haupstadt Urologie),8 a pilot urology network for the Berlin-Brandenburg region that covers approximately 30,000 square kilometres, and is home to over 6 million people.4 9 The network aims to make the hospital’s specialist expertise and technology available beyond its immediate catchment area.
All urologists in Berlin-Brandenburg can register to become part of the network.4 This gives them access to a digital platform, through which their patients can anonymously input information about their diagnosis, treatment side effects and quality of life.4 These data are continuously fed into an algorithm, which is used by the specialists at Charité – Universitätsmedizin Berlin to identify what has worked for people with similar tumour characteristics.4 They then send information on recommended treatments and relevant clinical trials to local urologists. In addition, DNA-Med offers recommendations on personalised care beyond active treatment, including relapse management and palliative care.4
What has been achieved?
As of 2021, more than half of the 240 urologists working in Berlin-Brandenburg had registered with the network, supporting more than 3,000 people with metastatic prostate cancer.4
With the network, urology specialists at Charité – Universitätsmedizin Berlin have been able to efficiently review large amounts of patient data and suggest suitable trials.2 Information on trials that a person with prostate cancer may be eligible for is fed back to their urologist, so they can be supported in making an informed decision about their potential involvement.2 8
In 2021, the team at Charité – Universitätsmedizin Berlin started to scale up the network to cover other parts of Germany, with regional centres of excellence in oncology providing the expertise, research capacity and technology required to deliver precision medicine.2 3
In 2022, DNA-Med will expand further to include other cancers, which have a particularly strong genetic component and are therefore likely to respond to precision medicine. 2 4 These will include melanoma, bladder cancer, ovarian cancer, breast cancer, stomach cancer, colon cancer and endometrial cancer.2 4 The team at Charité – Universitätsmedizin Berlin hospital also plan to refine its treatment algorithm for metastatic prostate cancer, using data from a forthcoming national genome network.7
- The DNA-Med website
- An article about the Haupstadt Urologie network published in Cancerworld magazine
Professor Thorsten Schlomm, Professor of Urology and Founder of DNA-Med, Thorsten.firstname.lastname@example.org
- McCrea EM, Lee DK, Sissung TM, et al. 2018. Precision medicine applications in prostate cancer. Therapeutic Advances in Medical Oncology 10: 1758835918776920
- Schlomm T. 2022. Interview with Catherine Hodge at The Health Policy Partnership [video call]. [accessed: March 2022]
- DNA-MED. 2022. DNA-MED. Available here: https://dna-med.de/ [accessed: March 2022]
- Crompton S. 2021. Berlin pilot project brings precision care to the peripheries. [Updated 15/01/21]. Available here: https://cancerworld.net/berlin-pilot-project-brings-precision-care-to-the-peripheries/ [accessed: March 2022]
- Global Cancer Observatory. 2020. Germany. Geneva: World Health Organization
- Prostate Cancer UK. 2020. Dr Matthew Hobbs is "doubly excited" by new precision medicines for advanced prostate cancer. [Updated 22/09/20]. Available here: https://prostatecanceruk.org/about-us/news-and-views/2020/9/dr-matthew-hobbs-precision-medicine-breakthroughs [accessed: March 2022]
- Olk J. 2020. Projekt 'Haupstadt Urologie' startet und soll Krebs präzise besiegen. [Updated 28/02/20]. Available here: https://amp2.handelsblatt.com/technik/forschung-medizin/virtuelles-praxisnetzwerk-projekt-hauptstadt-urologie-startet-und-soll-krebs-praezise-besiegen/25586930.html [accessed: March 2022]
- Haupstadt Urologie. 2021. Highly specialized cancer medicine for everyone - everywhere. Available here: https://hauptstadturologie.de/ [accessed: September 2021]
- Statistisches bundesamt. 2021. Population by nationality and federal states. [Updated 21/06/21]. Available here: https://www.destatis.de/EN/Themes/Society-Environment/Population/Current-Population/Tables/population-by-laender.html [accessed: April 2022]