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A clinical perspective: how will CHARM’s work impact pathologists and physicians?

We speak with Dr Franziska Hoffmann, a biologist working as a scientist at the University Hospital in Jena, whose team occupies the role of clinical partner within CHARM.

The CHARM project revolves around developing a microscope that will improve tumour analysis. Given this aim, it makes sense that the CHARM consortium includes clinical expertise and involvement – such as that of one particular scientific research team at the Jena University Hospital in Germany.

This team has an important role within CHARM: it both provides actual samples from patients with head and neck cancer undergoing surgery in the hospital and tests and evaluates the performance and usability of the microscope.

Dr Franziska Hoffmann, who works within this team at the hospital, explained to us her team’s role and involvement in CHARM in greater detail. Our interview with Franziska is as follows.

Dr Franziska Hoffmann, leader of the Innovative Biophotonics group at Jena’s University Hospital.

Hi Franziska, thank you for speaking with us today!

Yes, happy to do so. My name is Franziska Hoffmann, and I am a biologist leading the Innovative Biophotonics research group at the ENT department of the University Hospital in Jena.

Can you tell us more about the core research areas within biophotonics that are being explored at the University Hospital? 

Biophotonics research, in this instance, refers to the development and implementation of innovative optical/photonic methods and tools for multiscale spectroscopy and multimodal imaging in the context of biomedical diagnostics.

The good thing about researching such topics within a hospital context is that it places biophotonics and medical applications in an ongoing conversation with one another. At the hospital, our work helps develop biophotonic approaches to addressing needs within pathology and oncology.

Your team provides tumour samples from actual patients at the hospital. What is the process behind this? How does one go about collecting these samples?

I’m happy you asked about this because it is an area of work into which we naturally put a lot of thought and consideration. It is very important to researchers, pathologists, physicians, and of course, patients that we get this aspect of our work right.

The reason it is important to use samples from real patients is that cancer tissue is very complex, and no appropriate model system exists. It is, therefore, necessary to use real tumour tissue when developing a diagnostic device.

We use samples from patients with head and neck cancer who are undergoing surgery within our hospital. This gives us the opportunity to test and establish the process and workflow involved with tumour testing directly in the clinical environment with the involved persons, including pathologists, technicians, and physicians. This enables us to improve our practices in order to become more efficient as well as better skilled in communicating with patients about diagnostics and treatment.

Moreover – in this way – “real-world” data is used for improving the real clinical world.

What are the ethical considerations that go into using samples from real patients?

To be allowed to use samples from patients, we have to undergo a strictly regulated process which is based on the World Medical Association Declaration of Helsinki. Based on this, we then apply for ethics approval from the ethics committee of our University Hospital. 

In this approval are all the details of the study, including details about which kinds of samples are used; which kinds of patients; how the samples will be processed; how many patients are to be involved; and who is allowed to use the samples and the data, and how. 

A particularly important consideration is that the sourcing and the usage of the samples do not harm the patients, either during the process of taking the tissue samples or for the routine pathological diagnosis.

In the CHARM project, we use residual material that is taken out during the operation and which would otherwise be thrown away afterwards anyway. We use only samples from patients who give us their written permission to use the samples. We also make sure that all samples and data are anonymised during the analysis process. 

A good piece of feedback is that most patients are happy to take part in this study, as they are willing to participate in an initiative that has the potential to improve cancer treatment and therapy. This willingness suggests that the value of the CHARM project is evident, including to the general public, as well as that we are communicating effectively and connecting well with patients within clinical settings.

It’s great to hear that patients are willing to be involved – agreed, this definitely indicates effective communication as well as the project’s value. Out of curiosity, what are some of the other tasks you are undertaking in relation to CHARM beyond sourcing samples?

One essential task is that of continuously consulting with other partners; it is important always to bring the physicians’ point of view to the table in developing the microscope, and our team facilitates this. In a sense, our tasks include coordinating information across a variety of stakeholders. We, too, are very invested in the CHARM project, not least because it will have a very high impact on our work, even beyond the project duration.

What do you see as being the key impacts of CHARM within the clinical field?

Developing an automated tumour detection system and in-depth molecular analysis of patient samples will significantly improve the way pathologists work. And because pathologists are key players in cancer diagnosis, this will strongly impact many other people involved in the clinical cancer routine, making diagnosis much faster and more reliable.

In addition to the clinical impact, the research field will also benefit a lot. We are highly excited to use the new Coherent Raman Scattering (CRS) microscope to study cancer biology because this microscope will allow us to investigate tumour tissue at a deep molecular level very quickly and with a high degree of detail and accuracy.

What exactly is so different – and so valuable – about the CHARM approach, in a technical sense?

The important thing to understand is that so far, we have been limited to marker-based imaging techniques, which require time-consuming preparations that need to be scheduled in advance. Some of these techniques require days to obtain one image with the distribution of just one molecule.

With the CHARM approach, however, we can detect a huge number of molecules in a matter of minutes.
This information will give us new insights into the biology of cancer development and unravel new mechanisms of action – for example, providing insights into how healthy cells become cancer cells or why the immune system doesn’t fight against cancer.

What has been your experience of being a part of CHARM so far?

As a scientist in the field of translational research, it is a great experience to be a part of such an interdisciplinary team. The CHARM project allows me to be directly involved in creating a new product that other scientists and clinicians will use.

To see that things of such magnitude and impact can be developed from a purely experimental environment – such as that which forms a part of our daily laboratory routine – is something very special and exciting for scientists such as myself.

Franziska, thank you for your time. And we are excited to hear about what happens next – please do keep us in the loop about developments as they happen!

We will! We are excited as well, for the CHARM project holds a lot of promise. It’s a wonderful initiative of which to be a part.