When a rarer form of cancer competes for funding against more common cancer types, the rarer form is often overshadowed. According to Professor Heikki Joensuu, the number of such rare but dangerous cancers is nevertheless high – one of them is aggressive soft-tissue sarcoma of the supportive tissue of the gastrointestinal tract, also known as gastrointestinal stromal tumours (GIST). Joensuu's research group has been studying GIST tumours for a long time. Without support from donations, efforts focused on this cancer type would have been of a more narrow scope.
Three years ago, Joensuu’s group received additional funds for GIST research from a donation made by the Luise and Henrik Kuningas Foundation to the field of medicine and pharmacy at the University of Helsinki. The University decided to allocate the donation of €500,000 to cancer research, one of the focus areas in medical research at the University.
With the help of the donation, Joensuu’s group has, for example, advanced a 15-year-long international study whose results were recently published: the researchers found that the mortality of GIST patients can be reduced by roughly half by extending the duration of imatinib therapy to three years in post-operative treatment.
Research has significantly changed the prognosis for GIST
Imatinib, a drug initially used to treat leukaemia, revolutionised the treatment of GIST tumours in the early 2000s. Earlier, metastasised GIST was usually rapidly fatal, and apart from surgical treatment not much could be done. The drug improved the prognosis for GIST patients, and now approximately one-fifth of patients with metastatic GIST are alive ten years after surgery. The prognosis for localised GIST is usually good.
“However, if the risk of recurrence for locally diagnosed GIST is assessed as high in spite of successful surgery, imatinib is given as adjuvant therapy for three years on the basis of the international study we conducted. This is now the recommendation globally,” Joensuu says.
Joensuu notes that the GIST study is a good example of how research can significantly change the prognosis for one cancer type.
“And the change will continue,” Joensuu adds.
Currently, the donated funds are being used to investigate the possibility of extending the drug therapy further. As many as nine European countries and almost 60 hospitals have already expressed their interest in participating in future studies. Joensuu says that this is a perfect illustration of the model of cooperation currently prevalent in cancer research. Joensuu’s group is part of an extensive global network.
“For a small country such as Finland, it’s very important to join international networks. Collaboration with other countries is nothing short of essential in cancer research,” says Joensuu.
Cells cultured with nanocellulose in the GIST laboratory
The donation by the Luise and Henrik Kuningas Foundation resulted in the establishment of a GIST laboratory on Meilahti Campus. The laboratory, operational since 2018, investigates mutations in GIST cells and cultures them in order to determine cell–cell interaction and the effects of pharmaceutical agents on the cells.
“Having a laboratory dedicated to such a rare tumour is really wonderful; there are not many of these in Europe. Setting it up would not have been possible without the donation,” Joensuu says.
According to Joensuu, culturing GIST cells in laboratory conditions has been difficult, and cytological research has in fact been a bottleneck in GIST research. However, new techniques are gradually starting to make culturing increasingly successful. In the GIST laboratory at Biomedicum, cells are cultured in nanocellulose together with a research group headed by Docent Outi Monni.
Joensuu points out that cell culture can, at some point down the line, potentially be reflected in treatment.
“Important observations or new findings in the laboratory can be extremely useful, even if you don’t see their effects immediately like in clinical work,” he says.
Long-term funding provides a safety net and enables clinical research
Joensuu says that large donations provide a safety net for researchers not enabled by core funding: in fact, most of the support from donated funds enjoyed by Joensuu’s group is spent on staff salary expenses. For instance, an annual allocation of €100,000 covers in practice the recruitment of two researchers for a research group.
“Launching long-term projects is difficult with short-term funding. In addition, researchers cannot commit to projects lasting years whose funding could potentially fall through in the middle of their efforts. Long-term funding is invaluable at the moment, as without it conducting clinical research is very difficult,” Joensuu states.
Dean Risto Renkonen of the Faculty of Medicine says that large donations are highly valued by the Faculty. They make it possible to provide targeted support to important research fields.
“Donations enable further contributions that are fundamentally aimed at learning more about the causes and diagnostics of diseases as well as developing new therapies. In other words, donations help us provide patients with better care,” Renkonen sums up.
The Luise and Henrik Kuningas Foundation continues to support the University of Helsinki: in autumn 2020 the foundation made a new donation to the field of medicine and pharmacy.
The donation of €500,000 by the Luise and Henrik Kuningas Foundation to the field of medicine and pharmacy at the University of Helsinki in 2017 was made under the governmental matched-funding scheme (2014–2017). The government made investments in the basic capital of Finnish universities in proportion to the privately donated funds raised by the universities. The University of Helsinki received more than €34 million in donations eligible under the matched-funding scheme, on the basis of which the government allocated almost €40 million to the University.