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S c i e n t i f i c A n n u a l R e p o r t 2 0 1 4 Scientific Annual Report 2014 Netherlands Cancer Institute Plesmanlaan 121 1066 CX Amsterdam The Netherlands www.nki.nl Contents 2 Introduction 10 Board members Director of Research 14 Group leaders 14 Neil Aaronson 50 Kees Jalink 88 Hein te Riele 16 Reuven Agami 52 Jos Jonkers 90 Uulke van der Heide 18 Roderick Beijersbergen 54 Sabine Linn 92 Michiel van der Heijden 20 André Bergman 56 Rene Medema 94 Wim van Harten 22 René Bernards 58 Wouter Moolenaar 96 Marcel van Herk 24 Anton Berns 60 Jacques Neefjes 98 Flora van Leeuwen 26 Christian Blank 62 Huib Ovaa en Matti Rookus 28 Eveline Bleiker 64 Daniel Peeper 102 Fred van Leeuwen 30 Jannie Borst 66 Anastassis Perrakis 104 Maarten van Lohuizen 32 Piet Borst 68 Sven Rottenberg 106 Bas van Steensel 34 Thijn Brummelkamp 70 Sanne Schagen 108 Marcel Verheij 36 Karin de Visser 72 Jan Schellens 110 Emile Voest 38 John Haanen 76 Alfred Schinkel 112 Jelle Wesseling 40 Michael Hauptmann 78 Marjanka Schmidt 114 Lodewyk Wessels 42 John Hilkens 80 Ton Schumacher 116 Rob Wolthuis 44 Metello Innocenti 82 Titia Sixma 118 Lotje Zuur 46 Heinz Jacobs 84 Jan-Jakob Sonke 120 Wilbert Zwart 48 Jacqueline Jacobs 86 Arnoud Sonnenberg 124 Division of 140 Division of 154 Division of Diagnostic Oncology Medical Oncology Surgical Oncology 170 Division of 190 Biometrics 198 Research Radiotherapy Department facilities 200 Education in 204 Clinical 224 Invited oncology trials speakers 226 Research 250 Personnel projects index Scientific Annual Report 2014 Introduction I am pleased to present our Scientific Annual Report that contains an overview of the Director of Research scientific achievements of the Netherlands Cancer Institute in 2014. More background René Medema information on our research programs and principle investigators can be found on our website (www.nki.nl) or in our Scientific Brochure that is available for download on our website. The Netherlands Cancer Institute is a Comprehensive Cancer Center, combining a dedicated cancer hospital and cancer research institute in a single organization. Our hospital currently has 180 beds, an outpatient clinic and a large radiotherapy department and an extensive infrastructure for clinical research that includes clinical data management and a large array of diagnostic facilities. Over the years the hospital has built a large repository of patient data and a large collection of tumor and normal tissues. Clinical research spans across medical, surgical and diagnostic oncology, radiotherapy, pharmacology, epidemiology and psychosocial oncology and research into cost effectiveness of health care and efficiency of planning and organization. Our hospital has seen steady growth in patient numbers over the last years, with an average annual growth of 5%. To accommodate this growth, we are currently expanding the capacity of our outpatient clinic and intensive care, as well as the number of operation rooms. Construction is nearing its completion and the new facilities are expected to become operational in 2015, which will provide us with 4 additional operating rooms and the necessary expansion of our intensive care unit. The first change that took place in 2014 was that Sjoerd Rodenhuis retired from the Board of Directors after 15 years of service. During his time in the board, the Institute has undergone rapid expansion. Also, integration of research and clinic was optimized, allowing us to take a leading position in the translational research in oncology. On behalf of all of the present and former employees of the Netherlands Cancer Institute that had the pleasure to work with Sjoerd in his capacity of Medical Director, I would like to thank Sjoerd for his devotion and support to the mission of our Institute. Sjoerd will continue his clinical work at our Institute and we are very pleased that as of January 1st, 2014, Emile Voest joined our board as the new Medical Director. Following the acquisition of the hospital pharmacy of the neighboring Slotervaart hospital at the end of 2013, all of the pharmacy personnel transferred to the Netherlands Cancer Institute in 2014. As a consequence, the Netherlands Cancer Institute now has its own production unit for experimental drugs and clinical grade biologicals preparations. For the time being, the pharmacy will perform its activity in the currently allocated space, but plans are underway for the construction of a fully integrated new Pharmacological Unit, linked with hospital and research units. With the Slotervaart hospital we will also join efforts in neuro-oncology and colon cancer screening. Together with the Amsterdam Medical Center and the Free University Medical Center we plan to construct a facility for proton therapy adjacent to our current radiotherapy units. In the first half of 2015 we will finalize the plans for construction and initiate contract negotiations with the health care insurance companies. The technical challenges we have encountered in our plans to establish a cancer hospital in Utrecht in a joint venture with the University Medical Center (UMC) Utrecht have forced us to adapt the pace and approach in which we shape our alliance. Nonetheless, we both remain fully committed to our joint efforts to improve the quality of cancer care, and to bring together a large critical mass in areas such as radiology, radiotherapy and personalized cancer treatment. In 2014 we have initiated joint programs in lung, prostate and bladder cancer and we aim to expand the alliance to encompass pathology, neuro-oncology and neuro-endocrine tumors by the end of 2015. Despite the fact that we managed to end 2014 with a profit for the hospital, the 2 growth in numbers of patients, combined with tighter budgets from health insurance companies, are putting an increasing strain on all of our activities. Workload per employee and per square meter continue to be a concern and the amount of time our clinicians can dedicate to research has come under severe pressure. Also, the financial challenges that we face to be able to achieve the desired innovations that will improve the outlook for our patients are daunting. An important challenge for our institute is to accommodate sufficient growth to be able to provide the required clinical care for the growing numbers of cancer patients and at the same time be able to continue to develop better treatments. We strive to improve treatment options for all types of cancer, and in order to do so we need to be able to treat sufficient numbers of patients to provide the evidence that is necessary to make these new treatment options available to patients throughout the Netherlands. Our research budget has seen consistent growth over the last years, including 2014 (table 1). Unfortunately, this growth does not parallel the rate of growth of the financial demands that our research program brings forward. The complexity of the disease requires large investments in new high-end research platforms, such as next generation sequencing, proteomics and mouse intervention units. Also, we run many projects that produce very large datasets, but the long-term maintenance of these valuable resources requires extensive management and storage costs. These challenges are not unique to the Netherlands Cancer Institute, but they are more difficult for us to overcome due to the fact that our research program is in the largest part financed from project (short-term) funding. That ratio has steadily shifted towards external grants, donations ~ and short-term research agreements with third parties. Currently 65% of our total research budget comes from such sources, making it challenging to maintain sufficient manpower in the underlying infrastructure. On top of that, the complexity of current day cancer research also requires that we adopt a team-science approach. This requires continuation of a high-level expertise that is very difficult to maintain on external grants. TABLE 1 CORE RESEARCH FUNDING THE NETHERLANDS CANCER INSTITUTE - ANTONI VAN LEEUWENHOEK HOSPITAL BY THE DUTCH CANCER SOCIETY AND THE MINISTRY OF HEALTH, WELFARE AND SPORT IN THE PERIOD 2003 – 2014 IN MILLION EUROS. 30 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 25 20 15 10 5 0 DUTCH CANCER SOCIETY MINISTRY OF HEALTH, WELFARE & SPORT* TOTAL * EXCLUDED ARE THE REIMBURSEMENT FOR INTEREST AND DEPRECIATION OF BUILDINGS Fortunately, the Dutch Cancer Society (KWF) has again increased their financial support for our research by allowing a gradual increase of the core grant given by the Dutch Cancer Society to the Netherlands Cancer Institute. In an attempt to further increase our core funding, we have established the Antoni van Leeuwenhoek Foundation together with the Dutch Cancer Society that managed to raise over 1 million euro in private donations in 2014. 3 HIGHLIGHTS It is impossible to provide a complete overview of the total impact generated by our Institute in 2014 in this introduction. Many of the highlights can be found in the reports of the individual group leaders further on in this annual report or on our website. I have chosen to mention just a few highlights here. A particular strength of our comprehensive cancer center is the number of our own pre-clinical research studies that result into truly innovative clinical trials, based on new concepts discovered in our center. We currently have several clinical trials open based on synthetic lethality combination therapies that were inspired by basic research executed in our own center. In a joint research project, the labs of Rene Bernards, Lodewyk Wessels and Wilbert Zwart developed a gene expression classifier that selectively predicts outcome after tamoxifen therapy of breast cancer patients. With this classifier, individual breast cancer patients may be identified who would derive limited benefit from tamoxifen, and could be offered a more suitable and potentially more successful treatment instead. Ton Schumacher and colleagues demonstrated that memory T cells in the skin provide protection against renewed infection by inducing a state of ‘pathogen alert’ in the surrounding cells. In addition, together with John Haanen and colleagues they showed that CD4 T cells in melanoma patients frequently recognize mutated epitopes that are formed because of tumor-specific mutations. These data add to the notion that recognition of mutated antigens is an important ingredient of cancer immunotherapy. To identify factors necessary for driving melanoma expansion, Daniel Peeper’s group performed parallel in vitro and in vivo negative-selection short hairpin RNA (shRNA) screens. They uncovered a synthetic lethal interaction between DNA damage response kinases and hypoxia, which can be exploited pharmacologically. In addition, they found that loss of the melanocytic lineage transcription factor MITF causes severe resistance to a range of personalized medicines. This is associated with increased expression of the receptor tyrosine kinase AXL. Currently, the group is trying to translate both findings to a clinical setting. Lenno Krenning and Femke Feringa showed that a short pulse of p53 induction is sufficient to induce a permanent cell cycle exit in actively proliferating cells. Their work nicely shows how fractionation of irradiation can be used to selectively target proliferating cells. Lucas Jae clarified the entry route for Lassa virus and showed that this involved binding to LAMP1, a new receptor only engaged upon an intracellular signal. Earlier work in the Thijn Brummelkamp laboratory had revealed a similar tactic used by Ebola virus. Although both viruses enter cells using different host components, the conceptual similarity highlights a new paradigm in virus entry that was previously overlooked. Floris Groenendijk, working with Michiel van der Heijden, used Next Generation Sequencing to discover that mutations in ERBB2 characterize a subgroup of muscle-invasive bladder cancers with complete response to neoadjuvant chemotherapy. Katrien Berns used functional genomic approaches to find a vulnerability of clear cell ovarian cancer cells that have a mutation in the ARID1A chromatin remodeler gene, which can be exploited therapeutically. The Epidemiology group (Flora van Leeuwen) and the Department of Radiation Oncology (Berthe Aleman) showed that breast radiotherapy with tangential fields used after 1989 does not appear to increase risk of cardiovascular disease. This study represents the largest cohort study of breast cancer patients with ductal carcinoma in situ (DCIS) (n=10,000) in history. They also reported that survivors of Hodgkin lymphoma, who are known to have increased risks of second malignancy and cardiovascular disease, also have elevated risk of diabetes mellitus. This risk is significantly increased with higher mean radiation doses to the pancreatic tail. They concluded that screening for diabetes is indicated for Hodgkin survivors treated with para-aortic and splenic radiation fields. In addition, Michael Hauptmann led an international study that showed that radiotherapy involving parts of the stomach increases gastric cancer risk, with the highest risks after stomach doses of >30 Gy. These above results provide a solid basis for future research that can help us to develop novel anti-cancer therapies. In recent years, our research program has become very successful in clinical translation of the therapeutic concepts that stem from our basic and translational research program. Several clinical trials are currently ongoing at the Netherlands Cancer Institute that are the direct result of basic and translational research 4 that was performed in our Institute (table 2). We are very pleased with the fact that we have managed to significantly shorten the time between discovery and clinical application in the last few years, with examples of clinical studies that were opened before the original discovery was published. TABLE 2 THERAPEUTIC CONCEPTS THAT ARE THE PRODUCT OF FUNDAMENTAL AND TRANSLATIONAL RESEARCH PERFORMED AT THE NETHERLANDS CANCER INSTITUTE, AND CURRENTLY IN CLINICAL DEVELOPMENT IN OUR INSTITUTE. REFERENCE CLINICALTRIALS. AVL CODE NOVEL TREATMENT TUMOR TYPE NUMBER*** GOV 1 NCT01719380 M12LGX EGFRi + BRAFi ± PI3Ki Mutant BRaf Colorectal Cancer 1 NCT01750918 M13DPT EGFRi + BRAFi ± MEKi Mutant BRaf Colorectal Cancer 2 NCT02039336 M13DAP Pan-HERi + MEKi Mutant KRas Colorectal Cancer 2 NCT02230553 M14LTK Pan-HERi + MEKi Mutant KRas Colorectal Cancer 3-5 Registration M14REV Carboplatin + PARPi Advanced Breast Cancer with pending BRCA mutation 6,7 NCT02285179 M14POS Tamoxifen + PI3Ki ER/PR+ and HER2- Breast Cancer 8-10 NCT01057069 M09TNM Neo-adjuvant Chemo Triple-Negative Breast Cancer 8-15 NCT01898117 M13TNB Paclitaxel ± VEGFi BRCA1-like Breast Cancer 16 NTC02278887 M14TIL TIL vs. Ipilimumab Metastatic Melanoma 17-19 NCT00407186 M06CRI Chemoradiotherapy + surgery Resectable Gastric Cancer 20 NCT02229656 N13ORH Radiotherapy + PARPi Laryngeal and HPV-Negative Oropharyngeal SCC 20 NCT01562210 N11ORL Radiotherapy ± Cisplatin + Locally Advanced NSCLC PARPi 20 NCT02227082 N13ORB Radiotherapy + PARPi Locally Advanced Triple-Negative Breast Cancer 21 NCT01504815 M11ART Cisplatin + Adaptive High Dose Locally Advanced Oropharynx, Oral Radiotherapy Cavity or Hypopharynx SCC 22 *NCT01024829 M09PBO FDG-PET-based Boosting RT Inoperable NSCLC 23 NCT01780675 M12PHA Hippocampus Avoidance PCI SCLC 24 NCT01933568 N12HYB Combined Stereotactic and Stage II-III NSCLC Conventional Fractionated RT 25 *NCT01543672 M11VOL MLD-based SBRT Inoperable + Peripheral NSCLC 26 NCT01024582 M08PBI Partial Accelerated Early Stage Operable Breast Preoperative Irradiation Cancer 27,28 NCT00582244 P07CB Cognitive Behavioral Therapy Breast Cancer & Physical Exercise 29 NCT00783822 P08TIM Rapid Genetics BRCA mutant Breast Cancer 30,31 NCT015622431 P11SIG Problem checklist Breast & Colon Cancer 32 NCT01606566 M12PCA Efficacy of PC-A11 with Head and Neck superficial PDT REFERENCE NTR CODE AVL CODE NOVEL TREATMENT TUMOR TYPE NUMBER*** 33,34 *NTR4607 N14HPV DNA vaccination HPV16+ Vulvar Neoplasia 35 NTR3539 M11TCR MART-1 TCR gene therapy Metastatic Melanoma 36 NTR2159 P09PHY Physical Exercise Breast & Colon Cancer 37 NTR4026 N12RES In vivo respons assessment Liver/colorectal 38 NTR2557 N14RCS Smart tools during surgery Colorectal ** NTR4451 N12IGP Intra-operative fluorescence Prostate during prostate surgery 39 NTR4733 M13PSN ICG-99mTc-nanocolloid for Prostate sentinel node surgery ** NTR2614 N09PRF Pulsed RFA for post Breast mastectomy pain 40 pilot N13NAV Surgical navigation Colorectal 41 NTR 2588 N10DMY Dose reduction of preop RT liposarcoma * THERAPEUTIC CONCEPT NOT SOLELY, BUT PRIMARILY DEVELOPED AT THE NETHERLANDS CANCER INSTITUTE. ** PUBLICATION PENDING. *** SEE REFERENCE LIST ON NEXT PAGE 5 1. Prahallad A et al. Unresponsiveness 12. Wessels LF et al. Molecular 23. Van Kesteren Z et al. A practical 33. Kenter GG et al. Vaccination of colon cancer to BRAF(V600E) classification of breast carcinomas by technique to avoid the hippocampus in against HPV-16 oncoproteinsfor vulvar inhibition through feedback activation comparative genomic hybridization: prophylactic cranial irradiation for lung intraepithelial neoplasia. N Engl J Med. of EGFR. Nature 2012;483:100-3 a specific somatic genetic profile cancer. Radiother Oncol. 2012;102:225- 2009;361:1838-47 for BRCA1 tumors. Cancer Res 7 2. Sun C et al. Intrinsic resistance to 2002;62:7110-7117 34. Bins AD et al. A rapid and potent MEK inhibition in KRAS mutant lung and 24. Grills IS et al. A collaborative DNA vaccination strategy defined by in colon cancer through transcriptional 13. Van Beers EH et al. Comparative analysis of stereotactic lung vivo monitoring of antigen expression. induction of ERBB3. Cell Rep. genomic hybridization profiles in human radiotherapy outcomes for early-stage Nat Med. 2005;11:899-904 2014;7:86-93. BRCA1 and BRCA2 breast tumors non-small-cell lung cancer using highlight differential sets of genomic daily online cone-beam computed 35. Gomez-Eerland R et al. 3. Rottenberg S et al. High sensitivity aberrations. Cancer Res 2005;65:822- tomography image-guided radiotherapy. Manufacture of gene-modified human of BRCA1-deficient mammary tumors to 827 J Thorac Oncol. 2012;7:1382-93 T-cells with a memory stem/central the PARP inhibitor AZD2281 alone and in memory phenotype. Hum GeneTher combination with platinum drugs. Proc. 14. Joosse SA et al. Prediction of 25. Peulen H et al. Mid-ventilation Methods. 2014;25:277-87 Natl. Acad. Sci. USA 2008;105:17079-84 BRCA1-association in hereditary based PTV margins in Stereotactic non-BRCA1/2 breast carcinomas with Body radiotherapy (SBRT): a 36. Van Waart H et al. Effect of low 4. Fong PC et al. Inhibition of poly(ADP- array-CGH. Breast Cancer Res Treat clinical evaluation. Radiother Oncol. intensity physical activity and high ribose) polymerase in tumors from 2009;116:479-489 2014;110:511-6 intensity physical exercise during BRCA mutation carriers. N Engl J Med. adjuvant chemotherapy on physical 2009;361:123-34 15. Lips EH et al. Quantitative copy 26. Van der Leij F et al. Target volume fitness, fatigue and chemotherapy number analysis by Multiplex Ligation- delineation in external beam partial on physical fitness, fatigue and 5. Oonk AM et al. Clinical correlates dependent Probe Amplification (MLPA) breast irradiation: less inter-observer chemotherapy ompletion rates: Results of ‘BRCAness’ in triple-negative of BRCA1-associated breast cancer variation with preoperative- compared of the PACES randomized clinical trial. J breast cancer of patients receiving regions identifies BRCAness. Breast to postoperative delineation. Radiother Clin Oncol 2014 (in press) adjuvant chemotherapy. Ann Oncol. Cancer Res 2011;13:R107 Oncol. 2014;110:467-70 2012;23:2301-5 37. Spliethoff JW et al. Monitoring 16. Kvistborg P et al. TIL therapy 27. Duijts SFA et al. Efficacy of of tumor response to Cisplatin using 6. Beelen K et al. PIK3CA mutations, broadens the tumor-reactive CD8(+) T cognitive behavioral therapy and optical spectroscopy. Transl Oncol. phosphatase and tensin homolog, cell compartment in melanoma patients. physical exercise in alleviating 2014;7:230-9 human epidermal growth factor Oncoimmunology 2012;1:409-418 treatment-induced menopausal receptor 2, and insulin-like symptoms in patients with breast 38. Nachabé R et al. Diagnosis of growth factor 1 receptor and 17. Dikken JL et al. Neo-adjuvant cancer: Results of a randomized breast cancer using diffuse optical adjuvant tamoxifen resistance in chemotherapy followed by surgery controlled multicenter trial. J Clin Oncol spectroscopy from 500 to 1600 nm: postmenopausal breast cancer and chemotherapy or by surgery and 2012;30:4124-33 comparison of classification methods. J patients. Breast Cancer Res. chemoradiotherapy for patients with Biomed Opt. 2011;16:087010 2014;16:R13 resectable gastric cancer (CRITICS). 28. Mewes JC et al. Cost-effectiveness BMC Cancer 2011;11:329 of cognitive behavioral therapy and 39. Van der Poel HG et al. 7. Beelen K et al. Phosphorylated physical exercise for alleviating Intraoperative laparoscopic p-70S6K predicts tamoxifen resistance 18. Trip AK et al. Preoperative treatment-induced menopausal fluorescence guidance to the sentinel in postmenopausal breast cancer chemoradiotherapy in locally advanced symptoms in breast cancer patients. J lymph node in prostate cancer patients randomized between adjuvant gastric cancer, a phase I/II feasibility Cancer Surviv. 2014 (in press) patients: clinical proof of concept of an tamoxifen versus no systemic and efficacy study. Radiother Oncol. integrated functional imaging approach treatment. Breast Cancer Res. 2014;112:284-8 29. Wevers MR et al. Impact of rapid using a multimodal tracer. Eur Urol. 2014;16:R6 genetic counselling and testing on 2011;60:826-33 19. Trip AK et al. IMRT limits the decision to undergo immediate 8. Rodenhuis S et al. Efficacy of high- nephrotoxicity after chemoradiotherapy or delayed prophylactic mastectomy 40. KleinJan GH et al. Optimisation of dose alkylating chemotherapy in HER2/ for gastric cancer. Radiother Oncol. in newly diagnosed breast cancer fluorescence guidance during robot- neu-negative breast cancer. Ann Oncol. 2014;112:289-94 patients: Findings from a randomized assisted laparoscopic sentinel node 2006;17:588-96 controlled trial. Br J Cancer biopsy for prostate cancer. Eur Urol. 20. Verheij M et al. Novel therapeutics 2014;110:1081-7 2014;66:991-8 9. Vollebergh MA et al. An aCGH in combination with radiotherapy to classifier derived from BRCA1-mutated improve cancer treatment: Rationale, 30. Eijzenga W et al. Effect of 41. De Vreeze RS et al. Effectiveness breast cancer and benefit of high-dose mechanisms of action and clinical routine assessment of specific of radiotherapy in myxoid sarcomas platinum-based chemotherapy in HER2- perspective. Drug Resist Updat psychosocial problems on personalized is associated with a dense vascular negative breast cancer patients. Ann 2010;13:29-43 communication, referrals and distress pattern Int J.Radiation Oncology Biology Oncol. 2011;22:1561-70 levels in cancer genetic counseling and Physics 2008;72:1480-7 21. Heukelom J et al. Adaptive and practice: A randomized controlled trial. 10. Vollebergh MA et al. Genomic innovative Radiation Treatment FOR J Clin Oncol. 2014;32:2998-3004 patterns resembling BRCA1- and improving Cancer treatment outcomE BRCA2-mutated breast cancers predict (ARTFORCE); a randomized controlled 31. Eijzenga W et al. Routine benefit of intensified carboplatin-based phase II trial for individualized assessment of psychosocial problems chemotherapy. Breast Cancer Res. treatment of head and neck cancer. after cancer genetic counseling: 2014;16:R47 BMC Cancer 2013;13:84 Results from a randomized controlled trial. Clin Genetics 2014 (in press). 11. Rottenberg S et al. Impact 22. Van Elmpt W et al. The PET-boost of intertumoral heterogeneity on randomised phase II dose-escalation 32. Karakullukcu B et al. MR and CT predicting chemotherapy response of trial in non-small cell lung cancer. based treatment planning for mTHPC BRCA1-deficient mammary tumors. Radiother Oncol. 2012;104:67-71 mediated interstitial photodynamic Cancer Res 2012;72:2350-2361 therapy of head and neck cancer: Description of the method. Lasers Surg Med. 2013;45:517-23 6 QUALITY OF RESEARCH The quality of our research can be monitored in several ways. First of all, objective bibliometric parameters (citations and impact of scientific articles published by NKI staff) demonstrate that our scientific productivity, as measured in numbers of citations, is steadily increasing over time (table 3). It is therefore gratifying to note that we manage to maintain our position at the international forefront of cancer research. Through the participation in a pilot to designate excellent translational cancer research (with Cambridge and Helsinki) that was organized by the European Academy of Cancer Sciences, we scored very well and received valuable feedback on our performance. Secondly, our prominent international standing in cancer research is reflected by the frequency with which our staff members are invited to present at international meetings and in the awards and grants that they obtain. We score high on all of these accounts. Huib Ovaa and Jos Jonkers received a VICI award, Wilbert Zwart received a Bas Mulder Award and Ton Schumacher received the Queen Wilhelmina Research Prize from the Dutch Cancer Society. In addition to these awards, several NKI-postdocs have received competitive grants from national and international organizations. We decided to join five of the best Comprehensive Cancer Centers in Europe in the establishment of CanCerCore Europe in order to further develop and initiate high quality research for which consortio are increasingly important. TABLE 3 SHORT TERM CITATIONS AND IMPACT OF SCIENTIFIC ARTICLES PUBLISHED BY THE NETHERLANDS CANCER INSTITUTE RESEARCH STAFF 2002 - 2014 PUBLICATION PUBLICATIONS CITATIONS CITATIONS/ IMPACT YEAR PUBLICATIONS 2002 397 7436 18,7 2455 2003 366 5094 13,9 2122 2004 348 5267 15,1 1882 2005 405 6350 15,7 2461 2006 435 6336 14,6 2608 2007 430 5605 13,0 2969 2008 442 5657 12,8 2590 2009 511 7904 15,5 3074 2010 481 8788 18,3 2841 2011 459 8651 18,8 3110 2012 548 9460 17,3 3340 2013 482 3219 2014 542** 3712** * IN 2015 A NEW STANDARD WAS USED TO PERFORM THE CITATION AND IMPACT FACTOR ANALYSES. CONSEQUENTLY THE NUMBERS CAN DIFFER FROM THE PREVIOUS YEARS. ** ANALYSIS WAS PERFORMED IN FEBRUARY 2015. DATA CAN BE SUBJECT TO CHANGE. HONORS AND APPOINTMENTS The NKI-AVL cannot award university degrees, but many of our staff members hold special part-time chairs at Dutch Universities. This allows them to award PhD degrees to graduate students who receive their training at the Netherlands Cancer Institute. Currently, 35 staff members have professorships at one of the Dutch Universities. In 2014, Kees Jalink was appointed Professor of High Resolution Microscopy at the University of Amsterdam. Thijn Brummelkamp was elected as member of the European Molecular Biology Organization (EMBO). The department of Radiation Oncology has been honored with the Emmanuel van der Schueren Award 2014. The award, which is issued by the European School of Oncology, honors research institutions or departments that excel in translational research within the field of radiotherapy. Marcel Verheij, head of the Radiotherapy division, accepted the award on February 13 during the de 7

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Wevers BA, Orthwein A, Durocher D and Jacobs JJL. MAD2L2 controls DNA repair at telomeres and DNA breaks by inhibiting 5' end-resection. Nature 2014 Emilia Sawicki PhD student. Philip Schouten PhD student. Tesa Severon PhD student. Michel Hillebrand Technical staff. Joke Schol Technical
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