So how did Rozeman manage to get her research study done? 'It's a team effort,' says Lisette Rozeman modestly. 'There's a lot more involved in a clinical research study than you'd think. Besides a comprehensive study protocol there are all kinds of things that have to be done before you can begin. For instance, you have to build a database and you have to decide how tissue samples are going to be processed and assessed. And you have to agree on the logistics with all kinds of specialists: when will patients be coming to the hospital? How many scans will be needed? When will the patient be operated?'
That means getting everyone onto the same page, something Rozeman is very good at. 'Almost everyone here is very busy. I think I get things done quickly because I value the work that everyone else does, and I let that show. And I'm very aware that I'm just one more researcher calling with questions and wanting everything to be arranged as quickly as possible for their own study. But if you stay positive, if you're not deterred by setbacks, and you don't get irritated - or don't show it, anyway - then you can get a lot done.'
Rozeman not only got her clinical research done from the organisational and scientific perspectives, but she also treated the patients. 'I'm grateful that I was able to combine science and patient care in my PhD - not just doing data analysis. After all, research like this is done for actual patients.'
Those patients appear to have gained real benefit from her work. Rozeman's research focused on immunotherapy, an approach that aims to direct the patient's immune system against cancer cells (see e.g. this film). Three clinical studies on which she worked showed that it could be feasible and beneficial to employ immunotherapy even before a surgeon removes the tumour.
But why would you want to do so in the first place? There are at least two good reasons. Firstly, the immune reaction can be invoked more strongly when the whole tumour, with all its variations, is still present in the body. Secondly, it is possible to clearly detect, in the removed tumour, whether cancer cells have been killed, and therefore whether the patient has reacted well to immunotherapy. It might even be the case that patients who react well to immunotherapy can keep their lymph glands: at present these are always removed. A third, nearly completed study (PRADO) will soon shed more light on this topic.
Lisette Rozeman is currently training as an internist at UMC Utrecht and hopes to graduate at the end of 2020. She wants to specialise in oncology or haematology: 'I've been thinking about coming back to the Netherlands Cancer Institute, where I've worked with so much pleasure in recent years.' For the time being she is devoting one day a week there to research.
The Netherlands Cancer Institute awards the annual Antoni van Leeuwenhoek Award to its most talented young researcher. The award includes €6000, to be spent on new research. The Netherlands Cancer Institute wants to express its gratitude to NKI alumnus Professor Roel Nusse from Stanford University, for generously having offered to co-fund the award from 2019 onwards.