To provide top clinical care for patients with adrenal and neuroendocrine disorders from the whole country and from abroad with a multidisciplinary approach using state of the art diagnostic techniques and treatment modalities.
In addition, translational/clinical research and educational activities are performed in the field of adrenal and neuroendocrine disorders.
Research Activities
Participating physicians and scientists of the Center for Adrenal and Neuroendocrine Disorders are internationally acknowledged experts in this field and have a high scientific output with high impact publications. Both clinical and basal research is performed. The ACE participates in international clinical trials but also initiates investigator-initiated trials with medical therapy for adrenal and neuroendocrine tumors. Translational research is performed at the Laboratory of Neuroendocrinology where in vitro studies are performed on adrenal and neuroendocrine tumors with:
- assessment of hormone receptor expression and tumor sensitivity to drugs that inhibit hormone secretion and cell growth;
- identification of markers that differentiate between benign and malignant adrenal tumors;
- identification of markers that predict tumor response to medical therapy;
- identification of potential targets and pathways for medical therapy;
- evaluation of efficacy of new drug that influence hormone production and cell proliferation;
- identification of gene mutations associated with tumor behavior and tumor sensitivity to medical therapy.
National collaboration exists with all other university medical centers. International collaboration exists with the European Network for the Study of Adrenal Tumors, the University of Birmingham, University of Montreal, National Institutes of Health, USA and the European Neuroendocrine Tumor Society projects in Berlin, Rome, Genoa and Athens.
Collaborations
National collaboration exists with all other university medical centers. International collaboration exists with the European Network for the Study of Adrenal Tumors, the University of Birmingham, University of Montreal, National Institutes of Health, USA and the European Neuroendocrine Tumor Society projects in Berlin, Rome, Genoa and Athens.
Contributions
The ACE performs educational and training activities for different target groups with respect to adrenal and neuroendocrine disorders Medicine students are educated on these diseases in the bachelor and master phase. The ACE actively participates in the minor on endocrine disorders. In the training for internal medicine a course on these diseases for residents is organized at a regular basis.
For fellows in training for Endocrinology a course on diagnosis and treatment of adrenal and neuroendocrine diseases is given at regular basis.
Each year the Erasmus Endocrinology Course is given at which fellows Endocrinology and internist-endocrinologists are kept up to date on the latest development in this field. The ACE organizes courses for international participants on an annual basis. Many students and residents from abroad are invited to visit the ACE for a certain period of time as a training fellow. In 2015, 5 students were actively participating in the clinics. These students were from Malaysia, Portugal (2), Spain and Belgium. Participants of the ACE are frequently invited for lectures and meet-the-professor sessions at, international congresses. The ACE has a steady number of 9-10 PhDs. of which 2 are from abroad (2015: Belgium, USA). The ACE participates in the training of internist-endocrinologists, endocrine surgeons, nuclear medicine / radiology fellows and oncologists in training. Those responsible for the training are required to have BKO certificates and are participating in SET-Q feedback and D-RECT. Departments are audited at a regular basis for their training and education programs.
Care Activities
The ACE is acknowledged by NFU, Orphanet and the European Neuroendocrine Tumor Society (ENETS Center of Excellence).
The ACE provides top-clinical care for patients with rare adrenal and neuroendocrine disorders with well-defined clinical pathways. Within the ACE patients are discussed by a multidisciplinary team. The diagnostic and therapeutic plan is discussed at a combined outpatient clinic where the patient can be seen by different specialists on one day. A dedicated nurse practitioner guides the process and is contact person for the patient.
Patients are encouraged to visit relevant websites and to seek contact with patient organizations. The ACE is aiming at participation in the ERN EURACAN and is accepted as a partner in the ERN rare endocrine disorders. Participating physicians and scientists of the ACE are internationally acknowledged experts in this field. State of the art laboratory and imaging techniques are at disposal of the HCP including lc/ms measurement of plasma and urinary hormones, adrenal vein sampling for evaluation of primary hyperaldosteronism, genetic counseling and 68gallium-dotatate PET-scan.
Specific treatments available at the ACE include laparoscopic adrenal surgery, 131I-MIBG therapy, peptide receptor radiotherapy (PRRT) using 177Lu-octreotate, radiofrequency ablation and liver embolization. Somatostatin receptor imaging and PRRT were developed at the ACE. Both imaging and therapy are now widely applied in international centers.
Societal Relevance to Research, Education and Patient Care
The ACE was the first center in the world where somatostatin receptor imaging was developed. The group has also significantly contributed to the development of diagnostic pathways for NETs. The ACE was also the first center in the world where PRRT was applied. The ENETS Center Rotterdam is an international referral center for patients for PRRT. Both imaging and therapy have found their ways to many renown international centers.
Physicians of the ACE participate in Bijniernet Nederland an active organization which focuses on improved health and care for patients with adrenal disorders. Physicians of the ACE actively participate in ENETS activities for developing standards of care and guidelines. Also, the ACE played an active role in de development of national guidelines for neuroendocrine tumors as well as for adrenal disorders. The ACE has an up-to-date website for adrenal disorders as well as neuroendocrine tumors with links to the websites of all major societies and patients organizations in these fields.
Physicians of the ACE have played an active role in the development of patient information materials and video's. Participants of the ACE have contributed to programs of the Bachelor curriculum (Theme1 C) and Master curriculum (Theme 1B) of the study Medicine, Erasmus University Rotterdam.
Viability of Research, Education and Patient Care
Collaboration in the clinic in the ACE is based on multidisciplinary team approach and shared decision making. The variability in age of the participants guarantees a solid future. All PhDs are expected to present their work at international meetings and international collaboration is strongly supported.
Lab discussions and lectures are in the English language. At least 3 PhDs in the recent 10 years have started an international career. At least 2 PhDs in the recent 10 years have received international scholarships and were identified as potential future staff members. Biometric network figure cannot be uploaded.
Key and relevant publications of the last five years
- van Schaik, et al. J Clin Endocrinol Metab. 2011
- Bergsma, et al. Best Pract Res Clin Gastroenterol 2012
- Kamp, et al. Endocr Relat Cancer. 2012
- Hofland, et al., Orphanet J Rare Dis. 2013
- Quax, et al., Nat Rev Endocrinol. 2013
- De Martino, et al., Endocr Relat Cancer. 2014
- Kamp, et al. J Clin Endocrinol Metab. 2014
- Lacroix , et al. Lancet 2015
- Oberg, et al. Lancet Oncol. 2015
- Creemers, et al. Endocr Relat Cancer. 2016
PhD theses of the last five years
- E Korpershoek, 2011
- M van Essen, 2012
- J. Hofland, 2012
- R. Quax, 2013
- R. van der Pas, 2013
- E.I. van Vliet, 2013
- J Norenberg, 2013
- S.E. Pool, 2014
- M.C. De Martino, 2015
- K. Kamp, 2016