Professor Camilla Krakstad has her background from research on signal transduction, and during her PhD she studied cAMP signaling in apoptotic cell death in both normal and cancer cells.
Professor Krakstad is leader of the the Bergen Gynecologic Cancer Research Group, which focuses on molecular profiling of gynecological malignancies, with a special focus on identifying new biomarkers for endometrial and cervical cancers. Among the group’s interests are also the establishment of improved preclinical model systems for endometrial cancer, to generate tools that enable functional studies and evaluation of biomarker expression in relation to treatment.
Projects and important results
Blood-based biomarkers are attractive due to ease of sampling and standardized measurement technology, reducing obstacles for clinical implementation. The group has identified blood metabolites and steroids associated with poor prognosis in endometrial cancer. Elevated steroid levels are linked to increased estrogen signaling and fat distribution. The focus on steroids in blood samples adds to the group’s continuous focus on hormone receptors in endometrial cancer. The MOMATEC2 study, a phase 4 implementation trial for validation of ER/PR status as a stratifier for lymphadenectomy in endometrial cancer, is ongoing and inclusion of patients from international centers is increasing. During 2019, the Krakstad group performed the first interim analysis with focus on biomarker cut-offs (from 2015-2017).
During the past few years, the group has done extensive work to improve mouse models for endometrial cancer, and this work is continuously in focus. They have, in collaboration with the McCormack group, developed a new NIRF-based imaging method that enables detection of patient derived tissues in mice models (Fonnes et al, under review). This method is currently routinely used alongside imaging methods like FDG-PET and MRI to monitor treatment responses in mice models.
The Krakstad group continues its focus on preoperative patient imaging parameters derived from PET-CT and/or MRI as important biomarkers. In close collaboration with Professor Ingfrid Haldorsen at the Mohn Medical Imaging and Visualization Center, they integrate imaging data, clinical information and genetic data in large scale radiogenomic analyses.
Current challenges in the field
With a tight link between endometrial cancer and obesity, the incidence of endometrial cancer is expected to rise. Identifying specific patient populations that are likely to respond to therapy is therefore highly important. In recent years, much attention has been on identification of molecular subgroups of endometrial cancer. Following the TCGA report on endometrial cancer, efforts have been made to design a clinically relevant molecular classifier, and biomarkers like MSI status, P53 and POLE mutations are becoming implemented at many pathology departments. However, one key challenge is still to link these subgroups to relevant treatment and thereby improve patient treatment and outcome.
The group will continue to develop their molecularly defined models for endometrial cancer and will also shift focus more to the use of these models for drug testing, functional experiments and exploration of subtype specific genetic alterations. They will expand their biomarker focus and exploit the potential for immunohistochemical multiplexing available through the Hyperion equipment. The MOMATEC2 trial will be completed in collaboration with the currently contributing national and international centers.