Scientific breakthroughs are redefining what is possible in cancer care, yet the true test lies in translating discovery into meaningful and lasting patient benefit. Michael Baumann reflects on how the DKFZ is helping shape Germany's evolving oncology ecosystem through national research networks, precision medicine, clinical trial infrastructure, and a renewed focus on prevention, while offering a candid perspective on the cultural and regulatory changes Europe must embrace to remain at the forefront of innovation.
What drew you to lead the DKFZ, and what distinguishes the institution within Europe’s oncology landscape today?
I came to Heidelberg at the end of 2016 to become Chairman and Scientific Director of the German Cancer Research Center (DKFZ). By training, I am a medical doctor, radiation oncologist, and radiobiologist, and throughout my career I have combined patient care with laboratory research as a clinician-scientist. Before joining DKFZ, I spent more than two decades in Dresden helping build major translational oncology programmes and cancer research structures, while also serving in several leadership roles across European and German oncology. These experiences have given me a broad perspective on both the scientific and policy dimensions of cancer research in Europe.
Joining DKFZ was a natural next step. It is the largest biomedical research institute in Germany and among the largest cancer research centres in Europe. Founded in Heidelberg in 1964, we celebrated our 60th anniversary in 2024. Unlike institutions such as Institut Curie or Gustave Roussy, DKFZ was established as a research institute without its own hospital. While that may once have been perceived as a limitation, today we regard it as one of our greatest strengths. Our mission is to span the entire continuum from fundamental discovery to clinical and prevention research while working in close partnership with a number of university hospitals rather than operating within the boundaries of a single institution. Through these collaborations, we establish research platforms, provide infrastructure and funding, support professorships, and create the conditions needed to translate scientific advances into meaningful benefits for patients.
This approach is perhaps best illustrated by initiatives such as the National Center for Tumour Diseases (NCT), our platform for innovative clinical studies and investigator-initiated trials, and the German Cancer Consortium (DKTK), which strengthens preclinical and reverse translational cancer research across the country. In the era of precision oncology, where progress increasingly depends on access to large and diverse patient populations, a network-based model offers clear advantages. Rather than relying on a single hospital, we can connect expertise, infrastructure, and patients through national partnerships, enabling discoveries to move more efficiently from the laboratory into clinical practice. What may once have appeared to be a structural weakness has, in many respects, become one of DKFZ’s defining strengths.
How has the DKFZ structured its scientific priorities to address the growing complexity of modern oncology?
Oncology is an extraordinarily broad field, and DKFZ is broad as well. We employ around 3,600 people, which allows us to cover a wide spectrum of cancer research while remaining focused on the areas where we believe we can make the greatest contribution. Our work is organised around five major research programmes: Cell and Tumour Biology; Functional and Structural Genomics; Epidemiology, Public Health, Prevention and Survivorship; Immunology, Infection and Cancer; Imaging and Radiooncology and Oncoengineering. Importantly, each spans the entire translational continuum, from fundamental discovery through to clinical application. We conduct clinical trials not only in immunotherapy but also in areas such as surgery and biomedical engineering within a framework deliberately developed over the past two decades to translate scientific advances into patient benefit.
At the same time, we have become convinced that the most meaningful innovations in oncology rarely emerge from a single discipline working in isolation. Over the past decade, we have therefore developed a matrix structure that connects our major programmes through cross-cutting themes such as digital oncology, biomedical engineering, prevention, preclinical development, and clinical trials. Digital oncology is perhaps the clearest example, bringing together more than 400 scientists working on artificial intelligence and computational approaches across the organisation. Prevention follows a similar principle, as new strategies may emerge just as readily from fundamental immunology and vaccine development as from traditional public health research. We strongly believe in this model because genuine innovation often occurs at the interfaces between disciplines, where biology, technology, clinical research, and population science converge to move discoveries more effectively from the laboratory into clinical practice.
Which achievements over the past decade best illustrate the DKFZ’s approach to translating scientific discovery into patient benefit?
One of our highlights is what I would describe as a DKFZ blockbuster. Researchers at DKFZ and Heidelberg University developed and patented PSMA-617, a first-in-class theranostic radioligand targeting prostate-specific membrane antigen for patients with advanced metastatic castration-resistant prostate cancer whose disease had progressed despite hormone therapy. Through a series of partnerships, the compound evolved into ¹⁷⁷Lu-PSMA-617 before becoming Pluvicto, now marketed worldwide by Novartis and recognised as one of the most prominent examples of successful translational cancer research originating from academia. It is also a reminder that scientific excellence alone is not enough. At the time, Germany was not ideally equipped to conduct all stages of large international clinical development and, although German centres participated, the pivotal Phase III trial was led internationally by Novartis. Had the conditions been more favourable, we would have conducted more of that development here. Nevertheless, the therapy went on to receive FDA approval in 2022, followed by European approval later that year, demonstrating how discoveries made in an academic environment can reach patients around the world.
For us, this success story illustrates a broader philosophy. Traditional academic funding remains extremely important, and grants such as those from the European Research Council continue to be a key benchmark, but large research institutions also need effective mechanisms to ensure that promising discoveries do not remain confined to the laboratory. Technology transfer income generated from innovations such as PSMA-617 flows back into DKFZ and can be reinvested in future cancer research, creating a cycle in which one breakthrough helps enable the next. That is why we have deliberately strengthened our activities in technology transfer, intellectual property management, industry partnerships, and startup creation.
Since 2019, we expanded our traditional technology transfer office into a broader Innovation Management function that actively scouts discoveries across DKFZ, protects intellectual property, supports licensing and spin-offs, and builds relationships with industry to help move scientific advances towards practical application. We have also seen a growing number of our principal investigators establish startups, a development we would like to encourage further. Ultimately, if we want discoveries to benefit cancer patients around the world, academia and industry cannot operate in isolation from one another. DKFZ will never manufacture medicines itself, thus without industry partners it is very difficult to bring innovations to patients at scale. In that sense, we do not see these as separate worlds. Both are essential if we are serious about translating research into better outcomes for patients.
How would you assess the evolution of Germany’s oncology ecosystem, and where do you see the greatest opportunities for further progress?
Germany’s oncology landscape is highly developed but historically evolved as a highly decentralised system. Around the turn of the century, it became clear that this diversity required greater structure and coordination. The introduction of certified multidisciplinary cancer centres by the German Cancer Society and, subsequently, the systematic development of Comprehensive Cancer Centres through a highly successful program of the German Cancer AID, helped move Germany from a fragmented system towards one characterised by quality assurance, integrated care, research, and internationally recognised centres of excellence.
Where Germany continued to struggle, however, was in translating scientific excellence into clinical development. Fundamental research has always been a strength, but translational research and clinical trials lagged behind. The establishment of the German Cancer Consortium DKTK in 2012 strengthened research at the interface between laboratory discovery and clinical application, yet a benchmark conducted in 2022 still placed Germany near the bottom of the European rankings for clinical trials. There was insufficient infrastructure, limited expertise in developing investigator-initiated studies, and inadequate funding to move innovations emerging from the laboratory into the clinic.
This recognition ultimately contributed to the launch of the National Decade Against Cancer in 2019 and the nationwide expansion of the NCT, building on the successful Heidelberg and Dresden models to create a dedicated clinical research platform across Germany.
Today, that landscape looks very different. The NCT is establishing the expertise, infrastructure, and funding needed to support innovative clinical studies at a scale that was simply not possible in the past, with more than 80 trials already submittedto the network’s trial engine. Our ambition is to ensure that Germany’s internationally recognised strength in discovery science is matched by excellence in clinical development, so that innovations generated within our own system can reach patients more rapidly and more effectively.
Where are genomics, data science, and artificial intelligence having the greatest impact on precision oncology at the DKFZ?
We entered this field very early. DKFZ is one of the largest genomics centres in Europe, and for more than 15 years we have integrated cancer genomics into precision oncology to support treatment decisions for individual patients. Many of the studies now conducted through the NCT build on this foundation, so for us, precision oncology is not a new concept but a well-established part of our work. We also recognised early on that extracting meaningful insights from complex molecular data would require sophisticated computational approaches. One example is our work in brain tumours, where, together with colleagues at Heidelberg University Hospital, we developed an online platform that uses genome-wide DNA methylation profiling and machine-learning algorithms to classify central nervous system tumours more precisely than conventional histopathology. This work demonstrated that tumours appearing similar under the microscope often represented distinct molecular entities, fundamentally changing the way brain tumours are diagnosed. The approach has since been incorporated into the World Health Organization classification of central nervous system tumours and is now used routinely by neuropathologists around the world. With around 200,000 brain tumour profiles, the database has become an important resource for both research and clinical practice, and we established a startup to manage the regulatory requirements needed to support its implementation in routine care.
What excites me most is that these capabilities are becoming more accessible. Genomic profiling continues to become faster, less expensive, and more widely available, making it realistic to envisage a future in which molecular characterisation forms part of routine cancer care. The field is also moving beyond genomics towards integrated, multi-omic approaches that combine sequencing, gene expression, proteomics, and other layers of biological information. Interpreting these more complex datasets will require increasingly sophisticated analytical tools and new applications of artificial intelligence, but it also offers the opportunity to understand each patient’s disease in far greater depth. We have already shown, first through cohort studies and later through clinical trials, that using these methodologies to guide treatment decisions can benefit patients. The question is no longer whether these approaches have value, but how we can make them accessible to more patients so that the promise of genuinely personalised cancer care can be realised more broadly.
What will Germany need to do to strengthen its position as a destination for cancer innovation and generate more success stories like BioNTech?
I think the most important lesson is that these success stories do not emerge overnight. They are built on structures, and building those structures takes many years. Over the past two or three decades, we have established networks with university medical centres, developed translational platforms, and created environments in which experts from different disciplines can work together towards a common goal. That cultural shift is just as important as the infrastructure itself. We still need to become better at building partnerships and ensuring that they are fair, productive, and attractive to everyone involved. Those partnerships also have to extend beyond national borders. Particularly in rare tumours, European and often global collaboration is essential if we are to bring together the patient numbers and expertise needed to advance innovation. The direction has proven to be the right one. What we have built now needs to be strengthened and carried forward.
At the same time, we need to invest in people. Over the past decade, we have done a great deal to support clinician-scientists by creating protected time and dedicated training pathways that allow physicians to pursue high-level research alongside clinical work. We are now applying the same thinking to clinical trialists, because designing and conducting innovative clinical studies has become an increasingly specialised discipline. If we want talented doctors to choose these careers, they need to see that they are offered meaningful prospects and recognition comparable to other academic pathways. As progress is made, new challenges inevitably emerge and ensuring that we have the right people and a good mix – starting with basic scientists up to clinicians – with the right expertise will remain fundamental to translating discoveries into better patient care.
The other major issue is regulation. Europe, and Germany in particular, has become too bureaucratic and too slow. We often say that we want to be the most competitive region in the world, and I fully agree with that ambition, but in practice we have created layers of complexity that delay innovation. The Medical Research Act (Medizinforschungsgesetz) introduced by the previous government was a very good step in the right direction after many years in which too little happened, but it is not enough. Initiating a clinical trial in Germany can still take one or even two years, whereas countries such as Spain are often much faster. Multiple authorities, ethics committees, data protection requirements across different federal states, and additional approval processes all contribute to a system that has become unnecessarily cumbersome. At DKFZ, we devote considerable effort to engaging with policymakers in Berlin and Brussels because this must be an ongoing process of improvement rather than a single legislative intervention. We do not need regulation simply for the sake of regulation. What we need is a framework that is more efficient, more proportionate, and better able to support innovation, allowing scientific advances to reach patients more quickly while maintaining high standards of quality and safety.
Looking ahead, what legacy would you hope to leave at the DKFZ over the next decade?
I think one part of that legacy will be the continued development of a truly national cancer research ecosystem in Germany, bringing together preclinical discovery, translational research, and clinical application through structures that connect expertise across the country rather than concentrating it within a single institution. Equally important, however, is something we have not discussed in depth: the National Cancer Prevention Centre (NCPC), which we established together with German Cancer Aid in 2019. We have become much better at treating advanced cancer, but we remain far from where we need to be when it comes to preventing it, and that is true not only in Germany but across Europe. Based on what we know today, around 40 percent of cancers could be prevented through measures such as avoiding tobacco use, reducing obesity, and improving uptake of interventions such as human papillomavirus vaccination. If effective primary prevention is combined with better screening and early detection, we could prevent a substantial proportion of cancer deaths using approaches that already exist. Survivorship, or tertiary prevention, also deserves far greater attention, helping cancer survivors reduce the risk of recurrence and second malignancies. Better treatments will always be necessary, because there will remain cancers that cannot be prevented or detected early enough, but prevention and early detection represent one of the greatest opportunities we have to change outcomes at population level.
The NCPC was created to bring that entire continuum together under one roof, spanning fundamental research, translational science, prevention studies, education, policy advice, and citizen engagement. Because prevention concerns healthy people rather than patients, we must think beyond hospitals and develop approaches that can work within everyday life and in partnership with all stakeholders, including healthy citizens. We are currently building a dedicated centre in Heidelberg and, much as we have done with our other national initiatives, our ambition is ultimately to extend this model across Germany. In many respects, we are pioneering a new approach in Europe, one that recognises that preventing cancer can be just as transformative as treating it, while also creating opportunities to translate discoveries into practical interventions, whether through vaccines, digital applications, or other innovations developed together with industry. If I were to look back in ten years’ time, I would hope that we had not only strengthened Germany’s cancer research infrastructure, but had also helped shift the conversation towards preventing disease wherever possible, detecting it earlier when prevention is not enough, and ensuring that fewer people experience the burden of cancer in the first place.
