The Queen was welcomed by Gita Gallé, who introduced and chaired the working visit. After three years, the Máxima center has grown beyond the 'start-up' phase, Gallé said. During that time, the center has been hard at work, bringing together and training talented healthcare and research professionals. After the concentration and opening phase, our center is now continuing with the integration of care and research in all conceivable areas of pediatric oncology.
Rob Pieters talked the Queen through the strategic multi-year plan. ‘As a major pediatric cancer center, we have an obligation to make progress in all areas of pediatric oncology,’ he said. ‘So it's mainly about what we're going to pay extra attention to.’
The Queen indicated that she was particularly interested in the internationalisation, talent and funds aspects of the multi-year plan. She also called herself a ‘data freak’. She asked about the ways in which we deal with care and research data at the Máxima, and whether this also involves AI, for example, to study the bigger picture.
CAR-T immunotherapy
Friso Calkoen and Marieke van der Vlugt gave Máxima an overview of the developments in the field of CAR-T cell therapy. After a brief explanation of how this immunotherapy works, the Queen asked a number of pertinent questions, such as whether pediatric oncology can learn a lot from the effect in adults, and whether other recognition mechanisms are needed to make CAR-T work in different types of childhood cancer. She was well prepared: she was already aware of the need for a second Prodigy machine to be able to make CAR-T cells in Utrecht.
Queen Máxima also wondered about the side effects of this therapy. ‘There are certainly side effects of CAR-T, but so far we have not seen them in children in the Máxima center,’ said Van der Vlugt, who works with this immunotherapy as a nurse specialist in training. ‘At the start, children were admitted for 10-14 days, but now they can go home a day after they get the therapy. We keep a close eye on them through regular outpatient visits and telephone contact.’ Queen Máxima asked Van der Vlugt with interest about the progress of her education – both Calkoen and Van der Vlugt are in the talent program at the Máxima center.
Neuro-oncology
Eelco Hoving gave the Queen an update on the care and research into brain tumors. The Máxima center and the UMC Utrecht are making a huge investment in the so-called neurosuite. Queen Máxima added to Hoving's explanation about the MRI scan in the operating room: so that you can see where you are going. ‘Indeed, you can think of the brain as a kind of pudding in which you operate,’ was Hoving’s graphic explanation. ‘You can adjust the route planning with the MRI during the operation.’ He also spoke about the new robot arm and research into getting medicines through the so-called blood-brain barrier.
The next speaker, Marita Partanen, talked about her research into the neuropsychological effects of brain tumors and their treatment, such as cognition, social skills and emotions. When asked by the Queen whether the age dependence of the child's development had a major influence on this, they discussed the comparison with a kind of control group of healthy children.
Royal greetings
Finally, Lex Eggermont talked about the enormous importance of international collaboration in childhood cancer research. Eggermont: ‘As a large center, we see a relatively high number of patients for each diagnosis. This makes us an attractive center to work with in Europe and indeed the world.’ He cited our close collaboration with the Hopp-KiTZ in Heidelberg as a unique example of the critical mass that allows us to take even greater steps in research. ‘The institutes that can make tomorrow's medicine need to seek each other out,’ said Eggermont.
Queen Máxima appreciated the importance of partnerships with other countries. She also mentioned the balance between broadening knowledge about childhood cancer, without losing focus. She concluded a 'very interesting' working visit by saying that she is deeply involved with the center that bears her name, and will keep hold of us. The Queen logged out with: ‘Greetings to the entire staff!’