The Hallwang Clinic
The Hallwang Clinic is a specialized oncology clinic and helps patients to navigate in a very difficult situation. In contrast to the so-called „alternative clinics“, the medical team of the Hallwang Clinic consists of board-certified oncologists. This is a basic but major quality criteria. The medical team consists of an innovative interdisciplinary team of board-certified and specialized oncologists, hematologists, internal medicine specialists, naturopaths, specialized psychologists and oncology nurses, working in a collaborative university hospital and university institute network. The board-certified oncologists at the Hallwang Clinic have gained experience at well-known university institutes and university hospitals in Germany and world-wide, including the Center of Integrated Oncology of the University Hospital Cologne and the University Hospital Bonn (Germany), the Dana Farber Cancer Institute of the Harvard Medical School in Boston (USA), the Sidney Kimmel Comprehensive Cancer Center of the Johns Hopkins Hospital in Baltimore (USA), the Walter and Eliza Hall Institute (Australia) and other renowned cancer institutes. Furthermore, the specialized medical oncologists are members of the European Society for Medical Oncology, carrying the ESMO certificate of Oncology, and /or are members of the German Society of Hematology and Oncology. Many of the physicians have an intensive research and academic background in cancer medicine, particularly Immuno-Oncology. There is always an oncology team on-site. At the Hallwang Clinic, there is also an outpatient center as well, which is also fully covered by an oncology team. The medical oncology team follows the continuously updated international guidelines for cancer therapies. Nevertheless, at the Hallwang Private Oncology Clinic there is an ability to offer further therapy possibilities for patients who need an individualized therapy approach outside of clinical trials.
At the private oncology clinic “Hallwang Clinic”, the medical staff is indeed looking for the most effective therapy approaches that fit the individual characteristics of the patient’s medical history and condition. In heavily pretreated patients, they discuss targeted therapies based on biomarker analysis leading to genetic targeted therapies and immune therapies. The application of biomarker analysis has developed rapidly in the field of oncology. Immunotherapy is a complex field and not well understood by doctors with no expertise in immunooncology and immunotherapy. Beyond doubt, the field of cancer immunotherapy needs to be in the hands of oncologists and scientific professionals, since there are so many biomarker constellations that need to be considered in the decision making process of whether a patient will benefit from targeted immunotherapy or not. In triple negative breast cancer for example, the so-called immunotherapies are not yet approved but are achieving very promising results in clinical trials worldwide. As medical and scientific experts, the Hallwang medical team is convinced that certain patients benefit from this immunotherapy, as they have achieved for certain patients at the Hallwang Clinic extraordinary long-term therapy results, which are highly respected by medical experts world-wide. For many years, the so-called PD-L1 expression was used as a predictive marker. But nowadays, one already know more significant predictive markers, e.g. the tumor mutational burden, immune-prediction, among many others. The Hallwang Clinic is one of the first clinics worldwide that started using checkpoint antibody therapies for certain tumor entities. Navigating in a university hospital system, the Hallwang Clinic has access to the most advanced diagnostic and therapeutic strategies. They are open for complementary approaches, but the clear focus is on evidence-based treatment approaches.
The team of Hallwang Clinic
Over the last few years, the team of the Hallwang Clinic have seen that medical doctors at renowned hospitals in Europe and world-wide are willing to continue an immunotherapeutic approach after a successful initialization at the clinic. It is important that these therapies are applied and monitored by a specialized oncology team with a long standing experience in immuno-oncology like the Hallwang Clinic, since these therapies, although in general well-tolerated, can have severe immune related side-effects. Unfortunately, one will realize that most so-called experts are not able and will not be able to gain hands-on experience in the most advanced therapy possibilities due to restrictions and limitations in their home countries.
The medical team of the Hallwang Private Oncology Clinic is able to make use of the most advanced clinical research achievements worldwide and can discuss in an interdisciplinary team whether a patient who has already exhausted all possible standard line therapies would benefit from such a new treatment approach. In Germany, they have the possibility to use extensive biomarker analysis (Next-Generation Sequencing, Immune-Prediction, Tumor Mutational Burden Analysis, Gene-amplifications-/translocations) for private patients to allow for evaluation of precision-based targeted therapies.
Too many patients face limitations in their home country health system, even though certain treatments have shown to be effective. Patients who would most likely benefit from a precision-based therapy have been denied a precision-based medicine approach, because e.g. the trial has already stopped recruiting, or the patients do not meet all eligibility criteria from the clinical trial, etc.
The Hallwang clinic is no clinical study site. The private clinic “Hallwang Clinic” is too small and the patient population very heterogeneous, so clinical trials are not possible, since obviously, the team of the Hallwang Clinic wants to offer all its patients the best treatment possible, and not based on some criteria they might not meet, but would have to be met in order to be included in a trial. Many patients indeed come to the clinic, because they were not eligible for clinical trials, due to their age, treatment history, or other chronic diseases, etc. The aim of the Hallwang Private Oncology Clinic is to find the best treatment strategy for the patient, and not exclude any patient from a treatment protocol because of the factors mentioned beforehand. Also, clinical studies often use placebo as a control or some alternative, though possibly inferior, treatment protocol, in order to compare treatment responses in two groups of patients. Naturally, at the Hallwang Clinic, a patient will always receive the treatment the medical team think is best for the patient after a thorough discussion of state-of-the-art, alternatives, possible side effects and complications of this treatment.
Patients at the Hallwang Clinic
Patients at the Hallwang Clinic are treated with individual treatments. For example, doctors elsewhere persist on chemotherapeutic regimens and protocols that have been established years ago. These protocols may achieve a “good overall result“ – but they do not think about whether it would be possible to achieve even better or more durable results for those patients. While some patients respond well to a certain chemotherapeutic protocol, and do not experience severe side effects, others need to discontinue the standard protocol due to terrible side effects, or they progress under the standard protocol. Alternative protocols for these patients, that did not tolerate the standard chemo regimen, are limited. And if the patient then develops complications on the alternative chemo protocol, options become really scarce. In contrast, worldwide there are so many ongoing clinical trials with cancer drugs, showing amazing results in advanced clinical phases. But as long as these drugs are not approved, or only available if you pay for them privately, these drugs will not be provided to other patients who have already exhausted all available standard treatment strategies and are in immediate need for further options, as they are rapidly progressing. And this is terrible. There should be an open and honest discussion about what is known (and what is not known) about these modern drugs, what results have been achieved so far in other patients, what risks, side effects and complications can occur, so that the patient and his/her doctor can together weigh pros and cons and make an educated decision. The patient should know about his/her chances when he/she takes the drug in an experimental setting in contrast to when he/she takes no treatment at all. But the problem is that these new clinical trial drugs do not even come into question for these kind of heavily pre-treated and further progressing patients and are therefore not discussed with the patients due to country-specific limitations and laws, thus depriving patients of possibly life-extending or even life-saving treatments.
In conclusion, the Hallwang clinic is a pioneer for individualized targeted and precision-based therapies for patients who are eligible for these therapies based on a thorough biomarker analysis and who have no other guideline approved options. The Hallwang Private Oncology Clinic team has shown to be very successful in extremely difficult situations. Furthermore, they are able to provide further lines of therapeutic options due to a surrounding that offers close monitoring. You have to consider that the medical team of the Hallwang Clinic is having one oncologist for every 2-3 patients and nearly a 1:1 nurse/patient ratio, enabling therapies for critical patients which have been given no follow up therapy due to a lack of a close monitoring possibilities.