What happens when a promising discovery finally leaves the lab?

That is the question behind Oncode Institute’s Clinical Proof-of-Concept (CPOC) programme. The programme helps researchers take an earlier step towards patients by supporting early clinical studies. For researchers, that step can be difficult. A discovery may work well in a laboratory setting or in animal models, but clinical research asks different questions. Can the idea be tested safely in patients? Which patient group should be included? Is the study realistic to run in practice?

Prof. dr. Henk Verheul deals with those questions every day. As a medical oncologist and Chair of the Erasmus MC Cancer Institute, he works closely with both patients and researchers. He also chairs Oncode Institute’s Clinical Advisory Board (CAB), which advises Oncode on clinical strategy, study design and the route from research idea to patient study. “You can go from the clinic to the lab, or from the lab to the clinic,” he says. “That connection influences my work every day.”

For Verheul, one of the biggest challenges in cancer research is understanding earlier which ideas have real clinical potential and how they can responsibly move towards patients. That is where CPOC comes in.

What changes when research enters the clinic

CPOC supports early clinical studies. In simple terms, it helps researchers find out if a discovery from the lab has potential in patients. The programme offers funding, clinical and valorization expertise and guidance on study design. It helps researchers define the right clinical question, identify the right patient group and understand the practical steps needed to run a study. 

According to Verheul, this can change how researchers look at their own work. “Many researchers think they need years of additional preclinical work before something can be tested in patients,” he says. “But sometimes you can move to the clinic earlier than expected.” That does not mean skipping careful preparation. It means asking earlier if the idea is clinically relevant, feasible and ready for a first test in patients. “The real challenge is implementation,” Verheul says. “You need a clinical protocol, clinicians who want to participate and patients who can join the study.”

For many fundamental researchers, that is unfamiliar territory. CPOC helps make that first clinical step more accessible.

Building studies that work in practice

The CAB brings clinical experience into the process. Its members assess if a study can answer the question it sets out to ask. They look at feasibility, patient numbers, clinical relevance and the proposed design. “We look very carefully at if the setup is clear and if the primary aim of the study can actually be answered,” Verheul says.

That advice can also help create new connections. If a study needs more patients than one centre can provide, the CAB can encourage collaboration between university medical centres, the Dutch Cancer Institute and other clinical partners. For Verheul, this connection between researchers and clinicians is one of the strongest parts of Oncode’s approach. It helps researchers think earlier about medical needs and about what clinical development really requires.

CPOC helps researchers gain clinical insight earlier in the process. In some cases, that confirms a promising direction. In others, it helps researchers adjust their approach before investing years in additional development. One example is the RASTRIC trial, which tested a treatment combination in patients. The study generated important clinical insight and helped researchers better understand the limitations of combining those therapies in practice. “We now know that it is not easy to overcome that toxicity, so we have to rethink the strategy,” Verheul says. “It helps us better understand what is needed for the next step.” 

Another CPOC-supported study, led by Oncode Investigator Jacco van Rheenen, explores how the menstrual cycle may influence response to chemotherapy. If confirmed in patients, the findings could help improve treatment timing for women with breast cancer and other tumour types. “You can study it in mice and in a preclinical setting,” Verheul says. “But proving that in patients is the difficult part.”

What changes when patients are involved

Verheul also believes patients should be involved earlier in the process. According to him, researchers often gain a different perspective once they hear directly from the people their work may eventually help. Patients are increasingly interested in seeing what happens inside the lab, meeting researchers and understanding how discoveries are developed before they reach the clinic. “Patients are enthusiastic to see what is happening in the labs,” he says. “Researchers can also learn a lot from hearing directly from patients. It helps create awareness of real medical needs.”

Verheul would also like to see more clinicians spend time in research labs. According to him, understanding how difficult it is to develop and test new ideas helps build stronger connections between researchers and doctors. Laughing, he describes it simply: “As a doctor, I stood in the lab with my feet in the mud.” “That experience stays with you,” he says.

Why clinical progress takes time

Verheul is careful not to promise quick impact. Clinical development takes years. Drug development in pharma can take 15 to 20 years before a treatment becomes standard care. According to Verheul, programmes that connect research and clinical expertise earlier in the process can help shorten that path, while still requiring careful testing and validation.

That also means managing expectations. “If you look ahead ten years, I think discoveries from Oncode will have improved patient outcomes in the clinic,” he says. “But it takes time.” For Verheul, the strength of CPOC lies in helping researchers move into the clinic earlier, learn faster and stay closer to clinical need. For him, programmes like CPOC are essential because they help researchers and clinicians work more closely together from the start.

Fact box: CPOC in 2025

• 22 projects in the programme
• 3 new studies awarded
• 8 participating institutes
• 15 Oncode Investigators involved in projects
• 46 clinicians involved in studies

Studies highlighted in 2025

• New studies awarded, Zwart, Litjens and De Laat
• Research by Jacco van Rheenen on the menstrual cycle and chemotherapy response started
• RASTRIC trial, led by Hugo Snippert and Hans Bos, completed and continued within Oncode Accelerator