Profile: Dr. Ilja Frank Ciernik

Issue: Vol.8, No.4 - October 2009

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Article Type: Profile

Dr. Ilja Frank Ciernik, a reputed Radiation Oncologist and expert in PET/CT based radiotherapy planning is former Head of Radiation Oncology at Ospedale San Giovanni in Bellinzona, Switzerland, Privatdozent of the Medical Faculty of the University of Zurich and is a member scientist at the Center of Clinical Research at the University Hospital of Zurich University.

Dr. Ciernik is Swiss and French citizen and was born in February 1965 in Novy Jicin, Czech Republic. He grew up in Z|rich, Switzerland and received his pre-university education at the Freudenberg Gymnasium in Zurich, with proficiency in English and Latin. After schooling, he studied Medicine at the Medical faculty of the University of Zurich, including clinical rotations as a sub-intern in pediatrics at the Beth Israel Medical Center in New York, and in Medical Genetics at the Yale University Hospital in New Haven, U.S.A. in 1989. At Yale, he got exposed to basic and preclinical biomedical research including molecular biology and DNA recombination. The federal diploma to practice as a physician in Switzerland was granted to Dr. Ciernik in 1990. During the last year of training, he passed the ECFMG American medical board exams and he did his medical thesis with Professor Albert Hollinger from the Medical Faculty of Zurich University on the conservative treatment of humeral fractures (J Trauma 31:230).

Dr. Ciernik started his professional career as a research fellow in the laboratory of Professor Rolf M. Zinkernagel from the Institute for Experimental Immunology, at the Zurich University Hospital, on viral persistence and cellular immunology (J Virol 66:3661. J Virol 68: 3650), where he got interested in the role of the cellular immune responses to tumors and tumor specific-antigens and the possibilities of targeting these antigens for clinical use. Determined to continue in the field of cancer biology and oncology, Dr. Ciernik started his clinical training with Professor Urs M. L|tolf in Radiation Oncology at the Zurich University Hospital in Switzerland (J Clin Oncol 12:1484). He then joined Drs. David P. Carbone and John D. Minna at the Southwestern Medical Center, University of Texas, U.S.A. for a research fellowship in tumor immunology and immunological tumor-targeting in 1993. Together with Dr. David P. Carbone and Dr. Jay A. Berzofsky, from the National Cancer Institute in Bethesda, Maryland, Dr. Ciernik participated in development, pre-clinical, and clinical testing of the first mutant tumor-specific onco-peptide vaccines to treat metastatic cancer patients with breast, lung, colorectal, and pancreatic cancer. In preclinical studies, they showed, that a range of tumor-specifc p53-derived peptides surrounding a point mutation can be immunogenic in murine hosts. In the clinic, peptides were loaded on irradiated carrier peripheral blood lymphocytes and were re-transfused to patients as a cellular vaccine. The vaccines were sufficiently potent to elicit mutation-specific cellular immune responses in cancer patients with metastatic disease, and the immune responses to mutant p53 and K-ras were correlated with prolonged survival, as reported in the final paper of the clinical trial in 2005 (J Clin Oncol. 23:5099). In the field of vaccine immunology, Dr. Ciernik investigated novel possibilities of immunization strategies, such as the use of DNA vaccines with single T-cell epitopes for DNA for the purpose of targeted cellular immune responses and investigating the role of ionizing radiation or haplo-deficiency in order to improve immune reactions against tumor-associated T cell epitopes (J Immunol 156:2369. Clin Cancer Res 2:877. Clin Cancer Res 3:483. Hum Gene Therapy 8:187. Int J Radiat Oncol Biol Phys 45:735). Intrigued by the various mechanisms of immunological escape mechanisms of tumors, Dr. Ciernik investigated how HIV-associated Kaposi sarcoma may escape the growth-suppressive influence of TGF-beta a paracrine and a commonly found factor produced by the tumor cells to inhibit immune cell function and anti-tumor lymphocytes. He found that Kaposi sarcoma cells uniformly loose the expression of TGFR1, preventing heterodimerization with TGFR II thus escaping the growth inhibiting effect of TGFbeta. (Clin Cancer Res 1:119).

After retuning to Switzerland in 1996, Dr. Ciernik finished his clinical training in internal medicine at the Centre Hospitalier Universitaire Vaudois (CHUV) of the University of Lausanne and the Department of Internal Medicine at the University of Zurich and received the board certificate in internal medicine in 2000 (Clin Rheumatol 16:477. Arch Intern Med 158:192). During that time, his interest remained in the overlapping fields of immunology-oncology-hematology.  Intrigued by the various possible interferences of HIV with hematopoesis, Dr. Ciernik investigated the heterogeneous entity of thrombocytopenia during HIV-infection and showed that ITP-like thrombocytopenia in AIDS is HIV-replication dependent and improves with anti-retroviral treatment, whereas ITP during AIDS is less common, usually associated with more pronounced thrombocytopenia and non-responsive to anti-retroviral treatment (AIDS 13:1913).

After completing training in internal medicine, he pursued his training in radiation oncology with Professor Reni O. Mirimanoff at the CHUV at the University of Lausanne and Prof. Urs M. L|tolf at the University of Z|rich since 2000. His main focus remained in studying the influence of ionizing radiation on anti-tumor responses, the influence of ionizing radiation on the cell cycle and the definition of novel radiation-sensitizers, such as G2-interfering agents as taxans, or the novel group of epithilones (Int J Radiat Oncol Biol Phys 62:1390. Clin Cancer Res 11:1588. Gynecol Oncol 106:394). Special clinical interests relied within the field of radiotherapy in the context of the immune- compromised immune system as encountered during HIV-infection, lymphoma, or high-dose chemotherapy or myeloablative therapies (Bone Marrow Transplant 24:147. Hematol Oncol 26:82. J Clin Oncol 26: 2550.). Laboratory investigations continued on radiation sensitizers and the role of the genome wide methylation status in respect of radiation sensitivity and how epigenetic expression modulation might be exploited for the purpose of radiations sensitization. The university working environment furthermore allowed to Dr. Ciernik early to apply combined modality treatments of brain, lung, rectal, and head and neck cancer. The introduction of PET in the clinical routine opened a new way to define the potentials of functional-imaging-based in-line radiotherapy planning and to implement novel target structures for radiation treatment providing integrating patho-physiological or metabolic information into the treatment concepts and radio-therapeutic strategies, including adaptive treatment planning (Int J Radiat Oncol Biol Phys 57:853. Int J Radiat Oncol Biol Phys 62:893. Radiother Oncol 80:43. Technol Cancer Res Ther 6:23. Radiat Oncol 2:22. Int J Radiat Oncol Biol Phys 69:286). After the board certificate in radiation oncology in 2002, Dr. Ciernik was elected lecturer for Radiation Oncology and Cancer Research at the University of Z|rich in 2003, and he is member of the united Zurich Cancer Network of the University of Zurich and the Swiss Federal Institute of Technology in Zurich.

Dr. Ciernik served as head of Radiation Oncology at the Ospedale San Giovanni in Bellinzona, Siwtzerland from 2006 until 2008 and is a member scientist at the Center of Clinical Research of the University of Zurich. His current  focus remain advanced image guided- and functional imaging based radiotherapy planning with PET/CT. He continues investigating highly conformal adaptive radiotherapy to define new and improve d beam geometries such as non-coplanar continuous arc treatment techniques with simultaneous beam modulation, termed intensity modulated non-coplanar arc therapy (INCA) (Radiother Oncol 81:151). He continuous to contribute his efforts to investigate and apply novel radiotherapy technologies, in order to better define the role and utilities of radiotherapy for difficult-to-treat situations such as hemi-thoracic intensity-modulated radiotherapy after resection of mesothelioma (Int J Radiat Oncol Biol Phys 69:1593). Dr. Ciernik is co-investigator in the controlled phase II trial SAKK 17/04 investigating the role of postoperative radiotherapy after pleuropneumectomy and is principle investigator of SAKK trial 77/07, a multi-center trial on the role of curative radiotherapy in non-resectable primary liver cancer. His current laboratory activities have been focusing on the role of T cell memory subsets in the context of total body irradiation and lymphopenia in order to better understand how to enhance or stimulate anti-tumor immune responses of T cell precursor and memory cells after vaccination in combination with cytotoxic treatment.

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