Written by Federico Citterich
Conceived and reviewed by Alessandro Rossetta
Human samples are the indispensable bridge between technological innovation and clinical reality. In LaserBlood, advanced optical methods can only reach their full diagnostic potential when grounded in authentic patient material. In this interview, Prof. Christian Pilarsky from Uniklinikum Erlangen explains why carefully collected, well-characterised human samples are essential for developing robust, clinically meaningful solutions — and how hospital-based research ensures that innovation remains closely aligned with patient needs.
In northern Bavaria there’s a city shaped by medicine. Erlangen, home to one of Germany’s most research-intensive university hospitals, has one of the highest concentrations of physicians and medical researchers in the country.
That’s largely because of Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), whose medical faculty and university hospital – Uniklinikum Erlangen, partner of the LaserBlood project – are major research and treatment centers.
Uniklinikum Erlangen alone employs well over 1,200 doctors, not counting affiliated clinicians, specialists in research, or university faculty. For a city of just over 110,000 people, that means significantly more than the country’s average, about 4.5 physicians per 1,000 inhabitants (≈ 450 per 100,000).
“We are a tertiary hospital with a focus on oncologic treatment and cancer research”, says Prof. Christian Pilarsky, scientist at Uniklinikum Erlangen and Work Package (WP) leader for the hospital within LaserBlood. “That means we are a highly specialized medical center that provides advanced, complex care”.
Uniklinikum Erlangen
Uniklinikum Erlangen treats over 150 patients with pancreatic diseases each year, receives some of the most complicated oncological cases, and is part of the Central Biobank Erlangen (CeBE). This makes it a unique samples provider.
Within the LaserBlood project, Uniklinikum Erlangen provides plasma samples from patients with early-stage pancreatic cancer. “I work in the hospital’s Department of Surgery”, explains Pilarsky. “Pancreatic cancer patients admitted to our unit are usually still operable, meaning the tumor is in an earlier stage”, he adds.
This represents a crucial contribution, particularly given that the samples are derived from human patients. Human samples are extremely important in pancreatic cancer research. “You want to detect human pancreatic cancer”, says Pilarsky. “You need human samples in all their complexity, and you need as many as you can get”.
Animal models, especially genetically engineered ones, have significant limitations. When animal models are genetically engineered, they are modified to exhibit a specific phenotype1 within a relatively narrow biological range. “But you’d like to capture the broad spectrum of phenotypes that occur as pancreatic cancer develops”, adds Pilarsky.
Among the most important mutations observed during pancreatic cancer development are mutations in the KRAS gene. KRAS encodes a key protein in signal transduction2 that links extracellular stimuli to intracellular responses. In pancreatic cancer, the mutation is typically an activating mutation, meaning that the KRAS protein remains constitutively active and continuously stimulates downstream signaling pathways. “This usually enhances the proliferative capacity of cells”, says Pilarsky.
Prof. Christian Pilarsky
KRAS mutations are the primary driver in approximately 90–95% of pancreatic ductal adenocarcinomas. This effectively creates two molecular subgroups of the disease: the large majority of tumors that carry an activating KRAS mutation, and a small minority – roughly 5% – that are KRAS wild-type.
This imbalance presents a major challenge for early detection. “Most pancreatic cancers are driven by KRAS mutations”, explains Pilarsky. “As a result, many of the biomarkers we can detect in the blood are linked to KRAS-driven biology”.
Detection strategies that rely on KRAS mutations or their downstream molecular effects can therefore only identify the subset of patients whose tumors harbor these mutations. In practical terms, this means that current approaches may be able to detect up to 95% of cases – but the remaining KRAS–wild-type tumors risk being overlooked.
Identifying this smaller subgroup is particularly difficult because of its low frequency. Since KRAS–wild-type tumors represent only about 5% of cases, very large patient cohorts are required to reliably study them and develop dedicated detection strategies. “If you want to find the patients without the mutation, you need very large sample sizes”, says Pilarsky. “That is one of the biggest challenges for early detection”.
Overcoming this imbalance is essential if early detection strategies are to benefit all pancreatic cancer patients – not only the majority defined by KRAS mutations.
PARTNER DESCRIPTION
Uniklinikum Erlangen is a tertiary referral centre affiliated with Friedrich-Alexander-Universität Erlangen-Nürnberg and a major site for surgical oncology in Germany. Its Department of Surgery has a strong clinical focus on pancreatic diseases and manages a substantial annual caseload. This clinical activity is supported by established biobanking infrastructure and rigorous sample documentation, providing a reliable foundation for translational diagnostic research within LaserBlood.
Prof. Christian Pilarsky, based in the hospital’s Division of Surgical Research, leads the Erlangen contribution to LaserBlood together with Prof. Robert Grützmann and colleagues including Dr. Henriette Golcher and Dr. Eva Lentsch. The team combines clinical trial coordination, structured patient recruitment, and molecular analysis of pancreatic cancer. With expertise spanning biochemistry, molecular biology, and experimental modelling, Pilarsky’s group contributes biological interpretation and validation of the project’s diagnostic approach, ensuring that technological developments are assessed against well-characterised patient cohorts.
GLOSSARY
- Phenotype: The observable characteristics or traits of an organism, such as physical features, biochemical properties, or behavior. A phenotype results from the interaction between an organism’s genotype – the genetic makeup of an organism or cell – and environmental influences.
- Signal transduction: The process by which a cell converts an external signal, such as a growth factor or hormone, into a specific intracellular response. It typically involves a cascade of molecular interactions that transmit and amplify the signal inside the cell.
REFERENCES
City of Erlangen. (2026) University Hospital – Uniklinikum. Available at:
https://erlangen.de/en/aktuelles/uniklinikum
German Federal Statistical Office (Destatis), 2021. Physician density in 2020: 4.5 physicians per 1,000 people in Germany, Press release No. 304, 28 June. Available at:
Universitätsklinikum Erlangen. (n.d.) Uniklinikum Erlangen. Available at: