Dr. Markus Eszlinger

• Molecular diagnosis of indeterminate thyroid FNA cytologies

Dr. Eszlinger’s major research interests include the molecular etiology of thyroid nodules and the identification and application of molecular markers that help to differentiate benign and malignant thyroid tumors. In a translational approach he aims on improving the pre-surgical diagnosis of cytologically indeterminate thyroid nodules by analyzing a panel of point mutations, gene fusions and microRNA markers using targeted next generation sequencing and MALDI-TOF mass spectrometry. Together with Dr. Ralf Paschke he developed the ThyroSPEC™ MassARRAY panel which covers 117 point mutations and 23 rearrangements. The prospective evaluation of molecular fine-needle aspiration (FNA) diagnostics for indeterminate thyroid nodules with the ThyroSPEC™ panel led to its implementation by Alberta Public Laboratories and Alberta Health Services in October 2019. ThyroSPEC™ is a reimbursed routine molecular test for indeterminate thyroid nodule FNA cytologies to finally replace 600 diagnostic lobectomies per year in Alberta and potentially 3,500 diagnostic lobectomies in Canada. Moreover, Markus Eszlinger is interested in guiding cancer therapy with targeted drugs by analyzing the molecular profiles of these advanced cancers. In a project with Ralf Paschke and Sorana Morrissy he analyzed the mutation profiles of primary tumors and metastases by whole exome sequencing to predict success or failure of this approach and to identify targets for the off-label use of other tyrosine kinase inhibitors. In addition to the known driver mutations in BRAF and RAS, previously described EIF1AX and AKT1 mutations which could be targeted for example by mTOR inhibitors and also new alterations in oncogenic pathways, for example in the cell cycle pathway (E2F1 and CDK6 mutations) were identified. These results will allow to better stratify for newer and individually targeted drugs in case of radioiodine resensitization failure with Selumetinib, Vemurafenib, Tramatenib, or Dabrafenib.

With Ralf Paschke, Dr. Eszlinger is directing a research laboratory in the Arnie Charbonneau Cancer Institute (ACCI). Together with Drs. Khalil, Ghaznavi, Symonds, and Paschke, Dr. Eszlinger is aiming for a major change of clinical practice by solving the inherent limitations of thyroid fine needle aspiration cytology.

In a collaboration with the laboratory of Jukka Kero and Matti Poutanen at the University of Turku, Finland he recently published a mouse model of non-autoimmune hyperthyroidism with the first description of papillary thyroid cancers most likely induced by increased TSHR signaling (Jaeschke et al., Thyroid, 2018).

With Dr. Carolina Ferraz (Sao Paulo, Brazil) he is currently working on a project analyzing a miRNA panel in material obtained from fine needle aspiration biopsies of thyroid nodules and peripheral blood and its application as a diagnostic molecular test.