The panel discussion about implementing PRS tests included (from left to right): Peeter Padrik, CEO and founder of Antegenes, Solveig Hofvind, Head of the Mammography Programme at the Cancer Registry of Norway, Ole Alexander Opdalshei, Deputy Secretary General at the Norwegian Cancer Society, Lovise Olaug Mæhle, senior consultant at the Department of Medical Genetics at Oslo University Hospital and Ketil Widerberg, general manager at Oslo Cancer Cluster, as moderator. Photo: Wenche Gerhardsen / Oslo Cancer Cluster

Personalising breast cancer screening in Norway

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5 people sitting on stools in fromt of a white screen, being part of apanel for discussion.Wenche Gerhardsen

Are polygenic risk scores the key to personalising cancer prevention in Norway?

Imagine that your saliva can reveal your personal risk for developing certain diseases. Think about the possibilities of detecting cancer at an early stage, preventing serious disease and saving lives. This is what polygenic risk score (PRS) tests are all about.

The AnteNOR project has investigated how such a test for breast cancer can be implemented in the Norwegian healthcare system. In a recent seminar at Oslo Cancer Cluster Innovation Park, researchers and experts met to present the results and discuss the way forward.

Watch the seminar here:

 

Analysing Norwegian data

Eivind Hovig, Professor at the Centre for Bioinformatics at the University of Oslo, and group leader at Institute for Cancer Research, Oslo University Hospital, has investigated the performance of breast cancer polygenic risk score in the Norwegian population.

Eivind Hovig, Professor at the Centre for Bioinformatics at the University of Oslo, and group leader at Institute for Cancer Research, Oslo University Hospital. Photo: Sofia Linden / Oslo Cancer Cluster.

Denise O’Mahony, researcher at the Department of Medical Genetics, Institute of Medical Genetics at University of Oslo, supplemented Hovig’s presentation. Her research group has among other things analysed the distribution of polygenic risk scores in Norwegian data compared to Estonian data.

“By the age of 49 we see a total of 182 women that have a higher risk than the median absolute risk at 50, which is the age that women enter screening, therefore indicating the benefit of incorporating the PRS in clinical practice,” commented O’Mahony.

Denise O’Mahony, researcher at the Department of Medical Genetics, Institute of Medical Genetics at University of Oslo. Photo: Wenche Gerhardsen / Oslo Cancer Cluster.

 

Testing in the clinic

A clinical pilot study at Vestre Viken breast centre has evaluated the impact of implementing population-based genetic testing strategy for breast cancer precision prevention. There were 80 study participants aged 40-50 who took the saliva-based PRS test at the breast centre. Some of these women were ultimately recommended earlier screening or more intensive screening.

“Half of them were recommended to participate in standard screening. Almost half of them were recommended to start screening at an earlier age than 50. One was recommended to start annual mammography screening immediately,” said Tone Hovda, senior radiologist at Vestre Viken.

Tone Hovda, senior radiologist at Vestre Viken. Photo: Sofia Linden / Oslo Cancer Cluster.

 

Is this cost-effective?

As with any innovation, the tests come at a price. Kari Kollstad, health economist at Oecona AS, has developed a cost-effectiveness analysis of a polygenic risk-tailored breast cancer screening program in Norway.

“The preliminary results show that risk-stratified screening is more costly than current mammography screening, mainly driven by: costs associated with implementing the test and consultations, as well as screening costs. Risk-stratified screening also resulted in an increase in life years and quality-adjusted life years, and a redistribution of cancer cases compared to current mammography screening,” said Kollstad.

This means that while the tests come with a cost, risk stratified screening means that breast cancer can be detected at an earlier stage and that patients live longer.

Kari Kollstad, health economist at Oecona AS. Photo: Sofia Linden / Oslo Cancer Cluster

 

Towards individual-based screening

The presentation was followed by a panel discussion about how to implement PRS tests in clinical practice.

“As an oncologist with 33 years of experience, I have encountered numerous cases of advanced breast cancer in women of various ages. When analyzing their risks and individual stories, I realized that we could prevent most of these unfortunate situations. Breast cancer risks vary significantly among women, but our screening approaches are the same for all. It is crucial that we enhance the current real-world practices for breast cancer prevention and screening, especially considering the availability of innovative solutions,” commented Dr. Peeter Padrik, CEO and Founder of Antegenes.

The company Antegenes has developed novel polygenic risk score-based genetic tests to estimate the risk of common cancers.

Peeter Padrik, CEO and founder of Antegenes. Photo: Sofia Linden / Oslo Cancer Cluster

“I believe precision cancer prevention will be the right way for the future. We need to see what we can do to find more women with breast cancer that need to be treated,” commented Ole Alexander Opdalshei, deputy secretary general, the Norwegian Cancer Society.

“We have been doing mammography screening for 30 years now and using the same procedures and equipment, so it is definitely time for change. We need to go more personalised. We need more efficient tools and we need to consider if it is time to extend the age range targeted in the program. I think the Antegenes test could contribute to making BreastScreen Norway more personalized and better for women: if we could start inviting women 48 years old, test all women and plan a personalised screening for the women. It would be expensive, but perhaps cost-effective in the long run,” commented Solveig Hofvind, Head of the Mammography Programme at The Cancer Registry of Norway.

 

Project partners: Antegenes, Oslo Cancer Cluster, Oslo University Hospital, University of Oslo, Vestre Viken.

This project is supported by the Norway Green ICT Programme.

 

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Thomas London recently joined the board of Oslo Cancer Cluster Incubator. Photo: private

New incubator board member

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Thomas London

Thomas London has joined the board of Oslo Cancer Cluster Incubator

“It was an honour to be elected to the board,” Thomas London said.

London is a businessman who has been trying to buy property from Oslo municipality to expand Oslo Cancer Cluster Innovation Park to make room for more businesses and laboratories within the cancer sphere. The slow process now seems to have found a solution with the new Oslo City Council.

Read about the assurances from the City Council in the newspaper Dagsavisen (in Norwegian).

This is the entire incubator board. 

An active board member

London underlines the value for society in having an incubator dedicated to new companies working with cancer, often developing innovative Norwegian cancer research.

“The work of the incubator affects many lives and will continue doing so in the future. I wish to be an active board member and support the work of the incubator team in developing the incubator to be even bigger and help even more start-up companies through their first critical years.”

There is also a personal reason why Thomas London was eager to take on a board position in the incubator. Like so many, he has had close relations get cancer.

“I am personally invested in the fight against cancer and in developing better cancer care.”

Expanding the innovation park

As the manager of the real estate development company Oslo Science Hub AS, he oversees the final expansion of Oslo Cancer Cluster Innovation Park. The final expansion is planned to be about 40,000 square metres. London is sure that cancer innovation in Norway will grow with the park.

“In the coming years it will be easier to see the entire Campus Radiumhospitalet as one innovative area,” London said.

Arcitect model of buildings

A model of the planned expansion of Oslo Cancer Cluster Innovation Park. Phase 4 is being built today, between the hospital and the current park. Phase 5, to the far right in the picture, is planned to be built by 2028. The two planned building phases will add about 50,000 square metres to the park. Photo: Fartein Rudjord

You can read more about the expansion plans, and see the building site live, at the Oslo Cancer Cluster Innovation Park website. 

 

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Three of the speakers during the CellFIT workshop in Trondheim last week (from left to right): Anna Pasetto, PhD, Director of the Center for Advanced Cell Therapy (ACT), Section for Cell Therapy, Division for Cancer Treatment, Cancer Clinic, Oslo University Hospital, Hanne Haslene-Hox, PhD, Senior Research Scientist, SINTEF, and Else Marit Inderberg, PhD, Senior Scientist, Group Leader, Head of Immunomonitoring, Department of Oncology, Cellular Therapy, Oslo University Hospital. Photo: Dave Tippett.

CellFIT workshop in Trondheim

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How can manufacturing of T cell therapies be improved?

This was a key question at a workshop organised by the CellFIT project in Trondheim last week. The seminar brought together project partners and experts as they tried to address one of the biggest challenges for cell-based cancer therapy – efficient and scalable production.

“One of the key reasons why patients relapse after CAR T-cell therapy is that the therapeutic T cells do not persist in the patients after infusion. We know that patients that have cancer-reactive stem-cell like memory T cells respond better to treatment and these cells persist for a very long time, but these cells are rare. In the CellFit project we will optimize T cell manufacturing to produce more of these T cells for therapy.  OUS has a central role in CAR-T cell development and manufacturing, and can test this in patient T cells,” commented Else Marit Inderberg, PhD, Senior Scientist, Group Leader, Head of Immunomonitoring, Department of Oncology, Cellular Therapy, Oslo University Hospital.

ThermoFisher is one of the project partners and contributes with innovative reagents to ensure optimal growth factors for the cells.

“The Thermo Fisher Scientific team greatly appreciated the workshop and opportunity to meet face-to-face with the team and workshop participants. The presentations were of high quality covering important parts of cell therapy development from the development of novel CAR-T receptors, high-complex assays and initiatives to bring new cell therapies to patients via the ACT center. Already looking forward to the next workshop!” commented Tuva Holt Hereng, Senior Manager R&D Cell Therapy at Thermo Fisher Scientific.

State-of-the-art facilities

The day before the workshop, project partners were given a tour of the SINTEF Labs in Trondheim.

“It was great to welcome both the CellFit team and the workshop participants in Trondheim! Being close to the SINTEF labs a facility tour was a nice way to show some of the infrastructure used for high-throughput process development for the CellFit project. We also got great speakers that showed us the forefront of T-cell therapy development, which was both inspiring and very impressive,” commented Hanne Haslene-Hox, PhD, Senior Research Scientist, SINTEF.

Hanne Haslene-Hox, PhD, Senior Research Scientist, SINTEF gave a tour of the SINTEF labs in Trondheim. Photo: Dave Tippett

Public-private collaboration

To improve therapeutic efficacy, increased collaboration between manufacturers (industries) and patient treatment centers (hospitals) is needed.

“Supporting the scientists and stakeholders in the CellFit Project will help to assure that we reach collective goals. Oslo Cancer Cluster supports this project by providing advisory and opportunities for dissemination of knowledge to the wider oncology ecosystem,” commented Charlotte Wu Homme, Head of Membership and Events, Oslo Cancer Cluster.

Else Marit Inderberg, PhD, Senior Scientist, Group Leader, Head of Immunomonitoring, Department of Oncology, Cellular Therapy, Oslo University Hospital and Charlotte Wu Homme, Head of Membership and Events, Oslo Cancer Cluster. Photo: Dave Tippett

About CellFIT

The primary aim for the CellFit project is to define optimal growth conditions for improved manufacturing of therapeutically active T cells. Established in 2021 and funded by The Research Council of Norway, the CellFit Project is a collaboration led by Oslo University Hospital, Department of Cellular Therapy. The project includes project partners Oslo Cancer Cluster, SINTEF, and Thermo Fisher Scientific.

For more information, please visit the CellFIT website.

The post CellFIT workshop in Trondheim first appeared on Oslo Cancer Cluster.

Professor Åslaug Helland, MD Ph.D. is the Principal Investigator of the NIPU clinical trial, which has demonstrated that malignant mesothelioma patients live longer when treated with the universal cancer vaccine UV1. Photo: Per Marius Didriksen, Oslo University Hospital

First demonstration of universal cancer vaccine

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New data shows 27% improved survival for malignant mesothelioma patients in the NIPU trial.

Positive results from the NIPU trial announced last night show the combination of a universal cancer vaccine and checkpoint inhibitors in patients with malignant mesothelioma reduces the risk of death by 27%.

“For patients with malignant mesothelioma, few treatment options are available after first-line chemotherapy. The NIPU study showed that patients receiving UV1 vaccination as add-on to nivolumab and ipilimumab experienced an increased objective response rate and a clinically meaningful prolonged survival. These encouraging results provide a foundation for advancing further clinical development with UV1 vaccination in mesothelioma patients,” said Principal Investigator of the NIPU clinical trial, Professor Åslaug Helland, MD Ph.D.

Åslaug Helland, Principal Investigator of the NIPU clinical trial. Photo: Per Marius Didriksen, Oslo University Hospital

The ‘gold standard’

This is the first demonstration of the efficacy and therapeutic impact of a universal cancer vaccine in a Phase II trial. The universal cancer vaccine is the lead product of the Norwegian biotech company Ultimovacs, which is developing novel immunotherapies against cancer. The vaccine is currently being tested in five Phase II trials on different cancer indications.

“We are thrilled to announce the highly advantageous results from the first randomized UV1 Phase II trial, marking a major milestone for Ultimovacs. Overall survival is the ‘gold standard’ in cancer treatment. We believe these data support further development in mesothelioma, and we are looking forward to discussing the results with the regulatory authorities,” said Carlos de Sousa, CEO of Ultimovacs.

Carlos de Sousa, CEO of Ultimovacs. Photo: Ultimovacs

Since malignant mesothelioma is a hard-to-treat cancer, the positive results from the NIPU trial give cause for optimism in the ongoing Ultimovacs’ trials for other cancer indications too, including malignant melanoma, head and neck cancer, ovarian cancer, and non-small cell lung cancer.

In October 2023, the FDA ranted Orphan Drug Designation for UV1 in the treatment of mesothelioma, but there is still a way to go before the drug reaches the market. The treatment has to be assessed in a Phase III trial and undergo regulatory approval before becoming widely available.

Improved survival and response rate

Oslo University Hospital leads the NIPU study with support from Ultimovacs and Bristol-Myers Squibb. It includes 118 patients from Norway, Sweden, Denmark, Spain and Australia. The patients are in second-line treatment, which means they already received chemotherapy without beneficial results and have no other treatment options.

The patients were divided into two randomized groups: 59 patients received the universal cancer vaccine in combination with checkpoint inhibitors, and the other group received only checkpoint inhibitors. Results show that patients who received the universal cancer vaccine had a prolonged survival rate and a significantly better objective response rate. This means the patients lived longer and more patients’ tumours shrunk than in the control arm. In addition, the treatment showed no added side effects.

“We want to extend our gratitude to the patients and their families, as well as the dedicated investigators and all our supporters whose invaluable contributions made this study possible,” Helland commented.

For more information, please read the press release from Ultimovacs or follow the company’s webcast on Mon, Oct 23 2023 at 14:30 (CET).

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