The panel discussion at our breakfast meeting 27 March 2019. From the left: Jan Frich, Anette Grøvan, Odd Terje Brustugun, Heidi Brorson, Tove Nakken and Markus Moe.

Giving patients a stronger voice

How can the voices of cancer patients be heard when evaluating new methods of treatment?

A breakfast seminar was held yesterday in the series called The Cancer Treatments of the Future. Over 150 people attended at Litteraturhuset in Oslo, among them were relevant key players from the healthcare sector, governmental agencies, patient organisations and the public. The aim was to identify new opportunities to improve patient involvement when evaluating new methods of treatment.

The seminar was jointly arranged by Oslo Cancer Cluster, Legemiddelindustrin (LMI) and The Norwegian Cancer Society. The sponsors of the event were Astra Zeneca, Janssen and MSD.

 

Anne Grethe Erlandsen

Anne Grethe Erlandsen, the State Secretary of the Norwegian Ministry of Health and Care Services.

Anne Grethe Erlandsen, the State Secretary of the Norwegian Ministry of Health and Care Services, first talked about creating a healthcare service with the patient as the starting point. She said that it is important to involve the patient in the decision-making processes to bring in new perspectives, ask questions and challenge the healthcare service.

“The patient is the most radical agent of change in the healthcare sector.”
Anne Grethe Erlandsen

 

Ellen Nilsen

Ellen Nilsen, Special Adviser at Nye Metoder.

Next, Ellen Nilsen, Special Adviser at Nye Metoder, which is the national system for managed introduction of new health technologies within the specialist health service in Norway. Nilsen gave a presentation of Nye Metoder and its processes.

 “Anyone, including patients, their relatives or patient organisations, can submit a proposal for a new method of treatment.” Ellen Nilsen

The proposal is then managed by the regional health authorities in The Commissioning Forum, which commissions a full Health Technology Assessment (HTA) from The Norwegian Medicines Agency. Anyone can submit input to The Commissioning Forum by e-mail or in a form on the website.

Decisions are then made by the regional health authorities in The Decision Forum, based upon the HTA. Patient organisations are also represented in a reference group that meets every six months. The patient representatives are only observers, but have the right to make verbal contributions.

  • Learn more about Nye Metoder by reading this presentation in English from their official website.

 

Health Technology Assessment (HTA) is the evaluation of a new method of treatment, often in comparison to existing treatments. The treatments are assessed according to a set of criteria: the severity of the disease, the utility of the treatment and its cost effectiveness.

 

Anette Grøvan, Senior Adviser at The Norwegian Medicines Agency.

Then, Anette Grøvan, Senior Adviser at The Norwegian Medicines Agency, presented how they are developing a pilot project to involve patients in their HTAs. They have sporadically received input from patients and patient organisations in the past, but they wish to implement a better system for it now.

“Satisfied patients are important to us. Everyone should have a voice, regardless of their diagnosis or disease.” Anette Grøvan

They believe the patients can contribute with their experiences of living with the disease, the quality of existing treatments and their expectations on new treatments.

 

 

A panel discussion, moderated by Markus Moe, the Editor-in-Chief of Dagens Medisin, was then held with the following participants:

  • Tove Nakken, Head of brukerutvalget* at Oslo University Hospital and Deputy Head in Lymfekreftforeningen (The Norwegian Lymphoma Society)
  • Heidi Brorson, member of brukerutvalget* at the South-Eastern Norway Regional Health Authority and Special Adviser in the Norwegian Cancer Society
  • Anette Grøvan, Senior Adviser at The Norwegian Medicines Agency
  • Jan Frich, Chief Medical Officer at the South-Eastern Norway Regional Health Authority and Senior Adviser in the Commissioning Forum
  • Odd Terje Brustugun, oncologist at Drammen Hospital

*”brukerutvalget” is a selected group of patient representatives that exists in each regional health authority

 

The topic of the panel discussion was how to improve patient involvement when evaluating and approving new methods of treatment.

 

Nakken first highlighted the lengthy processes in Norway: “Patients want to take part of the treatments that have been approved in our neighbouring countries. But the bureaucracy in Norway takes too long.”

Brustugun agreed that there is a gap between the treatments available in Norway and abroad, and that this is affecting an ever-growing patient population: “The patient’s perspective is important, because there is a large group of patients that can potentially become long-term survivors if given the new treatments.”

Frich said the overall cost of pharmaceuticals in Norway has actually increased over the years, mostly due to new and expensive cancer therapies. He explained they are legally obliged by Stortinget to evaluate new methods according to a specific set of criteria. The reason that a treatment isn’t approved may be that the effect of it has not been documented well enough.

Brorson called for greater transparency in the decision-making processes: “If there was more openness about the decision-making, the patients would have a greater understanding for it and become better informed.”

Grøvan added: “We are not finished developing the system for patient involvement and there are a lot of considerations to make sure that it becomes structured and fair.”

 

The engaging panel discussion inspired the audience to make their own comments and reflections.

 

Looking forward

The fruitful discussion led to many constructive ideas on how to improve patient involvement. Hopefully, these kinds of collaborative discussions can inform politicians to take the necessary steps forward to improve cancer patients’ lives.

Oslo Cancer Cluster wants to thank the speakers, the sponsors, the organisers and everyone who attended! This discussion will continue at Arendalsuken 2019, at our event August 15. We hope to see you there!

 

  • Here is a summary of the event, written in Norwegian, from LMI’s official website.
Arctic Pharma, a member of Oslo Cancer Cluster, gave students a lecture on the chemistry behind cancer treatments.

Chemistry with mutual benefits

Students were taught about the chemistry behind developing cancer treatments in the Oslo Cancer Cluster Incubator.

In February, forty chemistry students were given a memorable specialisation day on the subject of the chemistry behind developing cancer treatments. The company Arctic Pharma in Oslo Cancer Cluster Incubator invited them to the lab and gave a long and detailed lecture on the chemistry behind the medication they are developing to treat cancer.

Karl J. Bonney, who is a researcher in the company, started the day with an interactive lecture in English about the chemistry of the substance Arctic Pharma hopes will be effective against cancer.

Bonney emphasised to the students that the company is in the early stages of the development, and that it will take approximately three to four years before they are potentially able to start clinical trials on humans to see whether the substance is effective.

The pupils who are studying chemistry as their specialisation in the last year of upper secondary school were obviously fascinated by what they heard. They asked many important questions both to the lecturer, Bonney, and the chemistry teacher, Karsten, who participated to explain the most difficult terms in Norwegian.

 

Sugar-hungry cancer cells
Arctic Pharma is exploiting a well-known biological fact regarding cancer cells, namely that they like sugar, which means they have a sweet tooth. This is called the Warburg effect, and, so far, nobody has used it in the treatment of cancer. Since this is such a characteristic aspect of cancer cells, it would make sense to think that this could be a viable starting point for treatment.

Arctic Pharma is one of the smaller companies in Oslo Cancer Cluster Incubator and is co-located with Ullern Upper Secondary School. Bonney has been permitted to use the school’s chemistry lab to test the chemical substance being developed to attack the Warburg effect.

The chemistry day at the company was organised to return the favour and to inspire the young chemistry students to keep studying chemistry at a university or university college.

 

 

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Raphael Lømo from Kuehne + Nagel gave a presentation at Oslo Cancer Cluster's Christmas gathering in 2018. Photo: Fullscreen Visuals

Why a logistics company joined the cluster

Raphael Lømo, Foto: Fullscreen Visuals

Kuehne + Nagel joined Oslo Cancer Cluster last year. Why did a logistics company join a cluster dedicated to cancer treatment?

Kuehne + Nagel is one of the world’s leading logistics providers, and pharmaceuticals are certainly a category of product that requires special care when moved between locations.

This is an interview with Raphael Lømo, the National Manager for Pharma & Healthcare Development Logistics for Kuehne + Nagel in Norway.

“Why did you join a cluster dedicated to cancer treatment?”

“Being one of the leading logistics companies in the pharmaceutical and healthcare industry, we realized that a membership in Oslo Cancer Cluster is beneficial for both the other members and us. The members get access to an international good distribution practice (GDP)-compliant pharmaceutical logistics network and professional support within the pharmaceutical supply chain. At the same time, Kuehne + Nagel gets linked to the currently leading and possible future players in the oncology field, which will help us to increase our understanding and to proactively try to design solutions for the members in this industry. Members can focus on their core competences which is in the R&D field while we offer to take care of the distribution challenges, which is our core competence. Kuehne + Nagel’s membership linked our industries and completed your oncology value chain.”

We are also very interested in working with start-up companies which are supported by Oslo Cancer Cluster Incubator. It is inspiring to be involved in interesting and innovative projects and at the same time it helps us to keep the finger on the pulse of the pharmaceutical industry. It would not be the first time that we successfully accompanied a start-up by offering pharmaceutical specific supply chain counselling and consulting services.”

Last but not least, it feels really good to contribute to improve the lives of often very sick cancer patients, which we have been doing for many years in the prostate cancer field. We can identify ourselves with your vision to help patients by accelerating the development of cancer treatments.” Raphael Lømo

“What does logistics innovation have to do with cancer medicine?”

“Well, based on our experience, cancer medicines are often extremely urgent, temperature sensitive and sometimes even classified as dangerous goods shipments, e.g. radioactive. This combination makes it quite challenging to design safe solutions and both visibility, risk control, and reliable handling are the most important factors to protect the integrity of cancer medicines. We constantly work on innovative solutions to improve the level of control of these factors, such as new IT systems and Internet of Things (IoT) real-time tracking devices. ”

Part of Kuehne + Nagel’s solution for safe logistics. Photo: Kuehne + Nagel

Part of Kuehne + Nagel’s solution for safe logistics. Photo: Kuehne + Nagel

“I understand that there are some “pharma shipment enemies” in the logistics industry: Temperature, time, handling and dangerous goods. What is your solution to these challenges in shipping pharmaceuticals?”

“Most importantly, you need a reliable logistics partner which understands the full scope of GDP and the challenges of shipping pharmaceuticals globally. Due to our close relationship to all major airlines, ground handlings agents, and trucking companies, in extreme cases we can customize solutions for very sensitive shipments. Such solutions will be complimented with state of the art tracking technology which transmits both location and other relevant data in real-time to KN Login, our data and IT solution that provides visibility and control of your shipment. There you can follow your shipments 24/7/365. Moreover, a team of trained pharmaceutical logistics specialists can monitor your shipment and provide status updates if required. In case of any deviation of the shipment plan, this global service desk can proactively take action to get your shipment back on track. Our award winning KN PharmaChain solution is the basis for every challenge in the pharmaceutical supply chain industry.”

“We have a vast database that includes the most important information and capabilities of major airlines and ground handling agents at the most important airports around the world. This is a unique database and provides very valuable information in order to plan shipments and conduct Lane Risk Assessments. As an example, with one click we know the capacity for storing pharmaceuticals at certain temperature ranges at warehouses of different airlines and airports all over the world. This tool helps us to analyses shipment processes and mitigate potential risks.”

“Do you have any advice to companies looking to send fragile drugs or other pharmaceuticals?” 

“Look for a reliable and experienced logistics partner with a global “owned” network which fully understands the requirements of shipping fragile pharmaceuticals but also follows the Good Distribution Practice (GDP), not only in Norway but globally. We highly recommend to conduct a GDP audit before working with a potential logistics partner. Norwegian logistics companies are not audited by the Norwegian Medicines Authorities and often do not understand and follow the full scope of the GDP guideline. Keep in mind that it is in the responsibility of the pharmaceutical company and not the logistics company that the products are transported under GDP compliant conditions.”

 

About the company
Kuehne+Nagel is listed on the Swiss stock exchange, but the majority is still owned by Mr. Klaus-Michael Kuehne.

Since 1890, when the business was founded in Bremen, Germany, by August Kuehne and Friedrich Nagel, Kuehne + Nagel has grown into one of the world’s leading logistics providers.

Today, the Kuehne + Nagel Group has some 1,300 offices in over 100 countries, with around 79,000 employees.

The company specialises in seafreight, airfreight, contract logistics and overland businesses, with a clear focus on high value-added segments such as IT-based integrated logistics solutions.

KN PharmaChain is Kuehne+Nagel’s supply chain innovation for pharmaceutical and healthcare shipments.

The panel discussion during Cancer Crosslinks 2019 was about the need to implement precision diagnostic methods in Norwegian health care. In the panel from the left: Kristin Vinje, Vice-Dean at the Faculty of Mathematics and Natural Sciences, University of Oslo, Bjørn Tore Gjertsen (hidden in picture), Professor at Haukeland University Hospital and University of Bergen, Hege G. Russnes, Senior Consultant and Researcher at Oslo University Hospital, Ola Myklebost, Professor at University of Bergen and Christian Kersten, Senior Consultant at Center for Cancer Treatment, Sørlandet Hospital. All photos: Fullscreen Visuals

Getting genomics into healthcare: look to the UK

Discussing health care at Cancer Crosslinks 2019

During Cancer Crosslinks 2019, one thing was crystal clear: there is a need to include broader genomic testing into treatments for cancer patients in Norway.

“We are lacking behind here in Norway!”

Professor Ola Myklebost, from the Department of Clinical Science at the University of Bergen, was definitely ready for action in the panel debate at Cancer Crosslinks 2019, fittingly named “Call for Action”.

The panel and the audience of about 300 people had just listened to the talk given by James Peach. He is the Precision Medicine Lead at UK Medicines Discovery Catapult, Alderly Park, and prior to this, he was the Managing Director at the main programme for Genomics England from 2013 to 2017 and led the UK’s Stratified Medicines Program.

Peach told the audience how they have been implementing precision medicine into the public health care system (NHS) in the UK, using genomic testing, during the last decade. He demonstrated how the industry is part of this public endeavour, how political support and investment contributed to industry development, and how they addressed complex issues like sharing health data and using artificial intelligence.

It started with very little.

“In 2010, we had no structure”, Peach told the audience.

James Peach presenting at Cancer Crosslinks 2019

Sequencing 100,000 genomes
Thanks to all the British cancer patients who consented to Genomics England using their data, and a lot of common public-private efforts, Genomics England has now reached its goal of sequencing 100,000 whole genomes from NHS patients, according to their webpage. It takes a lot to accomplish this number, but luckily there are things to learn from the UK effort.

“Circulating tumour DNA testing is absolutely necessary”, Peach said from the podium.

The Life Science Sector deal from the British government outlines this public-private effort. It shows how significant government commitment, funding and strategic actions triggered investment and initiatives from the life science industry. You can read the entire document at the official webpage of the British Department of Business, Energy and Industrial Strategy, following this link.

James Peach visited Norway earlier as a speaker at Cancer Crosslinks 2012. Returning now, he was truly surprised about the current state of precision medicine in Norway.

Concerned about Norway
In an interview with Oslo Cancer Cluster, James Peach shared a concern as an answer to the question “What impressions are you left with after this conference?” 

“It has left me quite concerned about the state of precision medicine in Norway. I thought you would be looking forward to the things you could do, but it turns out that there are actually some things that you should have done already.”

“Like what things?” 

“Like universal application of a cancer panel test that is commercially feasible and deals around getting your data shared appropriately.”

Do you think we can have a Genomics Norway?”

“Of course. It is probably about combining two things. One is that you got to get the basic stuff right. People need to have access to gene tests for their clinical care. Luckily the people here are a group of experts who are all connected to each other and who understand the system. It is not a massive system. I think there is a real chance to choose an area where Norway could do it exceptionally well. What that area is, is for you to choose.”

Concerns in Norway
Back in the panel discussion, Hege G. Russnes, Pathologist, Senior Consultant and Researcher at Oslo University Hospital, was getting involved:

“We need more information to help clinicians make therapy decisions. (…) Norway has no plan or recommendation for multi gene tests.”

Christian Kersten, Senior Consultant at the Center for Cancer Treatment at Sørlandet Hospital, agreed.

“I’m the clinician, I treat patients, patients die because of metastasis. I have been treating cancer patients for 20 years now and I feel it increasingly difficult to keep the trust of the patient.”

“If you ask the patients, they will sign the papers with consent of sharing data in 99% of the cases”, Myklebost added.

“We are only 5 million, we do not have to reinvent the wheel. Erna Solberg should invite James Peach for a cup of tea”, Christian Kersten said, finishing up the panel talk.

 

The entire panel debate is available to watch at the webcast webpage:

WATCH THE PANEL DEBATE

 

More on UK Medicines Discovery Catapult 

Did this brief article make you interested in the work that James Peach and UK Medicines Discovery Catapult does? In this short video, Peach explains the challenges with access to health data for drug discovery and how to overcome them:

 

More from Cancer Crosslinks 

We have more from Cancer Crosslinks 2019 coming up. Stay tuned and subscribe to our newsletter, and you will not miss videos of the talks and interviews with the other distinguished speakers at the conference.

NOME is based on the mentoring principals of MIT’s Venture Mentoring Service. The fundamental principle is to connect first time entrepreneurs with a team of three to four experienced and skilled mentors to help them reach their goals and technology milestones. Photo: Accelerace

Why a Nordic mentor network is a good idea 

Participants discussing at NOME mentor network.

The Nordic Mentor Network of Entrepreneurship (NOME) is the first pan-Nordic mentor network for lifescience start-ups. Why is it a good idea for start-ups working in cancer?

Bjørn Klem has an answer. He is the General Manager of Oslo Cancer Cluster Incubator and point of contact for start-ups within the cancer field in Norway.

“Start-ups working in cancer need to access commercialisation expertise and investor networks. When looking for this, it is an advantage to seek in other Nordic countries where investors are experienced with cancer and biotech in general. Participating in NOME will also take you into their global network.” Bjørn Klem

Connecting with a mentor team
NOME is based on the mentoring principals of MIT’s Venture Mentoring Service. The fundamental principle is to connect first time entrepreneurs with a team of three to four experienced and skilled mentors to help them reach their goals and technology milestones. 

From Boston to the Nordics, this is the first mentor network within life sciences that spans across all the Nordic countries. 

In Norway, Oslo Cancer Cluster Incubator og the health incubator Aleap are coordinating start-ups with suitable mentors.

“Team mentorship, where mentees have a group of mentors, rather than single one-on-one mentorship, encourages more diverse thinking, cross-disciplinary approaches to ideas and problem solving, and it allows the access to professionals from different fields.”  NOME Magazine Issue 1 2018

Norwegian mentors and start-ups
One of the Norwegian NOME mentors is Kari Grønås. She has extensive experience in drug development and commercialisation within the pharmaceutical industry.

You can listen to her (in Norwegian) in this video that was made by Oslo Cancer Cluster Incubator as the programme was just starting in Norway in 2017.

One of the Oslo Cancer Cluster members that have taken advantage of the NOME opportunity and mentors, is Nacamed.

Nacamed is a Norwegian spin-off company of Dynatec AS. The Nacamed technology is based on 10 years of research on silicon done by Dynatec engineering. According to the company webpage, this enables a production that can tailor particles with the desired physical attributes. With this, Nacamed aims to create a new generation of treatment methods.

Best in class-network 
This video, made by Accelerate, explains the concept of NOME and the value it adds to the Nordic startup ecosystem.

The mentors are volunteering to share their knowledge and experience with new entrepreneurs within fields such as digital health, immuno-oncology and AI in healthcare. NOME mentors can give unbiased advice, provide strategic guidance, open their network and possible collaboration partners, as well as assisting in reaching key milestones.

The start-ups have to be best in class too. The local NOME partners evaluate the companies on the novelty of the science or technology, their high commercial potential as well as the strength and commitment of the founding team. Furthermore, strong IP or alternative protection strategies, market differentiation, and the impact NOME potentially can have on the company’s development are also taken into consideration.

Participation is free of charge and funded by the Novo Nordisk Foundation.

Infographic from NOME magazine.

Source: The NOME Magazine, Issue 01, 2018

20 Start-ups since 2016
Since 2016, 20 start-ups have joined NOME and of these two have graduated from the program. Graduation usually means the start-up has successfully raised funds for the coming few years and has engaged a formal board and therefore has less need for the NOME mentors.

The mentors either move on to work with other emerging companies or have been so excited about the potential of the company they have been working with that they have taken a seat on the board.

By the end of 2018, NOME had 50 mentors and 18 enrolled start-ups.

Mentors in immuno-oncology
In the NOME Magazine first edition, released in October, Carl Borrebaeck, professor at Department of Immuno-technology at Lund University in Sweden, is interviewed about his field of expertise, immuno-oncology and creating companies from his research. Borrebaeck is a founding mentor in NOME and has been part of the network for the past two years. 

“People tend to think, that innovation just happens and that it will reach patients without any commercial drive. That is simply untrue.” Prof. Carl Borrebaeck 

He continues to explain what is really needed to make health innovations happen:

“A combination of companies and academia is needed. Big pharma is always looking for the newest discoveries and ways they can collaborate in order to stay at the forefront of innovative research. The Nordics are highly innovative and they have a strong reputation globally. However, there are too few big pharma companies commercializing the science at the very early stages. This is often a major challenge for emerging companies who then have to seek funding not only in the Nordics but across Europe and the US to cover this funding gap.”

Mentors in artificial intelligence
NOME has mentors in several interesting life science fields. Lars Staal Wegner, the CEO of Evaxion Biotech, is another mentor. He started a company dedicated to using artificial intelligence, supercomputers, and big data to fight cancer and infectious diseases. In the NOME Magazine Wegner says: 

“It is no longer the pharma industry or the companies producing the off-the-shelf drugs. It is the ones who own the data and know how to convert it to effect, the cloud-based giants that are half life science half tech. This is maybe 30-40 years into the future, but it is important already now to know that the tech evolution is not linear. It is exponential. We have reached an inflection point in tech. The industry doesn’t have five or ten years to toe the line. It is exploding.” 

Artificial intelligence and machine learning are expected to have an unprecedented impact on how drugs are developed, their cost, and time to market, according to Wegner. 

Nordic partnership
NOME is operated by Accelerace and funded by the Novo Nordisk Foundation. The initiative is represented in the Nordic region through partnerships in Sweden, Norway and Finland. In Norway, Oslo Cancer Cluster Incubator og the health incubator Aleap are coordinating start-ups with suitable mentors.

In the US, the California Life Sciences Institute (CLSI) is a new partner for NOME. In fact it is too new to have entered the overview below. CLSI is a non-profit organization which supports entrepreneurship, STEM education and workforce development for the life science industry in California. It is located in the San Francisco Bay Area.

Infographic from NOME magazine.

Source: The NOME Magazine, Issue 01, 2018

Aaron M. Goodman, MD, speaks at Cancer Crosslinks 2019 about his research from UC San Diego Health.

Cancer Crosslinks LIVE streaming

Presenter at Cancer Crosslinks 2019.

Today, Thursday 17 January, we broadcast LIVE from our conference Cancer Crosslinks at Oslo Cancer Cluster Innovation Park.

Please join us and hear from a distinguished panel of international and Norwegian experts as they discuss the Next Wave of Precision Oncology, share new perspectives, and address the challenges and opportunities ahead. The subtitle of this year’s 11th Cancer Crosslinks is “Next Wave Precision Oncology – Connecting the Dots for Improved Patient Care”.

The broadcast starts at 9 AM and last until the conference ends at about 4 PM. Please follow the link to watch LIVE:

LIVESTREAM HERE

 

If you would like to know more about the international speakers at Cancer Crosslinks 2019, please read this article.

New research from the immunomonitoring unit of the Department of Cellular Therapy at Oslo University Hospital is now available in a video and an article in the the Journal of Visualized Experiments, Jove. Photo: Christopher Olssøn.

New research: 3D structure tumors in immunotherapy

Researcher testing lab sample.

New work from cancer researchers at the Department of Cellular Therapy could help to streamline the development of exciting new immunotherapy approaches for treating cancer.

Cancer treatments that aim to switch on a patient’s immune system to kill tumor cells – so-called immunotherapy approaches – have received much attention and encouraging results in recent years. Now, the immunomonitoring unit of the Department of Cellular Therapy at Oslo University Hospital has devised a new experimental approach that could improve early stages of the immunotherapy development pipeline.

The unit is present in Oslo Cancer Cluster Incubator with a translational research lab, led by Drs. Else Marit Inderberg and Sébastien Wälchli.

Researchers in laboratory.

Dr. Sébastien Wälchli and colleagues in the translational research lab in Oslo Cancer Cluster Incubator. Photo: Christopher Olssøn

CAR T cells drive new successes
Our immune systems are generally very good at recognizing foreign infectious agents and disposing of them appropriately. However, although our immune systems are capable of recognizing tumors as a threat, cancer cells have adapted mechanisms that enable them to evade the immune response. Immunotherapy is the name given to a range of different approaches that aim to overcome this problem by improving the immune system’s ability to target cancer cells.

One relatively new example of an immunotherapy approach comes from CAR T cells. These are produced by isolating specific cells of the immune system (T cells) from a cancer patient and modifying them so that they become more effective at recognizing and killing cancer cells. The modified T cells are then placed back into the patient so that they can ‘home in’ on the tumor and kill the cancer cells.

Read about related research: T-cells and the Nobel Price

Difficult for solid cancers
Current models for testing new CAR T cells aren’t always optimal. Although CAR T cells have shown encouraging results in treating some cancers, particularly the blood cancers leukemia and lymphoma, the development of CAR T cells for non-blood, or ‘solid’, cancers has been more difficult.

In part, this is due to the fact that tumor models currently used in early stages of testing involve two-dimensional monolayers of cancer cells, which do not reflect the complex three-dimensional structure and organization of solid tumors found in patients.

Consequently, CAR T cells that show encouraging results using these two-dimensional models often produce less effective results at later stages of the development pipeline, meaning time, effort and resources are wasted.

3D tumor spheroids
To improve the early stages of testing new CAR T cells, Dr. Wälchli’s group has developed a new approach that enables researchers to grow three-dimensional cancer cell structures, or ‘spheroids’, in the lab, and to test the effect that CAR T cells have on killing off these spheroids.

Compared to current two-dimensional methods, the spheroids are more similar in complexity and structure to tumors found in patients.

In a recent publication in the Journal of Visualized Experiments, this group demonstrated for the first time that their spheroid approach has the potential to provide a useful new tool for developing CAR T cells.

They generated spheroids using colorectal cancer cells – a type of cancer for which there is currently no effective CAR T cell therapy available. These cancer cells were modified so that they possessed a molecule on their cell surface called CD19, which is known to be recognized by certain CAR T cells. The researchers then incubated these spheroids with CD19-targeting CAR T cells and used advanced live imaging techniques to track the effect on cancer spheroids.

To help other research groups who would like to start using the spheroid technique, Dr. Wälchli’s publication is accompanied by this video which introduces the approach and provides a basic overview of how it works. The Journal of Visualized Experiments requires a subscription to see the entire video. You can also read a PDF of the article “A Spheroid Killing Assay by CAR T Cells” without a subscription.

Successful approach
As expected, shortly after adding CAR T cells, the researchers could detect that spheroids were shrinking due to cancer cell death, proving that their approach successfully measures CAR T cell-induced tumor clearance in a quantitative manner.

Discussing the work, Dr. Wälchli says, “We believe this method can help to answer key questions about using 3D structure tumors as a suitable alternative for testing new immunotherapy approaches.”

The approach now opens the door for testing a range of different target molecules in combination with new CAR T cells targeting those molecules.

Fast, affordable and straightforward
Dr. Wälchli believes many researchers could benefit from the spheroid technique. He continues,

“A major advantage to our approach is that it is fast, affordable and straightforward, meaning any research group with the right equipment can test the effect of their immunotherapy on 3D tumors before moving to animal models”.

From the left: Professor Naiyer Rizvi, Dr. Marco Gerlinger and Dr. Aaron Goodman. Photos: Columbia University Medical Center / ICR / UC San Diego Health

International speakers at Cancer Crosslinks

International speakers at Cancer Crosslinks 2019

How can research help implement the next wave of precision oncology for patients? Meet the experts behind the research.

 

These leading international experts are part of the programme at Oslo Cancer Cluster Innovation Park, 17 January.
Not signed up for the 11thCancer Crosslinks yet? Join in here!

 

Professor Naiyer Rizvi is an internationally recognized leader in the treatment of lung cancer and immunotherapy drug development. He is the director of both thoracic oncology and of immunotherapeutics for the division of haematology and oncology at Columbia University Medical Center, Herbert Irving Comprehensive Cancer Center, New York, USA.

Prior to joining Columbia University Medical Center, his clinical research at Memorial Sloan Kettering Cancer played a significant role in the FDA approval path of a new class of immunotherapies, called immune checkpoint inhibitors, for melanoma and lung cancer.

Rizvi studies mechanisms of sensitivity and resistance to immunotherapy. Through genetic testing of tumours, he has been able to improve the understanding of why immune checkpoint inhibitors work in certain patients.

Rizvi is also studying why certain cancers do not respond to immune checkpoint inhibitors. This way we can find better ways to harness the immune system to attack cancer cells.

He oversees phase 1 immunotherapy research in solid tumours at Columbia University Medical Center and is conducting key clinical studies of novel immunotherapy drugs and immunotherapy combinations to help more patients in the fight against cancer.

Professor Naiyer Rizvi

During Cancer Crosslinks, Professor Rizvi will give the opening keynote speech titled: “Sensitivity and resistance to immuno-oncology: Biological insights and their translation into precision treatment”.

 

Dr. Aaron Goodman, MD, is a haematologist and medical oncologist specialized in treating a variety of blood cancers, including acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL) and multiple myeloma. He holds a position as Assistant Professor of Medicine at the Moores Cancer Center at UC San Diego Health in La Jolla, California.

Dr. Goodman performs stem cell transplants for cancer treatment. He also treats people with rare haematologic disorders using experimental therapeutics.

His research interests include immunotherapy and cellular therapy treatment for haematologic malignancies and identifying biomarkers for response to immunotherapy.

Dr. Aaron Goodman

During Cancer Crosslinks, Dr. Aaron Goodman will present and discuss the clinical aspects of tumour mutational burden and other tissue agnostic biomarkers for cancer immunotherapy.

 

Dr. Randy F. Sweis is an Assistant Professor in the haematology/oncology section at the University of Chicago. He works with cancer immunology, developmental therapeutics and biomarkers, with a clinical interest in phase 1 clinical trials and genitourinary malignancies. His laboratory research involves the identification and targeting of tumour-intrinsic immunotherapy resistance pathways.

Dr. Sweis is the recipient of numerous awards. In 2017, he was elected to co-lead TimIOs, an international project aimed at tackling tumor heterogeneity to enhance immunotherapy responses supported by the Society for Immunotherapy of Cancer (SITC).

Dr. Randy F. Sweis

During Cancer Crosslinks, Dr. Randy F. Sweis presents his work on immunophenotypes: The T cell-inflamed tumour microenvironment as a biomarker and its clinical implications.

 

Dr. Marco Gerlinger is a clinician scientist at the Center for Evolution and Cancer at the Institute of Cancer Research in London. He develops novel techniques to detect and track intra-tumour heterogeneity in solid tumours to define evolutionary plasticity and common evolutionary trajectories in cancers.

Dr. Gerlinger uses genomics technologies for treatment personalization. He treats patients with gastrointestinal cancers at The Royal Marsden NHS Foundation Trust.

One of the key aims of his work is to develop strategies to improve predictive and prognostic biomarker performance and the efficacy of drug therapy in heterogeneous cancers.

He contributes to The Darwin Cancer Blog– on mutational evolution of cancer.

Dr. Marco Gerlinger

During Cancer Crosslinks, Dr. Marco Gerlinger will share the latest insights into cancer evolution and discuss the limits of predictability in precision cancer medicine. 

 

Professor Dr. med. Lars Bullinger is Professor of Hematology and Oncology and Medical Director of the Department of Hematology, Oncology and Tumor Immunology at Charité University Medicine Berlin.

He is a partner in the Innovative Medicines Initiative project HARMONY (Healthcare alliance for resourceful medicines offensive against neoplasms in haematology) aiming to use big data to deliver information that will help to improve the care of patients with haematologic cancers.

In this video from June, you get a preview of the subject he will talk about at Cancer Crosslinks: 

During Cancer Crosslinks, Dr. Lars Bullinger will give an international keynote speech about haematological cancers, emerging treatment opportunities and the impact of big data. 

 

James Peach is the Precision Medicine Lead at UK Medicines Discovery Catapult, Alderly Park, UK. Prior to this role, he was the Managing Director at the main programme for Genomics England from 2013 to 2017.

Peach is a precision medicine strategist and operational leader with investment, commercial and public sector experience across cancer, rare diseases, and genetics. James Peach gave the opening keynote at Cancer Crosslinks 2012 – at that time as the Director for Stratified Medicine at Cancer Research UK, London.

In this video James Peach explains the challenges with access to health data for drug discovery and how to overcome them:

During Cancer Crosslinks, James Peach will present his perspectives on the implementation of precision medicine in the UK and discuss the status, lessons learned and the way forward. 

 

Not signed up for Cancer Crosslinks yet? Join in here!

 

 

Dr. Richard Stratford and Trevor Clancy in OncoImmunity are happy about getting prestigious financing through EUs SME Instrument in December 2018. Photo: Oslo Cancer Cluster

Machine-learning for immunotherapy

Photo of Richard Stratford and Trevor Clancy in OncoImmunity.

A prestigious EU-grant will advance OncoImmunity’s machine-learning approach to develop personalized cancer immunotherapy.

The bioinformatics company OncoImmunity AS is empowering cancer immunotherapy with artificial intelligence. They use innovative software solutions to guide the discovery of neoantigen-based personalized immunotherapies and biomarkers. What does this really mean?

It means that the software they have developed helps to identify neoantigens, also known as immunogenic mutations, in a patient’s cancer cells. Cancer cells deceive the immune system by looking like healthy cells. But they still express cancer-specific markers, known as neoantigens. (See facts box for explanation.)

Enables personalized medicine
The interesting part about neoanitgens, is that every patient’s tumor expresses a unique combination. This enables truly personalized medicine to be applied, if the correct neoantigens are selected from the thousands of possible candidates in the genome of a tumor. Researchers using this technology can now solve this “needle in the haystack” challenge by analyzing a tumor genome to figure out the right cocktail of neoantigens, for each individual patient, and design a specific vaccine or cell therapy uniquely designed just for them.

Such personalzed immunotherapy can for instance boost the immune system’s response by making the immune system better able to recognize and target the patient’s unique cancer cells.

Faster bespoke treatment
OncoImmunity’s flagship software, the ImmuneProfiler™,is a unique machine learning solution that makes it easier to instantaneously see and accurately select which neoantigens will be responsive in each patient.

It thereby helps biotech companies design neoantigen-based personalized cancer vaccines and cell therapies and enables bespoke treatments to be developed faster. Additionally, the technology allows clinical researchers to select which patients will likely respond to the wide range of cancer immunotherapies currently under development in the field.

In that sense, the OncoImmunity-approach to cancer treatment is exactly in line with Oslo Cancer Cluster’s main goal: to speed up the development of new cancer treatments for the benefit of cancer patients.

Prestigious EU-grant
Horizon 2020’s SME Instrument is a grant that is tailored for small and medium sized enterprises (SMEs). It targets innovative businesses with international ambitions — such as OncoImmunity.

The SME Instrument has two application phases. Phase one awards the winning company 50 000 Euros based on an innovative project idea. Phase two is the actual implementation of the main project. In this phase, the applicant may receive between 1 and 2,5 million Euros.

Oncoimmunity won the phase one project last year. Then, the founders of the bioinformatics company were happy about the opportunity to refine and optimize their machine-learning framework. Their goal has always been to facilitate personalized cancer vaccine design.

Fantastic funding
Now, they have won a considerably larger grant of 2,2 Million Euros that they are going to use to fund a project titled Machine-learning Engine for the Design of personalized Vaccines in Cancer (MEDIVAC).

The SME Instrument grant provides OncoImmunity the opportunity to further customise their machine-learning framework, called the ImmuneProfiler™,for specific vaccine platforms, facilitating the design of safer and more efficacious personalised cancer vaccines.

— We applied for the SME instrument grant as it represents a fantastic funding vehicle for cutting edge, innovative projects with huge commercial potential. The call matched our ambition to position OncoImmunity as the leading supplier of neoantigen identification software in the personalised cancer vaccine market, says Dr. Richard Stratford, Chief Executive Officer and Co-founder of OncoImmunity.

— This opportunity will also help us establish the requisite quality assurance systems, certifications, and clinical validation with our partners, to get our software approved as a medical device in both the EU and US, says Dr. Trevor Clancy, Chief Scientific Officer and Co-founder of OncoImmunity.

SMEs can apply
The SME Instrument is looking for high growth- and highly innovative SMEs with global ambitions. They are developing innovative technologies that have the potential to disrupt the established value networks and existing markets.

Companies applying for the SME Instrument must meet the requirements set by the programme. Please see the SME Instrument website for more information in English or the SME Instrument webpage of Innovation Norway for more information in Norwegian.

Curious about which companies have received the SME Instrument so far? Have look at this database with an overview of all the grant receiving companies in Europe.

Want to know which Norwegian companies received grants from The European Unions research programme Horizon2020 in 2018? Read this article from Innovation Norway (in Norwegian).

Oslo Cancer Cluster  supports members via the EU Advisor Program in collaboration with Innovayt, making them aware of relevant EU- and H2020 funding opportunities and helping them to identify the right calls for their development phase and goals. Oslo Cancer Cluster also assists with partner searches using national and international networks and provides direct support during the grant writing and submission process.

 

 — We want to use Norwegian spearhead technology to combat cancer, Per Håvard Kleven said during his pitch at the DNB Nordic Healthcare Conference 12 December 2018. 

Industrial precision against cancer 

The start-up company Kongsberg Beam Technology wants to direct the precision technology from smart missiles to hit tumours in the human body. — We want to use Norwegian spearhead technology to combat cancer, Per Håvard Kleven said during his pitch at the DNB Nordic Healthcare Conference 11 December 2018. 

Kongsberg Beam Technology wants to direct the precision technology from advanced industrial control systems to hit tumors in the human body.

— We want to use Norwegian spearhead technology to combat cancer, Per Håvard Kleven said from the stage as he pitched the idea of his start-up at the DNB Nordic Healthcare Conference 2018.

He is the founder of the start-up company Kongsberg Beam Technology AS. As he wrote the patent application for the technology behind this start-up, he was far from the only one to explore this field. Nevertheless, the patent was granted earlier this year (2018). He was ahead of companies like Siemens and other giants.

— There is a lot of research going into radiation and all of it is focusing on increased precision, but no one is attacking the problem as fundamentally as we are.

Precision proton radiation
The method in question is proton radiation. This kind of radiation is directed towards a tumour and radiates far more precisely than x-ray radiation, the standard radiotherapy that hospitals currently use to treat cancer.

Proton radiation requires special machines. There are currently only 85 of these machines, known as proton  therapy synchrocyclotrones, in the world. Norway awaits its first proton synchrocyclotron in a couple of years. The existence of such a machine in Norway is a precondition for the business plan of Kongsberg Beam Technology.

This is one of the few proton therapy machines in use in the world today. It is the proton therapy synchrocyclotron in the Jacobson Building at the Mayo Clinic in Rochester, Minnesota, USA. Photo: Jonathunder/ Wikimedia Commons

The ambition of Kleven and his new board of directors is to let proton radiation follow the movements of the tumour, meaning the smallest movements of the patient as she breathes. This does not seem like much, but there is actually a lot of movement in for instance the lungs. And with vital organs closely linked to the lungs, such as the heart and the spine, it is extremely important to have a precise beam.

There is in deed a need for more precision in radiation therapy.

— The radiation that the hospitals use to treat cancer today is not precise. Healthy tissue is always damaged with radiation and this is a problem which we are attacking.

Norwegian spearhead technology
The system in question is to figure out exactly where the tumour is situated in the body, how it moves and how much radioactive energy it takes to radiate it properly.

He wants to take the principals and methods currently used in precision industries such as defence, space and oil- and gas, and apply these to radiation in cancer treatments. The aim is to obtain industrial precision to avoid damaging any healthy tissue.

Aims to develop a solution
The mechanical part of the system makes it possible to do online tracking of the cancer and synchronise the beam so that it always hits exactly on the cancer. This might not sound like it should be too difficult, but indeed it is.

— We cannot control a beam of particles with the agility and precision that is required today, but these functions will develop. We aim to develop them!

– In five years, when our project makes proton radiation reach its potential for industrial precision, my assumption is that proton radiation will take a much higher share of radio therapy in cancer treatment and that the number of proton centres will increase steeply.

According to Kleven, the testing will start soon, followed by prototyping and further testing and qualification. The goal is to have a working system by mid 2024. Kleven assumes that the future product can be installed as an add-on to exciting proton therapy synchrocyclotrones.

— Testing and remaining R&D will start as soon as the needed capital is in place, he said.

Needs more funding
The financing for the start-up so far is covered by Buskerud county, Innovation Norway, Oslofjordfondet and the Research Council of Norway. Kongsberg Beam Technology needs 93 million NOK initially, to test, develop and qualify the technology. 60 million of this sum should come from investors.

Kleven shows an estimate of a one billion NOK turn-over after a few years, in a profitable company with growth possibilities.

The new business is going to be established in Kongsberg in Norway, a town that is already well established as a hub for spin offs of the Norwegian defence industry. Kleven himself has a lifetime of experience from this sector, since he started to work in Kongsberg Weapons Factory (Kongsberg Våpenfabrikk) in 1975.