Photo: Dave Tippett / Oslo Cancer Cluster

Norwegian symposium highlights molecular testing

Attendants from across Norway, the Nordics and the world discussed how molecular tests can realise precision cancer medicine in the clinic, through a prostate cancer perspective.

The Norwegian Cancer Symposium was held on 14-15 September in Oslo and titled “Sustainable Cancer Care Using Molecular Tests – From a Prostate Cancer Perspective”. The two-day event brought together top-ranking researchers, clinicians, industry and policymakers.

“The intention of the symposium is to strengthen collaborations between clinicians, researchers, health authorities and representatives from the patient organization and the industry to bring biomarkers needed to realize precision medicine into the clinic,” said Kristin Austlid Taskén, Senior Scientist and Professor at the Institute of Cancer Research, Oslo University Hospital, and Chair of the Organizing Committee for the 8th Norwegian Cancer Symposium.

Exploring the research forefront

The programme included presentations from high-profile speakers that had travelled to Norway from different parts of the world, including USA, United Kingdom, France, Switzerland, Germany, Netherlands and Sweden.

Austlid Taskén commented on what she thought were the highlights from the talks:

“How do we identify patients who will benefit from PARPi treatment? What is needed to include use of biomarkers in the guidelines for treatment and into the clinic? What is the role of the tumour microenvironment in biomarker discovery and precision medicine? What are the bottle necks in implementation of precision medicine? How can we coordinate efforts to build and finance powerful cohorts for biomarker discovery and validation?”

Industry met academia

The audience included participants from across Norway and the Nordic countries, both from academic institutions and from pharmaceutical companies.

Marte Jonsson, Medical Advisor, Oncology in Bayer, was eager to learn about the latest findings in the field of prostate cancer and form new relationships:

“It is possible to get to know other people in the field, to form new relationships, strengthen existing ones or find new collaboration partners. Over a coffee or lunch, you may meet someone who is interested in starting a new investigator-initiated clinical trial for instance. To advance in the field, it is important for all stakeholders to communicate with each other, and national conferences are a great place for researchers, clinicians and the industry to engage with each other.”

Arton Baftiu, Medical Advisor, Solid Tumor at Janssen, was one of the industry representatives attending the Norwegian Cancer Symposium 2022. Photo: Janssen

Arton Baftiu, Medical Advisor, Solid Tumor at Janssen, was impressed by the research updates presented:

“My highlight from this symposium is the impressive work that is being done in the field of cancer – starting from the discovery of new biomarkers, new genetic tests and the cutting-edge clinical trials that are now being rolled out to Norwegian cancer patients. As a pharmacist, to witness the medical advancements in the era of personalized cancer treatment within prostate- and lung cancer, giving patients better survival outcomes and quality of life, brings additional responsibility but also a huge motivation to my role as a medical advisor in Janssen.”

Important insights for patients

Several interviewees mentioned the patient story during the panel discussion as their most memorable moment from the symposium.

“The panel discussion, particularly with the patient who presented his case, not only based on emotions, but on facts, really impressed me. Listening to all the parts in the discussion made me realize that we have to work even harder to ensure that the gap we observe time after time between drugs that are approved and the needed diagnostic test needs to be closed much faster than it is today. Access to testing should not be the limiting factor, when we know every day counts,” said Reza Shirzadi, Oncology Diagnostic Liaison at AstraZeneca.

The Norwegian Cancer Symposium 2022 was presented by the Institute of Cancer Research, Oslo University Hospital, with sponsorship from Norsk Hydro’s Fund for Cancer Research, University of Oslo: Life Science, and with support from Oslo Cancer Cluster.  A special acknowledgement to Oslo Cancer Cluster’s membership and project team, together with Innovation Norway Mature Clusters funding. 

For more information, please visit the Norwegian Cancer Symposium website.

An eager crowd wanted to learn about the national initiatives for precision cancer medicine during Arendalsuka 2022. Photo: Sofia Linden / Oslo Cancer Cluster

The future of precision cancer medicine

The first national initiatives for precision cancer medicine have successfully taken shape in Norway, but what has been achieved and what does it mean for cancer patients?

“We are standing at the entrance of a fantastic era, where the dream is to give precise and effective treatment to all patients.”

Jan Frich, Deputy CEO and Chief Medical Officer at the South-Eastern Regional Health Authority opened the meeting at Arendalsuka 2022, where the key topics were cancer, precision medicine and cooperation.

The meeting gave an overview of the success of the national initiatives in precision cancer medicine in Norway over the last two years and was organised by the public-private consortium CONNECT.

Watch the meeting here:

Understanding cancer

So, what is cancer and precision medicine all about?

“It is about more precis diagnostics and more precise treatment, which consider the characteristics of the individual patient and their disease. The cancer is not classified in terms of where it is found, but in terms of its molecular traits,” Frich commented.

Sigbjørn Smeland, Head of the Cancer Clinic at Oslo University Hospital, agreed that the evolving understanding of cancer is now changing how cancer is diagnosed:

“Cancer is about specific changes in the genetic material, which lead to uncontrolled growth. There has been an extreme development in the technology for testing. Now you can get the results from a gene panel test in a matter of days. This changes oncology and it is the way we must go forward.”

Advantages of genetic testing

The national infrastructure for precision cancer diagnostics – also known as InPreD – is being set up at all university hospitals. Three hospitals have already begun testing.

Hege Russnes, Professor, Senior Consultant in Pathology and Research Group Leader at Oslo University Hospital, gave an update on their progress:

“We are well underway with broad gene panel testing of cancer patients that do not have other treatment options. Twice a week, the results are discussed in a tumour board that decides if the available treatments in clinical studies will be beneficial or not.”

Hege Russnes (Oslo University Hospital), Grethe Foss (Norwegian Health Directorate) and Birgitte Lygren (Roche) discussed the importance of precision diagnostics for cancer patients.

Hege Russnes (Oslo University Hospital), Grethe Foss (Norwegian Directorate of Health) and Birgitte Lygren (Roche Diagnostics) discussed the importance of precision diagnostics for cancer patients. Photo: Sofia Linden / Oslo Cancer Cluster

Grethe Foss, Senior Adviser at the Norwegian Directorate of Health, explained:

“The Norwegian Directorate of Health have helped to facilitate the refunds of the large gene panel tests. It is important to make this a part of the established health service. It makes it easier to recruit patients to clinical studies.”

The pharmaceutical industry also sees advantages in testing more cancer patients.

“Broad genetic testing is the basis for implementation of precision medicine, so we quickly can map out which patients can benefit from other treatments. To have this testing in place, enables us to open more clinical studies in Norway,” said Birgitte Lygren, Medical Affairs Manager at Roche Diagnostics.

From diagnosis to treatment

Patients that have received testing can be recruited into clinical trials. IMPRESS-Norway was established in 2020 as a national clinical study that aims to evaluate the efficacy of cancer drugs on new indications. Pharmaceutical companies contribute drugs into the study, which are reimbursed by the regional health authorities if the patient has responded to treatment after 16 weeks.

The study is available at all hospitals that treat cancer patients in Norway and coordinated by Åslaug Helland, Research Director at Oslo University Hospital and Professor at the University of Oslo.

“We have teamed up with four pharmaceutical companies and we know there are more coming onboard this autumn. That means we will be able to include more patients for treatment,” Helland said.

Ole Alexander Opdalshei (Norwegian Cancer Society), Eli Bergli (Novartis) and Åslaug Helland (Oslo University Hospital) talked about the importance of industry collaboration in clinical studies.

Ole Alexander Opdalshei (Norwegian Cancer Society), Eli Bergli (Novartis) and Åslaug Helland (Oslo University Hospital) talked about the importance of industry collaboration in clinical studies. Photo: Sofia Linden / Oslo Cancer Cluster

Eli Bergli, Medical Head Oncology at Novartis Norway, complemented:

“We gain more knowledge about medicines in new diagnostic areas, where they are not approved today. Our neighbouring countries are now looking to Norway and getting inspired of what we have achieved.”

Ole Alexander Opdalshei, Assistant General Secretary at the Norwegian Cancer Society, was impressed by the collaboration across sectors:

“As a patient, you are completely dependent on the good collaboration and trust between public and private. This is important to secure the patients access to new drugs.”

Where are we headed?

Approximately 100 patients have been included in IMPRESS so far and about 70 patients have reached the first end point. The results are promising, as about 40 per cent have responded to the off-label treatment so far.

Kjetil Taskén, Head of the Cancer Research Institute at Oslo University Hospital, said:

“Precision medicine is about using the knowledge we have and try to find the right treatment for each patient. With precision diagnostics, we can find out which treatments don’t work and, in principal, get better Return On Investment when paying for new treatments.”

Terje Svabø moderated the meeting. In this photo Steinar Thoresen (Merck) and Sigbjørn Smeland (Oslo University Hospital) explain the difference precision cancer medicine can make. Photo: Sofia Linden / Oslo Cancer Cluster

Steinar Thoresen, Senior Medical Consultant in Merck Oncology and Medical Director in NordicRWE, is eager to build on these initiatives:

“This has been built with enthusiasm and passion. We have become recognized internationally. Now, it is time to set new goals. What could they be? More drugs into IMPRESS, quicker access to novel treatments, new financing models and better use of health data.”

The fantastic era of precision medicine, that Frich referred to at the start, is no longer a distant dream. Norway is paving the way to make precision medicine available to all cancer patients.

Ketil Widerberg, daglig leder i Oslo Cancer Cluster, og Ingrid Stenstadvold Ross, generalsekretær i Kreftforeningen, ønsker næringsminister Jan Christian Vestre (til venstre) velkommen til Oslo Cancer Cluster innovasjonspark 26. august 2022. Kreftforeningen var vertskap sammen med Oslo Cancer Cluster. Alle foto og video: Oslo Cancer Cluster

Besøkte innovasjonsparken

Three people outside a building.Oslo Cancer Cluster

Næringsminister Jan Christian Vestre besøkte Oslo Cancer Cluster innovasjonspark, og fikk samtidig en omvisning i den norske næringen som er viktigst for kreftpasienter.

/ the Norwegian Minister of Trade, Industry and Fisheries, Jan Christian Vestre, visited Oslo Cancer Cluster Innovation Park and received a tour of the most important Norwegian industry for cancer patients. 

– Her kan du nesten gå med tøfler mellom sykehuset, forskningsbygget og bedriftene i innovasjonsparken. Det er noe som ikke finnes mange andre steder i verden, sa Ketil Widerberg, daglig leder i Oslo Cancer Cluster.

Han pekte på det nye bygget i Radiumhospitalet, som reiser seg etter planen tvers overfor Institutt for kreftforskning og Oslo Cancer Cluster innovasjonspark, blant annet med Ullern videregående skole og flere selskaper som jobber med kreft. Fire av dem skulle straks få næringsministeren på besøk.

– Campus Radiumhospitalet er kopibar, og vi forsøker å få til noe slikt også ved Rikshospitalet, med det nye Livsvitenskapsbygget, sa Bjørn Atle Bjørnbeth, administrerende direktør ved Oslo Universitetssykehus.

Nysgjerrig på kreftinnovasjoner

Første stopp på rundturen i parken var hos Oslo Cancer Cluster inkubator. Der sto oppstartsselskapet Oncosyne klar på laben for å vise fram sin arbeidsflyt. De dyrker en pasientprøve fra sykehuset og tester ut alle tilgjengelige legemidler på pasientens egne celler. Dataanalysen blir så til en diagnostisk rapport, som legene kan bruke til å gi akkurat denne pasienten riktig legemiddel til riktig tid. Det er presisjonsmedisinens prinsipp.

– Du piloterer på en måte kreftbehandlingen på celler i laboratoriet i stedet for på pasienten, sa næringsminister Jan Christian Vestre.

– Ja, akkurat, på pasientens egne celler, fordi det blir mer korrekt fordi kreft er en så heterogen sykdom, sier Jarle Bruun, CEO i Oncosyne.

Videoen viser en av cellelabene i Oslo Cancer Cluster Incubator, og en demonstrasjon av hvordan Oncosyne jobber.

Fra liten til stor næring

Etter besøket hos oppstartsselskapet, gikk turen videre til Ultimovacs, et selskap som ble etablert i 2011, og som nå er på børs, og har sitt hovedprodukt, en universale kreftvaksine, i flere kliniske studier. Kreftvaksinen er basert på forskning opprinnelig fra Radiumhospitalet.

I likhet med Ultimovacs, konkurrerer helseselskaper som får testet sine behandlinger i kliniske studier i et globalt marked helt fra start.

Etter en kort tur bortover gangen møtte statsråden Zelluna Immunotherapy, et selskap som lager en ny form for celleterapi, også med opprinnelse fra forskning fra Radiumhospitalet. De startet i 2016, og har i dag ansatte med hele tolv ulike nasjonaliteter. Folk flytter rett og slett til Norge for å jobbe i Zelluna Immunotherapy.

– Veien er kort fra forskere til selskaper her. For oss har det vært en kjempefordel å være her i inkubatoren, sa Geir Christian Melen, Finance Director i Zelluna Immunotherapy.

Et tema begynte å vise seg på rundturen. Hva har disse selskapene til felles? De er alle del av den norske helsenæringen, og de jobber med å lage bedre kreftbehandlinger for pasientene.

– Vi trenger selskaper for å få bedre behandlinger som kommer pasientene til gode. Det er dette som gjør nettopp helsenæringen spesiell. Den har et grunnleggende mål om å hjelpe pasienter, med diagnostikk, behandling eller oppfølging, sa Ingrid Stenstadvold Ross, generalsekretær i Kreftforeningen, som var vertskap for besøket sammen med Oslo Cancer Cluster.

Ønsker å investere

Neste stopp på rundturen var et stort, internasjonalt selskap, som nå ønsker å investere i en utvidelse av innovasjonsparken og miljøet rundt Radiumhostpitalet. Dette selskapet er Thermo Fisher Scientific.

Næringsbygg er en viktig del av grunnlaget for å drive næring, også helsenæring. I denne videoen forteller de fire lederne av de norske helseklyngene hva de mener er viktig at politikerne bidrar med. Videoen ble spilt inn i Arendal i august 2022, under Arendalsuka.

Thermo Fisher Scientific er et internasjonalt selskap med 400 milliarder kroner i omsetning og 100 000 ansatte. I Norge er omsetningen drøye 1,7 milliarder kroner, og her har de 300 ansatte, med kontorer i innovasjonsparken og produksjonslokaler i Lillestrøm. De lager viktige bestanddeler i celleterapi, diagnostikk og andre bioteknologiske prosesser.

– Helsenæring begynner i det små, med gode ideer, forskning og oppstartsbedrifter. Derfor er inkubatorer og støttemiljøer viktige, men det er også av betydning å ha investorer og internasjonale samarbeidspartnere i de samme lokalene som laboratorier og forskere. Nærhet gjør framgangen for små selskaper lettere, sa Ketil Widerberg.

Pople outside white building

Næringsminister Jan Christian Vestre (til høyre) avsluttet besøket hos Oslo Cancer Cluster inkubator og innovasjonspark med et stopp ved tomten som er prosjektert til å bygge ut parken. Elisabeth Kirkeng Andersen, kommunikasjonsansvarlig i Radforsk, forteller om utbyggingsplanene som blant annet Thermo Fisher Scientific ønsker å investere i. Med på bildet er blant andre også Gaute Moldestad (direktør industri SIVA SF), Sigbjørn Smeland (leder Kreftklinikken OUS) og Ingrid Stenstadvold Ross.


Thermo Fisher trenger umiddelbart 5000 kvadratmeter til nye laboratorier, kontorer, og visningssenter for celleterapi, og er villig til å investere på den gamle tomten sin ved siden av dagens innovasjonspark, der det i dag står gamle bygg og forfaller.

Investorene er klare for å bære kostnadene for en utbyggelse av Oslo Cancer Cluster innovasjonspark alene, men i likhet med kreftpasienter har de ikke tid til å vente.

Under Arendalsuka arrangerte Radforsk et møte om utbyggingen av Oslo Cancer Cluster innovasjonspark, som har stagnert i møte med Oslo kommune. I forkant av møtet lagde vi denne videoen av Jónas Einarsson, CEO i Radforsk. Møtet kan sees i opptak, følg denne lenken til Facebook.




Silje Morild Helland is fighting for breast cancer patients to gain access to new cancer treatments. Photo: Eline Feiring / LMI

Making every day count

Cancer patient Silje Morild Helland spends all her time searching for better treatments.

“I want to spend my time doing this. It is not just my life, but many people’s lives. We all want to be here for our loved ones. I have made friends who have the same diagnosis and several of them are not here anymore. People are dying while waiting for important medicines.”

Silje was diagnosed with breast cancer while pregnant in 2015. Since then, she has tried all the treatments that are available to her in Norway. Now, her current treatment is losing effect and Silje feels she has a responsibility to search for more options, since many other cancer patients cannot.

“I think it is problematic that breast cancer patients are assessed according to the average age of the entire patient group. It is said we are too old for the new treatment to be cost effective. It is too expensive in relation to how old we are on the group level, but I am not too old,” Silje said.

Silje told her story at the meeting Fremtidens Kreftbehandling – Hver Dag Teller, Eller? during the Norwegian political festival Arendalsuka. The meeting was organised jointly by Oslo Cancer Cluster, LMI, the Norwegian Cancer Society, Astra Zeneca Norway, Janssen Norway and MSD Norway.

Watch the meeting here:

Is this even legal?

The lawyer Geir Lippestad explained at the meeting that the system called Nye Metoder has been given the legal mandate by publicly appointed officials to decide which medicines will be approved in Norway.

“We do not have any case law or Supreme Court decisions concerning Nye Metoder. This is because it is not possible for patients to appeal decisions that have been made. This is not completely unproblematic. In an open society, the right to appeal is a guarantee for legal safety. This is something we need to debate politically. It is very unusual that there is not a bigger legal framework to appeal.”

Calling for a mission on cancer

Sigrid Bratlie, special advisor in the Norwegian Cancer Society, told the audience about recent advances in the cancer field.

“We are at a breaking point in the development of knowledge and technology. Two areas that are moving especially fast are personalised medicine and immunotherapy.”

Bratlie explained that future cancer treatments will be defined by four characteristics. The treatments will be more personalized and more influenced by advanced technologies. They will be given more in combination with one another, and clinical studies will be an integrated part of standard treatment.

“To realise the potential we have in Norway, we need to invest and set ambitious goals. The European Union has launched a Cancer Mission with the goal to improve the lives of 3 million people by 2030. The USA has the Cancer Moonshot to reduce the death rate from cancer by at least 50 percent over the next 25 years.”

Steinar Thoresen (Merck), Sigrid Bratlie (Kreftforeningen) and Truls Vasvik (Labour Party) discussed access to new cancer treatments. Photo: Sofia Lindén / Oslo Cancer Cluster

What is Norway doing?

Sigbjørn Smeland, Head of the Cancer Clinic at Oslo University Hospital, and Steinar Thoresen, Senior Medical Consultant Merck Oncology and Medical Director NordicRWE, introduced the new initiatives for precision cancer medicine in Norway.

One of them is IMPRESS, a national study where patients with metastatic cancer who have exhausted all treatment options get a chance to try another treatment based on the cancer’s genetic mutation.

Another initiative is CONNECT, a public-private consortium driving the implementation of precision medicine in Norway. Several companies in CONNECT have agreed to contribute pharmaceuticals to the IMPRESS study.

“Precision medicine is one of the pillars of the cancer treatments of the future. We must organise ourselves differently. It requires a closer collaboration between industry and academia. We are looking at the individual patient, instead of groups of patients, which gives us a different type of knowledge base,” Smeland explained.

Steinar Thoresen complemented:

“The industry has gone from being a part, to becoming a partner. For the first time we have a shared risk between private and public. This can be a framework for future payment structures. People have started to say ‘Look to Norway’ and we have no time to lose. We need to collaborate to get more clinical studies, to get more drugs into IMPRESS and to make use of Norwegian health data.”

The politician Truls Vasvik from the Norwegian Labour Party (Arbeiderpartiet) was also at the meeting.

“We need to work together with industry to succeed. We need to establish a system that can handle the extremely rapid changes in cancer treatment. We also need to think new about price models. We have a focus on cancer right now, because many are getting ill, and the development is going extremely fast.”

Silje Morild Helland does not think the system is good enough. If she can’t get new treatment in Norway, she plans on travelling abroad, like many other Norwegian cancer patients already have.