Eivind Hovig, Professor at the Department of Bioinformatics at the University of Oslo, is one of the co-authors behind the research article published in MDPI Cancer.

New research on genetic risk and breast cancer

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How a simple saliva test can reveal the risk of breast cancer in the Norwegian population.

A study by the University of Oslo, Oslo University Hospital and OÜ Antegenes looking into Polygenic Risk Scores (PRS) and breast cancer in Norway was recently published in the journal MDPI Cancer. PRS technology is a type of genetic test that can reveal an individual’s risk of developing cancer.

“The study was initiated to assess the possibility of using a combination of genetic markers for a given woman here in Norway to predict the risk of developing breast cancer over her life,” said Eivind Hovig, Professor at the Department of Bioinformatics at the University of Oslo, and one of the co-authors to the article.

Early detection

Every year, there are close to 4 200 new breast cancer cases and almost 600 deaths from breast cancer in Norway, according to reports from the Norwegian Cancer Registry. Early detection is crucial for survival, but almost 40 per cent of breast cancer cases are not diagnosed at an early stage.

“The results indeed indicate that it is entirely feasible to apply such a predictor meaningfully in a Norwegian context,” said Hovig.

Personalised screening

Current breast cancer screening in Norway is implemented for women at age 50-69, but approximately 20 per cent of breast cancer cases are diagnosed in younger women. These tests can potentially be used to identify younger women with a higher risk and lead to a more personalised screening approach.

“As the application of such a predictor may have implications for management of patients with high risk scores, it may lead to different screening strategies and a better understanding of the risk profiles of these patients,” added Hovig.

The PRS test used in the study was developed by the Estonian company Antegenes. The study was conducted as a part of AnteNOR, a project that investigates how PRS can be implemented for prevention and early detection of breast cancer in Norway.

The post New research on genetic risk and breast cancer first appeared on Oslo Cancer Cluster.

Ministers Jan Christian Vestre and Ingvild Kjerkol released the roadmap for the health industry from Nykode Therapeutics laboratories. Photo: Nærings- og fiskeridepartementet

A roadmap for the health industry

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How will Norway commercialise research and turn health into a green export success?

The roadmap for the health industry was released today by Ingvild Kjerkol, Minister of Health and Care Services, and Jan Christian Vestre, Minister of Industry, Trade and Fisheries. The roadmap includes 12 focus areas and 41 actions, which the two ministries have worked together with industry to identify.

Commercialising research

One of the focus areas is testing and piloting of novel health solutions.

“We will become better at commercialising research results and create industry. We want the state to contribute considerably more so companies have access to testing facilities, so they can develop their solutions. We will develop the catapult scheme for the health industry,” said Vestre.

Today there is no health catapult in Norway. SIVA, the Research Council of Norway and Innovation Norway will now investigate how the health industry can better utilise the catapult scheme.

“The health clusters are ready to contribute! Based on work we did in 2019 and 2020, Oslo Cancer Cluster, Norwegian Smart Care Cluster and Norway Health Tech have set up Health Catalyst, a national arena for developing, testing and piloting novel solutions in health. Among other things, we have signed an agreement to collaborate with Nortrials,” commented Ketil Widerberg, general manager of Oslo Cancer Cluster.

A green export opportunity

In 2021, the Norwegian health industry had a total turnover of NOK 65 billion, where NOK 22 billion came from export alone, according to a Menon Economics report (2023).

“The health industry has a natural place in a low emission society. We believe we can increase the export from the health industry considerably, and this will contribute to solve global challenges and create workplaces in our own country,” commented Vestre and added there will be additional funding for this.

The Norwegian health industry is united through the clusters and is ready to contribute as the government launches this historical investment.

“When we work with pharma and biotech, we create green workplaces. We work to establish national production, local testing, and precision medicine, which will shorten value chains, as well as decrease transport and logistics,” commented Widerberg.

A supercluster is needed

The Norwegian clusters were also mentioned especially for their ability to facilitate collaboration and knowledge transfer between large and small companies, and research environments – which will strengthen the success of Norwegian export.

“We want to clarify that the three internationally renowned, National Centres of Expertise (NCE) clusters in health, including Oslo Cancer Cluster, Norwegian Smart Care Cluster and Norway Health Tech, wish to unite into a supercluster.

“We hope the revised cluster programme builds on an understanding that all parties must contribute to the development and financing of the clusters to make public-private collaboration a reality,” commented Widerberg.

Towards a Cancer Mission?

Kjerkol also mentioned several actions that will make a big difference for the development of cancer therapeutics and diagnostics in Norway. These include:

  • Securing that research milieus in the private and public sector get guidance on clinical studies
  • Developing the Directorate for Medical Products
  • Facilitating access to health data for the health industry
  • Investing in clinical studies and personalised medicine
  • Creating a strategic arena for dialogue between health authorities and industry

“Oslo Cancer Cluster is delighted that input we have made over the last two years towards public policy are taken seriously in this roadmap, but there is still work to do. Our project CONNECT shows the opportunities of public-private collaboration in implementation of precision medicine including regulatory innovation. We applaud that the government wants to build on this.”

“We believe these combined efforts represent the first steps towards Norway making its mark internationally and are a contribution to the European Mission on Cancer,” said Widerberg.

Oslo Cancer Cluster has set up a hub to pursue the EU’s Cancer Mission nationally, together with the Research Council of Norway, the Cancer Society and several other key players.

 

 

The post A roadmap for the health industry first appeared on Oslo Cancer Cluster.

A panel conversation about how personalised medicine can create value in the national health service. From left to right: Åsmund Flobakk, oncologist at St Olavs hospital, Siri Børø, Medical Advisor Oncology at Merck, Giske Ursin, director at the Cancer Registry of Norway and Ulrich Spreng, Chief Medical Officer of Helse Sør-Øst.

Personalised medicine to relieve the health service

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Smaller patient groups and targeted treatments are the future of cancer care in Norway.

It is no longer a question of if but when personalised medicine will be a reality for all cancer patients in Norway. This was a key message in a recent meeting arranged by the public-private consortium CONNECT during Arendalsuka, where the resource crisis in the health service was discussed.

Forward-looking health authorities

Ulrich Spreng, Chief Medical Officer of the South-Eastern Regional Health Authority (Helse Sør-Øst), underlined how critical personalised treatments will be in the future. Spreng sits in the Decision Forum of New Methods, the national system that manages the introduction of new treatments in Norway. The Decision Forum looks at three criteria; the severity of the disease, the effect of the treatment and the resources it requires.

“If you can target treatment better according to an individual patient’s genetic profile, there will be a greater effect. This makes it easier to implement that drug since it is a different relationship between resources and effect than when you treat a large patient group where many do not have an effect. It is important for us to separate a total patient group into subgroups according to their genetic profile. This is very exciting for New Methods!” Spreng commented.

Urgent lack of resources

The Norwegian health service faces a lack of resources and personnel, according to an investigation by the Health Personnel Commission in 2022. Gro Live Fagereng, Coordinator Precision Cancer Medicine at Oslo University Hospital, agreed this is a major challenge:

“We have limited time and finances in the health service, so we must prioritise the available resources. Both personalised medicine and research in general form the basis for making the best priorities. We need to invest in research to make the most of our resources. I hope and believe we will have a more systematic and learning health service in the future; that we will learn more from patients, so we can update treatments and make better priorities.”

Åsmund Flobak, oncologist at St. Olavs Hospital, explained how personalised medicine enables us to learn from patients:

“Traditionally, we have treated patients on a group level, but we know that patients are different; some respond and some do not. The goal is to find out which biomarkers relate to which treatments. We have worked to establish publicly financed precision diagnostics through InPreD and we give patients precision treatment through IMPRESS. A third of us will at some point get cancer, so we must implement better treatments.”

Watch this video (in Norwegian) to understand personalised medicine:

Health economists also agree that this strategy can help to save resources.

“When a patient gets the right treatment, you avoid giving a treatment that doesn’t work well enough first and there are fewer side effects. The consequence is less use of resources in the health service and we can live better lives,” commented Erik Magnus Sæther, Partner at Oslo Economics.

Public-private collaboration needed

Karoline Knutsen, Manager Market Access at Legemiddelindustrien (LMI), said that the vision for the future looks grim:

“The number of people of working age will decrease, while there will be more elderly in need of health services. We will see more chronically ill people with complex diseases. We believe new technologies and treatments are part of the solution, so more of us can keep working. The success of implementation of personalised medicine relies not just on financial investments, but also on contributions from many key players and stakeholders. Everyone must sit around the same table.”

CONNECT was set up to be that table, as a public-private consortium driving the implementation of precision cancer medicine in Norway. Since 2020, CONNECT has gathered 30 partners, including industry, patient organisations, university hospitals and several governmental institutions.

“We need to nurture this collaboration, develop it and use it in more areas,” commented Thomas Axelsen, Head of Politics at the Norwegian Cancer Society. “Personalised medicine in cancer needs to happen, no matter what. It is just about how fast we want it to happen. If we do it faster, we can save patients’ lives.”

Political ambitions

The government’s ambition is also high in this area, as seen in the Strategy for Personalised Medicine launched in January 2022.

“Personalised medicine should be an integrated part of the specialist health service. We need to develop the health service in a way that maximises value creation, both for the individual and for society as a whole,” said Truls Vasvik, State Secretary of the Ministry of Health and Care Services.

“Our doors are always open. We need to talk together about the development of competences, research and new price models; how we can get documentation of small patient groups and single treatments with uncertain long-term effects,” added Vasvik.

The post Personalised medicine to relieve the health service first appeared on Oslo Cancer Cluster.

The expert panel discussed how Norway can implement a Cancer Mission. From left to right: Idar Kreutzer (NHO), Cathrine Lofthus (Ministry of Health and Care Services), Jónas Einarsson (Radforsk / Oslo Cancer Cluster), Astrid Bjerke (Norwegian Cancer Society), Erik Aasheim (moderator, Primus Productions).

Arendalsuka: – We need to attract the big companies

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Norway needs more big companies to deliver on the Mission on Cancer.

The European Union has launched the Mission on Cancer with the goal to improve the lives of 3 million Europeans. In the recent meeting Fremtidens kreftbehandling during Arendalsuka, key experts and politicians gathered to discuss the implications of this for Norway. See the meeting here. See the meeting here. 

“With missions, we need to mobilise all resources in society towards a common goal. This is a new way to work and it challenges the established system. It is a historic investment from the EU; they are leaving no stone unturned in the fight against cancer,” said Astrid Bjerke, strategic adviser for the Norwegian Cancer Society.

A Norwegian Cancer Mission Hub has already been set up in Norway by several stakeholders, including Cancer Society, Oslo Cancer Cluster, The Research Council, The Norwegian Health Directorate, the Cancer Registry of Norway, and more.

“Norway is a part of the Mission on Cancer and this is important both for the ministry and from political leadership. EU has seen that we have to work together in the area of health. It is important that Norway is a part of this, because it also gives us possibilities.

“We have a great health service and fantastic health data, which we need to take better advantage of. We have a high degree of knowledge and fabulous research environments, as well as a population with a high degree of trust. Many positive things are happening, but we need to attract the big companies and their competence,” said Cathrine Lofthus, Secretary General of the Ministry of Health and Care Services.

Successful industry collaborations

Idar Kreutzer, director of The Confederation of Norwegian Enterprise (NHO), gave several historic examples of how Norway has built industries based on public-private collaboration, such as water power and the oil industry.

“We were impressed when we saw the power of the development of vaccines during the pandemic, which was a real collaboration between authorities, researchers and industry – with impressive results! The health industry is already exporting for more than NOK 20 billion per year, but the potential is even larger and Norway has perfect conditions to grow a health industry,” said Kreutzer.

One example of a current collaboration between academia and industry is the Oslo Cancer Cluster Innovation Park, which is expanding and has recently signed a lease agreement with the global company Thermo Fisher Scientific.

“We are doing many of the right things in Norway from basic research to patient treatment, but we need to look at the whole ecosystem. We built this ecosystem in miniature around the Radium Hospital, because this is where most of the cancer patients come through and most cancer research is done. It has been a difficult journey, but we have a very exciting pipeline with several up-and-coming companies and promising treatments,” said Jónas Einarsson, CEO of Radforsk Investment Fund and founder of Oslo Cancer Cluster.

Is there political will?

There seemed to be broad political consensus around the Cancer Mission among the politicians at the meeting.

“Missions and the EU’s work in this area is a part of our new cancer strategy and we have to collaborate on this, as well as collaborate with the EU. The mission concept is nothing new. It is first and foremost about achieving collaboration between the health service and the industry. Our cancer strategy will lay the basis for this: to gather all resources around a common goal,” said Even Røed, the Labour Party (Norway).

“We need to replace the income from oil and gas with new industries, which need to have large potentials. All Nordic countries have managed to make their health industries grow. Now we have the opportunity in Norway. The health service, academic milieus and industry are already gathering momentum, but there is a lack of political will. Norway has joined the Mission on Cancer, but how will it be implemented in Norway? There needs to be political will to build the health industry,” said Alfred Bjørlo, the Liberal Party (Norway).

“This is a really exciting method, to involve civil society, industry and academic milieus. I am most concerned about this being politically anchored. Will we see it when the new Cancer Strategy is presented? Will we see the Minister of Health together with the Minister of Industry and a representative from the European Union? Will we be connected to the Europen Union, or will this be a Norwegian hobby project, where we don’t take advantage of the big advantages we have?” asked Kristoffer Robin Haug, Green Party (Norway).

 

The meeting was organised by Oslo Cancer Cluster, the Norwegian Cancer Society, Legemiddelindustrien LMI, MSD Norway, Janssen Norway and AstraZeneca Norway. Thank you to our collaboration partners!

 

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