Ketil Widerberg, General Manager at Oslo Cancer Cluster, opened the meeting on intelligent and personalized algorithms to prevent cancer 20 September 2018.

American tech and Norwegian health data

Combining country scale population data with world class computer systems and algorithms will push the boundaries of precision medicine.

This is a story about the unique American-Norwegian collaboration that combines the best health data with the most powerful computers in a pioneer project run by Cancer Registry of Norway and Lawrence Livermore National Laboratory.

Data to screen cancer 
The ongoing project was initiated after a talk on tech between the General Manager of Oslo Cancer Cluster and a Senior Scientist from Lawrence Livermore National Laboratory. Some months later, in San Francisco, a meeting room was filled with some of the world’s best minds on cancer and technology. The Norwegians knew cancer and the Americans knew computing. The outcome was unknown. 

They identified a concrete challenge. Can we see patterns in data to screen cancer more precisely?

The quest resulted in a successful cooperation between Lawrence Livermore and the Cancer Registry in January 2016 where a team from the Cancer Registry started the first project on cervical cancer. If successful, they would potentially identify and screen high risk patients earlier and leave the low risk patients unburdened. 

Now there are two ongoing projects, one on cervical cancer and one on multitask learning for cancer. The goal is to make predictions more accurate and improve precision medicine. 

– If successful we can potentially identify and screen high risk earlier and leave the low risk unburdened. The individual and social impact of such a strategy is significant. This may be the reason why Joe Biden mentioned details from this project at a UN Assembly last year, Widerberg said.

Former Vice President Joe Biden led the American cancer initiative known as the Cancer Moonshot Blue Ribbon Panel. Two years ago, when the collaborative project between Norway and the USA had just started, the Blue Ribbon Panel released a report describing ten transformative research recommendations for achieving the Cancer Moonshot’s ambitious goal of making a decade’s worth of progress in cancer prevention, diagnosis, and treatment in just 5 years.

One of the ten recommendations was to expand use of proven cancer prevention and early detection strategies.

The major research questions
– One of the major research questions right now is How do we design the optimal screening programs? Another is how to actually take advantage of the registry data that we have, said Giske Ursin, Director of the Cancer Registry of Norway.

In Norway, and similarly in the other Nordic countries, we have registries on various diseases, pregnancy/births, vaccinations, work history/unemployment, income and much more. We have data sets dating from the 1950s. That is unique in the world. 

– If you look at enough data, you can find interesting links that can be explored in the clinical world or elsewhere. For instance; how do other diseases affect cancer diseases? We need international expertise to cover areas we are not experts on ourselves, she said, showing a picture of one of the super computers at Lawrence Livermore.

Cancer and national security
Lawrence Livermore National Laboratory is a national security laboratory and part of the U.S Department of Energy. The laboratory has over 5000 employees, of which at least half are engineers and researchers.

– We have the mandate from the government to push the forefront on subjects like bio security. Precision medicine is alined with the bio security mission, but it is even more relevant to the super computing research mandate. What are the next types of problems that will move this forward? Biomedical data complexity. That is why we are in this, Ana Paula de Oliveira Sales from Lawrence Livermore National Laboratory said in her presentation. 

Some ingredients of the project on cervical cancer is to improve cancer outcome prediction by combining disparate cancer types. The preliminary results are encouraging.

 

Break down barriers
John-Arne Røttingen, CEO of the Research Council of Norway, gave a talk on how collaborations between the Nordic countries and other countries are important for population based clinical research and health research.

– Personalized medicine is full of promise and we want to contribute to this progress, but we cannot do this only with our data. We have to collaborate with other countries and with different fields of research, he said.

One important country in that respect is of course the USA.

Kenneth J. Braithwaite, U.S Ambassador to Norway, talked about the opportunities with the Norwegian databases in a meeting in the Oslo Cancer Cluster innovation park 20 September 2018.

— I have learned the past few years that data is king, and we need to wrap our arms around this. I think there is a responsibility from the governments to begin to break down the barriers and truly find a cure to cancer. That’s what we are up against, said U.S. Ambassador to Norway Kenneth J. Braithwaite, who is Rear Admiral of United States Navy (Retired).

— As we say in the Navy, full speed ahead!

The panel of experts during the oncology super session at Nordic Life Science Days 2018 in Stockholm, discussing the challenges and possibilities in cancer immunotherapy.

The next wave in cancer immunotherapy

What is driving the next wave of innovation in cancer immunotherapy?

This was the question the experts tried to answer in the oncology session of the conference Nordic Life Science Days in Stockholm 12 September.

International experts from pharma, biotech, academia and the investment community discussed how different approaches to innovative cancer treatments could address challenges and shape the next wave of innovation in cancer immunotherapy, also known as immuno-oncology.

They touched upon approaches such as big data, personalized medicine, new targets and lessons from neuroscience.

Over the past few years, the rapid development of novel cancer immunotherapy approaches has fundamentally disrupted the oncology space. Cancer immunotherapy has not only become a key component of cancer therapy, but it has also reshaped priorities in oncology research and development (R&D) across the industry, with unprecedented clinical success in certain cancer types continuing to fuel record investment and partnering activity.

As of today, more than 2.000 immuno-oncology agents, including checkpoint-inhibitors, vaccines, oncolytic viruses and cellular therapies are in preclinical or clinical development.

Read more about the cellular therapy research of Oslo Cancer Cluster members Oslo University Hospital and Zelluna.

Why so little effect? 
Despite all of this promising research, only a minority of patients benefits from effective and durable immuno-oncology treatments. Why is this happening?

Part of the answer is found in resistance or unexplained lack of response. This could be addressed through a better understanding of optimal timing of therapy, better combination therapy design, or improved patient selection. Another part of the answer lies in a lack of novel targets and of an overall better understanding of specific immune mechanisms. This lack of understanding is becoming a roadblock to further advance in this research space.

What can the experts do about this? It turns out they have several approaches. Two of the main ones include big data and turning so-called cold tumours hot.

Big data will expand
“We believe that this can be changed by adding deep and broad data from multiple sources”, said Richa Wilson, Associate Director, Digital and Personalized Healthcare in Roche Partnering.

“We use the words meaningful data at scale, that means high quality data with a purpose: to answer key scientific questions”, she said at the session.

These data will continue to evolve from clinical trials and aggregated trials and registries and in the future from real time and linked data. There was about 150 exabytes health data in 2015 and in 2020 it is expected to grow into 2300 exabytes, mainly from digital health apps and scans from the hospitals, Oslo Cancer Cluster member Roche presented.

Hot and cold tumours 
Emilio Erazo-Fischer, Associate Director of Global Oncology Business Development at Boehringer Ingelheim explained the cold and hot tumours and how the cold tumours can be turned hot and thus open for cancer immunology treatment. It is well explained in this short film by Oslo Cancer Cluster member Boehringer Ingelheim

Martin Bonde, CEO of Oslo Cancer Cluster member Vaccibody also presented how they try to turn the cold tumours hot.

The Norwegian company Vaccibody is a leader in the field of cancer vaccines and they are very ambitious. They currently have a trial for melanoma, lung, bladder, renal, head and neck cancer.

The impact of stress
Erica Sloan is the group leader of the Cancer & Neural-Immune Research Laboratory in Monash University in Australia. She gave a talk on how neural signalling stops immunotherapy working. The researchers at Monash University have led mouse studies where the nervous system is stressed. They show that immunotherapies fail unless peripheral neural stresses are excluded.

The threat of a cancer diagnosis is stressful, as are most certainly cancer and cancer treatments. The tumour micro environment inside the cells can hear the stress signal, that is adrenalin.

“So what can we do about it?” Erica Sloan asked, before she answered:

“Treating with beta blockers. Blocking neural signalling prevents cancer progression. It also has an effect on immunotherapies.”

Erica Sloan is the group leader for the Cancer & Neural-Immune Research Laboratory in Monash University, Australia. She gave an introduction to the effect of neural signalling on tumour cells during the NLSDays in Stockholm 2018.

“Could stress be responsible for non responders?”, the moderator Gaspar Taroncher-Oldenburg from Nature Publishing Group asked her in the panel. 

“Absolutely, neural signalling can be responsible for this. And the exciting thing with data sharing here is that it can allow us to see and understand the rest of the patients’ biology. We need to look more at the patients’ physiology and not just the tumour biology” she said. 

AI Speeds Up Pharmaceutical Testing

Oslo Cancer Cluster member Immunitrack has landed investments worth millions. The money will be used to develop a computer program that can predict how the immune system will react to different substances.

Already Immunitrack, co-founded by Stephan Thorgrimsen and Sune Justesen, is offering contracted research to the pharmaceutical industry predicting how the immune system react to different pharmaceuticals, by producing reagents that can be used to examine the immune systems reaction.

New AI in The Making
When scientists discover promising substances they think can be developed into medicine for future treatments, only a small percentage will prove to have an effect after testing. The testing process is important, but at the same time expensive, time and resource consuming. What if a lot of this testing could be done virtually by a computer program? This is what Immunitrack want to offer with their new AI- technology.

The new investment will take this further and enable the company to boost its production and analytical capabilities. The investment will enable increased efforts in the development of a new best in class Prediction Software using artificial intelligence (AI). The software is seen as a vital cornerstone for applying the technology from Immunitrack in large scale projects within cancer treatment and precision medicine.

The applications of the new AI platform are multiple: The technology increases vaccine potency, speeds up the development of personalized cancer vaccines and remove negative immunological effects. Additionally, it enhances precision medicine efforts by improving patient profiling and treatment selection.

And everything is really moving fast for Immunitrack.

— Until September last year it was only the two of us that stood for everything. Production, marketing, you name it. Then things started happening for real and now we have employed 4 new colleagues, says Stephan Thorgrimsen.

The Investor
The new investment is from Blenheim Capital Limited. They are a diversified investment company focusing on geographically, commercially and technologically frontier companies and projects.

The investment in Immunitrack ApS with its emphasis on transforming market proven immunology-based skill set into a commercially viable AI solution matches Blenheim’s investment profile.

About Immunitrack
Immunitrack aims at becoming a world leader within prediction and assessment of biotherapeutic impact on patient immune response. The company has until now provided services and reagents to more than 70 biotech companies worldwide, including 6 of the top 10 Pharma companies.

Immunitrack was founded in 2013 by Sune Justesen and Stephan Thorgrimsen. Sune Justesen brings in experience from more than a decade of working in one of the world leading research groups at the University of Copenhagen. The company started commercialization of its products in 2016, and has grown its staff from 2 to 6 within the last 8 months.

The Future Norway: Ketil Widerberg on Tech and Cancer

Our General Manager Ketil Widerberg visited the podcast People creating the future Norway (De som bygger det nye Norge) hosted by Silvija Seres and Oslo Business Forum.

Ketil and Silvija discussed important issues like: Is it possible to make cancer a chronic disease? And how do you really create medicine that is tailored for each individual? And many other important topics. Have a listen!

Listen to the podcast HERE (In Norwegian).