Photo: Stig Jarnes/Oslo Cancer Cluster

More precise cancer treatments with digital solutions

Ketil Widerberg, general manager, Oslo Cancer Cluster.

Ketil Widerberg, general manager of Oslo Cancer Cluster, gives his perspectives on why EHiN and digital health are important for faster development of new cancer treatments in Norway.

 

This interview was first published on EHiN’s website in Norwegian.

 

What do you think are the biggest challenges in the health sector today?

One challenge in cancer treatments is to give the right medicine to the right patient at the right time. This is called precision medicine and means that cancer treatments can to a greater extent be tailored to the individual patient. The government recently proposed more money for this in the State Budget for 2021. There are already digital tools that can identify more targeted treatments ready to be put to use. One example is our member NEC OncoImmunity, who are using artificial intelligence to develop new personalised immunotherapies against cancer.

Another big challenge is to shorten the development time for new cancer medicines. The corona pandemic has shown us that it is possible to quickly develop new treatments, initiate clinical studies and gather data. The analysis of health data will be essential for the development and approval of new treatments. It is important that national infrastructure, such as the Health Analysis Platform, is put in place. One inspiring company is our member Ledidi; their software solution was recently approved for all Covid-19-studies at Oslo University Hospital. This tool can also be used in cancer research to make quick statistical analysis and to cooperate across research groups, hospitals and countries.

A third challenge is how we involve the cancer patient in their own treatment. New technology, for example the data platform from our member Kaiku Health, enables the patients to self-report symptoms in real-time. If we can gather data on pain and side effects every day, instead of every third month, our understanding of cancer improves and the doctor can do a better job.

 

How can you contribute digitally to the health sector?

Oslo Cancer Cluster contributes to the digitalisation of the health sector by connecting pharmaceutical companies and biotech start-ups in cancer with tech companies.

Among other things, we are coordinating the Horizon 2020 EU-project “DIGI-B-CUBE”, which provides funds to collaboration projects between small to medium-sized companies in IT and health. They try to find digital solutions to challenges in the health sector.

Our cluster is also a part of the consortium «NORA EDIH – Norwegian Artificial Intelligence Research Consortium» that was recently selected as one of eight Digital Innovation Hubs that Innovation Norway will recommend to Digital Europe Programme. These innovation centres will be essential to stimulate increased use of digital solutions.

 

How has Covid-19 affected you?

Oslo Cancer Cluster Incubator has put several measures in place to keep laboratories and offices open to ensure that important cancer research and patient treatment can continue as normal during the pandemic. Start-ups, researchers and the incubator have received more support from the financial apparatus for business development, in order to strengthen the health industry in this period of uncertainty. In addition, the Incubator has updated its IT infrastructure to facilitate the increased use of digital solutions from home offices and streaming of meetings and events.

Covid-19 has proven that the health industry is important for society – to fight pandemics, to contribute to better health and to create value. Norwegian companies in health experience great interest from investors now. One example is our member Vaccibody, who signed the largest biotechnology agreement in Norway ever this month and later was listed on Merkur Market (Oslo Stock Exchange), valued at NOK 17 billion.

Covid-19 has also created challenges for cancer patients that missed treatments because of the risk of getting infected and for those who have avoided important health checks because they don’t want to put any extra stress on the health services. Pharma companies experienced a challenge to keep clinical trials running in the beginning of the pandemic, but most hospitals have facilitated this now.

One positive side-effect of the pandemic is that social distancing has led to a rapid digitalisation of the health sector and put digital health at the top of the agenda.

 

What do you expect from EHiN?

EHiN is an arena that connects cross-sectional initiatives in digitalisation and biology across public institutions and private companies. It is a meeting place to find good digital solutions that can be implemented in the health sector and can position Norway internationally in long-term trends, which also creates great value for society.

At EHiN, you will meet different decision makers and participate in setting the political agenda for e-health. We need to continue to stress the importance of good public-private collaboration to develop, test and approve treatments for cancer patients.

 

What else would you like to communicate?

EHiN is important because collaboration is the key to create changes in health. We are working now with an application to become a health catapult centre, in collaboration with several innovation environments in health. If we succeed, we can strengthen the health industry by offering important services to small and medium-sized enterprises in digital health.

We also think it is very positive that the Norwegian Cancer Society have a good collaboration with EHiN. It shows how important e-health in Norway is for the entire cancer community.

 

Meet Ketil Widerberg as he moderates the session “Fremtidsmennesket” on 10 November 2020 at 11:00-12:00 during EHiN 2020. 

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Professor Pål Rongved introduced the ZinChel technology that fights antimicrobial resistance at Oslo Life Science Week 2017. Photo: UiO/Terje Heiestad

Norwegian invention to fight antibiotic resistance

Professor Pål Rongved introduced the ZinChel technology that fights microbial resistance at Oslo Life Science Week 2017. Photo: UiO/Terje Heiestad

A new Norwegian technology may help stop the increase of antibiotic multi-resistance.

Antibiotic resistance is growing, and the world is running out of treatment options. In 2020, approximately 700 000 people will die from antibiotic-resistant infections. By 2050, as many as 10 million deaths are forecast.

Increasing numbers of cancer patients also develop resistance to multiple antibiotics, which potentially leads to life-threatening conditions. The World Health Organization (WHO) writes that: “Without effective antibiotics, the success of major surgery and cancer chemotherapy would be compromised.”

A Norwegian solution for global challenge

New Norwegian technology from the start-up Adjutec Pharma may help to stop increasing antibiotic resistance. The technology, known as ZinChel, was first developed in collaboration between the University of Tromsø (UiT) and the research group SYNFAS at the University of Oslo (UiO).

ZinChel has shown promising effects against a group of multi-resistant bacteria, which are increasingly widespread in many regions of the world, including Europe.

The bacteria, known as gram-negative, are equipped with a type of enzyme called “metallo-beta-lactamase”, which renders modern carbapenem antibiotics useless. These bacteria are on the World Health Organization’s list of the 12 most dangerous bacteria in the world, causing severe and often deadly infections.

Pål Rongved is a Professor at the University of Oslo with a PhD in chemistry. He is one of the inventors behind ZinChel and the founder and CEO of the start-up company Adjutec Pharma AS.

Adjutec Pharma AS has a strong momentum to develop the technology further together with our Norwegian partners and private investors. If we do this correctly, the results of this project can provide patients with vital treatment in the future and contribute to the establishment of a health industry that provides new jobs. We have an ethical and moral responsibility to bring the technology to market and patients as quickly as possible. There is no time to lose and we are on track”.

Creating value for patients and industry

The technology is not yet available to treat patients, because it is still in pre-clinical development. This means that it will need to be further tested on animals and humans to assess its safety and efficacy.

Adjutec Pharma has recently secured exclusive rights to the patents for the ZinChel technology and will raise more money to accelerate development of the drugs in collaboration with researchers at University of Oslo.

Adjutec Pharma has received $3 million in grants, including support from the Norwegian Research Council and Novo Nordisk. The company will raise $20 million in investments to reach Phase II clinical trials, including public and private funding.

Adjutec Pharma receives start-up services from Oslo Cancer Cluster (OCC) Incubator, who are partly financed by SIVA, a governmental enterprise facilitating a national infrastructure for innovation.

Bjørn Klem, general manager of Oslo Cancer Cluster Incubator, has provided important help in the establishment of Adjutec Pharma. Photo: Stig Jarnes

Bjørn Klem, general manager of Oslo Cancer Cluster Incubator, has provided important help in the establishment of Adjutec Pharma. Photo: Stig Jarnes

Bjørn Klem, general manager of OCC Incubator, said:

“OCC Incubator provided help and advice to the founders when establishing Adjutec Pharma, including finding competent people for the board. The OCC Incubator has negotiated the licensing agreement with the University of Oslo, which gives the company exclusive rights to commercialise the inventors’ patents. We also help the company with the development of a business strategy and financing through public funding programmes and private investors.”

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The students from the Researcher Programme were eager to hear more from Vegard Vinje after the mentor meeting. Vegard, in the middle, is a researcher at Simula and former student at Ullern Upper Secondary School. Photo: Elisabeth Kirkeng Andersen.

First-year students met their mentors

This fall, 32 students have begun their first year of the Researcher Programme at Ullern Upper Secondary School. Earlier in October, they met their four mentors, who will support them throughout the school year – and the mentors include some big names in the field.

Thirty-two nervous first-year students are sitting in Jónas Einarsson Auditorium. They are all attending the Researcher Programme. This is a unique opportunity for young people in Oslo who wish to immerse themselves in science, especially in biomedicine, and gain a more practical introduction to subjects like maths, physics, chemistry, biology, and IT and programming.

First of three meetings

Ragni Fet, former cancer researcher and currently biology teacher at Ullern school, is responsible for the first-year students at the Researcher Programme.

“It is nice to see all of you here and it is my pleasure to introduce the four mentors to you,” Fet says.

The mentors are:

  • Vegard Vinje, researcher at Simula and former Ullern student
  • Jónas Einarsson, CEO of Radforsk and initiator of Oslo Cancer Cluster and Oslo Cancer Cluster Innovation Park
  • Simone Mester, PhD student and former Ullern student
  • Bjørn Klem, general manager of Oslo Cancer Cluster Incubator and former Head of Research at Photocure.
The mentors. From left to right: Vegard, Jónas, Simone and Bjørn. Photo: Elisabeth Kirkeng Andersen.

The mentors. From left to right: Vegard, Jónas, Simone and Bjørn. Photo: Elisabeth Kirkeng Andersen.

Fet tells the students that they will meet the four mentors today and twice more during the school year. The next time the visit will take place at one of the mentor’s workplaces. Read more about what the students of the Researcher Programme (2019/2020) experienced when they visited Simone Mester at her workplace in December 2019.

The following time, the students will present their own research to the mentors and receive an evaluation from them. Read more about the type of research the students of the Researcher Programme (2019/2020) presented to their mentors.

“Today you can ask the mentors as many questions you like about their choices concerning education, focus, career, what they have learnt and experienced, and what they are doing today. Please feel free to ask your questions,” Fet says.

Question time

The students are eager to ask their questions to Vegard, Jónas, Simone and Bjørn during the next hour. It is obvious that the students have done some in-depth research on their four mentors.

When the question time was over, Jónas said:

“This was fun! You asked us good and interesting questions. This was both educational and entertaining for me too.”

You can read some of the questions and answers that occurred during the course of the hour they spent together below.

Q&As

Question: What is the most exciting thing you have experienced during your careers?

Vegard:

I was interviewed by NRK radio and they produced an article about our research. The research is about how breathing affects flows in the brain, something that can help to clear the brain from toxins.

An accumulation of toxins in the brain can be associated with an increased risk to develop Alzheimer’s disease, so NRK’s angle was: “Norwegian study: Your breathing can play a part in Alzheimers” even though our research does not say anything about causation. In the comments under the piece, the conclusion was practically “Yoga is good for the brain”, since breathing is an essential part of yoga.

It was interesting to see how our research was communicated so differently from what our work actually was.

The first-year students of the Researcher Programme listened intently to the mentors' stories. Photo: Elisabeth Kirkeng Andersen.

The first-year students of the Researcher Programme listened intently to the mentors’ stories. Photo: Elisabeth Kirkeng Andersen.

Jonas:

My biggest moment was two years ago when I was sitting at a science conference on immunotherapy against cancer in New York. The same day, it was announced that the two researchers Tasuku Honjo and James Allison had been awarded the Nobel Prize in Medicine for their discovery of how checkpoint inhibitors, a form of immunotherapy, can make the body’s own immune system fight cancer.

When the conference opened, Jim – which is James Allison’s nickname – came into the auditorium to give a presentation. This had already been decided long ago and had nothing to do with the Nobel Prize. The whole room stood up and clapped. That was huge. Jim was also here last year and visited the students who are now in the second year of the Researcher Programme.

Simone:

When I was finished with my master I was accepted into SPARK, which is the University of Oslo’s innovation programme. Because of that, I was also invited to Arendalsuka to present my project to many important people, and it was a big thing for me to be able to contribute.

In addition, it is always big when I experience an Eureka! moment in the laboratory: it is fun when you get a result that proves that your theory actually works.

Bjørn:

To find solutions to different things is what I like the most. If I had to choose one individual event, it would have to be this: I had worked for a long time in Photocure as Head of Research, and developed a medical device called Cevira, which is made to treat cervical cancer. We tested it in humans and it had good results, but then it was put on hold for many different reasons.

Then, about one year ago, the news came that a Chinese company had licensed this product for billions of NOK. They are already underway with the last part of the testing of Cevira, so maybe it will enter the market and be used by women all over the world in only a few years. I knew this product would work, so it is fun it is no longer forgotten about.

Question: Where do you think your research careers will take you, Simone and Vegard?

Vegard:

I dream about finding out more about the different flows in the brain that I am doing research on, but I am not sure I will find the answers. It is a simple transition between research and private industry, so maybe I will start my own company in time.

Simone:

I really want to start my own company and it is scary to even say it, but I am already underway. To start a company and develop a pharmaceutical that can make a difference for patients would be fun. I think it is a very exciting and challenging journey, and I am lucky to have guides that help me to do this.

Question: Why are you working with what you are doing now?

Vegard:

When I think back, it seems completely random. I did not have a plan about what I wanted to become when I attended upper secondary school. I liked maths and physics, and got an education in that, which was really fun. When I completed my bachelor degree, I got a summer job at Simula. This was in 2013 and after that, they have continued to offer me work and research projects.

Jónas:

I am a doctor by education and worked for many years as a general practitioner in Western Norway. When I moved from Western Norway to Oslo because of family, I did not have any job to go to and I did not know what I wanted to do either. A friend of mine worked at the Radium Hospital’s Research Foundation and offered me a project-based position for six months so that I could have time to think about the future, and since then I have remained.

Bjørn:

I do not think it is completely random, even if Vegard and Jónas say so, but it seems like that for me too. I studied pharmacy and later I was hired into Photocure and afterwards, I ended up here in the Incubator. But it isn’t completely random. We are affected by our surroundings: just think about what you do here at Ullern and what you are exposed to in the Oslo Cancer Cluster Innovation Park. Even if things seem random sometimes, they are not.

Bjørn Klem tells about his background as a pharmacist. Photo: Elisabeth Kirkeng Andersen.

Bjørn Klem tells the students about his background as a pharmacist. Photo: Elisabeth Kirkeng Andersen.

Jónas:

What you are talking about, Bjørn, is called Serendipity and is a type of unplanned discovery or a positive surprise when looking for something else.

For example, I was a rascal during upper secondary school and I wanted to study medicine, but my grades were not nearly good enough for that. So one day, my brother who was the president of ANSA, the association for Norwegian students who study abroad, called me. He told me that all Icelandic people are accepted to the first year of medical school in Iceland, and since I am an Icelandic citizen, that became my way in. That is typical serendipity.

Simone:

I studied science at Ullern Upper Secondary School and thought medicine would be a safe choice. But I wasn’t really interested of patient care, which made me very unsure. I talked a lot with Ragni, who was my biology teacher, and she encouraged me to study molecular biology at the university.

I was lost and confused the first year, because I wanted to study and work with something that has a value and is of use to others: to make a difference. Luckily, I found the research group led by Jan Terje Andersen and Inger Sandlie, where I have received a lot of support to go my own way and be innovative.

By the way, Inger Sandlie is my role model as a researcher and innovator. She has the most innovations registered with Inven2, the tech transfer office of the University of Oslo and Oslo University Hospital, and is behind Vaccibody, that recently entered Norway’s largest agreement in biotechnology.

Simone and Ragni. Ragni Fet, a former cancer researcher and now biology teacher at Ullern was crucial in Simone’s study choice. Photo: Elisabeth Kirkeng Andersen.

Simone and Ragni. Ragni Fet, a former cancer researcher and now biology teacher at Ullern was crucial in Simone’s decision to study molecular biology. Photo: Elisabeth Kirkeng Andersen.

Articles about previous mentor meetings

 

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Kjetil Taskén, Åslaug Helland and Hege Russnes from Oslo University Hospital are a few of the enthusiasts behind the national clinical study for cancer precision medicine in Norway. Photo: Oslo University Hospital

IMPRESS leads the way for cancer precision medicine

IMPRESS Norway is a national clinical study starting in 2021 working towards implementing cancer precision medicine in Norway.

As one of the initiators behind IMPRESS-Norway, Oslo Cancer Cluster is thrilled to see this national clinical study in cancer precision medicine become a reality.

Precision medicine is an approach to patient care that allows doctors to select treatments that are most likely to help patients based on a genetic understanding of their disease, according to the National Cancer Institute.

During 2019, Oslo Cancer Cluster hosted a series of workshops with public and private stakeholders in cancer. The joint goal was to accelerate the implementation of cancer precision medicine in Norway. The initial idea for IMPRESS emerged in one of these workshops. A dedicated team, including Kjetil Taskén, Sigbjørn Smeland, Åslaug Helland and Hege Russnes, at Oslo University Hospital quickly turned it into a national effort together with colleagues at university hospitals across Norway.

IMPRESS involves the active support of leading global pharmaceutical companies that will provide the study drugs and contribute with per patient fees. Public funding will help to ensure this innovative study paves the way for more cancer clinical trials in Norway.

National infrastructure for precision diagnostics is needed and is currently being set up at all Norwegian cancer hospitals. Cancer patients who are eligible for clinical trials can soon be tested and selected based on their specific genetic profile.

A new public-private partnership called CONNECT is also being established with Oslo Cancer Cluster as project coordinator. CONNECT will provide an arena for all stakeholders to jointly address key obstacles and to pilot novel solutions to advance the implementation of precision cancer medicine.

In the newly released Norwegian state budget, an additional NOK 30 million is allocated for personalized medicine. NOK 25 million is earmarked for the implementation of genetic precision diagnostics at the Norwegian hospitals. This demonstrates a commitment from the Norwegian government to advance the implementation of precision medicine for Norwegian cancer patients.

Learn more: Read the article (in Norwegian) at Oslo University Hospital’s website or the English translation below.

 

IMPRESS NORWAY: Large national precision medicine study in cancer

IMPRESS-Norway, a large national study on precision medicine against cancer, starts in the beginning of 2021. The study will, based on individual and expanded gene analysis give its participants the opportunity to receive so-called off-label medicines, that is medicines approved for the treatment of other diseases, to fight their specific unique cancer disease.

IMPRESS-Norway is a national clinical cancer study in precision medicine. The goal with the study is to test approved pharmaceuticals on new patient groups based on their cancer type and genetic mutations (molecular profile). The study is open for all hospitals in Norway that treat cancer patients and so far, thirteen hospitals have decided to participate in the study.

In the study, we will, in addition to data on clinical efficacy, collect comprehensive information about the molecular changes in the cancer tumour, by performing a complete DNA analysis, whole genome sequencing. This will provide us with a unique and comprehensive dataset that can be used by researchers across Norway to answer key questions in cancer treatment, such as improving the selection of patients for treatment and understanding resistance mechanisms.

For patients with advanced cancer who have received standard treatment

Patients with advanced cancer who have already received standard treatment are eligible to participate in IMPRESS-Norway, and we expect between 250 and 500 patients to be recruited every year. The patients will be included in patient groups (cohorts) based on molecular profiles, cancer diagnosis and medicine. Each cohort will first include eight patients. If one or more patients respond to the treatment, then another sixteen patients will be included. A cohort is considered positive if five or more patients of the total twenty-four patients, respond to the treatment.

The protocol for the study has been sent to The Norwegian Medicines Agency and it is expected to start in the beginning of 2021. The patients need to be referred to the study by their general practitioner or hospital clinician.

The study requires a national infrastructure

IMPRESS-Norway requires that cancer patients are offered an in-depth analysis of the cancer tumour’s genetic mutations. Therefore, the academic environments have worked, with dedicated funds from the regional health authorities, to establish a national infrastructure for precision diagnostics for cancer patients (National infrastructure for precision diagnostics called InPred).

Mapping 500 genes

The establishment of these new diagnostic services is already well underway at several hospitals. The goal is to offer expanded molecular diagnostics with mapping of 500 genes to all cancer patients who are eligible for clinical trial inclusion. The molecular results will be discussed in a national molecular tumour board, consisting of clinicians, pathologists and informaticians, and if the analysis shows that the patient has genetic mutations that can be treated with targeted therapy, the patient can be referred to the appropriate clinical trial or to IMPRESS-Norway.

Collaboration with pharmaceutical companies

IMPRESS-Norway is in dialogue with 17 pharmaceutical companies about contributing approved drugs that can be tested outside their approved indication (off-label). One goal with the study is to try out a concrete model for the implementation of personalized medicine. The clinical study will give health personnel and researchers unique experience with precision medicine and the use of molecular diagnostics in treatment, and will offer new treatments to a group of patients who have used up all other options. In addition, the collaboration partners of IMPRESS-Norway are planning to build a public – private collaboration (called CONNECT) where the experiences from IMPRESS-Norway will provide knowledge of how precision medicine affects, among other things, health economy, the health industry and the health services.

Learning from the Netherlands

IMPRESS-Norway is modelled on a precision medicine study called DRUP, which is currently ongoing in the Netherlands. Similar studies are being planned in several European countries and IMPRESS-Norway plans to collaborate on data sharing with the other Nordic countries. This is especially important since we know from experiences with the DRUP study that individual molecular profiles are so rare that it is difficult to fill the cohorts in a single country and therefore it becomes important to compile data from similar cohorts across studies.