Machine-learning for immunotherapy

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? 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.

 

Industrial precision against cancer 

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.

Surgery, squash and anaesthesia

Hannah (18) wants to become a doctor. After two days job shadowing doctors and nurses at the Norwegian Radium Hospital, she is even more certain that this is what she wants to do.

If your dream is to become a doctor, it may be a good idea to gain some insight into what the job actually involves before embarking on a long education. But job shadowing a doctor is usually only a possibility if you’re already a medical student.

Truls Ryder is a senior consultant and surgeon at the Norwegian Radium Hospital. He decided to do something about this, and over three days, one theme day that you can read more about here and two days of job shadowing, 18 pupils had the opportunity to experience surgery, morning staff meetings and patient consultations with the best cancer specialists and nurses in Norway.

Hannah Fiksdal is one of these pupils. And I, Elisabeth the journalist, shadowed her on the first of her two days at the Norwegian Radium Hospital. It was a day that neither of us will forget. A day that left Hannah with an even stronger desire to become a doctor.

‘I am incredibly grateful for the chance to shadow two different doctors, and to Truls Ryder for taking the initiative to allow pupils from Ullern to come to the Norwegian Radium Hospital. It gives us some idea of what may interests us before we apply for higher education in the spring. Having had a taste of two different aspects of medicine, I think that surgery and anaesthesiology were probably the things that I found most exciting.’

Hannah Fiksdal.

Hannah Fiksdal starts the day early at the hospital. Photo. Elisabeth Kirkeng Andersen

Tuesday 7 November

07:15 – the Norwegian Radium Hospital, basement level 2 – the corridor outside room AU 230
Sixteen excited pupils, 14 from the natural science and mathematics programme who will be shadowing doctors and two from the healthcare programme who will be shadowing nurses, are standing in a corridor two floors below the main entrance to the Norwegian Radium Hospital dressed in white hospital clothes.

Truls Ryder, senior consultant and prime mover behind the job shadowing scheme, is also here. He quickly reads out where each pupil will be spending the day, and sets of at a brisk pace with everyone in tow.

This is an indication of what is to come.

We go five floors up and then a couple of floors down via the back stairs. On the way, pupils peel off from the group to join other senior consultants and professors who they will be job shadowing today.

Hannah and Tristan are handed over to the anaesthetists at the anaesthesiology department. The department has nine senior consultants, one professor working 50% of a full-time position, and three specialist registrars.

07:34
The morning staff meeting has already started when Hannah and Tristan arrive. Eight doctors and nurses go through the list of patients who will need anaesthesia or pain relief today. Some will undergo surgery in the hospital’s central unit, and some require their services in other parts of the hospital, such as the radiotherapy department.

It is difficult to understand the discussions and information exchanged between the doctors and nurses. The jargon is technical, professional and precise. I wonder how much Hannah and Tristan understand? But it is clear that we have a full day ahead, and that many of the patients are seriously ill with cancer. Some are young, and some patients’ cancer has returned after treatment. Despite the difficult subject, the tone of the meeting is upbeat and friendly. It will remain so for the rest of the day.

08:00
Tristan and Hannah meet their mentors for the day. Tristan will join Senior Consultant Hege for a complicated operation that may take more than ten hours. The patient has a form of cancer that means that the surgeons have to go into the skeleton, among other things.

Hannah will be joining Senior Consultant Anne. Anne has several operations on her schedule today, and Hannah and I will be allowed to tag along and see how she works. Anne’s first patient is having an epidural and then a general anaesthetic. This is also a complicated operation.

Anne and Hege both tell us to be prepared that what we experience may make a strong impression on us and that it is natural to feel unwell. They both share stories about themselves and about medical students who have fainted both during and after visits to the operating theatre.

‘Let us know if you fell unwell,’ is their mantra, ‘and we will help you.’ I think back to the countless shifts I worked at nursing homes during my student days, and hope that they have prepared me for this. But what about young people of 18 and 19 who want to go on to work here?

08:07
Anne gives us green scrubs and a purple cap. We change in her office while she explains that her job can be compared to a pilot flying a plane. There is a lot to do when the operation starts until the patient is under anaesthesia, and then there is a calmer period of observation of the patient, often done by her colleagues, and then she goes back to full focus when the patient wakes up.

We get changed quickly.

8:10
Surgery starts early at the Norwegian Radium Hospital, and the patient arrives at the operating theatre at the same time as we do. Anne explains who Hannah and I are and why we are here. In addition to the patient, there are already five people working here.

Anne jokes and talks to the patient, who she has already met several times before. She explains that she will first be administering a local anaesthetic to the back before putting in an epidural, a form of pain relief given as an injection in the back. After that, a cannula will be inserted into a vein in the patient’s lower arm. When the patient is completely asleep, Anne will place a catheter in the neck that will be used to administer anaesthetics, pain relief, salts and anything else the body may need during an operation.

Anne involves Hannah in the work and explains what she is doing while she works, and she also explains to the patient.

‘It was also really nice to see how caring the doctors and nurses were and how they reassured the patients before surgery. They were very good at creating a pleasant atmosphere to make the patients feel safe despite the seriousness of the situation.’

Hannah Fiksdal.

08:41
Operating theatre 4 is a big, light room, and one of the long walls has big windows with a view of Mærradalsbekken stream and the surrounding forest. The river and the walking path meander side by side. But today, we can hardly see any of this through the darkness and fog.

Anne keeps an eye on the pulse and heart monitor that the patient is connected to, while the theatre nurse is preparing the instruments that the surgeons might need during the operation.

The patient is about to be put under full anaesthesia. Anne and her colleagues place a cannula in an artery in the patient’s lower arm/hand and a catheter in a vein in the neck. Anne is calm and talks to both the patient and Hannah. She explains to the patient that she will soon be asleep. She explains to Hannah what she is doing, and how you can tell the difference between a vein, which carries blood back to the heart: ‘It is darker in colour and pumps slower’ and an artery, which carries blood from the heart: ‘It is light in colour, full of oxygen, and has more force. If I had made a hole in an artery, the blood would have squirted out.’

Despite the number of people working in the operating theatre, the atmosphere is calm and pleasant.

Hannah pays close attention to Anne and asks questions while she is working. Anne is obviously impressed with the pupil: ‘Hannah, you are a tough cookie.’

09:10
The patient has been anaesthetised and is ready for surgery. At this stage, Anne and her colleagues’ responsibility is to ensure that the patient is okay during surgery.

09:40
The patient is in good hands in the operating theatre, so Anne goes to the recovery unit where the patients are taken to recover from the effects of surgery. Patients are closely monitored here. Many complications can arise following surgery, such as bleeding, breathing difficulties, a fall in blood pressure, pain and nausea.

Anne will set up a pain pump for the patient. This is a pump with morphine that Anne programs so that the patient can regulate how much pain relief she needs and wants in the days following the operation. We are allowed to use the staff’s break room while she is programming it. ‘Drink squash with sugar,’ she advises. We do as we are told, and talk a bit about what we have seen and experienced so far. Hannah is pleasantly surprised that she has been allowed into the operating theatre already, and at how open and welcoming everyone is.

‘There was some information about anaesthesia at the theme day yesterday, so I understand what is going on,’ says Hannah, and talks more about her wish to become a doctor.

Anne returns and takes the time to talk to Hannah about medical school and her many years working as an anaesthetist at Haukeland University Hospital. She took up her position at the Norwegian Radium Hospital a month ago, and there is still much that is unfamiliar.

10:01
We return to the operating theatre. There are suddenly a lot of people here, and several surgeons with different areas of specialisation discuss the surgery they are about to perform. It is a complex operation that requires cooperation.

After conferring for a while, the surgeons make a plan. Several of the Ullern pupils on job shadowing come by together with a gastrointestinal surgeon. One of the surgeons takes the time to explain the plan to Hannah and the others.

10:20
A theatre nurse goes through a checklist with the physician, surgeon and anaesthetist Anne. Everything is in order, and the operation can begin. Anne uses all her senses to check that the patient is still doing well.

Two surgeons cooperate on the operation. Hannah stands watching behind them. They talk about this and that while they are working, including the musical Book of Mormon. The actual operation is expected to take five hours. After working and discussing amongst themselves for a while, they ask for another surgeon to be called. They need what is called a ‘second opinion’, or another surgeon’s assessment.

There are suddenly a lot of people in the operating theatre, and several surgeons with different areas of specialisation discussing the case. Truls comes in with a couple of pupils who are shadowing him. Truls confers with his colleagues, and one of the surgeons explains that they are uncertain about the best way to proceed. When the surgeons opened the patient up, they found that the assumptions they had made from the outside were not correct. They have to rethink and make a new plan for the operation.

Anne lets us know that this is very unusual. There are rarely this many surgeons involved in an operation, and they do not often spend this much time discussing what to do. She suggests that we take a break and get something to eat. She has to work, though, both with more of today’s patients and planning for tomorrow, but she thinks that we should eat something.

‘Another thing that surprised me was the doctors’ willingness to show and tell me what they were doing and why. During the first day in particular I learnt a lot that I hope will be useful in my future studies. It was also very clear during the operations that good cooperation is incredibly important in order to achieve the best possible outcome for the patients. Everything from how the senior consultants’ discussed to find the best way to proceed during the first operation to how the two surgeons cooperated without needing to communicate much during the second one.’

Hannah Fiksdal.

11:07 Break room
Since we have green scrubs on, we have crispbread with cheese in one of the break rooms. Otherwise, we would have had to change, leave to eat and then change back afterwards. We also have more squash. With sugar. More pupils come in for a welcome break. Four intense hours have flown by. Two pupils have fainted and woken up again.

Ander Bayer from Oslo University Hospital’s communications department also joins us. He made this video about the job shadowing.

 

11:36 Operating theatre 2
Anne comes to get us. Hannah is going to go with her to another operation. Anne is to put another patient under anaesthesia. Again, Anne explains to the patient and theatre nurses who we are. This patient is also having an epidural in the back, and again, Anne alternates between speaking softly and reassuringly and explaining what she is doing to the patient and Hannah. Fourteen minutes after we entered the operating theatre, the patient is under. Two nurse anaesthetists help Anne by monitoring the patient. The theatre nurses wash the abdomen where the surgeons will open up the patient to remove tumours.

12:15 Operating theatre 4
Anne is needed in operating theatre 4 again, where three surgeons are operating on the first patient. They have now decided what to do.

12:23 Break
We get to take another break and have some squash with sugar, while Anne is preparing a pain pump for the second patient.

12:32
The second patient’s operation is under way. Two surgeons are standing face to face, working together. Anne gets a stool so that Hannah can stand by the patient’s head and watch the surgeons work inside the patient’s abdomen. They have made an incision that is held open by a large tool. There is a smell when the surgeon uses an electrosurgical knife to cut tissue and burn small blood vessels. The cancer they are removing is located around the vein and artery, the blood vessels running to and from the heart and legs. The surgeons show Hannah where they have to be careful. The cancer is removed, and they quickly suture the different layers of tissue before stapling the skin. The theatre nurses perform a routine equipment count. The operation is completed in 40 minutes.

The day in the operating theatre was at least as exciting as I imagined! I had not expected that they would allow us to get so close to the patients and really get a proper insight into what happens during an operation and also how the patients are anaesthetised.’

Hannah Fiksdal.

13:35
Anne returns to make sure that both the patient and Hannah are okay. Anne and her colleagues from the anaesthesiology department wake the patient up. The important thing now is for the patient to start breathing again. Everything goes as it should.

13:40
We accompany the patient to the recovery unit, where the patient will remain for a few hours. Anne’s work with this patient is now finished. We go back to her office to change out of the green sterile scrubs. Anne tells Hannah that she will probably doze off early after such a long and intense day. Anne’s shift will last until half past three, when other anaesthetists will take over for the evening shift. In the hall, Hannah thanks Anne for everything she has taught her and for taking care of her during the day.

14:00
As we leave the Norwegian Radium Hospital through the main entrance, we wonder how the first patient whose surgery we saw in the operating theatre is doing. And Hannah says that she is looking forward to another day of job shadowing tomorrow.

Epilogue
The evaluation results for the theme day and job shadowing were excellent. The pupils and teachers were highly satisfied, and it has already been decided that this will be made an annual event for pupils at Ullern upper secondary school who are considering a career in medicine.

‘Finally, I would like to say that it was very inspiring to see how committed Anne and Anna (Anna Winge-Main, who was Hannah’s mentor on the second day of job shadowing) was to their work and how much they loved their job. It was very clear that they are really dedicated to helping their patients. As Anne said, medical school can be hard and difficult, but once you start working as a doctor, nobody regrets their choice.’

Hannah Fiksdal.

READ MORE:

Days to partner up

Roche is looking for new partners in the innovative Norwegian life science scene. 

Roche is one of the largest pharmaceutical companies in the world with about 800 ongoing clinical trials. Within cancer research and development, this translates into about 500 clinical trials for many different types of cancer. Roche is a member in Oslo Cancer Cluster. 

Read more about Roche’s cancer research

As a part of Roche’s scouting for new innovative collaborations, the company arranged two partnering days in the beginning of December together with Oslo Cancer Cluster and the health cluster Norway Health Tech. Together, we welcomed start-ups, biotechs, academic researchers, clinicians, politicians, innovation agencies, students and other interested parties to a two day open meeting.

Partnering with companies 
The first day was at the at Oslo Cancer Cluster Innovation Park and the second day was at Oslo Science Park.

Growing life sciences in Norway is important to Oslo Cancer Cluster, and the larger pharmaceutical companies’ commitment to working with local stakeholders and local companies is an essential part of the innovative developments in this field.

Such collaborations have the potential to bring more investment to Norway and provide platforms for local companies to innovate, thrive and grow. 

— What we want to do is to strengthen the collaborations and to see even more companies emerge from the exciting research going on in academia in Norway, said Jutta Heix, Head of International Affairs at Oslo Cancer Cluster. 

Partnering with academia
Professor Johanna Olweus from the Institute for Cancer Research at Oslo University Hospital was one of the speakers. She also presented the Department of Immunology and K.G. Jebsen Center for Cancer Immunotherapy for a full auditorium at Oslo Cancer Cluster Innovation Park. 

Established back in 1954, the Institute for Cancer Research at Oslo University Hospital is certainly a well established institute and their Department of Immunology is currently involved in all the clinical trial phases.

— The scientists at the institute realise the importance of collaborating with the industry in order to get results out to the patients, Olweus said, and showed some examples of scientist-led innovations from the institute, including the Department of Cancer Immunology.  

In this story, you can read more about how science from Oslo University Hospital is turning into innovation that truly helps cancer patients.

The e-health meeting place

Starting next year, Oslo Cancer Cluster will co-power the conference E-health in Norway (EHiN).

– This is a natural continuation of the work we do in digitalisation, for a better understanding of cancer and better patient treatment, said Ketil Widerberg, General Manager of Oslo Cancer Cluster, at this year’s conference.

The Norwegian Ministry of Health and Care Services (HOD) and ICT Norway started a collaboration on creating a national meeting place for e-health. ICT Norway launched the first EHiN conference five years ago. Oslo Cancer Cluster is happy to announce that we are now one of the three stakeholders in this yearly conference, together with ICT Norway and Macsimum.

EHiN attracts a large audience from Norwegian government and business. The speaker in this picture is Christine Bergland, Director at the Norwegian Directorate of eHealth (NDE).

Norwegian e-health  
EHiN 2018 took place in Oslo Spektrum and was the biggest meeting place for actors in the public and private sector working with e-health in Norway. The conference had 150 speakers and 1300 participants. EHiN 2019 will be the 6th year of the conference.

What happened at EHiN 2018?

 — EHiN is an important meeting place for public and private actors, and for academia and business. This is a natural prolongation of the many meeting places Oslo Cancer Cluster is always working to establish and preserve, Ketil Widerberg says.

Digital technologies are part of what drives innovation to the maximum benefit of cancer patients. Widerberg is certain that e-health will change the way we understand and treat cancer in the future.

– E-health is part of the matrix for how we give the right medicine to the right patient at the right time, meaning precision medicine. One example of what we specifically do in this area, is a recent project we have been part of, called PERMIDES.

An e-health success story
From August 2016 until August 2018, Oslo Cancer Cluster together with five other European clusters in medicine and ICT, was managing a Horizon 2020 EU project called PERMIDES. It is a European e-health success story in bringing together biopharma and IT sectors.

D.B.R.K Gupta Udatha at the EHiN conference in 2018. Dr. Udatha was the project manager for PERMIDES at Oslo Cancer Cluster.

D.B.R.K Gupta Udatha is Director (Digital and EU) at Oslo Cancer Cluster. He has been instrumental in PERMIDES and explains why the project has had such a positive effect on the small and medium sized enterprises (SMEs) it has worked with. 

PERMIDES was a project to anchorage digital transformation across SMEs in biotechnology and pharmaceuticals. We aimed to see where the biopharma companies were lacking digital infrastructure and where the ICT companies could bring digital skills to make sure that the biopharma companies were up to date, Dr. Udatha said at this year’s EHiN.

The project created matchmaking opportunities between these two different categories of companies and was awarded EUR 4.8 million from the EU’s Horizon2020 programme. It addressed specific challenges for SMEs to go digital with a precision medicine product.

Read more bout the PERMIDES project here.

Let us cooperate on precise health technologies

International cooperation is key to fulfilling our vision of making cancer treatments more precise, and giving the patients new treatments more quickly.

This opinion piece is written by Ketil Widerberg, General Manager at Oslo Cancer Cluster. It was first published in the Norwegian newspaper Today’s Medicine, Dagens Medisin, 30 October 2018. 

The countries in Northern Europe have contributed to developing medical treatments that we today could not imagine living without. From the British discovery of antibiotics to the Danish development of a treatment for diabetes. Once again it is time for Northern European health innovation, this time in the field of health technology. What might the prime ministers from Northern Europe focus on when they meet in Oslo on 30 October to discuss health technology?

They might want to point out concrete and state-of-the-art initiatives from their respective countries. It could be Swedish biobanks, Finnish artificial intelligence, Danish health data, English genomics and Estonian health blockchain. These are exciting initiatives that make medicine more precise. This is particularly important when it comes to cancer because more precise treatments could save lives and limit the late effects resulting from imprecise treatment.

This opinion piece is written by Ketil Widerberg, General Manager at Oslo Cancer Cluster. It was first published in the Norwegian newspaper Today’s Medicine, Dagens Medisin, 30 October 2018.

At the same time, we see the contours of serious challenges arising with more precise medicine, such as each unit becoming more expensive. Smaller patient groups also mean that it is harder to find enough patients to understand the biological processes and the consequences of new medical treatments. As the prime ministers gather in Oslo to discuss health technology and plan the road ahead, it would not be amiss for them to look back in time and find inspiration from another technological development.

Precise through cooperation
In the 1990s, the search engine Yahoo helped us to quality-assure by categorising and being precise when we needed information on the internet. Yahoo thus contributed to the internet changing the world. However, the amount of data soon became enormous and complex, and a never-ending need for resources and experts arose. The traditional categorisation to ensure quality and structure the data became an impossible task.

This is very similar to what is happening in the health field today. We are constantly collecting more data and educating an increasing number of experts. With a few exceptions, every country is now collecting their data in their own registers and using a great deal of resources on assuring the quality of the data. The countries are rightfully proud of their initiatives. In Norway, we are proud of our biobanks and our health registers, such as the Cancer Registry of Norway. At the same time, we need to ask ourselves whether this national strategy really is the smartest way forward.

Let us go back to Yahoo. Towards the end of the 1990s, some engineers in California thought differently about the internet. How about using cooperation as a quality indicator? Instead of categorising, the links between the websites could ensure data quality. This is how Google was born, and we got precision, quality and insight into data that changed the world.

There are different challenges in the health field than on the internet. Data are more sensitive and the consequences for individuals can often be more dire. At the same time, health technology, in many ways, has reached the same point as the internet faced in the 1990s.  We do not have the quantity, the methods for analysis, or the quality to fully exploit the data to gather insight, or for treatment or innovation – yet.

From Yahoo to Google level
One way in which we could tackle the health technology challenges the data present us with is through international cooperation. It is about two things: to gather enough data, and to analyse the data to provide better and more precise treatment. The initiatives so far are promising, but they lack the potential to make the leap from Yahoo to Google.

The Northern European prime ministers can probably acknowledge this. The question is: what can they do? Should they encourage smart young engineers to analyse health data instead of developing the next app? Or should they change the way the hospitals buy technology?

A step in the right direction could be to look at what works best in the other countries. At the same time, we need to avoid new initiatives merely becoming a better horse-drawn carriage. Are there initiatives in existence that are scalable internationally so that we can bring health data up to the next level together? The answer is yes, but it requires visionary initiatives that have not been done anywhere else.

Common clinical studies
An area that the prime ministers will be able to highlight is a Northern European initiative for clinical studies. Together, the countries have a large number of patients, which gives researchers and doctors a better basis in their studies to understand more and provide better treatment. Such an initiative could also use health data from the national health services collected on a daily basis in several countries, known as real world data, instead of eventual clinical studies with patients over several years. This would be both quicker and much cheaper.

The prime ministers might also agree on cooperating on Northern European genetics. For 13 years, we collaborated on mapping our genes in the international  Human Genome Project. Now we need to get together to understand genes and treat the patients. With prioritised funding, genetics will soon be a part of the everyday clinical life in England. We can learn a lot from their experience.

Artificial intelligence
Lastly, the Northern European prime ministers may wish to collaborate on artificial intelligence in the health field. Today, cancer treatment, for instance, often only works on three out of ten patients. Artificial intelligence will change how we understand diseases such as cancer and how we treat the patients. The experiences from Finland of introducing artificial intelligence will help other countries to understand where the barriers are and where help might be needed first.

Oslo Cancer Cluster’s vision is to make cancer treatment more precise and provide new treatments more quickly to the patients. We see that international cooperation is key to obtaining this goal. As a result, we could also discover diseases more quickly and reduce the costs of the national health services. We hope the Northern European prime ministers will delve into these issues when they meet to discuss the health technologies of the future here with us.

By Ketil Widerberg, General Manager at Oslo Cancer Cluster.

– An idea needs to attract investors

Meet Thomas Andersson, our new Senior Advisor Business Development. How could he be of help to your startup company? 

— The most important thing I do is to get the startup companies rolling.

Thomas Andersson, the new Senior Advisor for Business Development at Oslo Cancer Cluster and Oslo Cancer Cluster Incubator, looks dead serious as he makes this statement, but immediately after he lets out a smile and elaborates:

— A company needs to be investible. An idea needs to attract investors.

A lifetime of experience
Thomas holds a Ph.D. in Physical Chemistry from Lund University in Sweden and has more than 30 years of experience from establishing, operating and funding start-ups in the life science field. He has a long background in business development in health tech startups, all the way back to the early 1980s.

— I’m that old! I went straight from my Ph.D. in biophysics into the problem-solving of business development.

In his career he has also taken on issues with patents and sales and he even bought a company that produced monoclonal antibodies with some friends and remodelled and sold it. 

— What did you learn from this journey? 

— I learned quite a lot, including the production business and the cell cultivation biotech business from the floor. I also learned how to lay out the production manufacturing facility.

See it like an investor
Thomas Andersson knows the biotech startup-scene from the investors’ point of view. He started to work at the tech transfer office of Karolinska Institutet in Sweden. It was called Karolinska Innovations back then, now it is known as KI Innovations.

— We raised a lot of money there, formed 45 companies as a group and we had a fantastic time! 

After 8 years he was recruited to Lund and worked in Lund University Bio Science and tried to vacuum clean the whole university for life science innovation.

— And we did find a lot! In the end there were about 20 investment proposals and those ended up in 9 investments, of which we turned down 5 or 6. Two of them are now at the stock market. 

In total, Thomas Andersson has been involved in starting about 20 companies, of which 5 survived and are now on the stock market.

Normally, it is said that only 1 in 30 biotech startups make it. 

 

Thomas Andersson, Senior Advisor Business Development. Photo: Oslo Cancer Cluster

Here for you
— How did you end up here at Oslo Cancer Cluster?  

— I have had my eyes on Oslo Cancer Cluster for a while. I have liked the ideas that the cluster stands for. And I wanted to do something new in the end of my career. That is why I am here as a senior advisor now. I like it here! I am working on very interesting projects and ideas.

Our new Senior Advisor Business Development is present in Oslo Cancer Cluster Incubator nearly every week although he still lives in Lund, Sweden, on a farm in the woods where he can be practical and hands-on with hardwood and fly fishing.

— My door is open to people in the cluster and incubator with projects and ideas. I have a network that can help them and I have the experience of how investors, scientists and other actors can value a company. And being a Swede in the Norwegian system; I am basically here also to encourage you to think differently.

 

Interested in more funding opportunities for your company?

Check out our Access to Capital-page. 

 

T-cells and the Nobel Price

What does the Nobel Prize have to do with cancer research in Oslo Cancer Cluster?

This year the Nobel Prize for Physiology and Medicine was awarded to James P. Allison and Tasuku Honjo for their work on unleashing the body’s immune system to attack cancer. This was a breakthrough that has led to an entirely new class of drugs and brought lasting remissions to many patients who had run out of options.

A statement from the Nobel committee hailed the accomplishments of Allison and Honjo as establishing “an entirely new principle for cancer therapy.”

This principle, the idea behind much of the immunotherapy we see developing today, is shared by several of our Oslo Cancer Cluster members, including Oslo University Hospital and the biotech start-up Zelluna.

– This year’s Nobel Price winners have contributed to giving new forms of immunotherapy treatments to patients, resulting in improved treatments to cancer types that previously had poor treatment alternatives, especially in combination with other cancer therapies, said doctor Else Marit Inderberg as a comment to the price.

She leads the immunomonitoring unit of the Department of Cellular Therapy at Oslo University Hospital. The unit is present in Oslo Cancer Cluster Incubator with a translational research lab.

Inderberg has been studying and working with T-cells since 1999, first within allergies and astma, before she was drawn to cancer research and new cancer therapies in 2001.

So, what is a T-cell?
T-cells have the capacity to kill cancer cells. These T-cells are a subtype of white blood cells and play a central role in cell-mediated immunity. They are deployed to fight infections and cancer, but malignant cells can elude them by taking advantage of a switch – a molecule – on the T-cell called an immune checkpoint. Cancer cells can lock onto those checkpoints, crippling the T-cells and preventing them from fighting the disease.

The drugs based on the work of Nobel Prize winners Allison and Honjo belong to a class called checkpoint inhibitors – the same immune checkpoint that we find on T-cells. Drugs known as checkpoint inhibitors can physically block the checkpoint, which frees the immune system to attack the cancer.

Group leaders Else Marit Inderberg and Sébastien Wälchli often work in one of the cell labs in Oslo Cancer Cluster Incubator. Photo: Christopher Olssøn

 

– We work on other ways of activating the immune system, but in several clinical trials we combine cancer vaccines or other therapies with the immune-modulating antibody, the checkpoint inhibitors, which the Nobel Price winners developed, Inderberg explained.

Inderberg and her team of researchers in the translational research lab in Oslo Cancer Cluster Incubator use the results from the Nobel Price winners’ research in their own research in order to develop their own therapy and learn more about the mechanisms behind the immune cells’ attack on the cancer cells and the cancer cells’ defence against the immune system.

– This Nobel Prize is very inspiring for the entire field and it contributes to making this kind of research more visible, Else Marit Inderberg added.

– Our challenge now is to make new forms of cancer therapies available for a large number of patients and find ways to identify patient groups who can truly benefit from new therapies – and not patients who will not benefit. Immunotherapy also has some side effects, and it is important that we keep working on these aspects of the therapy as well.

From research to company
Most of the activity of the translational research lab in Oslo relies on the use of a database of patient samples called the biobank. This specific biobank represents an inestimable source of information about the patients’ response to immunological treatments over the years. Furthermore, the patient material can be reanalysed and therapeutic molecules isolated. This is the basis of the Oslo Cancer Cluster member start-up company Zelluna.

 

Want to know more about Zelluna and the research they are spun out of?

This is a story about their beginning.

Curious about new research from the Department of Cellular Therapy in Oslo?

More on their webpage.

Want to hear from the Nobel committee about why this research was awarded the price?

Listen to this podcast by ScienceTalk. 

Prestigious partnership for Vaccibody

Oslo Cancer Cluster member Vaccibody is entering into a clinical collaboration with the American biopharmaceutical company Nektar Therapeutics.

The aim of the collaboration is to explore positive effects from the combination of Vaccibody’s personalized cancer vaccine VB10.NEO and Nektar Therapeutics cancer drug NKTR-214. Pre-clinical results of the combination are very positive and the collaboration will mark the start of a clinical trial stage.

The clinical trials will include patients with head and neck cancer and initially involve 10 patients.

What is Nektar?
Nektar Therapeutics is not just any company when it comes to immunotherapy. At Nasdaq their market value is set as high as 10 billion dollars.

– For a year now, Nektar might be the most talked about company within immunotherapy and this winter they landed the largest deal of its kind with Bristol Meyers-Squibb (BMS), says Agnete Fredriksen, President and Chief Scientific Officer, in an interview with Norwegian newspaper Finansavisen.

Help more patients
BMS and Nektar started collaborating on the development of the immunotherapy drug NKTR-214, the same drug that is part of the collaboration with Vaccibody, with a potential worth of 3.6 billion dollars.

– That they want to work with us is a nice validation of Vaccibody and makes us able to help even more cancer patients. We hope the combination of our products will lead to even better treatments, Agnete Fredriksen says to Finansavisen.

More about Vaccibody’s cancer vaccine

Nektar and Vaccibody each will maintain ownership of their own compounds in the clinical collaboration, and the two companies will jointly own clinical data that relate to the combination of their respective technologies. Under the terms of the agreement and following the completion of the pilot study, the two companies will evaluate if they will take the partnership to the next stage.

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.

You can read more about the research projects of Cancer Registry of Norway on their website.

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!