The panel discussion at our breakfast meeting 27 March 2019. From the left: Jan Frich, Anette Grøvan, Odd Terje Brustugun, Heidi Brorson, Tove Nakken and Markus Moe.

Giving patients a stronger voice

How can the voices of cancer patients be heard when evaluating new methods of treatment?

A breakfast seminar was held yesterday in the series called The Cancer Treatments of the Future. Over 150 people attended at Litteraturhuset in Oslo, among them were relevant key players from the healthcare sector, governmental agencies, patient organisations and the public. The aim was to identify new opportunities to improve patient involvement when evaluating new methods of treatment.

The seminar was jointly arranged by Oslo Cancer Cluster, Legemiddelindustrin (LMI) and The Norwegian Cancer Society. The sponsors of the event were Astra Zeneca, Janssen and MSD.

 

Anne Grethe Erlandsen

Anne Grethe Erlandsen, the State Secretary of the Norwegian Ministry of Health and Care Services.

Anne Grethe Erlandsen, the State Secretary of the Norwegian Ministry of Health and Care Services, first talked about creating a healthcare service with the patient as the starting point. She said that it is important to involve the patient in the decision-making processes to bring in new perspectives, ask questions and challenge the healthcare service.

“The patient is the most radical agent of change in the healthcare sector.”
Anne Grethe Erlandsen

 

Ellen Nilsen

Ellen Nilsen, Special Adviser at Nye Metoder.

Next, Ellen Nilsen, Special Adviser at Nye Metoder, which is the national system for managed introduction of new health technologies within the specialist health service in Norway. Nilsen gave a presentation of Nye Metoder and its processes.

 “Anyone, including patients, their relatives or patient organisations, can submit a proposal for a new method of treatment.” Ellen Nilsen

The proposal is then managed by the regional health authorities in The Commissioning Forum, which commissions a full Health Technology Assessment (HTA) from The Norwegian Medicines Agency. Anyone can submit input to The Commissioning Forum by e-mail or in a form on the website.

Decisions are then made by the regional health authorities in The Decision Forum, based upon the HTA. Patient organisations are also represented in a reference group that meets every six months. The patient representatives are only observers, but have the right to make verbal contributions.

  • Learn more about Nye Metoder by reading this presentation in English from their official website.

 

Health Technology Assessment (HTA) is the evaluation of a new method of treatment, often in comparison to existing treatments. The treatments are assessed according to a set of criteria: the severity of the disease, the utility of the treatment and its cost effectiveness.

 

Anette Grøvan, Senior Adviser at The Norwegian Medicines Agency.

Then, Anette Grøvan, Senior Adviser at The Norwegian Medicines Agency, presented how they are developing a pilot project to involve patients in their HTAs. They have sporadically received input from patients and patient organisations in the past, but they wish to implement a better system for it now.

“Satisfied patients are important to us. Everyone should have a voice, regardless of their diagnosis or disease.” Anette Grøvan

They believe the patients can contribute with their experiences of living with the disease, the quality of existing treatments and their expectations on new treatments.

 

 

A panel discussion, moderated by Markus Moe, the Editor-in-Chief of Dagens Medisin, was then held with the following participants:

  • Tove Nakken, Head of brukerutvalget* at Oslo University Hospital and Deputy Head in Lymfekreftforeningen (The Norwegian Lymphoma Society)
  • Heidi Brorson, member of brukerutvalget* at the South-Eastern Norway Regional Health Authority and Special Adviser in the Norwegian Cancer Society
  • Anette Grøvan, Senior Adviser at The Norwegian Medicines Agency
  • Jan Frich, Chief Medical Officer at the South-Eastern Norway Regional Health Authority and Senior Adviser in the Commissioning Forum
  • Odd Terje Brustugun, oncologist at Drammen Hospital

*”brukerutvalget” is a selected group of patient representatives that exists in each regional health authority

 

The topic of the panel discussion was how to improve patient involvement when evaluating and approving new methods of treatment.

 

Nakken first highlighted the lengthy processes in Norway: “Patients want to take part of the treatments that have been approved in our neighbouring countries. But the bureaucracy in Norway takes too long.”

Brustugun agreed that there is a gap between the treatments available in Norway and abroad, and that this is affecting an ever-growing patient population: “The patient’s perspective is important, because there is a large group of patients that can potentially become long-term survivors if given the new treatments.”

Frich said the overall cost of pharmaceuticals in Norway has actually increased over the years, mostly due to new and expensive cancer therapies. He explained they are legally obliged by Stortinget to evaluate new methods according to a specific set of criteria. The reason that a treatment isn’t approved may be that the effect of it has not been documented well enough.

Brorson called for greater transparency in the decision-making processes: “If there was more openness about the decision-making, the patients would have a greater understanding for it and become better informed.”

Grøvan added: “We are not finished developing the system for patient involvement and there are a lot of considerations to make sure that it becomes structured and fair.”

 

The engaging panel discussion inspired the audience to make their own comments and reflections.

 

The fruitful discussion led to many constructive ideas on how to improve patient involvement. Hopefully, these kinds of collaborative discussions can inform politicians to take the necessary steps forward to improve cancer patients’ lives.

Oslo Cancer Cluster wants to thank the speakers, the sponsors, the organisers and everyone who attended! This discussion will continue at Arendalsuken 2019, at our event August 15. We hope to see you there!

 

  • Here is a summary of the event, written in Norwegian, from LMI’s official website.
Arctic Pharma, a member of Oslo Cancer Cluster, gave students a lecture on the chemistry behind cancer treatments.

Chemistry with mutual benefits

Students were taught about the chemistry behind developing cancer treatments in the Oslo Cancer Cluster Incubator.

In February, forty chemistry students were given a memorable specialisation day on the subject of the chemistry behind developing cancer treatments. The company Arctic Pharma in Oslo Cancer Cluster Incubator invited them to the lab and gave a long and detailed lecture on the chemistry behind the medication they are developing to treat cancer.

Karl J. Bonney, who is a researcher in the company, started the day with an interactive lecture in English about the chemistry of the substance Arctic Pharma hopes will be effective against cancer.

Bonney emphasised to the students that the company is in the early stages of the development, and that it will take approximately three to four years before they are potentially able to start clinical trials on humans to see whether the substance is effective.

The pupils who are studying chemistry as their specialisation in the last year of upper secondary school were obviously fascinated by what they heard. They asked many important questions both to the lecturer, Bonney, and the chemistry teacher, Karsten, who participated to explain the most difficult terms in Norwegian.

 

Sugar-hungry cancer cells

Arctic Pharma is exploiting a well-known biological fact regarding cancer cells, namely that they like sugar, which means they have a sweet tooth. This is called the Warburg effect, and, so far, nobody has used it in the treatment of cancer. Since this is such a characteristic aspect of cancer cells, it would make sense to think that this could be a viable starting point for treatment.

Arctic Pharma is one of the smaller companies in Oslo Cancer Cluster Incubator and is co-located with Ullern Upper Secondary School. Bonney has been permitted to use the school’s chemistry lab to test the chemical substance being developed to attack the Warburg effect.

The chemistry day at the company was organised to return the favour and to inspire the young chemistry students to keep studying chemistry at a university or university college.

 

 

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Transporting patients

Student Jørgen Amdim got to experience life as an orderly on his one-week placement at the Norwegian Radium Hospital.

 

Transporting patients in Norway’s biggest cancer hospital is strenuous both physically and psychologically. “But it’s really good,” said Jørgen Amdim, who is studying the program Healthcare, childhood and youth development at Ullern Upper Secondary School. His one-week placement was at the Transport Section at the Norwegian Radium Hospital. The work experience certainly gave him a taste for more.

Jørgen has previously worked in a nursing home, but he found the work a little tedious. He enjoyed being an orderly though and asked the school if there were any available placements.

An orderly is an attendant in a hospital who is responsible for, among other things, transporting patients, medical equipment and other essential materials. Jørgen spent one week as an orderly at the Radium Hospital and he loved it. He enjoyed it so much that he wants to work there again during the summer of 2019.

Knut Arve Kristiansen, the Head of the Transport Section, has worked at the Radium Hospital for 30 years and praised Jørgen:

“He was a perfect addition to our team, and we are very happy with him.”

 

80 km per week

Jørgen enjoys manual labour, which is great if you want to become an orderly. Wheeling around heavy medical equipment or patients in beds and wheel chairs is hard work. Knut Arve explained:

”As orderlies, we’re constantly on the go, and we could end up walking around 80 kilometres on hard floors during a week of work.

“It can be strenuous for the body, so we have to regularly do strength exercises to keep fit,” Knut Arve continued.

Knut Arve only had positive things to say about Jørgen and he hopes that Jørgen will want to return to the Transport Section for a summer job as an orderly.

“Jørgen is a social person and very well liked. This is important for patients when they are transported between examinations and the rooms they are staying in,” said Knut Arve.

Jørgen praises the work environment and especially the warm welcome he received from the other staff.

Jørgen has constantly been accompanied by a colleague from the section during his stay, because he is not allowed to do much on his own when on a placement. If he returns for a summer job, things will be different. Then he will have to work more independently and take responsibility if an emergency should occur while he is transporting a patient.

The orderlies are also responsible for transporting food and medication. To newcomers, the Radium Hospital can appear to be a huge labyrinth, especially outside the wards. The hospital is also currently being renovated, because a new hospital is being built. A sense of direction is therefore essential for anyone finding their way through the building.

 

A future in health

Jørgen does not necessarily want to become an orderly, but sees himself working in healthcare:

“I would really like to work in an emergency room – receiving ill and injured people at the hospital when they arrive in an ambulance. But I think working as an orderly is very exciting too, so I don’t want to exclude it as an option.”

Knut Arve says that a trade certificate is required to work as an orderly and that they currently offer placements for several apprentices in the section. Students need to study Healthcare, childhood and youth development during upper secondary school and then finish a two-year apprenticeship to obtain their trade certificate as an orderly.

”Workdays here are very varied and you meet many different people. It is really fun to talk to people and no two days are the same. I have really enjoyed it.” said Jørgen.

 

Attracting and developing the life science talents of the future is an essential goal for Oslo Cancer Cluster. One way to do that is to take students outside the traditional classroom setting and invite them to work placements and educational lectures. These collaborations between industry and academia give the students a unique insight into the specialist skills needed to become tomorrow’s researchers and entrepreneurs.

  • Find out more about Oslo Cancer Cluster’s school collaboration with Ullern Upper Secondary School.

 

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Dr. Nadia Mensali (in the middle) and her colleagues from Oslo University Hospital in their cell lab at Oslo Cancer Cluster Incubator. Photo: Christopher Olssøn

Natural killer cells dressed to kill cancer cells

New research: A new study may potentially enable scientists to provide cancer immunotherapy that is cheaper, faster and more manageable.

New work by researchers with laboratories at Oslo Cancer Cluster Incubator may help to dramatically improve a T cell-based immunotherapy approach so that it can benefit many more patients.

 

T cell assassins

T cells are the professional killers of the immune system – they have a unique capability to specifically recognize ‘foreign’ material, such as infected cells or cancer cells. This highly specific recognition is achieved through receptors on the surface of T cells, named T cell receptors (TCRs). Once its receptor recognizes foreign material, a T cell becomes activated and triggers the killing of the infected or cancerous cell.

T cell receptors (TCRs): receptors on the surface of T cells, that recognize foreign material and activate the T cell. This triggers the killing of the infected or cancerous cell by the T cell.

 

Adoptive cell therapy 

Unfortunately, many cancers have adapted fiendish ways to avoid recognition and killing by T cells. To combat this issue, an immunotherapy approach known as adoptive cell therapy (ACT) has been developed in recent years. One such ACT approach is based on the injection of modified (or ‘re-directed’) T cells into patients. The approach is further explained in the illustration below.

 

Illustration from the research paper ‘NK cells specifically TCR-dressed to kill cancer cells’.

 

The left side of the illustration shows how redirected T-cell therapy involves:

1) Harvesting T cells from a cancer patient

2) Genetic manipulation of T cells to make them express an ideal receptor for recognizing the patient’s cancer cells

3) Growing T cells in culture to produce high cell numbers

4) Treating patients with large quantities of redirected T cells, which will now recognize and kill cancer cells more effectively

 

An alternative approach 

Adoptive T cell therapy has delivered very encouraging results for some cancer patients, but its application on a larger scale has been limited by the time consuming and costly nature of this approach. In addition, the quality of T cells isolated from patients who have already been through multiple rounds of therapy can sometimes be poor.

Researchers have long searched for a more automated form of adoptive cell therapy that would facilitate faster and more cost-effective T cell-based cancer immunotherapy.

One approach that has seen some success involves the use of different immune cells called Natural Killer cells – NK cells in brief.

Despite their great potential, NK cells have unfortunately not yet been proven to provide a successful alternative to standard T cell-based cancer immunotherapy. One major reason for this may be that, because NK cells do not possess T cell receptors, they are not very effective at specifically detecting and killing cancer cells.

NK cell lines: Natural Killer cells (NK cells) have the ability to recognise and kill infected or cancerous cells. Scientists have been able to manipulate human NK cells so that they grow without restriction in the lab. This is called a cell line. It enables a continuous and unlimited source of NK cells that could be used to treat cancer patients.

 

Cells dressed to kill

The group led by Dr. Sébastien Wälchli and Dr. Else Marit Inderberg at the Department of Cellular Therapy aimed to address this issue and improve NK cell-based therapies.

They reasoned that by editing NK cells to display anti-cancer TCRs on their cell surface they could combine the practical benefits of NK cells with the potent cancer killing capabilities of T cells. This is shown in the right hand side of the illustration above.

The researchers found that by simply switching on the production of a protein complex called CD3, which associates with the TCR and is required for T cell activation, they could indeed induce NK cells to display active TCRs. These ‘TCR-NK cells’ acted just like normal T cells, including their ability to form functional connections to cancer cells and subsequently mount an appropriate T cell-like response to kill cancer cells.

This was a surprising and important finding, as it was not previously known that NK cells could accommodate TCR signaling.

This video shows TCR-NK cell-mediated killing of cancer cells in culture. The tumour cells are marked in green. Tumour cells that start dying become blue. The overlapping colours show dead tumour cells.

 

The researchers went on to show that TCR-NK cells not only targeted isolated cancer cells, but also whole tumours.

The method was proven to be effective in preclinical studies of human colorectal cancer cells in the lab and in an animal model.  This demonstrates its potential as an effective new form of cancer immunotherapy.

 

Paving the way

Lead researcher Dr. Nadia Mensali said:

“These findings pave the way to the development of a less expensive, ready-to-use universal TCR-based cell therapy. By producing an expansive ‘biobank’ of TCR-NK cells that detect common mutations found in human cancers, doctors could select suitable TCR-NK cells for each patient and apply them rapidly to treatment regimens”.

Whilst further studies are needed to confirm the suitability of TCR-NK cells for widespread treatment of cancer patients, the researchers hope that these findings will be the first step on the road towards off-the-shelf immunotherapy drugs.

 

  • Read the whole research paper at Science Direct. The paper is called “NK cells specifically TCR-dressed to kill cancer cells”.
  • The researchers behind the publication consists of Nadia Mensali, Pierre Dillard, Michael Hebeisen, Susanne Lorenz, Theodossis Theodossiou, Marit Renée Myhre, Anne Fåne, Gustav Gaudernack, Gunnar Kvalheim, June Helen Myklebust, Else Marit Inderberg, Sébastien Wälchli.
  • Read more about research from this research group in this article from January.
  • Read more about Natural Killer cells in this Wikipedia article.

 

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Three offices have been converted into extra laboratory space for the members of the Incubator.

The Incubator Labs are expanding

The laboratories at Oslo Cancer Cluster Incubator are expanding to meet increasing demand from members.

 

Oslo Cancer Cluster Incubator has recently converted three offices into new laboratories to accommodate the rising demand from their members.

From the opening in 2015, the laboratories in the Incubator have been a great success. Several of the start-ups have expanded their work force and require more offices and lab space.

The new laboratory is jointly occupied by Zelluna Immunotherapy and the Department of Cellular Therapy (Oslo University Hospital). The Institute for Energy Technology and Arctic Pharma have also expanded their laboratories with an extra room each.

The laboratories are now running at full capacity, but there is some space available in the shared labs. Some of the members of the Incubator offer their services to outside companies who are in need of getting lab work done.

“Our ambition is to grow the Incubator Labs further into the new Innovation Park next door.” Bjørn Klem, General Manager

 

The Incubator occupies over 550 square meters. Offices have been converted into labs to meet the growing interest from the members.

 

A unique model

The Incubator Labs follow a unique model, which offers both private laboratories and fully equipped shared laboratories. The private laboratories are leased with furniture, water supply, electricity and ventilation. The companies bring their own equipment depending on their needs.

Shared laboratories, including a bacteria lab, a cell lab and wet lab, are leased including basic equipment with the opportunity for companies to bring their own if shared by all tenants. All laboratories share the common support facilities including a cold room for storage, a laundry room, and storage room including cell tanks and nitrogen gas.

“This model of a shared laboratory is very unusual,” said Janne Nestvold, Laboratory Manager at the Oslo Cancer Cluster Incubator.

The advantage of working in a shared lab is that companies can avoid the costs and limitations associated with setting up and managing a laboratory. A broad range of general equipment, including more advanced, analytical instruments, are provided by the Incubator.

”It would be too expensive for a small company to buy all this equipment themselves.” Janne Nestvold, Laboratory Manager

 

The Department of Cellular Therapy (Oslo University Hospital) are one of the members using the shared lab. Photograph by Christopher Olssøn

 

 

Open atmosphere

The laboratories have an open and light atmosphere. Large windows provide ample lighting and all spaces are kept clean and tidy. The halls are neatly lined with closets and plastic containers for extra storage.

The general mood is calm and friendly. Nestvold communicates daily with the users about changes, updates and improvements, which sets an informal tone. Thanks to monthly lab meetings, the users are also involved in the decision-making process. The companies often work side-by-side or in teams, fostering collaboration rather than competition. There is therefore a strong workplace culture based upon flexibility and mutual respect.

The companies often work side-by-side or in teams, fostering collaboration rather than competition.

Nestvold also ensures that the high demands on the infrastructure of the laboratory are met. She has put agreements in place to facilitate the members’ needs, such as the washing of lab coats, pipette service and shipping packages on dry ice. With all these services included, the Incubator Labs are attractive for researchers and companies to carry out their cancer research.

 

Over the years, Nordic Nanovector, OncoInvent, Targovax, Intersint, OncoImmunity have conducted research in the laboratories. Now, Arctic Pharma, the Department of Cellular Therapy (Oslo University Hospital), GE Healthcare, the Institute for Energy Technology, Lytix BioPharma, NorGenotech, Ultimovacs and Zelluna Immunotherapy are using the Incubator Labs to develop their cancer treatments.

 

  • For more information about the Incubator Lab, get in touch with Janne Nestvold.

 

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Dr. Jon Amund Kyte is the new Head at the Department of Experimental Cancer Treatment at OUH.

Attracting clinical trials to Norway

Dr. Jon Amund Kyte at Oslo University Hospital (OUH) and Oslo Cancer Cluster share the common goal of bringing more clinical trials to Norway.

 

Jon Amund Kyte is the new Head at the Department of Experimental Cancer Treatment at OUH. He also runs three separate clinical trials and is the leader of a research group at the Department of Cancer Immunology, where he develops novel CAR T cell therapy and conducts translational studies.

Kyte aims to increase the number of and improve the quality of clinical trials in Norway. He says this will contribute to more patients gaining access to novel cancer treatments and to improving the efficacy of cancer therapies.

“The only way to improve cancer treatment is to have clinical trials,” said Kyte.

Oslo Cancer Cluster also wants to bring more clinical trials to Norway to develop innovative cancer medicines. The ambition is to enable faster patient recruitment from across the Nordic region, so that many more can benefit from new treatments, such as immunotherapy.

 

CAR T cells are produced by isolating specific cells of the immune system (T cells) from a cancer patient and modifying them so that they become more effective at recognizing and killing cancer cells.

 

Promising advances

Immunotherapy represents a new type of cancer treatment, which activates the patient’s immune-system to fight off the cancer cells. It gives doctors the opportunity to help patients that previously had limited treatment options. Most types of immunotherapy also cause less side effects than traditional cancer treatments.

“The important point is that immunotherapy can have a long-term effect,” said Kyte.

“Most patients that experience a recurrence or progression of the disease cannot be cured. The traditional treatments only have a limited, short-term effect on them. But immunotherapy may have a long-term effect on the patient – and, in some cases, even cure the disease.”

 

Two big challenges

Immunotherapy may sound like a miracle drug, but researchers still have a long way to go to perfect the treatment for all cancer patients. Kyte highlights two of the biggest barriers that remain.

“One challenge is to develop immunotherapy so that it works efficiently on all types of cancer. The other challenge is to learn how to choose personalised treatment plans: to identify an individual’s biomarkers and find out which treatment will be effective for that specific patient.”

A biomarker is a biological molecule in the patient’s body and these may be used to see how well a patient will respond to a certain treatment. Kyte said that to develop immunotherapy, there needs to be more clinical trials. It is the only way for researchers to find out how to activate an immune response in the patient’s body.

“A big potential for development lies in trying different possible combinations of cancer treatments. In my clinical trials, for example, we combine immunotherapy with immunogenic chemotherapy or radiation therapy,” Kyte explained.

 

Jon Amund Kyte presenting the Clinical Trial Unit.

The Clinical Trial Unit are experts in assisting companies and researchers to conduct clinical trials in Norway.

 

Welcome, companies

OUH has a long history of conducting clinical trials and is an appealing option for both researchers, doctors and companies that wish to initiate their own trials. Kyte welcomes more companies to conduct clinical trials at OUH:

“The more clinical trials that are conducted here by companies, the stronger our clinical research environment becomes and our ability to run our own studies is also strengthened.”

The Clinical Trial Unit in Kyte’s department offers its services to companies that want to run a clinical trial at OUH. They have extensive background knowledge of how the hospital is organised and which approvals are needed to conduct a clinical trial in Norway. They can step in as project coordinator for companies that need help to get their clinical trials up and running.

“We are highly experienced in applying for approvals in Norway. When you run a clinical trial, there are regulations from the Norwegian Medicines Agency and the ethical committee and other governmental agencies. A clinical trial also involves many different parts of the hospital – the departments of pathology and radiology, the laboratories, the infusion unit, the hospital wards and out-patient clinic and the administrative offices that oversee different agreements, data management and biobanking.”

 

Nordic clinical trials

All these administrative obstacles may appear discouraging, but there are many convincing reasons to conduct a clinical trial in Norway.

“The Oslo University Hospital is a good place to run a clinical trial, because in terms of the number of cancer patients, it is one of the largest hospitals in Europe. Norwegian healthcare is also extremely well-organised. Patients are rarely lost to follow-up, because there are no private healthcare alternatives and patients rarely move out of the country,” Kyte explained.

The Clinical Trial Unit is also taking part in the development Nordic Nect, a collaboration to recruit patients from the entire Nordic region to clinical trials. The plan is to have one hospital where the clinical study is conducted and to involve patients from Sweden, Denmark, Finland and Norway. There will then be a population of 25 million people from which to recruit patients, which opens the possibility for larger clinical trials.

“This is a good thing for the companies that want to run clinical trials in Norway. It is also good for the researchers. But most of all, it is good for the patients – who have the opportunity to take part in more novel cancer treatments,” said Kyte.

 

 

 

 

Promising start for expansion group of Targovax clinical trial

Doctor examining the birthmark of a female patient

Targovax, one of the members of Oslo Cancer Cluster, has begun an expansion patient group in the clinical trial of a drug to treat skin cancer.

The company Targovax is developing immune activators to target solid tumours that are difficult to treat. The drug in question, called ONCOS-102, is aimed at patients with malignant melanoma (skin cancer) who have either been through chemotherapy, biological therapy or surgery and experienced a recurrence or progression of the cancer.

 

How does it work?

The immune activators work by activating the patient’s own immune system to attack the cancer cells. The drug that is now being tested is a genetically modified oncolytic adenovirus, a type of virus that has been designed to infect in the cancer cells and then replicate.

 

Initial positive results

Targovax, a member of the Oslo Cancer Cluster, are developing a treatment for skin cancer.

In September 2018, the first six patients had been treated with 3 injections of the drug and all of them showed a strong activation of their immune systems – one patient even had a complete response. The results suggested that the patients could benefit from more injections of the drug.

“The results seen to date with only three injections of ONCOS-102 are promising, and we are confident that by increasing to twelve injections we will release the full potential of ONCOS-102 to reactivate these patients to respond to Keytruda treatment,” said Magnus Jäderberg, CMO of Targovax.

 

Expansion patient group

On 11 February 2019, the first patient in the expansion group of the phase I trial was injected with ONCOS-102. The patient will be treated in combination with pembrolizumab, also known as Keytruda, an immunotherapy drug that works as an immune checkpoint inhibitor. This means that the drug involves antibodies, which “unlock” the protective mechanisms of the cancer cells so the immune system then can destroy them.

 

For more information, read the full press release from Targovax.

A new drug combination from Vaccibody and Roche may help to treat patients with cervical cancer.

New collaboration aims to treat cervical cancer

Hands cradling female reproductive system

The companies Vaccibody and Roche have started a new collaboration to investigate a drug combination to treat patients with advanced cervical cancer.

Both companies are members of Oslo Cancer Cluster and are involved in the development of novel cancer treatments.

Martin Bonde, CEO of Vaccibody, said: “We are very pleased with this collaboration. This is an important study as it explores a novel targeted treatment approach that addresses the high medical need of patients with advanced cervical cancer.”

Cervical cancer is the most commonly occurring cancer among women in developing countries and is the second most commonly occurring cancer amongst women worldwide.

Vaccibody is a vaccine company that aims to develop and discover new immunotherapies to treat difficult forms of cancer. They have developed a therapeutic DNA vaccine that treats cancers caused by HPV (the human papillomavirus).

Cervical cancer is caused by high risk HPV. HPV16 is the type that most frequently causes cancer.

Immunotherapy is a type of cancer treatment that aims to switch on a patient’s immune system to kill cancer cells.

Roche is a healthcare company that has developed an immune-checkpoint inhibitor. Now Vaccibody wants to test their vaccine in combination with the immune-checkpoint inhibitor designed by Roche.

An immune checkpoint inhibitor is a type of drug that blocks certain proteins made by some types of cancer cells. When these proteins are blocked, the “brakes” on the immune system are released and T cells are able to kill cancer cells better.

Agnete Fredriksen, President and CSO of Vaccibody, said that the combination of the two drugs build on the positive results seen when their vaccine has been used on patients with cervical cancer. Therefore they now expect to see positive results when they combine the vaccine with an immune checkpoint inhibitor.

During the second half of 2019, Vaccibody expects to begin the phase II study, which will involve 50 patients. It will assess the safety of the drug, its ability to invoke a response in the immune system, how the patients tolerate it and how efficient the drug is. The group for this new drug combination involves patients with advanced cervical cancer.

 

Raised NOK 230 million

Vaccibody also raised NOK 230 million (EUR 23.6 Million) in a private placement the same week. The sum was indeed placed all within one day, according to Agnete Fredriksen.

The proceeds from the share sales will be used to conduct the phase II clinical study of the drug combination from Vaccibody and Roche. The money will also go to the preparation of expansion patient groups in Vaccibody’s clinical trials and to generate corporate purposes.

 

For more information, read the press release from Vaccibody.

 

The pupils Kalina Topalova Casadiego, Ida Hustad Andresen,Andreas Bernhus and Dina Düring had the opportunity to experiment with fruit flies at the Institute for Cancer Research in Oslo.

Operation fruit flies

Three students experimenting with fruit flies in a lab.

Fruit flies are not only annoying little insects that appear when bananas are overripe. They are also popular research tools for cancer researchers.

The four pupils Kalina Topalova Casadiego, Ida Hustad Andresen, Andreas Bernhus and Dina Düring got to experience how cancer researchers look at fruit flies during their work placement in January.

“Let’s turn on the gas, and then I’ll put some fruit flies on the pad under your microscope.” Speaking is cancer researcher Lene Malrød who, together with her colleague Nina Marie Pedersen, is responsible for four pupils from Ullern Secondary School on work placements.

“Gosh! They’re moving,” proclaims one of the pupils.

But not for long. Soon, all the fruit flies are anaesthetised and, eventually, dead; then the pupils are tasked with surgically removing the ovaries of the female flies. It is easier said than done, even with the help of microscopes to enhance the tiny flies. Especially when the operating tools are two tweezers.

Fruit flies are kept in two test tubes

The fruit flies are kept in test tubes.

 

An exciting placement

It is the third day of the pupils’ work placement at the Institute for Cancer Research, located next to the school. For four days at the end of January, they have learnt about cancer research and which methods researchers use in their daily work.

“The work placement is not like we imagined,” says Kalina and Ida.

“There’s a lot more manual work than I would have thought, and then you realise how important research is through what we do,” says Ida.

She is the only one who is specialising in biology in combination with with other science subjects, and she finds this very useful when working in the lab together with researchers. The other three have had to catch up on the reading, but they all agree that it is very exciting.

“Yesterday, we learnt a lot about CRISPR, which is a new method for cutting and splicing genes. Media gives you the impression that this is a highly precise tool, but the researchers here say that a lot can go wrong, and that it’s not at all as precise as you might think,” says Ida.

A student looks at fruit flies under a microscope

The students look at the fruit flies under a microscope.

 

From Western Blot to flies

A total of twelve pupils were picked out for this work placement. They have been chosen based on motivation and grades, and they all have a wish to study something related to medicine or science after they finish upper secondary school.

The twelve students are divided into three groups with completely different activities and get to learn a number of different research methods. The group consisting of Ida, Kalina, Andreas, and Dina, for instance, is the only group which will have a go in the fly lab.

“Am I really supposed to remove the ovaries? I don’t see how,” one of the pupils say, equally discouraged and excited.

Andreas, on the other hand, is in complete control. First, he has separated the males and the females with a paint brush. He has then used the tweezers to remove the heads from the females, punctured the bottom to remove the intestines, and finally found the ovaries in the abdomen.

Lene gathers all the different body parts for the pupils to look at through a different microscope. These fruit flies are in fact genetically manipulated to glow in the dark – they are fluorescent.

If you are wondering why researchers use fruit flies as part of their research, you can read more about it in this article from Forskning.no (the article is written in Norwegian).

“It is so much fun to be here, and we are really lucky to get this opportunity,” says Dina on her way from the fly lab to another lab to carry out another experiment.

 

The pupils on the work placement have uploaded many nice photos and videos on Ullern Secondary School’s Instagram account – visit their account to see more from the placement.

All photos: Fullscreen Visuals

Top presentations from Cancer Crosslinks 2019

Audience at Cancer Crosslinks 2019

See them again or for the first time: videos from the Cancer Crosslinks 2019 presentations.

Cancer Crosslinks is Oslo Cancer Cluster’s annual, open conference for the Norwegian oncology community. It offers a full-day educational program featuring distinguished international and national experts presenting recent advances in precision oncology and cancer immunotherapy.

More than 300 participants joined Cancer Crosslinks on 17 January 2019 and enjoyed excellent talks and discussions presented by leading international oncologists and researchers and their Norwegian colleagues.

 

The speakers’ top topics

The speakers discussed new insights into sensitivity and resistance and features of the tumour microenvironment critical for the clinical course. They also discussed emerging tissue agnostic biomarkers, where «tissue agnostic” refers to the ability to develop therapies based upon biomarkers or other molecular targets to treat a disease. A biomarker is a measurable indicator of a biological state or condition.

Other topics were learnings from cancer molecular evolution studies, and how big data approaches are used to improve patient care. Together with an engaged audience, the presenters were really connecting the dots for improved patient care in precision oncology.


Professor Naiyer Rizvi
, Director of thoracic oncology and of immunotherapeutics for the division of haematology and oncology at Columbia University Medical Center, New York, gave the opening keynote in the form of a video presentation. He is an internationally recognized leader in the treatment of lung cancer and immunotherapy drug development.

In his presentation, titled: “Sensitivity and resistance to immuno-oncology: Biological insights and their translation into precision treatment”, Prof. Rizvi also addressed the question “What happens when the doctors expect the patient to respond to immunotherapy, but then the patient does not?”

WATCH PROF. RIZVI

Professor Rizvi

 

Dr. Aaron Goodman, MD, is a haematologist and medical oncologist specialized in treating a variety of blood cancers. He holds a position as Assistant Professor of Medicine at the Moores Cancer Center at UC San Diego Health in La Jolla, California.

During his talk, Dr. Goodman presented tumour mutational burden and other emerging tissue agnostic biomarkers for response to cancer immunotherapy and how to implement these into the clinic. He also spoke about his experience from the Rare Tumour Clinic in San Diego, where they perform a comprehensive molecular profiling for about 22-25% of cancer patients with rare tumours. The goal is to identify a matching therapy for each patient.

After his presentation, Dr. Goodman commented to Oslo Cancer Cluster:

“We started by doing data collections and help patients and learn at the same time. It is a benefit that we at least have the patient’s data and experience with that patient so that we can go forward and help the next patient.” Aaron Goodman

WATCH DR. GOODMAN

Dr Goodman

 

Dr. Randy F. Sweis is an Assistant Professor in the haematology/oncology section at the University of Chicago. He works with cancer immunology, developmental therapeutics and biomarkers, with a clinical interest in phase 1 clinical trials and genitourinary malignancies. His laboratory research involves the identification and targeting of tumour-intrinsic immunotherapy resistance pathways.

During Cancer Crosslinks, Dr. Sweis presented his work on immunophenotypes: “The T cell-inflamed tumour microenvironment as a biomarker and its clinical implications.”

WATCH DR. SWEIS

Dr. Sweis

 

Dr. Marco Gerlinger is a clinician scientist at the Center for Evolution and Cancer at the Institute of Cancer Research in London and a consultant Medical Oncologist in the GI Cancer Unit at Royal Marsden Hospital. He develops novel techniques to detect and track intra-tumour heterogeneity in solid tumours to define evolutionary plasticity and common evolutionary trajectories in cancers. Cancer cell plasticity is the ability of cancer cells to change their physiological characteristics.

Dr. Gerlinger shared the latest insights into cancer evolution and discussed the limits of predictability in precision cancer medicine. How can clinicians and researchers exploit important data on tumour development?

During his visit in Oslo, Dr. Gerlinger commented: “We have had fantastic discussions with an audience that is really well informed and brings up the challenges we are facing and the research we are doing.”

“This is the first time I have given a talk in Norway and obviously there is a lot going on here. I am already thinking about some collaborations, because there are some interesting advantages here through big tumour banks and cancer registries.” Dr. Marco Gerlinger

WATCH DR. GERLINGER

Dr Gerlinger

 

 

Professor Dr. med. Lars Bullinger is Professor of Hematology and Oncology and Medical Director of the Department of Hematology, Oncology and Tumor Immunology at Charité University Medicine Berlin.

He is a partner in the Innovative Medicines Initiative project HARMONY (Healthcare alliance for resourceful medicines offensive against neoplasms in haematology) aiming to use big data to deliver information that will help to improve the care of patients with haematologic cancers.

In his keynote speech he presented the “best of hematology from 2018” to the Cancer Crosslinks audience. He also addressed emerging therapeutic opportunities and the impact of big data for precision treatment in haematology.

WATCH PROF. DR. MED. LARS BULLINGER

Lars Bullinger

 

James Peach is the Precision Medicine Lead at UK Medicines Discovery Catapult, Alderly Park, UK. Prior to this role, he was the Managing Director at the main programme for Genomics England from 2013 to 2017. He presented his perspectives on the implementation of precision medicine in the UK and discussed the status, lessons learned and the way forward.

WATCH JAMES PEACH

James Peach


The expert panel
You can read more about how the Norwegian expert panel reacted to James Peach’s presentation and the state of precision medicine in Norway in the article below, also from Cancer Crosslinks 2019. The article contains a video of the panel debate.

Getting genomics into healthcare: look to the UK