The panel discussion during Cancer Crosslinks 2019 was about the need to implement precision diagnostic methods in Norwegian health care. In the panel from the left: Kristin Vinje, Vice-Dean at the Faculty of Mathematics and Natural Sciences, University of Oslo, Bjørn Tore Gjertsen (hidden in picture), Professor at Haukeland University Hospital and University of Bergen, Hege G. Russnes, Senior Consultant and Researcher at Oslo University Hospital, Ola Myklebost, Professor at University of Bergen and Christian Kersten, Senior Consultant at Center for Cancer Treatment, Sørlandet Hospital. All photos: Fullscreen Visuals

Getting genomics into healthcare: look to the UK

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Discussing health care at Cancer Crosslinks 2019

During Cancer Crosslinks 2019, one thing was crystal clear: there is a need to include broader genomic testing into treatments for cancer patients in Norway.

“We are lacking behind here in Norway!”

Professor Ola Myklebost, from the Department of Clinical Science at the University of Bergen, was definitely ready for action in the panel debate at Cancer Crosslinks 2019, fittingly named “Call for Action”.

The panel and the audience of about 300 people had just listened to the talk given by James Peach. He is the Precision Medicine Lead at UK Medicines Discovery Catapult, Alderly Park, and prior to this, he was the Managing Director at the main programme for Genomics England from 2013 to 2017 and led the UK’s Stratified Medicines Program.

Peach told the audience how they have been implementing precision medicine into the public health care system (NHS) in the UK, using genomic testing, during the last decade. He demonstrated how the industry is part of this public endeavour, how political support and investment contributed to industry development, and how they addressed complex issues like sharing health data and using artificial intelligence.

It started with very little.

“In 2010, we had no structure”, Peach told the audience.

 

James Peach presenting at Cancer Crosslinks 2019

Sequencing 100,000 genomes

Thanks to all the British cancer patients who consented to Genomics England using their data, and a lot of common public-private efforts, Genomics England has now reached its goal of sequencing 100,000 whole genomes from NHS patients, according to their webpage. It takes a lot to accomplish this number, but luckily there are things to learn from the UK effort.

“Circulating tumour DNA testing is absolutely necessary”, Peach said from the podium.

The Life Science Sector deal from the British government outlines this public-private effort. It shows how significant government commitment, funding and strategic actions triggered investment and initiatives from the life science industry. You can read the entire document at the official webpage of the British Department of Business, Energy and Industrial Strategy, following this link.

James Peach visited Norway earlier as a speaker at Cancer Crosslinks 2012. Returning now, he was truly surprised about the current state of precision medicine in Norway.

 

Concerned about Norway

In an interview with Oslo Cancer Cluster, James Peach shared a concern as an answer to the question “What impressions are you left with after this conference?” 

“It has left me quite concerned about the state of precision medicine in Norway. I thought you would be looking forward to the things you could do, but it turns out that there are actually some things that you should have done already.”

“Like what things?” 

“Like universal application of a cancer panel test that is commercially feasible and deals around getting your data shared appropriately.”

“Do you think we can have a Genomics Norway?”

“Of course. It is probably about combining two things. One is that you got to get the basic stuff right. People need to have access to gene tests for their clinical care. Luckily the people here are a group of experts who are all connected to each other and who understand the system. It is not a massive system. I think there is a real chance to choose an area where Norway could do it exceptionally well. What that area is, is for you to choose.”

 

Concerns in Norway

Back in the panel discussion, Hege G. Russnes, Pathologist, Senior Consultant and Researcher at Oslo University Hospital, was getting involved:

“We need more information to help clinicians make therapy decisions. (…) Norway has no plan or recommendation for multi gene tests.”

Christian Kersten, Senior Consultant at the Center for Cancer Treatment at Sørlandet Hospital, agreed.

“I’m the clinician, I treat patients, patients die because of metastasis. I have been treating cancer patients for 20 years now and I feel it increasingly difficult to keep the trust of the patient.”

“If you ask the patients, they will sign the papers with consent of sharing data in 99% of the cases”, Myklebost added.

“We are only 5 million, we do not have to reinvent the wheel. Erna Solberg should invite James Peach for a cup of tea”, Christian Kersten said, finishing up the panel talk.

 

The entire panel debate is available to watch at the webcast webpage:

WATCH THE PANEL DEBATE

 

More on UK Medicines Discovery Catapult 

Did this brief article make you interested in the work that James Peach and UK Medicines Discovery Catapult does? In this short video, Peach explains the challenges with access to health data for drug discovery and how to overcome them:

 

More from Cancer Crosslinks 

We have more from Cancer Crosslinks 2019 coming up. Stay tuned and subscribe to our newsletter, and you will not miss videos of the talks and interviews with the other distinguished speakers at the conference.

NOME is based on the mentoring principals of MIT’s Venture Mentoring Service. The fundamental principle is to connect first time entrepreneurs with a team of three to four experienced and skilled mentors to help them reach their goals and technology milestones. Photo: Accelerace

Why a Nordic mentor network is a good idea 

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Participants discussing at NOME mentor network.

The Nordic Mentor Network of Entrepreneurship (NOME) is the first pan-Nordic mentor network for lifescience start-ups. Why is it a good idea for start-ups working in cancer?

 

Bjørn Klem has an answer. He is the General Manager of Oslo Cancer Cluster Incubator and point of contact for start-ups within the cancer field in Norway.

“Start-ups working in cancer need to access commercialisation expertise and investor networks. When looking for this, it is an advantage to seek in other Nordic countries where investors are experienced with cancer and biotech in general. Participating in NOME will also take you into their global network.” Bjørn Klem

 

Connecting with a mentor team

NOME is based on the mentoring principals of MIT’s Venture Mentoring Service. The fundamental principle is to connect first time entrepreneurs with a team of three to four experienced and skilled mentors to help them reach their goals and technology milestones. 

From Boston to the Nordics, this is the first mentor network within life sciences that spans across all the Nordic countries. 

In Norway, Oslo Cancer Cluster Incubator og the health incubator Aleap are coordinating start-ups with suitable mentors.

“Team mentorship, where mentees have a group of mentors, rather than single one-on-one mentorship, encourages more diverse thinking, cross-disciplinary approaches to ideas and problem solving, and it allows the access to professionals from different fields.”  NOME Magazine Issue 1 2018

 

Norwegian mentors and start-ups

One of the Norwegian NOME mentors is Kari Grønås. She has extensive experience in drug development and commercialisation within the pharmaceutical industry.

You can listen to her (in Norwegian) in this video that was made by Oslo Cancer Cluster Incubator as the programme was just starting in Norway in 2017.

One of the Oslo Cancer Cluster members that have taken advantage of the NOME opportunity and mentors, is Nacamed.

Nacamed is a Norwegian spin-off company of Dynatec AS. The Nacamed technology is based on 10 years of research on silicon done by Dynatec engineering. According to the company webpage, this enables a production that can tailor particles with the desired physical attributes. With this, Nacamed aims to create a new generation of treatment methods.

 

Best in class-network

This video, made by Accelerate, explains the concept of NOME and the value it adds to the Nordic startup ecosystem.

The mentors are volunteering to share their knowledge and experience with new entrepreneurs within fields such as digital health, immuno-oncology and AI in healthcare. NOME mentors can give unbiased advice, provide strategic guidance, open their network and possible collaboration partners, as well as assisting in reaching key milestones.

The start-ups have to be best in class too. The local NOME partners evaluate the companies on the novelty of the science or technology, their high commercial potential as well as the strength and commitment of the founding team. Furthermore, strong IP or alternative protection strategies, market differentiation, and the impact NOME potentially can have on the company’s development are also taken into consideration.

Participation is free of charge and funded by the Novo Nordisk Foundation.

Infographic from NOME magazine.

Source: The NOME Magazine, Issue 01, 2018

 

20 start-ups since 2016

Since 2016, 20 start-ups have joined NOME and of these two have graduated from the program. Graduation usually means the start-up has successfully raised funds for the coming few years and has engaged a formal board and therefore has less need for the NOME mentors.

The mentors either move on to work with other emerging companies or have been so excited about the potential of the company they have been working with that they have taken a seat on the board.

By the end of 2018, NOME had 50 mentors and 18 enrolled start-ups.

 

Mentors in immuno-oncology

In the NOME Magazine first edition, released in October, Carl Borrebaeck, professor at Department of Immuno-technology at Lund University in Sweden, is interviewed about his field of expertise, immuno-oncology and creating companies from his research. Borrebaeck is a founding mentor in NOME and has been part of the network for the past two years. 

“People tend to think, that innovation just happens and that it will reach patients without any commercial drive. That is simply untrue.” Prof. Carl Borrebaeck 

He continues to explain what is really needed to make health innovations happen:

“A combination of companies and academia is needed. Big pharma is always looking for the newest discoveries and ways they can collaborate in order to stay at the forefront of innovative research. The Nordics are highly innovative and they have a strong reputation globally. However, there are too few big pharma companies commercializing the science at the very early stages. This is often a major challenge for emerging companies who then have to seek funding not only in the Nordics but across Europe and the US to cover this funding gap.”

 

Mentors in artificial intelligence

NOME has mentors in several interesting life science fields. Lars Staal Wegner, the CEO of Evaxion Biotech, is another mentor. He started a company dedicated to using artificial intelligence, supercomputers, and big data to fight cancer and infectious diseases. In the NOME Magazine Wegner says: 

“It is no longer the pharma industry or the companies producing the off-the-shelf drugs. It is the ones who own the data and know how to convert it to effect, the cloud-based giants that are half life science half tech. This is maybe 30-40 years into the future, but it is important already now to know that the tech evolution is not linear. It is exponential. We have reached an inflection point in tech. The industry doesn’t have five or ten years to toe the line. It is exploding.” 

Artificial intelligence and machine learning are expected to have an unprecedented impact on how drugs are developed, their cost, and time to market, according to Wegner. 

 

Nordic partnership

NOME is operated by Accelerace and funded by the Novo Nordisk Foundation. The initiative is represented in the Nordic region through partnerships in Sweden, Norway and Finland. In Norway, Oslo Cancer Cluster Incubator og the health incubator Aleap are coordinating start-ups with suitable mentors.

In the US, the California Life Sciences Institute (CLSI) is a new partner for NOME. In fact it is too new to have entered the overview below. CLSI is a non-profit organization which supports entrepreneurship, STEM education and workforce development for the life science industry in California. It is located in the San Francisco Bay Area.

Infographic from NOME magazine.

Source: The NOME Magazine, Issue 01, 2018

Aaron M. Goodman, MD, speaks at Cancer Crosslinks 2019 about his research from UC San Diego Health.

Cancer Crosslinks LIVE streaming

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Presenter at Cancer Crosslinks 2019.

Today, Thursday 17 January, we broadcast LIVE from our conference Cancer Crosslinks at Oslo Cancer Cluster Innovation Park.

Please join us and hear from a distinguished panel of international and Norwegian experts as they discuss the Next Wave of Precision Oncology, share new perspectives, and address the challenges and opportunities ahead. The subtitle of this year’s 11th Cancer Crosslinks is “Next Wave Precision Oncology – Connecting the Dots for Improved Patient Care”.

The broadcast starts at 9 AM and last until the conference ends at about 4 PM. Please follow the link to watch LIVE:

LIVESTREAM HERE

 

If you would like to know more about the international speakers at Cancer Crosslinks 2019, please read this article.

New research from the immunomonitoring unit of the Department of Cellular Therapy at Oslo University Hospital is now available in a video and an article in the the Journal of Visualized Experiments, Jove. Photo: Christopher Olssøn.

New research: 3D structure tumors in immunotherapy

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Researcher testing lab sample.

New work from cancer researchers at the Department of Cellular Therapy could help to streamline the development of exciting new immunotherapy approaches for treating cancer.

Cancer treatments that aim to switch on a patient’s immune system to kill tumor cells – so-called immunotherapy approaches – have received much attention and encouraging results in recent years. Now, the immunomonitoring unit of the Department of Cellular Therapy at Oslo University Hospital has devised a new experimental approach that could improve early stages of the immunotherapy development pipeline.

The unit is present in Oslo Cancer Cluster Incubator with a translational research lab, led by Drs. Else Marit Inderberg and Sébastien Wälchli.

 

Researchers in laboratory.

Dr. Sébastien Wälchli and colleagues in the translational research lab in Oslo Cancer Cluster Incubator. Photo: Christopher Olssøn

 

CAR T cells drive new successes

Our immune systems are generally very good at recognizing foreign infectious agents and disposing of them appropriately. However, although our immune systems are capable of recognizing tumors as a threat, cancer cells have adapted mechanisms that enable them to evade the immune response. Immunotherapy is the name given to a range of different approaches that aim to overcome this problem by improving the immune system’s ability to target cancer cells.

One relatively new example of an immunotherapy approach comes from CAR T cells. These 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. The modified T cells are then placed back into the patient so that they can ‘home in’ on the tumor and kill the cancer cells.

Read about related research: T-cells and the Nobel Price

 

Difficult for solid cancers

Current models for testing new CAR T cells aren’t always optimal. Although CAR T cells have shown encouraging results in treating some cancers, particularly the blood cancers leukemia and lymphoma, the development of CAR T cells for non-blood, or ‘solid’, cancers has been more difficult.

In part, this is due to the fact that tumor models currently used in early stages of testing involve two-dimensional monolayers of cancer cells, which do not reflect the complex three-dimensional structure and organization of solid tumors found in patients.

Consequently, CAR T cells that show encouraging results using these two-dimensional models often produce less effective results at later stages of the development pipeline, meaning time, effort and resources are wasted.

 

3D tumor spheroids

To improve the early stages of testing new CAR T cells, Dr. Wälchli’s group has developed a new approach that enables researchers to grow three-dimensional cancer cell structures, or ‘spheroids’, in the lab, and to test the effect that CAR T cells have on killing off these spheroids.

Compared to current two-dimensional methods, the spheroids are more similar in complexity and structure to tumors found in patients.

In a recent publication in the Journal of Visualized Experiments, this group demonstrated for the first time that their spheroid approach has the potential to provide a useful new tool for developing CAR T cells.

They generated spheroids using colorectal cancer cells – a type of cancer for which there is currently no effective CAR T cell therapy available. These cancer cells were modified so that they possessed a molecule on their cell surface called CD19, which is known to be recognized by certain CAR T cells. The researchers then incubated these spheroids with CD19-targeting CAR T cells and used advanced live imaging techniques to track the effect on cancer spheroids.

To help other research groups who would like to start using the spheroid technique, Dr. Wälchli’s publication is accompanied by this video which introduces the approach and provides a basic overview of how it works. The Journal of Visualized Experiments requires a subscription to see the entire video. You can also read a PDF of the article “A Spheroid Killing Assay by CAR T Cells” without a subscription.

 

Successful approach

As expected, shortly after adding CAR T cells, the researchers could detect that spheroids were shrinking due to cancer cell death, proving that their approach successfully measures CAR T cell-induced tumor clearance in a quantitative manner.

Discussing the work, Dr. Wälchli says, “We believe this method can help to answer key questions about using 3D structure tumors as a suitable alternative for testing new immunotherapy approaches.”

The approach now opens the door for testing a range of different target molecules in combination with new CAR T cells targeting those molecules.

 

Fast, affordable and straightforward

Dr. Wälchli believes many researchers could benefit from the spheroid technique. He continues,

“A major advantage to our approach is that it is fast, affordable and straightforward, meaning any research group with the right equipment can test the effect of their immunotherapy on 3D tumors before moving to animal models”.