A national precision cancer medicine implementation initiative for Norway

Taskén, Kjetil; Russnes, Hege Elisabeth Giercksky; Aas, Eline; Bjørge, Line; Blix, Ellen; Enerly, Espen; Fagereng, Gro Live; Flobak, Åsmund; Gilje, Bjørnar; Gjertsen, Bjørn Tore; Guren, Tormod Kyrre; Heix, Jutta; Hovig, Eivind; Hovland, Randi; Lønning, Per Eystein; Meza‐Zepeda, Leonardo A.; Mæhle, Per Magnus; Nilsen, Hilde; Thoresen, Steinar; Widerberg, Ketil; Smeland, Sigbjørn; Helland, Åslaug

doi:10.1038/s41591-022-01777-4

Cited by 13 publications

(5 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Processes were initiated, both bottom‐up and top‐down, to implement precision cancer medicine. In addition, connections were made with similar efforts in the Nordic countries and in the Netherlands, and a public‐private partnership was established [ 33 , 34 ].…”

Section: Session 3: How To Exploit Innovation As the Driver To Reduce...mentioning

confidence: 99%

Strategies to decrease inequalities in cancer therapeutics, care and prevention

Ringborg,

von Braun,

Celis

et al. 2024

Molecular Oncology

Self Cite

View full text Add to dashboard Cite

Analyses of inequalities related to prevention and cancer therapeutics/care show disparities between countries with different economic standing, and within countries with high Gross Domestic Product. The development of basic, technological and biological research provides clinical and prevention opportunities that make their implementation into healthcare systems more complex, mainly due to the growth of Personalized/Precision Cancer Medicine (PCM). Initiatives like the US‐Cancer Moonshot and the EU‐Mission on Cancer and Europe´s Beating Cancer Plan are initiated to boost cancer prevention and therapeutics/care innovation and to mitigate present inequalities. The conference organised by the Pontifical Academy of Sciences in collaboration with the European Academy of Cancer Sciences discussed the inequality problem, dependent on the economic status of a country, the increasing demands for infrastructure supportive of innovative research and its implementation in healthcare and prevention programs. Establishing translational research and a coherent cancer research continuum is still a challenge. Research has to cover the entire continuum from basic to outcomes research for clinical and prevention components. Comprehensive Cancer Centres (CCCs) are of critical importance for integrating research innovations to preclinical and early clinical research, as for ensuring state‐of‐the‐art patient care within healthcare systems. International collaborative networks between CCCs are necessary to reach the critical mass of infrastructures and patients for PCM research, and for introducing prevention modalities and new treatments effectively. Outcomes and health economics research are required to assess the cost‐effectiveness of new interventions, currently a missing element in the research portfolio. Data sharing and critical mass are essential for innovative research to develop PCM. Despite advances in cancer research, cancer incidence and prevalence is growing. Making cancer research infrastructures accessible for all patients, considering the increasing inequalities, requires science policy actions incentivising research aimed at prevention and cancer therapeutics/care with an increased focus on patients´ needs and cost‐effective healthcare.

show abstract

Section: Session 3: How To Exploit Innovation As the Driver To Reduce...mentioning

confidence: 99%

Strategies to decrease inequalities in cancer therapeutics, care and prevention

Ringborg,

von Braun,

Celis

et al. 2024

Molecular Oncology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Several countries have established substantial infrastructure to foster Patient Access to PO – with a particular emphasis on patients living in rural areas. Japan and Norway for example have set up nationwide hospital networks with centralized molecular tumor boards (MTBs) [4–8]. For Germany, the “National Decade against Cancer” organized by the Federal Ministry of Education and Research aims to tackle obstacles in Patient Access to PO [9,10].…”

Section: Introductionmentioning

confidence: 99%

The WERA Cancer Center Matrix: Strategic Management of Patient Access to Precision Oncology in a Large and Mostly Rural Area of Germany

Krebs,

Haller,

Spörl

et al. 2024

Preprint

View full text Add to dashboard Cite

Purpose: Offering equal Patient Access to Precision Oncology (PO) is a major challenge of clinical oncologists and cancer center representatives. Here, we provide an easily transferable model adopted from strategic management science to assess the geographic impact of a cancer center, in terms of general cancer care and PO participation. Methods: As members of the German WERA alliance, the cancer centers Wuerzburg, Erlangen, Regensburg and Augsburg merged care data regarding their geographical impact. Specifically, we examined the provenance of patients from WERA molecular tumor boards (MTBs) between 2020 and 2022 (n = 2,243). As second dimension, we added the provenance of patients receiving general cancer care (termed Total Cancer Care, TCC) by WERA. Clustering our outreach along these two dimensions allowed us to set up a four-quadrant matrix consisting of postal code areas with referrals towards WERA. These areas were re-identified on a map of the Federal State of Bavaria and surrounding regions. Results: In terms of positive MTB and general cancer care referrals, the WERA Matrix overlooked an active screening area of n = 821 postal code areas, representing about 50% of the spatial expansion of Bavaria and more than six million inhabitants. The WERA Matrix identified regions successfully connected to our outreach structures in terms of subsidiarity, with general cancer care mainly performed locally but PO performed in cooperation with WERA. At the same time, we detected postal code areas with a potential PO backlog, characterized by high levels of cancer care performed by WERA and low levels or no MTB representation. Conclusions: The WERA Matrix provided a transparent portfolio of postal code areas, which helped assessing the geographical impact of our PO program. We believe that its intuitive principle can easily be transferred to other cancer centers.

show abstract

“…while others (i.e. large centers, typically working closely with comprehensive cancer centers) cover multiple cancer types [7].…”

Section: Introductionmentioning

confidence: 99%

Application of comprehensive molecular genetic profiling in precision cancer medicine, Hungarian experiences

Tóth,

Kürönya,

Soós

et al. 2024

View full text Add to dashboard Cite

Recent developments in molecular genetic testing methods (e.g. next-generation sequencing [NGS]-panels) largely accelerated the process of finding the most appropriate targeted therapeutic intervention for cancer patients based on molecularly targetable genetic alterations. In Hungary, a centralized approval system following the recommendation of the National Molecular Tumor Board was launched for the coordination of all aspects of comprehensive genetic profiling (CGP) including patient selection and therapy reimbursement. Aim: The study aims to evaluate the clinical benefit of CGP in our Comprehensive Cancer Center Methods and patients: CGP was introduced into our routine clinical practice in 2021. An NGS-based large (> 500 genes) gene panel was used for cases where molecular genetic testing was approved by the National Molecular Tumor Board. From 2021 until August 2023 163 cases were tested. The majority of them were ECOG 0–1 patients with advanced-stage diseases, histologically rare cancer, or cancers with unknown primary tumours. Results: Seventy-four cases (74 of 163, 45%) had clinically relevant genetic alterations. In 34 patients, the identified variants represented an indication for an approved therapy (approved by the Hungarian authorities, on-label indication), while in 40 cases the recommended therapy did not have an approved indication in Hungary for certain tumour types, but off-label indication could be recommended. Based on our CGP results, 24 patients (24/163; 14.7%) received targeted therapy. Treatment duration was between 1 and 60 months. In total 14 (14/163; 8.5% of the tested cases) patients had a positive clinical response (objective response or stable disease) and were treated for more than 16 weeks. Interpretation: NGS-based CGP was successfully introduced in our institution and a significant number of patients benefited from comprehensive genetic tests. Our preliminary results can serve as the starting point of Drug Rediscovery Protocol (DRUP) studies.

show abstract

A national precision cancer medicine implementation initiative for Norway

Cited by 13 publications

References 5 publications

Strategies to decrease inequalities in cancer therapeutics, care and prevention

Strategies to decrease inequalities in cancer therapeutics, care and prevention

The WERA Cancer Center Matrix: Strategic Management of Patient Access to Precision Oncology in a Large and Mostly Rural Area of Germany

Application of comprehensive molecular genetic profiling in precision cancer medicine, Hungarian experiences

Contact Info

Product

Resources

About