A national precision cancer medicine implementation initiative for Finland

Abstract

To the Editor -The adaptation of nationwide genomic profiling and personalized cancer therapy in Finland has been challenging due to the lack of a uniform framework and funding. Meanwhile, increasing evidence demonstrates a clear benefit from precision medicine in cancer care [1,2] while the need for more efficient therapies in hard-to-treat cancers is evident. Equally a challenge for these cancers remains in the lack of randomized trials.Work to implement precision cancer medicine at a national level in Finland, began in 2021 led by Helsinki University Hospital (HUS) and FICAN South to meet three goals: (1) to implement genomic profiling and precision cancer medicine as standard of care, (2) establish equal access to molecular diagnostics and clinical trials in precision medicine, (3) to increase the number of precision cancer medicine trials and open a national DRUP (Drug Rediscovery Protocol)-like clinical trial.A multidisciplinary study team including oncologists, hematologists, gynecological oncologists, pathologists, cancer researchers, molecular and clinical geneticists was formed. This nationwide working group had the common aim to enable access to personalized cancer therapy for all patients in Finland irrespective of their residence. Early discussion amongst this initiative urged the need to equally engage stakeholders for reimbursement and sustained funding. Of equal importance was to explore the possibility of a public-private partnership for drug access and possibilities for shared pay for benefit funding. Political and financial support have revealed to be the most challenging steps within this initiative as consistent public funding is still lacking. Without international coordination with other major precision cancer medicine initiatives, especially the Dutch DRUP trial, the implementation would have been impossible.Tertiary care for cancer treatment in Finland is centralized to five university hospitals each governing a capture area of 0.7 to 1.7 M inhabitants. Each University hospital has a regional cancer center (FICAN South, West, East, North and Mid) that aims to promote equal access to diagnostics and treatment and, thus, the FICANs have played a major role in the precision cancer medicine initiative. During the past 3 years, we have therefore LETTER

Acta Oncologica Nordic Precision Cancer Medicine Symposium 2023 – merging clinical research and standard healthcare

“…ProTarget has so far evaluated 5000 genomic profiles and 185 patients have been treated in 112 cohorts. Katriina Jalkanen from the Helsinki University Hospital presented the FINPROVE trial at the conference, and an update is also published in this special issue [12]. The trial opened at the end of 2021, and so far, 310 patients have been evaluated and 85 patients have been offered treatment.…”