News regarding Oslo Cancer Cluster

Fremtidens Kreftbehandling: Kreft og kliniske studier. Et veikart for bedre kreftbehandling.

Integrating clinical trials in cancer treatment

/in , /by

How can we make clinical trials an integrated part of cancer treatment in Norway so that more patients can gain access to new and better treatments?

We arranged a webinar with key experts and politicians to answer this question. Watch the entire webinar on Youtube:

“The number of patients that get considered to participate in clinical studies in Norway is too low and it is difficult to arrange clinical studies across borders in the Nordics. This is unacceptable, but how can we change it?” This is how the moderator Ketil Widerberg, general manager of Oslo Cancer Cluster, set the scene for our first webinar, which was live-streamed from Kreftforeningens Vitensenter in Oslo.

A visionary plan

The Norwegian Ministry of Health and Care Services has said that clinical studies should be an integrated part of patient treatment in Norway. This is especially relevant when it comes to the advent of new cancer treatments and the fact that the number of clinical trials is decreasing in Norway. The Ministry is now working on a Clinical Studies Action Plan to be completed in 2020.

Maiken Engelstad, Deputy Director General of The Department of Specialist Health Care Services, gave a presentation on its contents so far. An overarching goal is to get more, useful clinical studies to Norway, so that more patients can receive better treatments, and ultimately achieve a more efficient health service.

Engelstad mentioned many important aspects to achieve this. For example, to create more collaborations between the industry and public sector, with NorCRIN as a “one-stop-shop” for clinical studies. Engelstad stressed that Norway needs to build capacity, so that feasibility, recruitment and approval is accelerated. Engelstad also talked about building competency, by including clinical research, gene therapy and artificial intelligence in education. Moreover, Engelstad wants to increase the multitude of different studies, catering to both big and small patient groups, vulnerable patients, assessing both new and established treatments, and conducting the trials both locally, nationally and internationally. 

“We need to look to Norway’s advantages, such as real world data, which can be used from designing the drugs to implementing new therapies in the clinic.” Maiken Engelstad

Engelstad said that there needs to be a national and regional framework in place to achieve this, with regulations, financing, infrastructure and competency. Engelstad finally highlighted that one of the biggest challenges is to achieve a cultural change towards conducting clinical trials in Norway.

The tangle of rules

The legal framework that regulates clinical studies in the Nordics is very difficult to navigate for patients who wish to participate in and for companies that wish to arrange clinical trials. Wenche Reed, Head of Research in The Section for Research, Innovation and Education at Oslo University Hospital, talked about how complicated it is to interpret the regulations. 

“There are many laws to consider when conducting clinical studies. It is not easy to navigate the legal landscape – not even for lawyers!” Wenche Reed

Reed explained that the advent of personalized medicine in cancer is challenging the division between patient treatment and clinical research. Moreover, the ethical and legal framework for handling big data is being challenged, because of new developments using artificial intelligence in diagnostics.

Tearing down the barriers

The introductory presentations were followed by a lively panel discussion, divided into three sections. The first section included a video message from Tone Skår, project manager in VIS Innovation and founder of the MED.hjelper project and #SpørOmKliniskeStudier social media movement. Skår emphasised the importance of informing patients of the possibility of participating in trials and creating incentives for doctors and hospitals to run the trials.

Sigrid Bratlie, Special Adviser in The Norwegian Cancer Society, commented that a cultural change is needed. Bratlie said we need to look at concrete cases to learn how to conduct successful clinical studies in cancer personalised medicine.

Bratlie highlighted that Norway has world-class cancer research milieus, especially in cell therapy, but the total number of clinical trials is dwindling. Europe risks falling far behind the US and China, because of the complicated legal framework.

“The Biotechnology Act is just one small piece of the puzzle. Soon there will be a hearing for the Genetechnology Act. We need to look at the bigger picture and how the different laws interact.” Sigrid Bratlie

The second part of the panel conversation turned to both clinicians and industry for their perspectives. Daniel Heinrich, Senior Consultant Oncologist at Akershus University Hospital and Head of The Norwegian Oncology Association, wants to offer his patients the opportunity to try new treatments, which potentially can be better than the standard treatment. Heinrich highlighted that it is difficult for patients that need to travel to different hospitals and private clinics for testing because the hospitals lack capacity. He said that the directives need to come from above, from hospital management, the Directorate of Health and the politicians.

“It is almost impossible to include patients in studies in other countries now. Often it is difficult to understand why!” Daniel Heinrich

Baldur Sveinbjørnsson, Chief Scientific Officer in Norwegian cancer start-up Lytix Biopharma, has tried to arrange a clinical trial in Norway, but found that it was better to conduct it from a hospital in Copenhagen. When patient recruitment was too slow and costs were mounting every day, Sveinbjørnsson travelled around the Nordics to attract patients. There was great interest, but the differing regulations and processes in the Nordic countries put a stop to recruitment.

“We have started looking towards the US and filed an application to the authorities to conduct our next clinical study there.” Baldur Sveinbjørnsson

Hege Edvardsen, senior adviser in Legemiddelindustrien (LMI), thinks Norwegian companies should be able to conduct their trials in Norway. Edvardsen said we need to establish a “one-stop-shop” for clinical studies in Norway. Edvardsen said that the pharmaceutical industry often turns to the most successful cancer centres and hospitals when placing their clinical trials.

“Dedicated enthusiasts are the ones running the clinical studies, but we need targeted financing, so the people doing the work are acknowledged.” Hege Edvardsen

The final part of the panel discussion included two politicians’ visionary perspectives for the future.

Marianne Synnes Emblemsvåg, politician for The Conservative Party of Norway – Høyre, said she was touched by the ambitious plans in the Action Plan. Emblemsvåg commented that she is an impatient person, but that the bureaucratic process takes time to change.

“We need to market Norway in a way that makes us attractive for clinical trials.” Marianne Synnes Emblemsvåg

Emblemsvåg commented that there are many exciting developments considering artificial intelligence and diagnosing cancer, but that they come with some very challenging ethical considerations.

Tuva Moflag, politician for The Labour Party of Norway – Arbeiderpartiet, agreed that things take time to change. Moflag emphasised that part of the political work is to “clean up” some of the bureaucratic mess and to remove the legal barriers.

“We should have high ambitions for clinical studies, considering that we are a rich country and should assume responsibility for our patients.” Tuva Moflag

Moflag also stressed that there needs to be infrastructure, personnel and financing to complete it. Creating a culture of innovation, so that medical personnel feel they are part of something bigger than themselves.

The webinar ended with some final comments from Engelstad, who had been listening and taking diligent notes to bring with her in her work with the Action Plan going forward.

We want to direct a special thank you to all the meeting participants, to the organising partners and to everyone who followed the live stream.

Our next meeting in this series will take place this fall. More details will be published on our website closer to the event.

 

Event organisers:

OCC logo

Kreftforeningen logo

LMI logo

AstraZeneca logo

 

Janssen logo

MSD logo

 

 

Sign up to our monthly newsletter

 

Pavlova, Photo by Alice Ponce from Pixabay.Alice Ponce / Pixabay

May 17th Virtual Greeting

/in , /by

”Gratulerer med dagen” (Congratulations!) on Norway’s Constitution Day from the entire Oslo Cancer Cluster team.

As a prelude to the May 17th celebrations, Oslo Cancer Cluster hosts an annual networking breakfast for our cluster’s members, neighbours in Oslo Cancer Cluster Innovation Park and the wider oncology community.

The Norwegian Constitution Day Breakfast 2020 has been adapted in the form of this virtual greeting as we observe social distancing together.

The team at Oslo Cancer Cluster and Oslo Cancer Cluster Incubator would like to wish Norwegians everywhere “Gratulerer med dagen!” with best wishes on this special day for Norway.

Oslo Cancer Cluster members in Norway and around the world, thank you for your support toward collective efforts to positively impact oncology research.

 

Henrik and Tia receive homeschooling during the corona lockdown.

Homeschooling for researchers-to-be

/in , /by

This article was originally published in Norwegian on our School Collaboration website.

Even during the corona lockdown, the researcher students have received inspiring classes online, but they miss the practical work and are happy to soon return to school.

The researcher programme is an opportunity for upper secondary students who want to specialise in the natural sciences and the teaching is based on a combination of practical work and in-depth theory. So, how has home schooling been during corona lockdown? Digital classes in biology have replaced the usual work placements in professional research laboratories and performing experiments in school. We talked to the students Tia and Henrik, and their teacher Monica, to find out more.

CORONA UPDATE


This article was written before the Norwegian government released the positive news that students will return to school during week 20.


Since Ullern Upper Secondary School houses almost 1 000 students, they will return gradually to control the spread of COVID-19. The Researcher Programme starts on Wednesday 13 May and the class will be off to a flying start.


“The students will receive a lecture from an astrophysicist on their first day back. It was supposed to be delivered digitally, but now it might take place in the classroom, which will be extra special!” says Monica.


Both Monica and the students are looking forward to returning to the school. Henrik and Tia were hoping to begin school again during May and now they are getting their wish fulfilled.

“I think home schooling works. It is effective. The teachers have made great arrangements and we are learning new things,” says Henrik Corneliussen, who is in his first year of the Researcher Programme.

“I think it is going surprisingly well in many subjects, but it is difficult to stay motivated and focused on the teaching when we are doing so much on our own. Math is a bit more difficult now and biology is also challenging,” says Tia Morigaki Sauthon, who is in the same class as Henrik.

Monica Flydal Jenstad and Ragni Fet are Natural Science teachers and have both been cancer researchers. They are responsible for the new Researcher Programme at Ullern Upper Secondary School and teach biology and natural science to the class of 32 students for 10 hours every week.

Almost overnight, the teachers had to change their planned classes, because of the corona pandemic. They went from being physically present in the classroom – with all the available lab equipment and the possibility to perform experiments to exemplify different theories – to communicating with the whole class over the video-calling system Teams and teaching the students by using PowerPoint presentations and group tasks.

“Ullern Upper Secondary School is following the normal curriculum during homeschooling. When class begins, everyone checks into our Teams chatroom and says hi. Ragni or I deliver the teaching, usually through a lecture, and then the students complete tasks in a program called ‘OneNote’. We can see if the students are completing the tasks and help them if they are stuck or wondering about something,” Monica says.

Monica explains that life as a teacher has become more hectic and intense during corona lockdown, delivering classes in a digital format and being more available via messaging and calls over Teams.

Missing the practical aspects

Even though Henrik and Tia are generally happy with the digital classes, there are a few things they miss during homeschooling.

“I really miss the practical schoolwork, which we can barely do at all, because we lack access to equipment that we need to perform experiments at home. We have also missed out on many placements, which is a shame. I have luckily already participated in one placement, but it is sad for the students who haven’t had the opportunity,” Henrik says.

The Ullern students visited the Core Facility for Advanced Light Microscopy at Oslo University Hospital.

Image caption: Henrik, second person from the left, is one of the lucky students on the Researcher Programme, who has already participated in a placement. The other students in the picture are Peder, Isha and Christopher. The placement was with the research group for advanced cancer therapy in February. Photo: Elisabeth Kirkeng Andersen

“It is really sad that we have missed out on so much practical work, which was why I chose the Researcher Programme. Fortunately, we have done a few experiments at home. We have, among other things, made our own solar thermal collectors and learnt how to measure light strength in lux, which we have used to understand how to measure the distance from the Earth to the stars,” says Tia.

Monica shares the students’ feelings.

“The students were in the middle of their independent research projects when the school closed. Some had already performed experiments at home with plants that they could follow up, but other students were dependent on finishing their projects at school. The purpose was always for them to present the results of their research during a poster session, which is a presentation format that researchers use to show data and other findings from their research, but we have had to postpone this activity. Hopefully, we can complete it in June with the students’ mentors present,” Monica says.

The poster session is not the only thing the students have missed. Four placements with different research groups at Oslo University Hospital and the company Thermo Fisher Scientific, and three relevant lectures by researchers, were planned for the period they have been stuck at home.

“The students have missed out on many aspects of the Researcher Programme in this period, because it is difficult to perform the practical work, both in the regular teaching and in the form of placements. It is simply a more boring school day,” Monica says.

The corona pandemic itself can however be used in the teaching, both in mathematics to learn about exponential growth and in biology to learn about viruses.

Happy to return to school

Tia and Henrik really miss being in school together with the other students of the Researcher Programme and other friends, both at Ullern and outside of school.

“I look forward to meeting my friends again. I don’t see many of them now. I also look forward to getting started with the practical work at school, with experiments in the natural sciences and biology. It is really fun, and the teachers are good at organising interesting experiments and placements, in collaboration with Oslo Cancer Cluster,” says Henrik.

Tia also misses her friends a lot.

“Maybe what I look forward to the most is getting back to the normal everyday routine – going to school and being with friends. I talk to my friends over Teams and have one friend I meet a lot, but I miss being with many people at once,” says Tia.

She thinks the learning is more challenging from home.

“It is easier to ask for help in school. It is much more difficult to get a verbal explanation without being shown how everything is connected by the teacher, so I spend a lot of time trying to figure things out myself instead of asking for help,” says Tia.

The students are also sorely missed by their teachers.

“I miss them all and especially the contact with the students in a classroom setting, one-on-one. It is much more fun and better to follow the students directly, especially when they think the subject is a bit heavy,” says Monica.

Tia is still sure that even though the corona pandemic has had far-reaching consequences, not all of them are bad.

“I think it seems like everyone has made the best out of the situation. It could have gone much worse and been much worse. In many ways, I think this is a useful experience and, one way or another, something good will come of it,” says Tia.

Summary of postponed or cancelled plans for the students:

  • Poster session about their own research projects with the mentors
  • Lecture on screening of new-borns with Janne Strand, Child- and Youth Clinic, Oslo University Hospital
  • Lecture on structural biology and drug design with Bjørn Dalhus, Oslo University Hospital
  • Lecture on organising research with Barbra Noodt, Cancer Clinic, Oslo University Hospital
  • Placement with Thermo Fisher Scientific
  • Placement with Harald Stenmark at the Department of Molecular Cell Biology, Oslo University Hospital
  • Placement with Hans Christian Aas at Flow Cytometry Core Facilities at Oslo University Hospital
  • Placement with Bjørn Dalhus’ research group Structural Biology and DNA repair, Oslo University Hospital.

 

Sign up to our monthly newsletter

Bilde av evaluering av bioteknologiloven

Research on gene-edited embryos allowed

/in , , /by

Important cancer research into gene-edited human embryos will now be possible in Norway

Research on gene-edited human embryos will now be allowed in Norway, after a majority agreement has been reached among parties in the Norwegian Parliament. The news was given at a press conference on Thursday, when representatives from the three political parties Arbeiderpartiet, Fremskrittspartiet and Sosialistisk Venstre presented the amendments to the Biotechnology Act (“bioteknologiloven”). This is the act relating to the application of biotechnology in medicine.

The changes to the Biotechnology Act are good news for cancer patients and researchers, as they allow for research into gene-edited human embryos. This will give us important knowledge about how cancer arises and how to develop effective treatments against cancer.

Oslo Cancer Cluster gave input to these changes, during a hearing on 6 February 2020 at the Ministry for Health and Care Services. We emphasised that it is important that the regulations are in line with technological developments to promote research, so that we in the future have improved access to personalised cancer diagnostics and treatments.

“These are important changes to promote cancer innovation in Norway. It will help accelerate research into new cell therapies, which will benefit cancer patients both here in Norway and abroad,” said Ketil Widerberg, general manager of Oslo Cancer Cluster.

Gene technology is an important area in cancer research, with many recent break-through discoveries. By gene-editing human embryos, researchers can develop personalised cancer treatments and diagnostics.

Cell division in embryos and uncontrolled cell division in cancer cells is regulated by the same genes. That is why research on gene-edited human embryos will give us valuable knowledge about genetic diseases like cancer.

Gene technology can be used to create genetic changes and give us more knowledge about cell division. For example, researchers can insert genetic markers in DNA and follow the cell’s development from stem cell to cancer cell. They can also produce mutations in an embryo and study how cancer develops at an early stage.

You can read more about cancer research and gene-editing on the Cancer Research UK Science Blog.

It is important to note that the embryos used for research and gene-editing are not allowed to be implanted in a female uterus for pregnancy. This is in line with the current Swedish regulations on gene-edited human embryos.

The fact that gene-editing human embryos will be allowed in Norway means that we can attract world-class cancer clinical studies and deliver new personalised treatments to cancer patients.

The Norwegian Parliament (“Stortinget”) will officially vote on the amendments on 26 May 2020 and we will follow any further developments closely.

Sign up to our monthly newsletter