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Fremtidens kreftbehandling frokostmøte 2022

Challenged politicians about cancer

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Where are the Norwegian political ambitions for cancer treatment? We need more public-private collaboration on cancer.

Breakfast and political conversations on cancer are the hallmark for our meeting series Fremtidens kreftbehandling. On 21 April 2022, health officials, politicians, patient spokespeople and industry representatives met to discuss the future of cancer treatments. They all agreed: we need more public-private collaboration on cancer.

As introduction, Ketil Widerberg, general manager of Oslo Cancer Cluster, presented the results from a recent survey by Kantar of the Norwegian population’s views on health policy. The survey showed a majority want more modern cancer treatments with less side effects at public hospitals. They want the same treatment options as in other Nordic countries. They also think the public health service should pay for cancer treatments that work.

“We believe cancer can go from being a deadly disease to a disease people live well with, but we can’t get new treatments to the patients if the public and private sector don’t work together,” Widerberg said. “When we build roads, we assess the economy on a broader scale than when we assess new treatments. Is this really the kind of politics we want?”

A cancer revolution underway

The people’s wishes are clear, but how can doctors offer more modern treatments to their patients? In the first panel discussion, Anne Karin Rime, president of the Norwegian Medical Association, Jan Frich, deputy CEO of the South-Eastern Regional Health Authority, and Ingrid Stenstadvold Ross, general secretary of the Norwegian Cancer Society discussed how patients can gain access to precision medicine, which means the right treatment to the right patient at the right time.

“We are living in a kind of cancer revolution. There are many extremely promising treatments on the way, especially in precision medicine,” Stenstadvold Ross said. “The current system assesses the cost and effect of a treatment by looking at an average patient group. For lung cancer, it will typically be 60-plus men with a history of smoking, but if I developed lung cancer, my characteristics wouldn’t fit this description.”

Rime argued that these new, revolutionary medicines have made the doctor’s job more complicated.

“The role of the doctor has changed from deciding the best treatment for the patient. Now the doctor also needs to think about society as a whole: what can we afford to treat? It is extremely difficult for a doctor to know there are treatments or diagnostics that may help the patient, which they can’t offer,” said Rime. “Diagnostics become more important now and offering genetic tests to all patients to identify which treatment will work.”

Frich agreed that more precise diagnostics is the solution.

“The key to personalised treatment is good diagnostics,” Frich commented. “The last two-three years, much has happened in personalised medicine. We have created a national plan for advanced diagnostics and set aside resources for this. An infrastructure for precision diagnostics is being built. The CONNECT collaboration with the pharmaceutical industry work on a large clinical study called IMPRESS, which is supported with NOK 60 million from the regional health authorities.”

Make your voice heard

The system needs to change so that patients can take part in the cancer revolution. Gloria Traina is a PhD and advisor at the Specialist Health Section in the Norwegian Ministry of Health and Care Services. They are working on a Strategy for Personalised Medicine to be launched before 2023.

“There has been some success getting precision medicine to Norway and there are many new initiatives, including InPred, IMPRESS and CONNECT. We now see there is a need for a revised strategy,” Traina explained.

More public-private collaboration

While the new strategy materialises, patients are still waiting for access to better treatments. In the debate, politicians were challenged to declare their ambitions for Norway.

”I want to see more political vision. The European Union has launched a Cancer Mission, the goal is to improve the lives of 3 million people by 2030. What are Norway’s ambitions?” Stenstadvold Ross asked.

“We need to look at how we rig the decision-making systems, for example by involving clinicians and patients, how we attract clinical studies and how we implement personalised medicine,” Karl Kristian Bekeng from the Labour Party (Arbeiderpartiet) said. “When it comes to collaboration on new technologies and new medicines, there should be a lot more public-private collaboration. This should not be a replacement of the public health service, but an improvement of the public health service.”

Sylvi Listhaug from the Progress Party Association (Fremskrittspartiet) criticised the decision-making system.

“I think many patients – and the population as a whole – question why Norway is so late in implementing new medicines that can save lives and give better quality of life. I also think there are many desperate doctors, who see there are medicines that can give their patients a better life, which they can’t offer. The way we do this in Norway is completely out-dated. It doesn’t work. We are putting forward a new bill to Parliament now to change the whole system,” Listhaug announced.

Hege Edvardsen, senior adviser in LMI, represented the pharmaceutical industry in the debate and challenged the politicians to become more hands-on.

“We see that political decisions do not agree with what is actually delivered in the health service,” said Edvardsen, “It is important to strengthen the public-private collaboration. We have done a lot in oncology, but we are still struggling to get access to new treatments and we are lagging behind other Nordic countries. We need to consider the entire ecosystem when we talk about these things. If we wish to increase the number of clinical studies and attract research investments to Norway, we must also become better at solving the access part.”

The meeting also included mingling between the participants and the audience, which sparked further conversations and reflections. The debate will continue in our communication channels and at our next meeting during Arendalsuka at Clarion Hotel Tyholmen on 18 August 2022 (08:00-09:30). We hope to see you there!

Watch the meeting here (in Norwegian):

 

 

This meeting was a collaboration between Oslo Cancer Cluster, Norwegian Cancer Society, LMI, AstraZeneca, Janssen and MSD.

logos of organising partners

 

Bjellesermoni Oslo Børs PCI Biotech

PCI Biotech works with Astra Zeneca

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PCI Biotech reveals they have been collaborating with Astra Zeneca since 2015.

Our member PCI Biotech grabbed the opportunity during their third quarter report this week to announce who their mystery collaboration partner since 2015 has been. The “top-ten pharma company in the world”, who has been helping them, is Astra Zeneca.

PCI Biotech is a company that is based on a technology called photochemical internalisation, which was invented by Professor Kristian Berg from the Norwegian Radium Hospital. The technology is a kind of drug and gene delivery method. It aims to improve the release of big molecules and chemotherapy drugs to the targeted cancer cells. The technology can also potentially be used for a wide variety of diseases and treatments.

The company currently develops three different programs:

  1. FimaCHEM: enhancing the effect of chemotherapy drugs for localised treatment of cancer
  2. FimaVACC: delivering cancer vaccines effectively to the cancer cell and kick-starting a immune response
  3. fimaNAc: delivering nucleid acid therapeutics

You can read more about the revolutionary light technology in the following article:

Astra Zeneca has said that the results from their tests of fimaNAc look very promising in the oncology area. Now, they wish to see if the same technology can work in other disease areas. The pre-clinical collaboration agreement between PCI Biotech and Astra Zeneca lasts until the end of 2019 and the following 6 months will be used to evaluate the potential for further collaboration.

Per Walday, CEO of PCI Biotech, had the following to say about the collaboration:

“Ensuring sufficient intracellular delivery of nucleic acid therapeutics is a major hurdle to realise the vast therapeutic potential of this drug class. We believe that the fimaNAc technology can play an important part in solving this delivery challenge.  PCI Biotech’s current collaborations and their progress suggest that external partners share this view.”

Listen to Per Walday and Ronny Skuggedal talk more about PCI Biotech, the “light technology”, their third quarter report and future milestones in the podcast Radium episode 103.

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Let us cooperate on precise health technologies

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International cooperation is key to fulfilling our vision of making cancer treatments more precise, and giving the patients new treatments more quickly.

This opinion piece is written by Ketil Widerberg, General Manager at Oslo Cancer Cluster. It was first published in the Norwegian newspaper Today’s Medicine, Dagens Medisin, 30 October 2018. 

The countries in Northern Europe have contributed to developing medical treatments that we today could not imagine living without. From the British discovery of antibiotics to the Danish development of a treatment for diabetes. Once again it is time for Northern European health innovation, this time in the field of health technology. What might the prime ministers from Northern Europe focus on when they meet in Oslo on 30 October to discuss health technology?

They might want to point out concrete and state-of-the-art initiatives from their respective countries. It could be Swedish biobanks, Finnish artificial intelligence, Danish health data, English genomics and Estonian health blockchain. These are exciting initiatives that make medicine more precise. This is particularly important when it comes to cancer because more precise treatments could save lives and limit the late effects resulting from imprecise treatment.

This opinion piece is written by Ketil Widerberg, General Manager at Oslo Cancer Cluster. It was first published in the Norwegian newspaper Today's Medicine, Dagens Medisin, 30 October 2018.

This opinion piece is written by Ketil Widerberg, General Manager at Oslo Cancer Cluster. It was first published in the Norwegian newspaper Today’s Medicine, Dagens Medisin, 30 October 2018.

At the same time, we see the contours of serious challenges arising with more precise medicine, such as each unit becoming more expensive. Smaller patient groups also mean that it is harder to find enough patients to understand the biological processes and the consequences of new medical treatments. As the prime ministers gather in Oslo to discuss health technology and plan the road ahead, it would not be amiss for them to look back in time and find inspiration from another technological development.

Precise through cooperation
In the 1990s, the search engine Yahoo helped us to quality-assure by categorising and being precise when we needed information on the internet. Yahoo thus contributed to the internet changing the world. However, the amount of data soon became enormous and complex, and a never-ending need for resources and experts arose. The traditional categorisation to ensure quality and structure the data became an impossible task.

This is very similar to what is happening in the health field today. We are constantly collecting more data and educating an increasing number of experts. With a few exceptions, every country is now collecting their data in their own registers and using a great deal of resources on assuring the quality of the data. The countries are rightfully proud of their initiatives. In Norway, we are proud of our biobanks and our health registers, such as the Cancer Registry of Norway. At the same time, we need to ask ourselves whether this national strategy really is the smartest way forward.

Let us go back to Yahoo. Towards the end of the 1990s, some engineers in California thought differently about the internet. How about using cooperation as a quality indicator? Instead of categorising, the links between the websites could ensure data quality. This is how Google was born, and we got precision, quality and insight into data that changed the world.

There are different challenges in the health field than on the internet. Data are more sensitive and the consequences for individuals can often be more dire. At the same time, health technology, in many ways, has reached the same point as the internet faced in the 1990s.  We do not have the quantity, the methods for analysis, or the quality to fully exploit the data to gather insight, or for treatment or innovation – yet.

From Yahoo to Google level
One way in which we could tackle the health technology challenges the data present us with is through international cooperation. It is about two things: to gather enough data, and to analyse the data to provide better and more precise treatment. The initiatives so far are promising, but they lack the potential to make the leap from Yahoo to Google.

The Northern European prime ministers can probably acknowledge this. The question is: what can they do? Should they encourage smart young engineers to analyse health data instead of developing the next app? Or should they change the way the hospitals buy technology?

A step in the right direction could be to look at what works best in the other countries. At the same time, we need to avoid new initiatives merely becoming a better horse-drawn carriage. Are there initiatives in existence that are scalable internationally so that we can bring health data up to the next level together? The answer is yes, but it requires visionary initiatives that have not been done anywhere else.

Common clinical studies
An area that the prime ministers will be able to highlight is a Northern European initiative for clinical studies. Together, the countries have a large number of patients, which gives researchers and doctors a better basis in their studies to understand more and provide better treatment. Such an initiative could also use health data from the national health services collected on a daily basis in several countries, known as real world data, instead of eventual clinical studies with patients over several years. This would be both quicker and much cheaper.

The prime ministers might also agree on cooperating on Northern European genetics. For 13 years, we collaborated on mapping our genes in the international  Human Genome Project. Now we need to get together to understand genes and treat the patients. With prioritised funding, genetics will soon be a part of the everyday clinical life in England. We can learn a lot from their experience.

Artificial intelligence
Lastly, the Northern European prime ministers may wish to collaborate on artificial intelligence in the health field. Today, cancer treatment, for instance, often only works on three out of ten patients. Artificial intelligence will change how we understand diseases such as cancer and how we treat the patients. The experiences from Finland of introducing artificial intelligence will help other countries to understand where the barriers are and where help might be needed first.

Oslo Cancer Cluster’s vision is to make cancer treatment more precise and provide new treatments more quickly to the patients. We see that international cooperation is key to obtaining this goal. As a result, we could also discover diseases more quickly and reduce the costs of the national health services. We hope the Northern European prime ministers will delve into these issues when they meet to discuss the health technologies of the future here with us.

By Ketil Widerberg, General Manager at Oslo Cancer Cluster.