213P - Unlocking cancer treatment opportunities by population-based advanced diagnostics in Norway

Background

Targeted cancer treatment has been developed at a rapid pace, but implementation of precision cancer medicine (PCM) has met several challenges. Key challenges are: 1) lack of clinical evidence within and across tumor groups 2) lack of predictive biomarker 3) access to medication and 4) regulatory and economic factors. These are interconnected, and PCM trials are needed to address most of them. To meet the need for tailored diagnostics for PCM trials, we designed a national Infrastructure for Precision Diagnostics – InPreD-Norway.

Methods

In 2020, the CEOs of the four Norwegian health regions allocated funding to the six university hospitals to form a collaborative network, InPreD, with dedicated environments (nodes) at each site for implementing next-generation cancer diagnostics. The first task has been to build a complete program for Comprehensive Gene Profiling (CGP), including a national virtual tumorboard, for patients eligible for experimental cancer treatment and trial inclusion.

Results

The InPreD nodes were gradually built at the six university hospitals. The largest hospital, Oslo University Hospital, was initiated first, built a transdisciplinary environment and implemented a complete pipeline for CGP testing (TSO500). These solutions were used by the other nodes when they were initiated. In spring 2023, the InPreD nodes had completed CPG profiling of 1000 patient cases. A new treatment opportunity was found for 34% of the patients, where referral to the national PCM trial IMPRESS-Norway trial dominated (21%). The National molecular tumorboard meets virtually twice weekly to discuss the analysed cases with the InPreD nodes and the referring physicians, providing both an advisory but also and educational role. InPreD now plan novel diagnostics such as drug sensitivity screening and digital pathology biomarkers for planned trials.

Conclusions

The national Infrastructure, InPreD, secures competence building and standardised service in CGP testing nationwide, providing new treatment opportunities for cancer patients. Beyond strengthening the ability to identify patients to clinical trials, it serves as a united interaction partner for national stakeholders such as governmental bodies, health authorities and industry.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The Norwegian regional health authorities.

Funding

The Norwegian regional health authorities and the involved hospitals.

Disclosure

H.E.G. Russnes: Financial Interests, Institutional, Invited Speaker, Speaker on Illumina satellite meeting ( ESMO 2022): Illumina; Financial Interests, Institutional, Advisory Board, Novartis satellite meeting, Nordic Lung Cancer meeting, 2022: Novartis; Financial Interests, Institutional, Other, Debate, precision medicine, Oslo 2022 : Merck; Financial Interests, Institutional, Other, Participation, round table, Cholangiocarcinoma; Nordic meeting 2021: Incyte; Financial Interests, Institutional, Coordinating PI, Funding of 500 FMliquid test to patients in the IMPRESS-Norway trial: Roche Norway; Financial Interests, Institutional, Coordinating PI, Funding of TSO500 liquid tests for 500 patients in the IMPRESS-Norway trial: Illumina; Non-Financial Interests, Leadership Role, InPreD is an establishment in the public health care, securing disciplinary work when implementing precision diagnostics for cancer.: National Infrastructure for Precision Diagnostics (InPreD); Non-Financial Interests, Leadership Role, A network structure established as part of the public health care system, to share knowledge, build competence and work with harmonisation and standardisation to implement precision medicine: National Competence Network for Precision Medicine; Non-Financial Interests, Leadership Role, Head of working group for molecular pathology and for the Norwegian association for molecular pathology: The Norwegian Association of Pathology. All other authors have declared no conflicts of interest.