Sweden launches testbed for clinical trials in cancer care

Vision Zero Cancer and Genomic Medicine Sweden (GMS) join forces with SciLifeLab, public sector authorities, regions, healthcare, academia, industry and patient associations to create an innovation milieu that facilitates the introduction of more precise prevention and treatment in cancer care.

Through the call Innovation milieus within Precision Health 2021, The Swedish Innovation Agency, Vinnova, has chosen to invest in 11 innovation milieus in precision health that will pave the way for more prevention, precision, and equity in healthcare and contribute to strengthening Sweden as a life science nation.

– For cancer patients, this is a piece of the puzzle that enables the development of new innovations so that more people can live longer and better. This initiative consolidates Vision Zero Cancer as a national point of contact for system innovation and strengthens our ambition to spread  the Vision Zero globally says Ebba Hallersjö Hult, co-founder and head of Vision Zero Cancer and Test Bed Sweden.

Ebba Hallersjö Hult. Photo: Micke Lundström.

– GMS is very pleased to participate in this broad consortium that together can move the positions for national clinical studies in cancer in Sweden. At GMS, we are already working on a national, structured implementation of genomics-based precision medicine and we look forward to working together furthering more clinical studies, says Anders Edsjö, Vice Chairman of GMS management team, Section Head and Senior Molecular Pathologist at Clinical Genetics and Pathology, Region Skåne.

Anders Edsjö. Photo: Nooreldin Zendehrokh.

The research institute SIR at the Stockholm School of Economics is the coordinator for Vision Zero Cancer and for the new innovation milieu “Test Bed Sweden for Clinical Trials and Implementation of Precision Health in Cancer Care”, which has been granted funding for five years by Vinnova and which will be part of the national strategic innovation program Swelife.

The patient perspective is central to the initiative

– The Network against Cancer looks forward to the joint work within the testbed with a focus on co-creation with patients and relatives. We see great opportunities to push for a faster roll-out of clinical studies and the implementation of precision medicine, says Margareta Haag, Chair of the Network against Cancer.

Margareta Haag. Photo: private.

Comprised in the Life Science strategy, the government has a stated ambition that Sweden should be a pioneer for the introduction of precision medicine in healthcare. Predictions suggest that precision medicine is likely to grow primarily in cancer care over the next decade. In 10 years, between 300 and 400 new immunotherapies, targeted drugs and tumour agnostic drugs could be approved.

– Conducting clinical studies within healthcare is a prerequisite for patients in Sweden to be able to take part of the fantastic opportunities brought by precision medicine. The initiative Vinnova has now decided to finance will advance the positions for how we conduct clinical studies, which in turn means increased stimulation and prerequisites for more pharmaceutical companies to place their studies in Sweden and thereby contribute to the development of precision medicine, says Frida Lundmark, expert policy at Lif – the research pharmaceutical companies.

Frida Lundmark. Photo: Lif.

Wide range of actors behind the initiative

Test Bed Sweden is an add-on and further development of the Vinnova-funded innovation milieu Vision Zero Cancer established in 2019 with the long-term vision that no one should have to die of cancer. Behind the Test Bed initiative and application are 16 different actors (see box below). The range of actors is something seen as a key to succeed.

– By developing and implementing precision medicine through diagnostics and treatment in clinical routine, there is a good chance to reach the Vision Zero. Giving patients faster access to effective and nationally equitable precision health in the field of cancer is crucial, says Hans Hägglund, Sweden’s national cancer coordinator and co-founder of Vision Zero Cancer and Test Bed Sweden.

Hans Hägglund. Photo: Micke Lundström.

– Sweden needs an innovation milieu to stimulate and facilitate national clinical studies within precision medicine for patients with cancer. We have gathered a number of important players who need to be involved to make this possible. The testbed has national and international reach to initiatives and groups of actors that can contribute and collaborate in this endeavor, concludes Richard Rosenquist Brandell, Chairman of GMS management team, Professor and Senior Physician in Clinical Genetics at Karolinska Institutet and Karolinska University Hospital.

Richard Rosenquist Brandell. Photo: Rick Guidotti.

Contact:

Ebba Hallersjö Hult, tel: 072-711 44 91 [email protected]

Behind the initiative and application are the following actors: Vision Zero Cancer, Genomic Medicine Sweden (GMS), Regional Cancer Centres (RCC), The Medical Products Agency, The Dental and Pharmaceutical Benefits Agency (TLV), SciLifeLab, the consortium behind the clinical trial Megalit coordinated by Uppsala University Hospital in Region Uppsala, Stockholm School of Economics, Halmstad University, the Swedish Institute for Health Economics (IHE),  the Network against Cancer, Lung Cancer Association, Lif – the research pharmaceutical companies, Swedish Medtech and Ascro.

This is Vision Zero Cancer

Vision Zero Cancer challenges the prevailing ecosystem and connects new ones. We are going to turn cancer from a deadly into a curable or chronic disease.

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Knowledge and experience exchange with Sweden: Early detection of lung cancer in never-smokers

Lung cancer accounts for one in five deaths worldwide. The past few years have seen considerable advances in treatment for lung cancer, yet the prognosis remains low. Lung cancer causes symptoms that come up late in the course of the disease and assessments are complicated. This means that half of the patients have a spread disease at diagnosis.

Early detection and prevention are the best strategies to improve the treatment outcome or eliminate the disease. People who smoke or have smoked have the greatest risk of lung cancer, though lung cancer also increasingly occurs in people who have never smoked. Lung cancer in never-smokers is a global rising concern and there is a fast growing need to understand how never-smokers’ disease differs from that of smokers, and how to effectively prevent and diagnose it early.

Vision Zero Cancer therefore invited participants ranging from current leading researchers in the field and clinicians to patient representatives and the medical industry to share experience and discoveries on how to develop an effective preventive strategy and opportunities for screening.

The meeting held around 30 participants and keynote speaker was Dr. Pan-Chyr Yang (MD, PhD, Chair Professor at the National Taiwan University Hospital and Academician of Academia Sinica, Taiwan). Dr. Yang shared the findings of the Taiwan Lung Cancer Screening for Never-Smoker Trial (TALENT), a nationwide lung cancer low-dose CT screening study focused on never-smokers which also aims to develop an effective strategy for screening of lung cancer in never-smokers and establish a risk prediction model to identify high-risk population that may benefit from low-dose CT screening.  In Taiwan, lung cancer is the leading cause of cancer mortality, and 53% of those who have died of lung cancer were never-smokers. The US National Lung Cancer Screening Trial (NLCST) and the Dutch NELSON trials demonstrated that the use of low-dose CT is effective for lung cancer screening; however, most of the lung cancer screenings focused on heavy smokers.

Of the 12,011 individuals included in the trial, the prevalence of lung cancer was 3.2% and 2.0% in participants with and without lung cancer family history, respectively. As explained during the meeting by Dr. Yang, 96.5% of the detected patients were stage 0 or 1 and potentially curable by surgery. The study also demonstrated the high risk of family history, especially among participants with a first-degree family history of lung cancer.The meeting further contained a panel discussion where Andrew Kaufman (MD, Associate Professor, thoracic surgeon at Mount Sinai Hospital in New York City) Kersti Oselin (MD, PhD, Medical Oncologist, North-Estonian Regional Hospital Cancer Center) Marcela Ewing (MD, PhD, Specialist Oncology and General Medicine, Sahlgrenska Academy, Regional Lead Early Detection of Cancer, Confederation of Regional Cancer Centres) Mattias Johansson (PhD, Scientist, Genetic Epidemiology Group, International Agency for Research on Cancer (IARC), World Health Organization) and Mikael Johansson (MD, Associate Professor, Senior Consultant Oncology, Umeå University Hospital and Senior lecturer at Umeå University, Chair of the National Working Group for Lung Cancer Care) together with Dr. Pan-Chyr Yang elaborated their thoughts on the findings of the TALENT-study and how this relates to what they are facing in their current work.

Andrew Kaufman who is the leader of the never-smoking initiative at Mount Sinai Hospital, New York, reflected that caring for never-smoking lung cancer patients comes down to the intersection between epidemiology, biology, clinical capability, precision medicine, surgical care and all other clinical attributes available. He put emphasis on that it takes a multidisciplinary approach to look at the data and find out what is the substrate we are dealing with in terms of a clinical population, while also stating that for most cancers unfortunately the time for best intervention is at an asymptomatic time point. Dr. Kaufman continued by being hopeful that discussions like the one this meeting facilitated will shed light on and give direction to find the right thread to start pulling on to make a difference in the case of lung cancer. By learning from the important findings of Dr. Yangs work we will be able to provide ways to be smarter at identifying patients at risk yet also not increasing the costs of the inefficiency of care.

The various competent outlooks and insights presented by the panel gave a good transition to the last part of the meeting where Mattias Johansson from the Genetic Epidemiology Group at the WHO International Agency for Research on Cancer (IARC) presented a proof on concept study on the use of biomarkers to improve early detection and the possibilities this presents to detect more lung cancer patients in time. Medical oncologist Kersti Oselin from the North-Estonian Regional Hospital Cancer Center gave insights on AI for early detection and the prognostic significance of genomic markers in lung cancer recurrence. Rounding up the meeting from London Amied Shamaan, director within AI and clinical collaboration presented the work of a collaboration between Oxford University and GE Healthcare with other industry partners in a consortium that is formed around lung cancer screening and innovation and goes under the name of  The Integration and Analysis of Data using Artificial Intelligence to Improve Patient Outcomes with Thoracic Diseases (DART). The consortium has come together to be agile around the lung cancer screening process in the UK to provide innovation in technology and to be able to involve and better affect the patient population.

During the autumn follow-up meetings will be held to dig deeper into the common areas and challenges facing early detection of never smokers. Leveraging clearly on the consensus of the meeting around the need to gather across professions and sectors to build momentum around who and how to find never-smoking lung cancer patients at the right time. 

Watch the recording of the meeting.

Meeting agenda Följ länk

The purpose of this meeting was to share discoveries and experience on how to develop an effective preventive strategy.

How do we detect cancer earlier?

The earlier cancer is detected, the greater are the chances of survival. With new systems and knowledge, we can pick up on symptoms earlier and more quickly come to treatment. And get more chances to reach the vision of zero people dying from cancer and more people living longer and better.

Early detection and diagnosis
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Estonia-Sweden workshop on cancer – improving health outcomes through innovation and collaboration

The aim of Europe’s Beating Cancer Plan is to tackle the entire disease pathway. Over the coming years, it will focus on research and innovation, tap into the potential that digitalisation and new technologies offer, and mobilise financial instruments to support Member States. With its policy objectives, supported by ten flagship initiatives and multiple supporting actions, the Cancer Plan will help Member States turn the tide against cancer. Sweden and Estonia have decided to join forces in this endeavour.

On the 26th of May North Estonia Medical Centre Regionaal Haigla and Vision Zero Cancer arranged an interactive meeting to share experience and explore areas for collaboration in research and innovation to deliver on the mission of beating cancer. The meeting was focused around five key areas presented after the shared introduction by Dr. Terje Peetso (MD, Member of the Board at North Estonia Medical Centre) and Ebba Hallersjö Hult (Head of Vision Zero Cancer).

Bettina Ryll (MD, PhD, member of the Horizon Europe Mission Board for Cancer, Chair ESMO Patient Advocacy Group, Founder Melanoma Patient Network Europe) shared her thoughts on the emergence of A new era in cancer care in Europe followed by Professor Hans Hägglund (MD, Professor, National Cancer Coordinator, Chairman of the Federation of Regional Cancer centres, Chairman of Vision Zero Cancer) who painted the picture of the Swedish setting of 10 years with a national strategy – achievements and future outlook complemented by Dr. Vahur Valvere (MD, PhD, Director of Research and Development, North-Estonian Regional Hospital Cancer Center, Chairman of the Board of Estonian Cancer Society) giving the outlook of the Estonian National Cancer Control Plan for 2021-2030.

Mia Rajalin (PhD., lic. psychologist, Director of Studies, Region Stockholm, Member of the Board, the Swedish Lung Cancer Association and Vision Zero Cancer) member of the Vision Zero Cancer core-team and lung cancer patient gave her story of how the diagnosis became a driver for improving cancer care. The case of lung cancer was further elaborated by Dr. Simon Ekman (MD, PhD, Associate Professor, Senior Consultant, Department of Oncology-pathology, Karolinska University Hospital and Karolinska Institutet) and Dr. Kersti Oselin (MD, PhD, Medical Oncologist, North-Estonian Regional Hospital Cancer Center) sharing experiences from the Swedish Precision treatment of lung cancer at Karolinska Comprehensive Cancer Center and Estonian work with AI for early detection and prognostic significance of genomic markers in lung cancer recurrence.

Anu Planken (MD, PhD, Medical Oncologist, North-Estonian Regional Hospital Cancer Center) presented an Overview of the personalised oncology landscape in Estonia building on the promise of personalized medicine for cancer prevention, diagnosis and treatment.  Complementing this with the perspective of data and information-sharing Arvid Widenlou Nordmark (Coordinator National Quality Registries for Cancer, Confederation of Regional Cancer Centres) gave the Swedish view of how national quality registries are used to guide and evaluate clinical improvement efforts and introduced the The Patient Overview – an enabler for personalised medicine. Rounding up the group of speakers was Dr. Indrek Seire (MD, Surgical Oncologist, North-Estonian Regional Hospital Cancer Center) giving an oversight of the Estonian work with Structured health data and site-based databases in oncology. 

The meeting continued with the approximately 25 participants being split into breakout groups discussing the question of how we can leverage the promise of personalised medicine (PM) for our patients and societies? with the goal of both sharing knowledge and insights while strengthening possibilities for successful international collaborations.

The successful outcome of the meeting has led to a deepened collaboration within cancer care between Sweden and Estonia with planned visits and experience exchanges on site in Sweden during the autumn 2021 and in Estonia in the spring of 2022.  

Watch the recorded meeting.

Meeting agenda Följ länk

North Estonia Medical Centre Regionaal Haigla and the Swedish Innovation Milieu Vision Zero Cancer held an interactive meeting to share experiences and explore areas for collaboration in research and innovation to deliver on the mission of beating cancer.

What we innovate

Fewer people shall get ill and die from cancer. For that to work, we need to think in new ways. Both in terms of developing new solutions and getting better at using what is available.

Five areas that need renewal
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This is Vision Zero Cancer

Vision Zero Cancer challenges the prevailing ecosystem and connects new ones. We are going to turn cancer from a deadly into a curable or chronic disease.

Who we are
Follow link