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A national precision cancer medicine implementation initiative for Norway

Nature Medicine volume 28, pages 885–887 (2022)Cite this article

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To the Editor — It has been difficult for countries in Europe that have publicly funded healthcare systems to implement precision cancer medicine on a large scale. This is despite the increasingly clear patient benefit from precision medicine1,2,3, and considerable concomitant interest from patients and payors.

To implement precision cancer medicine at a national level in Norway, work began in 2019 towards three goals: (1) to establish equal access to advanced molecular diagnostics, enabling stratification for clinical trials; (2) to increase the volume of precision cancer medicine trials and initiate a large national precision cancer medicine trial; and (3) to work on mechanisms to implement precision cancer medicine within standard-of-care.

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Fig. 1: InPreD allows the diagnosis and assessment of cancer patients where experimental treatment and clinical trial inclusion is an option.

References

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  8. CONNECT. Norwegian Cancer Precision Medicine Implementation Consortium; https://www.connectnorway.org/ (2020).

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Acknowledgements

The authors are grateful for public funding to the precision cancer medicine ecosystem from the Regional Health Authorities for South-Eastern, Western, Middle and Northern Norway, the Norwegian Clinical Treatment Research Programme (KLINBEFORSK), the Norwegian Cancer Society, the Nordic Trial Alliance/NordForsk, the Radium Hospital Foundation and other regional funds, as well as company contributions received so far from Roche, Novartis, Eli Lilly, Incyte and collaboration projects with Roche Foundation Medicine and Illumina. The Norwegian Medicines Agency represented by Marit Hystad participates in CONNECT as an observer.

Author information

Authors and Affiliations

  1. Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway

    Kjetil Taskén

  2. Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Kjetil Taskén, Hege E. G. Russnes, Ulla Randen, Ragnhild A. Lothe, Anne H. Ree, Geir E. Tjønnfjord, Hilde L. Nilsen, Sigbjørn Smeland & Åslaug Helland

  3. Department of Pathology, Oslo University Hospital, Oslo, Norway

    Hege E. G. Russnes, Tonje Lien, Pitt Niehusmann, Vigdis Nygaard, Anne Renolen, Bodil Bjerkehagen & Pitt Niehusmann

  4. Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway

    Hege E. G. Russnes, Tonje Lien & Åslaug Helland

  5. Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway

    Eline Aas

  6. Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway

    Eline Aas & Kåre B. Hagen

  7. Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway

    Line Bjørge

  8. Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway

    Line Bjørge & Bjørn T. Gjertsen

  9. Department of Clinical Science, University of Bergen, Bergen, Norway

    Line Bjørge, Bjørn T. Gjertsen, Olav K. Vintermyr, Gunnar Houge, Stian Knappskog, Per Eystein Lønning & Per E. Lønning

  10. Department of Oncology, University Hospital of North Norway, Tromsø, Norway

    Egil S. Blix, Fredrik Sund, Egil Blix & Tom Dønnem

  11. Institute of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

    Egil S. Blix, Egil Blix & Tom Dønnem

  12. Department of Research, Cancer Registry of Norway, Oslo, Norway

    Giske Ursin & Espen Enerly

  13. Institute for Cancer Research, Oslo University Hospital, Oslo, Norway

    Gro L. Fagereng & Gro Live Fagereng

  14. The Cancer Clinic, St. Olav University Hospital, Trondheim, Norway

    Åsmund Flobak & Bjørn H. Grønberg

  15. Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway

    Åsmund Flobak, Bjørn H. Grønberg & Ann-Charlotte Iversen

  16. Department of Oncology, Stavanger University Hospital, Stavanger, Norway

    Bjørnar Gilje

  17. Haematology Section, Department of Medicine, Haukeland University Hospital, Bergen, Norway

    Bjørn T. Gjertsen

  18. Department of Oncology, Oslo University Hospital, Oslo, Norway

    Tormod K. Guren, Sigmund Brabrand, Geir Olav Hjortland, Jon Amund Kyte & Åslaug Helland

  19. CONNECT Public–Private Partnership, Oslo Cancer Cluster SA, Oslo, Norway

    Jutta Heix, Steinar Ø. Thoresen & Ketil Widerberg

  20. Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway

    Eivind Hovig, Leonardo Meza-Zepeda & Leonardo A. Meza-Zepeda

  21. Centre for Bioinformatics, Department of Informatics, University of Oslo, Oslo, Norway

    Eivind Hovig

  22. Section for Cancer Genomics, Haukeland University Hospital, Bergen, Norway

    Randi Hovland, Hans-Rickard Brattbakk, Kari Ersland, Rakel Forthun, Hans Kristian Haugland & Olav K. Vintermyr

  23. Department of Oncology, Haukeland University Hospital, Bergen, Norway

    Åse Haug, Stian Knappskog, Per Eystein Lønning, Eli Sihn S. Steinskog & Per E. Lønning

  24. Department of Core Facilities, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway

    Susanne Lorenz, Daniel Vodak, Leonardo Meza-Zepeda & Leonardo A. Meza-Zepeda

  25. Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway

    Sigmund Brabrand, Pitt Niehusmann, Katarina Puco, Per M. Mæhle & Sigbjørn Smeland

  26. Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway

    Diana L. Bordin, Torben Lüders, John C. Noone & Hilde L. Nilsen

  27. Merck AB NUF, Oslo, Norway

    Steinar Ø. Thoresen

  28. Roche Norge AS, Oslo, Norway

    Terje C. Ahlquist, Ingvild Hagen, Kristin Krogsrud & Birgitte Lygren

  29. Bayer AS, Oslo, Norway

    Nyosha Alikhani

  30. Bristol-Myers Squibb Norway Ltd NUF, Oslo, Norway

    Ali Areffard & Gry Festervoll

  31. Novartis Norge AS, Oslo, Norway

    Eli Bergli & Petter Foss

  32. Association of the Pharmaceutical Industry in Norway, Oslo, Norway

    Hege Edvardsen & Monica Larsen

  33. Norwegian Directorate of Health, Oslo, Norway

    Grethe S. Foss

  34. Pubgene AS, Oslo, Norway

    Håvard H. Hauge

  35. AstraZeneca AS, Oslo, Norway

    Bjorn V. Herikstad

  36. Department of Oncology, Nord-Trøndelag Hospital Trust, Levanger, Norway

    Kristian Hveem & Olav T. D. Nguyen

  37. K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway

    Kristian Hveem

  38. HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway

    Kristian Hveem

  39. AbbVie AS, Oslo, Norway

    Elisabeth Jarnaess

  40. MSD Norge AS, Oslo, Norway

    Kristin Kittelsen

  41. Amgen AB Norway NUF, Oslo, Norway

    Mariam Lofwander

  42. GlaxoSmithKline AS, Oslo, Norway

    Aslaug Muggerud

  43. Pfizer Norge AS, Oslo, Norway

    Cathrine S. Notland

  44. Norwegian Cancer Society, Oslo, Norway

    Ole A. Oppdalshei

  45. Eli Lilly Norge AS, Oslo, Norway

    Ravinder Singh & Lars P. Strand

  46. Department of Research, Stavanger University Hospital, Stavanger, Norway

    Svein Skeie

  47. Takeda AS, Oslo, Norway

    Lidziya Ulvenes

  48. Janssen-Cilag AS, Oslo, Norway

    Sverrir Valgardsson

  49. Unit for Medicine and Health Sciences, Akershus University Hospital, Lørenskog, Norway

    Pål Wiik

  50. NEC Corporation, Tokyo, Japan

    Naoko Yamagata

  51. Department of Clinical Pathology, University Hospital of North Norway, Tromsø, Norway

    Thomas Berg, Ragnhild M. Wold & Kristin Åberg

  52. Department of Pathology, Akershus University Hospital, Lørenskog, Norway

    Richard Doughty & Ulla Randen

  53. Department of Pathology, Stavanger University Hospital, Stavanger, Norway

    Einar Gudlaugsson, Emiel Janssen & Sigmund V. Sperstad

  54. Department of Oncology, Akershus University Hospital, Lørenskog, Norway

    Hanne Hamre, Hanne Hamre & Anne H. Ree

  55. Department of Pathology, Haukeland University Hospital, Bergen, Norway

    Hans Kristian Haugland & Olav K. Vintermyr

  56. Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger, Norway

    Emiel Janssen

  57. Department of Pathology, St. Olav University Hospital, Trondheim, Norway

    Mari Jebens, Anne J. Skjulsvik & Sissel F. Wahl

  58. Department of Medical Genetics, Oslo University Hospital, Oslo, Norway

    Teresia Wangensteen

  59. Department of Pathology, Nordland Hospital Trust, Bodø, Norway

    Khalid Al-Shibli

  60. Southern and Eastern Norway Pharmaceutical Trust, Oslo, Norway

    Yvonne Andersson

  61. Department of Oncology, Vestre Viken Hospital Trust, Drammen, Norway

    Odd Terje Brustugun

  62. Department of Oncology, Hospital of Southern Norway, Kristiansand, Norway

    Marte G. Cameron

  63. Department of Oncology, Nordland Hospital Trust, Bodø, Norway

    Astrid Dalhaug

  64. Department of Oncology, Telemark Hospital Trust, Skien, Norway

    Dalia Dietzel

  65. Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway

    Ragnhild S. Falk

  66. Department of Oncology, Fonna Hospital Trust, Haugesund, Norway

    Sverre Fluge

  67. IMPRESS-Norway Patient representative, Oslo, Norway

    Kari Grønås

  68. Department of Oncology, Innlandet Hospital Trust, Brumunddal, Norway

    Daniel Heinrich & Hedda von der Lippe Gythfeldt

  69. Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway

    Gunnar Houge

  70. IMPRESS-Norway Patient representative, Trondheim, Norway

    Ann-Charlotte Iversen

  71. Department of Gynecological Oncology, Oslo University Hospital, Oslo, Norway

    Kristina Lindemann

  72. Department of Molecular Oncology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway

    Ragnhild A. Lothe

  73. Department of Oncology, Møre og Romsdal Hospital Trust, Ålesund, Norway

    Jo-Åsmund Lund

  74. Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway

    Monica C. Munthe-Kaas

  75. Department of Pathology, Førde Hospital Trust, Førde, Norway

    Tonje B. Riste

  76. Department of Oncology, Vestfold Hospital Trust, Tønsberg, Norway

    Karin Semb

  77. Department of Oncology, Østfold Hospital Trust, Kalnes, Norway

    Andreas Stensvold & Øyvind Tennøe

  78. Department of Pathology, Vestfold Hospital Trust, Tønsberg, Norway

    Pål Suhrke

  79. Department of Haematology, Oslo University Hospital, Oslo, Norway

    Geir E. Tjønnfjord

  80. Department of Oncology, Førde Hospital Trust, Førde, Norway

    Liv J. Vassbotn

Authors
  1. Kjetil Taskén
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  2. Hege E. G. Russnes
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  3. Eline Aas
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  4. Line Bjørge
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  5. Egil S. Blix
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  6. Espen Enerly
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  7. Gro L. Fagereng
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  8. Åsmund Flobak
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  9. Bjørnar Gilje
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  10. Bjørn T. Gjertsen
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  11. Tormod K. Guren
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  12. Jutta Heix
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  13. Eivind Hovig
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  14. Randi Hovland
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  15. Per E. Lønning
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  16. Leonardo A. Meza-Zepeda
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  17. Per M. Mæhle
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  18. Hilde L. Nilsen
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  19. Steinar Ø. Thoresen
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  20. Ketil Widerberg
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  21. Sigbjørn Smeland
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  22. Åslaug Helland
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Consortia

CONNECT Public–Private Partnership Consortium

  • Steinar Ø. Thoresen
  • , Sigbjørn Smeland
  • , Eline Aas
  • , Terje C. Ahlquist
  • , Nyosha Alikhani
  • , Ali Areffard
  • , Eli Bergli
  • , Hege Edvardsen
  • , Gry Festervoll
  • , Åsmund Flobak
  • , Grethe S. Foss
  • , Petter Foss
  • , Bjørn T. Gjertsen
  • , Ingvild Hagen
  • , Kåre B. Hagen
  • , Håvard H. Hauge
  • , Bjorn V. Herikstad
  • , Kristian Hveem
  • , Elisabeth Jarnaess
  • , Kristin Kittelsen
  • , Kristin Krogsrud
  • , Monica Larsen
  • , Mariam Lofwander
  • , Birgitte Lygren
  • , Aslaug Muggerud
  • , Cathrine S. Notland
  • , Ole A. Oppdalshei
  • , Hege E. G. Russnes
  • , Ravinder Singh
  • , Svein Skeie
  • , Fredrik Sund
  • , Lars P. Strand
  • , Kjetil Taskén
  • , Lidziya Ulvenes
  • , Giske Ursin
  • , Sverrir Valgardsson
  • , Ketil Widerberg
  • , Pål Wiik
  • , Naoko Yamagata
  •  & Jutta Heix

InPreD-Norway and National Molecular Tumor Board Consortium

  • Hege E. G. Russnes
  • , Thomas Berg
  • , Egil S. Blix
  • , Diana L. Bordin
  • , Hans-Rickard Brattbakk
  • , Richard Doughty
  • , Kari Ersland
  • , Åsmund Flobak
  • , Rakel Forthun
  • , Bjørnar Gilje
  • , Einar Gudlaugsson
  • , Hanne Hamre
  • , Hans Kristian Haugland
  • , Eivind Hovig
  • , Randi Hovland
  • , Emiel Janssen
  • , Mari Jebens
  • , Tonje Lien
  • , Susanne Lorenz
  • , Torben Lüders
  • , Leonardo A. Meza-Zepeda
  • , Per M. Mæhle
  • , Pitt Niehusmann
  • , Hilde L. Nilsen
  • , John C. Noone
  • , Vigdis Nygaard
  • , Ulla Randen
  • , Anne Renolen
  • , Anne J. Skjulsvik
  • , Sigmund V. Sperstad
  • , Olav K. Vintermyr
  • , Daniel Vodak
  • , Teresia Wangensteen
  • , Ragnhild M. Wold
  • , Kristin Åberg
  •  & Tormod K. Guren

IMPRESS-Norway Consortium

  • Åslaug Helland
  • , Hege E. G. Russnes
  • , Gro Live Fagereng
  • , Eline Aas
  • , Khalid Al-Shibli
  • , Yvonne Andersson
  • , Thomas Berg
  • , Line Bjørge
  • , Egil Blix
  • , Bodil Bjerkehagen
  • , Sigmund Brabrand
  • , Odd Terje Brustugun
  • , Marte G. Cameron
  • , Astrid Dalhaug
  • , Dalia Dietzel
  • , Tom Dønnem
  • , Espen Enerly
  • , Ragnhild S. Falk
  • , Åsmund Flobak
  • , Sverre Fluge
  • , Bjørnar Gilje
  • , Bjørn T. Gjertsen
  • , Bjørn H. Grønberg
  • , Kari Grønås
  • , Tormod K. Guren
  • , Hanne Hamre
  • , Åse Haug
  • , Daniel Heinrich
  • , Geir Olav Hjortland
  • , Eivind Hovig
  • , Gunnar Houge
  • , Randi Hovland
  • , Ann-Charlotte Iversen
  • , Emiel Janssen
  • , Stian Knappskog
  • , Jon Amund Kyte
  • , Hedda von der Lippe Gythfeldt
  • , Kristina Lindemann
  • , Ragnhild A. Lothe
  • , Jo-Åsmund Lund
  • , Per Eystein Lønning
  • , Leonardo Meza-Zepeda
  • , Monica C. Munthe-Kaas
  • , Olav T. D. Nguyen
  • , Pitt Niehusmann
  • , Hilde L. Nilsen
  • , Katarina Puco
  • , Ulla Randen
  • , Anne H. Ree
  • , Tonje B. Riste
  • , Karin Semb
  • , Eli Sihn S. Steinskog
  • , Andreas Stensvold
  • , Pål Suhrke
  • , Øyvind Tennøe
  • , Geir E. Tjønnfjord
  • , Liv J. Vassbotn
  • , Sissel F. Wahl
  • , Kjetil Taskén
  •  & Sigbjørn Smeland

Contributions

K.T. wrote the manuscript and integrated edits from other authors. Important discussions and contributions to the initiatives described were made by all authors. All authors have approved the final version of the text.

Corresponding author

Correspondence to Kjetil Taskén.

Ethics declarations

Competing interests

Participation in the CONNECT Public–Private Partnership is regulated by a consortium agreement that handles conflicts of interest and regulates interaction with the publicly funded infrastructure InPreD-Norway and the investigator-initiated and publicly funded trial IMPRESS-Norway. IMPRESS-Norway (principal investigator Å.H.) has company contributions from Roche, Novartis, Incyte and Eli Lilly and collaboration projects with Roche Foundation Medicine and Illumina, regulated by separate agreements with Oslo University Hospital as the coordinating institution. The authors declare no competing interests.

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Taskén, K., Russnes, H.E.G., Aas, E. et al. A national precision cancer medicine implementation initiative for Norway. Nat Med 28, 885–887 (2022). https://doi.org/10.1038/s41591-022-01777-4

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