NEW YORK (GenomeWeb) – NordForsk, a research funding organization of the Nordic countries, has invested NOK 165 million ($19 million) to support seven new personalized medicine projects in the Nordic region.
The projects, set to commence this year, concern prostate cancer diagnostics, infectious diseases, rheumatoid arthritis, inflammatory bowel disease, heart disease, and sleep disorders. A seventh project will study healthcare decision making in a personalized medicine context.
NordForsk was established by the Nordic Council to support research in Denmark, Finland, Iceland, Norway, and Sweden. Its stakeholders include these countries' national research councils, universities, and other organizations that support research.
Though the organization was founded in 2005, this is the first investment it is making in personalized medicine projects. "I think the initiative is excellent," said Henrik Grönberg, a professor of cancer epidemiology at the Karolinska Institute in Stockholm, Sweden, and the principal investigator on one of the newly funded projects.
"You can get funding for studies, you can get funding for basic research, but there is almost no funding for clinical implementation into healthcare," he noted.
Grönberg's project, NorDCap, received NOK 27 million to accelerate the implementation of a more personalized approach to prostate cancer diagnostics across the Nordic countries. The aim of the three-year effort is to improve patient quality of life and survival, as well as the cost-effectiveness and sustainability of various healthcare systems.
"The idea is to create a new, more modernized diagnostic chain for prostate cancer," he said. Grönberg and colleagues have developed a test called Stockholm3, a blood-based assay that predicts the risk of aggressive prostate cancer by analyzing five protein markers, more than a hundred genetic markers, and clinical data. The test is currently available only in Sweden via A23 Lab in Uppsala, but the NorDCap project could change that, as the test will be implemented and tested in trials at partner institutions in Denmark, Norway, and Sweden.
"It will be run in three locations around the Nordic countries in order to validate the test in their healthcare systems," said Grönberg. He noted that the test has been available through a partnership with Capio Saint Göran Hospital in Stockholm for several years and that about 12,000 men have been tested to date. "It's a big improvement," he claimed.
Grönberg and colleagues now hope to showcase the advantages of the test in adjacent markets while continuing the collaboration with Capio Saint Göran Hospital. The partners include Stavanger University Hospital in Norway, Aarhus University Hospital in Denmark, and Mehiläinen, a private diagnostics laboratory headquartered in Helsinki. They intend to look at between 10,000 and 15,000 men over the next three years using Stockholm3, MRI, and an artificial intelligence tool for prostate pathology. The team behind Stockholm3 has spun out a company, called OncoAlgorithm, that develops tools for genomics and proteomics analysis as well as imaging. The participants will use all three approaches as part of one diagnostic chain.
"We want to show that within the different healthcare systems, we can have the same quality that we have at Saint Göran," said Grönberg. "We want to see that it works in their healthcare systems, and this would be the next step for them to promote this at a national level in Norway, Sweden, Finland, and Denmark."
Grönberg noted that Thermo Fisher Scientific is a partner on the project and will provide all reagents and instruments. The researchers have used Thermo's QuantStudio 12K Flex Real-Time PCR system to look at the genetic markers in Stockholm3, as well as to survey the protein markers.
As part of the project, Thermo Fisher is planning to set up labs in Stavanger, Aarhus, and in Helsinki. "The samples will be run locally," said Grönberg. "That's a very important part of it."
Another Karolinska researcher who has benefitted from the NordForsk investment is Anna Norrby-Teglund, a professor of medical microbial pathogenesis at Karolinska's Center for Infectious Medicine. Norrby-Teglund is leading a project called Peraid that aims to implement personalized medicine approaches in treating severe infectious diseases, especially necrotizing soft tissue infections, such as in fasciitis, myositis, sepsis, and cellulitis.
"The problem is that in infectious diseases, particularly with severe soft tissue infections, a great number of patients still require amputation," she said. "Even though patients come in and receive modern medicine, we are still cutting off limbs. That is not where we should be today."
Norrby-Teglund said that Peraid, which will run for four years, will use omics data and experimental model systems to delineate the mechanisms underlying the diseases, leading to the development of tests to stratify patients and support clinical treatment decisions. Norrby-Teglund said the project benefits from already collected data from several hundred patients via Peraid's partners, including RNA-seq and metabolomics data. "It is a multilayered omics approach," she said.
"A key thing will be to create a Nordic platform where we can gather all of these patient cohorts [and their] clinical data, harmonize the data, and be able to get good data out of it," said Norrby-Teglund. By the end of the four-year project, she hopes to better understand mechanisms related to particular clinical presentations, forming the basis for stratification.
"We want to be able to say that this patient, with this pathogenic mechanism, caused by this bacterium, would benefit from this treatment," she said. "We will need new diagnostic tools to be able to do this." Norrby-Teglund and colleagues hope to embark on exploratory projects with a few patients to test the feasibility of this concept before applying it in larger cohorts.
The other Swedish projects funded through NordForsk include Nora, which aims to develop new prediction tools for managing rheumatoid arthritis and is led by Johan Askling, a professor of medicine at Karolinska, and Nordtreat, a study that will use an omics data-based algorithm for treating IBD led by Jonas Halfvarson, a gastroenterologist at Örebro University Hospital in Sweden.
Both Askling and Halfvarson declined to comment on their projects at this time.
Other projects include NordSleep, which introduces new tests for sleep apnea and is led by investigators at the University of Eastern Finland; PM-Heart, a personalized medicine project focused on heart disease run at Copenhagen University Hospital in Denmark; and Precise, which seeks to improve the cost-effectiveness and efficiency of personalized medicine in clinical practice. Precise is coordinated by investigators at the Norwegian Medicines Agency in Oslo.
Investigators associated with these projects did not respond to queries seeking comment. It is also unclear if NordForsk plans to continue investing in personalized medicine. The organization did not respond to a query seeking comment.
In a statement, Arne Flåøyen, director of the Oslo-based organization, said that the current projects would promote the implementation of personalized medicine in the Nordic region.
"There are many issues that pose obstacles to such implementation, and overcoming these obstacles will require close cooperation between the research community, industry, and the healthcare sector – as well as cross-border, cross-disciplinary innovation networks," Flåøyen said. "This unique Nordic collaboration aims to make a big difference in the ability of patients to get more accurate diagnoses and ideal treatment."