Personalized Cancer Medicine

Prosjektet er nå nærmest fullført, men en del dataanalyse gjenstår før de store publikasjonene er i havn. Dette gjelder særlig det nasjonale sarkomprosjektet (se http://NoSarC.no), der vi samler inn en populasjonsbasert, prospektiv kohort av pasienter med bindevevskreft. NCGC vil analysere prøver fra de første 100 pasientene, mens opptil 500 vil analyseres med ulik finansiering, deriblant fra Krafttak mot Kreft. Vi har bygget opp avansert datainfrastrukturen for å kunne ta i mot de store mengdene følsomme data, og har vært med på internasjonal validering av de komplekse algoritmene for identifikasjon av mutasjoner. I nært samarbied med IT-tjenesten ved Univeristetet i Oslo har vi etablert en kryptert "skytjeneste" som er tilgjengelig fra alle helseregioner. Det pågår også helseøkonomiske studier bla. av bruken av nestegenerasjpons sekvensanalyse i rutinepatologi for lungekreft.

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While adjuvant chemotherapy has improved long-term survival for many types of cancer, the fact that many patients relapse despite the best available treatment underlines the limitations of contemporary therapy. The mechanisms of chemoresistance in general are poorly understood; thus, we are unable to predict who will benefit or not from treatments. Over the last decades, a number of "targeted therapies" have been approved for certain histologically defined cancers. These therapies target defined markers ir phenotypes such as the HER-2 proto-oncogene; thus, they are effective only in cancers harboring certain gene aberrations. Notably, even among patients with tumor harboring the targeted defects, many may not respond to treatment, or eventually relapse. These findings underline the need for a wider mutation analysis to define the gene defects responsible also for drug resistance with respect to all forms of anticancer therapies. The accumulated data on tumour mutation spectra and outcome from traditio nal therapies will also yield important knowledge on which of the patients are likely to benefit from such therapy, and for whom other options need to be considered. Additionally, sequencing of the constitutional (normal) DNA will enable the identificatio n of predisposition to acute and late adverse effects. This project is a national collaboration among regional cancer centres as visioned by the National Coordination Group for Research in the Health Service (NSG). The main objective of this joint effor t is a national diagnostic service for all Norwegian cancer patients. In addition to the strong representation of clinical groups, we have involved some of strongest national networks in medical genomics, the Norwegian Microarray Consortium and the FUGE B ioinformatics Platform, with proven experience in the relevant deep sequencing of cancer mutations, as well as the CancerBioMedicine Centre of Excellence and the Norwegian Cancer Registry. There is also a strong int