The oncology research group is responsible for clinical trials testing new treatment regimens targeting cancer cells (tumor-directed). In addition, there is a focus on identifying the criteria for which patients benefit from chemotherapy (prognostics). Concurrently with tumor-directed treatment, there is a targeted, evidence-based focus on systematic mapping and treatment of the patient's problems and symptoms - a patient-centered approach.
The MENAC study tests multimodal treatment of cachexia and is an international randomized phase 3 study led from Norway.
The PACTO study is a Nordic randomized phase 2 study where patients receive tocilizumab (IL-6 inhibitor) in addition to chemotherapy, and the primary endpoint is survival, while various cachexia parameters are also measured.
The CNIS 973 study is an international randomized phase 3 study looking at the effects of blocking TGF-beta on survival and quality of life in patients receiving chemotherapy.
The ART 27.13 study is an international phase 2 study testing a synthetic cannabinoid in the treatment of cachexia, with endpoints being anorexia and weight loss.
In addition, the group plans to participate in the planned NorPACT-3 study led by the surgical work package in KNEP.
Data from the Quality Register for Pancreatic Cancer show that some patients receive chemotherapy at the end of life that is ineffective and only a burden for the patient (over-treatment). We analyze data from 189 patients with pancreatic cancer who participated in the PALLiON study, closely followed from the start of last-line chemotherapy to death. We look at how clinical and patient-reported data can be used to better predict which patients may benefit from chemotherapy towards the end of life. We have prospective measurements of functional status, weight, blood tests with CRP and albumin, as well as symptom burden and quality of life parameters. In addition, measurement of muscle loss (sarcopenia) in this patient group is planned using AI technology. Preliminary analyses show that functional status and inflammation parameters are robust predictors of survival at the start of last-line chemotherapy.
In recent years, progress in curing or extending the lives of patients with pancreatic cancer has been limited. Many patients live for shorter or longer periods with the disease and often suffer from malnutrition, cachexia, pain, and general reduced physical function. We will conduct clinical studies focusing, among other things, on improving the nutritional status in this patient group. In addition, we will focus on other patient-centered aspects, such as systematic mapping and follow-up of patients' needs. This has been shown to improve patients' quality of life, alleviate symptoms such as pain and malnutrition, and improve physical and mental function.
In the MyPath project, we are developing digital patient-centered pathways together with national partners in MATRIX and in a EU consortium. These pathways will be tailored to the individual patient's situation and needs. The content of the innovation 'MyPath' is under development and will gradually be implemented in Norway for all patients with pancreatic cancer in the period 2023-2026.
We will develop a comprehensive and user-friendly digital solution, where the patient registers symptoms and functional level on mobile, tablet, or PC before consultations with healthcare professionals. This information will immediately be available to healthcare professionals at their workstation and can then be assessed along with clinical data and information that emerges during the consultation. This information forms the basis for various recommendations and decisions about treatment, such as increasing or changing painkillers, referral to a clinical nutritionist, etc., the need for and frequency of new symptom registration, and further digital or physical consultations. This involves individual pathways, tailored to the individual patient's needs and problems and the current treatment situation, whether it be before, during, or after surgery, drug treatment, radiotherapy, or no active treatment. All pathways with changes over time will be available to the patient and healthcare professionals in MyPath.
Treatment decisions are made in consultation with the patient (shared decision-making). This will ensure that patients are more active in decision-making processes, express what is most important to them, and take ownership of their own treatment plan. MyPath will also ensure follow-up of relatives and give them the opportunity to contribute to the patient's treatment, as well as express their own needs.
The innovation in MyPath lies in the development of a comprehensive digital solution, with individual patient pathways and treatment decisions where the patient's own assessment is central, real-time communication, treatment plans that are updated as needed, and full overview of these. Many symptom apps on the market today do not contain such comprehensive solutions.
Collaborators
Knut Jørgen Labori (work package “Surgery”), Oslo University Hospital/University of Oslo
Elin H. Kure (work package “Molecular characterization of tumour tissue”), Oslo University Hospital