Norway has taken the first steps towards creating a national cancer genomic diagnostics service.
The first clinical applications of next-generation sequencing (NGS) technologies have been widely reported in the medical literature, and many hospitals around the world are trialing different forms of NGS-based analyses. The Norwegian Cancer Genomics Consortium, a national health service collaboration ‘to establish and evaluate genome-based diagnostics for cancer therapy decisions’, will perform tumour genome sequencing and analysis for 1000 cancer patients (and 3000 stored samples), in a pilot study to determine whether this information can help inform better treatment decisions.
The programme mirrors similar efforts such as the UK’s stratified cancer medicine
project led by Cancer Research UK (see previous news); however, the Norwegians plan to move on to a second phase that will create the laboratory, clinical and bioinformatics infrastructure to roll this approach out to all cancer patients in the health system, some 25,000 annually. This will include creation of a national cancer mutation database, in partnership with the national cancer registry.
Comment: The research evidence (to demonstrate potential improvements in care and outcomes) is a crucial base for moving new technologies such as genome sequencing into clinical practice, but the Norwegian approach is wise to take account of other equally vital considerations such as having nationally agreed protocols and systems to handle and process new testing and data, as well as efforts to underpin health professional and public education, and provide health economic impact data. These are precisely the sorts of measures recently recommended for the clinical implementation of genome sequencing for both cancer and inherited disease services in the UK by the PHG Foundation.