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Molecular diagnostics for better cancer care

Precision medicine is rapidly changing how hospitals diagnose and treat cancer, but this paradigm shift offers great challenges as well as opportunities.

DNV is mapping the procedures, infrastructure, and systems that enable modern molecular diagnostics at several Nordic hospitals, with the aim of providing visibility to common challenges and identifying solutions that can contribute to more effective molecular diagnostics, and ultimately better cancer care.

With the advent of NGS (Next-Generation Sequencing) technologies, targeted immunotherapies, and biomarker-based interventions, clinical oncology is one of the areas of medicine where precision medicine may have the greatest impact. New therapies and diagnostics offer great opportunities, but also raise significant questions regarding which tests to offer, how to integrate these into existing organizations and regular clinical practice, and how to ensure access to cutting-edge therapies while maintaining safety and quality.

“Although, we anticipate that there will be many exciting discoveries in the near future, the ultimate success of these endeavors rests on our ability to translate what is learned into better diagnosis, treatment and prevention of cancer.”

  • Mardis and Wilson,
  • ,
  • (2009)

Effective molecular diagnostics

As part of the Norwegian research-council funded BigMed project, DNV is mapping out the organizational structures, processes, and systems that support molecular diagnostics for cancer at health institutions across the Nordics. By interviewing stakeholders from different hospitals, DNV aims to describe common trends and generalized learnings, ultimately leading to more effective molecular diagnostics and better cancer care.

The information gathering process has begun, with a series of workshops at each institution discussing processes, systems, organizations, and the patient/sample pathway, due for completion in Q1 2020. As part of this process, DNV hosted a workshop with the Nordic Alliance of Clinical Genomics at its 2019 symposium. The workshop session examined topics related to the patient pathways, guidelines, and technical pipelines for somatic sequencing in the Nordics. Preliminary data from the BigMed project was presented with the goal of sharing an overview of routine somatic sequencing in the different countries and identifying important topics to address through the NACG forum.

The benefits

Early workshops have highlighted that while the technical infrastructure and capabilities needed to perform these diagnostics do exist in various settings, hospital organizational structure and pre-existing patient pathways play a significant role in determining whether these diagnostics are a part of routine care. Further workshops are being planned, and DNV’s aim is to synthesize this work and to issue a report in mid-2020.

It is hoped that stakeholders in the Nordic health care sector can use this shared knowledge to examine how they are supporting the uptake of precision medicine within their own hospitals, health regions, and countries, and that opportunities for Nordic cooperation can be identified for future initiatives.