The main research focus of Professor Line Bjørge's group is ovarian cancer, and the aim is to translate data from comprehensive molecular profiling into clinical meaningful strategies to improve prevention and individualized patient care.
The main focus of the translational research portfolio is biomarker studies, preclinical models, and early- and late-phase clinical studies. Dr. Bjørge is the principal investigator for two projects funded by the European Commission and national coordinator for different international early-phase and phase II and III studies on treatment of gynecological cancers.
Together with Professor Emmet McCormack, Bjørge has established the research group Innovative Novel Ovarian cancer treatment Approaches (INOvA, https://inova.w.uib.no).
The following projects are ongoing:
• Female cancer prediction using cervical omics to individualize screening and prevention (FORECEE, https://forecee.eu)
• Prediction of platinum response in ovarian carcinomas (RESPONSE)
• Precision medicine in epithelial ovarian cancer – The role of tumor biology for surgical outcomes
• Image-Guided Surgery (IGS) and Personalised Postoperative Immunotherapy To Improving Cancer Outcome (ISPIC, http://www.ispic.eu)
• Bioprofiling in patients undergoing treatment with targeted therapeutics
• Development and validation of a molecular tool for more precise diagnosis and personalized treatment of oral and vulva carcinomas
The INOvA team has identified a theranostic platform for image-guided surgery (IGS) in ovarian cancer and established a portfolio of different preclinical animal models for ovarian carcinoma. A multiparametric mass cytometry panel for bioprofiling of the tumor microenvironment has been established. The group’s very first investigator initiated early-phase clinical study is entitled IMPACT: A phase 0 non-randomized window-of-opportunity study of novel and repurposed therapeutic agents in women triaged to primary surgery for advanced epithelial ovarian cancer in stages IIIa – IV. The study is open and patient recruitment is ongoing. In late 2018, a contract with the pharmaceutical company AstraZeneca was signed for provision of the PARP inhibitor olaparib to be used as the first active treatment arm in the study. Phase I of the group’s second investigator-initiated clinical study, INFLUENCE: The influence of cytoreduction on patient-reported outcomes in patients with epithelial ovarian cancer, was initiated during the fall. The recruitment has been good, and the first cohort is already closed.
Current challenges in the field
Based on the improved recognition of cellular and molecular diversity, a more refined personalized approach to research and clinical trials for ovarian cancer is needed. A roadmap for research priorities has been suggested, including development of better experimental models, characterization of the tumor microenvironment, better understanding of clonal diversity, recurrent disease, exceptional responders, improved value of surgical cytoreduction, and stratified trials. Furthermore, as progress is being made in prolonging the survival of ovarian cancer patients, recognizing how the disease itself, as well as the treatment, may interfere with the patients’ overall wellbeing and quality of life is critical.
CCBIO focus in the coming years
The CCBIO platform represents a strong scientific foundation for collaboration, education, and training, as well as economic support. New and fruitful collaborations have been established both with groups in Bergen and abroad.
The overall goals for the CCBIO work are to establish preclinical tools for individual tumor characterization and to portray the tumor microenvironment and drug responses. The focus will be improvement of existing animal models, standardization of HGSOC-specific immunograms, and establishment of methodology for in vitro drug screening. The instruments will be validated through clinical translation into early-phase clinical trials. The final goals are to develop theranostics and diagnostic multiplex assays.