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.
Research focus and projects
Insight into the molecular background of high-grade serous ovarian carcinoma (HGSOC) is growing, and molecular (BRCA, HRR deficiencies) and phenotypic profiling (platinum sensitivity, degree of debulking) is beginning to be integrated into clinical trials and practice. The introduction of PARP inhibitors to frontline treatment is believed to translate into an overall survival benefit. Further improvements will require rethinking, and a roadmap for research priorities has been outlined.
Over the last decade, the group has established a multidisciplinary research portfolio focusing on HGSOC, called Rethinking Ovarian Cancer (RETHINK). Through a focus on biomarkers, preclinical models, and early-phase clinical studies, the aim is to translate data from comprehensive profiling into strategies that improve personalized patient care. The portfolio is divided into four programs: Experimental preclinical models, Tumor microenvironment, Image-guided surgery and Clinical translation (trials).
Together with the McCormack group, the Bjørge group has established the INOvA team (Innovative Novel Ovarian cancer treatment Approaches, https://inova.w.uib.no). All the results presented here are generated by the INOvA group. The gynecologic cancer unit at Haukeland University Hospital, Bergen, Norway, is an integrated part of this group, and a European Training Center in Gynecological Oncology. All in vitro and in vivo preclinical work is performed at the group’s laboratories and the clinical trials take place at the hospital’s trial units.
The group has established tools for deeptissue profiling, a comprehensive range of xenograft models, and early-phase studies with modern design. These discoveries represent the foundation of ongoing and future projects. Their two-investigator initiated early-phase clinical study is still ongoing, and during 2019, two of the group’s students have defended their PhD thesis.
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.
Inherent tumor biological characteristics of HGSOC influence the effect of different therapies (surgery, chemotherapy, targeted therapeutics), and the ability to select more individualized treatment establishment and validation of preclinical platforms for deep-tissue profiling, as well as drug screening is necessary. This can be achieved through the application of the comprehensive profiling program Bjørge’s group is establishing. Given the importance of surgery, a tumor targeted fluorescence-image guided surgery methodology will be further developed. Objectives include a generation of an HGSOC organoid platform, definition of the TME of HGSOC by means of the cancer immunogram, development of Fluorescence Image Guided Surgery (FIGS), preclinical evaluation of the targeted therapeutics, and identification of biomarkers for treatment selection.