DNA-sequencing penetrates Norway's healthcare system

With only 4.8 million people, Norway is a fraction of the size of the U.S. But it is galloping to the head of the pack with plans to bring next-generation DNA sequencing into its national healthcare system to personalize cancer treatments, Nature reports.

The U.K. is pursuing a similar pilot project, although some are worried it will cost too much. Research hospitals in France and the U.S. are piloting similar endeavors, according to the article. But Norway jumps to the head of the line because those efforts use conventional genetic testing rather than next-generation DNA sequencing, which has become drastically more affordable and makes Norway's approach financially feasible, James Peach, one of the coordinators of the British pilot, told Nature. Once complete, the project will handle DNA sequencing for the country's 25,000 or so people who face a cancer diagnosis annually, according to the article.

Such a move is relatively bold because clinical-quality genome sequencing isn't widely used yet, and not many hospitals can provide the service, the article points out. Furthermore, oncologists often don't need a genome sequence for every cancer patient, and genome sequencing doesn't commonly inform their treatment choices, Massachusetts General Hospital geneticist Leif Ellisen said in the Nature article. But Norway already tracks every patient diagnosed with cancer. The idea then beefs up the registry's significance, allowing oncologists to refer to patients whose treatment was based on a tumor mutation and then use that data to inform their own decision, Norway project leader Ola Myklebost told Nature.

For starters, the country's Norwegian Cancer Genomics Consortium will begin tumor genome sequencing of 1,000 patients to discover any tumor mutations that could help identify the most-effective cancer treatment. Other plans allow for doctors to study 3,000 tumor biopsies already collected so they can better understand different cancer mutations and how they react to treatment. Separately, they'll sequence 1,000 genes that often mutate in cancer, some of which have drugs designed to treat the mutation either already on the market or being tested. Longer term, the program will sequence the human genome's entire network of protein-coding genes, which number more than 20,000.

The project isn't fully funded yet, although it could cost more than $6.3 million excluding the price of equipment, Myklebost said. Still, the country expects to move ahead with a second phase. Plans call for building laboratory, clinical and computing infrastructure the country will need for a full ramp-up.

- here's the Nature story

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