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. 2024 May 23:63:379-384.
doi: 10.2340/1651-226X.2024.28322.

IMPRESS-Norway: improving public cancer care by implementing precision medicine in Norway; inclusion rates and preliminary results

Katarina Puco  1 , Gro Live Fagereng  1 , Sigmund Brabrand  2 , Pitt Niehusmann  3 , Egil Støre Blix  4 , Eli Sihn Samdal Steinskog  5 , Åse Haug  5 , Cecilie Fredvik Torkildsen  6 , Irja Alida Oppedal  7 , Sebastian Meltzer  8 , Åsmund Flobak  9 , Kajsa Anna Margareta Johansson  1 , Line Bjørge  10 , Geir Olav Hjortland  2 , Astrid Dalhaug  11 , Jo-Åsmund Lund  12 , Bjørnar Gilje  13 , Marte Grønlie Cameron  14 , Randi Hovland  15 , Ragnhild S Falk  16 , Sigbjørn Smeland  17 , Hege Elisabeth Giercksky Russnes  18 , Kjetil Taskén  1 , Åslaug Helland  19 ; InPreD Consortium; IMPRESS-Norway Consortium
Collaborators, Affiliations

IMPRESS-Norway: improving public cancer care by implementing precision medicine in Norway; inclusion rates and preliminary results

Katarina Puco et al. Acta Oncol. .

Abstract

Background and purpose: In Norway, comprehensive molecular tumour profiling is implemented as part of the public healthcare system. A substantial number of tumours harbour potentially targetable molecular alterations. Therapy outcomes may improve if targeted treatments are matched with actionable genomic alterations. In the IMPRESS-Norway trial (NCT04817956), patients are treated with drugs outside the labelled indication based on their tumours molecular profile.

Patients and methods: IMPRESS-Norway is a national, prospective, non-randomised, precision cancer medicine trial, offering treatment to patients with advanced-stage disease, progressing on standard treatment. Comprehensive next-generation sequencing, TruSight Oncology 500, is used for screening. Patients with tumours harbouring molecular alterations with matched targeted therapies available in IMPRESS-Norway, are offered treatment. Currently, 24 drugs are available in the study. Primary study endpoints are percentage of patients offered treatment in the trial, and disease control rate (DCR) defined as complete or partial response or stable disease in evaluable patients at 16 weeks (W16) of treatment. Secondary endpoint presented is DCR in all treated patients.

Results: Between April 2021 and October 2023, 1,167 patients were screened, and an actionable mutation with matching drug was identified for 358 patients. By the data cut off 186 patients have initiated treatment, 170 had a minimum follow-up time of 16 weeks, and 145 also had evaluable disease. In patients with evaluable disease, the DCR was 40% (58/145). Secondary endpoint analysis of DCR in all treated patients, showed DCR of 34% (58/170).

Interpretation: Precision cancer medicine demonstrates encouraging clinical effect in a subset of patients included in the IMPRESS-Norway trial.

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Conflict of interest statement

Katarina Puco reports receipt of honoraria for advisory board participation from Astellas, MSD, Pfizer and Bayer; honoraria for speaker services from Astella, Ipsen, Janssen-Cilaq, AstraZeneca and Merck.

Sigmund Brabrand reports receipt of honoraria for speaker services from Astellas and Pfizer.

Eli Sihn Samdal Steinskog reports receipt of honoraria for speaker services from Pfizer, Bayer and Roche.

Line Bjørge reports receipt of honoraria from AstaZeneca, GSK and MSD and institutional funding from AstraZeneca.

Sebastian Meltzer reports receipt of honoraria advisory board participation from GSK.

Randi Hovland reports receipt of honoraria advisory board participation from AstraZeneca and Novartis; honoraria for speaker services from Sanofi and Janssen-Cilaq.

Kjetil Taskén reports receipt of honoraria advisory board participation from Exscientia and Serca Pharmaceuticals and stock and other ownership in Serca Pharmaceuticals and Leididi.

Gro Live Fagereng, Pitt Niehusmann, Egil Støre Blix, Åse Haug, Cecilie Fredvik Torkildsen, Irja Aida Oppedal, Åsmund Flobak, Kajsa Anna Margareta Johansson, Geir Olav Hjortland, Astrid Dalhaug, Jo-Åsmund Lund, Bjørnar Gilje, Marte Grønlie Cameron, Ragnhild S. Falk, Sigbjørn Smeland, Hege Elisabeth Giercksky Russnes and Åslaug Helland did not report any possible conflicts of interest.

Merck (CrossRef Funder ID: 10.13039/100009945) reviewed this manuscript for medical accuracy only before journal submission. The authors are fully responsible for the content of this manuscript, and the views and opinions described in the publication reflect solely those of the authors.

Figures

Figure 1
Figure 1
Flow diagram of patients included in the IMPRESS-Norway analysis.
Figure 2
Figure 2
Preliminary results. a) Swimmer plot of the time on treatment, observed response at W16, and reason for treatment stop in response evaluable population, n=145. b) Disease control rate among response evaluable patients at W16, n=145
See this image and copyright information in PMC

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