Project’s goal
The general objective of the project is to implement AnteBC test as part of a breast cancer screening routine in Norway. Current breast cancer screening is only age based but can decrease mortality by around 20% if invitations account for AnteBC results. The project activities deploy AnteBC to Norwegian healthcare: a consortium of partners assesses the test performance in the Norwegian population, conducts a clinical pilot study and assembles technical documentation to prepare for public reimbursement.
Project result
By the end of the project, the performance of the AnteBC test based on the genetic data of the Norwegian population has been analyzed, a successful clinical trial has been conducted in Norwegian clinical settings and the necessary scientific and regulatory documentation has been developed for the implementation of breast cancer precision prevention. Also, necessary trainings for healthcare professionals have been conducted.
About us
Antegenes is an Estonian health technology company and medical laboratory with a goal to develop and implement advanced genetic tests based on polygenic risk scores technology for the prevention of major complex diseases.
Project main progress
Read more about the AnteNOR project from Oslo Cancer Cluster website.
July – December 2021
- AnteNOR project kick-off
- Green ICT project was mentioned in Delfi Ärileht article
- Mapped and interviewed Norwegian key stakeholders in the field of breast cancer and breast cancer mammography screening
- Applied and received the ethical commitee approval for genetic analysis study
- Analysis of Norwegian genetic data started
- Antegenes became a member of Oslo Cancer Cluster
- Presentation about Antegenes and AnteNOR project at Oslo Cancer Cluster virtual annual meeting on 15th of December
January – June 2022
- Started cooperation with Oecona AS
- Participated in EXPO 2020 Dubai for international scientific cooperations
- Green ICT project was mentioned in e-Estonia blog article.
- Development of the cost-benefit simulation study for Norwegian medical setting
- AnteNOR seminar was organized in Oslo by Oslo Cancer Cluster and Antegenes
- AnteNOR project clinical pilot study protocol created and ready
- Application for conducting the AnteNOR clinical pilot is submitted to Regional Ethical Commitee
July – December 2022
- Approval of the Ethics Committee to implement study in Oslo University Hospital and Vestre Viken Hospital was obtained.
- Clinical study was registered in the ClinialTrials.gov database.
- Clinical study logistics pathways were developed, study assistant was involved by Vestre Viken Hospital.
- Retrospective performance assessment of Antegenes PRS in Norwegian data has been conducted. Initial results have been compiled and presented as a poster at the Nordic Society of Human Genetics and Precision Medicine 2022 conference “Precision Medicine Research And Implementation: Rebooting In The Nordics Post-Covid” (3-4 November 2022, Copenhagen, Denmark) (Akdeniz et al. “Implementation of polygenic risk score guided breast cancer prediction in Norwegian data”).
- Oecona developed the cost-utility preliminary model for Norwegian medical setting. Collaboration with health economists of Sweden was launched.
- Norway specific health technology assessment and implementation options specific to Norwegian healthcare were developed.
- The article “Preventing breast cancer in Norway” was written and published on Oslo Cancer Cluster website.
January – June 2023
July – December 2023
- The health technology assessment report to support the development of a reimbursement application in Norway has been finalised and dossier developed.
- The clinical pilot in Oslo University Hospital and Vestre Viken Hospital was carried out.
- Data from clinical pilot was analysed and preliminary results were presented at AnteNOR results presentation seminar on 6th of November in Oslo.
- Comparison of polygenic risk scores’ performance to current breast cancer risk assessment methods is completed.
- The development of genetics guided breast cancer screening program policy document was continued.
- The manuscript titled „A Breast Cancer Polygenic Risk Score is feasible for risk-stratification in the Norwegian population“ was published in the journal MDPI Cancer. Read more here.
- October 12 an article “Implementation of Risk-Stratified Breast Cancer Prevention With a PRS test in Clinical Practice” was published in SAGE Journals. Read more here.
- Two articles were written and published on Oslo Cancer Cluster website:
1. September 6 about the Norwegian clinical and genetic data analyses.
2. November 10 about the AnteNOR results presentation seminar.
- Peeter Padrik participated in the European Hereditary Tumour Group Annual Meeting in Vilnius, where he gave a presentation on the topic “Clinical Applications of Breast Cancer Polygenic Risk Score Testing in Women”.
January – April 2024
- Denise O’Mahony gave an oral presentation titled „Polygenic Risk Scores in Sporiadic Breast Cancer Cases in Norway“ at the Norwegian Bioscience Society meeting in Gol in January.
- Tone Hovda gave a presentation introducing the AnteNOR clinical pilot at the European Congress of Radiology in Vienna.
- Tone Hovda gave a presentation introducing the AnteNOR clinical pilot at the National Clinical Conference for Breast Cancer Diagnostics and Treatment in Drammen.
- Kristine Sahlberg gave a talk titled „Towards personalised breast cancer screening“ at a conference on Women’s Health at the University of South Eastern Norway.
- Kristine Sahlberg gave a presentation introducing the AnteNOR clinical pilot at the National Network for Breast Cancer Research in Stavanger.
- Krista Kruuv-Käo introduced the AnteNOR project and results at a seminar in Uppsala „BRIGHT Breast Cancer Precision Prevention – presenting results from Sweden, Estonia and Portugal“.
- AnteNOR team organised the final AnteNOR seminar in Oslo on the 30th of April titled „Results from the AnteNOR projects – Norway’s way towards precision prevention“. Read more about it here.
- Two articles were published on Oslo Cancer Cluster website:
1. About the results of the clinical pilot.
2. About the AnteNOR final seminar and how home testing improves cancer prevention.
Scientific evidence creation in AnteNOR
The consortium has worked on several publications to engage with the scientific and medical communities, create missing evidence enabling and supporting technology and service uptake, and raise stakeholder awareness.
- The manuscript titled „A Breast Cancer Polygenic Risk Score is feasible for risk-stratification in the Norwegian population“ was published in the journal MDPI Cancer. Read more here.
As a result of analysis, the individuals in the highest decile of the PRS have at least twice the risk of developing breast cancer compared to the individuals with a median PRS. The article concludes that the previously validated PRS models have a similar observed accuracy in the Norwegian data as in the UK and Estonian populations.
- The “Guidance for the Clinical Use of the Breast Cancer Polygenic Risk Score” scientific publication manuscript was developed and submitted to a scientific peer reviewed journal. Experts from AnteNOR partners, the UK, Sweden, Portugal and Estonia collaborated on the manuscript, consolidating evidence and offering practical guidance to help clinicians adopt AnteBC in practice.
Preprint can be read here.
- The manuscript “A cost-utility analysis: incorporating polygenic risk score into the standard breast cancer screening versus standard screening in Norway” developed in collaboration with AnteNOR and BRIGHT colleagues was submitted to PharmacoEconomics – Open.
It outlines that adding PRS screening is potentially more cost-effective than standard age-based screening, the costs are in line with the healthcare public financers “willingness to pay”, and it helps reducing cancer deaths.
- The article “Implementation of Risk-Stratified Breast Cancer Prevention With a Polygenic Risk Score Test in Clinical Practice” is the first published scientific introduction of a polygenic risk score into routine clinical practice. In the article, the development and validation of a breast cancer polygenic risk score genetic test, the creation of its clinical usage model and test report, as well as initial results from its application in Estonian healthcare for breast cancer prevention based on individual genetic risks are outlined.
Read more about it here.
- The implementation of personalised breast cancer prevention tested in AnteNOR feasibility study was analysed and concluded in the manuscript “Implementing a Polygenic Risk Score Test in a Breast Clinic: A Clinical Pilot Study for Personalized Risk-Based Breast Cancer Screening”. The manuscript is submitted to Scientific Reports.
