Precision Medicine in Diagnostics and Therapy of Biliary Tract Cancer

Precision Medicine in Diagnostics and Therapy of Biliary Tract CancerCholangiocarcinoma is a rare cancer with approximately 150 new cases in Norway each year. Despite aggressive treatment efforts, cholangiocarcinoma holds a dismal prognosis due to late diagnosis and lack of therapy. We aim to develop a personalized patient journey to enhance diagnostic accuracy, treatment efficacy, and patient outcomes.One of the major challenges in management of patients with cholangiocarcinoma is early diagnosis in order to increase the number of patients eligible for potentially curable surgery, and thereby lead to improved survival. This project aims to build up a diagnostic platform using artificial intelligence and machine learning by collaborating with national and international expertise in the field in order to achieve early and more accurate diagnosis. Augmenting the current work with data analytics and machine learning techniques we expect will allow patient specific optimal treatment while minimizing side effects. Further, we will investigate actionable mutations by genomic sequencing of tumors and use the in-house developed cholangiocarcinoma organoids to set up drug-screening. Taken together this will improve treatment options as well as survival for both patients with resectable disease and with more advanced (nonresectable) disease by providing personalized medicine and thereby also increasing the quality of health service delivery to cholangiocarcinoma patients. This project builds on collaboration among world-leading surgical, medical, and translational research expertise who will work together to personalize the cancer care pathway at all levels; from early and accurate diagnosis (implementation of artificial intelligence in imaging and pathology) to proper treatment (surgery/transplantation/chemotherapy), and tumor-organoid-based adjuvant treatment. During the recent year, we have established collection of surgical samples from cholangiocarcinoma for genomic sequencing as well as spatial transcriptomic. We have developed and started inclusion of patients in TESLA-trial (liver transplant for non-resectable cholangiocarcinoma). Finally, we have published our results for treatment of cholangiocarcinoma with open or laparoscopic surgery, and in another article we have published the risk of cholangiocarcinoma associated with increasing body mass index.

Precision Medicine in Diagnostics and Therapy of Biliary Tract CancerCholangiocarcinoma is a rare cancer with approximately 150 new cases in Norway each year. Despite aggressive treatment efforts, cholangiocarcinoma holds a dismal prognosis due to late diagnosis and lack of therapy. We aim to develop a personalized patient journey to enhance diagnostic accuracy, treatment efficacy, and patient outcomes.One of the major challenges in management of patients with cholangiocarcinoma is early diagnosis in order to increase the number of patients eligible for potentially curable surgery, and thereby lead to improved survival. This project aims to build up a diagnostic platform using artificial intelligence and machine learning by collaborating with national and international expertise in the field in order to achieve early and more accurate diagnosis. Augmenting the current work with data analytics and machine learning techniques we expect will allow patient specific optimal treatment while minimizing side effects. Further, we will investigate actionable mutations by genomic sequencing of tumors and use the in-house developed cholangiocarcinoma organoids to set up drug-screening. Taken together this will improve treatment options as well as survival for both patients with resectable disease and with more advanced (nonresectable) disease by providing personalized medicine and thereby also increasing the quality of health service delivery to cholangiocarcinoma patients. This project builds on collaboration among world-leading surgical, medical, and translational research expertise who will work together to personalize the cancer care pathway at all levels; from early and accurate diagnosis (implementation of artificial intelligence in imaging and pathology) to proper treatment (surgery/transplantation/chemotherapy), and tumor-organoid-based adjuvant treatment. During the recent year, we have established collection of surgical samples from cholangiocarcinoma for genomic sequencing as well as spatial transcriptomic. We have developed and started inclusion of patients in TESLA-trial (liver transplant for non-resectable cholangiocarcinoma). Finally, we have published our results for treatment of cholangiocarcinoma with open or laparoscopic surgery. We are now working on establishing the AI platform for PFF slides of cholangiocarcinoma in order to find prognostic factors.

Precision Medicine in Diagnostics and Therapy of Biliary Tract CancerCholangiocarcinoma (CCA) is a rare cancer in the Western world that holds an extremely dismal prognosis due to late diagnosis and lack of therapy. The tumor is characterized by unspecific symptoms and is hard to diagnose accurately, and the majority of patients are thus ineligible for potential curative surgery at time of diagnosis.One important cause of CCA in Norway is the chronic inflammatory bile duct disease primary sclerosing cholangitis (PSC). PSC shows a lifetime cumulative risk of CCA of 10-20%, often presenting at late stage with a median survival of only 7-9 months. Cancer is the cause of death in almost half of the PSC patients, and improved management options are urgently needed. Recently, progress has been made for technologies involved in personalized medicine. However, implementation in everyday patient care is very limited and often restricted to individual technologies. In the present project, we aim to establish a personalized CCA patient journey, integrating several technological opportunities to enhance diagnostic accuracy, treatment efficacy, and patient outcomes. Using CCA as a model cancer entity with great unmet needs, the proposed project aims to assemble a prototype cancer care pathway by incorporating artificial intelligence assessments of biopsies and imaging, genomic technologies for targetable mutational analysis, and organoid-based drug screening. Coming from the surgical perspective of the PI the project aims to maximize synergies between world-leading medical, surgical, and research expertise in CCA at Oslo University Hospital, to build a model for CCA diagnosis and management that holds relevance also for cancer care in general. From the patient perspective, tackling CCA remains a major unmet need in the management of PSC, and the Norwegian patient organization (www.fal.link) has been actively engaged in the development of project priorities and design.

Precision Medicine in Diagnostics and Therapy of Biliary Tract CancerCancer of the biliary tree (Cholangiocarcinoma) is a rare cancer. Despite aggressive treatment efforts, cholangiocarcinoma holds a dismal prognosis. The tumor is characterized by unspecific symptoms, hard to accurately diagnose at an early stage, and the majority of patients are ineligible for potential curative surgery at time of diagnosis.We aim to develop a personalized cholangiocarcinoma patient journey incorporating artificial intelligence assessments of biopsies and imaging, genomic technologies for targetable mutational analysis, and organoid-based drug screening in order to enhance diagnostic accuracy, treatment efficacy, and patient outcomes. The project started 1st of December 2020, and the first weeks has been used to initiate meetings with involved parties and organize project members. There are no results to report for the first weeks of the project.