Interview with CGI-Clinics project partner, INAB-CERTH
Mata Laidou, Tonia Kouroutzidou and Christina Kakalou join us from INAB-CERTH to share more about their involvement in CGI-Clinics and how they anticipate the project’s progress.
Please introduce INAB-CERTH.
The Institute of Applied Biosciences at the Centre for Research and Technology Hellas (INAB-CERTH) conducts multidisciplinary Biomedical Research with a particular focus on non-communicable diseases (NCDs), while it is also very active in eHealth and personalised medicine. INAB’s researchers play an important role in identifying, disseminating and supporting good research and educational practices, thus facilitating interaction between scientists, authorities and society. This strengthens our cooperation with critical ‘players’ both nationally and internationally, giving them the opportunity to upgrade their services in healthcare.
INAB-CERTH specialises in cancer genomics, particularly in hematologic malignancies. This entails the development of novel analytical protocols (particularly on NGS immunogenetics) as well as novel bioinformatics pipelines for data analysis and interpretation. In parallel, we are also very active in developing standardised biomedical data repositories and management systems for facilitating real world evidence generation in cancer.
What most excites you about the CGI-Clinics project?
What excites us most about the CGI-Clinics project is its unwavering commitment to addressing fundamental challenges associated with interpreting the cancer genome. Every day, we wrestle with the puzzle of deciphering the cancer genome. Scattered knowledge, the continuous emergence of new genetic findings, and the vast amount of information pose significant barriers to the implementation of Precision Oncology. An additional challenge concerns how to effectively share this information with clinicians and, even more difficult, with patients who often lack a clear understanding of their tumour genomic profile and interpretation, hindering their ability to actively participate in discussions with their physicians and understand the rationale behind various treatment options.
The very concept of CGI-Clinics as a tool that holistically tackles these challenges, by both incorporating artificial intelligence for variant interpretation and prioritising patient involvement in diagnosis and decision-making, is truly ground-breaking. We strongly believe that the deployment of CGI-Clinics can simplify genomic data for patients, facilitating access to scientific information in an understandable way; this is essential for realising participatory medicine, and we are truly honored to be part of this effort.
What resources and experience do you bring from CERTH to support the goals of CGI-Clinics?
The Genomics Research Unit at INAB-CERTH engages a multidisciplinary team of over thirty research professionals, including principal investigators, postdoctoral scientists, research assistants, and post-graduate students, who implement NGS for diagnosis and research in cancer, particularly focused on defining tumor genomic profiles, characterising tumour heterogeneity, and discovering novel biomarkers. Additionally, our bioinformatics unit specialises in the development of computational approaches to analyze large-scale omics data, critically also including intuitive visualisation. Finally, our patient empowerment program, led by trained health psychologists and social scientists, focuses on how to establish effective protocols and tools for physician-patient communication, and assess the impact of various patient empowerment strategies on treatment outcomes. Capitalising on these resources and expertise, we are poised to make even greater strides, particularly through our participation in the CGI-Clinics project.
How will your expertise with blood cancers contribute to improving the CGI tool?
Through sequencing numerous patient samples of patients with blood cancers, we have accumulated a substantial reservoir of tumour genomic data, and our priority now is to harness this data in a practical and systematic manner. Our involvement in CGI-Clinics since the summer of 2023 serves exactly this purpose. By continuously recording samples and sequencing results of a large number of patients with hematological cancers, all this data will be the primary training material for the tool’s artificial intelligence algorithms, improving its ability to interpret variations. However, our contribution to the tool does not stop there. With years of dedicated research and hands-on experience in hematologic cancers, we possess a deep understanding of the molecular and cellular processes underlying these diseases. Consequently, continuous critical evaluation of the tool’s results will aid in optimising its performance.
How does participating in this international project fit into INAB-CERTH’s own goals?
Our primary objective is to support personalised medical care by effectively interpreting the results obtained from NGS analyses. Currently, the interpretation of somatic and germline alterations in tumour genomes relies heavily on the expertise of our group and involves comparisons of mutations in a patient’s tumour with curated databases containing information on known oncogenic mutations and biomarkers of drug response. Despite our expertise and efforts, this approach is time-consuming, introduces biases, leads to long response times, and may result in suboptimal interpretation outcomes. Moreover, the existing databases do not comprehensively explain the significance of all variants observed across tumours. In fact, approximately 80% of variants affecting known cancer driver genes are of unknown significance, making it challenging to assess their relevance for therapeutic decision-making. Therefore, integrating a new AI tool into our workflow, capable of delivering variant interpretation within seconds, presents an invaluable opportunity.
More broadly, our participation in such a large-scale project not only fulfills the purpose of enhancing patient care but also strengthens our institute’s competitiveness at the national and international level. Indeed, the CGI-Clinics project assists us in positioning ourselves at the forefront of scientific innovation.
What do you hope your involvement means for advancing innovative cancer care in Greece?
Today, Greece’s healthcare system grapples with multifaceted challenges, primarily stemming from chronic underfunding. Years of economic instability have led to significant budget cuts in healthcare, resulting in shortages of essential supplies, understaffed hospitals, and inadequate infrastructure. Another critical issue is brain drain. Greece has witnessed a significant exodus of healthcare professionals seeking better opportunities abroad, weakening the healthcare workforce and diminishing the quality and availability of care for Greek citizens. The introduction and integration of personalised medicine have not been immune to these systemic issues, as medical professionals find themselves constrained by limited resources and support. Access to advanced molecular testing, a cornerstone of personalised medicine, remains a privilege afforded to a select few. Additionally, the critical evaluation of genomic data, a task requiring the expertise of seasoned scientists, is not readily accessible. Consequently, disparities in cancer diagnosis and treatment persist, especially in rural or underserved areas. In parallel, there is a notable absence of initiatives focused on educating patients about cancer genomics and empowering them to take an active role in their healthcare journey, rather than being passive bystanders.
Given the multifaceted nature of these challenges, a methodical and systematic approach is essential in devising solutions. The integration of an easy-to-use and reliable tool that facilitates the interpretation of cancer findings swiftly, supports clinicians in decision-making, and empowers patients by providing them with a foundational understanding of their condition is certainly a promising avenue. It would represent a significant step forward in strengthening the Greek healthcare system and addressing the complex needs of its population.
What kind of patient empowerment initiatives do you already have going on, from other projects or initiatives?
INAB-CERTH has been actively promoting the empowerment of patients with cancer by actively undertaking empowerment projects in this direction, particularly focused on chronic lymphocytic leukemia (CLL), the most common adult hematologic malignancy. INAB-CERTH aims to catalyse a paradigm shift in CLL care, emphasising a patient-centric approach. We have strived to provide CLL patients with the information, tools, and steadfast support, fostering resilience and active participation along their disease trajectory. In addition, we have made efforts to promote shared decision-making among healthcare providers by creating a common language and effective channels of communication. We have systematically studied and analysed the experience and perspectives of patients and healthcare professionals, and on these grounds, developed an educational framework for both. The framework aims to enhance healthcare professionals’ communication skills, as well as promote patient knowledge, self-assessment, and self-management. Our main activities have included qualitative and quantitative research and data analysis, the development of clinical tools, as well as the creation of an online repository with multimedia educational materials, such as podcasts, leaflets, and infographic animated videos. By empowering patients to take an active role in their care and become knowledgeable about their condition and available treatments, we hope to transform the CLL healthcare landscape.
What are the next steps for the development of the CGI tool?
The first version of CGI was developed more than five years ago. Our team has already developed a new pilot version, currently in use by clinical partners for analysing their current patients. The plan is to have, in the next few years, a more advanced platform developed together with an external software company. This new platform will contain many improvements such as a completely new interface, a new reporting system tailored to the needs of the clinical practice, options to provide statistical insights into patient data and results provided by CGI, and a functionality that enables professionals from different hospitals to interact and discuss difficult cases before making decisions. We have recently started the development of the new CGI tool, a process in which we will incorporate continous feedback from the clinical partners to ensure that the platform is optimised to the clinical context. By the end of 2024, we should be ready to start validating the new CGI tool together with the clinical partners.
About the CGI-Clinics Project
The CGI-Clinics project is a five-year EU project, and stakeholders are encouraged to follow its progress by signing up for the newsletter or following the project on social media.
