The national Network Genomic Medicine (nNGM) Lung Cancer constitutes a collaborative research alliance of the German Oncology Centers of Excellence funded by the German Cancer Aid (Deutsche Krebshilfe, DKH).
The goal is to implement nationwide comprehensive molecular diagnostics and personalized therapy for patients with advanced lung cancer. A prototypic strategy for innovation transfer in oncology will be developed and realized with centralized molecular multiplex-diagnostics, consultation regarding the therapeutic consequences of molecular findings, clinical trial allocation, patient selection for off-label treatment and evaluation, while most of the patients will be treated close to home. Therefore, the establishment of regional networks by the Oncology Centers of Excellence (nNGM centers) and a structure for rapid innovation on personalized cancer care is of major importance for success.
To achieve nNGM´s ambitious goals, work packages have been defined and allocated to distinct task forces (TF). These tackle harmonization and further development (TF1a) as well as quality assurance (TF1b) of molecular diagnostics, documentation and evaluation (TF2), consultation (TF3), clinical trials (TF4), reimbursement (collaboration with health insurance companies; TF5) and translational research (TF6).
Background and Aims of the nNGM
In 2017, centralized NGS-based molecular multiplex diagnostics was performed for about 4,500 patients from about 300 referring partners (50% hospitals, 50% private practices). NGM provides counseling and recommendations for off-label use and clinical trial participation. The high screening capacity allowed us to competitively participate in international early proof-of-concept and late phase trials, in particular for rare genetic lung cancer subgroups.
In addition, our central database enabled not only the first demonstration of a substantial survival benefit with targeted therapy vs. chemotherapy, but also the biological and clinical characterization of rare genetic lung cancer subgroups. NGM has also contracted with the major German health insurance companies for full reimbursement of NGS-based molecular diagnostics and consultation for advanced lung cancer patients.
From NGM to nNGM
Based on these encouraging experiences in the Cologne NGM, we started the initiative of the nNGM Lung Cancer and applied for funding by the German Cancer Aid (DKH) in 2017. The idea of nNGM is to extend the NGM model nationwide and thus to create access to highly innovative molecular diagnostics and innovative therapy for preferably all patients with advanced lung cancer in Germany.
The nNGM strongly believes that such a strategy will rapidly lead to a substantially prolonged overall survival of these patients as we could demonstrate already in NGM. The nNGM is funded by the DKH since April 2018.
Within nNGM 15 university cancer centers, all of them certified as Oncology Centers of Excellence at the time of submitting the application, aim at establishing regional collaborations with hospitals and private practices.
In these networks centralized and nationwide harmonized molecular multiplex diagnostics, counseling, trial allocation and evaluation will be provided by the nNGM centers, while, with the exception of early phase trials, treatment may take place close to home. Following this strategy, access for all patients then could be realized integrating the multiplicity of smaller hospitals and private practices in particular in Germany.