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By studying biomarkers - the measurable biological characteristics - researchers at CCBIO have enabled faster and more personalized diagnostics and treatment of malignant tumors. The center adopted an innovative approach by focusing on what may be referred to as “the cancer neighborhood” - or, more technically, the tumor microenvironment. This perspective became a cornerstone of cancer research at the center.

“Our results have improved the level of precision in both diagnostics and clinical procedures in cancer treatment, leading to better outcomes for patients. Furthermore, our research has contributed to more cost-effective treatment approaches, with an impact on cancer care and public health both in Norway and internationally,” says Centre Director Lars A. Akslen.

«The results from CCBIO range from fundamental biological discoveries to direct influence on clinical guidelines and national health policy. For example, findings related to the dissemination of cancer cells in breast cancer patients have been incorporated into national guidelines for breast cancer treatment, and a new treatment approach for pancreatic cancer has resulted in a significant improvement in survival».

The tumor microenvironment

A fundamental question at the establishment of the center was whether the tissue surrounding cancer cells merely constitutes a structural framework in which the cells grow, or whether this environment also influences the cancer cells biologically. At the time, most cancer researchers focused primarily on the cells themselves, and particularly their genes. Akslen and his colleagues chose instead to focus on the supportive tissue, or microenvironment, surrounding the cancer cells.

“In some cases, we have seen that the microenvironment is just as important, and perhaps even more important, for tumor development than the cancer cells themselves. Understanding the supportive functions of the microenvironment is therefore a decisive factor for effective cancer treatment,” says Akslen, adding:

“In simple terms, we now have a much clearer understanding of the importance of treating both the cancer cells and their surrounding environment. A malignant tumor often requires several different types of treatment and combinations of methods. Some interventions target the cells directly, while others target the supportive functions.”

Use of innovative imaging technology

Akslen and his colleagues early recognized the importance of ensuring that research findings could be translated into clinical practice. Through its work on cancer biomarkers, CCBIO has generated extensive new knowledge that has helped strengthen diagnostic precision in cancer care.

“Biomarkers are measurable biological characteristics that enable highly accurate diagnosis and allow treatment to be tailored to the individual patient. From the outset, our goal was therefore not only to understand the biological mechanisms underlying cancer, but also to ensure that our discoveries could be applied directly in the clinic and make a tangible difference for patients,” Akslen says.

This work was enabled, in part, by an innovative tissue imaging technology known as Imaging Mass Cytometry (IMC), which allows cancers to be studied at extremely high resolution.

CCBIO was the first laboratory in Northern Europe to establish this technology, making it possible to map in detail how single cells within the tumor microenvironment are organized. This method also enables researchers to study how the areas surrounding cancer cells respond to specific treatments, while simultaneously assessing treatment effects.

A holistic and interdisciplinary approach

“There were several additional elements that distinguished CCBIO. One was our strong focus on protein patterns (proteomics) at a time when the dominant approach - then and still largely today - has been to study genes (genomics),” says Akslen. He explains that while genes can be seen as a kind of map, it is proteins that carry out the biological functions in tissues and tumors.

Another guiding principle was that research outcomes should generate broader societal value. For this reason, ethical considerations, such as healthcare prioritization and societal costs, were an integral part of the center’s activities.

“I believe one of the main reasons for our success was how well these elements were integrated, giving the center a coherent and distinctive profile. I am also a strong proponent of bringing together people with very different backgrounds, ideas, and areas of expertise. From the outset, I made it clear that it was acceptable to challenge others by asking ‘naïve’ questions. This openness became a defining characteristic of CCBIO, an approach that has led to many original and innovative findings” says Akslen.

Impact on health policies and new initiatives

The center’s results span from fundamental biological discoveries to direct impact on clinical guidelines and national health policies. The center’s success and organizational strength have also been instrumental in establishing several new initiatives. Key researchers at CCBIO have subsequently received major funding, including Ole Frithjof Norheim, who was granted a Centre of Excellence (SFF), for research on healthcare prioritization (BCEPS), and the , led by Bjørn Tore Gjertsen. Furthermore, a number of other researchers affiliated with the center have secured external funding to develop new projects based on emerging ideas.

For Akslen, supporting career development for students and early‑career researchers was a central motivation throughout CCBIO’s work. In 2014, the center therefore established the CCBIO Research School for Cancer Studies (RSCS).

“It has been deeply rewarding to help build something that ensures knowledge is passed on and continues to have impact long after those of us who are a bit older have ‘left the stage’. It is also gratifying to see that our efforts have inspired similar initiatives in other research environments,” says Akslen.

He points, among other examples, to the , which focuses on neurological conditions such as multiple sclerosis, dementia, Parkinson’s disease, and ALS. In addition, CCBIO established the CCBIO Masterclass, a year‑long program offering particularly talented early‑career researchers tailored education, mentoring, and professional development. This inspired similar initiatives at MED and UIB.

CCBIO 2.0

Towards the end of the SFF period, researchers identified new research questions, including the role of neural structures in malignant tumors.

“Although this is an emerging field, we are now beginning to see indications that increased nerve density may contribute to more aggressive tumor behavior,” says Akslen, noting that significant knowledge gaps remain.

According to Akslen, this line of research will be carried forward into the center’s next phase, CCBIO 2.0. This phase builds on the thematic focus and interdisciplinary expertise developed over many years as a Centre for Excellence, while placing greater emphasis on innovation, entrepreneurship, and application to ensure that research findings are translated into practical benefit.

The transition to CCBIO 2.0 was marked by a .

In this new phase, Akslen highlights two overarching priorities: precision diagnostics and precision therapy, alongside innovation projects linked to these areas.

“Many of our researchers share a strong commitment to ensuring that the results reach patients as quickly as possible. Innovation and application will therefore be key elements of CCBIO 2.0, through patenting, start-ups, and collaboration with the pharmaceutical industry,” says Akslen. He expresses gratitude to the University of Bergen for its support both during the SFF period and in the continuation of activities into the CCBIO 2.0 phase.

You can read CCBIO in Brief here, constituting CCBIO’s end report for the SFF period.