I am an associate professor of biostatistics at the Department of Medical Epidemiology and Biostatistics (MEB) at Karolinska Institutet (KI). I did all my undergraduate studies at Uppsala University, apart from a three-semester stint at the University of Otago in Dunedin, New Zealand, where I studied mathematics and biotechnology. I also did my PhD at Uppsala University, mainly focusing on computer intensive methods for statistical model choice and validation with applications in the drug development pipeline. After I finished my PhD, I did postdocs at the section for Global Safety Assessment at AstraZeneca and at the Department of Medical Epidemiology and Biostatistics, KI. During 2013 and 2014, I was based in San Francisco and worked at the Department of Surgery, University of California San Francisco (UCSF). Since 2015, I work as an assistant professor at MEB, where I focus my research on reducing the mortality of breast- and prostate cancer through the use of individualized prevention, diagnostic, and treatment based on the combined use of biomarkers, genomics, and imaging.
- PhD Bioinformatics, Uppsala University, 2010
- MSc Molecular Biotechnology (civilingenjör), Uppsala University, 2005
- MSc Mathematics, Uppsala University, 2006
- BSc Macroeconomics, Uppsala University, 2004
My research focuses on the intersection between statistics and translational medicine, in particular related to improvement in early detection and treatment of prostate and breast cancer. I am involved as investigator in a number of clinical trials:
Stockholm3 (sthlm3.se) is a large-scale prospective and population-based prostate cancer diagnostic study involving close to 60,000 men in Stockholm 2013-2015. Two screening methods, PSA and the Stockholm3 Model (S3M), were tested and compared for safety and efficacy. The primary aim of Stockholm3was to investigate if S3M could substantially reduce the proportion of men undergoing prostate biopsy whilst maintaining the sensitivity for detecting consequential prostate cancer (Gleason Score 7 or above) compared to PSA. We are now conducting a number of follow-up studies to Stockholm3, e.g. Stockholm3-MRI, which combines S3M with MRI to further improve prostate cancer diagnostics, and Stockholm3-clinic, which involves final clinical implementation of the Stockholm3 results. We are also investigating the use of S3M and MRI for active surveillance of men diagnosed with low-risk prostate cancer.
The WISDOM trial
The WISDOM trial (wisdomstudy.org) investigates whether a risk-based approach to breast cancer screening is as safe and effective as annual mammograms. We will also determine whether women readily accept personalized screening and if knowledge of their own risks, and the reasons for less-frequent screening, will reduce anxiety about breast cancer. Finally, we will determine whether our personalized approach will lead to more of the highest-risk women deciding to use strategies that can prevent breast cancer. Participants in the personalized screening arm receive a risk assessment that includes family and medical history, breast density measurement, and genomic tests (SNPs and high-penetrance genes such as BRCA1/2). WISDOM will enroll 100,000 women across California and South Dakota and is funded by the Patient Centered Research Outcomes Institute (PCORI).
Approximately 30% of men diagnosed with prostate cancer develop lethal metastatic castration-resistant prostate cancer (mCRPC). Although recently approved new drugs are beneficial for many mCRPC patients they carry three serious disadvantages. First, these drugs are all very expensive. Second, the response rates to these drugs are low, ranging between 20-40%. This leads to suboptimal treatment and unnecessary side-effects. Third, there are no predictive treatment markers available in clinical care today, which leads to ineffective trial-and-error in treatment decisions. Our hypothesis is that treatment decisions based on molecular profiling will significantly increase progression free survival compared to current clinical care. The vast majority of CRPC metastasize to the bone, with low success rate in obtaining sufficient material. Therefore, we will sequence circulating tumor DNA (ctDNA) consisting of DNA debris from apoptotic cancer being present at high levels in plasma. This hypothesis will be tested in the ProBio trial starting in the end of 2018, a large, nationwide, multicentre randomized study in men with CRPC. ProBio uses an outcome-adaptive randomization trial design, with the goal to learn as rapidly as possible which treatments are effective for which ctDNA biomarker profiles.
Current supervision of PhD students
Current supervision of postdocs
Current research grants (as PI)
My research is supported by the Swedish Research Council (Vetenskapsrådet), the Swedish Research Council for Health, Working Life and Welfare (FORTE), the Swedish Cancer Society (Cancerfonden), and the European Institute of Innovation & Technology (EIT).
I currently teach the course “Multivariable prediction modeling with applications in precision medicine” (LK2990) together with Mattias Rantalainen.
- A. Wallerstedt, P. Ström, H. Grönberg, Tobias Nordström, and M. Eklund. Risk of prostate cancer in men treated with 5-alpha-reductase inhibitors - results from a large population-based prospective study. JNCI: Journal of the National Cancer Institute, djy036, 2018.
- H. Grönberg, M. Eklund, W. Picker, M. Aly, F. Jäderling, J. Adolfsson, M. Landquist, E. Skaaheim Haug, P. Ström, S. Carlsson, and T. Nordström. Detection of prostate cancer using a combination of blood-based risk prediction and multiparametric magnetic resonance imaging. European Urology, 2018, [Epub ahead of print].
- P. Ström, T. Nordström, H. Grönberg, and M. Eklund. The Stockholm-3 model (S3M) for prostate cancer detection: biomarker contribution and reflex test potential. European Urology, 2018 [Epub ahead of print].
- Breast Cancer Screening in the Precision Medicine Era: Risk-Based Screening in a Population-Based Trial.
J. Natl. Cancer Inst. 2017 01;109(5):
- Detection of ductal carcinoma in situ and subsequent interval cancers.
BMJ 2016 Feb;352():i551
- Population-based screening for cancer: hope and hype.
Nat Rev Clin Oncol 2016 09;13(9):550-65
- Prostate cancer screening in men aged 50-69 years (STHLM3): a prospective population-based diagnostic study.
Lancet Oncol. 2015 Dec;16(16):1667-76
- Comparison Between the Four-kallikrein Panel and Prostate Health Index for Predicting Prostate Cancer.
Eur. Urol. 2015 Jul;68(1):139-46