Genetic Expertise Hub for improved cancer prevention and treatment services

GENE-CONNECT, is a collaborative project aimed at improving cancer prevention and treatment services in the Romania-Moldova region. The primary challenge in this area is the lack of uniformity in cancer diagnosis and treatment, leading to disparities in care quality. The project aims to address this by setting a new benchmark for cancer care in the region, focusing particularly on inherited cancer syndromes. The overall objective of GENE-CONNECT is to harmonize and elevate the standards of cancer diagnosis and treatment across the Romania-Moldova region. This will be achieved through technology standardization, professional training and capacity building, and the enhancement of healthcare services. The main outputs of the project include the establishment of uniform, cross-border standards for cancer diagnosis and treatment, the enhancement of healthcare professionals' skills and knowledge in genetic cancer diagnosis and treatment, and the improvement of healthcare infrastructure and services. The approach of the project involves a comprehensive, collaborative effort encompassing various key pillars such as harmonization of cancer diagnosis and treatment protocols, capacity building and professional development, upgrading healthcare infrastructure and services, promotion of integrated community care models, and cross-border collaboration and knowledge sharing. What makes this project new and original is its focus on inherited cancer syndromes and the use of advanced genetic testing methods. It also emphasizes the importance of cross-border collaboration and knowledge sharing in improving cancer care standards. Furthermore, it seeks to transition from institutional to community-based care models, thereby improving access to cancer care services, especially for remote and underserved communities.

During the first four months of implementation, the GENE-CONNECT project has advanced in line with the Grant Contract, the approved Work Plan, and the guidance provided by the Managing Authority. The project was officially registered in the national government portal (amp.gov.md), which enabled the transfer of the 30% advance payment and ensured financial stability from the outset. A key milestone was the working visit to the Regional Institute of Oncology (IRO) in Iași, where strategic discussions focused on project coordination, communication flows, and the harmonization of diagnostic and treatment protocols. During this visit, the Steering Committee and the Oversight Committee were formally established, setting the foundations for transparent management and oversight. At the same time, both partners defined their internal project teams, and contracts were signed for staff members in accordance with their qualifications and the requirements of the financing contract (Activity 1.1). Financial management mechanisms were also put in place. A controller was contracted by LP 1 in accordance with the Program rules, and on July 8, 2025, the agreement for expenditure verification was signed, ensuring transparency and accountability in the use of project funds. Communication and visibility actions were launched to raise awareness of the project. Materials such as an official letterhead, PowerPoint template, posters, and a billboard were created and approved, while a dedicated Facebook page was set up to engage with the wider public (Activity 1.2). On the scientific side, important steps were taken toward achieving the project’s core objectives. A joint workshop on genetic screening brought together researchers from both partners to establish eligibility criteria for hereditary cancer testing. This resulted in a draft methodology for genetic counseling, testing, and interpretation, including cascade screening for high-risk relatives. Building on this, the Research Protocol was finalized and submitted to the National Committee for Ethical Review of Clinical Studies (Activity 1.3). At the same time, work began on creating long-term cooperation tools: - a cross-border knowledge hub (Activity 1.7), designed as a digital portal for oncology collaboration, with the first contributions from both laboratories on their infrastructure and expertise; - a joint genomic screening database (Activity 1.8), with a structure developed to allow secure exchange of genetic data, supporting both clinical practice and public health planning. The added value of the cooperation lies in the way both institutions – the PMSI Institute of Oncology and the Regional Institute of Oncology, Iași – are combining resources, knowledge, and experience. Together, they are building common methodologies, digital tools, and governance structures that no institution could achieve alone. These achievements already demonstrate the potential of cross-border collaboration to improve prevention, early diagnosis, and treatment of cancer for patients on both sides of the border. Overall, the cooperation between the partners has already produced tangible results: the establishment of joint governance structures, harmonization of protocols, the creation of communication tools, and the development of a robust methodology for genetic screening. These achievements not only strengthen institutional capacities but also provide added value by building a cross-border platform for knowledge exchange, improved prevention, and innovative approaches to cancer management During Implementation Period 2, the GENE-CONNECT project progressed coherently and consistently, achieving significant results in management, communication, pilot screening program development, and professional capacity building. All activities were implemented in compliance with contractual requirements and the Interreg NEXT Romania–Republic of Moldova Programme, demonstrating effective cross-border collaboration between LP1 and PP2. Activity 1.1 – Technical and Administrative Coordination LP1 hosted the second Steering Committee meeting on 11 October 2025 to review Annex 3 – Risk Analysis and Action Plan, assess overall project progress, and update the timeline for Period 2. Two active risks were identified: insufficient financial progress and delays in PP2 staff recruitment. Five corrective measures were approved, including accelerating procurement, completing the project team within one month, monthly monitoring of technical and financial progress, implementing activities according to the approved Work Plan, and maintaining effective communication with the Joint Secretariat. Virtual Monitoring Committee meetings confirmed that all deliverables for Activities 1.1–1.4 were structured, complete, and fully compliant with programme requirements. Activity 1.2 – Communication and Dissemination LP1 and PP2 developed the Project Communication Strategy to ensure transparent information flow to all stakeholders. Actions included launching the official project website, managing and updating content on social media, organizing a dissemination event for healthcare professionals, patients, and the public, preparing a press release, and contracting service providers for promotional materials. LP1 and PP2 contributed content and technical support, ensuring accuracy, accessibility, and engagement, raising awareness of the importance of advanced genetic testing for hereditary cancer syndromes. Activity 1.3 – Pilot Screening Program and Standardization Joint workshops at LP1 premises (Co-design on 3–4 November 2025 and Co-working on 14–15 November 2025) involved PP2 experts in technical and clinical consultations on hereditary cancer syndromes (BRCA1/2, Lynch, TP53/Li-Fraumeni), screening protocols for breast, colorectal, ovarian, and pancreatic cancers, and risk assessment tools (BOADICEA, PREMM5). Ethical and quality frameworks were aligned with ESMO 2023, ACMG 2021, ISO 15189:2022, GDPR 2016/679, and ESHG Core Competences 2020. Key deliverables developed include the Pilot Screening and Standardization Program, patient information brochure, report on germline genetic testing panels, and database structure for clinical physicians. Public procurement for two advanced genetic equipment units was initiated to support program implementation. Activity 1.4 – Professional Training and Capacity Building LP1 and PP2 coordinated questionnaires assessing knowledge in cancer genetics and genomics among medical staff, researchers, and laboratory specialists. Based on results, the Joint Medical Committee was established to coordinate training, standardize content, supervise quality, and ensure alignment with international best practices. The Training Needs Assessment Report serves as the foundation for developing targeted training modules to strengthen professional competencies and ensure a coherent educational framework. Cross-border Knowledge Hub and Database PP2 contributed to establishing the Knowledge Hub, creating communication channels, and developing the conceptual framework for an interactive platform for sharing guidelines, best practices, and research results. A preliminary database structure was developed to enable secure exchange and analysis of genomic data, supporting identification of disease-associated genes, personalized treatments, and public health initiatives. Conclusion Implementation during Period 2 demonstrates coherent and compliant progress, with active partner involvement. Deliverables such as the Pilot Screening Program, patient brochure, genetic testing report, database structure, Communication Strategy, and Training Needs Assessment Report provide functional tools for cross-border cooperation, improving clinical services, diagnostic accuracy, professional capacities, and the sustainability and impact of hereditary cancer care in Romania and Moldova. Implementation Period 3 was highly dynamic, marked by significant progress in the execution of planned activities. The period began with an on-site verification visit by AM-SMP and concluded with an online monitoring visit by the Antenna SC Office. Two minor amendments were introduced to the Project Application Form (C4 – Work Plan, WP1), affecting activities A1.3/D.1.3.2 and A1.8/D.1.8.1 and Budget PP2 – External expertise and services (budget line „Subscriptions for open access to grating access to international medical education portals for trainees (A.1.4)”). Project governance was strengthened through Steering and Monitoring Committee meetings. The 3rd Steering Committee meeting addressed compliance with the Grant Agreement and risks related to the non-submission of the previous report, establishing corrective measures. The 4th meeting evaluated updates to the Action Plan and and the upcoming changes that will take place within the PP2 team, ensuring continuity of implementation. Monitoring Committee meetings validated key deliverables across Activities 1.1, 1.3, 1.4, 1.5, 1.7, and 1.8, and confirmed the implementation timeline for Activity 1.4. Communication and dissemination efforts increased project visibility through social media management and a dedicated dissemination event organized by PP2 at IRO Iași, attended by healthcare professionals and the public. Compliance with programme requirements was ensured, including prior notification and approval of communication materials. A major achievement was the modernization of laboratory infrastructure at LP1 through the installation and commissioning of the Ion Chef Instrument integrated with the Ion GeneStudio S5 System and PP2 completed the commissioning of the miVac DNA Concentrator. This was complemented by specialized training in automated workflows and NGS bioinformatic analysis, including quality control and clinical interpretation in line with ACMG/AMP guidelines. These efforts resulted in deliverables D.1.3.1 and D.1.3.4, covering modernized infrastructure and standardized sequencing protocols. In parallel, finalized the operationalization of laboratory equipment and contributed to the development of standardized cross-border procedures, including complete workflows for sequencing and data analysis. Significant progress was also made in professional training and capacity building. A comprehensive training curriculum (D.1.4.2), aligned with international standards (ESMO, ACMG, ESHG, NCCN), was developed and delivered through multiple workshop sessions in Chișinău, supported by PP2 experts. The Joint Medical Committee was established, setting the framework for mobility programs and training in hereditary cancer detection. The first mobility program, hosted at IRO Iași, enhanced participants’ competencies through clinical practice, multidisciplinary collaboration, and applied workshops in oncology and medical genetics. Activities under the Community Care Model (D.1.5.1) were initiated through the establishment of a multidisciplinary committee, tasked with analyzing system challenges, identifying best practices, and developing a framework aligned with international standards, laying the foundation for upcoming actions in Period 4. In terms of digital infrastructure, the GENE-CONNECT community was established on the Zenodo platform, integrating ORCID accounts and enabling secure, ethical data sharing. The platform serves as a cross-border knowledge hub, facilitating access to anonymized genetic data and supporting continuous education. The screening database (D.1.8.1) was also transitioned to Zenodo, ensuring improved accessibility, interoperability, and transparency, with clearly defined procedures for data upload and risk management. Overall, LP1 and PP2 maintained active involvement across all core activities, contributing to governance, training, infrastructure development, cross-border exchange, and the creation of standardized tools, thereby ensuring coherent and effective project implementation.