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East Hospital and Stradiņš Hospital Launch Pilot Project to Test a Globally Recognised Breast Cancer Treatment Solution
Riga East Clinical University Hospital (East Hospital), in collaboration with Pauls Stradiņš Clinical University Hospital (Stradiņš Hospital), is successfully continuing the implementation of a pilot project aimed at improving the quality of breast cancer treatment. The project introduces the Oncotype DX genetic test into the clinical care pathway for breast cancer patients, using a personalised, value-based medical approach.
Initial results suggest that this test, which helps determine not only prognosis but also the potential benefit of chemotherapy, could enable over 70% of early-stage, high-risk breast cancer patients to avoid the toxicity of chemotherapy—mirroring international experience.
As part of the pilot project, tumour samples from 28 patients at East Hospital and 26 at Stradiņš Hospital were selected and sent for Oncotype DX genetic testing by 1 April 2025, as recommended by the Breast Cancer Multidisciplinary Tumour Board. To date, 45 test results have been received, indicating that chemotherapy is necessary in only 12 cases—or 26% of patients. This precise risk stratification means that more than 70% of patients could avoid chemotherapy-related toxicity. Based on the molecular test results, all patients received personalised treatment plans.
The Oncotype DX genetic test identifies patients who are scientifically proven to benefit from chemotherapy while sparing others from unnecessary, toxic treatment that can reduce quality of life and lead to long-term disability or work incapacity. This reflects a value-based approach to cancer care that is recommended internationally.
“Oncotype DX testing marks a significant step forward in personalised oncology. It allows for an accurate assessment of tumour biology and supports treatment strategies that are both effective and less harmful. In over 70% of cases, this approach avoids unnecessary chemotherapy—a key factor not only in improving patients’ quality of life, but also in enhancing healthcare system sustainability. A national decision to incorporate this testing into routine care for eligible patients would represent a major shift in Latvian oncology—from a general approach to precise, individualised treatment,” says Associate Professor Alinta Hegmane, the project’s scientific advisor and Director of the Latvian Cancer Centre at East Hospital.
Collaboration between university hospitals on research and pilot projects lays the foundation for improved treatment quality. It promotes evidence-based practice and medical innovation that can directly benefit patients nationwide. Associate Professor Arvīds Irmejs, lead breast surgeon at Stradiņš Hospital and pilot project expert, explains: “Breast cancer changes everything for a woman. That’s why we must be certain we are giving her only the treatment she truly needs. The Oncotype DX test enables informed, personalised decisions that reduce unnecessary strain and severe side effects. Every patient’s life is unique and valuable—our responsibility is not just to treat the cancer, but to do so with respect for her physical, mental, and everyday well-being.”
In parallel, a quality-of-life (QoL) assessment has been introduced for breast cancer patients to evaluate not only treatment effectiveness, but also how patients feel and function after therapy.
As part of the project, Oncotype DX testing will be carried out for 200 patients. According to East Hospital’s estimates, this could save the public budget more than EUR 680,000 by avoiding the cost of unnecessary chemotherapy, supportive medications, treatment of complications (such as febrile neutropenia), and compensation for up to six months of work disability related to chemotherapy. The project will conclude with an evaluation and economic analysis, forming the basis for including the test in the list of publicly funded services for breast cancer patients.
The Oncotype DX genetic test is recommended by international clinical guidelines and is publicly funded in most EU member states, including Estonia. Implementation is also underway in Lithuania. However, the test is currently not included in the list of state-funded medical services in Latvia.
In an effort to introduce cutting-edge solutions and improve accessibility to services within the publicly funded healthcare system, the National Health Service is implementing the project ‘Healthcare Service Model Development Laboratory’, with financial backing from the EU Recovery and Resilience Facility. The project will enable the testing and evaluation of innovative or previously underdeveloped healthcare service models until 2026. Achieving effective results could allow for their inclusion in the publicly funded services programme.
Three pilot projects implemented by East Hospital seek to introduce cutting-edge solutions in Latvia’s healthcare system, ensuring targeted and personalised high-precision services for the diagnosis and treatment of oncological diseases, such as ‘High-precision robotic percutaneous thermal ablation laboratory for inoperable malignant tumours’, ‘Introduction of new molecular genetic diagnostic methods for personalised treatment of breast cancer patients in Latvia’, and ‘Implementation of new highly effective molecular pathology diagnostic methods and services for the development of precision medicine in oncology’.
The pilot project ‘Introduction of new molecular genetic diagnostic methods for personalised treatment of breast cancer patients in Latvia’ is being implemented under the EU Recovery and Resilience Facility Plan’s reform 4.3.1.r, titled ‘Sustainability of healthcare, strengthening governance, efficient use of health resources, increase of the total public budget in the health sector’, as part of the National Health Service’s open pilot project selection for the ‘Healthcare Service Model Development Laboratory’. The approved funding for the project under the Recovery and Resilience Facility Plan amounts to EUR 853 725.18, with implementation planned by 31 March 2026.
About the East Hospital
Riga East Clinical University Hospital is the largest and strategically significant multi-profile hospital in the country. The hospital consists of five inpatient facilities – Gaiļezers, Latvian Oncology Centre, Biķernieki, Tuberculosis and Lung Disease Centre, and Latvian Infectious Diseases Centre, along with various specialised centres and clinics. The hospital provides highly specialised inpatient and secondary outpatient healthcare, offering multidisciplinary tertiary-level treatment and care in line with modern technology and medical knowledge. Approximately 80% of all cancer patients in Latvia are treated at the hospital. It serves as a practical training base for both Latvian educational institutions and foreign students, providing further education and knowledge transfer to healthcare specialists within and beyond the country. The hospital engages in scientific research and develops innovative methods for patient treatment. As the third-largest employer in the country, the hospital employs around 5000 staff members.
