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Landscape of cancer biomarker testing in England following genomic services reconfiguration: insights from a nationwide pathologist survey

Taniere, Phillipe; Nicholson, Andrew G; Gosney, John R; Montero Fernandez, Maria Angeles; Bury, Danielle; Moore, David Allan; Verghese, Eldo; ... Ryan, Jacqueline; + view all (2023) Landscape of cancer biomarker testing in England following genomic services reconfiguration: insights from a nationwide pathologist survey. Journal of Clinical Pathology 10.1136/jcp-2023-208890. (In press). Green open access

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Abstract

AIMS: Cancer diagnostics have been evolving rapidly. In England, the new National Health Service Genomic Medicine Service (GMS) provides centralised access to genomic testing via seven regional Genomic Laboratory Hubs. The PATHways survey aimed to capture pathologists’ experience with current diagnostic pathways and opportunities for optimisation to ensure equitable and timely access to biomarker testing. METHODS: A nationwide survey was conducted with consultant pathologists from regional laboratories, via direct interviews based on a structured questionnaire. Descriptive analysis of responses was undertaken using quantitative and qualitative methods. RESULTS: Fifteen regional centres completed the survey covering a median population size of 2.5 (1.9–3.6) million (each for n=12). The median estimated turnaround time (calendar days) for standard molecular markers in melanoma, breast and lung cancers ranged from 2 to 3 days by immunohistochemistry (excluding NTRKfus in breast and lung cancers, and PD-L1 in melanoma) and 6–15 days by real-time-PCR (excluding KIT for melanoma), to 17.5–24.5 days by next-generation sequencing (excluding PIK3CA for breast cancer). Tests were mainly initiated by pathologists and oncologists. All respondents discussed the results at multidisciplinary team (MDT) meetings. The GMS roll-out was perceived to have high impact on services by 53% of respondents, citing logistical and technical issues. Enhanced education on new pathways, tissue requirements, report interpretation, providing patient information and best practice sharing was suggested for pathologists and other MDT members. CONCLUSION: Our survey highlighted the role of regional pathology within the evolving diagnostic landscape in England. Notable recommendations included improved communication and education, active stakeholder engagement, and tackling informatics barriers.

Type: Article
Title: Landscape of cancer biomarker testing in England following genomic services reconfiguration: insights from a nationwide pathologist survey
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jcp-2023-208890
Publisher version: https://doi.org/10.1136/jcp-2023-208890
Language: English
Additional information: © 2023 BMJ Publishing Group Ltd & Association of Clinical Pathologists. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license (http://creativecommons.org/licenses/by-nc/4.0/).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: https://discovery.ucl.ac.uk/id/eprint/10184184
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