A new report by the UK Lung Cancer Coalition (UKLCC), reveals thousands of lung cancer patients may be missing out on life-extending, targeted treatments due to lengthy genomic testing turnaround times.

Genomic testing is a crucial component of the lung cancer diagnostic and treatment pathway. It identifies the molecular characteristics of tumours, allowing patients to access a growing range of innovative and personalised treatments tailored to their specific mutation, thereby improving survival rates.

As many as 30,000 UK lung cancer patients a year have tissue sent for genomic testing. Yet, despite the recommended 14-calendar day turnaround time for genomic testing (from tissue biopsy to full results report), patients in some regions are experiencing delays of several weeks.

“This situation is wholly unacceptable, causing significant physical and mental harm to patients who, after receiving a devastating diagnosis, must endure prolonged waits before starting the most suitable treatment,” says Robert Rintoul, Professor of Thoracic Oncology, University of Cambridge; Honorary Consultant Respiratory Physician, Royal Papworth Hospital, and the UKLCC’s Clinical Lead. “Lung cancer is a rapidly fatal disease, so timely access to test results and effective treatments is essential.”

The Darzi review indicates that less than two-thirds (60%) of genomic tests in England are delivered on time.

The report, titled ‘Faster Testing, Better Outcomes: Genomic Testing in Lung Cancer,’ calls for a maximum of 14 days turnaround time for genomics testing and highlights the current challenges and delays within the complex genomics pathway. Issues include a lack of published turnaround time data across genomic laboratory hubs (GLHs), inconsistent tissue sample quality, non-uniform results reporting, inadequate IT systems, staffing shortages in laboratories, and inefficient sample transportation (with some tissue samples being sent by second-class post).

It also offers practical solutions to ensure timely, accurate, and high-quality genomic test results across the UK - and uses examples of where processes are working well. Report recommendations focus on all three key stages of the genomics testing pathway (pre-genomic, genomic and post-genomic) which include:

Pre-genomic (biopsy, pathology and sample in transit)

·         Clinicians should plan lung cancer biopsies to maximise staging information and ensure high-quality material for pathology and genomics testing.

·         Pathologists and genomics scientists should collaborate to expedite sample processing for faster pathology and genomic results.

·         NHS administrations must provide daily inter-site transport between pathology labs and GLHs.

·         NHS and Government administrations must invest in a digital tracking system to monitor patient samples throughout their journey.

Genomics (laboratory)

·         The devolved NHS and Government administrations must adjust genomic laboratory turn-around-time targets for lung cancer samples to 7 days. To realistically achieve this, the laboratories must be sufficiently resourced, operating a 7-day working model

Post-genomics (reporting)

·         Devolved health administrations must ensure all clinicians in the lung cancer pathway have access to a single online platform for rapid results.

·         Genomics labs across the four nations should adopt standardised reporting templates to improve report consistency and understanding.

·         Each pathology and genomics lab should have a named individual responsible for overseeing the entire testing pathway and meeting turnaround time targets.

The report also urges the Department of Health and Social Care to increase the number of healthcare scientists’ training places as set out in the NHS Long Term Workforce Plan. It also calls for the Government and the devolved health administrations to collect and publish turnaround times so that pathology and genomics laboratories are held to account.

“Faster genomic testing can streamline the overall lung cancer pathway, avoid less-effective treatments, and ultimately save costs for the NHS,” adds Professor Rintoul.

Lung cancer is the UK’s leading cause of cancer death, with nearly 35,000 fatalities annually. It accounts for over a fifth (21%) of all UK cancer deaths, and lung cancer in never-smokers is the eighth most common cause of cancer-related death in the UK.  Five-year survival rates for lung cancer in the UK are poor compared to similar European countries (16.2%), and over one-third (35%) of lung cancer diagnoses in England occur through emergency hospital admissions. However, early diagnosis can lead to a cure.

“No one diagnosed with lung cancer should wait more than 14 days for genomic test results,” says Dr. David Gilligan, Consultant Clinical Oncologist at Cambridge University Hospitals and Royal Papworth Hospitals. “We owe it to our patients to ensure they receive the most appropriate and effective treatment as swiftly as possible.”

A copy of the full report can be accessed at: www.uklcc.org.uk/our-reports

Source: UKLCC