Molecular

BCPS is committed to ensuring that the patients at its partner trusts are able to access the right biomarker results at the right time, in order to allow them to receive cancer treatment which is as personalised as possible.

BCPS is one of the leading engagers in the region with NHS England’s genomic strategy. By mid-2023, the goal is that all eligible patients with cancer will routinely undergo comprehensive next-generation sequencing (NGS) provided by the Central and South Genomic Laboratory Hub (GLH). BCPS is also developing the capability to prepare tissue for whole genome sequencing, with a go-live target of early 2023. Since 2021, BCPS has been a partner to the GLH in routinely providing training to its scientific staff.

However, while centralised NGS testing provides comprehensive information, this is too slow for some patients who require very urgent treatment. BCPS has therefore developed a bespoke system whereby the patients who are most in need of urgent treatment undergo rapid in-house targeted testing for the key molecular targets, while centralised NGS testing is in progress. This allows patients to access first-line treatments extremely rapidly, while ensuring that they do not miss out on the comprehensiveness of NGS. This is already in place for patients with colorectal cancer, and will be rolled out for patients with lung cancer and melanoma by early 2023.

In 2021, BCPS was successful in bidding for funding to undertake key biomarker tests in-house, with the goal of speeding up results and getting patients on treatment more quickly. This included PD-L1 expression which is important in lung cancer, melanoma, head and neck cancers, breast cancer, bladder cancer, cervical cancer and gastro-oesophageal cancers, and HER2 expression which is important in breast cancer and gastrointestinal tract cancers. The funding has allowed us to develop a dedicated molecular laboratory team and to procure new testing platforms. This is currently being implemented and is anticipated to be operational by early 2023.

The approach at BCPS is twofold. We are engaging fully with our regional partners in order to ensure that our patients have full access to specialist and comprehensive testing which can be provided only on a regional scale. At the same time though, we are developing our local capabilities to make sure that – where speed of starting treatment is the priority – we are able to provide our patients with the results they need to start treatment without delay.