Implementing Genomic Testing for Lung Cancer Into Routine Clinical Practice - The Welsh Experience

Area of Science:

• Oncology
• Genomics
• Molecular Diagnostics

Background:

• Non-small cell lung cancer (NSCLC) has seen rapid advancements in identifying actionable driver mutations.
• Numerous targeted therapies are now available for NSCLC patients with specific genetic alterations.

Purpose of the Study:

• To summarize the implementation of a national biomarker testing pathway for NSCLC in Wales.
• To embed this pathway within the National Optimal Pathway for Lung Cancer.

Main Methods:

• A working group was established by the Welsh Thoracic Oncology Group to standardize genomic testing.
• A national survey of multidisciplinary teams (MDTs) and a retrospective audit of the next-generation sequencing (NGS) pathway were conducted.

Main Results:

• Seventy percent of MDTs participated in the survey, revealing variability in testing practices.
• 87% of MDTs adopted DNA and RNA NGS as standard care, with a median turnaround time of 25-26 days.
• Pathology-initiated reflex testing was associated with shorter biopsy-to-result times.

Conclusions:

• Significant progress has been made in establishing a national NSCLC biomarker testing pathway in Wales.
• Challenges persist in optimizing tissue quality and reducing turnaround times for genomic testing.
• Further improvements are needed to ensure timely and comprehensive testing for optimal treatment selection and patient outcomes.