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Best-Practice Biomarker Testing of Oesophago-Gastric Cancer in the UK: Expert Consensus Recommendations Developed

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Biomarker testing for oesophago-gastric cancers (OGCs) needs standardization across the UK. Consensus was reached on best practices, but pathologist capacity remains a challenge for timely treatment decisions.

Keywords:
Consensus recommendationsHER2MSI/MMRPD-L1oesophago-gastric cancerpathology

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Area of Science:

  • Oncology
  • Molecular Pathology
  • Cancer Biomarkers

Background:

  • Oesophago-gastric cancers (OGCs) are common worldwide with high mortality.
  • Predictive biomarkers enable personalized therapy but face inconsistent testing.
  • Variation in biomarker testing uptake exists across the UK.

Purpose of the Study:

  • To establish consensus recommendations for best-practice biomarker testing in OGCs in the UK.
  • To address challenges in current biomarker testing pathways.
  • To improve individualized cancer therapy through biomarker identification.

Main Methods:

  • A modified Delphi study involving two rounds of online questionnaires and a virtual consensus meeting.
  • Inclusion of pathologists and oncologists from across the UK.
  • Discussion of key biomarkers (HER2, MSI/MMR, PD-L1) and pathway considerations.

Main Results:

  • Consensus achieved on standardizing the biomarker pathway, quality assurance, and pathology report content.
  • Oncologists agreed on reflex testing; pathologists raised concerns about capacity and workload.
  • Participants believed reflex testing accelerates treatment decisions and enhances patient care.

Conclusions:

  • Recommendations for best-practice biomarker testing in OGCs should be implemented for multidisciplinary decision-making.
  • Standardization is needed to address practical challenges, particularly pathologist capacity.
  • The study highlights critical issues in biomarker testing for OGCs in clinical practice.