Pathology at the forefront of liquid biopsy implementation

Cellular Molecular Pathology Initiative (CM-Path), PHG Foundation and Cancer Research UK have released a consensus statement on the important role of pathologists in the implementation of innovative technologies, such as liquid biopsies, into the health system.

A cutting-edge test, liquid biopsies involve taking a simple blood sample and genetically testing tumour DNA circulating in the bloodstream. The test could increase access to targeted treatments for certain cancer patients who are currently unable to be genetically tested for their suitability for these treatments as a solid tumour sample cannot be obtained. Liquid biopsies could also allow repeat testing of tumours over time to monitor if an alternative targeted drug could be more effective.

Pathologists play a key role in the handling, processing and analysis of patient samples to diagnose diseases. The consensus statement places the pathology community at the forefront in helping to manage the issues of engagement, logistics and validation, cost and ethics that surround the implementation of innovative technologies, such as liquid biopsies that involve genetic testing.

One recommendation is for the Royal College of Pathologists to guarantee that pathology training enables trainees to spend time with clinical genomic scientists and bioinformaticians so trainees can produce reports that examine both structural and molecular features of tumour samples. This will help to ensure that pathologists have a comprehensive understanding of a patient’s tumour, bringing together in one place all of the information required to make optimal treatment decisions for each patient. 

The document also states that CM-Path, an initiative set up by the National Cancer Research Initiative to reinvigorate academic pathology, is working with the confederation of cancer biobanks to develop a quality improvement tool that will also include standards for processing and preserving samples for liquid biopsy analysis.

The document follows a recent CM-Path workshop, which brought together pathologists, oncologists, scientists and pharma to highlight advances in liquid biopsy technologies to the pathology community and how pathologists are integral in integrating this technology into clinical care. The event was held in association with Cancer Research UK and the PHG Foundation.

Last year PHG Foundation released a report Developing effective ctDNA testing services in lung cancer, which called for increased awareness of validated ctDNA testing for lung cancer and urged health commissioners to concentrate on strengthening existing services and to improve provision of this technology. Read the report and recommendations here.