A report published today by the PHG Foundation argues that limited awareness of validated ctDNA testing technology is restricting access to targeted therapy in a sub-group of patients with non-small cell lung cancer.
Lung cancer is an area of unmet clinical need with only 5% of patients surviving more than 10 years post diagnosis. Developing effective ctDNA testing services for lung cancer outlines the most pressing issues affecting the implementation and provision of ctDNA testing and describes examples of good practice from some of the laboratories that have pioneered the introduction of ctDNA testing into the NHS.
Dr Laura Blackburn, Policy Analyst (Biomedical Sciences) at PHG Foundation, who is lead author of the report, said: “The development and provision of ctDNA testing for patients with NSCLC by NHS laboratories in the UK is a positive advance. Not only is this testing increasing access to targeted therapies that improve patient outcomes, but it is also a less invasive method of testing as it only requires a blood sample, and benefits patients who are unable to undergo a solid tumour biopsy for clinical reasons or who have had a failed biopsy.”
Targeted therapies for non-small cell lung cancer (NSCLC) patients can only be offered following a genetic test on the patient’s tumour. But in 30% of NSCLC patients the biopsies to collect tumour tissue fail, closing the opportunity for these patients to access a targeted therapy. Circulating tumour DNA testing gives these patients a chance to access testing, and involves a simpler procedure where a blood sample is taken to analyse the tumour DNA circulating in the blood stream.
The PHG Foundation report urges health commissioners to concentrate on strengthening existing services and to improve provision of this technology, and for clinicians with expertise in ctDNA testing to take the lead as clinical champions to raise awareness within the health system.
Specific recommendations include:
- Clinical guidelines on the use of ctDNA testing in NSCLC should be developed by one or more of the professional societies and organisations
- Laboratory websites should include up-to-date and clear electronic referral information and resources, including testing information, costs and logistics
- Engagement with ctDNA testing can take place within the multidisciplinary team (MDT)
Developing effective ctDNA testing services for lung cancer was informed by a workshop led by PHG Foundation, held in March 2017, which brought together clinicians, NHS clinical scientists and the commercial sector, to identify and focus on the most pressing issues affecting the implementation of effective and equitable ctDNA testing.