The Royal Marsden NHS Foundation Trust has completed a six-month pilot of a new ‘oncogenetic’ gene testing pathway which is much faster and less costly than standard gene testing pathways.
The gene testing was performed by TGLclinical, a laboratory established with funding from The Royal Marsden Cancer Charity and The Institute of Cancer Research, London.
TGLclinical has state-of-the-art gene sequencing equipment which can do many more tests, much faster and at much lower cost than traditional testing methods.
More than 100 Royal Marsden cancer patients have now benefitted from BRCA1 and BRCA2 gene tests through the new pathway since the pilot began in July 2013.
The ‘oncogenetic’ pathway brings gene testing directly to the patient through their existing oncology appointments. Previously, patients could only have a gene test via referral to genetics departments.
The ‘oncogenetic’ pathway allows members of the cancer team who have completed online training to order gene tests for eligible patients directly, but retains the flexibility to refer patients to genetics if more detailed discussions will be helpful. Any patient found to have a gene mutation is seen by a geneticist. Those with normal results can be referred in the standard manner, if required. This represents a more patient-centred, flexible gene testing service. It also allows more people to have access to gene testing.
Professor Nazneen Rahman, Head of the Cancer Genetics Clinical Unit at The Royal Marsden and Head of Genetics at The Institute of Cancer Research (ICR), said:
“Using new sequencing technologies and the ‘oncogenetic’ testing pathway we can make gene testing accessible to many more people. We are delighted that the feedback from patients and clinicians in the pilot has been overwhelmingly positive.
In 2013 NICE recommended people with >10% chance of having a mutation in either the BRCA1 or BRCA2 gene should be offered testing. This includes >10,000 cancer patients per year. However, limited capacity and high costs of traditional gene testing pathways limits the BRCA1 and BRCA2 testing doctors are currently able to provide for their patients.
“The oncogenetic gene testing pathway could be used to deliver the NICE recommendations cost-effectively” said Professor Rahman.
Professor Martin Gore, Medical Director of the Royal Marsden NHS Foundation Trust and one of the oncologists who participated in the pilot, said:
“Knowing whether or not a patient has a gene mutation is an important part of making personalised treatment plans. Patients are also increasingly aware of the value of gene testing and more and more patients are requesting testing. The ‘oncogenetic’ pathway makes gene testing quicker and simpler but still provides input from genetics when we need it. Many of our patients have already benefitted as a result of being able to have a gene test. The Royal Marsden is delighted we can offer this testing to our patients.”
The new laboratory test and clinical testing pathway are now ready for roll-out to other hospitals and a second pilot involving more centres is in planning.
“Ultimately we hope that the clinical and technological advancements we are developing will be able to benefit patients anywhere in the NHS” said Professor Rahman.