New "revolutionary" cancer blood test being rolled out on NHS
The new "liquid biopsy" test searches for tiny fragments of DNA that are shed by tumours into the bloodstream - it can deliver a specific diagnosis up to two weeks earlier than usual tissue biopsy methods
A "revolutionary" cancer blood test is set to transform the NHS, marking a global first that promises to fast-track personalised treatment for thousands. The innovative "liquid biopsy" test hunts for minuscule DNA fragments released into the bloodstream by tumours.
It boasts the ability to pinpoint a diagnosis up to a fortnight earlier than traditional tissue biopsies, enabling quicker selection of appropriate therapies and reducing the need for superfluous tests and treatments.
On the cusp of the world's largest cancer conference in Chicago starting Friday, NHS national clinical director for cancer Professor Peter Johnson proclaimed the dawn of "a new era of personalised cancer care". He suggested that liquid biopsies might one day be used to "scan the body" for emerging cancers with just a single blood draw.
Prof Johnson enthused: "It's fantastic that we are now able to expand the use of this revolutionary test on the NHS to help tailor treatment for thousands of patients across the country.
"Cutting-edge genomic testing is helping us deliver more targeted and kinder care for patients, enabling some to avoid more intensive treatments such as further chemotherapy, which can have a huge impact.", reports the Express.
Following triumphant pilot schemes, the test is poised for deployment across all English hospitals, potentially benefiting up to 15,000 patients annually who are suspected of having non-small cell lung cancer.
Individuals will now be given the chance to undergo a test in hospital once their GP or specialist consultant has flagged potential concerns, specifically if a CT scan indicates possible lung cancer. Until recently, tissue biopsies were the norm for confirming diagnoses, with samples then being examined for genomic insights.
This innovative approach positions the NHS as the pioneering health system globally to adopt a "blood test first" protocol, relegating tissue biopsies to secondary status.
Findings from pilot studies indicate that individuals subjected to this avant-garde testing had expedited access to personalised treatment, syncing with the genetic intricacies of their tumours, roughly two weeks in advance.
Additionally, nearly 5,000 women with advanced breast cancer will experience the benefits of this test to ascertain whether they possess one of four genetic variants amenable to new life-prolonging therapies after previous regimens have fallen short.
Hospital implementation
Implementation has begun in hospitals, rewarding approximately 1,600 patients suspected of having lung cancer and 600 with breast cancer since April. Moreover, the NHS is contemplating the extension of this blood test to other cancer types such as pancreatic and gallbladder.
Professor Johnson remarked: "We are already seeing the difference this test can make in lung and breast cancer - and we hope to roll it out for patients with other forms of cancer in the near future.
"As research progresses, it's thrilling to think that this method could enable us to 'scan' the body with a single blood test to identify where and in what way cancer may be manifesting and tackle it with rapidity and precision to save more lives."
During its pilot phase, approximately 10,000 individuals suffering from non-small cell lung cancer underwent the liquid biopsy across 176 hospitals.
An independent assessment of the health economics involved suggests the test might lead to savings of up to £11 million annually in managing lung cancer, by minimising unnecessary diagnostic steps and treatments, including chemotherapy.
Professor Sanjay Popat, a consultant medical oncologist at The Royal Marsden and joint clinical head of the pilot scheme, commented: "We have seen first-hand how the implementation of a simple blood-draw and testing in our laboratory has revolutionised treatment for lung cancer patients.
"Earlier access to highly effective targeted medicines allows more patients to avoid delays, start treatment early, and start the best treatment for their type of cancer. I am really pleased that we are now able to roll this out nationally."
Adding to the enthusiasm, Co-lead Professor Alastair Greystoke, an honorary medical oncologist at the Newcastle upon Tyne Hospitals NHS Foundation Trust, stated: "This is the first ever national implementation of a 'liquid biopsy first' approach to the diagnosis and treatment of a cancer."
New method
The introduction of a new diagnostic method has not only expedited and refined treatment for lung cancer patients but has also proven to be cost-effective for the NHS, paving the way for its evaluation in other cancers. Professor Dame Sue Hill, Chief Scientific Officer for England, hailed the development as "a real step-change in care for eligible lung and breast cancer patients on the NHS".
She further explained: "The liquid biopsy testing enables genomic mutations in the fragments of cancer that enter the bloodstream of these patients to be detected.
"This testing is transforming care and helping clinicians match patients earlier especially when cancer tissue may not be available with potentially life-extending targeted therapies rapidly and with greater precision.
"This test is a great example of the NHS harnessing the power of genomic technological advances to enable the latest groundbreaking treatment to be delivered to patients."
Upcoming research on the application of liquid biopsies for cancer diagnosis and monitoring will be showcased at the American Society for Clinical Oncology's annual conference this weekend.
Dr Julie Gralow, ASCO's chief medical officer and executive vice president, commented on the innovation, saying the tests were "a cool way of not having to stick needles into wherever the cancer is, but just drawing blood".
She explained, "If you had three spots in the liver, five spots in the bone and a spot in the lung, it might be that 90 per cent of them are still responding to treatment but one is growing.
"You can't go and stick a needle in all of them but, if you look in the blood, the most active cancer - the one that's growing - is the one that's shedding its DNA and that's what you're going to find in the blood. It helps you hone in on the active part of the cancer."
Revolutionary blood tests
Dr Gralow discussed how cancer blood tests could revolutionise the way doctors detect tumour growth and resistance to treatment. She stated, "You can see this mutation happening and intervene before you see obvious evidence of the tumour growing or spreading to new places.
"It's live monitoring at a level that is actually much more specific and early than waiting for it to show up on scans."
Highlighting the significance of these advancements, Dr Isaac Garcia-Murillas from The Institute of Cancer Research in London called the potential patient benefits and NHS cost savings "incredible".
He confirmed that some tests might detect cancer with "micro metastases" far earlier than traditional scans—possibly up to a year sooner.
Emphasising the current limitations, he said, "Not only is the whole imaging pathway cumbersome, but by the time you have tested a tumour by imaging it has already grown."
Catching cancer at an early stage allows for more timely intervention, and smaller tumours may respond better to treatment which can not only simplify the process but also enhance patient outcomes, according to insights from the medical community.
These blood tests have yet to replace tissue biopsies completely, but Dr Garcia-Murillas believes their potential is undeniable. He is excited about the progress, declaring: "I think we are at a stage where something we have researched for years will become the standard of care for most solid tumour types and that is super cool."
Sharing her personal success story as testament to the breakthrough, Rebeca explained how the test identified her cancer's ALK genetic mutation, enabling her to start targeted treatment with brigatinib – the presence of the mutation was later confirmed by a tissue biopsy.
Emotional toll
Reeling from her stage four cancer diagnosis, Rebeca, 41, recounted the emotional toll: "When I found out I had stage four cancer it felt like I'd been punched in the gut."
The situation had her thinking of her children's futures anxiously: "I was scared, I just thought about my children, and if I would get to see my little girl start nursery, and how I would explain my diagnosis to my children - it was just heart-breaking to think about."
However, she added that the medication had significantly improved her life, remarking: "But the medication has given me my life back and my kids have got their mum back."
Rebeca, hailing from Carlisle, had initially been diagnosed and treated for what was thought to be a chest infection, presenting symptoms such as breathlessness, shoulder pain, lethargy, and coughing up blood.
She shared an update on her condition: "I'm taking it day-by-day and for now the treatment is doing what it's meant to be doing and shrinking the tumour, and I've got my energy back."
Expressing acceptance of her situation, she said, "I know I'm not going to be cured but I've come to terms with my diagnosis and the pills are stopping my cancer cells from spreading. We'll keep fighting this and dealing with what's been thrown at us."
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