Thousands of NHS patients with lung and breast cancer are to benefit from liquid biopsies, speeding up access to targeted therapy.
The move will see the NHS become the first health service in the world to roll-out a ‘blood test-first’ approach to diagnosing suspected lung cancer, with the test to be used before traditional tissue biopsies.
Following a successful pilot, NHS England today announced up to 15,000 patients with suspected lung cancer could now benefit from the test each year, which can detect tiny fragments of tumour DNA in the blood. The test will help fast-track lung cancer patients to receive targeted therapy up to two weeks earlier, while helping some avoid further tests and treatments including chemotherapy.
On the eve of the ASCO cancer conference in Chicago, the NHS said it was also expanding testing in advanced breast cancer, with several genetic variations now being screened for and around 5,000 women set to benefit per year – with the test being hailed as ‘transforming’ cancer care for NHS patients.
An independent health economic assessment of the pilot estimated the test could save the NHS up to £11 million per year in lung cancer care, and the NHS is now looking at its use in a range of other cancers, including pancreatic and gallbladder cancer.
Professor Peter Johnson, NHS National Clinical Director for cancer, said: “Liquid biopsies are leading us into a new era of personalised cancer care and 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. 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 exciting that this approach has the potential to help us ‘scan’ the body in a single blood test to see where and how cancer may be developing and target it with speed and precision to help save more lives.”
Liquid biopsy testing is now available for all eligible lung and breast cancer patients in NHS hospitals across England, with more than 1,600 patients with suspected lung cancer and around 600 advanced breast cancer patients tested since April.
Patients with advanced breast cancer whose cancer has not responded to previous treatment can now receive a liquid biopsy to determine if they are eligible for targeted treatments.
Breast and lung cancers are two of the most common cancers in England – with around 50,000 women diagnosed every year with breast cancer, and around 40,000 people are diagnosed with lung cancer per year.
The blood test, or liquid biopsy, can detect tiny fragments of circulating tumour DNA (ctDNA) and looks for specific genetic variations of cancer, allowing patients to access targeted therapies which are tailored to the genetic profile of their cancer.
Pilot data in lung cancer showed that in some cases, patients received the results of ctDNA testing needed to make treatment decisions 16 days earlier with liquid biopsies, than the standard cancer tissue biopsy approach.
Professor Dame Sue Hill, Chief Scientific Officer for England, said: “This represents a real step-change in care for eligible lung and breast cancer patients on the NHS. The liquid biopsy testing enables genomic mutations in the fragments of cancer that enter the blood stream 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.”
NHS pilots in suspected lung cancer patients found that as well as reducing time to treatment, liquid biopsies helped patients avoid repeated diagnostic procedures, unnecessary treatment, such as standard chemotherapy and its side effects, and improved patients’ quality of life.
Around 10,000 patients with the most common type of lung cancer – non-small cell lung cancer – have already had a liquid biopsy test as part of a recent NHS pilot which involved around 176 hospitals around the country.
Tissue biopsies are used to confirm a diagnosis of lung cancer and samples can be sent for genomic testing,