The NHS should offer all cancer patients genetic profiling of their cancers to help inform their care and to track how the disease evolves, experts say today.
A consensus group of leading experts has called for the removal of barriers that prevent patients from gaining access to ‘biomarker’ tests so that genetic information and other tests can routinely be used to select the most suitable precision medicine for each patient.
The consensus group, convened by The Institute of Cancer Research, London, included nine institutions, charities, stakeholder groups and life-science companies, including Cancer Research UK and the Association of the British Pharmaceutical Industry.
Although it is important for clinicians to be able to assess biomarkers, so they can match patients with treatments, the consensus group warned testing is not always done because regulatory processes and resources have not kept pace with the science.
The Institute of Cancer Research (ICR) has released new consensus statements that call for a series of changes in the way biomarker tests are developed, made available and routinely used in the UK.
Professor Kristian Helin, chief executive of ICR, said: “We believe every cancer patient should have the opportunity for their cancer to be molecularly profiled to assess biomarkers that can give vital clues about how their disease should best be treated. Biomarker tests can direct treatment precisely to the patients who will most benefit, which can both improve the lives of patients and increase the cost-effectiveness of treatment for the NHS.
“It’s essential that the regulations that govern clinical trials and the approval of new tests and treatments keep pace with the rapidly moving science. At the moment, it can be hard to get new biomarker tests developed, approved and made available for patients. That can in turn act as a disincentive for companies and academics to develop new biomarkers to guide treatment in the future.”
The consensus group says all cancer patients should have their cancers molecularly profiled as standard within the NHS to identify mutations and guide their treatment and that the NHS should use panel tests to assess many different biomarkers at once, both at diagnosis and at intervals afterwards so treatment can be adjusted in line with changes in the cancer.
The group says biomarker tests should be routinely developed alongside new cancer drugs to ensure that the right patients are treated, and the cancers are targeted more effectively, while health technology assessment bodies, such as NICE, should take a more positive view of companion biomarker tests for new drugs.
It also calls on the NHS to develop a broader and more transparent directory of biomarker tests, including all the non-genomic biomarker tests that the NHS will provide alongside gene tests.
The group says the costs of developing biomarker tests often outweigh the financial benefits of doing so, discouraging industry and academia from investing in biomarker research, but that targeting therapies to those who are most likely to respond would be more cost-effective for the NHS.
Dr Jennifer Harris, director of research policy at the ABPI, said: “All patients, including cancer patients, should be able to get the best treatments available for their condition.
“Biomarker tests provide crucial information to help doctors select the treatments that will have the best chance of success in each person.
“Overcoming the barriers to developing and using biomarker tests would be a big step forward for personalised care. We will continue to work with the ICR and other partners to help make this happen.”
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