‘Revolutionary’ cancer genomic testing service launched in Wales

The Cymru Service for Genomic Oncology Diagnoses uses sequencing to screen specific genes and provide information on a patient's prognosis, as well as the recommended treatment.

A “groundbreaking” new service for people with cancer has been launched in Wales with the ambition of embedding genomic testing into routine care.

The All Wales Medical Genomics Service (AWMGS), which is hosted by the Cardiff and Vale University Health Board, has announced the launch of the Cymru Service for Genomic Oncology Diagnoses on 23 September 2021.

Described as “revolutionary” by the AWMGS, the new service will support oncologists, haematologists and other healthcare professionals to routinely undertake rapid and extensive genomic analysis of cancer samples and tailor treatment.

The service can now be used to test non-small cell lung cancer, melanoma, glioma, gastrointestinal stromal tumour, colorectal cancer and thyroid cancer. It uses sequencing to screen specific genes and provide information on a patient’s prognosis, as well as which treatment is most likely to be effective.

The future aim is that all people with cancer in Wales will be routinely offered genomic testing in the next ten years, which is in line with ambitions laid out in the ‘NHS long-term plan‘ to extend the use of genetic diagnostics in cancer.

Samantha Cox, clinical oncologist at Velindre Cancer Centre in Cardiff and chair of the All Wales Genomics Oncology group, said: “The number of targeted drugs available to use in day-to-day clinical practice is set to significantly increase over the coming months and years, as our knowledge and understanding of genetic pathways which cause cancer improves.

“This is already routine practice for some patients in the NHS — for example, in my job as a cancer specialist, I routinely request genetic testing for every patient with a particular type of lung cancer.

“I can see the real benefits that such personalised treatment offers. These newer treatments are usually better tolerated and are more convenient for patients, as they can often be taken as a daily tablet at home, avoiding the need for frequent trips to hospital for treatment,” she added.

Eluned Morgan, health minister for Wales, said that the new service puts Wales at the forefront of genomic testing in the UK and cements Wales’ place as a leader in the field. “This service will provide ground-breaking testing and treatment options for people with cancer and will support healthcare professionals to routinely care for more people using the latest genomic advances.

“I’d like to thank all those involved in making the launch of this service possible.”

Germline testing on blood samples is available in England and Wales for people with cancer being treated with common fluoropyrimidine-based chemotherapies, 5-fluoruracil and/or capecitabine.

In this testing process, a polymerase chain reaction test is performed to identify variants in the dihydropyrimidine dehydrogenase (DPYD) gene that increase a patient’s risk of severe or fatal toxicity to fluoropyrimidine-based chemotherapies. It has been routinely available via the NHS Genomic Medicine Service, delivered by the national NHS Genomic Laboratory Hubs in England, since November 2020.

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Citation
The Pharmaceutical Journal, PJ, September 2021, Vol 307, No 7953;307(7953)::DOI:10.1211/PJ.2021.1.106880