A blood test pilot which could help people receive earlier, more targeted, lung cancer treatments is set to be expanded to thousands more patients.
The circulating tumour DNA (ctDNA) test can identify genetic variants in a tumour through a simple blood sample.
Patients that receive CT scan results showing suspected lung cancer will have a small blood sample sent to a genomic laboratory for ctDNA testing, with results returned in around 14 days.
Cancerous tumours often release pieces of DNA into the bloodstream (known as circulating tumour DNA) and these can be sampled using a ctDNA blood test to identify key genetic drivers of tumours.
Currently, tissue biopsies are used to confirm a diagnosis of lung cancer and samples can then be sent for genomic testing – but this new test could provide patients with these results faster, meaning they could start targeted treatment sooner.
The move from NHS England follows a smaller initial pilot which saw more than 2,000 patients referred for the service from 80 trusts across England.
The pilot is now set to be rolled out to provide the test for up to a further 10,000 patients with suspected non-small cell lung cancer by next March – and could involve most trusts across the country.
Kat Robinson, a 33-year-old from Dorset, was diagnosed with stage 4 non-small cell lung cancer in September 2023. Thanks to the ctDNA pilot at Poole Hospital which Kat took part in, clinicians confirmed that her cancer was being driven by two genetic mutations known as ALK fusion and TP53. This enabled them to provide brigatinib, a precision treatment that is highly effective against cancer with changes in the ALK gene.
Peter Johnson, National Clinical Director for Cancer at NHS England, said: “This new blood test that we have been piloting has the potential to help many more cancer patients access targeted treatments more rapidly on the NHS, to make personalised treatments available sooner, and ensure that people with cancer have the best possible chance of survival.
“The NHS has shown it can lead the way on innovation in cancer diagnosis and treatment, and this pilot is another example of our commitment to getting patients cutting-edge treatments and therapies to improve outcomes, giving people facing lung cancer more precious time with loved ones”.
The NHS England pilot is being managed through the NHS Genomic Medicine Service.
Earlier testing was carried out by Guardant Health and Roche, who have developed liquid biopsy technology. The Royal Marsden NHS Foundation Trust is now working with Guardant Health on what is known as the Marsden360 service.
