This article has just appeared in "Doctors.net.uk". Is the system going to assist NWBO or be a rival to DCVax or have no effect at all?
Ultra-rapid tool can give brain tumour genetic diagnosis in 2 hours 21 May 2025, 2:00am
A test to provide an almost 'real time' genetic diagnosis of brain tumours during surgery is being considered for rollout across NHS sites. Developed at the University of Nottingham, the nanopore sequencing technique has been used to successfully classify tumours in 50 surgeries in only 2 hours. With genetic testing of brain tumours currently taking 6 to 8 weeks to complete, it is hoped the tool will speed up decision making about chemotherapy and radiotherapy after surgery - and could also guide surgeons during the operation.
Dr Stuart Smith, a neurosurgeon at Nottingham University Hospitals NHS Trust who has helped test the tool, said the technology would have “immediate benefits” for people with brain tumours. “Traditionally, the process of diagnosing brain tumours has been slow and expensive," he said. "Now, with this new technology we can do more for patients because we can get answers so much more quickly which will have a much bigger influence on clinical decision making, in as little as two hours.” He added: “It is agony for patients waiting weeks for results to find out whether they can expect to survive for months or years.”
Speaking with Doctors.net.uk, Professor Matt Loose, a biologist from the school of life sciences at the University of Nottingham, explained that the approach involves a portable sequencing device from Oxford Nanopore Technologies. A software tool, known as ROBIN, sequences the DNA by detecting the change in current flow as single molecules of DNA pass through a nanopore in a membrane, they reported in Neuro-Oncology. Once a sample of tissue is available from the patient, the ultra-rapid test looks at various genetic properties. This includes methylation initially followed by comprehensive molecular profiling, including single nucleotide variants, copy number variants, and structural variants to provide a full picture within 24 hours.
It is so quick, it could have an impact on the operation itself, Dr Smith explained. “As a surgeon knowing a confident molecular diagnosis during surgery is also potentially a game changer. “Surgical strategy can be tailored to be more or less radical depending on tumour type, again with immediate patient benefit.”
The team is now embedding the approach into the pathology laboratory at Queen’s Medical Centre in Nottingham but other hospitals are also considering using the technology, including King’s College Hospital in London. “We have already run samples in this method alongside current standard of care array-based methods with excellent concordance. There are multiple centres in the UK replicating our setup and approach,” Loose said. The test is also cheaper than current methods because it eliminates the need for multiple tests, he added. “Our calculations stand at around £450 per person, potentially less when scaled-up.”
?Dr Simon Newman, chief scientific officer at The Brain Tumour Charity, said: “The potential to combine so many separate tests into one and deliver at a localised level is a game changer for driving equity of access to rapid and accurate molecular diagnosis.
“The BRAIN MATRIX Trial, funded by the Brain Tumour Charity, is now exploring how this technology can match patients to personalised clinical trials across the UK.”
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