An ultra-rapid method of genetically diagnosing brain tumors has been developed by scientists at the University of Nottingham and clinicians at Nottingham University Hospitals NHS Trust (NUH). Their approach, could cut the time it takes to classify brain tumors to as little as two hours, where it typically takes from 6-8 weeks.
The groundbreaking technique is detailed in a new study published yesterday in Neuro-Oncology. It builds on earlier work and the senior author is Matt Loose, a biologist from the School of Life Sciences at the University of Nottingham. The technique marries a nanopore-based assay, intraoperative methylome classification, and next-day comprehensive profiling.
“This approach is an acceleration of the underlying principles of rapid-cns2. In addition to the classifier in that original work, we use multiple classifiers. We have also developed new protocols that generate read lengths which better suits the method as well as being faster and cheaper. In addition, we’ve developed the new software suite—Robin—which provides real time analysis giving all the results to the clinician immediately,” Loose told Inside Precision Medicine.
Simon Paine, a Consultant Neuropathologist at NUH said, “This new method of diagnosing brain tumors is going to be a game changer, it really is revolutionary. It not only increases the speed at which the results will be available, but the degree of accuracy of the diagnosis as well is incredible.”
The team is now looking to get the new testing rolled out at NHS Trusts across the U.K.
“Not only is the test more accurate and quicker, but it is also cheaper than current methods,” said Loose. “Our calculations stand at around £450 per person, potentially less when scaled-up. There are a few reasons for this. Our method can eliminate the need for four to five separate tests, reducing costs as a consequence as we are getting more information from the single test we do. Most importantly, it delivers results to the patients when they need them.”
The team applied their approach to 50 brain tumor surgeries. They report their technique has achieved a 100% success rate, providing diagnostic results in under two hours from surgery and detailed tumor classifications within minutes of sequencing. Moreover, the platform’s ability to continue sequencing enables a fully integrated diagnosis within 24 hours.
Stuart Smith, a Neurosurgeon from the School of Medicine at the university and within NUH, said, “Traditionally, the process of diagnosing brain tumors has been slow and expensive. 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.”
The current treatment pathway starts with an MRI scan to ascertain the presence of a tumor, then patients will speak to clinicians to discuss the possibilities of what type of tumor they may have. For many tumor types, people would then undergo some form of surgery to obtain a sample of the tumor, which currently is sent away to centralized labs for testing to look for abnormalities in the DNA—which will determine what type of tumor it is. Experts would then look at the specimens and the neuropathology view would be to try and identify the cells visually.
Loose said, “When we first were able to sequence an entire human genome in 2018, it took around five labs and six months to do, which obviously isn’t ideal when time is of the essence for a patient.”
