Group calls for genomic testing for every cancer patient in Scotland

Patients should be given genomic testing appropriate to their cancer as soon as they are diagnosed to improve outcomes for them, an industry group has said.

The Scottish Precision Medicines Industry Group (SPMIG) is urging health chiefs to develop a strategy that delivers a “step change” in how NHS Scotland commissions genomic testing of people with cancer.

It said the move could ensure people are routinely identified for medicines that will directly target genetic causes of their disease.

SPMIG said this would ensure that patients receive the most suitable treatment and that the NHS can use its resources to the greatest effect.

A report commissioned by SPMIG makes a series of recommendations based on in-depth interviews with 15 cancer clinicians, service managers, scientists and patient advocates.

Report author John Macgill, from health policy and communications consultancy Ettrickburn, said: “Across the 15 interviews a single theme emerged – patients must be able to have routine and equitable access to the broadest genomic testing appropriate to their cancer to ensure they can be appropriately considered for existing precision treatments and new ones as they become available.

“One patient told us that, had she had the full molecular information about her cancer from the start, she’d not have been given – or spent thousands of her own money on – treatments that were never going to have worked for her.

“Clinicians and service managers told us that genomic testing, costing less than a single CT scan, can save the NHS tens of thousands of pounds and avoid creating false hope, by showing in advance whether a treatment will work.

“Most immediately, we were told that there is a worrying mismatch, whereby Scottish Medicines Consortium (SMC) can accept a medicine for use in Scotland but NHS laboratories are not ready to do the diagnostic test needed to see if the treatment is appropriate for any patients. One patient advocate called this ‘a new lottery’.

“The Scottish Precision Medicines Industry Group welcomes the work being done by the Scottish Government and NHS to build genomics into the care of cancer patients and would ask that this work continues to be funded as a priority – and that things that can be done now aren’t put off until the strategy is published next summer.”

SPMIG comprises pharmaceutical companies AstraZeneca, Lilly, Novartis and Roche.

They are increasingly developing precision treatments for patients based on targeting particular genetic molecular characteristics of their illness.

These treatments can only be used when a “companion diagnostic” test identifies that the genetic make-up of a patient’s cancer is suitable.

SPMIG is calling for NHS Scotland to mandate comprehensive genomic testing appropriate to each cancer type as soon as a person is diagnosed, and to ensure companion diagnostic tests are in place for each new precision medicine when it is approved for use in Scotland by the SMC.

The group also wants to see more investment in Scotland’s genomic laboratories.

A Scottish Government spokesman said: “NHS Genetic laboratories across Scotland already provide a range of cancer genetic tests to support the diagnosis and treatment of cancer and a Transformation Team, led by a Clinical Scientist, is working to ensure rapid adoption of a number of genetic tests for cancer across the genetic laboratories.

“The Scottish Government is committed to expanding genomics capacity in Scotland and is providing £5m of funding through the new Scottish Strategic Network for Genomic Medicine to do so whilst working with partners to develop a Genomics Strategy for Scotland.”