Oncologists: How to talk with your pathologist about cancer molecular testing

June 01, 2014

As targeted therapies become more available, increasing opportunity exists to match treatments to the genetics of a specific cancer. But in order to make this match, oncologists have to know these genetics. This requires molecular testing of patient samples. An education session presented today at the American Society for Clinical Oncology (ASCO) Annual Meeting 2014 details the challenges in this process and makes recommendations that oncologists can use to ensure their patients' samples are properly tested, helping to pair patients with the best possible treatments.

"The problem is there are lot of technical, logistical steps involved in the process of obtaining and molecularly testing patient samples and each step is a place where things can go wrong," says Dara Aisner, MD, PhD, investigator at the CU Cancer Center and molecular pathologist at the CU School of Medicine. The nature of tissue samples and molecular testing means that miscommunications or mistakes can ultimately render a sample unusable.

For example, Aisner points out that the mechanics of some pathology labs dictates that biopsies performed on a Friday may sit in the preservative formalin until Sunday evening - fine for microscopy but potentially detrimental for molecular testing. Or, Aisner says, bone biopsies are commonly treated with decalcification solution to make the sample pliable enough to be cut - another technique that negates molecular testing. Or a small sample may be used up during immunohistochemistry testing that may come first in a pathology lab workflow unless mechanisms are put into place to specifically prioritize molecular testing over other evaluations.

"A pathology lab is a high volume environment that's optimized to treat all samples the same way, according to the same protocols. If every time you want molecular testing to be the priority, you have to call and make special arrangements, it can be disruptive. The best solution for oncologists and pathology labs is to set up new norms designed to meet the needs of molecular testing, which is quickly becoming the new paradigm," Aisner says.

Aisner suggests close communication, systems approaches, keeping special requests to a minimum, and patience on the part of requesting oncologists. The key, she says, is writing new institutional protocols to keep pace with the new reliance on molecular testing.

"Oncologists and pathologists both know that molecular testing is becoming an essential piece of cancer care," Aisner says. "The question now is how to best implement this testing in an efficient way that leads to the least disruption and best patient outcomes."
-end-


University of Colorado Anschutz Medical Campus

Related Genetics Articles from Brightsurf:

Human genetics: A look in the mirror
Genome Biology and Evolution's latest virtual issue highlights recent research published in the journal within the field of human genetics.

The genetics of blood: A global perspective
To better understand the properties of blood cells, an international team led by UdeM's Guillaume Lettre has been examining variations in the DNA of 746,667 people worldwide.

Turning to genetics to treat little hearts
Researchers makes a breakthrough in understanding the mechanisms of a common congenital heart disease.

New drugs more likely to be approved if backed up by genetics
A new drug candidate is more likely to be approved for use if it targets a gene known to be linked to the disease; a finding that can help pharmaceutical companies to focus their drug development efforts.

Mapping millet genetics
New DNA sequences will aid in the development of improved millet varieties

Genetics to feed the world
A study, published in Nature Genetics, demonstrated the effectiveness of the technology known as genomic selection in a wheat improvement program.

The genetics of cancer
A research team has identified a new circular RNA (ribonucleic acid) that increases tumor activity in soft tissue and connective tissue tumors.

New results on fungal genetics
An international team of researchers has found unusual genetic features in fungi of the order Trichosporonales.

Mouse genetics influences the microbiome more than environment
Genetics has a greater impact on the microbiome than maternal birth environment, at least in mice, according to a study published this week in Applied and Environmental Microbiology.

New insights into genetics of fly longevity
Alexey Moskalev, Ph.D., Head of the Laboratory of Molecular Radiobiology and Gerontology Institute of Biology, and co-authors from the Institute of biology of Komi Science Center of RAS, Engelgard's Institute of molecular biology, involved in the study of the aging mechanisms and longevity of model animals announce the publication of a scientific article titled: 'The Neuronal Overexpression of Gclc in Drosophila melanogaster Induces Life Extension With Longevity-Associated Transcriptomic Changes in the Thorax' in Frontiers in Genetics - a leading open science platform.

Read More: Genetics News and Genetics Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.