Testing the accuracy of FDA-approved and lab-developed cancer genetics tests

December 14, 2017

Cancer molecular testing can drive clinical decision making and help a clinician determine if a patient is a good candidate for a targeted therapeutic drug. Clinical tests for common cancer causing-mutations in the genes BRAF, EGFR and KRAS abound, and include U.S. Food and Drug Administration (FDA)-approved companion diagnostics (FDA-CDs) as well as laboratory-developed tests (LDTs). LDTs are tests that have been designed and implemented in a single laboratory - some are completely homegrown while others are commercial kits, including "off label" uses of FDA-CDs (also known as in vitro diagnostics). Amid the debate about how much these tests should be regulated by the FDA, one question has gone unanswered: how well do LDTs and FDA-CDs perform? A new study published this week in JAMA Oncology, which analyzed data from almost 7,000 tests, finds that the answer is: very well and very comparably.

"We find that both laboratory-developed tests and FDA-approved companion diagnostics demonstrate excellent performance on proficiency testing," said corresponding author Annette Kim, MD, PhD, of BWH's Department of Pathology. "And, importantly, more than 60 percent of the laboratories in our study that were using an FDA-CD kit report using it with modifications - rendering those assays LDTs. These modifications appear to be driven by the exigencies of real day-to-day clinical practice that requires altering the assays to meet the needs of a variety of clinical situations that may not be accommodated by the FDA-approved protocol."

These modifications include, for example, the testing of other tumor types that may carry targetable variants, different types of input specimen preparations available in pathology such as cytology smears or other fresh specimens rather than paraffin blocks and availability of different methods of DNA quantification than those mandated by FDA approval based upon pre-existing technologies in the laboratories.

"In the clinical lab, we are always acutely aware that there is a patient awaiting this result and we validate our assays to ensure that we can provide reliable and accurate results from our laboratory under as many varied clinical situations as possible," said Kim.

The research team used data from proficiency tests provided by the College of American Pathologists Molecular Oncology Committee which provides external proficiency testing for labs to determine the accuracy of testing. Combing through data from 6,897 proficiency testing responses, the team found that both LDTs and FDA-CDs exceeded 97 percent accuracy combined across the three cancer genes.

The team's results also indicate that the majority of laboratories purchasing in vitro diagnostics for FDA-CDs are in fact modifying their use - making them into laboratory-developed tests.

"These data question the distinction between FDA-CDs and LDTs from a regulatory standpoint and note the greater clinically relevant applications of LDTs," the authors write.
-end-
Paper cited: Kim, AS et al. "Comparison of Laboratory-Developed Tests and FDA-Approved Assays for BRAF, EGFR, and KRAS Testing" JAMA Oncology DOI: 10.1001/jamaoncol.2017.4021

Brigham and Women's Hospital

Related Data Articles from Brightsurf:

Keep the data coming
A continuous data supply ensures data-intensive simulations can run at maximum speed.

Astronomers are bulging with data
For the first time, over 250 million stars in our galaxy's bulge have been surveyed in near-ultraviolet, optical, and near-infrared light, opening the door for astronomers to reexamine key questions about the Milky Way's formation and history.

Novel method for measuring spatial dependencies turns less data into more data
Researcher makes 'little data' act big through, the application of mathematical techniques normally used for time-series, to spatial processes.

Ups and downs in COVID-19 data may be caused by data reporting practices
As data accumulates on COVID-19 cases and deaths, researchers have observed patterns of peaks and valleys that repeat on a near-weekly basis.

Data centers use less energy than you think
Using the most detailed model to date of global data center energy use, researchers found that massive efficiency gains by data centers have kept energy use roughly flat over the past decade.

Storing data in music
Researchers at ETH Zurich have developed a technique for embedding data in music and transmitting it to a smartphone.

Life data economics: calling for new models to assess the value of human data
After the collapse of the blockchain bubble a number of research organisations are developing platforms to enable individual ownership of life data and establish the data valuation and pricing models.

Geoscience data group urges all scientific disciplines to make data open and accessible
Institutions, science funders, data repositories, publishers, researchers and scientific societies from all scientific disciplines must work together to ensure all scientific data are easy to find, access and use, according to a new commentary in Nature by members of the Enabling FAIR Data Steering Committee.

Democratizing data science
MIT researchers are hoping to advance the democratization of data science with a new tool for nonstatisticians that automatically generates models for analyzing raw data.

Getting the most out of atmospheric data analysis
An international team including researchers from Kanazawa University used a new approach to analyze an atmospheric data set spanning 18 years for the investigation of new-particle formation.

Read More: Data News and Data 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.