TESSA JOWELL BRAIN MATRIX PLATFORM STUDY: PRELIMINARY ANALYSIS OF THE PRIMARY FEASIBILITY & PROCESS-CENTRED OBJECTIVE Free

The Tessa Jowell BRAIN MATRIX (ISRCTN14218060) is an ongoing platform study, collecting disease, treatment, and outcome data prospectively in glioma patients, across nine UK hospitals. We report a preliminary analysis of the primary feasibility and process-centred objectives.

Primary Objective: Test the feasibility of establishing an integrated histological-molecular diagnosis using Whole Genome Sequencing (WGS) and Epigenomic Classification (EC) (‘Heidelberg Classifier’) data in NHS practice within 28 days.

Primary Outcome: Time (from surgery) to integrated histological–molecular diagnosis (TTMD) using WGS and EC.

Secondary Outcome: Time to completion of each node (stage) of the tissue and imaging pathway.

Data snapshot on 23-Feb-2023 confirmed 250 patients recruited. Nine nodes along the tissue & imaging pathway were defined. Twenty-one patients had completed the pathway and time to each node was calculated. Median time to complete the pathway was 404 days (range 124-653). There was a trend of improvement in TTMD in recently recruited patients.

The patient pathway from surgery to clinical feedback through a Genomic Tumour Advisory Board (GTAB) utilises NHS-accredited pathways and protocols. Delays inherent in the pathway emphasise the urgent need for infrastructure and operational delivery improvements of the NHS Genomic Medicine Service for brain cancer patients as the current timeframe is not clinically relevant for informing patient care. These data also highlight geographical inequality in accessing genomic medicine within England, across the seven Genomic Laboratory Hubs, and the devolved nations. Detailed analysis of the delays at each node will identify opportunities and solutions to inform discussions with the NHS and Genomics England.